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Corral Nunez C, Hurtado A, Latapiat Parodi A, Osorio Larraín R, Ríos Erazo M, Herrera Ronda A, Varas Reyes J, Rojas Alcayaga G. Traumatic dental injuries sustained during Chile's civil unrest: A case series study. Dent Traumatol 2024; 40:316-324. [PMID: 37997492 DOI: 10.1111/edt.12911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND/AIM During Chile's period of social unrest, numerous people suffered physical trauma due to the use of police force. However, there have been no reports regarding traumatic dental injuries (TDIs) suffered in this context. This study aims to describe the dental trauma of patients injured by police during the social unrest period in Chile from 2019 to 2021. MATERIAL AND METHODS A case series methodology was employed. Following informed consent, clinical records of patients admitted to the Ocular and Dentomaxillofacial Prosthetic Care and Rehabilitation Program, who were affected by the violence of state agents during social mobilizations, were reviewed from October 2019 to December 2021. Information on the sociodemographic characteristics of the patients and the TDI diagnoses with their treatment needs were collected. A descriptive analysis was performed. RESULTS Forty-six patients were identified, nine of whom agreed to the informed consent. Most were male, with a mean age of 28 years, public health insurance, and a high educational level. The most common causes of injury were kinetic impact projectiles (KIPs) and the use of physical force (punches, kicks, or pushes). Of the nine cases described, 26 teeth were affected by TDI. The most affected teeth were the central upper incisors and, in most cases, they presented lesions in both injury categories: NA0D.0 (the tooth and pulp) and NA0D.1 (periodontal tissues). Treatment needs varied and included some complex procedures, such as implant-retained crowns and removable dental prostheses. CONCLUSIONS The use of force by police during the period of social unrest in Chile caused TDIs among demonstrators, which were mainly due to physical force from less-than-lethal weapons. Most cases presented injuries affecting the incisors with multiple teeth requiring complex treatments.
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Affiliation(s)
- Camila Corral Nunez
- Department of Restorative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
- Center for Surveillance and Epidemiology of Oral Diseases, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Alvaro Hurtado
- Department of Restorative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - André Latapiat Parodi
- Department of Restorative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Rodrigo Osorio Larraín
- Department of Restorative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Matías Ríos Erazo
- Behavioral Sciences Area, Institute for Dental Sciences Research, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Andrea Herrera Ronda
- Behavioral Sciences Area, Institute for Dental Sciences Research, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Joaquín Varas Reyes
- Department of Occupational Therapy and Occupational Science, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Gonzalo Rojas Alcayaga
- Behavioral Sciences Area, Institute for Dental Sciences Research, Faculty of Dentistry, University of Chile, Santiago, Chile
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Zein-Elabdin H, Ghanem MA. Two case reports of fatal injuries sustained from tear gas guns loaded with pebbles as missiles. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00756-6. [PMID: 38036763 DOI: 10.1007/s12024-023-00756-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 12/02/2023]
Abstract
These two case reports are of fatal injuries from less-lethal weapons (tear gas guns) using pebbles as an unconventional ammunition. Reported here are the fatal outcomes of two 19-year-old males, one with head trauma and the other with abdominal trauma. They were admitted to the ED and subjected to immediate exploratory operations, but they passed away. On autopsy, the first case demonstrated a right frontal bone fracture with subdural hemorrhage and a 3 × 2.5 cm pebble retained in the skull. The second case showed severe liver laceration in close vicinity to a cubical pebble (3.2 × 3 cm). The mechanical forces involved in skull fracture and autopsy are discussed. In the current cases, the relatively larger weight and size together with the surface configuration of the pebble projectile were the main influential factors that contributed to the severity of damage and fatality.These case reports are a working example of the effect of the mass of projectiles in increasing the power of penetration. The direct shooting to the head and the abdomen together with the misuse of these weapons are capable of inflicting fatal injuries.
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Affiliation(s)
- Hisham Zein-Elabdin
- Forensic Medicine Corporation and Forensic Medicine and Clinical Toxicology, Department Faculty of Medicine, University of Science and Technology, Omdurman, Sudan
| | - Maha A Ghanem
- Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Medical Doctorate Degree of Forensic Medicine and Clinical Toxicology, Alexandria University, Alexandria, Egypt.
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Fémy F, Sultan-Dumenil N, Marciano E, Bokobza J, Chauvin A, Choquet C, Ogereau C, Delannoy Q, Juvin P, Feral-Pierssens AL. Injuries caused by defensive bullet launchers and resource utilization during the French yellow vests protests: A retrospective study. Am J Emerg Med 2023; 72:122-126. [PMID: 37523992 DOI: 10.1016/j.ajem.2023.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/04/2023] [Accepted: 07/14/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND In 2018, the French "Yellow Vest" social protest movement spread with weekly demonstrations resulting in confrontations between protesters and law enforcement. Non-lethal weapons, such as defensive bullet launchers (DBL) were used, and significant injuries have been reported through media, leading to public controversy regarding their use. These injuries are not well-known to civilian emergency physicians. The aim of this study is to describe the injuries caused by DBL among Emergency Department (ED) patients during these demonstrations and to identify the characteristics that required specialized care and hospital admission. METHODS A multicenter retrospective study was conducted in 7 EDs of academic hospitals in Paris, France. Adult ED patients who presented with DBL injuries during "yellow vest" strikes between November 2018 and May 2019 were included. The primary outcome was the rate of DBL patients requiring hospital admission. We also compared the characteristics of the injuries and the care provided between the admitted patients and other DBL patients. RESULTS 152 patients were included. 17% were admitted to hospital, with 19% of them being transferred to intensive care units. 49% of all patients had head, face, eye or neck injuries including 4 cases of intracranial hemorrhage, 1 carotide dissection, 1 laryngeal edema, 1 pneumencephalus. 11% of all patients presented with multiple wounds, and 28% had fractures (77% of admitted patients vs 18%, p < 0.001). Surgery was required for 20% of all patients (62% of admitted patients vs 10%, p < 0.001). Maxillofacial surgery was performed on 38% of admitted patients, orthopedic surgery on 25%, and neurosurgery on 13%. No death were reported. CONCLUSION The use of DBL during the "yellow vest" civil strikes was associated with a high rate of head, face, eye or neck injuries among injured ED patients. Hospital admission was associated with a higher rate of fractures, with most of them requiring maxillofacial, orthopedic and neurosurgeries.
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Affiliation(s)
- Florent Fémy
- IMPEC Federation, 103 boulevard Magenta, 75010 Paris, France; Emergency Department, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, 20 rue Leblanc, 75015 Paris, France; Toxicology and Chemical Risks Department, French Armed Forces Biomedical Institute, Base aérienne 217, 91220 Bretigny-Sur-Orges, France.
| | - Nour Sultan-Dumenil
- Emergency Department, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, 20 rue Leblanc, 75015 Paris, France
| | - Eva Marciano
- Emergency Department, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, 11 rue des menus, 92100 Boulogne-Billancourt, France
| | - Jérome Bokobza
- IMPEC Federation, 103 boulevard Magenta, 75010 Paris, France; Emergency Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, 27 rue du faubourg Saint-Jacques, 75014 Paris, France.
| | - Anthony Chauvin
- IMPEC Federation, 103 boulevard Magenta, 75010 Paris, France; Emergency Department, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 Paris, France.
| | - Christophe Choquet
- Emergency Department, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, 46 rue Henri Huchard, 75018 Paris, France.
| | - Carl Ogereau
- Emergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, 1 avenue Claude Vellefaux, 75010 Paris, France.
| | - Quentin Delannoy
- IMPEC Federation, 103 boulevard Magenta, 75010 Paris, France; Emergency Department, Pitié-Salpétrière Hospital, Assistance Publique-Hôpitaux de Paris, 91 boulevard de l'hôpital, 75013 Paris, France.
| | - Philippe Juvin
- Emergency Department, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, 20 rue Leblanc, 75015 Paris, France; Sorbonne Université, 21 rue de l'Ecole de Médecine, 75006 Paris, France.
| | - Anne-Laure Feral-Pierssens
- IMPEC Federation, 103 boulevard Magenta, 75010 Paris, France; SAMU 93 - Emergency Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris, 125 avenue de Stalingrad, 93000 Bobigny, France; LEPS UR 3412, Université Sorbonne Paris Nord, 74 rue Marcel Cachin, 93017 Bobigny, France.
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Darwazeh R, Darwazeh M, Elzain MA, Hoz SS, Al-Kanash R. Rubber bullet-related craniocerebral injuries. Br J Surg 2022; 110:403-405. [PMID: 36073201 DOI: 10.1093/bjs/znac316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/10/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Rami Darwazeh
- Department of Neurosurgery, Arab Women’s Union Hospital , Nablus , Palestine
| | - Mazhar Darwazeh
- Department of Neurosurgery, Arab Women’s Union Hospital , Nablus , Palestine
| | - Mohammed A Elzain
- Department of Neurosurgery, King Saud Medical City , Riyadh , Saudi Arabia
| | - Samer S Hoz
- Department of Neurosurgery, University of Cincinnati , Cincinnati, Ohio , USA
| | - Rasha Al-Kanash
- Endoscopic Spine Department, Razi Spine Clinic , Amman , Jordan
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Abdul-Nabi SS. Chronicles of an Emergency Medicine Resident in Lebanon. J Emerg Med 2021; 61:602-606. [PMID: 34521546 DOI: 10.1016/j.jemermed.2021.07.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/03/2021] [Indexed: 11/24/2022]
Abstract
Residency is expected to be a long and difficult road. When living in Lebanon, however, this path can be even more demanding. This reflection is my story, an Emergency Medicine Resident at the American University of Beirut Medical Center living in Lebanon. In this essay, I narrate how I experienced the past two years in Lebanon from protests, to an economic collapse, to a massive urban explosion and a pandemic. This narrative is a reflection on the challenges experienced as both an Emergency Medicine resident and a Lebanese citizen working in these settings.
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Affiliation(s)
- Sarah S Abdul-Nabi
- Department of Emergency Medicine. American University of Beirut Medical Center, Beirut, Lebanon
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Congenital Heart Disease in Syrian Refugee Children: The Experience at a Tertiary Care Center in a Developing Country. Pediatr Cardiol 2021; 42:1010-1017. [PMID: 33738510 DOI: 10.1007/s00246-021-02574-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 02/25/2021] [Indexed: 10/21/2022]
Abstract
The influx of Syrian refugees to Lebanon that began in 2012 created new health-care and financial stressors on the country with an increase in communicable and non-communicable diseases. This study aims to describe the presentations, diagnoses, management, financial burden, and outcomes among Syrian refugees with congenital heart disease (CHD) in Lebanon. This is a retrospective study that was conducted through reviewing the charts of all Syrian pediatric patients referred to the Children's Heart Center at the American University of Beirut Medical Center for evaluation between the years 2012 and 2017. We reviewed the charts of 439 patients. The mean age at presentation was 3.97 years, and 205 patients (46.7%) were females. 99 Patients (22.6%) were found to have no heart disease, 69 (15.7%) had simple, 146 (33.3%) had moderate, and 125 (28.5%) had complex heart diseases. 176 (40.1%) Patients underwent interventional procedures, with a surgical mortality rate of 10.1%, compared to a rate of 2.9% among non-Syrian children. The average cost per surgical procedure was $15,160. CHD poses a significant health and financial burden on the Syrian refugee population in Lebanon, a small country with very limited resources. The Syrian cohort had a higher frequency of complex cardiac lesions, presented late with additional comorbidities, and had a strikingly elevated surgical mortality rate. Securing appropriate funds can improve the lives of this population, ease the financial burden on the hosting country, provide adequate health-care services, and improve morbidity and mortality.
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