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1	The Value of Simplicity: Externally Validating the Baylor Cranial Gunshot Wound Prognosis Score Yengo-Kahn, Aaron M., Patel, Pious D., Kelly, Patrick D., Wolfson, Daniel I., Dawoud, Fakhry, Ahluwalia, Ranbir, Bonfield, Christopher M., Guillamondegui, Oscar D. 09 March 2021 (has links) OBJECTIVE: Gunshot wounds to the head (GSWH) are devastating injuries with a grim prognosis. Several prognostic scores have been created to estimate mortality and functional outcome, including the so-called Baylor score, an uncomplicated scoring method based on bullet trajectory, patient age, and neurological status on admission. This study aimed to validate the Baylor score within a temporally, institutionally, and geographically distinct patient population. METHODS: Data were obtained from the trauma registry at a level I trauma center in the southeastern US. Patients with a GSWH in which dural penetration occurred were identified from data collected between January 1, 2009, and June 30, 2019. Patient demographics, medical history, bullet trajectory, intent of GSWH (e.g., suicide), admission vital signs, Glasgow Coma Scale score, pupillary response, laboratory studies, and imaging reports were collected. The Baylor score was calculated directly by using its clinical components. The ability of the Baylor score to predict mortality and good functional outcome (Glasgow Outcome Scale score 4 or 5) was assessed using the receiver operating characteristic curve and the area under the curve (AUC) as a measure of performance. RESULTS: A total of 297 patients met inclusion criteria (mean age 38.0 [SD 15.7] years, 73.4% White, 85.2% male). A total of 205 (69.0%) patients died, whereas 69 (23.2%) patients had good functional outcome. Overall, the Baylor score showed excellent discrimination of mortality (AUC = 0.88) and good functional outcome (AUC = 0.90). Baylor scores of 3-5 underestimated mortality. Baylor scores of 0, 1, and 2 underestimated good functional outcome. CONCLUSIONS: The Baylor score is an accurate and easy-to-use prognostic scoring tool that demonstrated relatively stable performance in a distinct cohort between 2009 and 2019. In the current era of trauma management, providers may continue to use the score at the point of admission to guide family counseling and to direct investment of healthcare resources. gunshot wound penetrating brain injury prognostic scores trauma traumatic brain injury Internal Medicine
2	Estudo por tomografia computadorizada helicoidal com múltiplas fileiras de detectores em vítimas de ferimento por arma de fogo abdominal / Multi-detector row computed tomography study in abdominal gunshot wound victims Melo, Ernesto Lima Araujo 03 June 2009 (has links) O principal objetivo deste estudo foi testar a capacidade da tomografia computadorizada helicoidal com múltiplas fileiras de detectores (TCMD) na identificação/exclusão de lesões em vítimas de ferimento por arma de fogo (FAF) abdominal. Os achados de imagem foram comparados aos cirúrgicos em todos os pacientes da amostra. A TCMD demonstrou elevada acurácia na avaliação de órgãos sólidos, vísceras ocas, grandes vasos e diafragma. Quase a metade dos pacientes (45,2%) não exibiu lesões que necessitassem obrigatoriamente de correção cirúrgica. A TCMD mostrou-se excelente na avaliação dos pacientes da amostra, podendo contribuir com informações importantes ao manejo de vítimas de FAF abdominal. / The main objective of this study was to test the ability of multi-detector row computed tomography (MDCT) in the identification/exclusion of lesions in abdominal gunshot wound (GW) victims. The imaging findings were compared with the surgical ones in all of the studied patients. MDCT demonstrated elevated accuracy in the evaluation of solid organs, hollow viscus, great vessels, and diaphragm. Almost half of the patients (45.2%) did not show lesions requiring obligatory surgical interventions. MDCT showed to be excellent in the evaluation of the studied patients, and can contribute with important information for the management of abdominal GW victims. Abdominal trauma Computed tomography spiral Ferimentos por arma de fogo Gunshot wound Laparotomia Laparotomy Tomografia computadorizada espiral Traumatismos abdominais
3	Estudo por tomografia computadorizada helicoidal com múltiplas fileiras de detectores em vítimas de ferimento por arma de fogo abdominal / Multi-detector row computed tomography study in abdominal gunshot wound victims Ernesto Lima Araujo Melo 03 June 2009 (has links) O principal objetivo deste estudo foi testar a capacidade da tomografia computadorizada helicoidal com múltiplas fileiras de detectores (TCMD) na identificação/exclusão de lesões em vítimas de ferimento por arma de fogo (FAF) abdominal. Os achados de imagem foram comparados aos cirúrgicos em todos os pacientes da amostra. A TCMD demonstrou elevada acurácia na avaliação de órgãos sólidos, vísceras ocas, grandes vasos e diafragma. Quase a metade dos pacientes (45,2%) não exibiu lesões que necessitassem obrigatoriamente de correção cirúrgica. A TCMD mostrou-se excelente na avaliação dos pacientes da amostra, podendo contribuir com informações importantes ao manejo de vítimas de FAF abdominal. / The main objective of this study was to test the ability of multi-detector row computed tomography (MDCT) in the identification/exclusion of lesions in abdominal gunshot wound (GW) victims. The imaging findings were compared with the surgical ones in all of the studied patients. MDCT demonstrated elevated accuracy in the evaluation of solid organs, hollow viscus, great vessels, and diaphragm. Almost half of the patients (45.2%) did not show lesions requiring obligatory surgical interventions. MDCT showed to be excellent in the evaluation of the studied patients, and can contribute with important information for the management of abdominal GW victims. Ferimentos por arma de fogo Laparotomia Tomografia computadorizada espiral Traumatismos abdominais Abdominal trauma Computed tomography spiral Gunshot wound Laparotomy
4	IMPROVING THE FIDELITY OF AGENT-BASED ACTIVE SHOOTER SIMULATIONS THROUGH MODELING BLOOD LOSS AND INJURY MANAGEMENT Krassimir Tzvetanov (11818304) 09 December 2021 (has links) <p>Simulation modeling has proven beneficial in gathering insights that may aid safety policy considerations for schools, offices, and outdoor events. This is especially true when conducting a drill that is not practical or possible, such as active shooter response. However, we can improve the current modeling practices with high-fidelity simulation logic reflecting a victim's well-being. Currently, victims are modeled either as “killed,” or they continue their normal movement. The binary approach is suitable for many simulations developed to understand course trends in an event space but does not allow for more fine-tuned insights that may be beneficial when developing a safety and response protocol for a specific facility or event. Additional victim characteristics, such as tracking the location of a victim's wound and the rate of physiological decline, may be added into a model that will improve the realism and lead to an improved response protocol. The increased fidelity will be helpful when simulating and assessing the effects of volunteer response, critical care transport for medical intervention, and other first-responder interventions.</p> <p>While some think it is not possible or necessary to simulate how fast gunshot victims would lose blood, we show that a high-fidelity simulation is possible. The main counterargument is that there is no sufficient data, and also it will be challenging to implement this process as it is occurring. However, we found enough data or were able to extrapolate the missing pieces and develop a consistent and realistic blood loss model. In addition, the state of current simulation packages, such as AnyLogic, has advanced to the point where we can model a liquid system dynamic within an agent-based model. Furthermore, there is an acute benefit to conducting this type of research as it can help us develop better response policies, which result in more saved lives.</p> <p>The research aims to improve emergency-response simulation fidelity by developing a model that simulates gunshot wounds and the subsequent blood loss while accounting for a victim's age, weight, gender, and the affected area. The model also accounts for the body's compensatory response and medical interventions, such as tourniquet application, wound packing, and direct pressure. The work presents an analytical model and its implementation using agent-based modeling in AnyLogic. This AnyLogic module can be inserted into active shooter simulations that easily integrate with the existing logic. This integration happens through a high-level application programming interface (API) exposed to the user. The API allows for automatic infliction of injury and mitigation. The extensive literature review and case studies provide a sound foundation for creating the model. AnyLogic was chosen due to its common usage and versatility with other systems and computer programming languages.</p> Medical Simulation Active shooter active shooter mitigation hemorrhage simulation gunshot wound simulation Applied Computer Science
5	Benefity CT vyšetření v soudním lékařství / The Benefits of the Computed Tomography in the Forensic Medicine Pohlová Kučerová, Štěpánka January 2021 (has links) The benefits of the computed tomography in the forensic medicine Radiological imaging methods represent one of the complementary examination methods supplementing conventional autopsy in addition to histological, toxicological, biochemical, microbiological, and serological examination in forensic medicine. The basic and commonly available radiological imaging method in forensic practice is X-ray imaging. With the development of modern radiological imaging methods (especially computed tomography and nuclear magnetic resonance), these modern methods have been gradually applied to the field of forensic medicine. The rapid development of radiological imaging methods in recent years (especially computed tomography and nuclear magnetic resonance) has caused the gradual application of these modern methods in the field of forensic medicine. Post mortem CT (pmCT) examination is now a common part of forensic medicine in the most developed world countries (Switzerland, Denmark, Australia, Japan, Germany, Italy, France and others) and since 2015 this examination has been available at two departments of forensic medicine in the Czech Republic. The primary aim of the study was to evaluate the benefits of pmCT examination in routine forensic practice in three comprehensive groups of individuals who died as a result of...
6	Untersuchung der Geschosswirkung in der sehr frühen Phase unter besonderer Berücksichtigung der Hochgeschwindigkeitsmunition / Study of bullet effects at a very early stage with special consideration of high-speed ammunition Siegmund, Bernward 13 November 2006 (has links) No description available. 610 Medizin, Gesundheit Medicine Ausschuss ballistische Gelatine ballistisches Pendel Druckwelle Druckverlauf Energieabsorption Energieverlust Einschuss Energieabgabe Fragmentation Frangible Training Ammution Gewehr Geschwindigkeit Geschosse gerichtliche Medizin Glasfaserhydrophon Geometrie Hochgeschwindigkeit Hochgeschwindigkeitskamera Hochgeschwindigkeitsmunition Jagdunfälle Kaliber Kavitation Kaliber Militär Munition Projektil Reflexion Rechtsmedizin Schallgeschwindigkeit Schussverletzungen Schusswaffen Schusswirkung Schusswunden temporäre Zielhöhle Tötungsdelikt Vollmantelmunition Wechselwirkung Wundballistik Zugwelle Zielballistik Zielpulsation ammunition ballistic gelatine ballistic pendulum bullet bullet hole calibre cavitation energy absorption energy emission firearm forensic medicine fragmentation frangible training ammunition full metal ammunition geometry glass fibre hydrophone gunshot wound high speed high speed camera homicide hunting accident interaction loss of energy medial jurisdiction military pressure progression projectiles rejects reflection rifle shot effect shock wave speed speed of sound suction waves target ballistics target pulsation temporary target cave wound ballistics 44.72 MED 590: Rechtsmedizin

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