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Introduction: Extremity vascular trauma is common in civilian population following RTA. The aim of this study is to evaluate the results following intervention in extremity vascular trauma cases admitted in Rajiv Gandhi Government General Hospital , Chennai , during period 1st July 2016 to 31st June 2018. Method Of Study: Prospective study Results: Of 94 cases,Commonly injured artery was popliteal artery (31.9%). Most of the cases were treated with interposition vein bypass(88.29%) and remaining with primary repair(6.38%), ligation(4.25%) and thrombectomy (1.06%). Failure following repair was 6.66% . Limb salvage rate was 96.8%. Conclusion: Early intervention with interposition vein bypass with proper technique and proper case selection with adequate fasciotomy and wound care yield better results.

I propose a theory of legislator‐to‐constituent communication that describes a relationship between the types of votes a legislator reveals and the partisan composition of her constituency. To test this theory, I use an original data set of 40,000 official communications containing 30,000 vote revelations from the 111th Congress. I find evidence substantiating this theory; the extent to which a legislator endeavors to appear more ideologically extreme in communications varies systematically with the relative amounts of different types of voters in her district. This result is contrasted with an analysis of voting extremism where I find that the ideological preferences of donors better explain voting patterns.

Abstract Background Ballistic high-energy trauma has substantially increased the severity of non-fatal extremity injuries incurred in modern warfare. Expedient medical care, refinement in surgical techniques, and soft tissue coverage have brought about a paradigm shift in the management of lower extremity wounds during the last decade with an increased emphasis on limb salvage. Methods A literature-based study was conducted to analyze reconstructive modalities based on the location, depth, and severity of wounds, as well as mechanism of injury, concomitant vascular injuries and open fractures, choice of flap, timing of definitive reconstruction, and complications. Results Extremity injuries account for over 60 % of injuries in the recent conflicts in Iraq and Afghanistan, with the majority secondary to explosive devices. The severity of these injuries is profound compared with civilian registries, and conventional injury scoring systems have failed to accurately predict outcomes in combat trauma. The mainstay of treatment is serial debridement, negative pressure therapy, fracture stabilization, and treatment of concomitant injuries by the forward medical teams with subsequent definitive reconstruction after transport to an advanced military treatment facility. Autologous reconstruction with free tissue transfer and pedicled flaps remains the primary modality for soft tissue coverage in limb salvage. Adjunct innovative modalities, such as external tissue expansion, dermal substitutes, and regenerative matrices, have also been successfully utilized for limb salvage. Conclusion Lower extremity injuries account for the vast majority of injuries in modern warzones. Explosive devices represent the most common mechanism of injury, with blast impact leading to extensive soft tissue injuries necessitating complex reconstructive strategies. Serial debridement, negative pressure therapy, and autologous reconstruction with free tissue transfer and pedicled flaps remain the mainstay of treatment in recent conflicts.

Objective: Musculoskeletal tissues repeatedly loaded in vitro fail in accordance with material fatigue failure theory, and there is evidence to suggest that the same process occurs in vivo. The current paper presents a new upper extremity risk assessment tool, the Distal Upper Extremity Tool (DUET), predicated on material fatigue failure theory. Methods: DUET requires an estimate of force exertion level and the number of repetitions performed to derive estimates of damage and probabilities of experiencing a distal upper extremity outcome. Damage accrued over multiple tasks may be summed to estimate the cumulative damage (CD) accrued over a workday. Validation of this tool was performed using five distal upper extremity (DUE) outcomes (involving medical visits and pain) from an existing epidemiological database involving data from six automotive manufacturing plants. Logistic regression was used to assess the association of the log of the DUET CD measure to DUE outcomes. Results: Results demonstrated that the log of the DUET CD measure was highly associated with all five DUE outcomes in both crude analyses and those adjusted for site, age, gender, and body mass index ( p < .01). A model relating the continuous DUET log CD score to the probability of the DUE outcome Injury + Pain Last Year was developed, which demonstrated a significant dose-response relationship. Conclusions: Results suggest that fatigue failure–based risk assessment techniques are highly associated with DUE outcomes and provide support for the notion that an underlying fatigue failure process may be involved in the development of upper extremity musculoskeletal disorders.

Objective: To verify the hypothesis that neurologic injuries are less prevalent in civilian gunshot injuries than that reported in the military literature, and are more likely to occur with concomitant fracture. Methods: In order to investigate the incidence and patient variables of gunshot injury with neurologic injury, a retrospective chart review was performed at a single urban trauma center over a five‐year period. Results: One thousand eight hundred and fifty‐one patients with gunshot injuries were treated at our center over the five year study period. Of these, 895 patients (48%) had involvement of at least one extremity and 382 (21%) had concomitant fractures. Seventy‐four had concomitant neurologic injury. There was a statistically significant difference of 14% (53/382) and 4% (21/513) (P < 0.0001) between the group with fracture (53 patients) and the group without fracture (21 patients), respectively, in the occurrence of neurologic insult. Conclusion: This incidence of neurologic injuries in civilian gunshot injuries is lower than that previously reported in the military population and the presence of a fracture is clearly an additional risk factor for neurologic injury.

In this book, the author presents an interpretation of four thinkers: Nietzsche, Heidegger, Foucault, and Derrida. In an attempt to place these thinkers within the wider context of the crisis-oriented modernism and postmodernism that have been the source of much of what is most original and creative in twentieth-century art and thought.