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Bileaflet mitral valve prolapse (MVP) can be associated with malignant ventricular arrhythmias. It is unknown whether surgical correction alone of this mitral valve pathology leads to a reduction in ventricular dysrhythmias. We retrospectively analyzed 4477 patients who underwent mitral valve surgery from 1993–2013 at Mayo Clinic in Rochester, MN. Among these, eight patients with bileaflet MVP who had an internal cardioverter defibrillator (ICD) in place both pre- and post-surgery were identified. ICD interrogation records were evaluated for episodes of ventricular tachycardia (VT), ventricular fibrillation (VF), and appropriate ICD shock therapy. Of these eight patients, five had a malignant ventricular arrhythmia prior to surgery. Data was available 4.6 ± 2.9 years before versus 6.6 ± 4.2 years following surgical intervention. Among these patients, there was a reduction in VF (0.6 versus 0.14 events per-person-year pre- and post-surgery, respectively), VT (0.4 versus 0.05 events per-person-year pre- and post-surgery, respectively), and ICD shocks (0.95 versus 0.19 events per-person-year pre- and post-surgery) following mitral valve surgery. We report a series of cases where the surgical correction of bileaflet MVP alone was associated with a reduction in malignant arrhythmia and appropriate shocks. These early observations merit further investigation involving larger cohorts to further evaluate the association between abnormal mechanical forces in degenerative mitral valve disease and ventricular dysrhythmias.

Implantable cardioverter-defibrillators (ICD) provide treatment for life-threatening ventricular tachyarrhythmias. Failure of the pace/sense conductor of an ICD lead can cause noise on the sensing electrogram (EGM) that may be misinterpreted as ventricular activity, triggering inappropriate therapy. An algorithm based upon the confirmation of ventricular activity from a far-field EGM has been developed to reduce inappropriate therapies resulting from this type of lead failure, while ensuring that appropriate therapy is delivered. The objectives of this study were to evaluate the algorithm’s ability to discriminate lead noise from ventricular tachycardia/ventricular fibrillation (VT/VF) and to determine whether it inhibits inappropriate shocks without delaying appropriate shocks. The algorithm was prospectively tested using near- and far-field EGM recordings from patients in three conditions: normal sinus rhythm with sustained and non-sustained lead noise via manipulation of the ICD pocket or lead system, and VT/VF induced during defibrillation threshold testing. The recordings were played through a bench-top device running the algorithm with the diagnosis, time to diagnosis, and inhibition of therapy documented. The algorithm detected noise and withheld inappropriate therapy in 231 of 238 recordings of sustained lead noise that would otherwise have been diagnosed as VT/VF (97.1 %). Non-sustained lead noise was correctly diagnosed in 47 of the 52 recordings (90.4 %). The device appropriately identified all 853 recordings of VT/VF (100 %), without an increase in the time to detection (0.01 ± 0.14 s). The SecureSenseTM algorithm correctly diagnosed sustained and non-sustained lead noise recordings without compromising detection of VT/VF. Use of the algorithm may reduce inappropriate shocks and alert clinicians to lead noise indicative of lead failure.

Objective: After several years of relative stability in Iraq, the emergence of the Islamic State militant group has spurred a resurgence of violence. This study explores the impact of the conflict on the overall injury profile to estimate the proportion of injury fatalities related to conflict and better understand how violence has affected nonconflict-related injuries. Design: Routine prospective injury surveillance operated by the Iraqi Ministry of Health. Setting: Surveillance data were collected from coroner offices in eight pilot governorates: Al-Anbar, Baghdad, Basrah, Erbil, Kerbala, Maysan, Ninevah, and Al-Sulaimaniya. Participants: We analyzed all fatalities from external injury causes recorded between January 1, 2010 and December 31, 2013. Analysis included 32,664 fatal injuries. Results: Of all injury fatalities reported, 27.1 percent were conflict-related fatalities, approximately the same proportion as road traffic-related fatalities (24.4 percent) and other unintentional injuries (27.5 percent). The proportion of fatalities from conflict was approximately three times higher among males than females (33.0 percent and 10.3 percent, respectively) and four times higher among adults than children (29.8 percent and 7.3 percent, respectively). The total number of injury fatalities remained stable between 2010 and 2012; an increase in injury fatalities in 2013 was driven primarily by increases in fatalities from both interpersonal violence and conflict. Conclusions: From 2010 to 2013, nearly one in four injury fatalities in Iraq was attributable to conflict, a notably higher proportion than other conflict-affected countries in the region. The overall profile of nonconflict injuries in Iraq is also distinct from other countries of similar socioeconomic level that have not experienced violence.

The case of a 77-year-old man admitted for suspected epileptic seizure is reported. Patient history showed implantation of a single-chamber implantable cardioverter-defibrillator (ICD) after cardiac arrest in 2007 with replacement in 2012 due to battery depletion; the patient reported no previous syncope, unconsciousness or seizures. Interrogation records of the ICD showed five ventricular tachyarrhythmia episodes that corresponded to the "seizure". Further examination revealed incorrect position of the RV-lead. Diagnosis was a provoked epileptic seizure due to undersensing of ventricular tachycardia because of improper ICD lead implantation in the coronary sinus. Treatment consisted of implantation of a new device with an additional ICD lead into the right ventricle.

To compare psychological difficulties experienced during the initial acute hospitalization and the last follow up visit for children with electrical injuries (EI) and children without electrical injuries (non-EI). We hypothesized that children with electrical burns would have different psychological outcomes.This retrospective study compared emotional and cognitive functioning of EI patients and a matched group of survivors of other burns.Medical records of 67 patients with and without EI were reviewed. For the EI group, the mean age at injury was 12.6±3.9 years, the mean age at follow up was 15.5±4.6 years, and mean TBSA 32±21%. For the Non-EI group, the mean age at injury was 12.4±3.9 years, the mean age at follow up was 14.5±4.7 years, and mean TBSA 32±21.5%. During the acute hospitalization, a significant difference was found between the groups in the area of neuropathic pain (Chi-square tests p0.011). Individuals with EI were more likely to have acute stress disorder/post-traumatic stress disorder as well as amnesia of the accident than the controls; however, this did not reach statistical significance. No differences were found between the groups in other psychological areas. Follow up information from the last documented psychology/psychiatric visit revealed an equal number of patients experienced anxiety disorders, depression, grief, behavioral problems, and cognitive difficulties.Some differences were evident between the groups immediately after injury; however, long term outcomes were similar.

Defibrillation testing (DT) has traditionally been performed at the time of implantable cardioverter defibrillator (ICD) insertion. However, there has been a trend away from conducting DT, in part due to observational studies showing uncommon but serious complications related to DT. More recently, several randomized trials have shown no improvement in the efficacy of clinical shocks among patients assigned to have DT. These trials also suggest a modest increase in perioperative complications related to DT; however, the overall rate of complications was very low. This review focuses on the prevalence of complications associated with DT and elaborates on a number of indications for DT.

Controversy still exists regarding inpatient monitoring of patients exposed to electrical injuries. In a monocentric retrospective study, we evaluated the medical records of 169 patients admitted to the University Hospital of Cologne from January 2000 to January 2014 because of electrical trauma. The electrocardiogram (ECG) data of 40 patients were missing. Patients in our collective were predominantly young men (60 %) with an average age of 17.5 ± 17 years (1 year to 73 years). The electrical trauma occurred occupational (20 %), domestic (65 %), and during leisure time (15 %). In the high-voltage (≥ 1000 V) group (n = 7; 71 % male; 40.0 ± 19.4 years) one death was reported, related to an open intracranial injury and cardiac arrest. Of the six surviving patients five showed normal ECGs and one a sinus tachycardia. In the low-voltage (

In this article, the authors discuss electric shock fatalities in Aydın province and compare these findings with the findings of other studies conducted in Turkey and worldwide. Data were gathered from 2001-2013 autopsy reports retrospectively. A total of 34 cases were reviewed in terms of age and gender, scene and time of event, number of lesions and their locations, organ injuries, origin of electricity, and degree of burns. In all cases, electrical death was accidental. Electrical shock fatalities were most common in the 30 to 39 age group. Fourteen cases (41.2%) involved workers: 7 cases (2.6%) were agricultural workers, 4 cases (11.8%) were housewives, 2 (5.9%) were electrical workers, and 7 (20.6%) were unemployed or in other occupations. The authors are addressing this public health problem to minimize the number of electrical deaths.

Background The arboreal nature of rhesus macaques makes them vulnerableto electrocution from high-voltage industrial supply as well as low-tensiondomestic wires. The data on pattern of electrocution injuries and electrocu-tion mortalities in free-ranging rhesus macaques are rarely reported.Methods From January 2011 to 2013, the cases of accidental electrocutioninjuries were recorded in difference to sex, age group, season, body regiondistribution, contact details, and extent of injuries in free-ranging rhesusmacaques (Macaca mulatta) of Shivalik hill areas.Results electrocution injuries were highest in juveniles (52.05%), followed byadults (30.13%) and old (10.95%) rhesus macaques. Of the 73 casesrecorded, 23 (31.50%) succumbed to death following severe electrocutionand associated injuries. The intensity and body region distribution of electro-cution injuries was recorded.Conclusion High-voltage current is the most common factor for fatal injuries.Strategies to avoid such electrocutions include burying all lines and trans-formers, shielding and insulating all high-tension lines, installing bridges thatmonkeys, and other arboreal species can use to move around.IntroductionOf the 15 species of non-human primates present inIndia, only three are commensal, the Rhesus (Macacamulatta), Bonnet (Macaca radiata), and the Commonlangur (Seminopithecus entellus). Of these, only theRhesus macaque (M. mullatta) is the most commoncommensal monkey of North India [23, 30]. Thesegregarious monkeys which live in groups of up to 30individuals have managed to survive in cities and alsothrive is a testament to this fact as a result of whichthe conflict between humans and these primates iscommon and increasing [9, 19, 31]. In Himachal Pra-desh, for example, nearly 68,000 of the approximately2, 24,000 rhesus macaque population occur in ruraland urban areas of the Shivalik hills. Moreover, thispopulation is stated to be on the rise and macaqueincreasingly becoming commensal due to change intheir feeding habits in a wide range of habitats. Thecommensal behavior of monkey is attributed toincreased interaction of these primates with humansespecially in urban areas, road sides, villages andother public places etc. The monkey human interac-tion is increasingly acquiring monkey man conflictdimensions often referred to as ‘monkey menace’.Some aspects of city life are very dangerous liketreacherous roads, electric cable wires crisscrossing allover the place and of course the petty attitudes ofsome people and dogs. Macaques mainly because oftheir arboreal and climbing nature are highly vulnera-ble to electrocution by electric wires. Macaques arehighly susceptible to electric injuries and often getelectrocuted by low-tension household current orfrom high-tension electric wires.

Contact with high- or low-voltage electricity can cause injury. Low-voltage damage is more common and widespread, although there is little information on it in the literature. Exposure to an electrical current can effect every organ system in the body. The degree of damage is related to many factors, including the duration of exposure, type of current, and nature of the affected tissue. An unusual low-voltage electrical injury with a serious pulmonary lesion is presented, including the clinical intervention and imaging findings. We present a 20-year-old male electrician who sustained direct electrical damage to the pulmonary parenchyma, with no signs of chest wall damage, when exposed to a 380 V shock while working. Imaging demonstrated an electrical burn of the posterior right lower lobe. This case demonstrates that a low-voltage electric current can cause lung damage. A timely diagnosis is required for treatment.

Objective To summarize the characteristics of cases of electrocution due to direct current （DC） electronic hunter, and to provide references for forensic identification. Methods Four cases of electrocution due to DC electronic hunter were collected. Statistical analysis was carried out from the perspective of the scene and electric marks distribution, damage characteristics and histopathological changes. Results All the 4 cases of electrocution were accidental events. There were multiple electric marks, most of which were located in the lower limbs with serious damage. Some strip type electric marks were visible. Conclusion The distribution, morphological characteristics and severity of the electric marks caused by DC electronic hunter are different from those of the ordinary low-voltage alternating current damage. It is alerting that there would be actions of destroying the scene and abandoning the corpse in such cases.4例直流电子捕猎器电击死亡分析.目的 总结直流电子捕猎器电击死亡案件的特征，为法医学鉴定提供参考。 方法 收集4例直流电子捕猎器电击死亡案例，从案件现场及电流斑分布情况、损伤特征、组织病理学变化等角度进行统计分析。 结果 4例直流电子捕猎器电击死均为意外事件，均有多处电流斑，多位于下肢且损伤严重，部分可见长条状电流斑。 结论 直流电子捕猎器电击死亡电流斑的位置分布、形态特征及严重程度均异于普通低压交流电损伤，警惕此类案件有破坏现场或抛尸行为。.法医病理学；电击伤；电子捕猎器；直流高压电；电流斑.

Elektrik yaralanmaları tüm dünyada görülen önemli sağlık sorunlarından birisidir. Bu yaralanmalar, küçük deri yanıklarından yaşamı tehdit eden iç organ hasarına neden olabilirler. Bu çalışmanın amacı elektrik yaralanmaları ile acil servise başvuran hastaların klinik bilgilerini değerlendirmektir.Bu çalışmada, Mersin Üniversitesi Acil Tıp Anabilim Dalı'na 01.01.2012-31.12.2016 tarihleri arasında elektrik yaralanması nedeniyle başvuran hastalar retrospektif olarak incelendi. Hastaların, demografik, klinik ve laboratuvar bulguları kaydedildi.Çalışmaya, 103'ü erkek olmak üzere toplam 124 hasta alındı. Tüm hastaların yaş ortalamaları 31,5 ± 11,2 idi Hastaların %85,5'i düşük voltaj, %14,5'i ise yüksek voltaja maruz kalmıştı. Yüksek voltajlı yaralanmayla gelen vakaların tamamının iş kazası olduğu görüldü (p

İnsanoğlunun geçmiş dönemlerden itibaren birçok biçimde enerji ihtiyacına talepleri oluşmuştur. Bu oluşan talepleri karşılama konusunda en önemlisi ve halen günümüzde en çok ihtiyaç duyulan enerji çeşidi elektrik enerjisidir. Elektrik enerjisine olan bu yüksek talebin ilerleyen dönemlerde de aynen bu şekilde hızlı artışlar göstereceği muhtemel bir gerçektir. Ayrıca bu kadar sık bir şekilde elektrik enerjisi kullanımı hayatımızda bazı olumsuzlukların yaşanmasına da sebep olabilmektedir. Bunlar elektrik enerjisinden kaynaklanan kazalardır. Bu kazaların oluşmasındaki en önemli etken bilgisizlik ve yanlış davranışlara sonucu olumsuz etkilerin yaşanmasında zemin hazırlanmasından dolayı kaynaklanmaktadır. Elektrik kazalarının önlenmesi konusunda alınması gereken tedbirler dizisinin tamamı bir arada kullanılmalıdır.Günümüzade elektrikaile alakalı işakazalarının yaşanmasınada en sıkaolarakarastlananı elektriğinainsan vücudunaaçarpması yaniaetki etmesiahususu olarakagösterilebilmektedir. Buaatipaaelektrik kazalarınınaaönlenmesi konusundaaaalınması gerekenaatedbirlerin en başındaaçalışanlara veaelektriği hayatındaakullanan herkeseabu konu hakkındaagerekli eğitimlerinaverilmesi gelmektedir. Çalışmamızdaabu noktalaraadeğinmek veaöneminden bahsetmekaiçin literatür araştırmasıave anketadeğerlendirmesiayapılmıştır. Çalışmamızın birinciabölümünde çalışmanınaamacı, konusu, soruları, problemiaveasınırlılıklarından bahsedilmiştir. İkinciabölümde elektrikaile alakalıagenel tanımlamalar ve tarihçeden bahsedilmiştir. Bununaayanı sıra elektriğinaazararlı etkilerindenaakorunmaaayöntemleri detaylıabir şekilde altabaşlıklar halindeatanımlanmış veaalınması gerekenaönlemlerden bahsedilmiştir. Enaason bölümdeaaanket ve literatürden hareketleaasonuç kısmınaaayer verilerekatezatamamlanmıştır.Anahtar Kelimeler: İnşaat, Elektrik, Değerlendirme Humanabeings haveademanded energyademands inamany waysasince theapastaperiods. This isathe most importantathing inameeting theademands andathe energyatype thatais still mostaneeded today isaelectricity energy. Thisahigh demandafor electricityais aareal possibilityathat it willashow sucharapid increasesain the followingaperiods. Inaaddition, theause of electricityain such a frequentamanner can alsoacause some negativitiesain our lives. Theseaare accidentsaacaused byaaelectricity. Theamosta importantaafactor inathe formationaof these accidentsais due to theafact that theaignorance andawrong behavior result inanegative effects onathe preparationaof the ground. Theaprecautions toabe taken in theaprevention ofaelectric accidentsamust be usedatogetheraall at once.Today, theamost common occurrenceaof electricity-relatedawork accidentsacan be seen as theaimpact of electricityaon the humanabody. The precautionsato be takenain the preventionaof this kindaof electric accidentsaare given toathe employees andathose who useaelectricity inatheir lives. Thealiterature surveyaand questionnaireaevaluationawere conducted toaaddress this issueaand to talkaabout its significanceain our work. Inathe first part ofaour work, theaaim, the questions, theaproblems andalimitations ofaworking are mentioned. Inathe secondapart, general definitionsaand historyarelated toaelectricity are mentioned. Inaaddition to this, theamethods of protectionafrom harmful effectsaof electricityaare described inasub-headings in detailaand the precautions toabe takenaare mentioned. Inathe last part, theathesis is completedawith the result ofathe questionnaire andaliterature.Key Words: Construction, Electricity, Evaluation 102

The effect of gestational age and other factors that could influence the outcome of an electric shock in pregnancy have not been defined yet. Objective of this study is to provide reliable data on medical issues linked to electric shock in pregnancy.Authors consulted the most important scientific databases investigating reactions to electric shock in pregnancy, analyzing mechanism of electric shock, gestational age at the time of injury, the post-shock complications, interval from injury to delivery and fetal and maternal outcome.The spectrum of electrical injuries in pregnancy ranges from transient unpleasant sensation with no effect on the fetus to sudden maternal and fetal death. The clinical presentation of the fetal injury may manifest immediately or even postnataly. Reported outcomes include spontaneous abortion, placental abruption, cardiac arrhythmias, fetal burn and intrauterine fetal death. If the pregnancy is continued, decreased fetal movements and asphyxia, pathological fetal heart patterns, intrauterine fetal growth retardation, damage to the fetal central nervous system and oligoamnios can occur.More large prospective observational studies are necessary for a proper insight into the expected outcomes of the electric shock in pregnancy as well as for a final definition of monitoring procedures of such pregnancies.

Electrical injury (EI) produces a variety of physical, cognitive, and emotional consequences. Psychiatric and neurocognitive symptoms may complicate survivors' psychosocial adjustment and ability to return to work. However, due to a paucity of longitudinal research, the long-term course of EI remains poorly understood. The purpose of this study was to investigate psychiatric and functional status in EI patients over a decade after injury. Fourteen EI patients who originally underwent baseline neuropsychological evaluation participated in this long-term follow-up. Participants completed a telephone survey of functional status, neuropsychological symptom checklist, and the Psychosocial Adjustment to Illness Scale Self-Report. Participants were grouped according to baseline Beck Depression Inventory (BDI) scores. After an average of 12.36 years postinjury, participants with elevated baseline BDI scores experienced difficulty across multiple domains of psychosocial adjustment at follow-up. This group was also less likely to return to work and exhibited a significant increase in psychological distress. EI results in significant chronic psychiatric complaints for many survivors. In the current sample, psychiatric sequelae of EI continue to persist over a decade after injury. Moreover, elevated baseline BDI scores predicted worse outcomes for vocational and psychosocial adjustment. Findings underscore the impact of emotional symptoms on recovery and need for specialized psychiatric intervention immediately following injury.

Out-of-hospital cardiac arrest patients require immediate interventions by bystanders and emergency medical services (EMS). However, in many low- and middle-income countries (LMIC), bystanders witnessing a cardiac arrest rarely perform chest compressions and contact EMS. This paper attempts to draw lessons from a case of a patient with a cardiac arrest who could have survived with immediate interventions. A 40 year old man collapsed following electrocution at a construction site. His colleagues immediately transferred him to hospital via taxi, without performing chest compressions. At the hospital he showed ventricular fibrillation; resuscitation attempts failed and he died. Ventricular fibrillation due to electrocution is a benign type of cardiac arrest. The chance of survival increases with immediate chest compressions and prompt defibrillation. We discuss the reasons why the bystanders did not perform resuscitation or contact EMS and identify approaches for the improvement of pre-hospital care in LMICs.

The findings of histological examination and the results of energy-dispersive X-ray spectrometry (EDX) analysis were compared to identify skin metallization in experimental electrical injury. Rats were divided into three experimental groups (n = 5, each group): control, current exposure for five seconds, and current exposure for ten seconds. A relatively high peak of copper, which was used as an electrical conductor, was detected in formalin-fixed skin samples of the two current exposure groups by EDX. There was a significant increase of the specific X-ray intensity in the two current exposure groups compared to the control group. On histological examination, epidermal nuclear elongation was observed in all samples of the two current exposure groups. However, deposition of metal was observed in two samples of each current exposure group. Metallization is an important finding for the diagnosis of electrocution. The present results suggest that EDX analysis is useful for the proof of metallization in electrocution, even where it is not identified on morphological examination.

While the physiologic effects of conducted electrical weapons (CEW) have been the subjects of numerous studies over nearly two decades, their effects on neurocognitive functioning, both short-term and long-term, have only recently been studied. In a 2014 study involving use-of-force scenarios, including a CEW scenario, we found that there was a decline in neurocognitive performance immediately post-scenario in all groups; however this effect was transient, of questionable clinical/legal significance, not statistically different between the groups, and, returned to baseline by one hour post-scenario. Two subsequent studies by other authors have also found transient neurocognitive effects in the immediate post-exposure period; however, in one study, the effect was greater in one measure (of 5) for the CEW compared to exertion, and the authors suggested that this effect could have implications for the Miranda waiver obtained before custodial interrogation as well as consent. In our current study, we compared the neurocognitive effects of an exposure to a CEW to another exertion regimen, as well as to alcohol intoxication given the latter has significant established case law with regard to the Miranda waiver and consent. Such a comparison may offer more insight into the clinical/legal significance of any measured changes. As with the prior studies, the neurocognitive performance decrements of the CEW and exertion regimens, found only in one measure in this study (of three), were transient, and here, non-significant. Only alcohol intoxication resulted in statistically significant performance declines across all measures and these were persistent over the study period. Given that the neurocognitive changes associated with the CEW were non-significant, but were significant for alcohol intoxication, and given that current case law does not use intoxication as a per se or bright line barrier to Miranda and consent, our results do not suggest that a CEW exposure should preclude waiving of Miranda rights or obtaining consent.

Introduction: High-tension electricity can cause devastating injuries that may result in abdominal wall loss, visceral damage, and sometimes major threat to life. The visceral organ may be exposed after debridement and require flap cover, but the tensile strength of abdominal wall may be lack even if flap transplanted. Methods: From April 2007 through May 2015, 5 patients with severe abdominal electrical injury were treated at our hospital. Exploratory laparotomy was performed based on their clinical manifestations and debridement findings of abdominal wall at early stage, and decision regarding technique for reconstruction of abdominal wall was based on an assessment of the location and extent of the defect. Medical records were reviewed for these data. Results: Clinical evaluation and debridement findings of the abdomen revealed 4 patients with suspicious visceral damage. Laparotomy was performed in 4 cases, and revealed obvious lesion in 3 cases, including segmental necrosis of small intestine, partial necrosis of diaphragm, left liver and gastric wall, and greater omentum. Five patients underwent abdominal wall reconstruction using island retrograde latissimus dorsi myocutaneous flap or free/island composite anterolateral thigh myocutaneous flap. All flaps survived, abdominal bulging occurred in 3 cases after follow-up of 12 to 36 months. Conclusions: The clinical manifestations and wound features of abdomen collectively suggest a possible requirement of laparotomy for severe abdominal electrical burns. Retrograde latissimus dorsi myocutaneous flap or composite anterolateral thigh myocutaneous flap is an effective option for reconstruction of abdominal wall loss, the long-term complication of abdominal bulging, however, remains a significant clinical challenge.

Electrical injury is damage caused by an electrical current passing through the body. We have previously reported that irregular stripes crossing skeletal muscle fibers (python pattern) and multiple small nuclei arranged in the longitudinal direction of the muscle fibers (chained nuclear change) are uniquely observed by histopathological analysis in the skeletal muscle tissues of patients with electrical injury. However, it remains unclear whether these phenomena are caused by the electrical current itself or by the joule heat generated by the electric current passing through the body. To clarify the causes underlying these changes, we applied electric and heat injury to the exteriorized rat soleus muscle in situ . Although both the python pattern and chained nuclear change were induced by electric injury, only the python pattern was induced by heat injury. Furthermore, a chained nuclear change was induced in the soleus muscle cells by electric current flow in physiological saline at 40 °C ex vivo , but a python pattern was not observed. When the skeletal muscle was exposed to electrical injury in cardiac-arrested rats, a python pattern was induced within 5 h after cardiac arrest, but no chained nuclear change was observed. Therefore, a chained nuclear change is induced by an electrical current alone in tissues in vital condition, whereas a python pattern is caused by joule heat, which may occur shortly after death. The degree and distribution of these skeletal muscle changes may be useful histological markers for analyzing cases of electrical injury in forensic medicine.

A normal bone marrow microenvironment plays a very important role in the normal functioning of hematopoietic stem cells. Once disturbed, this microenvironment can become favorable for the occurrence of blood disorders, cancers, and other diseases. Therefore, further studies on the bone marrow microenvironment should be performed to reveal regulatory and stem cell fate determination mechanisms and promote the development of bone marrow transplantation, tissue repair and regenerative medicine, and other fields. A small animal model for further research is also urgently needed. In this study, an electric shock device was designed to elicit a femur bone marrow microenvironment injury in mice. A wire was inserted into the distal femur but not into the proximal femur, and the bone marrow microenvironment was evidently damaged by application of 100 ± 10 V for 1.5 ± 0.5 min ; mortality, however, was low in the mice. Gross observation, hematoxylin and eosin staining, immunohistochemistry, bright-field microscopy, and micro-CT scanning were also conducted. A large number of new blood capillaries and sinusoids appeared in the injured distal femur after 2 weeks. The capillaries in the injured femur disappeared after 4 weeks, and mature blood vessels were scattered throughout the injured area. Red blood cells disappeared, and the cellular structure and trabecular bone were better than those observed 2 weeks previously. Thus, we developed a simply operated, accurate, reliable, and easily controlled small animal model as a good technical platform to examine angiogenesis and segmentation damage in the bone marrow microenvironment.

We utilized cerebral blood volume (CBV) magnetic resonance imaging and diffusion tensor imaging (DTI) to investigate changes in cognitive networks in patients experiencing cognitive dysfunction following electrical injury. Cognitive function was assessed across various domains, including attention, verbal memory, executive function, and language. Depressive symptoms were also evaluated. CBV maps and DTI measures were obtained from 24 patients (age, 41.8 ± 5.8 years; education, 13.3 ± 1.9 years) and 24 healthy controls (age, 42.3 ± 2.7 years; education, 14.3 ± 1.9 years). CBV maps and DTI measures were compared between patients and controls, and correlations between these measures and each cognitive assessment score were examined. Patients exhibited lower attention, verbal memory, and executive function scores than controls (all p

Hydrocephalus has rarely been reported to be associated with trigeminal neuralgia. Here we report for the first time a case of trigeminal neuralgia associated with hydrocephalus, whose symptoms completely resolved twice after ventriculoperitoneal shunting. The patient had a high-voltage electric shock to his head, which has not been reported in a patient with ventriculoperitoneal shunt to the best of our knowledge. The possible underlying mechanism of this situation is discussed in addition to a brief review of the literature.

Overseas contingency operations which occur in areas lacking medical infrastructure pose challenges to the stabilization and transportation of critically ill patients. In particular, metabolic derangements resulting from acute kidney injury (AKI) make long-distance aeromedical evacuation risky. Here, we report the first modern use of in-flight continuous veno-venous hemofiltration (CVVH) for intercontinental aeromedical evacuation. Hospital and transport records were reviewed for a 31-yr-old male active duty service member who sustained 40% total body surface area full thickness burns after high-voltage electrical exposure in the southern Philippines. He was evacuated to the Burns Centre at Singapore General Hospital, where CVVH was initiated for anuric AKI secondary to rhabdomyolysis. The United States Army Institute of Surgical Research (USAISR) Burn Flight Team transported the patient to the USAISR Burn Center at Fort Sam Houston, TX, USA. CVVH was performed in-flight for 15 h out of 19.5 h of total flight time. CVVH settings were maintained as follows: blood flow 250 mL/min; replacement fluid rate 3,500 mL/h; and no ultra-filtrate removal. Unfractionated heparin at 500 units/h was utilized for regional anticoagulation. No filter clotting was encountered; a planned filter change was performed during a midway refueling stop. Pre-flight hyperkalemia was managed with low-potassium replacement fluid. No fluid was removed in the setting of large wound insensible losses. The patient remained hemodynamically stable and required no vasoactive medications. Continuous veno-venous hemofiltration can be used safely during high-altitude flight to evacuate casualties with AKI from distant contingency operations. The use of portable hemodialysis equipment in this case also proves the feasibility of deploying renal replacement therapies to more forward facilities than previously considered.

Deaths which occur in association with agricultural electric fences are very rare. In fact, electric fences have undoubtedly saved numerous human and animal lives by safely and reliably keeping livestock confined to their fields and enclosures and thus preventing motor vehicle incidents when livestock get onto roads and highways. Accidental and intentional human contact with electric fences occurs regularly and causes little more than transient discomfort, however, on exceptional occasions, contact with electric fences appears to be directly related to the death of the individual. The precise pathophysiological cause of these deaths is unclear. We present two cases of deaths associated with electric fences, discuss the possible pathophysiological mechanisms in these cases, and suggest a universal approach to the medico-legal investigation and documentation of these deaths.

CASE A 43-year-old man suffered household electric shock from 220 V alternating current when he accidently touched a live wire with his left hand. Subsequently, he was diagnosed to have osteonecrosis of the left femoral head and underwent total hip arthroplasty. CONCLUSION We suggest that the electric current could have thrombosed the terminal subsynovial vessels of the femoral head, leading to osteonecrosis. To the best of authors' knowledge, only 2 cases of osteonecrosis of the hip after electric shock have been reported in the literature. A literature review of the delayed consequences of electric shock injuries pertaining to orthopaedics is also presented.

CONTEXT: Electrical burns are an important etiology in dealing with patients suffering from burns. In situations of extensive deep lesions of multiple organs and systems affecting young and economically active people, there is a need for expensive multidisciplinary treatment, with a high socioeconomic cost for the community. Among the permanent injuries that explain this high cost, eye injuries stand out, since they are widely disabling. Although rare, lesions of the posterior segment of the eye are associated with higher incidence of major sequelae, and thus deserve special attention for dissemination and discussion of the few cases observed.CASE REPORT: The authors report the case of a patient who suffered high-voltage electrical burns and presented bilateral maculopathy, which evolved with a need for a surgical approach to repair retinal detachment and permanent low visual acuity.CONCLUSION: This report highlights the rarity of the etiology of maculopathy and the need for campaigns for prevention not only of burns in general, but also especially of electrical burns.

The aim of this study was to investigate the epidemiological characteristics of low-voltage electrocution deaths in Guangdong, China. Three thousand three hundred seventy autopsy reports from the Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, over a period of 10 years (2001-2010) were reviewed, of which 71 low-voltage electrocution cases were identified. The descriptive statistical analyses were carried out with the application of SPSS 19.0 software. Electrocution accounted for 2.11% of all autopsied cases. The age range was 3 to 57 years with a mean age of 31.77 ± 11.0 years. The average age of male victims was 33.08 ± 10.77 years, and that of female victims was 22.63 ± 11.06 years. The majority of the victims (87.33%) were male. Among the circumstances leading to electrocution, most of them occurred in factory and in the street. Considering the contact details, deaths were caused most frequently by touching electrical wires (n = 27, 38.02%), followed by touching charged machine (n = 20, 28.17%). There were no suicide and homicide cases. Of all electrocution cases, 50.70% occurred during the summer period from June through August. The upper extremity was the most frequently involved contact site (59.72%). No electrical burn marks were present in 14 cases (19.72%). Our results indicated that most deaths from electrocution occur more often in factories, in summer seasons, and to young male workers, which can help in the development of a differentiated strategy for the prevention of electrocution, while taking into consideration sex, age, occupation, and season of the year.

In this study, we explored the experiences of 13 individuals who had suffered an electrical injury at work and had subsequently returned to work. In this article, we report on the social, institutional, and relational elements that workers perceived to influence return to work experiences and the provision of workplace accommodations. These elements included (a) worker resources, (b) job characteristics, (c) workplace setting, (d) injury elements, (e) workers’ compensation context, and (f) supports and advocacy provided. We conclude that the availability and provision of supportive accommodations are influenced by a multiplicity of interrelated factors including the legitimacy of resulting impairments following electrical injury, institutional structures (e.g., compensation and health care systems), the social relations of work, and broader labor market and economic contexts. Those workers who were vulnerable because of factors such as employment circumstances or labor market conditions were often poorly supported when returning to work following electrical injury.

Deaths due to electric shock are increasing despite stringent laws and preventive measures. These shocks are a leading cause of death amongst construction workers. In about 20% of the cases, no visible injury due to electricity can be seen. In some cases, non-electrical injuries are present and at times there are no eyewitnesses to provide a detailed account of events. In such circumstances, examination of scene of death, autopsy and accident reconstruction with the help of an electrical expert are all necessary to determine the cause of death. Here, we report one such case where a mason working on the second floor of a building under construction sustained an electrical injury, following which he was thrown to the ground sustaining a fatal traumatic injury. After careful consideration, his death was attributed to the head injury.

Rationale. Taking into account the incidence and the severity of electrocutions, we consider it extremely necessary to find effective, appropriate and particularized therapeutic solutions aimed at improving the survival, decreasing the mortality, ensuring a superior functional and aesthetic effect and facilitating the social reintegration. Given the severity of the general condition of the electrically injured patient and the fact that any worsening of the lesions has a systemic echo, the selection of the timing for re-excision is very important. The postponement of the surgical timing can break the precarious metabolic equilibrium and can hasten the installation of the multisystem organ failure (MSOF). Objective. The study is intended to establish a possible connection between the clinical evolution of the electrically injured patient and the dynamics of three important biological parameters, able to provide data concerning the therapeutic attitude to be followed. The patients with a diagnostic of high-voltage electrocution, who will be admitted to the Clinic, will be followed for a period of 2 years. The parameters to be followed daily will be: - Creatin-kinase, as a marker of muscular damage - Hemoglobin, as a marker of tissue oxygenation - Leukocytes, as an indicator of a possible septic evolution. The therapeutic alternatives, including the administration of antiplatelet drugs will be studied. Methods and Results. In the period October 2010-June 2013 a total of 12 cases of high-voltage electrocution were admitted in our clinic. Among these, some could be placed in the study of 7 cases, as the remaining patients died within the first 24 hours of hospitalization due to the endured lesions. All the patients were admitted to the ICU ward that supported the treatment and monitoring until their stabilization, at which time they were transferred to the ward. All the patients received anti-thromboxane treatment from their admission (injectable NSAIDs associated with antisecretory drugs). By mutual agreement with ICU service, Dipyridamole was not introduced because of the “steal effect” in the viable areas to the detriment of the already ischemic areas, the drug effect being obvious in vitro, but hard to be proven in the clinical case. The relationship between the CK level and the clinical appearance of the ischemic areas is relative. We cannot conclude that an increased level of CK is equivalent to an enlarged ischemic area and even less it does not provide us direct information concerning the best time for re-excision. The presence of a viable blood supply around the necrotic tissue will lead to an important resorption of degradation products in that area, a quasinormal level of CK having no value. The sealing of the necrosis areas and the lack of immediate resorption does not have a positive prognostic value. Taking into account that the electrocutions are mostly multiple injuries, the CK level can increase even after some muscular damages, fractures, independent of the actual electrocution lesion. In one case, the patient suffered from electrocution at both thoracic limbs. With the carbonization of the hands and grifa installed up to the level of the elbow fold, he stayed for 6 hours at the accident site until he had been recovered. At the moment of presentation to the hospital, his consciousness condition was satisfactory but the CK level was of over 20000 IU, becoming rapidly non-detectable, in combination with black urine. The patient's condition deteriorated quickly, and, although the bilateral shoulder disarticulation has been carried out, he died in the next 12 hours. Discussion. As a conclusion, the CK level did not prove itself a prognostic for the surgical timing or the actual surgical attitude and could be influenced by a whole series of factors, dependent or not on the electrocution lesion. A radical attitude is to be preferred in cases with established ischemia; the prognostic being the more reserved the larger the damage and the longer the period of time from the event. The established treatment is of renal support and treatment of acute renal injury (AKI) subsequently installed. An increased level of leukocytes is always present as in any severe trauma, even if there are no immediate signs of infection of the electrocution lesions. Taking into account that the electrocution lesion as well as the one caused by burning destroys the natural defense barrier represented by the skin, the infection risk is major and that is why the therapeutic protocol stipulates the immediate establishment of a treatment with broad-spectrum antibiotics or with an association of antibiotics. The increase of the leukocytes level under antibiotics treatment involves either the contamination with a germ that is not sensitive to the respective antibiotic or the persistence of necrosis areas which secondarily infect, and where antibiotic penetration is very low. Therefore, the excision of the compromised tissues is an absolute necessity. In terms of prognostic, the increase of the leukocytes number signified an insufficient excision and indicated the resuming and deepening of the excisions. Taking into account that the patient has been admitted through the ICU service, the risk of contracting severe infections with selected germs is real. Another risk is that of infection with Clostridium difficile following the prolonged utilization of broad-spectrum antibiotics, especially in patients with associated diseases and reduced immunity per primam. The existence of completely separate circuits should solve the problem of contamination with bacteria of selected species; unfortunately, in our cases, we have faced this problem and the utilization of last choice antibiotics (Imipenem, Vancomycin, Targocid, etc.) as well as the association of immunoglobulins was necessary. All the patients admitted in the study received anti-thromboxane drugs in order to limit the ischemic process at tissue level. Despite the efforts we have made, the lack of blood and its derivatives or simply the negligence in patient monitoring, allowed the decrease, even transient of the Hb level, sometimes only for a few hours, but enough to allow the deepening of the ischemic lesions. Excisions were carried out in all the patients in emergency or even amputations of the extremities, with the wish to limit the extension of the ischemic lesions and the resorption of cell degradation products. The amputations performed in emergency did not always represent a saving solution; however, they remained the most effective measures when they were carried out immediately after the accident and obviously in viable tissue. The increase of CK is not an indicative factor itself in making re-excisions but orients the therapeutic approach, the utilization of the dialysis when the values do not decrease by treatment for renal support and the forcing of diuresis is required. The normalization of CK indicates the time when we can start the covering of the defects resulted as a consequence of the excisions. The level of the leukocytes represents both a prognostic factor and an indicative factor for the re-excision of the ischemic areas. An increased level under antibiotic therapy signifies either an incomplete excision or the contamination with flora resisting to the antibiotic that has been used. In the light of findings in the caring of the patients with electrocutions, I propose several caring/assessment protocols for the severe electrically injured patient.

Summary Defibrillator shocks, appropriate or not, are associated with significant morbidity, as they decrease quality of life, can be involved in depression and anxiety, and are known to be proarrhythmic. Most recent data have even shown an association between shocks and overall mortality. As opposed to other defibrillator-related complications, the rate of inappropriate and unnecessary shocks can (and should) be decreased with adequate programming. This review focuses on the different programming strategies and tips available to reduce the rate of shocks in primary prevention patients with left ventricular dysfunction implanted with a defibrillator, as well as some of the manufacturers’ device specificities.

ObjectiveTo determine acute and long-term clinical, neuropsychological, and return-to-work (RTW) effects of electrical injuries (EIs). This study aims to further contrast sequelae between low-voltage and high-voltage injuries (LVIs and HVIs). We hypothesise that all EIs will result in substantial adverse effects during both phases of management, with HVIs contributing to greater rates of sequelae.DesignRetrospective cohort study evaluating EI admissions between 1998 and 2015.SettingProvincial burn centre and rehabilitation hospital specialising in EI management.ParticipantsAll EI admissions were reviewed for acute clinical outcomes (n=207). For long-term outcomes, rehabilitation patients, who were referred from the burn centre (n=63) or other burn units across the province (n=65), were screened for inclusion. Six patients were excluded due to pre-existing psychiatric conditions. This cohort (n=122) was assessed for long-term outcomes. Median time to first and last follow-up were 201 (68–766) and 980 (391–1409) days, respectively.Outcome measuresAcute and long-term clinical, neuropsychological and RTW sequelae.ResultsAcute clinical complications included infections (14%) and amputations (13%). HVIs resulted in greater rates of these complications, including compartment syndrome (16% vs 4%, p=0.007) and rhabdomyolysis (12% vs 0%, pConclusionsThis is the first investigation to determine acute and long-term patient outcomes post-EI as a continuum. Findings highlight substantial rates of neuropsychological and social sequelae, regardless of voltage. Specialised and individualised early interventions, including screening for mental health concerns, are imperative to improvingoutcomes of EI patients.

Individuals who have experienced an electrical injury have been reported to demonstrate both acute and delayed cognitive and psychiatric symptoms. The present study assessed 20 electrically injured patients who underwent neuropsychological evaluations twice following their injury. Time since injury, time between assessments, and longitudinal mood changes were evaluated for their potential impact on simple and complex attention outcomes. As an overall group, there was little change over time from low average to average baseline attention/concentration performance. However, results indicated that longitudinal increases in depressive symptoms were consistently associated with poorer performance on a measure of simple and complex attention. Loss of consciousness, litigation status, baseline injury status (acute vs. post-acute), and time between evaluations were not significant predictors of changes in cognitive performance. Implications for the treatment of comorbid psychiatric issues and for future research on victims of electrical trauma are discussed. Language: en

This technical note describes a method for distinguishing normal skin tissue samples from those electrically injured by Fourier transform infrared microspectroscopy (FTIR MSP). Furthermore, the infrared spectral features of electrically injured cells and tissues were evaluated to identify molecular changes in epidermal cells. In the present study, 20 human hand tissue samples were evaluated macroscopically and histopathologically. The electrically injured skin samples were subdivided into 2 regions [normal cell regions (NCRs) and polarized cell regions (PCRs)] and 14 major spectral absorption bands were selected. The spectral results showed that the band absorbance at 1080, 1126, 1172, 1242, 1307, 1403, 1456, 1541, 2852, 2925, 2957, 3075, and 3300cm(-1) increased significantly both in the stratum and non-stratum corneum of the PCRs in electrically injured skin tissues samples. No significant difference was found between normal skin and the NCR of the electrically injured skin samples. The band absorbance ratios of A1172/A1126, A1456/A1403, and A2925/A2957 were significantly increased, whereas the A1652/A1541 ratio was decreased in the PCR of the stratum corneum and non-stratum corneum. Baseline changes from 4000 to near 1737cm(-1) were observed in the spectra of the electrically injured skin samples, which were interpreted in terms of the pathological process involved in electrical injury. FTIR-MSP presents a useful method to provide objective spectral markers for the assisted diagnosis of electrical marks.

Electrical injuries are a form of trauma with extreme gravity and a unique pathophysiology: they affect the entire organism. A wide range of voltages may cause electrical accidents. Complications should be anticipated and prevented in order to minimize the complication risk and assure a vital, functional and esthetic prognosis as good as possible. The article presents a case treated in our clinic together with the unique particular clinical situation and algorithm that led to a favorable result.

It is well known that peripheral nerves are very vulnerable to electricity. However, only a small portion of individuals who have had high-voltage electrical injury exhibit peripheral nerve damage. The aim of this study was to investigate peripheral nerve damage in high-voltage electrical injury, which often occurs in the industrial field. The authors reviewed the medical records of patients who were admitted to their hospital from January 2009 to December 2011, because of electrical injuries. The results of nerve conduction studies (NCSs) were reviewed retrospectively. NCS data of the injured site were compared with those of the opposite noninjured site and follow-up data. Thirty-seven extremities were reviewed. The authors found that 18 of 33 median nerves (48.6%) showed abnormalities in at least one parameter and 15 of 36 ulnar nerves (41.7%) exhibited abnormalities. There was no evidence of demyelination. Eight patients had undergone NCS on the opposite normal extremities. The compound muscle action potential and nerve conduction velocity were higher at the normal site. Follow-up NCS were performed in 14 patients: the compound muscle action potential and nerve conduction velocity values of all patients were improved. High-voltage electricity damaged peripheral nerves by causing axonal injury rather than demyelinating injury. Hence, even if NCSs yield normal findings, peripheral nerves may be damaged. F/U studies and opposite examinations are required for the exact evaluation of peripheral nerve damage.

Background/Aims: Optimizing the treatment regimens of extensive or nonhealing defects is a constant challenge. Tissue-cultured skin autografts may be an alternative to mesh grafts and keratinocyte suspensions that are applied during surgical defect coverage. Methods: Autologous epidermal and dermal cells were isolated, in vitro expanded and seeded on collagen-elastin scaffolds. The developed autograft was immunohistochemically and electron microscopically characterized. Subsequently, it was transplanted onto lesions of a severely burned patient. Results: Comparability of the skin equivalent to healthy human skin could be shown due to the epidermal strata, differentiation, proliferation markers and development of characteristics of a functional basal lamina. Approximately 2 weeks after skin equivalent transplantation the emerging new skin correlated closely to the adjacent normal skin. Conclusion: The present study demonstrates the comparability of the developed organotypic skin equivalent to healthy human skin and its versatility for clinical applications.

Implantable cardioverter defibrillators (ICDs) save lives in patients at risk for sudden death attributable to ventricular arrhythmias, pacemakers (PMs) have been improving symptoms in patients with bradyarrhythmias for decades, and, more recently, cardiac resynchronization devices have improved mortality, morbidity, and quality of life for patients with heart failure.1 However, these devices can also be life-changing for the patients receiving them. The need for long-term follow-up, concerns regarding malfunction, and lifestyle restrictions all affect patients with any implanted device. For patients with ICDs, receiving shocks, both appropriate and inappropriate, can impact quality of life (QOL). Lead or device malfunction can result in unnecessary shocks, and recalls can cause anxiety. Shocks at the end of life can be particularly devastating. However, with careful attention by the healthcare team, both shocks and their impact can be reduced. In addition to shocks, restrictions imposed by the ICD can also impact QOL. The possibility of syncopal arrhythmias and loss of control attributable to shocks, as well, has led to concerns regarding the safety of driving and of sports participation for some individuals, a further burden. Remote monitoring increases the ease of follow-up for patients and physicians and may improve timeliness of management. However, a consequence of remote follow-up has been a decrease in the amount of time electrophysiologists may spend face-to-face with patients, emphasizing the importance of communication between electrophysiologist and primary cardiologist. This article will review ways in which electrophysiologists, general cardiologists, and patients can work together to minimize the burdens that can accompany these devices, often weighing issues of patient QOL, safety, and autonomy. Studies of overall QOL for patients with ICDs have shown mixed results. Some studies have found no significant differences in overall QOL between ICD patients and other cardiac patients,2,3 PM patients, or the general population. …

The aim of this study was to investigate spinal cord injury (SCI) on the basis of diffusion tensor imaging (DTI) in patients with high-voltage electrical injury. We recruited eight high-voltage electrical injury patients and eight healthy subjects matched for age and sex. DTI and central motor conduction time were acquired in both the patient and control groups. We obtained DTI indices according to the spinal cord levels (from C2 to C7) and cross-section locations (anterior, lateral, and posterior). Fractional anisotrophy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were compared between the two groups; additionally, they were compared in relation to spinal cord level and cross-section location. In the patient group relative to the control group, the FA value decreased and the MD and RD values increased in all of the regions of interest (ROI) with statistical significance (p

Electrocution on overhead power structures negatively affects avian populations in diverse ecosystems worldwide, contributes to the endangerment of raptor populations in Europe and Africa, and is a major driver of legal action against electric utilities in North America. We investigated factors associated with avian electrocutions so poles that are likely to electrocute a bird can be identified and retrofitted prior to causing avian mortality. We used historical data from southern California to identify patterns of avian electrocution by voltage, month, and year to identify species most often killed by electrocution in our study area and to develop a predictive model that compared poles where an avian electrocution was known to have occurred (electrocution poles) with poles where no known electrocution occurred (comparison poles). We chose variables that could be quantified by personnel with little training in ornithology or electric systems. Electrocutions were more common at distribution voltages (≤33 kV) and during breeding seasons and were more commonly reported after a retrofitting program began. Red-tailed Hawks (Buteo jamaicensis) (n = 265) and American Crows (Corvus brachyrhynchos) (n = 258) were the most commonly electrocuted species. In the predictive model, 4 of 14 candidate variables were required to distinguish electrocution poles from comparison poles: number of jumpers (short wires connecting energized equipment), number of primary conductors, presence of grounding, and presence of unforested unpaved areas as the dominant nearby land cover. When tested against a sample of poles not used to build the model, our model distributed poles relatively normally across electrocution-risk values and identified the average risk as higher for electrocution poles relative to comparison poles. Our model can be used to reduce avian electrocutions through proactive identification and targeting of high-risk poles for retrofitting. Modelo Predictivo del Riesgo de Electrocucion de Aves en Lineas Electricas Elevadas Resumen La electrocucion en estructuras de energia elevadas afecta negativamente a poblaciones de aves en diversos ecosistemas en todo el mundo, contribuye al riesgo de poblaciones de rapaces en Europa y Africa, y es una causa importante de accion legal contra empresas electricas en Norte America. Investigamos los factores asociados con la electrocucion de aves para que postes que posiblemente electrocuten a una ave sean identificados y sean acondicionados antes de que causen mortalidad de aves. Utilizamos datos historicos del sur de California para identificar patrones de electrocucion de aves por voltaje, mes y ano para identificar las especies que mueren mas frecuentemente por electrocucion en nuestra zona de estudio y desarrollar un modelo predictivo que comparo postes en los que se sabia habia ocurrido una electrocucion (postes de electrocucion) con postes en los que no hubo electrocucion (postes de comparacion). Seleccionamos variables que pudieran ser cuantificadas por personal con poco entrenamiento en ornitologia o sistemas electricos. Las electrocuciones fueron mas comunes en voltajes de distribucion (≤33kV) y durante epocas reproductivas y fueron reportadas mas comunmente despues de que comenzo un programa de acondicionamiento. Las especies electrocutadas mas frecuentemente fueron Buteo jamaicensis (n = 265) Corvus brachyrhynchos (n = 258). En el modelo predictivo, se requirieron 4 de 14 variables consideradas para distinguir los postes de comparacion de los postes de comparacion: numero de puentes (cables cortos que conectan equipo energizado), numero de conductores primarios, presencia de conexiones a tierra y presencia de areas deforestadas y no pavimentadas dominantes en la cobertura de suelo cercana. Al probarlo con una muestra de postes no utilizados para construirlo, nuestro modelo distribuyo los postes nomalmente en los valores de riesgo de electrocucion e identifico el riesgo promedio mas alto para postes de electrocucion en relacion con los poses de comparacion. Nuestro modelo puede ser usado para reducir electrocuciones de aves mediante la identificacion proactiva de postes con alto riesgo.