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Here in Canada, we often think of gun violence as confined to conflict zones, terrorism, and more of a problem for our southern neighbor. However, in recent years, it has also become a Canadian problem with increased gun violence related to criminal activity presenting in daily practice. Radiologists play a critical role in the evaluation of ballistic trauma and must therefore be familiar with both the common and uncommon patterns of ballistic injury. In this article, we review the mechanisms of ballistic trauma as well as their resultant injury patterns in order to guide image interpretation. [ABSTRACT FROM AUTHOR]

Population reduction or eradication of domestic or non-domestic species may be required to address their impacts on the environment, other species, or human interests. Firearms are often used to accomplish these practical management objectives, and there is increased concern that the methods used may compromise animal welfare. We document the accuracy and humaneness of gunshot placement to the brain and cervical vertebrae of Philippine deer (Rusa marianna) on Guam during depopulation activities as a model for meeting AVMA standards of euthanasia under field conditions (e.g., animal is not in hand). Deer were shot with a .223 caliber rifle from 10–125 m and approached immediately (<20 s) for assessment. A subset of adult deer was further evaluated for physiological responses including cessation of heart rate, respiration, ocular reflexes, and post-mortem spasms. All deer shot in the brain (n = 132) and upper cervical spine (C1—C3; n = 18) died immediately due to the destruction of the brain or spinal tissue. Shot placements were all within 1.9 cm of the point of aim (i.e., the center of the target region). The accuracy and immediate insensibility resulting from targeting of C1—C3 demonstrates that this is an alternative target site when animal positioning is not optimal for targeting the brain, or there is a need to preserve brain tissue (e.g., Chronic Wasting Disease testing). While targeting of C4 –C7 vertebrae (n = 6) was accurate and resulted in immediate incapacitation, the failure to produce immediate insensibility does not support the use of this shot placement when upper cervical or brain shot placement is an option. It is reasonable to achieve sufficient accuracy to target the brain or upper cervical vertebrae of deer under field conditions and meet standards of euthanasia while accomplishing management objectives. [ABSTRACT FROM AUTHOR]

Introduction: Gunshot Wounds (GW) are to date a public health problem worldwide. In United States, each year from 30,000 to 50,000 people die secondary to a gunshot wound, making gunshot wounds the leading cause of death in the age group between 1-19 years of age, it is also estimated that for every death there are at least three disabling injuries resulting in approximately 150,000 injuries caused by firearm projectiles each year. In Mexico, the epidemiology of these injuries is unknown. The Military Central Hospital has no record of what could provide us some information to make it better to understand the magnitude of this problem in our environment and thereby take medical decisions best suited to the survival of our beneficiaries. Objective: To analyze the epidemiology of injuries by firearm projectile. Materials and Methods: We conducted a retrospective observational study of six years from January fist 2006 to December 31, 2011, in which 246 patients who first entered the Central Military Hospital in Mexico with a diagnosis of "Gunshot wound injury" according to their clinical record, subsequently clinical records were obtained of the Central Military Hospital archive, proceeding to the database filling with the parameters set by the researchers. Taking the patient dependent variables such as: age, sex, status in the army, hierarchy in the army (in case of being army man); were subjected to the clinical description of the injury, including anatomic site, fracture, production time between injury and admission to the emergency room and fist diagnosis, also the circumstances of injuries were described, including the place of injury, use of body armor, the caliber of the projectile and the number of impact. Variables during hospitalization were taken such as hospital days, surgical procedures, the use of hyperbaric chamber, antibiotic therapy, the number of specialties involved in the care of these patients, the use of blood transfusions, infections according to the medium culture, their complications and readmissions and the degree of disability certification for employment as military. Then, we made tables and statistical analysis of descriptive data, expressing the results in graphs and thus drawing conclusions. Results: From January the first 2006 to December 31ST 2011 we received a total of 246 patients with the diagnosis of "Gunshot wound injury" in the emergency department of the Central Military Hospital in Mexico with a total of 313 bullets, the male sex was predominant with 93% of the lesions, most patients were military (81%) and troop mainly (56%), the main circumstance in which our patients were injured by firearms was the street (56%) followed by confrontation with armed group (22%), 9 mm weapons are primarily used to produce these lesions, generating between 1 and 6 impacts per patient, mostly 2. The main affected anatomical site was lower limb, followed by chest and upper extremities, generating aggregate fractures in the 45%. While in emergency management, 16% required blood transfusion. During hospitalization most patients required one (39%) to two antibiotics (43%), being required hyperbaric chamber therapy in 5%. During follow-up, 19% of patients had a readmission for treating gunshot injuries. Conclusions: The management of these patients is a public health problem in the military population and an important issue to consider because of the large number of human and material resources for the management of these lesions resources, considering that the 246 patients were 877 performed several surgeries and that the average length of stay was 21days alert us because of the number of specialists needed to meet these demands. [ABSTRACT FROM AUTHOR]

Our purpose was to demonstrate the consistency of radiologists' three-dimensional measurements of simulated blast fragment locations in vitro in an effort to objectively localize retained fragments and wound paths. We designed a phantom consisting of 10 nail heads (simulating blast fragments) glued to wooden pegs that were randomly situated at distances from a reference point within a plastic tub. The x, y, and z coordinates of simulated fragments were recorded in Cartesian 3-space relative to the reference point. Computed tomography images of the phantom were acquired. Differences in x, y, and z positions as determined by three observers were summed for each fragment. Agreement between recordings of coordinates across readers was assessed using the intraclass correlation coefficient. Summed differences in coordinate positions as determined by readers ranged between 0.00 and 1.204 cm (mean: 0.732 cm). Across readers, the intraclass correlation coefficient for each dimension was >0.99. We found excellent agreement among readers with minimal discrepancy of measured locations of simulated fragments. Our results provide a foundation for trajectory analysis necessary to lead to automated organ damage reporting for immediate assessment in the emergency department and for forensic investigation and long-term epidemiological analysis. [ABSTRACT FROM AUTHOR]