IntroductionThe incidence and epidemiological causes of maxillofacial (MF) trauma varies widely. The objective of this study is to point out maxillofacial trauma patients’ epidemiological properties and trauma patterns with simultaneous injuries in different areas of the body that may help emergency physicians to deliver more accurate diagnosis and decisions.MethodsIn this study we analyze etiology and pattern of MF trauma and coexisting injuries if any, in patients whose maxillofacial CT scans was obtained in a three year period, retrospectively.Results754 patients included in the study consisting of 73.7% male and 26.3% female, and the male-to-female ratio was 2.8:1. Mean age was 40.3 ± 17.2 years with a range of 18 to 97. 57.4% of the patients were between the ages of 18–39 years and predominantly male. Above 60 years of age, referrals were mostly woman. The most common cause of injuries were violence, accounting for 39.7% of the sample, followed by falls 27.9% and road traffic accidents 27.2%. The primary cause of injuries were violence between ages 20 and 49 and falls after 50. Bone fractures found in 56,0% of individuals. Of the total of 701 fractured bones in 422 patients the most frequent was maxillary bone 28,0% followed by nasal bone 25,3%, zygoma 20,2%, mandible 8,4%, frontal bone 8,1% and nasoethmoidoorbital bone 3,1%. Fractures to maxillary bone were uppermost in each age group.8, 9% of the patients had brain injury and only frontal fractures is significantly associated to TBI (p < 0.05) if coexisting facial bone fracture occurred. Male gender has statistically stronger association for suffering TBI than female (p < 0, 05). Most common cause of TBI in MF trauma patients was violence (47, 8%).158 of the 754 patients had consumed alcohol before trauma. No statistically significant data were revealed between alcohol consumption gender and presence of fracture. Violence is statistically significant (p < 0.05) in these patients.ConclusionStudies subjected maxillofacial traumas yield various etiologic factors, demographic properties and fracture patterns probably due to social, cultural and governmental differences. Young males subjected to maxillofacial trauma more commonly as a result of interpersonal violence.

Trauma management shows significant progress in last decades. Determining the time and place of deaths indicate where to focus to improve our knowledge about trauma. We conducted this retrospective study from data of trauma victims who were brought to a major tertiary hospital which is a level one trauma center in Ankara, Turkey, and died even if during transport or in the hospital between 1 March 2010 and 1 March 2013. The patients' demographic characteristics, trauma mechanisms, time frames and causes of deaths determined by physicians were recorded. Traumas were grouped as "high energy trauma" (HET) and "low energy trauma" (LET). Falls from ground level were defined as LET. 209 traumatic deaths due to trauma or trauma-related conditions were found in the study period. 161 of 209 (78 %) patients suffered from HET. Motor vehicle collisions (MVC) (56 %) were the most common mechanism of trauma followed by burns (16 %), falls (11 %), gunshots (9 %) and stabs (6 %) in this group and traumatic brain injuries (TBI) (41 %) were the most common cause of death followed by circulatory collapse (22 %) and multi-organ failure (20 %). 36 % of deaths occurred before arrival at hospital, 25 % in the first 24 h of admission, 18 % between 2nd and 7th day and 21 % after first week. Trimodal distribution of traumatic deaths was not valid for all types of injuries and the most important factor to decrease traumatic deaths is still prevention. Also we have to keep on searching to improve our knowledge about trauma management.

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Objectives Violence is defined as either the use of voluntary physical power against the person himself or someone else, a group, a society or to threaten them without the use of physical power. Patients' relatives as well as patients themselves are prone to exert violence against the healthcare professionals. These behaviors may ben seen as ordinary interactions of the daily activities. Some can be tolerable under certain circumstances while some others can be forgivable assuming that the person's current mood is not so well. However, the meanings and the dimensions of these continuous and repeating behaviors at workplace change by time and they turn into dangerous social behaviors. In this regard, the allied healthcare personnelmay face the violence directly as victims or face it indirectly as witnesses and this reality reveals the importance of this problem. In this study we aimed to investigate the violence towards the emergency care providers in an urban emergency department. Methods The study was carried out between March 1st-10th, 2011 at Ankara Numune Training and Research Hospital (Turkey). The healthcare providers were grouped as emergency medical technicians, nurses and sanitary servants. The data was evaluated with the SPSS v.18 and chisquare test was used for the comparison of the groups. A p value <0.05 was accepted as significant. Results There were 44 (50.6%) males and 43 (49.4%) females in the study group. The group that was exposed to violence most frequently was determined to be the 32 years and older in age with 49 (56.3%) cases. Conclusions The results showed that males were predominantly exposed to violence and rates of exposure increases as the education level decreases.

BACKGROUND:Head trauma is associated with a significant risk of cerebrospinal fluid (CSF) fistula.