Evidence map›Paper›PMID 32571856›Full record

ArticleBMJ open2020

Disturbing medical findings in war-related traumatic amputation patients: a clinical descriptive study from Gaza.

Hanne Edoy Heszlein-Lossius, Anas Ismail, Yahya Al-Borno, Samar Shaqqoura, Nashwa Skaik, Iman Al Hinnawi, Mahmoud Matar, Mads Gilbert

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 10 citations in OpenAlex.

  1. Radiology in conflict: scoping review.Conflict and health · 2024
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Hanne Edoy Heszlein-LossiusThe Anaesthesia and Critical Care Research Group, Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway hannelossius@gmail.com.ORCID 0000-0003-2371-0868
Anas IsmailFaculty of Medicine, Al-Azhar University, Gaza, Palestine.
Yahya Al-BornoAl-Shifa Medical Centre, Gaza, Palestine.
Samar ShaqqouraAl-Shifa Medical Centre, Gaza, Palestine.
Nashwa SkaikAl-Shifa Medical Centre, Gaza, Palestine.
Iman Al HinnawiAl-Shifa Medical Centre, Gaza, Palestine.
Mahmoud MatarAl-Shifa Medical Centre, Gaza, Palestine.
Mads GilbertThe Anaesthesia and Critical Care Research Group, Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway.
Dar Al-Shifa Hospital · PSAl-Azhar University – Gaza · PSUiT The Arctic University of Norway · NOUniversity Hospital of North Norway · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe aim of this study was to explore possible long-term negative health effects of injuries sustained by modern weaponry.

settingThe study was conducted in Gaza's main hospital, Al-Shifa Hospital.

participantsDuring the last 10 to 15 years, thousands of civilian Palestinians in Gaza have survived numerous military incursions, but with war-related traumatic injuries caused by explosive weapons. It is unclear to which extent the injuries sustained by such modern weaponry may increase survivors' risks of negative long-term health effects and serious illness. We have reported mechanisms and severity of injury, demographics and psychosocial status among 254 Palestinian patients in Gaza with war-related extremity amputations. Among the same amputees, subgroups of patients presented a variety of alarming symptoms and findings. 94 patients received further diagnostic clinical exploration, radiology imaging and clinical chemistry laboratory tests at the main clinical centre in Gaza, the Al-Shifa Hospital.

resultsNine out of ten of the referred patients were young (median 31.5 years) males (88/94, 92.6%). Ultrasound imaging revealed that 19 of 90 patients (20%) had fatty liver infiltration, 3 patients had lung nodules and 10 patients had lung atelectasis on chest CT. Twelve had remaining shrapnel(s) in the chest, five patients had shrapnel(s) in the abdomen and one in the scrotum. We found shrapnel(s) in the amputation stumps of 26 patient's amputated limbs, while 8 patients had shrapnel in the non-amputated limb. Three patients had liver lesions. Nineteen patients had elevated liver enzymes, 32 patients had elevated erythrocyte sedimentation rate and 12 were anaemic. Two patients tested positive for hepatitis C virus and three were positive for hepatitis B virus (HBV). One of the 19 patients with fatty liver tested positive for HBV. Two of the patients with fatty liver infiltration had elevated glycatedhaemoglobin levels and confirmed diabetes mellitus type II.

conclusionNearly half (44, 8%) had remaining metal fragments from explosives of unknown composition harboured in various parts of their bodies. All patients identified with lesions and nodules are being followed up locally. As of now, we cannot anticipate the long-term health consequences of living with metal residuals from modern explosive weapons embedded in body organs and tissue.

Indexed as

Injury Severity ScoreAdultAmputation, TraumaticArabsFemaleHumansLiverMaleMiddle EastWar-Related Injuriesaccident & emergency medicinehealth & safetypublic healthtrauma management

Identifiers

PMID32571856
PMCPMC7311037
OpenAlexW3036657675

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.