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The growing elderly population in the United States presents medical, engineering, and legislative challenges in trauma management and prevention. Thoracic injury incidence, morbidity, and mortality increase with age. This study utilized receiver-operator characteristic analysis to identify the quantitative age thresholds associated with increased mortality in common isolated types of thoracic injuries from motor vehicle crashes (MVCs).

Trauma in the US's increasingly aged population will pose medical, engineering, and legislative challenges in the coming decade. This study sought to identify the age threshold of maximal risk for patients with the three most common isolated types of head injuries from motor vehicle crashes (MVCs).

The triathlon is one of the fastest developing sports in the world due to expanding participation and media attention. The fundamental change in Olympic triathlon races from a single to a multistart event is highly demanding in terms of recovery from and prevention of exercise-induced muscle injures. In elite and competitive sports, ultrastructural muscle injuries, including delayed onset muscle soreness (DOMS), are responsible for impaired muscle performance capacities. Prevention and treatment of these conditions have become key in regaining muscular performance levels and to guarantee performance and economy of motion in swimming, cycling and running. The aim of this review is to provide an overview of the current findings on the pathophysiology, as well as treatment and prevention of, these conditions in compliance with clinical implications for elite triathletes. In the context of DOMS, the majority of recovery interventions have focused on different protocols of compression, cold or heat therapy, active regeneration, nutritional interventions, or sleep. The authors agree that there is a compelling need for further studies, including high-quality randomized trials, to completely evaluate the effectiveness of existing therapeutic approaches, particularly in triathletes. The given recommendations must be updated and adjusted, as further evidence emerges.

Injury is a major public health problem. In rich countries fall injures now kill more people than all other injury mechanisms together, because of global ageing and large-scale sustainable injury prevention programs for all other injury mechanisms but falls. Injuries from falls in the young are often trivial, but in old people falls may have devastating consequences. We used the Umeå Injury Database, 1993 – 2014, 220,014 injury events attended to by the emergency department: e.g., type of injury, localization, mechanism, activity and severity. Logistic regression was used to evaluate injury trends, Cox regression for associations between injury type, severity and recidivism. Fractures were responsible for 1⁄4 of all injuries and for 3⁄4 of trauma inpatient days. Fractures and contusions became more common with increasing age while sprains and wounds decreased with age. Injuries due to fall increased during the study period. Recurrent injuries accounted for some 40%, mostly in young men and in old women. Prior fractures and sprains were strongest predictors for recurrent serious injuries. The hip fracture incidence fell for the most important age/sex groups during the 22-year period, but the total number increased with 3,5%, due to an increasing elderly population. 40% of all hip fracture patients had sustained a previous injury. Multiple previous injuries also increase the risk of future hip fracture. No less than 12% hip fracture patients suffered a new one. With age, injury pattern changed, with more lower extremity fractures that also were more proximally located. Soft tissue injuries to the head/face also increased, also indicating that the ability to reduce and spread the impact of the kinetic energy is a key factor in geriatric trauma, in addition to tissue strength The most common, expensive and devastating injury mechanism, falls, are still outrageously neglected, especially concerning injury prevention, which has been so successful in reducing road traffic- and workplace-related deaths. Why? A common misconception is the primitive belief is that fall injuries are fated and therefore inevitable. There are also few economic and legal drivers to prevent falls, especially recurrent ones. Another reason is that GDPR has prohibited the injury database. Statistics on fall injuries are necessary for targeting preventive interventions. Without spying, no clue. On-line feedback of official statistics should be used to monitor the results. There are no technical, just legal hurdles. The Swedish parliament has since 1997 flagged a zero vision for road traffic injuries; in 2015 the government also launched a more modest goal for a 50% reduction of falls in the elderly. So far, nothing has happened. ; Skador är ett gigantiskt globalt folkhälsoproblem som enligt WHO dödar fler människor än tuberkulos, malaria och AIDS tillsammans. Skador drabbar individen med smärta/invaliditet, samhället med vårdkostnader och produktionsbortfall. Sverige har varit föregångare i trafiksäkerhetsarbetet, inom arbetslivets risker och inom barnsäkerhetsarbetet. År 2020 omkom 190 individer i trafiken, vilket är det lägsta antalet någonsin. Dödliga fall däremot, som senaste åren passerat över 1500 årligen, uppmärksammas betydligt mindre, kanske pga. att de ofta uppkommer i hemmet, drabbar äldre kvinnor och sannolikt också att de betraktas som ej möjliga att förebygga. Fallskador dödar fler än alla andra skador tillsammans och är nu det största trauma-problemet i rika länder. Vi analyserade 220 014 skadetillfällen som registrerats på akutmottagningen i Umeå 1993– 2014 i en bred översikt av skadepanoramat, med speciell inriktning på fall, den viktigaste och vanligaste skademekanismen. Vilka skadar sig flera gånger? Hur ökar tidigare skador risken för nya skador? Detta är speciellt intressant för höftfraktur. Målet är att förbättra det skadeförebyggande arbetet. Umeå hade en yngre befolkning än krans-kommunerna och närheten till akuten ökade umeåbornas akutbesök jämfört med de övriga kommunerna. Fallskador stod för nästan hälften, och hem- och fritidsskador dominerade panoramat. Efter medelåldern utgjorde fall ungefär samma procentuella andel av alla skademekanismer som den kronologiska åldern. Trafikskadorna utgjorde en femtedel, varav de cykelrelaterade utgjorde knappt hälften. Frakturer stod för en fjärdedel av alla skador, hälften hos äldre, och ansvarade för hela 75% av alla skade-relaterade vårddagarna. Men även mjukdelsskador var viktiga och utgjorde ungefär hälften av skadorna och en väsentlig del av vårddagarna på sjukhus. Upprepade skador utgjorde hos vuxna 40% av alla skador, vanligast hos unga män och äldre kvinnor. Att drabbas av en fraktur eller stukning ökade risken att ådra sig ytterligare en allvarlig skada. Hos yngre män fann vi att även hjärnskakning ökade risken för förnyad allvarlig skada. Med ökad ålder ökade risken betydligt för upprepad allvarlig skada. En 90- årig kvinna hade 10 gånger högre risk än en 20-årig. Tidigare skador gav en måttlig riskökning för höftfraktur. Även här framkommer att fraktur är den vanligaste skadetypen som föregår en höftfraktur. 40% av alla som drabbas av en höftfraktur har haft en eller flera tidigare skador och de som drabbas av höftfraktur är mer skadebenägna än de som inte drabbas av höftfraktur. Flera tidigare skador ökar också risken för framtida höftfraktur. Vi fann att 12% av alla med höftfraktur drabbas av en ytterligare höftfraktur. Förekomsten av höftfraktur ökar med en faktor på cirka 100 under livet—en exceptionell åldersfördelning, vilket troligen beror mer på falltendens och oförmåga att parera fall än enbart på benskörhet. Skadorna visar nämligen ett åldersrelaterat anatomiskt mönster där frakturerna i nedre extremiteten blir allt vanligare, och även centralt lokaliserade, närmare bålen. Även mjukdelsskador i ansikte/huvud ökar med åldern vilket också visar betydelsen av att kunna ta mot sig och dämpa rörelseenergin.iiiFör alla andra skadesituationer utom fall finns en utbyggd skadeprofylax. Antalet 80+ ökar kontinuerligt och kommer att ytterligare belasta sjukvården i framtiden. Tidigare frakturer med även andra skador och andra kända riskfaktorer som finns dokumenterade i patientjournalen borde kunna användas i ett riktat preventionsarbete. Men för att få kraftfull effekt krävs många andra åtgärder och inte minst informationskampanjer riktade till befolkningen. Att skador uppstår till följd av slump eller otur är en vanlig åsikt som är djupt rotad hos oss människor och som måste ändras. Resultaten av de massiva insatser som gjorts inom trafiken och arbetslivet har visat att det är möjligt; tiden är nu inne för att minska antalet fallskador. Regeringen har en nollvision för trafik-"olyckor" och formulerade 2015 en målsättning att halvera fallskadorna hos gamla. Men vad har hänt?

The study describes the osteoporosis patient's need of support from medical social workers because of risks and injury events in residential environments. The study includes qualitative interviews of patients and a survey of medical social worker visibility in the media. Findings show that patients feel a lack of knowledge, recognition, and moral respect from the environment. Support from a medical social worker is significant, and activation in a patient association and an osteoporosis school is seen as employing valuable information channels. However, these have a fairly limited visibility in the media, when it comes to describing support opportunities and preventive work.

Organ injuries caused by environmental chemical exposures or use of pharmaceutical drugs pose a serious health risk that may be difficult to assess because of a lack of non‐invasive diagnostic tests. Mapping chemical injuries to organ‐specific histopathology outcomes via biomarkers will provide a foundation for designing precise and robust diagnostic tests. We identified co‐expressed genes (modules) specific to injury endpoints using the Open Toxicogenomics Project‐Genomics Assisted Toxicity Evaluation System (TG‐GATEs) – a toxicogenomics database containing organ‐specific gene expression data matched to dose‐ and time‐dependent chemical exposures and adverse histopathology assessments in Sprague–Dawley rats. We proposed a protocol for selecting gene modules associated with chemical‐induced injuries that classify 11 liver and eight kidney histopathology endpoints based on dose‐dependent activation of the identified modules. We showed that the activation of the modules for a particular chemical exposure condition, i.e., chemical‐time‐dose combination, correlated with the severity of histopathological damage in a dose‐dependent manner. Furthermore, the modules could distinguish different types of injuries caused by chemical exposures as well as determine whether the injury module activation was specific to the tissue of origin (liver and kidney). The generated modules provide a link between toxic chemical exposures, different molecular initiating events among underlying molecular pathways and resultant organ damage. Published 2016. This article is a U.S. Government work and is in the public domain in the USA. Journal of Applied Toxicology published by John Wiley & Sons, Ltd.

A fall from a height is one of the most serious hazards faced by employees in the work environment. It is present mostly at workstations in such industries as construction, power engineering, mining, storage, etc. Using individual protective equipment against falls from a height is a basic method of protecting workers under such conditions. The choice of this method carries specific risks associated with the functioning of equipment during fall arrest. Hitting elements of the workstation during fall arrest associated with pendulum movement is a very serious threat. This paper presents conditions which trigger pendulum movement during fall arrest and the positions which a human equipped with a full body harness can assume then. Potential effects of the impact of the head against an obstacle during pendulum movement are discussed on the basis of the results of research with an anthropomorphic dummy. The article discusses methods of preventing swing movement and ways of mitigating the effects of collisions with obstacles within the workstation. It also presents the basic requirements for protective helmets intended for use with individual protection equipment against falls from a height.

Blasts injuries are responsible for about two-thirds of the conventional combat injuries during any military operation and account for a sizeable number during terrorist activities. The pathophysiology, clinical presentation and urgency of management vary significantly in primary blast injuries. These can lead to a wide range of overt and covert injuries, making diagnosis and management difficult. The clinical picture varies from acute respiratory distress to deafness with absence of any external injuries. Such patients are best identified and dealt with by a team of health care professionals well acquainted with battle field injuries.