Pediatric restraint use in motor vehicle collisions: reduction of deaths without contribution to injury.

HYPOTHESIS: Restraint use for children in automobiles is mandated in every state, but injury patterns are unknown. Although use of pediatric retraints is associated with reducing morbidity and mortality, the injury distribution for specific anatomic sites may be altered in restrained vs unrestrained children. DESIGN: Review of trauma registry data, medical records, and autopsy findings. SETTING: Urban level I trauma center and tertiary care children's hospital. PATIENTS: All children aged 6 years or younger who were in motor vehicle collisions from June 1, 1990, through March 31, 1997. MAIN OUTCOME MEASURES: Age, weight, restraint use and type, collision data, Injury Severity Score (ISS), injury type, and outcome. RESULTS: We included 600 children. The restrained group showed a reduction in severe injuries for every anatomic site and had a lower mean ISS, fewer injuries, and more uninjured children. The restrained group also had a reduction in the incidence of hollow- and solid-organ abdominal injuries. CONCLUSIONS: Age-appropriate restraint devices decrease mortality and reduce the incidence of significant injury in motor vehicle collisions for all anatomic sites in young children. In contrast to injuries attributed to restraint use in adults, specific restraint-related injury patterns were not seen in children.

Iliofemoral venous injuries: an indication for prophylactic caval filter placement.

Prophylactic placement of vena caval filters is recommended in trauma patients at high risk for pulmonary embolism (PE). We present a group of patients with iliofemoral venous trauma, and subsequent complications of deep venous thrombosis (DVT) and PE. Of twelve patients with iliac or common femoral venous injuries, seven underwent primary repair. All received DVT/ PE prophylaxis with mini-dose heparin and/or sequential compression hose. In spite of this, two patients suffered DVT, one patient had DVT and PE and one patient had clinical evidence of PE but did not undergo confirmatory testing. Three patients underwent prophylactic caval filter placement without complication. The DVT/PE complication rate in this small group was at least 43% (3 of 7). Patients with repaired iliofemoral venous injuries represent a high risk subset for DVT/PE and prophylactic caval filter placement is recommended.

Prevalence and epidemiology of the major gastrointestinal parasites of horses in Perth, Western Australia.

A survey was conducted on the prevalence of the major gastrointestinal parasites in 140 horses necropsied in Perth, Western Australia, during 1979 to 1982. Adult Strongylus vulgaris were found in 22.5 per cent of horses and verminous arteritis in 62.9 per cent. The peak worm prevalence was in November to January (summer). S edentatus had a similar prevalence and seasonality but S equinus was not found in this survey. Draschia megastoma and Habronema muscae were found in 66.2 per cent and 35.3 per cent of horses respectively. Infection is probably acquired in summer when 8 per cent of the Musca domestica in the vicinity of the stables carried third stage spiruroid larvae. Gasterophilus intestinalis and G nasalis occurred in 36.4 per cent and 22.1 per cent of the horses respectively and 52.1 per cent of horses were infected with one or both species. The peak prevalence of G intestinalis larvae occurred in December with a trough in February-April; the peak prevalence of G nasalis was in May with a trough in November-December. Parascaris equorum was found in 9.9 per cent of the horses and in 21.3 per cent of those less than three years old. Anoplocephala perfoliata was found in 4.9 per cent of the horses and most of these were in older horses.

An ultrastructural study of the microtriches of adult Proteocephalus tidswelli (Cestoda: Proteocephalidea).

Ultrastructural observations on adult Proteocephalus tidswelli revealed a marked microtrichial polymorphism. Structural and dimensional variations of microtriches between different regions of the strobila and scolex, as well as within the same region, were observed. The authors suggest that microtriches are involved in a diversity of functions, and possible functional activities are discussed.