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1

2003 Nevada Test Site Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for 2003 for the Nevada Test Site. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

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2010 Argonne National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-06-20

3

2006 Pantex Plant Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-05-19

4

2007 Hanford Site Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-07-16

5

2010 Idaho National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-09-26

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2010 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-08-16

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2006 Nevada Test Site Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-04-24

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2006 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-03-06

9

2010 Sandia National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-10-26

10

2007 Idaho National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-05-04

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2010 Kansas City Plant Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-06-20

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2006 Kansas City Plant Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-06-13

13

2010 Hanford Site Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-10-05

14

2006 Hanford Site Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-05-14

15

2008 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-12-10

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2008 Kansas City Plant Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-09-22

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2008 Sandia National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-09-17

18

2007 Sandia National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-02-04

19

2007 Nevada Test Site Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-06-30

20

2007 Kansas City Plant Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-07-13

 
 
 
 
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2008 Nevada Test Site Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-10-05

22

2008 Idaho National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2010-11-23

23

Sports injuries surveillance during the 2007 IAAF World Athletics Championships  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objective: The aim of this study was to analyze all sports injuries incurred in competitions and/or training during the 2007 World Athletics Championships and to prove the feasibility of the injury surveillance system developed for the 2008 Olympic Games for individual sports. Design: Prospective recording of injuries. Setting: 11th IAAF World Championships in Athletics 2007 in Osaka, Japan. Participants: All national team physicians and physiotherapists; Local Organising Committee (LOC) phys...

Alonso, Juan Manuel; Junge, Astrid; Renstro?m, Per; Engebretsen, Lars; Mountjoy, Margo; Dvorak, Jiri

2009-01-01

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A multinational injury surveillance system pilot project in Africa.  

Science.gov (United States)

This paper describes the development of a pilot project to test the implementation of an epidemiological surveillance system for intentional (violent) and non-intentional injuries, at emergency departments in selected hospitals in five African countries applying the World Health Organization's guidelines. We outline obstacles and opportunities encountered during the process. By definition, a surveillance system systematically collects, reviews, and evaluates information to understand the context in which specific injuries occur. Implementation in diverse sociocultural environments in Zambia, Uganda, Democratic Republic of the Congo, Nigeria, and Kenya has provided an opportunity to gather reliable data on injuries for comparisons between these countries. Analysis of the detailed information may permit researchers to generate evidence-based recommendations. Addressed to public authorities, and health authorities in particular, they can help address injury incidence in their communities from a public health perspective. PMID:17955008

Zavala, Diego E; Bokongo, Simon; John, Ime A; Mpanga, Senoga Ismail; Mtonga, Robert E; Aminu, Zakari Mohammed; Odhiambo, Walter; Olupot-Olupot, Peter

2007-12-01

25

Evaluating Utility of Cold-Injury Syndromic Surveillance Data in New York City  

Science.gov (United States)

Objective 1) Develop cold exposure-related injury syndromic case definitions 2) use historical data to compare trends among cases identified in syndromic surveillance and cases identified in NY Statewide Planning and Research Cooperative System (SPARCS) hospital discharge data to evaluate representativeness and 3) develop regression models to examine relationships with cold weather conditions, and compare relationships across case definitions and data sources. Introduction Cold weather exposure-related injuries range from hypothermia to less severe conditions such as frost bite, trench foot, and chilblains, which are all preventable causes of mortality and morbidity. In recent years, NYC has successfully used syndromic surveillance of heat-related ED visits to inform emergency response during heat waves. Similar timely surveillance of cold-exposure related injuries could also inform public health protection measures during severe winter weather or cold season power outages. We conducted a retrospective analysis to compare hypothermia and cold-injury patient case characteristics, as well as temporal and meteorological correlates, between syndromic surveillance data and hospital discharge data. Methods Using chief complaint key words, we developed syndromic case definitions for 1) hypothermia only and 2) all injury caused by environmental cold exposure. Case definitions were applied to an archive of 2008–2010 cold season (October to April) syndromic surveillance data reported from a subset of NYC emergency departments (ED SS), representing 95% of all ED visits in NYC. Relevant ICD-9 codes (991, E901.0, E901.8, E901.9, E988.3) were applied to ED discharge data (ED Dx) to detect hypothermia and cold injury cases. Age, gender, and alcohol involvement were compared using tests of proportion to determine whether characteristics of cases identified through ED SS were representative of cases identified in ED Dx data. Poisson regression models were fit to estimate the relation of daily ED SS and Dx counts with daily temperature, snow depth, and other weather conditions. Models were adjusted for month, holiday, day of week, and year to account for potential temporal confounding. Results Fewer hypothermia and cold injury cases were detected with ED SS than with ED Dx but the two populations did not differ significantly with respect to age and sex. From 2008–2010, there were 292 hypothermia cases with an average annual rate of 1.2 per 100,000 people, and 445 cold injury cases (1.8 per 100,000) identified in ED SS data. Over the same time period, there were 566 hypothermia cases (2.3 per 100,000) and 933 cold injury cases (3.7 per 100,000) identified in ED Dx data. Daily counts of hypothermia and cold injury were correlated across data sources. In preliminary analyses using both case definitions, minimum daily temperature was associated with increases in daily ED SS and ED Dx counts. Mean daily snow depth was associated with ED SS and ED Dx cold injury cases, although not with hypothermia counts. Risk increased at lower temperatures for both case definitions. Conclusions There were no meaningful differences between ED SS and ED Dx weather models. Minimum temperature is associated with both case definitions. Snow depth is associated with cold injury. Daily minimum temperature and mean snow depth are potentially useful in determining timing of surveillance. Syndromic surveillance data are a timely means for monitoring hypothermia and other cold-related injuries, and could provide health departments with useful information during severe winter weather to guide prevention.

Lane, Kathryn; Lall, Ramona; Wheeler, Katherine; Ito, Kazuhiko; Matte, Thomas

2013-01-01

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Injury in China: a systematic review of injury surveillance studies conducted in Chinese hospital emergency departments  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Injuries represent a significant and growing public health concern in China. This Review was conducted to document the characteristics of injured patients presenting to the emergency department of Chinese hospitals and to assess of the nature of information collected and reported in published surveillance studies. Methods A systematic search of MEDLINE and China Academic Journals supplemented with a hand search of journals was performed. Studies published in the period 1997 to 2007 were included and research published in Chinese was the focus. Search terms included emergency, injury, medical care. Results Of the 268 studies identified, 13 were injury surveillance studies set in the emergency department. Nine were collaborative studies of which eight were prospective studies. Of the five single centre studies only one was of a prospective design. Transport, falls and industrial injuries were common mechanisms of injury. Study strengths were large patient sample sizes and for the collaborative studies a large number of participating hospitals. There was however limited use of internationally recognised injury classification and severity coding indices. Conclusion Despite the limited number of studies identified, the scope of each highlights the willingness and the capacity to conduct surveillance studies in the emergency department. This Review highlights the need for the adoption of standardized injury coding indices in the collection and reporting of patient health data. While high level injury surveillance systems focus on population-based priority setting, this Review demonstrates the need to establish an internationally comparable trauma registry that would permit monitoring of the trauma system and would by extension facilitate the optimal care of the injured patient through the development of informed quality assurance programs and the implementation of evidence-based health policy.

Taylor Colman

2011-10-01

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[Unintentional injuries at the Emergency Department Injury Surveillance System--Brazil, 2006].  

Science.gov (United States)

In 2006, the Brazilian Ministry of Health established the Injury Surveillance System Network in Sentinel Services (Rede VIVA) to describe data on injuries victims treated at emergency departments (ED), especially minor injuries which do not cause deaths and hospitalization. This study describes the characteristics of unintentional injuries victims treated in these EDs by means of a transversal descriptive study with data coming from EDs located in 35 municipalities with the highest injury rates. The data were collected during 30 consecutive days in an alternated 12-hour shift. There were a total of 41,677 patients with unintentional injuries, mainly among males (64.8%), people aged 20 to 29 years (23.0%) and low level of education (45.8%). Falls were the main cause (40.1% overall), followed by transport related injuries (26.6% overall). The more frequent place of occurrence were public streets (36.3% overall) and residences (33.6% overall). The body parts most affected were upper members (42.7%), lower members (42.0%) and head/face (29.2%). The injury surveillance in sentinel services allows collecting timeless data about minor cases which is essential for planning and implementing preventive measures. PMID:19851578

Mascarenhas, Márcio Dênis Medeiros; da Silva, Marta Maria Alves; Malta, Deborah Carvalho; de Moura, Lenildo; Gawryszewski, Vilma Pinheiro; Costa, Valter Chaves; Souza, Maria de Fátima Marinho; de Morais Neto, Otaliba Libânio

2009-01-01

28

Brain Injury Association of America  

Science.gov (United States)

... Only) 1-800-444-6443 Welcome to the Brain Injury Association of America Brain injury is not an event or an outcome. ... misunderstood, under-funded neurological disease. Individuals who sustain brain injuries must have timely access to expert trauma ...

29

2004 Hanford Site Annual Illness and Injury Surveillance Report, Revised October 2007  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program for 2004 for the Hanford site. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-24

30

2003 Idaho National Engineering and Environmental Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for 2003 for Idaho National Lab. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

31

2003 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for 2003 for ORNL. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

32

Validity of a surveillance system for childhood injuries in a rural block of Tamilnadu  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Childhood injuries are increasingly getting the attention of public health experts following WHO?s report on global burden of diseases. Surveillance is an important component of control of any disease and effectiveness of the surveillance system depends upon completeness of the information about occurrence of the health related events to the public health authorities. Aims: This study aimed to set up a surveillance system for childhood injuries and validate it by a survey and thereafter estimate the incidence of childhood injuries using capture recapture method. Settings and Design: Observational study design. Materials and Methods: Passive surveillance system for childhood injuries was created for 26,811 children of less than fourteen years of Kaniyambadi block and it was validated by cross sectional study at the end of surveillance period. Using these two independent information systems, capture recapture method was applied to find out the possible incidence of injuries in the given population at a given period of time. Statistics: Chi square, Lincoln Peterson formula for capture re-capture method. Results: Surveillance and survey for childhood injuries identified 13.59/1000 child-years (CI: 11.86 -15.32 and 341.89/1000 child-years (CI: 254.46-429.33 of injury rates, respectively. Conclusion: Passive surveillance system underreports childhood injuries markedly but it does identify childhood injuries of serious nature.

Sivamani M

2009-01-01

33

2007 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-05-20

34

2006 Sandia National Laboratories--Albuquerque Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-05-13

35

2010 Nevada National Security Site Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-07-28

36

2010 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-07-28

37

2006 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-05-16

38

2006 Y-12 National Security Complex Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-04-17

39

2006 Los Alamos National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-06-13

40

2006 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-03-27

 
 
 
 
41

The impact of playing in matches while injured on injury surveillance findings in professional football.  

Science.gov (United States)

This study aimed to analyze the frequency, nature, and consequences of footballers playing matches while injured, and to examine the impact on injury surveillance findings. High levels of inter-rater reliability and content validity were established for a tool designed to document players who were already injured at the start of a match. The tool was implemented in three English football teams (a Championship, League 1, and League 2 team) for one season, using a "time loss" definition of injury. One hundred forty-three matches were surveyed, revealing 102 match appearances by players who were already injured. Almost half of all games featured at least one injured player, with episodes of playing with injury occurring more frequently and lasting longer in League 2 players compared with higher level players. No association was observed between the number of injured players starting matches and match outcome [?(2) (4, N = 143)?= 3.27, P = 0.514]. Fifteen percent of all injury episodes captured were only through prospective documentation of playing while injured. The findings show that both traumatic and overuse injuries are managed by footballers through competitive matches, and have important implications for aiding understanding of the epidemiology of injury in professional football. PMID:24118123

Hammond, L E; Lilley, J M; Pope, G D; Ribbans, W J

2014-06-01

42

Parachuting injury surveillance, Fort Bragg, North Carolina, May 1993 to December 1994.  

Science.gov (United States)

Surveillance for parachute-related injuries was conducted at Fort Bragg, North Carolina, between May 1993 and December 1994. During this 20-month period, lower-extremity injuries (27% of all injuries), axial skeletal (back and neck) strains and sprains (19.3%), and closed head injuries (18.4%) were the leading causes of injury. The incidence of injuries requiring emergency care was 8/1,000 jumps. This rate is well within the jump injury planning estimate, suggesting that airborne training and operations are conducted in a safe and effective manner at Fort Bragg. PMID:9121659

Craig, S C; Morgan, J

1997-03-01

43

Occupational injury surveillance: A study in a metal smelting industry  

Directory of Open Access Journals (Sweden)

Full Text Available An investigation of occupational injury was undertaken in a metal smelting industry to examine the occurrence and nature of occupational accidents where analysis of occupational injury records was carried out. At the same time, all the workers were interviewed to collect data in relation to personal and occupational characteristics. With this information, the study aimed to examine the role of different factors in the causation of occupational accidents. High incidence of superficial injuries of limbs due mostly to stepping / striking against objects and overexertion / wrong movements of the workers and the frequent association of handling of small tools with work injuries, observed in this study indicated the role of human error in these accidents and highlighted the necessity of proper safety training of the workers. This study also highlighted the need of elevated safety status during summer months and in evening and night shifts (more so in the second half. Moreover, this study could categorize some high-risk groups e.g. young workers, less-experienced workers, obese workers, workers having smoking / chewing habits etc, who need special attention so far as workplace safety is concerned.

Saha Asim

2007-01-01

44

Injury surveillance in low-resource settings using Geospatial and Social Web technologies  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Extensive public health gains have benefited high-income countries in recent decades, however, citizens of low and middle-income countries (LMIC have largely not enjoyed the same advancements. This is in part due to the fact that public health data - the foundation for public health advances - are rarely collected in many LMIC. Injury data are particularly scarce in many low-resource settings, despite the huge associated burden of morbidity and mortality. Advances in freely-accessible and easy-to-use information and communication (ICT technology may provide the impetus for increased public health data collection in settings with limited financial and personnel resources. Methods and Results A pilot study was conducted at a hospital in Cape Town, South Africa to assess the utility and feasibility of using free (non-licensed, and easy-to-use Social Web and GeoWeb tools for injury surveillance in low-resource settings. Data entry, geocoding, data exploration, and data visualization were successfully conducted using these technologies, including Google Spreadsheet, Mapalist, BatchGeocode, and Google Earth. Conclusion This study examined the potential for Social Web and GeoWeb technologies to contribute to public health data collection and analysis in low-resource settings through an injury surveillance pilot study conducted in Cape Town, South Africa. The success of this study illustrates the great potential for these technologies to be leveraged for public health surveillance in resource-constrained environments, given their ease-of-use and low-cost, and the sharing and collaboration capabilities they afford. The possibilities and potential limitations of these technologies are discussed in relation to the study, and to the field of public health in general.

Schuurman Nadine

2010-05-01

45

2003 Y-12 National Security Complex Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for 2003 for Y-12. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

46

2003 Los Alamos National Laboratory Annual Illness and Injury Surveillance Report, Revised September 2007  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for 2003 for Los Alamos National Lab. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-04

47

2003 Hanford Site Annual Illness and Injury Surveillance Report, Revised October 2007  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for the Hanford site. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers. The prpogram is part of DOE's commitment to assuring the health and safety of its workers and includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-24

48

2003 Savannah River Site Annual Illness and Injury Surveillance Report, Revised September 2007  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for 2003 for the Savannah River Site. DOE is commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The report monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-05

49

2003 Pantex Plant Annual Illness and Injury Surveillance Report, Revised September 2007  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for 2003 for the Pantex Plant. DOE is commited to assuring the health and safety of its workers. This includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-05

50

2003 Sandia National Laboratories--Albuquerque Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for 2003 for Sandia National Laboratories-Albuquerque. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

51

2003 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for 2003 for Lawrence Livermore National Lab. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

52

2004 Hanford Site Annual Illness and Injury Surveillance Report, Revised October 2007  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for 2004 for the Hanford site. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-24

53

2003 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report, Revised September 2007  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for 2003 for Brookhaven National Lab. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-02

54

2003 Fernald Environmental Management Project Annual Illness and Injury Surveillance Report, Revised September 2007  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for 2003 for the Fernald Environmental Management Project. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-04

55

2003 Kansas City Plant Annual Illness and Injury Surveillance Report, Revised September 2007  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for 2003 for the Kansas City Plant. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-04

56

2008 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-09-21

57

2008 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-12-14

58

2007 Los Alamos National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-06-30

59

2008 Y-12 National Security Complex Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-12-11

60

2007 Y-12 National Security Complex Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-07-01

 
 
 
 
61

2007 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-03-04

62

The relevance of WHO injury surveillance guidelines for evaluation: learning from the aboriginal community-centered injury surveillance system (ACCISS and two institution-based systems  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Over the past three decades, the capacity to develop and implement injury surveillance systems (ISS has grown worldwide and is reflected by the diversity of data gathering environments in which ISS operate. The capacity to evaluate ISS, however, is less advanced and existing evaluation guidelines are ambiguous. Furthermore, the applied relevance of these guidelines to evaluate ISS operating in various settings is unclear. The aim of this paper was to examine how the World Health Organization (WHO injury surveillance guidelines have been applied to evaluate systems operating in three different contexts. Methods The attributes of a good surveillance system as well as instructions for conducting evaluations, outlined in the WHO injury surveillance guidelines, were used to develop an analytical framework. Using this framework, a comparative analysis of the application of the guidelines was conducted using; the Aboriginal Community-Centered Injury Surveillance System (ACCISS from Canada, the Shantou-Emergency Department Injury Surveillance Project (S-EDISP from China, and the Yorkhill-Canadian Hospitals Injury Reporting and Prevention Program (Y-CHIRPP imported from Canada and implemented in Scotland. Results The WHO guidelines provide only a basic platform for evaluation. The guidelines over emphasize epidemiologic attributes and methods and under emphasize public health and injury prevention perspectives requiring adaptation for context-based relevance. Evaluation elements related to the dissemination and use of knowledge, acceptability, and the sustainability of ISS are notably inadequate. From a public health perspective, alternative reference points are required for re-conceptualizing evaluation paradigms. This paper offers an ISS evaluation template that considers how the WHO guidelines could be adapted and applied. Conclusions Findings suggest that attributes of a good surveillance system, when used as evaluation metrics, cannot be weighted equally across ISS. In addition, the attribute of acceptability likely holds more relevance than previously recognized and should be viewed as a critical underpinning attribute of ISS. Context-oriented evaluations sensitive to distinct operational environments are more likely to address knowledge gaps related to; understanding links between the production of injury data and its use, and the effectiveness, impact, and sustainability of ISS. Current frameworks are predisposed to disassociating epidemiologic approaches from subjective factors and social processes.

Auer Anna M

2011-09-01

63

Poisson Regression Analysis of Illness and Injury Surveillance Data  

Energy Technology Data Exchange (ETDEWEB)

The Department of Energy (DOE) uses illness and injury surveillance to monitor morbidity and assess the overall health of the work force. Data collected from each participating site include health events and a roster file with demographic information. The source data files are maintained in a relational data base, and are used to obtain stratified tables of health event counts and person time at risk that serve as the starting point for Poisson regression analysis. The explanatory variables that define these tables are age, gender, occupational group, and time. Typical response variables of interest are the number of absences due to illness or injury, i.e., the response variable is a count. Poisson regression methods are used to describe the effect of the explanatory variables on the health event rates using a log-linear main effects model. Results of fitting the main effects model are summarized in a tabular and graphical form and interpretation of model parameters is provided. An analysis of deviance table is used to evaluate the importance of each of the explanatory variables on the event rate of interest and to determine if interaction terms should be considered in the analysis. Although Poisson regression methods are widely used in the analysis of count data, there are situations in which over-dispersion occurs. This could be due to lack-of-fit of the regression model, extra-Poisson variation, or both. A score test statistic and regression diagnostics are used to identify over-dispersion. A quasi-likelihood method of moments procedure is used to evaluate and adjust for extra-Poisson variation when necessary. Two examples are presented using respiratory disease absence rates at two DOE sites to illustrate the methods and interpretation of the results. In the first example the Poisson main effects model is adequate. In the second example the score test indicates considerable over-dispersion and a more detailed analysis attributes the over-dispersion to extra-Poisson variation. The R open source software environment for statistical computing and graphics is used for analysis. Additional details about R and the data that were used in this report are provided in an Appendix. Information on how to obtain R and utility functions that can be used to duplicate results in this report are provided.

Frome E.L., Watkins J.P., Ellis E.D.

2012-12-12

64

Understanding unintentional childhood home injuries: pilot surveillance data from Karachi, Pakistan  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Childhood injuries, an important public health issue, globally affects more than 95% of children living in low-and middle-income countries. The objective of this study is to describe the epidemiology of childhood unintentional injuries in Karachi, Pakistan with a specific focus on those occurring within the home environment. Methods This was a secondary analysis of a childhood unintentional injury surveillance database setup in the emergency department of the Aga Khan Hospital, Karachi, Pakistan for 3 months. The data was collected by interviewing caretakers of children under 12 years of age presenting with an unintentional injury to the emergency departments of the four major tertiary care hospitals of Karachi, Pakistan. Results The surveillance included 566 injured children of which 409 (72% injuries had taken place at/around home. Of 409 children, 66% were males and mostly between 5 and 11 years of age. Injuries commonly occurred during play time (51%. Fall (59%, dog bites (11% and burns (9% were the commonest mechanisms of injury. The majority of the children (78% were directly discharged from the emergency room with predicted short term disability (42%. There were 2 deaths in the emergency department both due to falls. Conclusion Childhood injury surveillance system provides valuable in-depth information on child injuries. The majority of these unintentional childhood injuries occur at home; with falls, dog bites and burns being the most common types of unintentional childhood home injuries. Specific surveillance systems for child injuries can provide new and valuable information for countries like Pakistan.

Zia Nukhba

2012-01-01

65

Nonfatal wheelchair-related accidents reported to the National Electronic Injury Surveillance System.  

Science.gov (United States)

To better understand the epidemiology of accidents affecting wheelchair users, we evaluated 2,066 nonfatal wheelchair-related accidents reported, between 1986 and 1990, to the National Electronic Injury Surveillance System (NEISS) Division of the United States Consumer Product Safety Commission. The NEISS used data from representative emergency departments across the United States during this period. An extrapolation from this sample and from those of 1991 and 1992 provided an average national estimate of 36,559 wheelchair-related accidents per year that are serious enough to cause the injured person to seek attention at an emergency department; there was a significant (P = 0.007) upward trend over time. Elderly women were the most likely to sustain an injury. Of the people injured, 7.6% were not wheelchair users themselves. The most common causes of accidents were related to falls and tips in 73.2% of incidents, associated secondary causes (e.g., a ramp) in 41.4% and transfers in 16.9%. The most frequently reported location for the falls was at home (50.8%). The majority of resulting injuries were contusions and abrasions (32.8%), lacerations (28.0%), fractures (20.2%) and sprains and strains (10.3%). Hospitalization was required in 12% of cases. The results of this analysis have implications for rehabilitation professionals, regulatory bodies and wheelchair manufacturers. PMID:8198772

Ummat, S; Kirby, R L

1994-06-01

66

Occupational injury surveillance: A study in a metal smelting industry  

Digital Repository Infrastructure Vision for European Research (DRIVER)

An investigation of occupational injury was undertaken in a metal smelting industry to examine the occurrence and nature of occupational accidents where analysis of occupational injury records was carried out. At the same time, all the workers were interviewed to collect data in relation to personal and occupational characteristics. With this information, the study aimed to examine the role of different factors in the causation of occupational accidents. High incidence of superficial injuries...

Saha Asim; Kumar Sunil; Vasudevan D

2007-01-01

67

Alaska's model program for surveillance and prevention of occupational injury deaths.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The National Institute for Occupational Safety and Health (NIOSH) established its Alaska Field Station in Anchorage in 1991 after identifying Alaska as the highest-risk state for traumatic worker fatalities. Since then, the Field Station, working in collaboration with other agencies, organizations, and individuals, has established a program for occupational injury surveillance in Alaska and formed interagency working groups to address the risk factors leading to occupational death and injury ...

Conway, G. A.; Lincoln, J. M.; Husberg, B. J.; Manwaring, J. C.; Klatt, M. L.; Thomas, T. K.

1999-01-01

68

A new Italian surveillance system for occupational injuries: characteristics and initial results  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The aim of the study is to illustrate the design, potential uses and limitations of a new occupational surveillance system based on the linkage of work histories (INPS) and occupational injuries (INAIL). To validation of the system is very positive: The success of linkage between work histories and occupational injuries is very high for all the years considered; The comparison of the rates calculated using the WHIP-INAIL sample are highly coherent with what is currently published in Eurostat ...

Costa, Giuseppe; Leombruni, Roberto

2012-01-01

69

Slipping and tripping: fall injuries in adults associated with rugs and carpets  

Directory of Open Access Journals (Sweden)

Full Text Available BACKGROUND: Falls are a leading cause of unintentional injury among adults age 65 years and older. Loose, unsecured rugs and damaged carpets with curled edges, are recognized environmental hazards that may contribute to falls. To characterize nonfatal, unintentional fall-related injuries associated with rugs and carpets in adults aged 65 years and older. METHODS: We conducted a retrospective analysis of surveillance data of injuries treated in hospital emergency departments (EDs during 2001–2008. We used the National Electronic Injury Surveillance System-All Injury Program, which collects data from a nationally representative stratified probability sample of 66 U.S. hospital EDs. Sample weights were used to make national estimates. RESULTS: Annually, an estimated 37,991 adults age 65 years or older were treated in U.S. EDs for falls associated with carpets (54.2% and rugs (45.8%. Most falls (72.8% occurred at home. Women represented 80.2% of fall injuries. The most common location for fall injuries in the home was the bathroom (35.7%. Frequent fall injuries occurred at the transition between carpet/rug and non-carpet/rug, on wet carpets or rugs, and while hurrying to the bathroom. CONCLUSIONS: Fall injuries associated with rugs and carpets are common and may cause potentially severe injuries. Older adults, their caregivers, and emergency and primary care physicians should be aware of the significant risk for fall injuries and of environmental modifications that may reduce that risk.

Tony Rosen

2013-01-01

70

A successful model of road traffic injury surveillance in a developing country: process and lessons learnt  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Road Traffic Injuries (RTIs are one of the leading causes of death and disability worldwide with 90% of global mortality concentrated in the low and middle income countries. RTI surveillance is recommended to define the burden, identify high risk groups, plan intervention and monitor their impact. Despite its stated importance in the literature, very few examples of sustained surveillance systems are reported from low income countries. This paper shares the experience of setting up an urban RTI surveillance program in the emergency departments of five major hospitals in Karachi, Pakistan. Method We describe the process of establishing a surveillance system including assembling a multi-institution research group, developing a data collection methodology, carrying out data collection and analysis and dissemination of information to the relevant stakeholders. In the absence of a road safety agency, the surveillance system required developing individual partnerships with industry, police, city government, media and many other stakeholders. Impact of the surveillance is demonstrated by some initiatives in the local trauma system and improvements in road design to effect hazard reduction. Conclusion We demonstrated that a functional RTI surveillance program can be established, and effectively managed in a developing country, despite lack of infrastructure and limitation of resources. Data utilization in the absence of well defined road safety infrastructure within the government is a challenge. More effective actions are hampered by the limited capacity in the transport and health sectors to do in-depth analysis through road safety audits and trauma registries.

Razzak Junaid

2012-05-01

71

Electronic Data Capture for Injury and Illness Surveillance : A usability study  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Despite the development of injury surveillance systems for use at large multi sportsevents (Junge 2008), their implementation is still methodologically and practicallychallenging. Edouard (2013) and Engebretsen (2013) have pointed out that thecontext of athletics championships feature unique constraints, such as a limiteddata-collection window and large amounts of data to be recorded and rapidlyvalidated. To manage these logistical issues, Electronic Data Capture (EDC) methodshave been propos...

Karlsson, David

2013-01-01

72

Information extraction approaches to unconventional data sources for "Injury Surveillance System": the case of newspapers clippings.  

Science.gov (United States)

Injury Surveillance Systems based on traditional hospital records or clinical data have the advantage of being a well established, highly reliable source of information for making an active surveillance on specific injuries, like choking in children. However, they suffer the drawback of delays in making data available to the analysis, due to inefficiencies in data collection procedures. In this sense, the integration of clinical based registries with unconventional data sources like newspaper articles has the advantage of making the system more useful for early alerting. Usage of such sources is difficult since information is only available in the form of free natural-language documents rather than structured databases as required by traditional data mining techniques. Information Extraction (IE) addresses the problem of transforming a corpus of textual documents into a more structured database. In this paper, on a corpora of Italian newspapers articles related to choking in children due to ingestion/inhalation of foreign body we compared the performance of three IE algorithms- (a) a classical rule based system which requires a manual annotation of the rules; (ii) a rule based system which allows for the automatic building of rules; (b) a machine learning method based on Support Vector Machine. Although some useful indications are extracted from the newspaper clippings, this approach is at the time far from being routinely implemented for injury surveillance purposes. PMID:20703703

Berchialla, Paola; Scarinzi, Cecilia; Snidero, Silvia; Rahim, Yousif; Gregori, Dario

2012-04-01

73

The epidemiology of seatbelt-associated injuries.  

Science.gov (United States)

This study examined the frequency of spine and abdominal injuries to motor vehicle occupant crash victims, the relationship between the two types of injuries, and the association with restraint use. There were 303 motor vehicle occupants treated at a regional trauma center for spine and/or abdominal injuries over a 5-year period. Patients with Chance-type fractures of the lumbar spine were much more likely to be rear seat passengers and to be using a lap belt than were patients with other types of spinal injuries. Similarly, patients with hollow viscus injuries were more likely to be rear seat passengers and to be lap belted than were patients with injuries to the spleen, liver, pancreas, or kidneys. Nearly two thirds of the lumbar Chance-type fractures were associated with hollow viscus injuries, including six of seven children. This increased risk of Chance-type fractures and hollow viscus injuries was associated with increased use of lap-belt seat restraints in the population. PMID:1986134

Anderson, P A; Rivara, F P; Maier, R V; Drake, C

1991-01-01

74

Hospital costs associated with pediatric burn injury.  

Science.gov (United States)

Modern burn care is a resource intensive endeavor requiring specialized equipment, personnel, and facilities in order to provide optimum care. The costs associated with burn injury to both patients and society as a whole can be multifaceted and large. The purpose of this study was to evaluate the association between hospital costs, patient characteristics, and injury factors in a cohort of pediatric patients admitted to a regional burn center. We performed a review of the hospital charges accrued by pediatric patients (age 9026 (SD = dollars 25,483; median = dollars 2138). Area of full thickness burn was the only patient or injury factor significantly associated with greater hospital costs (P < .05) on multivariate analysis. No single anatomic area was associated with increased hospital costs when adjusted for total overall burn size. Injury severity was the most significant factor impacting index hospitalization costs following pediatric burn injury. Further studies defining the long-term societal costs impact of burn injury are needed as are studies that evaluate the impact of burn injury on quality of life. PMID:18535469

Klein, Matthew B; Hollingworth, William; Rivara, Frederick P; Kramer, C Bradley; Askay, Shelley W; Heimbach, David M; Gibran, Nicole S

2008-01-01

75

Review of meniscal injury and associated sports.  

Science.gov (United States)

Meniscal injuries produce disability in a large portion of the population, and sports injuries are a common cause. Nicholas emphasized the importance of epidemiologic studies in an effort to better define the risk of various sports. There are significant regional differences in sports-related meniscal injuries depending upon the popularity of specific sports. Although publications in the European literature document some of these variations, there is little epidemiologic documentation of the variation in specific areas of the United States. Meniscectomies performed in Syracuse, New York, from 1973 to 1982 were reviewed. Sports-related meniscal injuries were tabulated and compared against all other causes. Our results indicate that the incidence of meniscal injury resulting in meniscectomy is 61 per 100,000 population. The sex ratio was three males to one female. Medial versus lateral meniscus injury was 81 versus 19%. Football had a 75% predominance of medial meniscectomy; basketball, 75%; wrestling, 55%; skiing, 78%; and baseball, 90%. Our data indicate that there are differences in the ratio of medial versus lateral meniscal disruption associated with specific sports activities. Medial meniscal injuries were, nevertheless, consistently more common in all of our categories except wrestling, where the frequency of lateral meniscal tear is nearly equal to that of medial meniscal tear. Additionally, the right knee is at a greater risk of meniscal injury in basketball than in other sports or the general population, and female skiers are at equal or greater risk of meniscal injury compared to male skiers. PMID:3838420

Baker, B E; Peckham, A C; Pupparo, F; Sanborn, J C

1985-01-01

76

Skeletal injuries associated with sexual abuse  

Energy Technology Data Exchange (ETDEWEB)

Background: Sexual abuse is often associated with physical abuse, the most common injuries being bruising and other soft-tissue injuries, but fractures occur in 5% of sexually abused children. The fractures described to date have formed part of the spectrum of injuries in these children and have not been specifically related to the abusive act. Objective: To describe concurrent sexual abuse and fractures. Materials and methods: Three children with pelvic or femoral shaft injuries in association with sexual abuse. Results: A 3-year-old girl with extensive soft-tissue injuries to the arms, legs and perineum also sustained fractures of both pubic rami and the sacral side of the right sacro-iliac joint. A 5-month-old girl with an introital tear was shown to have an undisplaced left femoral shaft fracture. A 5-year-old girl presented with an acute abdomen and pneumoperitoneum due to a ruptured rectum following sexual abuse. She had old healed fractures of both pubic rami with disruption of the symphysis pubis. Conclusions: Although the finding of a perineal injury in a young child may be significant enough for the diagnosis of abuse, additional skeletal injuries revealed by radiography will assist in confirmation of that diagnosis and may be more common than hitherto suspected. (orig.)

Johnson, Karl; Chapman, Stephen [Department of Radiology, Birmingham Children' s Hospital, Steelhouse Lane, B4 6NH, Birmingham (United Kingdom); Hall, Christine M. [Department of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom)

2004-08-01

77

Vertebral column injuries associated with tobogganing.  

Science.gov (United States)

Twenty-four cases of vertebral column injuries associated with tobogganing accidents are presented. The position assumed by the participants increased flexion of the vertebral column, therefore enhancing the possibility of injury to the spine, especially at the mobile thoracolumbar junction. The importance of a thorough examination in evaluating these patients is emphasized as not all injuries are benign. We urge safer and better organization of tobogganing facilities. Two case reports, one a burst fracture of L1 with neurologic involvement and the second, a traumatic spondylolisthesis of L1, are presented in detail. PMID:731742

Herkowitz, H N; Samberg, L C

1978-12-01

78

Wristwatch-associated ski injury.  

Science.gov (United States)

Upper limb injuries are a common occurrence in snowboarders, and these may be reduced by wearing wrist guards that transmit the force of the fall across the forearm. We present a case of a 26-year-old man who experienced a displaced left radial and ulnar fracture related to wearing a wristwatch while snowboarding. The wristwatch acted as a fulcrum around which the arm was fractured, serving as a stress riser that focused the force of the fall. The fracture was treated using open reduction and internal fixation. PMID:23246346

Cope, Thomas A; McCabe, Michael

2013-03-01

79

Pediatric injuries associated with high chairs and chairs in the United States, 2003-2010.  

Science.gov (United States)

This study describes the epidemiology of injuries among children ?3 years old associated with high chairs compared with chairs by retrospectively analyzing data from the National Electronic Injury Surveillance System from 2003 to 2010. An estimated 402 479 (95% confidence interval = 335 116-469 842) injuries associated with high chairs and chairs were treated in United States emergency departments, with an average of 9421 high chair-related injuries and 40 889 chair-related injuries annually. The number of high chair-related injuries significantly increased by 22.4% from 8926 injuries in 2003 to 10 930 injuries in 2010. Falling was the most common injury mechanism associated with high chairs (92.8%) and chairs (87.3%). Closed head injury was the most common diagnosis associated with high chairs (37.3%), and increased in number (P = .005) and rate (P = .006) from 2003 to 2010. Child caregivers should properly engage high chair safety restraint systems and encourage appropriate behaviors by young children when using chairs. PMID:24322954

Kurinsky, Rachel M; Rochette, Lynne M; Smith, Gary A

2014-04-01

80

Falls in residential carpentry and drywall installation: findings from active injury surveillance with union carpenters.  

Science.gov (United States)

Active injury surveillance was conducted with a large, unionized workforce of residential and drywall carpenters over a 3-year period. Injured carpenters were interviewed by trained carpenter investigators and sites were visited where falls occurred. Qualitative information was collected on exposures, risk perception, training, and mentoring. Falls accounted for 20% of injuries. Same-level falls were often related to weather, carrying objects-sometimes with an obstructed view-housekeeping, terrain of the lot, and speed of work. Falls from height occurred from a variety of work surfaces and involved ladders, scaffolding, roofs, work on other unsecured surfaces, unprotected openings, speed, and weather conditions. Recognized fall protection strategies, such as guardrails, toe boards, tying off to appropriate anchors, and guarding openings, would have prevented many of these falls; these practices were not the norm on many sites. PMID:12915790

Lipscomb, Hester J; Dement, John M; Nolan, James; Patterson, Dennis; Li, Leiming; Cameron, Wilfred

2003-08-01

 
 
 
 
81

Patterns of injury associated with automobile airbag use.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The wide use of automobile airbags has undoubtedly reduced the mortality and the incidence of serious injuries from motor vehicle accidents. However, automobile airbags appear to be associated with a variety of injuries including fatal injuries, ocular injuries, upper limb and chest injuries. Further improvements in airbag design together with education of the general public in their use should help reduce airbag-related injuries.

Mohamed, A. A.; Banerjee, A.

1998-01-01

82

Equine-associated maxillofacial injuries: retrospective 5-year analysis.  

Science.gov (United States)

We explored the relation between the causes of facial injuries in equestrians and the presence or absence of associated injuries. Over a 5-year period we retrospectively reviewed all patients who presented to the John Hunter Hospital, New South Wales, with facial injuries that had resulted from activity with horses. We analysed the rates of hard and soft tissue injuries, and of associated injuries by sex and mechanism. A total of 85 patients were included (50 female and 35 male) with an age range of 2-88 years. There was a significant difference in the rate of maxillofacial and associated injuries when groups were analysed for sex and mechanism of injury. Facial injuries caused by falling from a horse were more often associated with other injuries in men than in women (pmanagement. PMID:24168759

Islam, Shofiq; Gupta, Benjamin; Taylor, Christopher J; Chow, Jeffrey; Hoffman, Gary R

2014-02-01

83

Cardiac Surgery-Associated Acute Kidney Injury  

Science.gov (United States)

Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common and serious postoperative complication of cardiac surgery requiring cardiopulmonary bypass (CPB), and it is the second most common cause of AKI in the intensive care unit. Although the complication has been associated with the use of CPB, the etiology is likely multifactorial and related to intraoperative and early postoperative management including pharmacologic therapy. To date, very little evidence from randomized trials supporting specific interventions to protect from or prevent AKI in broad cardiac surgery populations has been found. The definition of AKI employed by investigators influences not only the incidence of CSA-AKI, but also the identification of risk variables. The advent of novel biomarkers of kidney injury has the potential to facilitate the subclinical diagnosis of CSA-AKI, the assessment of its severity and prognosis, and the early institution of interventions to prevent or reduce kidney damage. Further studies are needed to determine how to optimize cardiac surgical procedures, CPB parameters, and intraoperative and early postoperative blood pressure and renal blood flow to reduce the risk of CSA-AKI. No pharmacologic strategy has demonstrated clear efficacy in the prevention of CSA-AKI; however, some agents, such as the natriuretic peptide nesiritide and the dopamine agonist fenoldopam, have shown promising results in renoprotection. It remains unclear whether CSA-AKI patients can benefit from the early institution of such pharmacologic agents or the early initiation of renal replacement therapy. PMID:24454314

Mao, Huijuan; Katz, Nevin; Ariyanon, Wassawon; Blanca-Martos, Lourdes; Adybelli, Zelal; Giuliani, Anna; Danesi, Tommaso Hinna; Kim, Jeong Chul; Nayak, Akash; Neri, Mauro; Virzi, Grazia Maria; Brocca, Alessandra; Scalzotto, Elisa; Salvador, Loris; Ronco, Claudio

2013-01-01

84

Quality of Life Following Brain Injury: Perspectives from Brain Injury Association of America State Affiliates  

Science.gov (United States)

Objective: to examine the perspectives of brain injury professionals concerning family members' feelings about the quality of life experienced by individuals with brain injuries. Participants: participating in the study were 28 individuals in leadership positions with the state affiliates of the Brain Injury Association of America (BIAA). Methods:…

Degeneffe, Charles Edmund; Tucker, Mark

2012-01-01

85

Developing a new national approach to surveillance for ventilator-associated events: executive summary.  

Science.gov (United States)

In September 2011, the Centers for Disease Control and Prevention (CDC) convened a Ventilator-Associated Pneumonia (VAP) Surveillance Definition Working Group to organize a formal process for leaders and experts of key stakeholder organizations to discuss the challenges of VAP surveillance definitions and to propose new approaches to VAP surveillance in adult patients (Table 1). The charges to the Working Group were to (1) critically review a draft, streamlined VAP surveillance definition developed for use in adult patients; (2) suggest modifications to enhance the reliability and credibility of the surveillance definition within the critical care and infection prevention communities; and (3) propose a final adult surveillance definition algorithm to be implemented in the CDC's National Healthcare Safety Network (NHSN), taking into consideration the potential future use of the definition algorithm in public reporting, interfacility comparisons, and pay-for-reporting and pay-for-performance programs. PMID:24176770

Magill, Shelley S; Klompas, Michael; Balk, Robert; Burns, Suzanne M; Deutschman, Clifford S; Diekema, Daniel; Fridkin, Scott; Greene, Linda; Guh, Alice; Gutterman, David; Hammer, Beth; Henderson, David; Hess, Dean R; Hill, Nicholas S; Horan, Teresa; Kollef, Marin; Levy, Mitchell; Septimus, Edward; VanAntwerpen, Carole; Wright, Don; Lipsett, Pamela

2013-11-01

86

Motor Vehicle Crash-Associated Eye Injuries Presenting to U.S. Emergency Departments  

Science.gov (United States)

Introduction Motor vehicle crashes (MVCs) are a leading cause of injury in the United States (U.S.). Detailed knowledge of MVC eye injuries presenting to U.S. emergency departments (ED) will aid clinicians in diagnosis and management. The objective of the study was to describe the incidence, risk factors, and characteristics of non-fatal motor vehicle crash-associated eye injuries presenting to U.S. EDs from 2001 to 2008. Methods Retrospective cross-sectional study using the National Electronic Injury Surveillance System All Injury Program (NEISS-AIP) from 2001 to 2008 to assess the risk of presenting to an ED with a MVC-associated eye injury in relation to specific occupant characteristics, including age, gender, race/ethnicity, disposition, and occupant (driver/passenger) status. Results From 2001 to 2008, an estimated 75,028 MVC-associated eye injuries presented to U.S. EDs. The annual rate of ED-treated eye injuries resulting from MVCs declined during this study period. Males accounted for 59.6% of eye injuries (95% confidence interval [CI] 56.2%–63.0%). Rates of eye injury were highest among 15–19 year olds (5.8/10,000 people; CI 4.3–6.0/10,000) and among African Americans (4.5/10,000 people; CI 2.0–7.1/10,000). Drivers of motor vehicles accounted for 62.2% (CI 58.3%–66.1%) of ED-treated MVC eye injuries when occupant status was known. Contusion/Abrasion was the most common diagnosis (61.5%; CI 56.5%–66.4%). Among licensed U.S. drivers, 16–24 year olds had the highest risk (3.7/10,000 licensed drivers; CI 2.6–4.8/10,000). Conclusion This study reports a decline in the annual incidence of ED-treated MVC-associated eye injuries. The risk of MVC eye injury is greatest among males, 15 to 19 year olds and African Americans. PMID:25247045

Armstrong, Grayson W.; Chen, Allison J.; Linakis, James G.; Mello, Michael J.; Greenberg, Paul B.

2014-01-01

87

Prostatic surgery associated acute kidney injury.  

Science.gov (United States)

Acute kidney injury (AKI) is associated with extended hospital stays, high risks of in-hospital and long-term mortality, and increased risk of incident and progressive chronic kidney disease. Patients with urological diseases are a high-risk group for AKI owing to the coexistence of obstructive uropathy, older age, and preexistent chronic kidney disease. Nonetheless, precise data on the incidence and outcomes of postoperative AKI in urological procedures are lacking. Benign prostatic hyperplasia and prostate cancer are common diagnoses in older men and are frequently treated with surgical procedures. Whereas severe AKI after prostate surgery in general appears to be unusual, AKI associated with transurethral resection of the prostate (TURP) syndrome and with rhabdomyolysis (RM) after radical prostatectomy have been frequently described. The purpose of this review is to discuss the current knowledge regarding the epidemiology, risk factors, outcomes, prevention, and treatment of AKI associated with prostatic surgery. The mechanisms of TURP syndrome and RM following prostatic surgeries will be emphasized. PMID:25374813

Costalonga, Elerson Carlos; Costa E Silva, Verônica Torres; Caires, Renato; Hung, James; Yu, Luis; Burdmann, Emmanuel A

2014-11-01

88

Epidemiology of Injuries in Belgium: Contribution of Hospital Data for Surveillance  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objectives. Investigating injuries in terms of occurrences and patient and hospital stay characteristics. Methods. 17370 stays, with at least one E code, were investigated based on data from 13 Belgian hospitals. Pearson’s chi-square and Kruskal-Wallis tests were used to assess the variations between distributions of the investigated factors according to the injury’s types. Results. Major injuries were accidental falls, transport injuries, and self-inflicted injuries. There were more men ...

Senterre, Christelle; Leve?que, Alain; Di Pierdomenico, Lionel; Dramaix Wilmet, Miche?le; Pirson, Magali

2014-01-01

89

Use of surveillance data for prevention of healthcare-associated infection: risk adjustment and reporting dilemmas.  

LENUS (Irish Health Repository)

Healthcare-associated or nosocomial infection (HCAI) is of increasing importance to healthcare providers and the public. Surveillance is crucial but must be adjusted for risk, especially when used for interhospital comparisons or for public reporting.

O'Neill, Eoghan

2009-08-01

90

Characterization plan for routine waste from surveillance and maintenance of 221-U and associated facilities  

International Nuclear Information System (INIS)

This characterization plan describes how to collect samples, gather radiological survey information, and identify what chemical/radiological analyses are necessary to characterize routine waste generated during surveillance and maintenance of 221-U and associated facilities

91

Surveillance for illness and injury after Hurricane Katrina--three counties, Mississippi, September 5-October 11, 2005.  

Science.gov (United States)

Hurricane Katrina made landfall on the U.S. Gulf Coast on August 29, 2005, resulting in massive destruction from wind damage and storm surge. In Mississippi, the storm surge was an estimated 27 feet high at the Hancock County Emergency Operations Center and extended inland for 6-12 miles, causing extensive flooding in Biloxi and Gulfport and rendering approximately 80% of buildings in Waveland uninhabitable. The devastation was greatest in the coastal counties of Hancock, Harrison, and Jackson, where public infrastructure (e.g., electric power, communications networks, roads, sanitation systems, and water treatment plants) was severely disrupted. Multiple hospitals, health clinics, and public health facilities were either destroyed or nonfunctioning immediately after the hurricane. The Mississippi Department of Health (MDH) asked CDC to help conduct active surveillance at hospital emergency departments (EDs), federal Disaster Medical Assistance Team (DMAT) operation sites, and outpatient health-care facilities in Hancock, Harrison, and Jackson counties. On September 4, a team of 17 CDC staff members was deployed to Mississippi to work with MDH and an Epi Strike Team from the Florida Department of Health to provide surveillance for injury and illness. This report describes those surveillance activities and their findings, which determined that no major outbreaks of infectious illnesses or clusters of preventable major injuries occurred after the hurricane. However, daily reports to MDH provided reassurance regarding outbreaks and data to help direct public health activities in the affected region. PMID:16528228

2006-03-10

92

Road traffic injuries in one local health unit in the Lazio region: results of a surveillance system integrating police and health data  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Objective Different sources are available for the surveillance of Road Traffic injuries (RTI, but studied individually they present several limits. In this paper we present the results of a surveillance integrating healthcare data with the data gathered by the municipal police in the southeastern area of Rome (630,000 inhabitants during the year 2003. Methods The Municipal police RTI reports, which list the exact location, circumstances and some risk factor of the crash, were searched in the emergency visit, hospitalization and mortality databases, to integrate them with the information on health consequences. A multivariate analysis was conducted to evaluate risk factors (crash circumstances, age ad gender of the casualty associated with hospital admission following a RTI. Mapping of RTI locations was created. The locations with higher risk of accidents with severe health consequences and at higher risk for pedestrians were identified. Results According to police records 4571 RTI occurred in 2003, 75% of which led to emergency department admissions. Sixteen percent of these emergency visits ended in hospitalization, and 44 deaths were reported within 30 days of the event, most of which occurred in young men. The people with the highest risk of hospitalization after an RTI were the cyclists, pedestrians and followed by people on two-wheeled vehicles. The type of crash with the highest risk of hospitalization was head-on collision. Geographical analyses showed four clusters with higher severity of RTI. Specific attention was paid to pedestrian injuries. Analyzing the locations of RTIs involving pedestrians permitted us to rank the most dangerous streets. The roads at high risk for pedestrians identified problems in the bus stop constructions and in the placement of the zebra pedestrian crossings. Conclusion This study proves the feasibility of an integrated surveillance system of RTI by using routinely collected local data. The high-risk locations identified with the geographic analyses method in this study highlighted infrastructural problems, suggesting immediate preventive interventions.

Camilloni Laura

2009-04-01

93

Atendimentos de emergência por acidentes na Rede de Vigilância de Violências e Acidentes: Brasil, 2006 Unintentional injuries at the Emergency Department Injury Surveillance System: Brazil, 2006  

Directory of Open Access Journals (Sweden)

Full Text Available Em 2006, o Ministério da Saúde implantou a Rede de Serviços Sentinelas de Vigilância de Violências e Acidentes (Rede VIVA a fim de descrever os atendimentos de emergência por violências e acidentes, principalmente as lesões de menor gravidade que não implicam mortes ou internações. Neste artigo, descrevem-se as características dos atendimentos de emergência por acidentes realizados nesses serviços. Estudo descritivo, de corte transversal, realizado em 35 municípios com os maiores coeficientes de morbimortalidade por causas externas. Os dados foram coletados durante trinta dias consecutivos em plantões alternados de doze horas. Registraram-se 41.677 atendimentos por acidentes, com predomínio de homens (64,8%, pessoas de 20 a 29 anos de idade (22,9% e com baixa escolaridade (56,8%. As quedas (40,2% foram a principal causa, seguidas dos acidentes de transporte (26,6%. Os locais de ocorrência mais frequentes foram via pública (36,2% e residência (33,7%. As partes do corpo mais atingidas foram membros superiores (38,1%, membros inferiores (37,6% e cabeça/face (25,7%. A vigilância sentinela de violências e acidentes permite coletar dados em tempo hábil sobre eventos menos graves, cujo conhecimento é fundamental para o planejamento de medidas preventivas.In 2006, the Brazilian Ministry of Health established the Injury Surveillance System Network in Sentinel Services (Rede VIVA to describe data on injuries victims treated at emergency departments (ED, especially minor injuries which do not cause deaths and hospitalization. This study describes the characteristics of unintentional injuries victims treated in these EDs by means of a transversal descriptive study with data coming from EDs located in 35 municipalities with the highest injury rates. The data were collected during 30 consecutive days in an alternated 12-hour shift. There were a total of 41,677 patients with unintentional injuries, mainly among males (64.8%, people aged 20 to 29 years (23.0% and low level of education (45.8%. Falls were the main cause (40.1% overall, followed by transport related injuries (26.6% overall. The more frequent place of occurrence were public streets (36.3% overall and residences (33.6% overall. The body parts most affected were upper members (42.7%, lower members (42.0% and head/face (29.2%. The injury surveillance in sentinel services allows collecting timeless data about minor cases which is essential for planning and implementing preventive measures.

Márcio Dênis Medeiros Mascarenhas

2009-12-01

94

Atendimentos de emergência por acidentes na Rede de Vigilância de Violências e Acidentes: Brasil, 2006 / Unintentional injuries at the Emergency Department Injury Surveillance System: Brazil, 2006  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: Portuguese Abstract in portuguese Em 2006, o Ministério da Saúde implantou a Rede de Serviços Sentinelas de Vigilância de Violências e Acidentes (Rede VIVA) a fim de descrever os atendimentos de emergência por violências e acidentes, principalmente as lesões de menor gravidade que não implicam mortes ou internações. Neste artigo, de [...] screvem-se as características dos atendimentos de emergência por acidentes realizados nesses serviços. Estudo descritivo, de corte transversal, realizado em 35 municípios com os maiores coeficientes de morbimortalidade por causas externas. Os dados foram coletados durante trinta dias consecutivos em plantões alternados de doze horas. Registraram-se 41.677 atendimentos por acidentes, com predomínio de homens (64,8%), pessoas de 20 a 29 anos de idade (22,9%) e com baixa escolaridade (56,8%). As quedas (40,2%) foram a principal causa, seguidas dos acidentes de transporte (26,6%). Os locais de ocorrência mais frequentes foram via pública (36,2%) e residência (33,7%). As partes do corpo mais atingidas foram membros superiores (38,1%), membros inferiores (37,6%) e cabeça/face (25,7%). A vigilância sentinela de violências e acidentes permite coletar dados em tempo hábil sobre eventos menos graves, cujo conhecimento é fundamental para o planejamento de medidas preventivas. Abstract in english In 2006, the Brazilian Ministry of Health established the Injury Surveillance System Network in Sentinel Services (Rede VIVA) to describe data on injuries victims treated at emergency departments (ED), especially minor injuries which do not cause deaths and hospitalization. This study describes the [...] characteristics of unintentional injuries victims treated in these EDs by means of a transversal descriptive study with data coming from EDs located in 35 municipalities with the highest injury rates. The data were collected during 30 consecutive days in an alternated 12-hour shift. There were a total of 41,677 patients with unintentional injuries, mainly among males (64.8%), people aged 20 to 29 years (23.0%) and low level of education (45.8%). Falls were the main cause (40.1% overall), followed by transport related injuries (26.6% overall). The more frequent place of occurrence were public streets (36.3% overall) and residences (33.6% overall). The body parts most affected were upper members (42.7%), lower members (42.0%) and head/face (29.2%). The injury surveillance in sentinel services allows collecting timeless data about minor cases which is essential for planning and implementing preventive measures.

Márcio Dênis Medeiros, Mascarenhas; Marta Maria Alves da, Silva; Deborah Carvalho, Malta; Lenildo de, Moura; Vilma Pinheiro, Gawryszewski; Valter Chaves, Costa; Maria de Fátima Marinho, Souza; Otaliba Libânio de, Morais Neto.

95

[Elbow problems associated with sports injuries in children].  

Science.gov (United States)

Elbow problems associated with sports injuries may result from overuse, micro- or macrotraumas. Overuse injuries are frequent and are often closely related to mechanical characteristics of sports. Sports-related elbow injuries mainly occur in sports involving throwing such as baseball and javelin throwing, which require forced valgus and extension of the elbow, predisposing it to overuse injuries. Overuse injuries in child athletes are generally defined as Little League elbow, the most common of which are medial epicondyle apophysitis, osteochondritis dissecans of the capitellum, radial head deformation, flexion contractures, and injuries to the olecranon. Most of these injuries can be healed without or with minimal sequelae by early diagnosis and proper treatment. Therefore, mechanisms of, and risk factors for, elbow problems encountered in pediatric athletes should be well-understood in order to avoid the risks for a permanent deformity in the child's anatomy. PMID:15187462

Demirhan, Mehmet; Güne?li, Taner

2004-01-01

96

Injuries associated with combat sports, active component, U.S. Armed Forces, 2010-2013.  

Science.gov (United States)

The practice of combat sports creates a potential for training- and sports-related injuries among military members. During the 4-year surveillance period, there were 12,108 cases of injuries associated with combat sports among active component service members; the overall incidence rate was 21.0 per 10,000 person-years (p-yrs). The rates were higher among service members who were male, Hispanic, in the youngest age groups, in the Army, junior enlisted, and in combat-specific occupations. The rate among recruit/ trainees (779.4 per 10,000 p-yrs) was more than 165 times the rate among all other active component service members (non-recruits) (4.7 per 10,000 p-yrs). Sprains, strains, and contusions accounted for more than one-half of the primary (first-listed) diagnoses associated with combat sports cases. More serious conditions such as concussions/head injuries and skull/face fractures/intracranial injuries were reported among 3.9% and 2.1% of all cases and were more common among boxing-related cases. Hand/wrist fractures were also common among boxing cases. Wrestling had comparatively greater proportions of dislocations and open wounds. Although the combat sport training provides many physical and mental benefits to the individual, safety practices should be enforced to reduce the most frequent and serious injuries. PMID:24885879

2014-05-01

97

Injuries in Patients with Epilepsy and Some Factors Associated with Injury  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: The aim of the study was to evaluate injuries in patients with epilepsyand some factors associated with injury.Methods: This study included 126 epileptic patients who attended a neurology outpatient clinic of a hospital between March 2009 and March 2010. Data were collected using a patient information form and an injury evaluation form. The data were evaluated using percentage, mean and the Chi square test. Results: 82.5% of patients have sustained injury due to an epileptic seizure. Soft tissue injuries were the most common (70.2%, followed by head injury (61.5%, dental and tongue injury (%58.6, burns (24%, and orthopaedic injury (21.2%.The most common site of burns were the upper extremities and the face (36% and 24%, respectively. Burns occurred during cooking in 32% of cases. Five patients had upper extremity fractures. Four patients faced the risk of bathtub drowning. The injuries usually occurred at home. The significant risk factors for injury were generalized tonic-clonic seizures and high frequency of seizures. Twenty-six patients were taken to the emergency unit due to an injury.Conclusion: Injury is a common problem in patients with epilepsy. Dental and tongue injury was the most common seizure-related injury. The risk factors were generalized tonic-clonic seizures, and high frequency of seizures. Patients with epilepsy can lead normal lives but certain precautions are needed to prevent seizure-related injuries. (Arc¬hi¬ves of Neu¬ropsy¬chi¬atry 2013; 50: 269-273

Mukadder MOLLAO?LU

2013-09-01

98

Injuries associated with the 580 km university student grand voluntary road march: focus on foot injuries.  

Science.gov (United States)

College student volunteers (n = 142) completed a 580 km road march for 21 consecutive days. Each volunteer carried a backpack that weighed 14.1 ± 1.4 kg on the average. We investigated the incidence and location of blisters associated with the road march using a foot map along with other injuries. Overall, 95.1% of the subjects (135 of 142) sustained one or more injuries. All injured subjects had foot blisters, and 18% had other foot injuries. The most common locations of blister development were the right 5th toe (61%) and the left 5th toe (57%). The little toes seem to have been subjected to the greatest friction and shearing forces. March-related injuries, excluding foot injuries, were ankle pain (12.7%), knee pain (12.7%) and Achilles tendon pain (7.7%). Six subjects (4.2%) needed extra medical treatment for more than 2 weeks prior to returning to their daily lives after completion of the march due to associated injuries. The present study observed a very high incidence rate of injuries (95.1%) associated with the 580 km university students grand road march. These injuries posed an obstacle against completion of the road march and against returning to daily life. Active preventive interventions such as physical therapy and customized reinforced shoes and education program are recommended for reducing incidence rate and severity of injuries. PMID:24339714

Choi, Sang-cheon; Min, Young-gi; Lee, In-Soo; Yoon, Gi-Ho; Kang, Bo-Ra; Jung, Yoon-Seok; Cho, Joon-Pil; Kim, Gi-Woon

2013-12-01

99

Injuries Associated with the 580 km University Student Grand Voluntary Road March: Focus on Foot Injuries  

Science.gov (United States)

College student volunteers (n = 142) completed a 580 km road march for 21 consecutive days. Each volunteer carried a backpack that weighed 14.1 ± 1.4 kg on the average. We investigated the incidence and location of blisters associated with the road march using a foot map along with other injuries. Overall, 95.1% of the subjects (135 of 142) sustained one or more injuries. All injured subjects had foot blisters, and 18% had other foot injuries. The most common locations of blister development were the right 5th toe (61%) and the left 5th toe (57%). The little toes seem to have been subjected to the greatest friction and shearing forces. March-related injuries, excluding foot injuries, were ankle pain (12.7%), knee pain (12.7%) and Achilles tendon pain (7.7%). Six subjects (4.2%) needed extra medical treatment for more than 2 weeks prior to returning to their daily lives after completion of the march due to associated injuries. The present study observed a very high incidence rate of injuries (95.1%) associated with the 580 km university students grand road march. These injuries posed an obstacle against completion of the road march and against returning to daily life. Active preventive interventions such as physical therapy and customized reinforced shoes and education program are recommended for reducing incidence rate and severity of injuries. PMID:24339714

Choi, Sang-cheon; Min, Young-Gi; Lee, In-Soo; Yoon, Gi-Ho; Kang, Bo-Ra; Jung, Yoon-Seok; Cho, Joon-Pil

2013-01-01

100

Improving the work efficiency of healthcare-associated infection surveillance using electronic medical records.  

Science.gov (United States)

In this study, we developed an integrated hospital-associated urinary tract infection (HAUTI) surveillance information system (called iHAUTISIS) based on existing electronic medical records (EMR) systems for improving the work efficiency of infection control professionals (ICPs) in a 730-bed, tertiary-care teaching hospital in Taiwan. The iHAUTISIS can automatically collect data relevant to HAUTI surveillance from the different EMR systems, and provides a visualization dashboard that helps ICPs make better surveillance plans and facilitates their surveillance work. In order to measure the system performance, we also created a generic model for comparing the ICPs' work efficiency when using existing electronic culture-based surveillance information system (eCBSIS) and iHAUTISIS, respectively. This model can demonstrate a patient's state (unsuspected, suspected, and confirmed) and corresponding time spent on surveillance tasks performed by ICPs for the patient in that state. The study results showed that the iHAUTISIS performed better than the eCBSIS in terms of ICPs' time cost. It reduced the time by 73.27s, when using iHAUTISIS (114.26s) and eCBSIS (187.53s), for each patient on average. With increased adoption of EMR systems, the development of the integrated HAI surveillance information systems would be more and more cost-effective. Moreover, the iHAUTISIS adopted web-based technology that enables ICPs to online access patient's surveillance information using laptops or mobile devices. Therefore, our system can further facilitate the HAI surveillance and reduce ICPs' surveillance workloads. PMID:25154644

Lo, Yu-Sheng; Lee, Wen-Sen; Chen, Guo-Bin; Liu, Chien-Tsai

2014-11-01

 
 
 
 
101

Molecular Identification of Aspergillus Species Collected for the Transplant-Associated Infection Surveillance Network?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A large aggregate collection of clinical isolates of aspergilli (n = 218) from transplant patients with proven or probable invasive aspergillosis was available from the Transplant-Associated Infection Surveillance Network, a 6-year prospective surveillance study. To determine the Aspergillus species distribution in this collection, isolates were subjected to comparative sequence analyses by use of the internal transcribed spacer and ?-tubulin regions. Aspergillus fumigatus was the predominan...

Balajee, S. Arunmozhi; Kano, Rui; Baddley, John W.; Moser, Stephen A.; Marr, Kieren A.; Alexander, Barbara D.; Andes, David; Kontoyiannis, Dimitrios P.; Perrone, Giancarlo; Peterson, Stephen; Brandt, Mary E.; Pappas, Peter G.; Chiller, Tom

2009-01-01

102

Bowel injury associated with pelvic radiotherapy  

International Nuclear Information System (INIS)

Radiation therapists have to deal with the difficulty to give an efficient radiation dose to the tumor without generating unacceptable normal tissue injury. Acute reactions are experienced in most of the patients and are characterized by diarrhea resulting from intestinal mucosal injury. In some cases, intestinal wall fibrosis may develop, with hazard of occlusion syndrome. The only therapeutic recourse consists of surgical resection of the injured bowel

103

Soldier occupational load carriage: a narrative review of associated injuries.  

Science.gov (United States)

This narrative review examines injuries sustained by soldiers undertaking occupational load carriage tasks. Military soldiers are required to carry increasingly heavier occupational loads. These loads have been found to increase the physiological cost to the soldier and alter their gait mechanics. Aggregated research findings suggest that the lower limbs are the most frequent anatomical site of injury associated with load carriage. While foot blisters are common, other prevalent lower limb injuries include stress fractures, knee and foot pain, and neuropathies, like digitalgia and meralgia. Shoulder neuropathies (brachial plexus palsy) and lower back injuries are not uncommon. Soldier occupational load carriage has the potential to cause injuries that impact on force generation and force sustainment. Through understanding the nature of these injuries targeted interventions, like improved physical conditioning and support to specialised organisations, can be employed. PMID:24028439

Orr, Robin Marc; Pope, Rodney; Johnston, Venerina; Coyle, Julia

2014-12-01

104

Maxillofacial injuries associated with intimate partner violence in women  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The facial region has been the most common site of injury following violent episodes. The purpose of this study was to determine the prevalence and pattern of maxillofacial injuries associated with intimate partner violence (IPV in women treated at a single facility in Malaysia. Methods A retrospective review of 242 hospital records of female IPV victims who were seen at the One-Stop Crisis Centre (OSCC in Hospital Raja Perempuan Zainab II, Kelantan over a two-year period (January 1, 2005 to December 31, 2006 was performed. A structured form was used for data collection. Information regarding the anatomical sites of injuries, types of injuries, and mechanisms of assault were obtained. Results Most victims were married (85.1%, were injured by the husband (83.5%, and had at least one previous IPV episode (85.5%. Injury to the maxillofacial region was the most common (50.4%, followed by injury to the limbs (47.9%. In 122 cases of maxillofacial injuries, the middle of the face was most frequently affected (60.6%, either alone or in combination with the upper or lower third of the face. Injury to soft tissues (contusions, abrasions and lacerations was the most common (87.7%. Conclusions This study indicates there is a high prevalence of maxillofacial injuries associated with IPV among women treated at the OSCC in Kelantan, Malaysia.

Daud Razak

2010-05-01

105

Abdominal hollow viscus injuries are associated with spine and neurologic infections after penetrating spinal cord injuries.  

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Penetrating spinal cord injuries are rare but potentially devastating injuries that are associated with significant morbidity. The objective of this study was to assess the impact of abdominal hollow viscus injuries (HVIs) on neurologic and spinal infectious complications in patients sustaining penetrating spinal cord injuries. We performed a 13-year retrospective review of a Level I trauma center database. Variables analyzed included demographics, injury patterns and severity, spine operations, and outcomes. Spine and neurologic infections (SNIs) were defined as paraspinal or spinal abscess, osteomyelitis, and meningitis. Multivariate analysis was performed to identify factors associated with SNI. Of 137 patients, there were 126 males (92%) with a mean age of 27 ± 10 years. Eight patients (6%) underwent operative stabilization of their spine. Fifteen patients (11%) developed SNI. There was a higher incidence of SNI among patients with abdominal HVI compared with those without (eight [26%] vs six [6%], P injury severity, solid abdominal injury and HVI, vascular injury, and spine operation, abdominal HVIs were independently associated with an increased risk for SNI (odds ratio, 6.88; 95% confidence interval, 2.14 to 22.09; P = 0.001). Further studies are required to determine the optimal management strategy to prevent and successfully treat these infections. PMID:25264640

Schwed, Alexander C; Plurad, David S; Bricker, Scott; Neville, Angela; Bongard, Fred; Putnam, Brant; Kim, Dennis Y

2014-10-01

106

Unintentional Childhood Injury Patterns, Odds, and Outcomes in Kampala City: an analysis of surveillance data from the National Pediatric Emergency Unit  

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Full Text Available BACKGROUND: Unintentional Childhood Injuries pose a major public health challenge in Africa and Uganda. Previous estimates of the problem may have underestimated the childhood problem. We set to determine unintentional childhood injury pattern, odds, and outcomes at the National Paediatric Emergency unit in Kampala city using surveillance data. METHODS: Incident proportions, odds and proportional rates were calculated and used to determine unintentional injury patterns across childhood (1-12 years. RESULTS: A total of 556 cases recorded between January and May 2008 were analyzed: majority had been transported to hospital by mothers using mini-buses, private cars, and motorcycles. Median distance from injury location to hospital was 5 km. Homes, roads, and schools were leading injury locations. Males constituted 60% of the cases. Play and daily living activities were commonest injury time activities. Falls, burns and traffic accounted for 70.5% of unintentional childhood injuries. Burns, open wounds, fractures were commonest injury types. Motorcycles, buses and passenger-cars caused most crashes. Play grounds, furniture, stairs and trees were commonest source of falls. Most burn injuries were caused by liquids, fires and hot objects. 43.8% of cases were admitted. 30% were discharged without disability; 10%, were disabled; 1%, died. Injury odds and proportional incidence rates varied with age, place and cause. Poisoning and drowning were rare. Local pediatric injury priorities should include home, road and school safety. CONCLUSIONS: Unintentional injuries are common causes of hospital visit by children under 13 years especially boys. Homes, roads and educational facilities are commonest unintentional injury sites. Significant age and gender differences exist in intentional injury causation, characteristics and outcomes. In its current form, our surveillance system seems inefficient in capturing poisoning and drowning. The local prevention priorities could include home, road and school safety; especially dissemination and uptake of proven interventions. Burns should be focus of domestic injury prevention among under-fives. Commercial passenger motorcycles require better regulation and control.

Emilio Ovuga

2011-01-01

107

Factors associated with severity of road traffic injuries, Thika, Kenya  

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Full Text Available BACKGROUND: Road traffic injuries continue to exert a huge burden on the health care system in Kenya. Few studies on the severity of road traffic injuries have been conducted in Kenya. We carried out a cross-sectional study to determine factors associated with severity of road traffic injuries in a public hospital in Thika district, Kenya. METHODS: Road crash victims attending the Thika district hospital, a 265-bed public hospital, emergency room were recruited consecutively between 10th August 2009 and 15th November 2009. Epidemiologic and clinical information was collected from medical charts and through interview with the victims or surrogates using a semi-structured questionnaire. Injuries were graded as severe or non-severe based on the Injury Severity Score (ISS. Independent factors associated with injury severity were assessed using multivariate logistic regression. RESULTS: The mean age of participants was 32.4 years, three quarters were between 20-49 years-old and 73% (219 were male. Nineteen percent (56/300 of the victims had severe injury. Five percent (15 had head injury while 38% (115 had fractures. Vulnerable road users (pedestrians and two-wheel users comprised 33% (99/300 of the victims. Vulnerable road users (OR=2.0, 95%CI=1.0-3.9, road crashes in rainy weather (OR=2.9, 95%CI=1.3-6.5 and night time crashes (OR=2.0, 95%CI=1.1-3.9 were independent risk factors for sustaining severe injury. CONCLUSION: Severe injury was associated with vulnerable road users, rainy weather and night time crashes. Interventions and measures such as use of reflective jackets and helmets by two wheel users and enhanced road visibility could help reduce the severity of road traffic injuries

Osoro Mogaka Eric

2011-03-01

108

MR imaging of anterior cruciate ligament injury: associated findings  

International Nuclear Information System (INIS)

y injured seven patients. In acute cases, the bone marrow changes were depicted as diffuse or focal high signal intensity lesions in lateral femoral or tibial condyles in contrast to the changes in chronic cases depicted as focal low signal intensity lesions in variable location. Lateral femoral condylar notch depression were found in nine patients (19%) and avulsion fractures of anterior tibial spine in four patients(9%). The associated findings with ACL injury (anterior translocation, buckling of PCL, associated bone, ligament and meniscus injuries) are considered to be helpful in the diagnosis of ACL injury on Knee MR images, when the findings of anterior cruciate ligament itself are not confirmative

109

A surveillance of needle-stick injuries amongst student nurses at the University of Namibia  

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Needle-stick injuries have the potential to change a student nurse’s life; yet they are dealt with covertly and many go unreported. This could create difficulties when evaluating a curriculum, because potential risk issues in nursing education might go undetected. In addition, needlestick injuries are inherently preventable occupational health hazards. The fact that there has been, until now, no information available on the incidence of, and context in which needlestick injuries occur among...

Ackerman, Maria J.; Althea Walters; Louise Pretorius; Louis Small

2011-01-01

110

MR imaging of anterior cruciate ligament injury: associated findings  

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Authors investigated the associated findings and their value in the diagnosis of anterior cruciate ligament (ACL) injury in MR image. The knee MR images of 47 patients with ACL injury (complete;24, partial;23) and 61 patients with normal ACL confirmed by the knee arthroscopy or operation were reviewed retrospectively. The degree of anterior translocation of tibia and the degree of posterior cruciate ligament (PCL) buckling were evaluated. The prevalence and pattern of associated adjacent bone, ligament and meniscus injuries were studied. The means({+-} 2 standard errors) of anterior translocation were different significantly in statistical analysis ({rho} < 0.001, student t-test) between injury group (7.51 {+-} 1.16 mm) and normal group (-0.56 {+-} 0.92mm). In the level of 5mm of anterior translocation for the criteria of ACL injury, the sensitivity, specificity, accuracy were 78.7%, 89.5%, 84.3% for each. The means of PCL buckling ratio were also different statistically between injury group(0.23 {+-} 0.02) and normal group(0.17 {+-} 0.01)({rho} < 0.001). In the level of 0.20 for diagnostic criteria of ACL injury, the sensitivity, specificity, accuracy were 71.4%, 83.6%, 78.4% for each. Thirty one medial meniscus tear (66%), thirteen lateral meniscus tear (28%), ten medial collateral ligament injury (28%), one PCL injury(2%) were associated with ACL injury. The twenty nine bone marrow changes were found in twenty patients (43%) which included acutely injured seven patients. In acute cases, the bone marrow changes were depicted as diffuse or focal high signal intensity lesions in lateral femoral or tibial condyles in contrast to the changes in chronic cases depicted as focal low signal intensity lesions in variable location. Lateral femoral condylar notch depression were found in nine patients (19%) and avulsion fractures of anterior tibial spine in four patients(9%). The associated findings with ACL injury (anterior translocation, buckling of PCL, associated bone, ligament and meniscus injuries) are considered to be helpful in the diagnosis of ACL injury on Knee MR images, when the findings of anterior cruciate ligament itself are not confirmative.

Han, Gi Seok; Kang, Heung Sik; Goo, Jin Mo; Kim, Chu Wan; Cho, Kyu Hyung; Seong, Sang Cheol [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1995-04-15

111

MR imaging of medial collateral ligament injury and associated internal knee joint injury  

International Nuclear Information System (INIS)

To assess the value of MR imaging in the diagnosis of medial collateral ligament injury of the knee, we used MR imaging to evaluate the characteristic findings in MCL tears and the frequency of associated knee joint injury. We retrospectively reviewed 26 patients within four weeks of MCL injury, analysed MR findings and correlated them with surgical findings. We evaluated discontinuity, heterogeneous signal intensity of MCL, thin band- like low signal intensity at MCL, facial edema, loss of clear demarcation of adjacent fat also combined bone injury, meniscus injury and other ligament injury. Complete MCL tears were present in 14 patients and partial tears in 12. Complete tears showed discontinuity of MCL, fascial edema and loss of clear demarcation from adjacent fat in 11 patients(79%);proximal MCL tears are more common than distal tears. Partial tears showed thin band-like low signal intensity within MCL, fascial edema and loss of clear demarcation from adjacent fat in seven patients (58%);all patient s with MCL injury showed fascial edema;in 12 patients there was loss of clear demarcation from adjacent fat. We could not, however, distinguish between complete tears and partial tears when MCL showed heterogeneous high signal intensity. Combined bone injury in MCL tears was found in eight patients(62%);the most common sites of this were the lateral femoral condyle and lateral tibial plateau. There was associated injury involving other ligaments(ACL:50%;PCL:27%). Combing other ligaments(ACL:50%;PCL:27%). Combined meniscus injury in MCL tears was present in 17 patients and the most common meniscus site(50%) is the posterior horn of the medial meniscus. Complete MCL tears showed discontinuity of MCL and partial tears showed a thin band-like low signal intensity within MCL. All patients with MCL injury showed fascial edema, and loss of clear demarcation from adjacent fat. Various other injuries combine with MCL tears. MR imaging is therefore useful in the evaluation of medial collateral ligament injury and asssociated knee joint injury

112

Unusual limb injury associated with sport parachuting.  

Science.gov (United States)

The case is reported of an open injury of the right arm sustained during a parachute jump. The fracture was managed in the usual way with wound debridement, wound irrigation, skeletal stabilisation, and reconstruction of the soft tissues. Good shoulder and elbow function were achieved. The combined effort of an orthopaedic trauma surgeon and plastic surgeon is essential to improve outcomes in such cases. PMID:12893728

Ng, A B Y; Alfred, A; Donaldson, D Q; Bale, R S

2003-08-01

113

Acute traumatic injury of the distal descending aorta associated with thoracic spine injury  

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A rare case of traumatic injury of the distal descending aorta associated with thoracic spine injury is reported. A 21-year-old man was admitted after a traffic accident. Thoracic CT and angiography demonstrated a false aneurysm of the distal descending aorta and a compression fracture of the eleventh thoracic vertebra. At emergency surgery, a transverse linear tear at the level of the aortic hiatus was confirmed and repaired. (orig.) With 5 figs., 14 refs.

Murakami, R.; Ichikawa, K.; Kobayashi, Y.; Sugizaki, K.; Yamamoto, K. [Department of Radiology, Tama-Nagayama Hospital, Nippon Medical School, Tokyo (Japan); Tajima, H.; Kumazaki, T. [Department of Radiology, Nippon Medical School Hospital, Tokyo (Japan); Kurokawa, A. [Department of Emergency Medicine, Tama-Nagayama Hospital, Nippon Medical School, Tokyo (Japan)

1998-02-01

114

Acute traumatic injury of the distal descending aorta associated with thoracic spine injury  

International Nuclear Information System (INIS)

A rare case of traumatic injury of the distal descending aorta associated with thoracic spine injury is reported. A 21-year-old man was admitted after a traffic accident. Thoracic CT and angiography demonstrated a false aneurysm of the distal descending aorta and a compression fracture of the eleventh thoracic vertebra. At emergency surgery, a transverse linear tear at the level of the aortic hiatus was confirmed and repaired. (orig.)

115

A needle in a haystack: the use of routinely collected emergency department injury surveillance data to help identify physical child abuse.  

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A retrospective, descriptive analysis of a sample of children under 18 years presenting to a hospital emergency department (ED) for treatment of an injury was conducted. The aim was to explore characteristics and identify differences between children assigned abuse codes and children assigned unintentional injury codes using an injury surveillance database. Only 0.1% of children had been assigned the abuse code and 3.9% a code indicating possible abuse. Children between 2 and 5 years formed the largest proportion of those coded to abuse. Superficial injury and bruising were the most common types of injury seen in children in the abuse group and the possible abuse group (26.9% and 18.8%, respectively), whereas those with unintentional injury were most likely to present with open wounds (18.4%). This study demonstrates that routinely collected injury surveillance data can be a useful source of information for describing injury characteristics in children assigned abuse codes compared to those assigned no abuse codes. PMID:23768210

Scott, Debbie; Walker, Sue; Fraser, Jennifer A; Valmuur, Kirsten

2014-01-01

116

Prevention of injury associated with rotating action machines  

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BACKGROUND Repeated analyses of the Swedish national workers’ compensation claims data material in the Occupational No-Fault Liability Insurance Scheme have pointed to the high incidence of severe hand injury associated with getting caught in rotating (drilling, milling, boring, turning, grinding) machines in the metal manufacturing and engineering industry (Jedeskog & Larsson, 1988; Larsson, 1990; Persson, 1992). In an analysis of all permanently disabling injuries sustained in the Swe...

Larsson, Tore J.; Bra?felt, Olle; Astervik, Magnus; Knutsson, Eric

2001-01-01

117

Spinal cord injury and its association with blunt head trauma  

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Full Text Available Wellingson S Paiva, Arthur MP Oliveira, Almir F Andrade, Robson LO Amorim, Leonardo JO Lourenço, Manoel J TeixeiraDivision of Neurosurgery, University of São Paulo, BrazilBackground: Severe and moderate head injury can cause misdiagnosis of a spinal cord injury, leading to devastating long-term consequences. The objective of this study is to identify risk factors involving spine trauma and moderate-to-severe brain injury.Methods: A prospective study involving 1617 patients admitted in the emergency unit was carried out. Of these patients, 180 with moderate or severe head injury were enrolled. All patients were submitted to three-view spine series X-ray and thin cut axial CT scans for spine trauma investigations.Results: 112 male patients and 78 female patients, whose ages ranged from 11 to 76 years (mean age, 34 years. The most common causes of brain trauma were pedestrians struck by motor vehicles (31.1%, car crashes (27.7%, and falls (25%. Systemic lesions were present in 80 (44.4% patients and the most common were fractures, and lung and spleen injuries. 52.8% had severe and 47.2% moderate head trauma. Fourteen patients (7.8% suffered spinal cord injury (12 in cervical spine, one in lumbar, and one thoracic spine. In elderly patients, the presence of associated lesions and Glasgow Coma Scale (GCS < 9 were statistically significant as risk factors (P < 0.05 for spine injury.Conclusion: Spinal cord injury related to moderate and severe brain trauma usually affects the cervical spine. The incidence of spinal lesions and GCS < 9 points were related to greater incidence of spinal cord injury.Keywords: head injury, spine trauma, risk factors

Paiva WS

2011-09-01

118

Is automated electronic surveillance for healthcare-associated infections accurate in the burn unit?  

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As monitoring requirements for healthcare-acquired infection increase, an efficient and accurate method for surveillance has been sought. The authors evaluated the accuracy of electronic surveillance in multiple intensive care unit settings. Data from 500 intensive care unit patients were reviewed to determine the presence of central line-associated blood stream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI). An electronic surveillance report was obtained to determine whether patients had a blood-line nosocomial infection marker or a urine nosocomial infection marker. Manual review was based on Centers for Disease Control and Prevention criteria. An infection preventionist then reviewed all discrepant cases and made a final determination, which was used as the gold standard. Sensitivity, specificity, false-positive rate, and false-negative rate were then calculated for electronic surveillance. In the burn population the sensitivity of electronic surveillance for CAUTI was 66.66%, specificity 96.5%, false-positive rate 3.44%, false-negative rate 33%; and for CLABSI the sensitivity was 100%, specificity 95%, false-positive rate 4.96%, false-negative rate 0%. In the nonburn population the sensitivity for CAUTI was 50%, specificity 97.9%, false-positive rate 2%, and false-negative rate 30%; and for CLABSI sensitivity was 60%, specificity 98.8%, false-positive rate 1%, and false-negative rate 60%. Burn centers may experience a higher false-positive rate for electronic surveillance of CLABSI and CAUTI than other critical care units. PMID:24121803

Venable, Amanda; Dissanaike, Sharmila

2013-01-01

119

Personnel injuries/illnesses associated with natural environment hazards  

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The purpose of this paper is to demonstrate how an existing Department of Energy (DOE) resource can be used to gain valuable insight concerning injury/illness incidents. That resource is the Computerized Accident/Incident Reporting System (CAIRS) module of DOE`s Safety Performance Measurement System (SPMS). Although this demonstration could have been performed by analyzing reports associated with any numbers of hazards (e.g., noise, chemicals, explosives, electricity, or tools-power/hand), the CAIRS data selected for analysis were the 1981--1991 DOE injury/illness reports that cited a ``natural environment hazard`` as either the direct or indirect cause of the injury/illness. Specifically, injury/illness reports were selected for analysis if they had a causal factor link to one or more of four natural environment hazard categories; weather, animal life, vegetation, or specific acts of nature (e.g., floods, earthquakes, and lightning strikes).

Hill, J.R. [USDOE Assistant Secretary for Environment, Safety, and Health, Washington, DC (United States). Risk Analysis and Technology Div.; Miller, C.F. [EG and G Idaho, Inc., Idaho Falls, ID (United States)

1991-12-31

120

Personnel injuries/illnesses associated with natural environment hazards  

Energy Technology Data Exchange (ETDEWEB)

The purpose of this paper is to demonstrate how an existing Department of Energy (DOE) resource can be used to gain valuable insight concerning injury/illness incidents. That resource is the Computerized Accident/Incident Reporting System (CAIRS) module of DOE's Safety Performance Measurement System (SPMS). Although this demonstration could have been performed by analyzing reports associated with any numbers of hazards (e.g., noise, chemicals, explosives, electricity, or tools-power/hand), the CAIRS data selected for analysis were the 1981--1991 DOE injury/illness reports that cited a natural environment hazard'' as either the direct or indirect cause of the injury/illness. Specifically, injury/illness reports were selected for analysis if they had a causal factor link to one or more of four natural environment hazard categories; weather, animal life, vegetation, or specific acts of nature (e.g., floods, earthquakes, and lightning strikes).

Hill, J.R. (USDOE Assistant Secretary for Environment, Safety, and Health, Washington, DC (United States). Risk Analysis and Technology Div.); Miller, C.F. (EG and G Idaho, Inc., Idaho Falls, ID (United States))

1991-01-01

 
 
 
 
121

Impact of associated injuries in the Floating knee: A retrospective study  

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Full Text Available Abstract Background Floating knee injuries are usually associated with other significant injuries. Do these injuries have implications on the management of the floating knee and the final outcome of patients? Our study aims to assess the implications of associated injuries in the management and final outcome of floating knee. Methods 29 patients with floating knees were assessed in our institution. A retrospective analysis of medical records and radiographs were done and all associated injuries were identified. The impact of associated injuries on delay in initial surgical management, delay in rehabilitation & final outcome of the floating knee were assessed. Results 38 associated injuries were noted. 7 were associated with ipsilateral knee injuries. Lower limb injuries were most commonly associated with the floating knee. Patients with some associated injuries had a delay in surgical management and others a delay in post-operative rehabilitation. Knee ligament and vascular injuries were associated with poor outcome. Conclusion The associated injuries were quite frequent with the floating knee. Some of the associated injuries caused a delay in surgical management and post-operative rehabilitation. In assessment of the final outcome, patients with associated knee and vascular injuries had a poor prognosis. Majority of the patients with associated injuries had a good or excellent outcome.

Yesupalan Rajam S

2009-01-01

122

Trastuzumab (Herceptin)-associated lung injury.  

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We report a case of trastuzumab pneumonitis in a patient with metastatic breast cancer. Bronchoalveolar lavage showed marked neutrophilia. A CT scan of the chest showed diffuse ground-glass opacities. The patient was treated with corticosteroids with a partial response. Trastuzumab-associated pneumonitis is not well described, and data in the literature is sparse. We describe the clinical and radiographical findings of trastuzumab-associated pneumonitis. PMID:16916343

Vahid, Bobbak; Mehrotra, Anita

2006-09-01

123

Liver injury associated with ketoconazole: Review of the published evidence.  

Science.gov (United States)

The azole antifungal agent ketoconazole has been available since 1981 for the treatment of fungal infections. In 2013, the American Food and Drug Administration and the European Medicines Agency issued warnings or prohibitions against the clinical use of oral ketoconazole due to the risk of liver injury which may lead to liver transplantation or death. From the available published evidence it is difficult to determine the actual incidence or prevalence of liver injury during clinical use of ketoconazole as an antifungal. Hepatic injury, when it occurs, is generally evident as asymptomatic and reversible abnormalities of liver function tests. However, serious liver injury has been reported. Alternatives to ketoconazole (such as itraconazole, fluconazole, voriconazole, and terbinafine) are available, but improved safety with respect to liver injury risk is not clearly established. We are not aware of published reports of significant ketoconazole-associated liver injury in volunteer study participants when ketoconazole has been used as a CYP3A inhibitor in the context of clinical research on drug metabolism. Possible alternatives to ketoconazole as prototype CYP3A inhibitors include ritonavir and potentially itraconazole, but not clarithromycin. PMID:25216238

Greenblatt, H Karl; Greenblatt, David J

2014-12-01

124

Open bicondylar Hoffa fracture associated with extensor mechanism injury.  

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Two cases of open bicondylar Hoffa fracture of the knee associated with extensor mechanism injury are described in two active young patients with multiple fractures. The level of the fracture was determined by the proximal insertion of the posterior cruciate ligament and anterior cruciate ligament in the medial and lateral condyle. The level of the extensor mechanism injury was determined by the degree of flexion of the knee at the moment of impact. No ligament or meniscal tears were found. Open reduction and internal fixation with four lag screws and bone-to-tendon repair of the patellar and quadriceps tendon gave excellent results after more than 2 years of follow-up. The mechanism of injury and the therapeutic implications are discussed, and the literature is reviewed. PMID:15105758

Calmet, J; Mellado, J M; García Forcada, I L; Giné, J

2004-01-01

125

Injury surveillance at a level 1 trauma centre in Johannesburg, South Africa  

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Full Text Available An analysis of 16 357 trauma patients seen over a one year period at the trauma casualty of an academic hospital in Johannesburg was carried out to determine the profile of injuries sustained by victims in the Johannesburg region. Opsomming ’n Analise van 16 357 trauma-pasiënte gesien in ’n een-jaar periode in die trauma-ongevalle van ’n akademiese hospitaal in Johannesburg, is uitgevoer ten einde ’n profiel van beserings wat opgedoen is deur slagoffers, in die Johannesburg-area, te bepaal. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

Jasmin Gassiep

2003-03-01

126

Surveillance of device-associated infections at a teaching hospital in rural Gujarat - India  

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Full Text Available Purpose: Surveillance of hospital-acquired infection (HAI, particularly device-associated infection (DAI, helps in determining the infection rates, risk factors, and in planning the preventive strategies to ensure a quality healthcare in any hospital. The present study was carried out to know the prevalence of DAI in a tertiary care teaching hospital of rural Gujarat. Materials and Methods: A prospective, site-specific surveillance of three common DAIs that is catheter-associated urinary tract infection (CA-UTI, IV-catheter-related bloodstream infection (IV-CRBSI, and ventilator-associated pneumonia (VAP was carried out between July 2007 and April 2008, in different wards/ICUs. A surveillance plan, with guidelines and responsibilities of nurses, clinicians and microbiologist was prepared. Infection surveillance form for each patient suspected to have DAI was filled. The most representative clinical sample, depending on the type of suspected DAI, was collected using standard aseptic techniques and processed for aerobes and facultative anaerobes. All the isolates were identified and antimicrobial sensitivity testing performed as per CLSI guidelines. An accurate record of total device days for each of the indwelling devices under surveillance was also maintained. Data, collected in the prescribed formats, were analysed on monthly basis; and then, compiled at the end of the study. Descriptive analysis of the data was done and DAI rate was expressed as number of DAI per 1000 device days. Results: The overall infection rate for CA-UTI, IV-CRBSI, and VAP were found to be 0.6, 0.48, and 21.92 per 1000 device days, respectively. The organisms isolated were Staphylococcus aureus, CONS, Enterococci, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. Conclusions: Duration of indwelling devices was found to be the major risk-factor for acquiring DAIs. Low DAI rate might have been due to use of antibiotics, often prophylactic. Active surveillance is quite a tedious and time-consuming process; however the outcome is useful in prevention and control of DAIs.

Singh S

2010-01-01

127

Occult bony lesions associated with anterior cruciate ligament injury  

International Nuclear Information System (INIS)

To examine bony lesions associated with anterior cruciate ligament (ACL) injuries, magnetic resonance (MR) imaging was performed on 55 knees with ACL injuries. With respect to the period between ACL injuries and MR imaging, the knees were divided into acute (within one month), subacute (from one month to one year) and chronic (over one year) groups, containing 19, 16 and 20 knees, respectively. Occult bony lesions not shown in roentgenography were observed more frequently in the acute group (13/19) than in the other two groups (subacute group, 5/16; chronic group, 1/20), located in the lateral compartment of the knee joint. In the acute group, bony lesions had high signal intensity on T2-weighted images and low signal intensity on proton density images. In the subacute and chronic groups, bony lesions were less pronounced and had low signal intensity on T2-weighted images. These findings suggest that bony lesions are frequently associated with and occur simultaneously with ACL injury. (author)

128

Molecular Identification of Aspergillus Species Collected for the Transplant-Associated Infection Surveillance Network?  

Science.gov (United States)

A large aggregate collection of clinical isolates of aspergilli (n = 218) from transplant patients with proven or probable invasive aspergillosis was available from the Transplant-Associated Infection Surveillance Network, a 6-year prospective surveillance study. To determine the Aspergillus species distribution in this collection, isolates were subjected to comparative sequence analyses by use of the internal transcribed spacer and ?-tubulin regions. Aspergillus fumigatus was the predominant species recovered, followed by A. flavus and A. niger. Several newly described species were identified, including A. lentulus and A. calidoustus; both species had high in vitro MICs to multiple antifungal drugs. Aspergillus tubingensis, a member of the A. niger species complex, is described from clinical specimens; all A. tubingensis isolates had low in vitro MICs to antifungal drugs. PMID:19675215

Balajee, S. Arunmozhi; Kano, Rui; Baddley, John W.; Moser, Stephen A.; Marr, Kieren A.; Alexander, Barbara D.; Andes, David; Kontoyiannis, Dimitrios P.; Perrone, Giancarlo; Peterson, Stephen; Brandt, Mary E.; Pappas, Peter G.; Chiller, Tom

2009-01-01

129

Molecular identification of Aspergillus species collected for the Transplant-Associated Infection Surveillance Network.  

Science.gov (United States)

A large aggregate collection of clinical isolates of aspergilli (n = 218) from transplant patients with proven or probable invasive aspergillosis was available from the Transplant-Associated Infection Surveillance Network, a 6-year prospective surveillance study. To determine the Aspergillus species distribution in this collection, isolates were subjected to comparative sequence analyses by use of the internal transcribed spacer and beta-tubulin regions. Aspergillus fumigatus was the predominant species recovered, followed by A. flavus and A. niger. Several newly described species were identified, including A. lentulus and A. calidoustus; both species had high in vitro MICs to multiple antifungal drugs. Aspergillus tubingensis, a member of the A. niger species complex, is described from clinical specimens; all A. tubingensis isolates had low in vitro MICs to antifungal drugs. PMID:19675215

Balajee, S Arunmozhi; Kano, Rui; Baddley, John W; Moser, Stephen A; Marr, Kieren A; Alexander, Barbara D; Andes, David; Kontoyiannis, Dimitrios P; Perrone, Giancarlo; Peterson, Stephen; Brandt, Mary E; Pappas, Peter G; Chiller, Tom

2009-10-01

130

Knee ligament injuries associated with long bone fractures  

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Full Text Available Background: Tibial and femoral fractures, commonly seen in emergency departments, may be associated with various knee ligament injuries. The aim of this study was to determine the prevalence of such fracture-associated knee ligament problems, with especial attention to rapid diagnosis. Methods: This study was carried out in patients with femoral or tibial fractures who were operated on in Imam Khomeini Medical Center from March 2003 to March 2005. All patients underwent surgical repair immediately after acute fracture, followed by a thorough knee examination. Patients with positive clinical findings were further evaluated using the stress view and arthroscopy. Results: We enrolled 470 cases in this study, of which 266 were tibial and 204 were femoral fractures. There were 404 men and 67 women, with an average age of tibial fracture patients was 34.5 and 44.6 years for those with femoral fractures. Of all fractures, 66% were due to car accidents, 16% to industrial accidents and 8% due to falling. The overall prevalence of ligament injuries in tibial fractures was as follows: 6.58% ACL tearing, 2.5% PCL, 21.95% MCL and 14.63% LCL. The overall prevalence of ligament injuries in femoral fractures was as follows: 6% ACL tearing, 3% PCL, 14% MCL and 8% LCL. Conclusion: The prevalence of ligament injuries of the knee was highest in distal femoral and tibial plateau fractures. It is prudent to perform a thorough knee examination once the fracture is stabilized in the operating room for the early detection of ligament injuries and prevention of further complications.

Kaseb M.H

2007-06-01

131

Death Associated Protein Kinases: Molecular Structure and Brain Injury  

Science.gov (United States)

Perinatal brain damage underlies an important share of motor and neurodevelopmental disabilities, such as cerebral palsy, cognitive impairment, visual dysfunction and epilepsy. Clinical, epidemiological, and experimental studies have revealed that factors such as inflammation, excitotoxicity and oxidative stress contribute considerably to both white and grey matter injury in the immature brain. A member of the death associated protein kinase (DAPk) family, DAPk1, has been implicated in cerebral ischemic damage, whereby DAPk1 potentiates NMDA receptor-mediated excitotoxicity through interaction with the NR2BR subunit. DAPk1 also mediate a range of activities from autophagy, membrane blebbing and DNA fragmentation ultimately leading to cell death. DAPk mRNA levels are particularly highly expressed in the developing brain and thus, we hypothesize that DAPk1 may play a role in perinatal brain injury. In addition to reviewing current knowledge, we present new aspects of the molecular structure of DAPk domains, and relate these findings to interacting partners of DAPk1, DAPk-regulation in NMDA-induced cerebral injury and novel approaches to blocking the injurious effects of DAPk1. PMID:23880846

Nair, Syam; Hagberg, Henrik; Krishnamurthy, Rajanikant; Thornton, Claire; Mallard, Carina

2013-01-01

132

Death Associated Protein Kinases: Molecular Structure and Brain Injury  

Directory of Open Access Journals (Sweden)

Full Text Available Perinatal brain damage underlies an important share of motor and neurodevelopmental disabilities, such as cerebral palsy, cognitive impairment, visual dysfunction and epilepsy. Clinical, epidemiological, and experimental studies have revealed that factors such as inflammation, excitotoxicity and oxidative stress contribute considerably to both white and grey matter injury in the immature brain. A member of the death associated protein kinase (DAPk family, DAPk1, has been implicated in cerebral ischemic damage, whereby DAPk1 potentiates NMDA receptor-mediated excitotoxicity through interaction with the NR2BR subunit. DAPk1 also mediate a range of activities from autophagy, membrane blebbing and DNA fragmentation ultimately leading to cell death. DAPk mRNA levels are particularly highly expressed in the developing brain and thus, we hypothesize that DAPk1 may play a role in perinatal brain injury. In addition to reviewing current knowledge, we present new aspects of the molecular structure of DAPk domains, and relate these findings to interacting partners of DAPk1, DAPk-regulation in NMDA-induced cerebral injury and novel approaches to blocking the injurious effects of DAPk1.

Claire Thornton

2013-07-01

133

Direct cost associated with acquired brain injury in Ontario  

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Full Text Available Abstract Background Acquired Brain Injury (ABI from traumatic and non traumatic causes is a leading cause of disability worldwide yet there is limited research summarizing the health system economic burden associated with ABI. The objective of this study was to determine the direct cost of publicly funded health care services from the initial hospitalization to three years post-injury for individuals with traumatic (TBI and non-traumatic brain injury (nTBI in Ontario Canada. Methods A population-based cohort of patients discharged from acute hospital with an ABI code in any diagnosis position in 2004 through 2007 in Ontario was identified from administrative data. Publicly funded health care utilization was obtained from several Ontario administrative healthcare databases. Patients were stratified according to traumatic and non-traumatic causes of brain injury and whether or not they were discharged to an inpatient rehabilitation center. Health system costs were calculated across a continuum of institutional and community settings for up to three years after initial discharge. The continuum of settings included acute care emergency departments inpatient rehabilitation (IR complex continuing care home care services and physician visits. All costs were calculated retrospectively assuming the government payer’s perspective. Results Direct medical costs in an ABI population are substantial with mean cost in the first year post-injury per TBI and nTBI patient being $32132 and $38018 respectively. Among both TBI and nTBI patients those discharged to IR had significantly higher treatment costs than those not discharged to IR across all institutional and community settings. This tendency remained during the entire three-year follow-up period. Annual medical costs of patients hospitalized with a brain injury in Ontario in the first follow-up year were approximately $120.7 million for TBI and $368.7 million for nTBI. Acute care cost accounted for 46-65% of the total treatment cost in the first year overwhelming all other cost components. Conclusions The main finding of this study is that direct medical costs in ABI population are substantial and vary considerably by the injury cause. Although most expenses occur in the first follow-up year ABI patients continue to use variety of medical services in the second and third year with emphasis shifting over time from acute care and inpatient rehabilitation towards homecare physician services and long-term institutional care. More research is needed to capture economic costs for ABI patients not admitted to acute care.

Chen Amy

2012-08-01

134

Nutritional parameters are associated with mortality in acute kidney injury  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: The objective of this study was to perform a nutritional assessment of acute kidney injury patients and to identify the relationship between nutritional markers and outcomes. METHOD: This was a prospective and observational study. Patients who were hospitalized at the Hospital of Botuca [...] tu School of Medicine were evaluated between January 2009 and December 2011. We evaluated a total of 133 patients with a clinical diagnosis of acute kidney injury and a clinical presentation suggestive of acute tubular necrosis. We explored the associations between clinical, laboratory and nutritional markers and in-hospital mortality. Multivariable logistic regression was used to adjust for confounding and selection bias. RESULTS: Non-survivor patients were older (67±14 vs. 59±16 years) and exhibited a higher prevalence of sepsis (57.1 vs. 21.4%) and higher Acute Tubular Necrosis-Individual Severity Scores (0.60±0.22 vs. 0.41±0.21) than did survivor patients. Based on the multivariable analysis, laboratorial parameters such as blood urea nitrogen and C-reactive protein were associated with a higher risk of death (OR: 1.013, p?=?0.0052; OR: 1.050, p?=?0.01, respectively), and nutritional parameters such as low calorie intake, higher levels of edema, lower resistance based on bioelectrical impedance analysis and a more negative nitrogen balance were significantly associated with a higher risk of death (OR: 0.950, p?=?0.01; OR: 1.138, p?=?0.03; OR: 0.995, p?=?0.03; OR: 0.934, p?=?0.04, respectively). CONCLUSIONS: In acute kidney injury patients, a nutritional assessment seems to identify nutritional markers that are associated with outcome. In this study, a low caloric intake, higher C-reactive protein levels, the presence of edema, a lower resistance measured during a bioelectrical impedance analysis and a lower nitrogen balance were significantly associated with risk of death in acute kidney injury patients.

Marina Nogueira, Berbel; Cassiana Regina, de Góes; André Luis, Balbi; Daniela, Ponce.

2014-07-01

135

Nutritional parameters are associated with mortality in acute kidney injury  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: The objective of this study was to perform a nutritional assessment of acute kidney injury patients and to identify the relationship between nutritional markers and outcomes. METHOD: This was a prospective and observational study. Patients who were hospitalized at the Hospital of Botuca [...] tu School of Medicine were evaluated between January 2009 and December 2011. We evaluated a total of 133 patients with a clinical diagnosis of acute kidney injury and a clinical presentation suggestive of acute tubular necrosis. We explored the associations between clinical, laboratory and nutritional markers and in-hospital mortality. Multivariable logistic regression was used to adjust for confounding and selection bias. RESULTS: Non-survivor patients were older (67±14 vs. 59±16 years) and exhibited a higher prevalence of sepsis (57.1 vs. 21.4%) and higher Acute Tubular Necrosis-Individual Severity Scores (0.60±0.22 vs. 0.41±0.21) than did survivor patients. Based on the multivariable analysis, laboratorial parameters such as blood urea nitrogen and C-reactive protein were associated with a higher risk of death (OR: 1.013, p?=?0.0052; OR: 1.050, p?=?0.01, respectively), and nutritional parameters such as low calorie intake, higher levels of edema, lower resistance based on bioelectrical impedance analysis and a more negative nitrogen balance were significantly associated with a higher risk of death (OR: 0.950, p?=?0.01; OR: 1.138, p?=?0.03; OR: 0.995, p?=?0.03; OR: 0.934, p?=?0.04, respectively). CONCLUSIONS: In acute kidney injury patients, a nutritional assessment seems to identify nutritional markers that are associated with outcome. In this study, a low caloric intake, higher C-reactive protein levels, the presence of edema, a lower resistance measured during a bioelectrical impedance analysis and a lower nitrogen balance were significantly associated with risk of death in acute kidney injury patients.

Marina Nogueira, Berbel; Cassiana Regina, de Góes; André Luis, Balbi; Daniela, Ponce.

136

Hemoretroperitoneum associated with liver bare area injuries: CT evaluation  

International Nuclear Information System (INIS)

In hepatic injury restricted to the postero-superior region of segment VII (bare area), hemoperitoneum may be absent and this condition may be associated with hemoretroperitoneum. The aim of this paper is to present the association between bare area injuries and hemoretroperitoneum evaluated by CT. The CT examinations of 32 patients with blunt liver trauma were reviewed and the number and location of lesions were evaluated. Right lobe involvement was identified, focusing on the bare area lesions. The presence of hemoperitoneum and hemoretroperitoneum were determined. In the 32 patients 44 parenchymal lesions were detected. Segment VII was involved in 16 cases: 5 patients presented an intraparenchymal lesion, 11 patients a lesion emerging to the liver surface. In 8 cases the lesion was localized in the bare area. In the 16 patients presenting a segment-VII lesion, hemoperitoneum was detected in 3 cases, hemoretroperitoneum in 4 cases, and both conditions in 4 cases. A traumatic hepatic lesion may be associated with hemoretroperitoneum rather than hemoperitoneum. This justifies the absence of clinical signals of peritoneal irritation; the negativity of both US scan and peritoneal lavage may cause an inappropriate therapeutic management. Computed tomography yields both the detection of the parenchymal damage and the correct localization of the intraperitoneal and retroperitoneal hemorrhage. (orig.)

137

Metformin-associated acute kidney injury and lactic acidosis.  

Science.gov (United States)

Objectives. Metformin is the preferred oral antidiabetic agent for type 2 diabetes. Lactic acidosis is described as a rare complication, usually during an acute kidney injury (AKI). Material and Methods. We conducted a prospective observational study of metformin-associated AKI cases during four years. 29 cases were identified. Previous renal function, clinical data, and outcomes were recorded. Results. An episode of acute gastroenteritis precipitated the event in 26 cases. Three developed a septic shock. Three patients died, the only related factor being liver dysfunction. More severe metabolic acidosis hyperkalemia and anemia were associated with higher probabilities of RRT requirement. We could not find any relationship between previous renal dysfunction and the outcome of the AKI. Conclusions. AKI associated to an episode of volume depletion due to gastrointestinal losses is a serious complication in type 2 diabetic patients on metformin. Previous renal dysfunction (mild-to-moderate CKD) has no influence on the severity or outcome. PMID:21792389

Arroyo, David; Melero, Rosa; Panizo, Nayara; Goicoechea, Marian; Rodríguez-Benítez, Patrocinio; Vinuesa, Soledad García; Verde, Eduardo; Tejedor, Alberto; Luño, José

2011-01-01

138

A proposta da rede de serviços sentinela como estratégia da vigilância de violências e acidentes / The injury surveillance system based on sentinel health services  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: Portuguese Abstract in portuguese No Brasil, as bases de dados oficiais permitem o monitoramento da mortalidade e internações no SUS, decorrentes dos acidentes e violências. É preciso conhecer a magnitude e o perfil dessas causas que demandam os serviços de emergência, bem como identificar alguns problemas ocultos tais como as violê [...] ncias doméstica e sexual. O propósito deste artigo é apresentar a proposta do Ministério da Saúde de implantação da Rede de Serviços Sentinela de Vigilância de Violências e Acidentes - Rede VIVA, iniciada em 2006, que visa complementar o sistema de informações existente para a vigilância dessas causas. Para obter um quadro mais completo do problema e atender à legislação vigente no País, foram estabelecidos dois componentes: 1) Vigilância de acidentes e violências em emergências hospitalares selecionadas: coleta em um mês a cada ano, através de uma amostra; 2) Vigilância das violências sexual, doméstica e/ou outras violências interpessoais em serviços de referência: coleta universal e contínua. O estabelecimento da Rede VIVA foi realizado pelo Ministério da Saúde em parceria com as Secretarias Estaduais e Municipais de Saúde a partir de critérios previamente estabelecidos. A adesão ao projeto foi acima das expectativas, todas as regiões do Brasil foram representadas. Abstract in english In Brazil, the official data sets allow monitoring the impact of injury deaths and injury hospitalization in the public health system. But it is necessary to gather more information about the magnitude and the characteristics of injuries at Emergency Departments (ED), as well as to identify some hid [...] den problems, such as domestic and sexual violence. The purpose of this article is to present the new Injury Surveillance System based on Sentinel Health Services, carried out by the Ministry of Health in order to broaden the knowledge of these causes.To have a more accurate picture of injuries and to enforce the law which made mandatory the information about violence against women in the country, the measures to be taken were twofold: 1) injury surveillance in ED, carried out in chosen services, collecting one-month data yearly, through a sample; 2) domestic, sexual and interpersonal violence surveillance carried out in violence reference services, through universal and continuous data collection, involving a larger number of services. The implementation of that Health Sentinel Services Network has been conducted by the Ministry of Health in partnership with the State and Municipal Health Departments based on pre-established criteria. The adherence to the project has been taken place all over Brazil.

Vilma Pinheiro, Gawryszewski; Marta Maria Alves da, Silva; Deborah Carvalho, Malta; Márcio Denis Medeiros, Mascarenhas; Valter Chaves, Costa; Sônia Gesteira e, Matos; Otaliba Libânio de, Moraes Neto; Rosane Aparecida, Monteiro; Cynthia Gazal, Carvalho; Maria de Lourdes, Magalhães.

139

A proposta da rede de serviços sentinela como estratégia da vigilância de violências e acidentes The injury surveillance system based on sentinel health services  

Directory of Open Access Journals (Sweden)

Full Text Available No Brasil, as bases de dados oficiais permitem o monitoramento da mortalidade e internações no SUS, decorrentes dos acidentes e violências. É preciso conhecer a magnitude e o perfil dessas causas que demandam os serviços de emergência, bem como identificar alguns problemas ocultos tais como as violências doméstica e sexual. O propósito deste artigo é apresentar a proposta do Ministério da Saúde de implantação da Rede de Serviços Sentinela de Vigilância de Violências e Acidentes - Rede VIVA, iniciada em 2006, que visa complementar o sistema de informações existente para a vigilância dessas causas. Para obter um quadro mais completo do problema e atender à legislação vigente no País, foram estabelecidos dois componentes: 1 Vigilância de acidentes e violências em emergências hospitalares selecionadas: coleta em um mês a cada ano, através de uma amostra; 2 Vigilância das violências sexual, doméstica e/ou outras violências interpessoais em serviços de referência: coleta universal e contínua. O estabelecimento da Rede VIVA foi realizado pelo Ministério da Saúde em parceria com as Secretarias Estaduais e Municipais de Saúde a partir de critérios previamente estabelecidos. A adesão ao projeto foi acima das expectativas, todas as regiões do Brasil foram representadas.In Brazil, the official data sets allow monitoring the impact of injury deaths and injury hospitalization in the public health system. But it is necessary to gather more information about the magnitude and the characteristics of injuries at Emergency Departments (ED, as well as to identify some hidden problems, such as domestic and sexual violence. The purpose of this article is to present the new Injury Surveillance System based on Sentinel Health Services, carried out by the Ministry of Health in order to broaden the knowledge of these causes.To have a more accurate picture of injuries and to enforce the law which made mandatory the information about violence against women in the country, the measures to be taken were twofold: 1 injury surveillance in ED, carried out in chosen services, collecting one-month data yearly, through a sample; 2 domestic, sexual and interpersonal violence surveillance carried out in violence reference services, through universal and continuous data collection, involving a larger number of services. The implementation of that Health Sentinel Services Network has been conducted by the Ministry of Health in partnership with the State and Municipal Health Departments based on pre-established criteria. The adherence to the project has been taken place all over Brazil.

Vilma Pinheiro Gawryszewski

2006-01-01

140

A proposta da rede de serviços sentinela como estratégia da vigilância de violências e acidentes / The injury surveillance system based on sentinel health services  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese No Brasil, as bases de dados oficiais permitem o monitoramento da mortalidade e internações no SUS, decorrentes dos acidentes e violências. É preciso conhecer a magnitude e o perfil dessas causas que demandam os serviços de emergência, bem como identificar alguns problemas ocultos tais como as violê [...] ncias doméstica e sexual. O propósito deste artigo é apresentar a proposta do Ministério da Saúde de implantação da Rede de Serviços Sentinela de Vigilância de Violências e Acidentes - Rede VIVA, iniciada em 2006, que visa complementar o sistema de informações existente para a vigilância dessas causas. Para obter um quadro mais completo do problema e atender à legislação vigente no País, foram estabelecidos dois componentes: 1) Vigilância de acidentes e violências em emergências hospitalares selecionadas: coleta em um mês a cada ano, através de uma amostra; 2) Vigilância das violências sexual, doméstica e/ou outras violências interpessoais em serviços de referência: coleta universal e contínua. O estabelecimento da Rede VIVA foi realizado pelo Ministério da Saúde em parceria com as Secretarias Estaduais e Municipais de Saúde a partir de critérios previamente estabelecidos. A adesão ao projeto foi acima das expectativas, todas as regiões do Brasil foram representadas. Abstract in english In Brazil, the official data sets allow monitoring the impact of injury deaths and injury hospitalization in the public health system. But it is necessary to gather more information about the magnitude and the characteristics of injuries at Emergency Departments (ED), as well as to identify some hid [...] den problems, such as domestic and sexual violence. The purpose of this article is to present the new Injury Surveillance System based on Sentinel Health Services, carried out by the Ministry of Health in order to broaden the knowledge of these causes.To have a more accurate picture of injuries and to enforce the law which made mandatory the information about violence against women in the country, the measures to be taken were twofold: 1) injury surveillance in ED, carried out in chosen services, collecting one-month data yearly, through a sample; 2) domestic, sexual and interpersonal violence surveillance carried out in violence reference services, through universal and continuous data collection, involving a larger number of services. The implementation of that Health Sentinel Services Network has been conducted by the Ministry of Health in partnership with the State and Municipal Health Departments based on pre-established criteria. The adherence to the project has been taken place all over Brazil.

Vilma Pinheiro, Gawryszewski; Marta Maria Alves da, Silva; Deborah Carvalho, Malta; Márcio Denis Medeiros, Mascarenhas; Valter Chaves, Costa; Sônia Gesteira e, Matos; Otaliba Libânio de, Moraes Neto; Rosane Aparecida, Monteiro; Cynthia Gazal, Carvalho; Maria de Lourdes, Magalhães.

 
 
 
 
141

Clinic-based surveillance for bacterial- and rotavirus-associated diarrhea in Egyptian children.  

Science.gov (United States)

To identify enteropathogens for vaccine development, we implemented clinic-based surveillance for severe pediatric diarrhea in Egypt's Nile River Delta. Over 2 years, a physician clinically evaluated and obtained stool samples for microbiology from patients with diarrhea and less than 6 years of age. In the first (N = 714) and second clinic (N = 561), respectively, 36% (N = 254) and 46% (N = 260) of children were infected with rotavirus, enterotoxigenic Escherichia coli (ETEC), Campylobacter, or Shigella. When excluding mixed rotavirus-bacterial infections, for the first and second clinic, 23% and 10% had rotavirus-associated diarrhea, and 14% and 17% had ETEC-associated diarrhea, respectively. Campylobacter-associated diarrhea was 1% and 3%, and Shigella-associated diarrhea was 2% and 1%, respectively, for the two clinics. Rotavirus-associated diarrhea peaked in late summer to early winter, while bacterial agents were prevalent during summer. Rotavirus-associated cases presented with dehydration, vomiting, and were often hospitalized. Children with Shigella- or Campylobacter-associated diarrhea reported as watery diarrhea and rarely dysentery. ETEC did not have any clinically distinct characteristics. For vaccine development and/or deployment, our study suggests that rotavirus is of principle concern, followed by ETEC, Shigella, and Campylobacter. PMID:16407360

Wierzba, Thomas F; Abdel-Messih, Ibrahim Adib; Abu-Elyazeed, Remon; Putnam, Shannon D; Kamal, Karim A; Rozmajzl, Patrick; Ahmed, Salwa F; Fatah, Abdel; Zabedy, Khaled; Shaheen, Hind I; Sanders, John; Frenck, Robert

2006-01-01

142

Salmonella infections associated with international travel: a Foodborne Diseases Active Surveillance Network (FoodNet) study.  

Science.gov (United States)

Salmonella species cause an estimated 1.2 million infections per year in the United States, making it one of the most commonly reported enteric pathogens. In addition, Salmonella is an important cause of travel-associated diarrhea and enteric fever, a systemic illness commonly associated with Salmonella serotypes Typhi and Paratyphi A. We reviewed cases of Salmonella infection reported to the Centers for Disease Control and Prevention's (CDC) Foodborne Diseases Active Surveillance Network (FoodNet), a sentinel surveillance network, from 2004 to 2008. We compared travelers with Salmonella infection to nontravelers with Salmonella infection with respect to demographics, clinical characteristics, and serotypes. Among 23,712 case-patients with known travel status, 11% had traveled internationally in the 7 days before illness. Travelers with Salmonella infection tended to be older (median age, 30 years) than nontravelers (median age, 24 years; pdestinations reported were Mexico (38% of travel-associated infections), India (9%), Jamaica (7%), the Dominican Republic (4%), China (3%), and the Bahamas (2%). The proportions of travelers with Salmonella infection hospitalized and with invasive disease were inversely related to the income level of the destination (p<0.0001). The most commonly reported serotypes, regardless of travel status, were Enteritidis (19% of cases), Typhimurium (14%), Newport (9%), and Javiana (5%). Among infections caused by these four serotypes, 22%, 6%, 5%, and 4%, respectively, were associated with travel. A high index of clinical suspicion for Salmonella infection is appropriate when evaluating recent travelers, especially those who visited Africa, Asia, or Latin America. PMID:21563923

Johnson, Laura R; Gould, L Hannah; Dunn, John R; Berkelman, Ruth; Mahon, Barbara E

2011-09-01

143

Association of prostate cancer risk alleles with unfavourable pathological characteristics in potential candidates for active surveillance  

Science.gov (United States)

OBJECTIVE To assess whether the carrier status of 35 risk alleles for prostate cancer (CaP) is associated with having unfavourable pathological features in the radical prostatectomy specimen in men with clinically low risk CaP who fulfil commonly accepted criteria as candidates for active surveillance. PATIENTS AND METHODS We studied men of European ancestry with CaP who fulfilled the commonly accepted clinical criteria for active surveillance (T1c, prostate-specific antigen < 10 ng/mL, biopsy Gleason ? 6, three or fewer positive cores, ? 50% tumour involvement/core) but instead underwent early radical prostatectomy. We genotyped these men for 35 CaP risk alleles. We defined ‘ unfavourable ’ pathological characteristics to be Gleason ? 7 and/or ? pT2b in their radical prostatectomy specimen. RESULTS In all, 263 men (median age 60 [46 – 72] years) fulfilled our selection criteria for active surveillance, and 58 of 263 (22.1%) were found to have ‘ unfavourable ’ pathological characteristics. The frequencies of three CaP risk alleles (rs1447295 [8q24], P = 0.004; rs1571801 [9q33.2], P = 0.03; rs11228565 [11q13], P = 0.02) were significantly higher in men with ‘ unfavourable ’ pathological characteristics. Two other risk alleles were proportionately more frequent (rs10934853 [3q21], P = 0.06; rs1859962 [17q24], P = 0.07) but did not achieve nominal statistical significance. Carriers of any one of the significantly over-represented risk alleles had twice the likelihood of unfavourable tumour features (P = 0.03), and carriers of any two had a sevenfold increased likelihood (P = 0.001). Receiver – operator curve analysis demonstrated an area under the curve of 0.66, suggesting that the number of single nucleotide polymorphisms carried provided discrimination between men with ‘ favourable ’ and ‘ unfavourable ’ tumour features in their prostatectomy specimen. CONCLUSION In potential candidates for active surveillance, certain CaP risk alleles are more prevalent in patients with ‘ unfavourable ’ pathological characteristics in their radical prostatectomy specimen. PMID:22077888

Kundu, Shilajit; Hu, Qiaoyan; Banks, Jessica A.; Cooper, Phillip; Catalona, William J.

2014-01-01

144

Inflammatory Signalling Associated with Brain Dead Organ Donation: From Brain Injury to Brain Stem Death and Posttransplant Ischaemia Reperfusion Injury  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Brain death is associated with dramatic and serious pathophysiologic changes that adversely affect both the quantity and quality of organs available for transplant. To fully optimise the donor pool necessitates a more complete understanding of the underlying pathophysiology of organ dysfunction associated with transplantation. These injurious processes are initially triggered by catastrophic brain injury and are further enhanced during both brain death and graft transplantation. The activated...

Watts, Ryan P.; Fraser, John F.

2013-01-01

145

Serum Liver Enzyme Pattern in Birth Asphyxia Associated Liver Injury  

Science.gov (United States)

Purpose To study temporal pattern of serum liver enzymes levels in newborns with hepatic injury associated with birth asphyxia (BA). Methods Singleton term newborns with BA and ?72 hours of age admitted to neonatal intensive care unit were prospectively enrolled. Term newborns with physiological jaundice and without BA were studied as controls. Serum liver enzymes were measured at +2 SD) above the mean of control subjects at any of the three time points. Results Sixty controls and 62 cases were enrolled. Thirty-five cases (56%) developed BA-associated liver injury (ALT>81 IU/L). They had higher serum levels of ALT, aspartate aminotransferase, lactate dehydrogenase than the control infants, with peak at 24-72 hours. In controls, serum liver enzyme levels were significantly higher in appropriate-for-date (AFD) babies than small-for-date (SFD) babies. Serum enzyme pattern and extent of elevation were comparable between SFD and AFD babies. Degree of serum liver enzyme elevation had no relationship with severity of hypoxic encephalopathy. Conclusion Serum liver enzyme elevation is common in BA; it peaks at 24-72 hours followed by a sharp decline by 6-12 days of age. Pattern and extent of enzyme elevation are comparable between SFD and AFD babies. PMID:25349832

Chhavi, Nanda; Zutshi, Kiran; Singh, Niranjan Kumar; Awasthi, Ashish

2014-01-01

146

Revisiting acute liver injury associated with herbalife products.  

Science.gov (United States)

In the November 27, 2010 issue of the World Journal of Hepatology (WJH), three case reports were published which involved patients who had consumed various dietary supplements and conventional foods generally marketed as weight loss products. The reference to Herbalife products as contaminated and generally comparable to all dietary supplements or weight loss products is not scientifically supported. The authors provided an insufficient amount of information regarding patient histories, concomitant medications and other compounds, dechallenge results, and product specifications and usage. This information is necessary to fully assess the association of Herbalife products in the WJH case reports. Therefore, the article does not objectively support a causal relationship between the reported cases of liver injury and Herbalife products or ingredients. PMID:22059112

Appelhans, Kristy; Smith, Casey; Bejar, Ezra; Henig, Y Steve

2011-10-27

147

Vigilancia epidemiológica de infecciones asociadas a la asistencia sanitaria / Epidemiological surveillance of healthcare-associated infections  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Introducción: la vigilancia epidemiológica es una herramienta útil para identificar el riesgo de adquirir una infección asociada a la asistencia sanitaria en los hospitales y los factores de riesgo relacionados. Objetivo: demostrar los resultados de la vigilancia epidemiológica de infecciones en el [...] Hospital General Abel Santamaría Cuadrado de la provincia Pinar del Río. Material y método: se realizó un estudio observacional, descriptivo, prospectivo. El universo de estudio quedó constituido por los 25786 pacientes egresados en el año 2012 y la muestra por los 578 pacientes que adquirieron una infección asociada a la asistencia sanitaria. Se utilizaron las variables: servicio de procedencia, localización de la infección, microorganismo aislado y defunción. La información se obtuvo mediante la revisión de historias clínicas, registros de microbiología, registros de anatomía patológica y certificados de defunción. Resultados: se obtuvo una tasa global de infección de 2,2 por cada 100 egresos del servicio. El 47,5% de los pacientes con infecciones tuvo una afección respiratoria. Las enterobacterias fueron los gérmenes de mayor frecuencia de aislamiento, predominando entre ellos la E. Coli y el enterobacter. El riesgo de morir por infecciones asociadas a la asistencia fue de 4 por 1000 egresos hospitalarios, con un letalidad de un 20,1%. Conclusiones: la vigilancia epidemiológica mostró ser efectiva para la identificación de infecciones asociadas a la asistencia, con una tasa de incidencia hospitalaria adecuada, siendo más frecuentes las infecciones respiratorias sobre todo por enterobacterias, con una mortalidad y letalidad adecuada para este tipo de hospital. Abstract in english Introduction: epidemiological surveillance is useful for identifying the risk of acquiring in hospitals a healthcare-associated infection and other related risk factors. Objective: show the results of epidemiological surveillance of infections in Abel Santamaría Cuadrado General Hospital of Pinar de [...] l Río Province. Material and method: An observational, descriptive, prospective study. The study group was composed of the 25 786 patients discharged in 2012 and the sample, by the 578 patients who acquired an infection associated to healthcare. The following variables were used: service of origin, location of infection, isolated organism and death. The information was obtained by reviewing medical, microbiology and pathological anatomy records and death certificates. Results: a generalized infection rate of 2.2 per 100 discharges from service was obtained. 47.5% of patients with infections had a respiratory condition. Enterobacteria were germs isolated the most, predominantly including E. coli and Enterobacter. The risk of dying from healthcare-associated infections was 4 per 1000 hospital discharges with a fatality rate of 20.1%. Conclusions: epidemiological surveillance was effective for identifying healthcare-associated infections with an adequate rate of hospital incidence, being more frequent respiratory infections, especially Enterobacteriaceae, with mortality and lethality suitable for this type of hospital.

Vicente Mario, Pacheco Licor; Dianelys de la Caridad, Gutiérrez Castañeda; Marly, Serradet Gómez.

2014-06-01

148

Association of lower limb injury with boot cleat design and playing surface in elite soccer.  

Science.gov (United States)

Reducing external injury risk factors associated with the boot-surface interaction is important in reducing the incidence and severity of foot and ankle injury. A review of prospective football (soccer) injury epidemiology studies determined that the incidence of noncontact ankle sprain injury is relatively high. Research on the impact of cleat shape and configuration and boot design on the boot-surface interaction is providing new understanding of the impact on player biomechanics and injury risk but is not keeping pace with commercial advances in boot design and innovation in natural and synthetic turf surface technology. PMID:23707183

O'Connor, Anne-Marie; James, Iain T

2013-06-01

149

Ventilator-associated lung injury during assisted mechanical ventilation.  

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Assisted mechanical ventilation (MV) may be a favorable alternative to controlled MV at the early phase of acute respiratory distress syndrome (ARDS), since it requires less sedation, no paralysis and is associated with less hemodynamic deterioration, better distal organ perfusion, and lung protection, thus reducing the risk of ventilator-associated lung injury (VALI). In the present review, we discuss VALI in relation to assisted MV strategies, such as volume assist-control ventilation, pressure assist-control ventilation, pressure support ventilation (PSV), airway pressure release ventilation (APRV), APRV with PSV, proportional assist ventilation (PAV), noisy ventilation, and neurally adjusted ventilatory assistance (NAVA). In summary, we suggest that assisted MV can be used in ARDS patients in the following situations: (1) Pao(2)/Fio(2) >150?mm Hg and positive end-expiratory pressure???5 cm H(2)O and (2) with modalities of pressure-targeted and time-cycled breaths including more or less spontaneous or supported breaths (A-PCV [assisted pressure-controlled ventilation] or APRV). Furthermore, during assisted MV, the following parameters should be monitored: inspiratory drive, transpulmonary pressure, and tidal volume (6 mL/kg). Further studies are required to determine the impact of novel modalities of assisted ventilation such as PAV, noisy pressure support, and NAVA on VALI. PMID:25105820

Saddy, Felipe; Sutherasan, Yuda; Rocco, Patricia R M; Pelosi, Paolo

2014-08-01

150

Severe rhabdomyolysis without renal injury associated with lightning strike.  

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Lightning strikes cause injuries in multiple systems and organs. Early recognition of lightning injury syndromes and anticipation of harmful complications can improve outcomes for these patients. The author has presented a case report of a patient who was struck by lightning and exhibited extensive soft tissue injury with myoglobinuria. He was treated with delayed fasciotomy and had evidence of severe muscle injury with markedly elevated creatine kinase levels that gradually improved with aggressive fluid infusion. The patient did not require alkalinization of urine, mannitol, or dialysis, and his renal function remained normal. PMID:22929530

Navarrete, Norberto; Aldana, Norberto Navarrete

2013-01-01

151

Role of quantitative endotracheal aspirate and cultures as a surveillance and diagnostic tool for ventilator associated pneumonia: A pilot study  

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Full Text Available Background: Accurate diagnosis and appropriate treatment of ventilator associated pneumonia (VAP is crucial for good outcomes. Endotracheal suctioning is performed in ventilated patients as part of routine care and for tracheal toileting. Aim: We evaluated if quantitative endotracheal aspirate (ETA was a suitable alternative to bronchoalveolar lavage (BAL for suspected VAP. In addition we assessed if surveillance ETA guided antibiotic selection for subsequent VAP. Setting and Design: Prospective study in the surgical intensive care unit (ICU of a tertiary hospital in India. Materials and Methods: Two hundred consecutive patients with mean (standard deviation APACHE II score of 12.3±5 and requiring mechanical ventilation beyond 48 hours underwent surveillance ETA cultures. A second ETA and BAL were performed if the patient developed features of VAP. The threshold for microbiological diagnosis of VAP was taken as 10 5 colony forming units/ml (cfu/ml for ETA and 10 4 cfu/ml for BAL. Statistical Analysis: The sensitivity and specificity of surveillance and concurrent ETA aspirate cultures were compared with BAL cultures. RESULTS: VAP was suspected clinically and corroborated radiologically in 27/177 patients (15.3%. Although microbiological support for VAP was obtained by ETA in 19 patients, bronchoscopy was possible only in 13 patients, 8 of whom had isolates at significant threshold. Of the 16 organisms isolated from BAL, 11 were of significant threshold with 9/11 (82% BAL isolates having a similar antibiogram to a concurrent ETA. Only one BAL isolate (9%, at significant threshold, was not isolated on a concurrent ETA. On the other hand just 6/11 BAL isolates (55% had an identical antibiogram to surveillance ETA. BAL had 3 additional isolates (27% at significant threshold not isolated on surveillance ETA. Conclusions: Concurrent quantitative ETA could substitute BAL cultures for VAP. Surveillance ETA at 48 hours of ventilation does not appear to assist with antibiotic selection for a subsequent VAP.

Nair Shalini

2008-08-01

152

Acromioclavicular joint dislocation with associated brachial plexus injury.  

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We present the case of a 32-year-old female who sustained a left acromioclavicular (AC) joint type V injury and brachial plexus injury. The patient's AC joint injury was identified 6?days after she was involved in a motorbike accident where she sustained multiple other injuries. She required operative fixation of the AC joint using a locking compression medial proximal tibial plate. At 3?months post operatively, the patient was found to have a subluxed left shoulder as a result of an axonal injury to the upper trunk of the brachial plexus. In addition, the tibial plate had cut out. The plate was subsequently removed. At 8?months the glenohumeral articulation had been restored and the patient had clinically regained significant shoulder function. After 15?months the patient was pain free and could complete all her activities of daily living without impediment. She returned to playing competitive pool after 24?months. PMID:24855076

Gallagher, Charles Alexander; Blakeney, William; Zellweger, René

2014-01-01

153

Inflammatory Signalling Associated with Brain Dead Organ Donation: From Brain Injury to Brain Stem Death and Posttransplant Ischaemia Reperfusion Injury  

Science.gov (United States)

Brain death is associated with dramatic and serious pathophysiologic changes that adversely affect both the quantity and quality of organs available for transplant. To fully optimise the donor pool necessitates a more complete understanding of the underlying pathophysiology of organ dysfunction associated with transplantation. These injurious processes are initially triggered by catastrophic brain injury and are further enhanced during both brain death and graft transplantation. The activated inflammatory systems then contribute to graft dysfunction in the recipient. Inflammatory mediators drive this process in concert with the innate and adaptive immune systems. Activation of deleterious immunological pathways in organ grafts occurs, priming them for further inflammation after engraftment. Finally, posttransplantation ischaemia reperfusion injury leads to further generation of inflammatory mediators and consequent activation of the recipient's immune system. Ongoing research has identified key mediators that contribute to the inflammatory milieu inherent in brain dead organ donation. This has seen the development of novel therapies that directly target the inflammatory cascade. PMID:23691272

Watts, Ryan P.; Thom, Ogilvie; Fraser, John F.

2013-01-01

154

Surveillance of multidrug resistance-associated genes in Acinetobacter baumannii isolates from elderly patients  

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Full Text Available Objective?To understand the status of multidrug resistance-associated genes carried by Acinetobacter baumannii isolates from elderly patients in our hospital in order to provide a basis for surveillance of drug-resistance and inflection control. Methods?One hundred and twenty A. baumannii isolates were collected from elderly patients between 2008 and 2010. The mean age of the patients was 85 (65 to 95 years. Whonet 5.6 software was used to analyze the resistance rate of 16 antimicrobial agents. Polymerase chain reaction (PCR and the sequencing method were adopted to detect 10 kinds of resistance genes (blaOXA-51-like, blaOXA- 23-like, blaOXA-24-like, blaOXA-58-like, blaTEM, blaampC, armA, ISAba1, intI 1, and intI 2. The corresponding resistance gene profiling(RGP was analyzed and designated according to the status of resistance genes. Results?The resistance rates to the remaining 15 kinds of antibiotics varied between 70.8% and 97.5%, with the exception of the sensitivity rate to polymyxin B by up to more than 90%. The positivity rates of blaOXA-51-like, blaOXA-23-like, blaOXA-58-like, blaTEM, blaampC, armA, ISAba1 and intI 1 were 100%, 81.7%, 0.8%, 10.8%, 91.7%, 81.7%, 86.7%, and 83.3% respectively. A total of 18 kinds of drug-resistant gene maps were found, but blaOXA-24-like and intI 2 were not detected. Among these gene maps, the rate of RGP1 (blaOXA-23-like+blaampC+armA+ISAba1+ intI 1 was as high as 60.8%. Conclusions A. baumannii isolates from elderly patients have a higher carrying rate of drug-resistant genes, resulting in severe multidrugresistant conditions. Therefore, full-time infection control personnel and clinical physicians should actively participate in the surveillance, prevention, and control of infections caused by A. baumannii in the elderly.

Zhe DONG

2012-03-01

155

Cellular therapies for treating pain associated with spinal cord injury  

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Full Text Available Abstract Spinal cord injury leads to immense disability and loss of quality of life in human with no satisfactory clinical cure. Cell-based or cell-related therapies have emerged as promising therapeutic potentials both in regeneration of spinal cord and mitigation of neuropathic pain due to spinal cord injury. This article reviews the various options and their latest developments with an update on their therapeutic potentials and clinical trialing.

Leung Lawrence

2012-03-01

156

Review of liver injury associated with dietary supplements.  

Science.gov (United States)

Dietary supplements (DS) are easily available and increasingly used, and adverse hepatic reactions have been reported following their intake. To critically review the literature on liver injury because of DSs, delineating patterns and mechanisms of injury and to increase the awareness towards this cause of acute and chronic liver damage. Studies and case reports on liver injury specifically because of DSs published between 1990 and 2010 were searched in the PubMed and EMBASE data bases using the terms 'dietary/nutritional supplements', 'adverse hepatic reactions', 'liver injury'; 'hepatitis', 'liver failure', 'vitamin A' and 'retinoids', and reviewed for yet unidentified publications. Significant liver injury was reported after intake of Herbalife and Hydroxycut products, tea extracts from Camellia sinensis, products containing usnic acid and high contents of vitamin A, anabolic steroids and others. No uniform pattern of hepatotoxicity has been identified and severity may range from asymptomatic elevations of serum liver enzymes to hepatic failure and death. Exact estimates on how frequent adverse hepatic reactions occur as a result of DSs cannot be provided. Liver injury from DSs mimicking other liver diseases is increasingly recognized. Measures to reduce risk include tighter regulation of their production and distribution and increased awareness of users and professionals of the potential risks. PMID:21457433

Stickel, Felix; Kessebohm, Kerstin; Weimann, Rosemarie; Seitz, Helmut K

2011-05-01

157

Using mortuary statistics in the development of an injury surveillance system in Ghana / Utilisation des statistiques des morgues d'hôpital dans la mise au point d'un système de surveillance des traumatismes au Ghana / Uso de estadísticas de depósitos de cadáveres para desarrollar un sistema de vigilancia de los traumatismos en Ghana  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: English Abstract in spanish OBJETIVO: Desarrollar un programa piloto destinado a mejorar la exactitud de los registros de las defunciones por traumatismos en un depósito de cadáveres. MÉTODOS: Se procedió a mejorar el sistema de registro de las defunciones por traumatismos en la morgue del Hospital Docente Komfo Anokye, en Kum [...] asi, Ghana, en 1996, procediendo para ello a crear una base de datos prospectivos. RESULTADOS: Se observó un incremento del número de defunciones por traumatismos notificadas anualmente, de las 72 registradas antes de 1995 a las 633 de 1996-1999. Los traumatismos representaban el 8,6% de todas las defunciones registradas en la morgue, y el 12% de las defunciones registradas en el intervalo de 15 a 59 años; el 80% de las defunciones causadas por traumatismos se produjeron fuera del hospital, y por tanto no aparecían reflejadas en las estadísticas hospitalarias. El 88% de las defunciones por traumatismos estaban relacionadas con el transporte, y en el 50% de los casos las víctimas eran peatones. CONCLUSIÓN: Los traumatismos eran una causa importante de mortalidad en este entorno urbano de África, sobre todo entre los adultos en edad activa. Usando métodos sencillos y baratos se consiguió hacer más completa y precisa la notificación de las defunciones asociadas a traumatismos en un depósito de cadáveres. Esta fuente de datos podría ser una contribución importante a un sistema de vigilancia de los traumatismos, junto con los archivos hospitalarios y los informes de la policía sobre los accidentes. Abstract in english OBJECTIVE: To develop, in a mortuary setting, a pilot programme for improving the accuracy of records of deaths caused by injury. METHODS: The recording of injury-related deaths was upgraded at the mortuary of the Komfo Anokye Teaching Hospital, Kumasi, Ghana, in 1996 through the creation of a prosp [...] ectively gathered database. FINDINGS: There was an increase in the number of deaths reported annually as attributable to injury from 72 before 1995 to 633 in 1996-99. Injuries accounted for 8.6% of all deaths recorded in the mortuary and for 12% of deaths in the age range 15-59 years; 80% of deaths caused by injury occurred outside the hospital and thus would not have been indicated in hospital statistics; 88% of injury-related deaths were associated with transport, and 50% of these involved injuries to pedestrians. CONCLUSIONS: Injury was a significant cause of mortality in this urban African setting, especially among adults of working age. The reporting of injury-related deaths in a mortuary was made more complete and accurate by means of simple inexpensive methods. This source of data could make a significant contribution to an injury surveillance system, along with hospital records and police accident reports.

Jason, London; Charles, Mock; Francis A., Abantanga; Robert E., Quansah; K.A., Boateng.

158

The Association Between Environmental Events and Self-Injurious Behaviour in Cornelia de Lange Syndrome  

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There has been limited empirical research into the environmental causes of self-injury in Cornelia de Lange syndrome. The present study examined the variability of self-injurious behaviour in Cornelia de Lange syndrome across environmental setting events. Additionally, the association between setting events and more specific environmental events…

Moss, J.; Oliver, C.; Hall, S.; Arron, K.; Sloneem, J.; Petty, J.

2005-01-01

159

[Hypoxic brain injuries notified to the Danish Patient Insurance Association during 1992-2004. Secondary publication  

DEFF Research Database (Denmark)

We investigated the files of the Danish Patient Insurance Association for newborns suffering from hypoxic brain injuries. From 1992 to 2004, a total of 127 approved claims concerning peripartum hypoxic injury were registered. Thirty-eight newborns died and the majority of the 89 surviving children suffered major handicaps, primarily cerebral palsy. In 69 of the cases, misinterpretation of or late action in response to an abnormal cardiotocography caused the hypoxic brain injuries. All injuries could potentially have been avoided using established obstetric practice Udgivelsesdato: 2008/9/1

Bock, J.; Christoffersen, J.K.

2008-01-01

160

Nonsuicidal Self-Injury in an American Indian Reservation Community: Results from the White Mountain Apache Surveillance System, 2007-2008  

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Objective: To describe characteristics and correlates of nonsuicidal self-injury (NSSI) among the White Mountain Apache Tribe. NSSI has not been studied before in American Indian samples despite associated risks for suicide, which disproportionately affect American Indian youth. Method: Apache case managers collected data through a tribally…

Cwik, Mary F.; Barlow, Allison; Tingey, Lauren; Larzelere-Hinton, Francene; Goklish, Novalene; Walkup, John T.

2011-01-01

 
 
 
 
161

Renal-associated TLR2 mediates ischemia/reperfusion injury in the kidney.  

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TLRs are conserved pattern recognition receptors that detect motifs of pathogens and host material released during injury. For unknown reasons, renal TLR2 mRNA is mainly expressed by tubular cells and is enhanced upon renal ischemia/reperfusion (I/R) injury. We evaluated the role of TLR2 in I/R injury using TLR2-/- and TLR2+/+ mice, TLR2 antisense oligonucleotides, and chimeric mice deficient in leukocyte or renal TLR2. Tubular cells needed TLR2 to produce significant cytokine and chemokine amounts upon ischemia in vitro. TLR2 played a proinflammatory and detrimental role in vivo after I/R injury, as reflected by a reduction in the amount of local cytokines and chemokines, leukocytes, and the level of renal injury and dysfunction in TLR2-/- mice compared with controls. Analysis of chimeric mice suggested that TLR2 expressed on renal parenchyma plays a crucial role in the induction of inflammation and injury. TLR2-antisense treatment protected mice from renal dysfunction, neutrophil influx, and tubular apoptosis after I/R injury compared with nonsense treatment. In summary, we identified renal-associated TLR2 as an important initiator of inflammatory responses leading to renal injury and dysfunction in I/R injury. These data imply that TLR2 blockade could provide a basis for therapeutic strategies to treat or prevent renal ischemic injury. PMID:16167081

Leemans, Jaklien C; Stokman, Geurt; Claessen, Nike; Rouschop, Kasper M; Teske, Gwendoline J D; Kirschning, Carsten J; Akira, Shizuo; van der Poll, Tom; Weening, Jan J; Florquin, Sandrine

2005-10-01

162

Reducing the risk of needlestick injury associated with implanted ports.  

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Implanted ports give many of our patients a sense of freedom that they have not known since they have been sick. Between infusions, they do not have to be reminded constantly of their illness through an external vascular access device. However, this patient advantage does carry some degree of risk for the nurse working with the patient and the device. Needlestick injuries are serious and expensive. There is a financial and emotional toll that cannot be measured. Each employer is required by OSHA to have an exposure control plan for eliminating or minimizing employee exposure to bloodborne pathogens (OSHA, 1991, 1994). Inventions such as the HuberLoc meet the criteria for devices that can reduce the risk of injury through engineering controls. Agencies need to know that OSHA-mandated worker protection can be both easy to use and cost effective. Home care nurses need to be more proactive in informing agencies about such devices and lobbying for their use. PMID:9592423

Carroll, P L

1998-04-01

163

Accuracy of administrative code data for the surveillance of healthcare-associated infections: a systematic review and meta-analysis.  

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Administrative code data (ACD), such as International Classifications of Diseases, Ninth Revision, Clinical Modification codes, are widely used in surveillance and public reporting programs that seek to identify healthcare-associated infections (HAIs); however, little is known about their accuracy. This systematic review summarizes evidence for the accuracy of ACD for the detection of selected HAIs, including catheter-associated urinary tract infection, Clostridium difficile infection (CDI), central line-associated bloodstream infection, ventilator-associated pneumonia/events, postprocedure pneumonia, methicillin-resistant Staphylococcus aureus, and surgical site infections (SSIs). We conducted meta-analysis for SSIs and CDIs, where acceptable numbers of primary studies were available. For these 2 conditions, ACD have moderate sensitivity and high specificity, but evidence for detection of other HAIs is limited. With current low prevalence of HAIs, the positive predictive value of ACD algorithms would be low. ACD may be inaccurate for detection of many HAIs and should be used cautiously for surveillance and reporting purposes. PMID:24218103

Goto, Michihiko; Ohl, Michael E; Schweizer, Marin L; Perencevich, Eli N

2014-03-01

164

Acute mild traumatic brain injury is not associated with white matter change on diffusion tensor imaging.  

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This study was designed to (i) evaluate the influence of age on diffusion tensor imaging measures of white matter assessed using tract-based spatial statistics; (ii) determine if mild traumatic brain injury is associated with microstructural changes in white matter, in the acute phase following injury, in a large homogenous sample that was carefully screened for pre-injury medical, psychiatric, or neurological problems; and (iii) examine if injury severity is related to white matter changes. Participants were 75 patients with acute mild traumatic brain injury (age = 37.2 ± 12.0 years, 45 males and 30 females) and 40 controls (age = 40.6 ± 12.2 yrs, 20 males and 20 females). Age effects were analysed by comparing control subgroups aged 31-40, 41-50, and 51-60 years against a group of 18-30-year-old control subjects. Widespread statistically significant areas of abnormal diffusion tensor measures were observed in older groups. Patients and controls were compared using age and gender as covariates and in age- and gender-matched subgroups. Subgroups of patients with more severe injuries were compared to age-and gender-matched controls. No significant differences were detected in patient-control or severity analyses (all P-value > 0.01). In this large, carefully screened sample, acute mild traumatic brain injury was not associated with diffusion tensor imaging abnormalities detectable with tract-based spatial statistics. PMID:24818956

Ilvesmäki, Tero; Luoto, Teemu M; Hakulinen, Ullamari; Brander, Antti; Ryymin, Pertti; Eskola, Hannu; Iverson, Grant L; Ohman, Juha

2014-07-01

165

Use of consomic rats for genomic insights into ventilator-associated lung injury  

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Increasing evidence supports the contribution of genetic influences on susceptibility/severity in acute lung injury (ALI), a devastating syndrome requiring mechanical ventilation with subsequent risk for ventilator-associated lung injury (VALI). To identify VALI candidate genes, we determined that Brown Norway (BN) and Dahl salt-sensitive (SS) rat strains were differentially sensitive to VALI (tidal volume of 20 ml/kg, 85 breaths/min, 2 h) defined by bronchoalveolar lavage (BAL) protein and l...

Nonas, Stephanie A.; Vinasco, Liliana Moreno; Ma, Shwu Fan; Jacobson, Jeffrey R.; Desai, Ankit A.; Dudek, Steven M.; Flores, Carlos; Hassoun, Paul M.; Sam, Lee; Ye, Shui Q.; Moitra, Jaideep; Barnard, Joe; Grigoryev, Dmitry N.; Lussier, Yves A.; Garcia, Joe G. N.

2007-01-01

166

Skin disruption is associated with indomethacin-induced small intestinal injury in mice.  

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One mechanism by which non-steroidal anti-inflammatory drugs (NSAIDs) cause intestinal injury is by inducing matrix metalloproteinases (MMPs) that degrade and remodel the extracellular matrix. In addition to the intestinal mucosa, MMPs are expressed in the skin and can be activated by mast cell-secreted tryptase. We therefore investigated whether intestinal injury resulting from treatment with the NSAID indomethacin induced MMPs in the skin of mice and caused an associated disruption of skin function. Hairless mice and mast cell-deficient mice were administered indomethacin, after which damage to the jejuna and skin was assessed with immunohistochemistry and Western blotting. The plasma concentration of inflammatory mediators was assessed to evaluate potential pathways for signalling skin disruption in response to intestinal injury. In hairless mice with intestinal injury, transepidermal water loss (TEWL) was higher and skin hydration was lower than in control mice. The expression levels of mast cells, tryptase, MMP-1 and MMP-9 were also increased, with concurrent degradation of types I and IV collagen. In contrast, no changes in skin TEWL or skin hydration were observed in mast cell-deficient mice with indomethacin-induced intestinal injury. In all mice evaluated, the plasma concentrations of IgE, IgA, histamine and TNF-? were increased in response to indomethacin treatment. Skin disruption was strongly associated with indomethacin-induced small intestinal injury, and the activation of mast cells and induction of tryptase, MMP-1 and MMP-9 are critical to this association. PMID:25041031

Yokoyama, Satoshi; Hiramoto, Keiichi; Koyama, Mayu; Ooi, Kazuya

2014-09-01

167

Intestinal Injury Currents Associated with Mesenteric Ischemia and Reperfusion  

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A non-invasive method of detecting mesenteric ischemia is presented. The aim of this study was to evaluate the effect of arterial reperfusion on these injury currents. The small bowel of New Zealand white rabbits was exteriorized and the mesenteric blood flow interrupted. Experiments were conducted in three groups, control (n = 3), ischemia (n = 6) and reperfusion following ischemia (n = 5). The subject's position was modulated in and out of the biological field detection range of a SQUID magnetometer. The changes in magnetic field amplitude for the experimental groups were 9.3% and 31.0% for the control and the ischemia groups respectively. The reperfusion group first exhibited a decrease of 17.4% from pre-ischemic to the ischemic period followed by an increase of 13.9% of the ischemic value after re-establishing perfusion. It is concluded that injury currents in GI smooth muscle that appear during ischemia are reduced to pre-ischemic levels during reperfusion.

Cordova, T.; Bradshaw, L. A.; O'Mahony, G. P.; Gallucci, M. R.; Berch, B.; Richards, W. O.

2006-09-01

168

Factores asociados con la intencionalidad en las lesiones de causa externa Intent-associated factors in injuries of external cause  

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Full Text Available Introducción: El aumento de las lesiones intencionales y no intencionales se ha convertido en un apremiante problema de salud pública. Recientemente se hizo énfasis en la importancia de estudiar las "causas" de la violencia para conocer cómo combatirlas. El objetivo del estudio fue identificar los factores asociados con la intencionalidad de las lesiones. Materiales y métodos: Se diseñó un estudio analítico basado en los registros obtenidos del sistema de vigilancia epidemiológica de lesiones de causa externa del Hospital Mario Correa Rengifo de Cali, Colombia. Se incluyeron todos los pacientes y se calcularon estadísticas descriptivas y medidas de asociación. Resultados: Entre el total de 5236 personas que ingresaron con lesiones de causa externa entre noviembre de 2003 y diciembre de 2005, se encontró que 64,0% eran lesiones no intencionales, 32,6% intencionales interpersonales y 1,6% intencionales autoinflingidas. La intencionalidad tiene asociación positiva con sexo masculino (OR: 3,33, ingesta de bebidas alcohólicas (OR: 8,89, consumo de psicofármacos (OR: 5,61, lesiones penetrantes profundas (OR 23,85 y trauma en abdomen (OR 7.90, tórax (OR 7,00, sistémico (OR 2,19 y cuello (OR 1,88. Se observó que las lesiones intencionales tienen puntajes más bajos de RTS que las no intencionales (OR: 2,32. Conclusiones: sistema de vigilancia epidemiológica permite a las instituciones de salud evaluar la morbimortalidad de su población para definir políticas de intervención. Este estudio encontró que la intencionalidad de las lesiones de causa externa tiene una fuerte asociación con consumo de alcohol y otros psicotrópicos. Las características de los factores asociados con lesiones de causa externa permiten implementar integralmente acciones preventivas y educativas en la comunidad, con el propósito de disminuir la ocurrencia de estas lesiones y por tanto la pérdida de vidas.Introduction: The increase in the incidence of intentional and nonintentional injuries has become an important public health problem. There has been a recent emphasis on the importance of investigating the «causes» of violence in order to define how to prevent them. The purpose of the present study was to identify factors associated with intentional injuries. Materials and methods: An analytic study was designed based on the registry of the epidemiologic surveillance system of Hospital Mario Correa Rengifo, Cali, Colombia. All patients were included and the descriptive and association measures were calculated. Results: Among the 5,236 persons that were seen because of injuries of external cause in the period November 2003-December 2005, we found that 64% were nonintentional, 32.6% were interpersonal intentional, and 1.6% were self-inflicted. Intentional lesions exhibited positive association with the male sex (OR 8.89, alcohol and or illegal drug consumption (OR 5.61, penetrating stab wounds (OR 23.85, abdominal trauma (OR 7.90, thoracic trauma (OR 7.00, systemic trauma (OR 2.19, and cervical trauma (OR 1.88. Intentional lesions showed a lower Revised Trauma Score (RTS in comparison with nonintentional lesions (OR 2.32. Conclusions: The hospital epidemiologic surveillance systems permit the evaluation of morbidity and mortality rates and patterns of traumatic lesions of external cause, intentional or nonintentional. Alcohol and illegal drug consumption increase several times the risk of having an intentional lesion and a lesion of greater severity. This information serves the governments to generate preventive programs with the purpose of identifying modifiable variables oriented towards the abolition of violent injuries, especially during weekends.

Mónica Bejarano Castro

2006-12-01

169

Factores asociados con la intencionalidad en las lesiones de causa externa / Intent-associated factors in injuries of external cause  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish Introducción: El aumento de las lesiones intencionales y no intencionales se ha convertido en un apremiante problema de salud pública. Recientemente se hizo énfasis en la importancia de estudiar las "causas" de la violencia para conocer cómo combatirlas. El objetivo del estudio fue identificar los f [...] actores asociados con la intencionalidad de las lesiones. Materiales y métodos: Se diseñó un estudio analítico basado en los registros obtenidos del sistema de vigilancia epidemiológica de lesiones de causa externa del Hospital Mario Correa Rengifo de Cali, Colombia. Se incluyeron todos los pacientes y se calcularon estadísticas descriptivas y medidas de asociación. Resultados: Entre el total de 5236 personas que ingresaron con lesiones de causa externa entre noviembre de 2003 y diciembre de 2005, se encontró que 64,0% eran lesiones no intencionales, 32,6% intencionales interpersonales y 1,6% intencionales autoinflingidas. La intencionalidad tiene asociación positiva con sexo masculino (OR: 3,33), ingesta de bebidas alcohólicas (OR: 8,89), consumo de psicofármacos (OR: 5,61), lesiones penetrantes profundas (OR 23,85) y trauma en abdomen (OR 7.90), tórax (OR 7,00), sistémico (OR 2,19) y cuello (OR 1,88). Se observó que las lesiones intencionales tienen puntajes más bajos de RTS que las no intencionales (OR: 2,32). Conclusiones: sistema de vigilancia epidemiológica permite a las instituciones de salud evaluar la morbimortalidad de su población para definir políticas de intervención. Este estudio encontró que la intencionalidad de las lesiones de causa externa tiene una fuerte asociación con consumo de alcohol y otros psicotrópicos. Las características de los factores asociados con lesiones de causa externa permiten implementar integralmente acciones preventivas y educativas en la comunidad, con el propósito de disminuir la ocurrencia de estas lesiones y por tanto la pérdida de vidas. Abstract in english Introduction: The increase in the incidence of intentional and nonintentional injuries has become an important public health problem. There has been a recent emphasis on the importance of investigating the «causes» of violence in order to define how to prevent them. The purpose of the present study [...] was to identify factors associated with intentional injuries. Materials and methods: An analytic study was designed based on the registry of the epidemiologic surveillance system of Hospital Mario Correa Rengifo, Cali, Colombia. All patients were included and the descriptive and association measures were calculated. Results: Among the 5,236 persons that were seen because of injuries of external cause in the period November 2003-December 2005, we found that 64% were nonintentional, 32.6% were interpersonal intentional, and 1.6% were self-inflicted. Intentional lesions exhibited positive association with the male sex (OR 8.89), alcohol and or illegal drug consumption (OR 5.61), penetrating stab wounds (OR 23.85), abdominal trauma (OR 7.90), thoracic trauma (OR 7.00), systemic trauma (OR 2.19), and cervical trauma (OR 1.88). Intentional lesions showed a lower Revised Trauma Score (RTS) in comparison with nonintentional lesions (OR 2.32). Conclusions: The hospital epidemiologic surveillance systems permit the evaluation of morbidity and mortality rates and patterns of traumatic lesions of external cause, intentional or nonintentional. Alcohol and illegal drug consumption increase several times the risk of having an intentional lesion and a lesion of greater severity. This information serves the governments to generate preventive programs with the purpose of identifying modifiable variables oriented towards the abolition of violent injuries, especially during weekends.

Mónica, Bejarano Castro; Luis Fernando, Rendón; Martha Cristina, Rojas; Carlos Andrés, Durán; Maribel, Albornoz.

170

Hepatoxicity associated with weight-loss supplements: A case for better post-marketing surveillance  

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Full Text Available There is a growing number of case reports of hepatoxicity from the widely marketed weight-loss supplement Hydroxycut, which contains the botanical ingredient Garcinia cambogia. These case reports may substantially undercount the true magnitude of harm. Based on the past experience with harmful dietary supplements, US regulators should assume the more precautionary approach favored by Canada and Europe. Lacking effective adverse event surveillance for supplements, or the requirements to prove safety prior to coming to the market, case reports such as those summarized here assume added importance.

Ano Lobb

2009-04-01

171

The French human Salmonella surveillance system: evaluation of timeliness of laboratory reporting and factors associated with delays, 2007 to 2011.  

Science.gov (United States)

Given the regular occurrence of salmonellosis outbreaks in France, evaluating the timeliness of laboratory reporting is critical for maintaining an effective surveillance system. Laboratory-confirmed human cases of Salmonella infection from whom strains were isolated from 2007 to 2011 in France (n=38,413) were extracted from the surveillance database. Three delay intervals were defined: transport delay (strain isolation, transport from primary laboratory to national reference laboratory), analysis delay (serotyping, reporting) and total reporting delay. We calculated the median delay in days and generated the cumulative delay distribution for each interval. Variables were tested for an association with reporting delay using a multivariable generalised linear model. The median transport and analysis delays were 7 and 6 days respectively (interquartile range (IQR: 6-10 and 4-9 respectively), with a median total reporting delay of 14 days (IQR: 11-19). Timeliness was influenced by various external factors: decreasing serotype frequency, geographical zone of primary laboratory and strain isolation on Sundays were the variables most strongly associated with increased length of delay. The effect of season and day of the week of isolation was highly variable over the study period. Several areas for interventions to shorten delays are identified and discussed for both transport and analysis delays. PMID:24434174

Jones, G; Le Hello, S; Jourdan-da Silva, N; Vaillant, V; de Valk, H; Weill, Fx; Le Strat, Y

2014-01-01

172

Drug-Induced Liver Injury Associated with Noni (Morinda citrifolia) Juice and Phenobarbital.  

Science.gov (United States)

Noni (Morinda citrifolia) juice is a popular herbal dietary supplement globally used for preventive or therapeutic purposes in a variety of ailments, claiming to exhibit hepatoprotective properties as well. Herein we present the case of a 38-year-old woman who developed acute liver injury associated with noni juice consumption on a long-term (9 months) anticonvulsant therapy. Clinical presentation and liver biopsy were consistent with severe, predominantly hepatocellular type of injury. Both agents were stopped and corticosteroids were initiated. Five months later the patient had fully recovered. Although in the literature the hepatotoxicity of noni juice remains speculative, sporadic but emerging cases of noni juice-associated liver injury address the need to clarify and investigate potential harmful effects associated with this supplement. PMID:23467452

Mrzljak, Anna; Kosuta, Iva; Skrtic, Anita; Kanizaj, Tajana Filipec; Vrhovac, Radovan

2013-01-01

173

Tears of anterior cruciate ligament and associated injury in the knee joint: MR imaging  

International Nuclear Information System (INIS)

The objective of the study was to evaluate the characteristic findings in tears of the anterior cruciate ligament(ACL) and associated injury at MR imaging. We reviewed the findings of MR images and the corresponding arthroscopic results of 32 patients with ACL tears. We evaluated the signal intensity and contour of ACL surrounding bony structures, menisci and associated injury of the knee joint. Complete ACL tears were present in 25 patients and partial ACL tears were in 7 patients. Complete ACL tears showed heterogenously increased signal intensity with contour bulging of the ACL in 14 patients (56%) and without bulging or absence in 11 patients(44%). Most patients torn ACL with contour bulging(12/14) had bone bruise, but only one patient torn ACL without bulging contour had bone bruise. ACL with thin continuous low signal band surrounding heterogenously increased signal intensity suggests partial tear which was seen in three patients of seven proved partial ACL tears. Combined bone injury in ACL tear were in 23 patients (73%) and most of these(22/23) were at midportion of lateral notch of femur and/or posterior portion of lateral tibial plateu. Deepening of lateral notch of femur were noted in 17 patients(53%). Associated injuries of the other ligaments of knee joint were buckling of the posterior cruciate ligament(16/32, 50%) and tears of the medial collateral ligament(11/32, 34%). Posterior horns of menisci were more frequent site of combined injury within menisci in patients with ACL tear. Acute tearing of ACL in MRI is seen as heterogenously increased signal intensity with contour bulging of ACL and combined bone bruises. Patients with torn ACL frequently have various combined injury. In patient with knee injury, these associated or ancillary findings suggest that ACL tear is present

174

Association between ADHD drug use and injuries among children and adolescents.  

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To study the association between attention deficit hyperactivity disorder (ADHD) drug use and the incidence of hospitalization due to injuries. A random sample of 150,000 persons (0-18 years) was obtained from the Dutch PHARMO record linkage system. An ADHD medication cohort as well as an up to six age/sex/index date sampled control cohort with no history of ADHD drug use was formed. Differences in incidence of hospitalization due to injuries were stratified for age and sex and compared prior, during and after exposure on ADHD drugs. The overall incidence of hospital admissions for injuries was two times higher in the ADHD medication cohort [incidence rate ratios (IRR) 2.2 (95 % CI 1.6-2.9)]. The incidence rate for injuries during exposure to ADHD drugs was lower in the exposed period compared to the period prior to ADHD drug use, although the difference was not statistically significant [IRR 0.68 (95 % CI 0.29-1.60)]. The relative risk for injuries was almost five times higher in the ADHD medication cohort among those who concomitantly used other psychotropics [IRR 4.8 (95 % CI 1.4-16.9)]. Risk for injuries was highest in 12-18 years olds. Children and adolescents using ADHD medication showed a twofold risk for hospital admissions for injuries. ADHD drug use might diminish the increased injury risk, but still overall risk is higher than in age/sex sampled children and adolescents without treatment with ADHD drugs. Use of ADHD and concomitant psychotropics increases the risk for injuries compared to only ADHD drug use. PMID:23733150

van den Ban, Els; Souverein, Patrick; Meijer, Willemijn; van Engeland, Herman; Swaab, Hanna; Egberts, Toine; Heerdink, Eibert

2014-02-01

175

The Brazilian Football Association (CBF model for epidemiological studies on professional soccer player injuries  

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Full Text Available OBJECTIVE: This study aims to establish a national methodological model for epidemiological studies on professional soccer player injuries and to describe the numerous relevant studies previously published on this topic. INTRODUCTION: The risk of injury in professional soccer is high. However, previous studies of injury risk in Brazil and other countries have been characterized by large variations in study design and data collection methods as well as definitions of injury, standardized diagnostic criteria, and recovery times. METHODS: A system developed by the Union of European Football for epidemiological studies on professional soccer players is being used as a starting point to create a methodological model for the Brazilian Football Association. To describe the existing studies on professional soccer player injuries, we developed a search strategy to identify relevant epidemiological studies. We included the Latin American and Caribbean Center on Health Sciences and Medline databases in our study. RESULTS: We considered 60 studies from Medline and 16 studies from the Latin American and Caribbean Center on Health Sciences in the final analysis. Twelve studies were selected for final inclusion in this review: seven from the Latin American and Caribbean Center on Health Sciences and five from Medline. We identified a lack of uniformity in the study design, data collection methods, injury definitions, standardized diagnostic criteria, and the definition of recovery time. Based on the information contained within these articles, we developed a model for epidemiological studies for the Brazilian Football Association. CONCLUSIONS: There is no uniform model for epidemiological studies of professional soccer injuries. Here, we propose a novel model to be applied for epidemiological studies of professional soccer player injuries in Brazil and throughout the world.

Gustavo Goncalves Arliani

2011-01-01

176

The Brazilian Football Association (CBF) model for epidemiological studies on professional soccer player injuries  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: This study aims to establish a national methodological model for epidemiological studies on professional soccer player injuries and to describe the numerous relevant studies previously published on this topic. INTRODUCTION: The risk of injury in professional soccer is high. However, previ [...] ous studies of injury risk in Brazil and other countries have been characterized by large variations in study design and data collection methods as well as definitions of injury, standardized diagnostic criteria, and recovery times. METHODS: A system developed by the Union of European Football for epidemiological studies on professional soccer players is being used as a starting point to create a methodological model for the Brazilian Football Association. To describe the existing studies on professional soccer player injuries, we developed a search strategy to identify relevant epidemiological studies. We included the Latin American and Caribbean Center on Health Sciences and Medline databases in our study. RESULTS: We considered 60 studies from Medline and 16 studies from the Latin American and Caribbean Center on Health Sciences in the final analysis. Twelve studies were selected for final inclusion in this review: seven from the Latin American and Caribbean Center on Health Sciences and five from Medline. We identified a lack of uniformity in the study design, data collection methods, injury definitions, standardized diagnostic criteria, and the definition of recovery time. Based on the information contained within these articles, we developed a model for epidemiological studies for the Brazilian Football Association. CONCLUSIONS: There is no uniform model for epidemiological studies of professional soccer injuries. Here, we propose a novel model to be applied for epidemiological studies of professional soccer player injuries in Brazil and throughout the world.

Gustavo Goncalves, Arliani; Paulo Santoro, Belangero; Jose Luiz, Runco; Moisés, Cohen.

177

Analysis of factors associated with injury severity in crashes involving young New Zealand drivers  

DEFF Research Database (Denmark)

Young people are a risk to themselves and other road users, as motor vehicle crashes are the leading cause of their death. A thorough understanding of the most important factors associated with injury severity in crashes involving young drivers is important for designing well-targeted restrictive measures within youth-oriented road safety programs. The current study estimates discrete choice models of injury severity of crashes involving young drivers conditional on these crashes having occurred. The analysis examined a comprehensive set of single-vehicle and two-vehicle crashes involving at least one 15–24year-old driver in New Zealand between 2002 and 2011 that resulted in minor, serious or fatal injuries. A mixed logit model accounting for heterogeneity and heteroscedasticity in the propensity to injury severity outcomes and for correlation between serious and fatal injuries proved a better fit than a binary and a generalized ordered logit. Results show that the young drivers’ behavior, the presence of passengers and the involvement of vulnerable road users were the most relevant factors associated with higher injury severity in both single-vehicle and two-vehicle crashes. Seatbelt non-use, inexperience and alcohol use were the deadliest behavioral factors in single-vehicle crashes, while fatigue, reckless driving and seatbelt non-use were the deadliest factors in two-vehicle crashes. The presence of passengers in the young drivers’ vehicle, and in particular a combination of males and females, dramatically increased the probability of serious and fatal injuries. The involvement of vulnerable road users, in particular on rural highways and open roads, considerably amplified the probability of higher crash injury severity.

Weiss, Harold B.; Kaplan, Sigal

2014-01-01

178

Analysis of factors associated with injury severity in crashes involving young New Zealand drivers.  

Science.gov (United States)

Young people are a risk to themselves and other road users, as motor vehicle crashes are the leading cause of their death. A thorough understanding of the most important factors associated with injury severity in crashes involving young drivers is important for designing well-targeted restrictive measures within youth-oriented road safety programs. The current study estimates discrete choice models of injury severity of crashes involving young drivers conditional on these crashes having occurred. The analysis examined a comprehensive set of single-vehicle and two-vehicle crashes involving at least one 15-24 year-old driver in New Zealand between 2002 and 2011 that resulted in minor, serious or fatal injuries. A mixed logit model accounting for heterogeneity and heteroscedasticity in the propensity to injury severity outcomes and for correlation between serious and fatal injuries proved a better fit than a binary and a generalized ordered logit. Results show that the young drivers' behavior, the presence of passengers and the involvement of vulnerable road users were the most relevant factors associated with higher injury severity in both single-vehicle and two-vehicle crashes. Seatbelt non-use, inexperience and alcohol use were the deadliest behavioral factors in single-vehicle crashes, while fatigue, reckless driving and seatbelt non-use were the deadliest factors in two-vehicle crashes. The presence of passengers in the young drivers' vehicle, and in particular a combination of males and females, dramatically increased the probability of serious and fatal injuries. The involvement of vulnerable road users, in particular on rural highways and open roads, considerably amplified the probability of higher crash injury severity. PMID:24456849

Weiss, Harold B; Kaplan, Sigal; Prato, Carlo G

2014-04-01

179

Spinal cord injury and the neuron-intrinsic regeneration-associated gene program.  

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Spinal cord injury (SCI) affects millions of people worldwide and causes a significant physical, emotional, social and economic burden. The main clinical hallmark of SCI is the permanent loss of motor, sensory and autonomic function below the level of injury. In general, neurons of the central nervous system (CNS) are incapable of regeneration, whereas injury to the peripheral nervous system is followed by axonal regeneration and usually results in some degree of functional recovery. The weak neuron-intrinsic regeneration-associated gene (RAG) response upon injury is an important reason for the failure of neurons in the CNS to regenerate an axon. This response consists of the expression of many RAGs, including regeneration-associated transcription factors (TFs). Regeneration-associated TFs are potential key regulators of the RAG program. The function of some regeneration-associated TFs has been studied in transgenic and knock-out mice and by adeno-associated viral vector-mediated overexpression in injured neurons. Here, we review these studies and propose that AAV-mediated gene delivery of combinations of regeneration-associated TFs is a potential strategy to activate the RAG program in injured CNS neurons and achieve long-distance axon regeneration. PMID:25269879

Fagoe, Nitish D; van Heest, Jessica; Verhaagen, Joost

2014-12-01

180

Overuse Injuries Associated with Mountain Biking: Is Single-Speed Riding a Predisposing Factor?  

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Full Text Available Though mountain bikers are at significant risk for overuse injury, there is minimal quality research describing this relationship. Single-speed mountain biking, in which participants pedal a bike with only a single gear, may place riders at even greater risk for overuse problems due to the disproportionate physical effort associated with this type of riding. The focus of this study was to provide additional perspective on overuse injuries sustained by mountain bikers and to determine if single-speed mountain biking places participants at greater risk for overuse conditions. Four hundred and four (404 mountain bikers were surveyed concerning overuse injuries sustained during the previous year. Findings indicate that 63% of respondents reported an overuse injury affecting at least one area with the most commonly reported areas being the lumbar spine, knees, hand/wrist, and cervical spine. Individuals riding single-speed mountain bikes did not have a higher incidence of overuse injuries than riders of multiple-geared bikes. However, respondents who split time between riding single-speed and multiple-geared bikes were significantly more likely to report an overuse syndrome than those only riding single-speed or multiple-geared bikes (p = 0.0104. This group of riders may be at greater risk for overuse injury due to excessive fatigue and poor biomechanics.

Michael T. Lebec

2014-01-01

 
 
 
 
181

The Analysis of Generalized Tonic Clonic Seizures Associated Injuries in Emergency Department  

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Full Text Available Objectives: Persons with epilepsy are believed to be at greater risk of incurring accidental injury than those without seizures. During generalized seizures the individual is unable to utilize protective reflexes during falls and may consequently suffer head, orthopedic, or soft tissue injury. Our aim is to evaluate the spectrum of trauma in epilepsy patients presenting to our emergency department as a result of generalized tonic-clonic seizure (GTCS. Methods: We retrospectively reviewed patient records collected between January 2004 and December 2007 at the Emergency Department of Dicle University Medical School. All patients aged 15 years or more with epilepsy and trauma due to generalized tonic clonic seizures were included in the study. Records were analyzed for age, gender, type of injury, sufficiency of anti-epileptic medication, and mortality. Results: The average age of the 51 patients included in the study was 26.02±9.86 years, range 15-52 years. Thirty-three patients (64.7% were male; the male female ratio was 1.83. Soft tissue injuries were the most common injury (26 instances. Head trauma, cuts, dental and tongue injuries were less common. Blood levels of anti-epileptic medication were in the therapeutic range in 9 (17.6% patients, while 42 (82.4% had sub therapeutic levels for effective treatment. Four (7.8% of the patients died. The trauma in 2 mortalities involved burns; remaining deaths were associated with submersion injury and fall (subarachnoidal hemorrhage. Conclusions: There was no significant association between sub therapeutic levels of anti-epileptic medication and mortality.

Ayhan OZHASENEKLER

2010-01-01

182

Sharps injuries among radiographers: Dangers associated with opening bottles of contrast agent  

International Nuclear Information System (INIS)

Purpose: Injuries associated with the use of glass bottles in the healthcare setting have been largely overlooked in the literature. Such injuries are sustained if the glass is broken, but more often during the opening of the bottles, either directly on the sharp edges of the aluminium crimp-top seals or indirectly when another instrument is used to prise open the bottle after the crimp-top opening mechanism fails. Such injuries are not inconsequential; of sharps injuries (excluding those caused by hollow-bore needles), an estimated 16% are caused by glass and a further 15% by other sharp items. Furthermore, any puncture wound in the healthcare setting carries a threat of transmission of infectious blood-borne diseases. This survey is the first of its kind to be done in Europe, and offers an insight into the risk of bottle-opening associated injuries in radiology departments. Results: The findings indicate that radiographers/technologists are injured up to 24.4 times (±22.2) a year during the opening of glass bottles of contrast agents, translating into 3.5 h a month of lost time in an average radiology department of 24.4 radiographers or technologists; although almost half (47%) of the injuries draw blood, few are reported and the respondents in this survey were generally unconcerned by the risks. Conclusion: The injuries discussed can be a nuisance and disturb the workflow of the department and are, importantly, avoidable, with polymer bottles available that pose nith polymer bottles available that pose no threat during opening or when damaged

183

Spatial dynamics of stink bugs (Hemiptera: Pentatomidae) and associated boll injury in southeastern cotton fields.  

Science.gov (United States)

Grid sampling (one sample per 0.40 ha) in 12 cotton (Gossypium hirsutum L.) fields for stink bugs and boll injury caused by stink bug feeding was conducted in 2007 and 2008 in South Carolina and Georgia. The main species collected using the beat cloth method were the green stink bug, Acrosternum hilare (Say) (69%); brown stink bug, Euschistus servus (Say) (18%); and the southern green stink bug, Nezara viridula (L.) (14%), respectively. The inverted distance weighted interpolation method and Spatial Analysis by Distance IndicEs analyses showed spatial variability in both boll injury and stink bug densities. Four of five fields with field-average boll injury exceeding 15% had a combination of either soybean or peanut adjacent to the cotton field of interest. The Spatial Analysis by Distance IndicEs index of dispersion for stink bug densities and boll injury averaged over the season indicated significant aggregation at the 5% error rate in only one and four analyses (combinations of fields, species, and life stages) of a total of 54 in 2007 and 2008, respectively. By sampling date, overall indices of dispersion for boll injury data indicated significant aggregation in four of the 63 date-field combinations at the 5% error rate. Across years, overall indices of spatial association between boll injury and stink bug densities were significant in 17 of 69 analyses, with positive associations detected in seven of 12 fields; these data suggest that spatial distribution of stink bugs in cotton fields does not always coincide with boll injury. PMID:20550811

Reay-Jones, F P F; Toews, M D; Greene, J K; Reeves, R B

2010-06-01

184

Surveillance for waterborne disease outbreaks associated with drinking water and other nonrecreational water - United States, 2009-2010.  

Science.gov (United States)

Despite advances in water management and sanitation, waterborne disease outbreaks continue to occur in the United States. CDC collects data on waterborne disease outbreaks submitted from all states and territories through the Waterborne Disease and Outbreak Surveillance System. During 2009-2010, the most recent years for which finalized data are available, 33 drinking water-associated outbreaks were reported, comprising 1,040 cases of illness, 85 hospitalizations, and nine deaths. Legionella accounted for 58% of outbreaks and 7% of illnesses, and Campylobacter accounted for 12% of outbreaks and 78% of illnesses. The most commonly identified outbreak deficiencies in drinking water-associated outbreaks were Legionella in plumbing systems (57.6%), untreated ground water (24.2%), and distribution system deficiencies (12.1%), suggesting that efforts to identify and correct these deficiencies could prevent many outbreaks and illnesses associated with drinking water. In addition to the drinking water outbreaks, 12 outbreaks associated with other nonrecreational water were reported, comprising 234 cases of illness, 51 hospitalizations, and six deaths. Legionella accounted for 58% of these outbreaks, 42% of illnesses, 96% of hospitalizations, and all deaths. Public health, regulatory, and industry professionals can use this information to target prevention efforts against pathogens, infrastructure problems, and water sources associated with waterborne disease outbreaks. PMID:24005226

2013-09-01

185

Is Nonsuicidal Self-Injury Associated with Parenting and Family Factors?  

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The present study investigates the association of parenting and family factors with nonsuicidal self-injury (NSSI) in preadolescents. A sample of 1,439 preadolescents and their parents were assessed by means of (a) adolescent-reported parenting behaviors (support and behavioral/psychological control), (b) parent-reported parenting behaviors…

Baetens, Imke; Claes, Laurence; Martin, Graham; Onghena, Patrick; Grietens, Hans; Van Leeuwen, Karla; Pieters, Ciska; Wiersema, Jan R.; Griffith, James W.

2014-01-01

186

Intrapersonal and Interpersonal Functions of Non Suicidal Self-Injury: Associations with Emotional and Social Functioning  

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Understanding the functions of nonsuicidal self-injury (NSSI) has important implications for the development and refinement of theoretical models and treatments of NSSI. Emotional and social vulnerabilities associated with five common functions of NSSI-emotion relief (ER), feeling generation (FG), self-punishment (SP), interpersonal influence…

Turner, Brianna J.; Chapman, Alexander L.; Layden, Brianne K.

2012-01-01

187

Association between living alone and physical inactivity among people with and without disability, Florida Behavioral Risk Factor Surveillance System, 2009.  

Science.gov (United States)

People with disability may be at risk of developing diseases due to physical inactivity; social support from family and friends is positively related to engaging in regular physical activity. We compared the association between living alone and engagement in physical activity among people with and without disability in Florida. We used multivariate logistical regression to analyze 2009 Florida Behavioral Risk Factor Surveillance System data (n = 10,902) to assess differences in physical activity in disability levels for respondents who lived alone versus those who did not. Respondents with a disability were less likely to engage in physical activity than were people without a disability, regardless of disability type, and the lowest rates of engaging in physical activity were found for people with disability who lived alone. Public health efforts should consider the role of household composition when targeting physical activity interventions among people with disability. PMID:25299979

Escobar-Viera, César G; Jones, Patrice D; Schumacher, Jessica R; Hall, Allyson G

2014-01-01

188

Radioactive waste disposal areas and associated environmental surveillance data at Oak Ridge National Laboratory  

International Nuclear Information System (INIS)

Environmental surveillance data have been collected around radioactive waste disposal areas for the past thirty years at Oak Ridge National Laboratory (ORNL). The wealth of data collected around the ORNL radioactive waste burial grounds is presented in this review. The purpose of this paper is to describe the solid waste burial grounds in detail along with the environmental monitoring data. The various monitoring systems are reviewed, and the liquid discharge trends are discussed. Monitoring at White Oak Dam, the last liquid control point for the Laboratory, was started in the late 1940's and is continuing. Presently, a network of five environmental monitoring stations is in operation to monitor the radionuclide content of surface waters in the White Oak Creek watershed. Facts observed during the lifetime of the disposal sites include: (1) a large amount of 106Ru released during 1959 to 1964 due to the fact that Conasauga shale did not retain this element as well as it retained other radionuclides. (2) Large quantities of tritiated water have been released to the Clinch River in recent years, but, from a practical standpoint, little can be done to inhibit or control these releases. (3) A general downward trend in the number of curies released has been observed for all other radionuclides. A number of corrective measures that have been initiated at ORNL to reduce the radioactive liquid discharges are outlined in the paper

189

Successful Mitigation of Delayed Intestinal Radiation Injury Using Pravastatin is not Associated with Acute Injury Improvement or Tumor Protection  

International Nuclear Information System (INIS)

Purpose: To investigate whether pravastatin mitigates delayed radiation-induced enteropathy in rats, by focusing on the effects of pravastatin on acute cell death and fibrosis according to connective tissue growth factor (CTGF) expression and collagen inhibition. Methods and Materials: Mitigation of delayed radiation-induced enteropathy was investigated in rats using pravastatin administered in drinking water (30 mg/kg/day) 3 days before and 14 days after irradiation. The ileum was irradiated locally after surgical exteriorization (X-rays, 19 Gy). Acute apoptosis, acute and late histologic alterations, and late CTGF and collagen deposition were monitored by semiquantitative immunohistochemistry and colorimetric staining (6 h, 3 days, 14 days, 15 weeks, and 26 weeks after irradiation). Pravastatin antitumor action was studied in HT-29, HeLa, and PC-3 cells by clonogenic cell survival assays and tumor growth delay experiments. Results: Pravastatin improved delayed radiation enteropathy in rats, whereas its benefit in acute and subacute injury remained limited (6 h, 3 days, and 14 days after irradiation). Delayed structural improvement was associated with decreased CTGF and collagen deposition but seemed unrelated to acute damage. Indeed, the early apoptotic index increased, and severe subacute structural damage occurred. Pravastatin elicited a differential effect, protecting normal intestine but not tumors from radiation injury. Conclusion: Pravastatin provides effective protection against delayed radiation enteropathy without interfering with the primary antitumor action of radiotherapy, suggesting that clinical transfer is feasible

190

Feasibility of Serial Saliva Collection for Surveillance of Swimming-Associated Illness  

Science.gov (United States)

BACKGROUND. The symptoms of many swimming-associated illnesses overlap, and clinical diagnoses often require serum or stool samples. Therefore, it has been difficult to determine the contributions of different etiologic agents to swimming-associated illness. OBJECTIVES. We collec...

191

Prevalence of COPD and its association with socioeconomic status in China: Findings from China Chronic Disease Risk Factor Surveillance 2007  

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Full Text Available Abstract Background Socioeconomic status is likely an independent risk factor for Chronic Obstructive Pulmonary Disease (COPD, but little research has been done in China to study this association in a nationwide sample. Methods We used data from the 2007 China Chronic Disease Risk Factor Surveillance of 49,363 Chinese men and women aged 15-69 years to examine the association between the prevalence of self-reported physician diagnosed COPD and socioeconomic status defined by both educational level and annual household income. Multivariable logistic regression modelling was performed with adjustement for potential confounders. Results Both low educational attainment and low household income were independently associated with higher risk of physician-diagnosed COPD. Compared to subjects with high educational level, subjects with low educational level had a significantly increased risk of COPD (OR 1.67, 95%CI 1.32-2.13, p for trend Conclusions Socioeconomic status is a risk factor for self-reported physician-diagnosed COPD independently of current or passive smoking. Prospective studies are needed in China to better understand the association between socioeconomic status and COPD.

Jiang Yong

2011-07-01

192

Case report and cohort analysis of drug-induced liver injury associated with daptomycin.  

Science.gov (United States)

A patient receiving daptomycin developed asymptomatic transaminitis and hyperbilirubinemia without concurrent multiorgan dysfunction or elevation of his creatinine kinase level. After ruling out other etiologies, the liver injury was attributed to daptomycin and was subsequently resolved. A single-center retrospective cohort analysis of baseline and follow-up liver function panels (n = 614) from all admissions from 2008 to 2013 during which daptomycin was administered did not reveal any other cases of probable or definite drug-induced liver injury associated with daptomycin. PMID:24820087

Bohm, Nicole; Makowski, Charles; Machado, Mario; Davie, Adam; Seabrook, Nelson; Wheless, Lee; Bevill, Benjamin; Clark, Bradley; Kyle, T Rogers

2014-08-01

193

MicroRNA changes in rat mesentery and serum associated with drug-induced vascular injury  

Energy Technology Data Exchange (ETDEWEB)

Regulatory miRNAs play a role in vascular biology and are involved in biochemical and molecular pathways dysregulated during vascular injury. Collection and integration of functional miRNA data into these pathways can provide insight into pathogenesis at the site of injury; the same technologies applied to biofluids may provide diagnostic or surrogate biomarkers. miRNA was analyzed from mesentery and serum from rats given vasculotoxic compounds for 4 days. Fenoldopam, dopamine and midodrine each alter hemodynamics and are associated with histologic evidence of vascular injury, while yohimbine is vasoactive but does not cause histologic evidence of vascular injury in rat. There were 38 and 35 miRNAs altered in a statistically significant manner with a fold change of 2 or greater in mesenteries of fenoldopam- and dopamine-dosed rats, respectively, with 9 of these miRNAs shared. 10 miRNAs were altered in rats given midodrine; 6 were shared with either fenoldopam or dopamine. In situ hybridization demonstrated strong expression and co-localization of miR-134 in affected but not in adjacent unaffected vessels. Mesenteric miRNA expression may provide clarity or avenues of research into mechanisms involved in vascular injury once the functional role of specific miRNAs becomes better characterized. 102 miRNAs were altered in serum from rats with drug-induced vascular injury. 10 miRNAs were commonly altered in serum from dopamine and either fenoldopam or midodrine dosed rats; 18 of these 102 were also altered in mesenteries from rats with drug-induced vascular injury, suggesting their possible utility as peripheral biomarkers. -- Highlights: ? Mesentery and serum were examined from rats given vasoactive compounds for 4 days. ? 72 miRNAs were altered in mesenteries from rats with vascular injury. ? miR-134 was localized to affected but not adjacent unaffected vessels. ? 102 miRNAs were changed in serum from rats with vascular injury. ? 18 miRNAs changed in both mesenteries and serum from rats with vascular injury.

Thomas, Roberta A., E-mail: Roberta.A.Thomas@gsk.com; Scicchitano, Marshall S.; Mirabile, Rosanna C.; Chau, Nancy T.; Frazier, Kendall S.; Thomas, Heath C.

2012-08-01

194

Electronic Surveillance  

Science.gov (United States)

The FBI maintains a Web site (1) that explains the purposes and ramifications of the Communications Assistance for Law Enforcement Act (CALEA). In addition to discussing the telecommunication industry's role in supporting the act, the site defines electronic surveillance and offers several documents regarding associated legal issues. An excellent source for government surveillance information comes from the Center for Democracy and Technology (2). The material includes an overview of wiretapping and details about government interceptions of Internet communications. Shortly after the terrorist attacks, the Defense Advanced Research Projects Agency began the Total Information Awareness (TIA) Program. This highly controversial project is introduced by the American Civil Liberties Union (3). The site does a good job of describing the objectives of the TIA, and several links to other sources of information are given. In a technical paper published in August 2002 (4), researchers show that optical emanations from telecommunications devices can be monitored remotely. Light emitting diodes, often used as indicators in modems and other data transfer equipment, flash in distinct patterns that could compromise otherwise secure data transmission. Despite being easy to exploit, the authors point out that this vulnerability would generally be simple to fix. A news story from May 16, 2003 (5) highlights a recent US Government report stating that secure telephones can be wiretapped nearly as easily as standard phones. The article is accompanied by links to the original report and an essay on security. Companies often monitor employee computer and email activity. A law professor from Bentley College writes about workplace privacy in an essay from 2003 (6). Citing a number of hypothetical examples, the author weighs the employees' rights versus those of the company. The technical implementation of the aforementioned CALEA is described in a detailed article from May 2003 (7). The needs of law enforcement are compared to what is achieved with the resulting systems and technology, and a few statistics are included to show that electronic surveillance can be effective. Lastly, an article from PC World (8) reports that the US Government is seeking to increase its surveillance of email and Web usage. The article includes a link to the 120-page draft of the Domestic Security Enhancement Act of 2003.

Leske, Cavin.

195

The Association of Pneumonia with Clinical Outcome in Patients with Inhalation Injury  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: Inhalation injury is a particularly lethal form of thermal burn injury, and is associated with increased morbidity and mortality. Pneumonia is a common complication of inhalation injury, due to the increased susceptibility of lungs that have been stripped of their biologic defense mechanisms, as well as the general susceptibility of the burn population to infections. While older series suggest that pneumonia is associated with worse mortality and morbidity, recent reports suggest that this may not be the case in all populations. Methods: We attempted to clarify the impact of pneumonia in terms of mortality, length of mechanical ventilation, need for tracheostomy, and discharge disposition, in patients admitted with inhalation injury by performing a retrospective review of patients admitted to a regional burn center 2002-2009. Burn registry and electronic chart review were used to obtain demographic, clinical and outcome data. Univariate and multivariate analysis was used to compare outcomes in patients who developed pneumonia versus those who did not. Results: The study cohort comprised 166 patients, of whom 21 (13% were diagnosed with pneumonia. Development of pneumonia was not predicted by age, surface area burned or other complications such as acute respiratory distress syndrome. Surprisingly, pneumonia was associated with reduced inpatient mortality (p = 0.006. However, patients who developed pneumonia were also more likely to have prolonged ventilator dependence (19 vs 5 days, p

Sharmila Dissanaike

2013-01-01

196

The association of blisters with musculoskeletal injuries in male marine recruits.  

Science.gov (United States)

A prospective study examining the epidemiology of blisters and, in particular, the association of blisters with subsequent injuries was conducted involving 2,130 male US Marine Corps recruits participating in initial physical training at the Marine Corps Recruit Depot in San Diego, California. From January 1993 through September 1994, recruits experienced an incidence of 2.05 blisters per 100 recruit-months. Recruits with blisters were 50% more likely to experience an additional training-related injury. Blisters, in combination with other related injuries, resulted in 159 clinic visits, 103 days of assigned light duty, and 177 lost days of training. This loss of time cost a minimum of $29,529. Extrapolating to the annual population of recruits, this represents an approximate annual expense of $690,000. Aggressive blister prevention and management in this setting has the potential to greatly reduce morbidity and fiscal costs. PMID:10800273

Bush, R A; Brodine, S K; Shaffer, R A

2000-04-01

197

Global childhood unintentional injury surveillance in four cities in developing countries: a pilot study / Surveillance internationale des traumatismes non intentionnels de l'enfant dans quatre métropoles de pays en développement: étude pilote / Vigilancia mundial de las lesiones infantiles no intencionales en cuatro ciudades de países en desarrollo: estudio piloto  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: English Abstract in spanish OBJETIVO: Determinar la frecuencia y naturaleza de las lesiones infantiles y explorar sus factores de riesgo en países de bajos ingresos, utilizando para ello los datos de vigilancia de los departamentos de urgencias (DU). MÉTODOS: Este estudio piloto representa la fase inicial de un proyecto plurin [...] acional de vigilancia mundial de las lesiones infantiles no intencionales y se basó en una muestra secuencial de menores de 11 años, de ambos sexos, que se presentaron en 2007 en DU seleccionados de Bangladesh, Colombia, Egipto y Pakistán a lo largo de un periodo de 3 a 4 meses, variable según el centro. RESULTADOS: De 1559 niños lesionados observados en todos los centros, 1010 (65%) eran varones; 941 (60%) tenían³ 5 años, y 32 (2%) Abstract in english OBJECTIVE: To determine the frequency and nature of childhood injuries and to explore the risk factors for such injuries in low-income countries by using emergency department (ED) surveillance data. METHODS: This pilot study represents the initial phase of a multi-country global childhood unintentio [...] nal injury surveillance (GCUIS) project and was based on a sequential sample of children 5 years, 32 (2%) were

Adnan A, Hyder; David E, Sugerman; Prasanthi, Puvanachandra; Junaid, Razzak; Hesham, El-Sayed; Andres, Isaza; Fazlur, Rahman; Margie, Peden.

198

Global childhood unintentional injury surveillance in four cities in developing countries: a pilot study / Surveillance internationale des traumatismes non intentionnels de l'enfant dans quatre métropoles de pays en développement: étude pilote / Vigilancia mundial de las lesiones infantiles no intencionales en cuatro ciudades de países en desarrollo: estudio piloto  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: English Abstract in spanish OBJETIVO: Determinar la frecuencia y naturaleza de las lesiones infantiles y explorar sus factores de riesgo en países de bajos ingresos, utilizando para ello los datos de vigilancia de los departamentos de urgencias (DU). MÉTODOS: Este estudio piloto representa la fase inicial de un proyecto plurin [...] acional de vigilancia mundial de las lesiones infantiles no intencionales y se basó en una muestra secuencial de menores de 11 años, de ambos sexos, que se presentaron en 2007 en DU seleccionados de Bangladesh, Colombia, Egipto y Pakistán a lo largo de un periodo de 3 a 4 meses, variable según el centro. RESULTADOS: De 1559 niños lesionados observados en todos los centros, 1010 (65%) eran varones; 941 (60%) tenían³ 5 años, y 32 (2%) Abstract in english OBJECTIVE: To determine the frequency and nature of childhood injuries and to explore the risk factors for such injuries in low-income countries by using emergency department (ED) surveillance data. METHODS: This pilot study represents the initial phase of a multi-country global childhood unintentio [...] nal injury surveillance (GCUIS) project and was based on a sequential sample of children 5 years, 32 (2%) were

Adnan A, Hyder; David E, Sugerman; Prasanthi, Puvanachandra; Junaid, Razzak; Hesham, El-Sayed; Andres, Isaza; Fazlur, Rahman; Margie, Peden.

2009-05-01

199

Risk factors and musculoskeletal injuries associated with all-terrain vehicle accidents.  

Science.gov (United States)

Accidents, injuries, and deaths sustained via all-terrain vehicle (ATV) use are on the rise. In addition to safe and proper ATV operation, accident-related risk factors include operator controllable behaviors such as helmet use, alcohol use, and deciding whether or not to carry a passenger. What the operator has little or no control over, however, is the inherently unstable ATV design with its narrow wheelbase, short turning radius, and high center of gravity, in addition to common use of low tire pressure to maximize maneuverability. These factors lead to musculoskeletal injuries that consist predominantly of extremity fractures, primarily through rollover events. There is a need for improved ATV operator safety education and more stringent regulations. The purpose of this review is to identify the accident and injury risk factors associated with ATV operation and to compare them with bicycle and motorcycle accident and injury risk factors to enable emergency medical professionals to develop better patient management and injury prevention strategies. PMID:17933478

Balthrop, Paul M; Nyland, John; Roberts, Craig S

2009-02-01

200

Albumin-induced podocyte injury and protection are associated with regulation of COX-2.  

Science.gov (United States)

Albuminuria is both a hallmark and a risk factor for progressive glomerular disease, and results in increased exposure of podocytes to serum albumin with its associated factors. Here in vivo and in vitro models of serum albumin-overload were used to test the hypothesis that albumin-induced proteinuria and podocyte injury directly correlate with COX-2 induction. Albumin induced COX-2, MCP-1, CXCL1, and the stress protein HSP25 in both rat glomeruli and cultured podocytes, whereas B7-1 and HSP70i were also induced in podocytes. Podocyte exposure to albumin induced both mRNA and protein and enhanced the mRNA stability of COX-2, a key regulator of renal hemodynamics and inflammation, which renders podocytes susceptible to injury. Podocyte exposure to albumin also stimulated several kinases (p38 MAPK, MK2, JNK/SAPK, and ERK1/2), inhibitors of which (except JNK/SAPK) downregulated albumin-induced COX-2. Inhibition of AMPK, PKC, and NF?B also downregulated albumin-induced COX-2. Critically, albumin-induced COX-2 was also inhibited by glucocorticoids and thiazolidinediones, both of which directly protect podocytes against injury. Furthermore, specific albumin-associated fatty acids were identified as important contributors to COX-2 induction, podocyte injury, and proteinuria. Thus, COX-2 is associated with podocyte injury during albuminuria, as well as with the known podocyte protection imparted by glucocorticoids and thiazolidinediones. Moreover, COX-2 induction, podocyte damage, and albuminuria appear mediated largely by serum albumin-associated fatty acids. PMID:24918154

Agrawal, Shipra; Guess, Adam J; Chanley, Melinda A; Smoyer, William E

2014-12-01

 
 
 
 
201

Childhood and adolescent injuries in elementary schools in north-western Uganda: extent, risk and associated factors.  

Science.gov (United States)

Childhood injuries remain understudied in Uganda. The objective of this study was to determine the extent, nature and determinants of school-related childhood injury risk in north-western Uganda. A cohort of 1000 grade fives from 13 elementary schools was followed-up for one term. Survival and multi-level modelling techniques compared the risk rates across gender, schools and locations. Childhood injuries are common in north-western Uganda. Most of them occur during travel, breaks, practical classes and gardening, while walking, playing, learning and digging. Most injuries result from collisions with objects, sports and falls. Two-thirds of children receive first aid and hospital care. Times to injury were 72.1 and 192.9 person days (p = 0.0000). Gender differences in time to event were significant (p = 0.0091). Girls had better survival rates: cumulative prevalence of childhood injury was 36.1%; with significant gender differences (p = 0.007). Injury rate was 12.3/1000 person days, with a hazard ratio of 1.4. Compared to girls, boys had a 37% higher injury rate (p = 0.004). Rates varied among schools. Associated factors include sex and school. Rural-urban location and school differences do influence childhood injury risk. Childhood injuries are common: the risk is high, gender- and school-specific. Determinants include gender and school. Location and school contexts influence injury risk. PMID:22273248

Mutto, Milton; Lawoko, Stephen; Ovuga, Emilio; Svanstrom, Leif

2012-01-01

202

Ejection associated injuries within the German Air Force from 1981-1997.  

Science.gov (United States)

From 1981-1997 there were 86 ejections from 56 aircraft within the German Air Force. Of these, 24 accidents were associated with the F-104 Starfighter, 14 with the PA 200 Tornado, 12 from the F-4 Phantom, 5 from the Alpha Jet and 1 from a MiG 29 Fulcrum. One case involved a front seat pilot, who had already sustained fatal injuries from midair collision, being command ejected by the rear seat pilot. The remaining 85 ejections are the basis of this study. One weapons system officer died from hypothermia after landing in the sea and another from bleeding into the medulla oblongata after flailing; all other participants survived. This is an overall success rate of 97.6%. Of all 85 participants, 12 (14%) were uninjured, 41 (48.2%) were slightly injured, and 30 (35.3%) were severely injured. Typical injuries were those of the spine and lower limbs. The most common severe injury was a vertebral fracture caused by ejection acceleration. This is followed by lower limb injuries received during the parachute landing fall. At the time of ejection, all uninjured crews were flying below 3500 ft altitude and below 260 kn airspeed. Of all ejections from each aircraft type, the percentage of vertebral fractures is highest with the F-4 Phantom (31.8%), followed by the F-104 (16.6%) and the PA 200 Tornado with only 14.8%. The PA 200 is equipped with the most modern type of ejection seat of these aircraft. A conclusion of the gained data is that more modern ejection seat types provide lower injury severity but not fewer total injury numbers, and that the medical data taken during accident investigation should be taken more accurately and in a more standarized fashion to be comparable. PMID:10596782

Werner, U

1999-12-01

203

The incidence and risk factors of ventilator-associated pneumonia in patients with severe traumatic brain injury  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. Patients with severe traumatic brain injury are at a risk of developing ventilator-associated pneumonia. The aim of this study was to describe the incidence, etiology, risk factors for development of ventilator- associated pneumonia and outcome in patients with severe traumatic brain injury. Material and Methods. A retrospective study was done in 72 patients with severe traumatic brain injury, who required mechanical ventilation for more than 48 hours. Results. Ventilator-associated pneumonia was found in 31 of 72 (43.06% patients with severe traumatic brain injury. The risk factors for ventilator-associated pneumonia were: prolonged mechanical ventilation (12.42 vs 4.34 days, p<0.001, longer stay at intensive care unit (17 vs 5 days, p<0.001 and chest injury (51.61 vs 19.51%, p< 0.009 compared to patients without ventilator-associated pneumonia.. The mortality rate in the patients with ventilator-associated pneumonia was higher (38.71 vs 21.95%, p= 0.12. Conclusion. The development of ventilator-associated pneumonia in patients with severe traumatic brain injury led to the increased morbidity due to the prolonged mechanical ventilation, longer stay at intensive care unit and chest injury, but had no effect on mortality.

Marjanovi? Vesna

2011-01-01

204

Injury of anterior cruciate ligament with associated bony lesions: MR image  

International Nuclear Information System (INIS)

To evaluate the characteristic MR findings in injury of the anterior cruciate ligament (ACL) with associated bony lesions. We reviewed MR findings and the corresponding arthroscopic or operative results of 48 patients with ACL injuries, and evaluated ACL signal intensity and contour. In associated bony lesions, we determined the location of avulsion fracture and bony bruise. Complete ACL tears were seen in 27 cases, partial tears in 13, and avulsion injury in eight. Complete tears showed heterogeneously increased signal intensity with contour bulging in ten cases (37%), and combined bony lesion in 14 (52%). ACL with a thin continous low signal intensity band surrounding heterogeneously-increased signal intensity suggested partial tears, and was seen in three of 13 proven cases (23%) of partial ACL tears;combined bony lesion was seen in four such cases(31%). There were eight cases of avulsion fracture;the most frequent site was the anterolateral portion of the tibial spine (n=6). The most frequent sites of bony lesion were at the midportion of the lateral femoral condyle (n=6), and the posterior portion of the lateral tibial plateau (n=6);the next most frequent site was the anterior portion of the lateral tibial plateau (n=5). Tearing of the ACL was seen on MRI as ligament discontinuity, and heterogeneously increased signal intensity with ACL contour bulging. The most frequent sites of associated bony lesions were the midportion of the lateral femoral condyle, and the n of the lateral femoral condyle, and the posterior portion of the lateral tibial plateau. In associated bony lesions, bony contusion suggested ACL tearing, but avulsion fracture suggested ligament avulsion injury without tear

205

Adverse Clinical Outcomes Associated With Elevated Blood Alcohol Levels at the Time of Burn Injury  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Elevated blood alcohol content (BAC) on admission is associated with poorer outcomes, larger burns and more inhalation injury. This study’s purpose was to examine the effects of alcohol through a matched case-controlled study, measuring early and extended markers of clinical outcomes. The hypothesis was that patients with an elevated admission BAC would require more resuscitation and have a longer hospital stay. Admissions 16 to 75 years of age with 15 to 75% TBSA and admission BACs were id...

Silver, Geoffrey M.; Albright, Joslyn M.; Schermer, Carol R.; Halerz, Marcia; Conrad, Peggie; Ackerman, Paul D.; Lau, Linda; Ann Emanuele, Mary; Kovacs, Elizabeth J.; Gamelli, Richard L.

2008-01-01

206

Role of myelin-associated inhibitors in axonal repair after spinal cord injury  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Myelin-associated inhibitors of axon growth, including Nogo, MAG and OMgp, have been the subject of intense research. A myriad of experimental approaches have been applied to investigate the potential of targeting these molecules to promote axonal repair after spinal cord injury. However, there are still conflicting results on their role in axon regeneration and therefore a lack of a cohesive mechanism on how these molecules can be targeted to promote axon repair. One major reason may be the ...

Lee, Jae K.; Zheng, Binhai

2012-01-01

207

Strong ion gap is associated with mortality in pediatric burn injuries.  

Science.gov (United States)

Severe burn injury produces significant tissue damage, resulting in metabolic acidosis. Current methods of acid-base evaluation are based on dependent variables that may not be accurate after burn injury. The strong ion method of acid-base evaluation is based on independent variables and may accurately predict outcomes in severely burn-injured patients. The authors hypothesize that an increased strong ion gap present on admission will be associated with mortality in severely burn-injured pediatric patients. A retrospective chart review was performed of burn-injured pediatric patients with a TBSA 20% or greater. Data collected included age, TBSA burn injury, mechanism of injury, survival, ventilator days, hospital length of stay, intensive care unit length of stay, and admission laboratory values. Apparent and effective strong ion difference (SIDa, SIDe) were calculated. The strong ion gap (SIG) was determined as the difference between SIDa and SIDe. A total of 48 patients were included in the study. Mean age (years) and TBSA were 7.9 ± 0.8 years and 56.8 ± 2.6%. Eleven patients (23%) died. Mean TBSA for survivors (54.2 ± 2.9%) did not significantly differ from that of nonsurvivors (65.7 ± 5.34%). Ten patients suffered inhalation injury, which was associated with an odds ratio of 10.1* for mortality. Mean SIDa was 44.2 ± 3.2 for the entire study population. Survivors had a significantly lower SIDa (36.6 ± 0.5) than nonsurvivors (59.7 ± 13*). Mean SIDe for all patients was (25 ± 0.7) and did not differ significantly between survivors (24.7 ± 0.7) and nonsurvivors (25.8 ± 2). SIG for nonsurvivors (33.91 ± 14*) was significantly higher than for survivors (14.9 ± 0.3). Controlling for both TBSA and inhalation injury, death was associated with both an increased SIDa (B = 19.3*) and SIG (B = 17.3*). SIG is increased in severely burn-injured pediatric patients, indicating the presence of metabolic acidosis. Furthermore, an increased SIG is significantly associated with mortality. (*P <.05.). PMID:24823334

Sen, Soman; Wiktor, Arek; Berndtson, Allison; Greenhalgh, David; Palmieri, Tina

2014-01-01

208

Adolescent Peer Victimization, Peer Status, Suicidal Ideation, and Nonsuicidal Self-Injury: Examining Concurrent and Longitudinal Associations  

Science.gov (United States)

This study examined concurrent and longitudinal associations among peer victimization, peer status, and self-injurious thoughts and behaviors (i.e., suicidal ideation and nonsuicidal self-injury [NSSI]) over a 2-year period. A community sample of 493 adolescents (51% girls) in Grades 6-8 participated in the study. Participants completed measures…

Heilbron, Nicole; Prinstein, Mitchell J.

2010-01-01

209

MR imaging of the combined anterior and posterior cruciate ligament tears: focussing on the ratterns of injuries and associated findings  

Energy Technology Data Exchange (ETDEWEB)

To evaluate the patterns of injuries and frequency of associated findings on MR imaging in patients with both anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL)tears;to compare the associated findings, as seen on MR imaging, in cases with both ACL and PCL tears with those with ACL or PCL tears. Ten patients with compbined ACL and PCL tears, 16 with ACL tears and 18 with PCL tears, all confirmed by arthroscopy or open surgery, were involved in this study. To identify the associated knee injuries, MR images were retrospectively evaluated. In ten patients with combined ACL and PCL tears, open surgery led to the identification of six complete ACL tears (60%), four partial ACL tears (40%), eitht complete PCL tears (80%) and two partial PCL tears (20%). Injuries associated with these combined tears, and revealed by MR imaging, comprised six medial collateral ligament injuries (60%), six lateral collateral ligament jnjuries (60%), five medial meniscal injuries (50%), three lateral meniscal injuries (30%), nine bony injuries (90%), two posterior capsular injuries (20%), and three popliteus muscle injuries (30%). The frequency of popliteus muscle injury was significantly different (p<0.05, Fisher's exact test) between the group with both ACL and PCL tears and that with ACL or PCL tears. Associated findings in patients with combined ACL and PCL tears are more frequent than in those with ACL or PCL tears. In cases involving combined ACL and PCL tears, associated findings-as seen on MR images-should thus be carefully examined.

Kwon, Seon Young; Choi, Chang Lak; Park, Dal Soo; Park, Eun Hee; Lee, Sang Ho; Song, Mun Kab; Lee, Kwang Won [Eulji Medical College, Taejon (Korea, Republic of); Kwon, Soon Tae [Chungnam National Univ. College of Medicine, Taejon (Korea, Republic of)

1997-09-01

210

Dura mater?associated Creutzfeldt–Jakob disease: experience from surveillance in the UK  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Between 1970 and 2003, seven cases of human dura mater?associated Creutzfeldt–Jakob disease (CJD) were identified in the UK. Furthermore, we identified a case of CJD in a porcine dura graft recipient. The mean incubation period of the human dura mater cases was 93 (range 45–177)?months. The clinico?pathological features of the cases are described and compared with cases previously reported in the world literature.

Heath, C. A.; Barker, R. A.; Esmonde, T. F. G.; Harvey, P.; Roberts, R.; Trend, P.; Head, M. W.; Smith, C.; Bell, J. E.; Ironside, J. W.; Will, R. G.; Knight, R. S. G.

2006-01-01

211

Botulinum toxin injection for bruxism associated with brain injury: Case report  

Directory of Open Access Journals (Sweden)

Full Text Available Bruxism is involuntary grinding of the teeth and can occur as a complication of brain injury. If untreated, bruxism can lead to severe occlusal trauma. Herein, we present a patient with traumatic brain injury and nocturnal bruxism that was treated with botulinum toxin injection. A 21 yr old male patient with traumatic brain injury from a car accident was admitted to our inpatient rehabilitation unit. He had a history of coma for 2 wk in the intensive care unit. The initial cranial computed tomography scan indicated a superior thalamic hemorrhage. On admission to our department 3 mo postinjury, his mental status was good and he was able to walk without assistance, but he had mild ataxia. He complained about severe teeth grinding at night, which began 2 mo postinjury. Botulinum toxin-A was injected into the masseter muscles (20 U in each muscle and temporalis muscles (15 U in each muscle bilaterally. A decrease in bruxism was reported within 3 d. Clinical improvement persisted at assessment 4 mo posttreatment. Botulinum toxin injection can be used as an effective treatment for bruxism associated with brain injury.

Serdar Kesikburun, MD

2014-07-01

212

Factors associated with discharge destination from acute care after acquired brain injury in Ontario, Canada  

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Full Text Available Abstract Background The aim of this paper is to examine factors associated with discharge destination after acquired brain injury in a publicly insured population using the Anderson Behavioral Model as a framework. Methods We utilized a retrospective cohort design. Inpatient data from provincial acute care records from fiscal years 2003/4 to 2006/7 with a diagnostic code of traumatic brain injury (TBI and non-traumatic brain injury (nTBI in Ontario, Canada were obtained for the study. Using multinomial logistic regression models, we examined predisposing, need and enabling factors from inpatient records in relation to major discharge outcomes such as discharge to home, inpatient rehabilitation and other institutionalized care. Results Multinomial logistic regression revealed that need factors were strongly correlated with discharge destinations overall. Higher scores on the Charlson Comorbidity Index were associated with discharge to other institutionalized care in the nTBI population. Length of stay and special care days were identified as markers for severity and were both strongly positively correlated with discharge to other institutionalized care and inpatient rehabilitation, compared to discharge home, in both nTBI and TBI populations. Injury by motor vehicle collisions was found to be positively correlated with discharge to inpatient rehabilitation and other institutionalized care for patients with TBI. Controlling for need factors, rural location was associated with discharge to home versus inpatient rehabilitation. Conclusions These findings show that need factors (Charlson Comorbidity Index, length of stay, and number of special care days are most significant in terms of discharge destination. However, there is evidence that other factors such as rural location and access to supplemental insurance (e.g., through motor vehicle insurance may influence discharge destination outcomes as well. These findings should be considered in creating more equitable access to healthcare services across the continuum of care.

Chen Amy Y

2012-03-01

213

Automatic Association of Chats and Video Tracks for Activity Learning and Recognition in Aerial Video Surveillance  

Directory of Open Access Journals (Sweden)

Full Text Available We describe two advanced video analysis techniques, including video-indexed by voice annotations (VIVA and multi-media indexing and explorer (MINER. VIVA utilizes analyst call-outs (ACOs in the form of chat messages (voice-to-text to associate labels with video target tracks, to designate spatial-temporal activity boundaries and to augment video tracking in challenging scenarios. Challenging scenarios include low-resolution sensors, moving targets and target trajectories obscured by natural and man-made clutter. MINER includes: (1 a fusion of graphical track and text data using probabilistic methods; (2 an activity pattern learning framework to support querying an index of activities of interest (AOIs and targets of interest (TOIs by movement type and geolocation; and (3 a user interface to support streaming multi-intelligence data processing. We also present an activity pattern learning framework that uses the multi-source associated data as training to index a large archive of full-motion videos (FMV. VIVA and MINER examples are demonstrated for wide aerial/overhead imagery over common data sets affording an improvement in tracking from video data alone, leading to 84% detection with modest misdetection/false alarm results due to the complexity of the scenario. The novel use of ACOs and chat Sensors 2014, 14 19844 messages in video tracking paves the way for user interaction, correction and preparation of situation awareness reports.

Riad I. Hammoud

2014-10-01

214

Automatic association of chats and video tracks for activity learning and recognition in aerial video surveillance.  

Science.gov (United States)

We describe two advanced video analysis techniques, including video-indexed by voice annotations (VIVA) and multi-media indexing and explorer (MINER). VIVA utilizes analyst call-outs (ACOs) in the form of chat messages (voice-to-text) to associate labels with video target tracks, to designate spatial-temporal activity boundaries and to augment video tracking in challenging scenarios. Challenging scenarios include low-resolution sensors, moving targets and target trajectories obscured by natural and man-made clutter. MINER includes: (1) a fusion of graphical track and text data using probabilistic methods; (2) an activity pattern learning framework to support querying an index of activities of interest (AOIs) and targets of interest (TOIs) by movement type and geolocation; and (3) a user interface to support streaming multi-intelligence data processing. We also present an activity pattern learning framework that uses the multi-source associated data as training to index a large archive of full-motion videos (FMV). VIVA and MINER examples are demonstrated for wide aerial/overhead imagery over common data sets affording an improvement in tracking from video data alone, leading to 84% detection with modest misdetection/false alarm results due to the complexity of the scenario. The novel use of ACOs and chat Sensors 2014, 14 19844 messages in video tracking paves the way for user interaction, correction and preparation of situation awareness reports. PMID:25340453

Hammoud, Riad I; Sahin, Cem S; Blasch, Erik P; Rhodes, Bradley J; Wang, Tao

2014-01-01

215

Hard ticks (Ixodidae) in Romania: surveillance, host associations, and possible risks for tick-borne diseases.  

Science.gov (United States)

Ticks and tick-borne diseases represent a great concern worldwide. Despite this, in Romania the studies regarding this subject has just started, and the interest of medical personnel, researchers, and citizens is increasing. Because the geographical range of many tick-borne diseases started to extend as consequences of different biological and environmental factors, it is important to study the diversity of ticks species, especially correlated with host associations. A total number of 840 ticks were collected between 1 April and 1 November 2010, from 66 animals, from 17 species in 11 counties, spread all over Romania. Four Ixodidae species were identified: Dermacentor marginatus (49.2%), Ixodes ricinus (48.3%), Hyalomma marginatum (2.4%), and Rhipicephalus sanguineus (0.1%). The obtained results indicate that D. marginatus is the most abundant tick species and I. ricinus is the most prevalent. As both of them are important vectors for human and animal diseases, the present paper discusses the associated risks for tick-borne diseases. PMID:22033737

Dumitrache, M O; Gherman, C M; Cozma, Vasile; Mircean, V; Györke, A; Sándor, A D; Mihalca, A D

2012-05-01

216

Molecular surveillance of drug-resistance associated mutations of Plasmodium falciparum in south-west Tanzania  

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Full Text Available Abstract Background In Tanzania, drug-resistant malaria parasites are an increasing public health concern. Because of widespread chloroquine (CQ resistance Tanzania changed its first line treatment recommendations for uncomplicated malaria from CQ to sulfadoxine-pyrimethamine (SP in 2001. Loss of SP sensitivity is progressing rapidly. SP resistance is associated with mutations in the dihydrofolate reductase (pfdhfr and dihydropteroate synthase (pfdhps genes. Methods In samples from 86 patients with uncomplicated Plasmodium falciparum malaria from Mbeya and Matema, Mbeya region, south-western Tanzania, the occurrence of mutations was investigated in the pfcrt and pfmdr1 genes which are associated with CQ resistance and in pfdhfr and pfdhps, conferring SP resistance, as well in cytb which is linked to resistance to atovaquone. Results Pfcrt T76 occurs in 50% and pfmdr1 Y86 in 51.7%. Pfdhfr triple mutations coexisting with pfdhps double mutations were detected in 64.3% of the P. falciparum isolates. This quintuple mutation is seen as a possible predictive molecular marker for SP treatment failure. Mutations of the cytb gene were not detected. Conclusion These findings of a high prevalence of mutations conferring SP resistance correspond to data of in vivo SP efficacy studies in other regions of Tanzania and underline the recommendation of changing first-line treatment to artemisinin-based combination therapy.

Berens-Riha Nicole

2007-01-01

217

The Warfighter Associate: decision-support software agent for the management of intelligence, surveillance, and reconnaissance (ISR) assets  

Science.gov (United States)

A unique and promising intelligent agent plug-in technology for Mission Command Systems— the Warfighter Associate (WA)— is described that enables individuals and teams to respond more effectively to the cognitive challenges of Mission Command, such as managing limited intelligence, surveillance, and reconnaissance (ISR) assets and information sharing in a networked environment. The WA uses a doctrinally-based knowledge representation to model role-specific workflows and continuously monitors the state of the operational environment to enable decision-support, delivering the right information to the right person at the right time. Capabilities include: (1) analyzing combat events reported in chat rooms and other sources for relevance based on role, order-of-battle, time, and geographic location, (2) combining seemingly disparate pieces of data into meaningful information, (3) driving displays to provide users with map based and textual descriptions of the current tactical situation, and (4) recommending courses of action with respect to necessary staff collaborations, execution of battle-drills, re-tasking of ISR assets, and required reporting. The results of a scenario-based human-in-the-loop experiment are reported. The underlying WA knowledge-graph representation serves as state traces, measuring aspects of Soldier decision-making performance (e.g. improved efficiency in allocating limited ISR assets) across runtime as dynamic events unfold on a simulated battlefield.

Buchler, Norbou; Marusich, Laura R.; Sokoloff, Stacey

2014-06-01

218

ERG Protein Expression in Diagnostic Specimens Is Associated with Increased Risk of Progression During Active Surveillance for Prostate Cancer  

DEFF Research Database (Denmark)

BACKGROUND: Compelling biomarkers identifying prostate cancer patients with a high risk of progression during active surveillance (AS) are needed. OBJECTIVE: To examine the association between ERG expression at diagnosis and the risk of progression during AS. DESIGN, SETTING, AND PARTICIPANTS: This study included 265 patients followed on AS with prostate-specific antigen (PSA) measurements, clinical examinations, and 10-12 core rebiopsies from 2002 to 2012 in a prospectively maintained database. ERG immunohistochemical staining was performed on diagnostic paraffin-embedded formalin-fixed sections with a ready-to-use kit (anti-ERG, EPR3864). Men were characterised as ERG positive if a minimum of one tumour focus demonstrated ERG expression. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Overall AS progression was defined as clinical progression: increased clinical tumour category ?cT2b by digital rectal examination and ultrasound, and/or histopathologic progression: upgrade of Gleason score, more than threepositive cores or bilateral positive cores, and/or PSA progression: PSA doubling time <3 yr. Risk of progression was analysed using multiple cause-specific Cox regression and stratified cumulative incidences (Aalen-Johansen method). Curatively intended treatment, watchful waiting, and death without progression were treated as competing events. RESULTS AND LIMITATIONS: A total of 121 of 142 ERG-negative and 96 of 123 ERG-positive patients had complete diagnostic information. In competing risk models, the ERG-positive group showed significantly higher incidences of overall AS progression (p<0.0001) and of the subgroups PSA progression (p<0.0001) and histopathologic progression (p<0.0001). The 2-yr cumulative incidence of overall AS progression was 21.7% (95% confidence interval [CI], 14.3-29.1) in the ERG-negative group compared with 58.6% (95% CI, 48.7-68.5) in the ERG-positive group. ERG positivity was a significant predictor of overall AS progression in multiple Cox regression (hazard ratio: 2.45; 95% CI, 1.62-3.72; p<0.0001). The main limitation of this study is its observational nature. CONCLUSIONS: In our study, ERG positivity at diagnosis can be used to estimate the risk of progression during AS. If confirmed, ERG status can be used to individualise AS programmes. PATIENT SUMMARY: The tissue biomarker ERG identifies active surveillance patients with an increased risk of disease progression.

Berg, Kasper Drimer; Vainer, Ben

2014-01-01

219

Surveillance of artemether-lumefantrine associated Plasmodium falciparum multidrug resistance protein-1 gene polymorphisms in Tanzania  

DEFF Research Database (Denmark)

BACKGROUND: Resistance to anti-malarials is a major public health problem worldwide. After deployment of artemisinin-based combination therapy (ACT) there have been reports of reduced sensitivity to ACT by malarial parasites in South-East Asia. In Tanzania, artemether-lumefantrine (ALu) is the recommended first-line drug in treatment of uncomplicated malaria. This study surveyed the distribution of the Plasmodium falciparum multidrug resistance protein-1 single nucleotide polymorphisms (SNPs) associated with increased parasite tolerance to ALu, in Tanzania. METHODS: A total of 687 Plasmodium falciparum positive dried blood spots on filter paper and rapid diagnostic test strips collected by finger pricks from patients attending health facilities in six regions of Tanzania mainland between June 2010 and August 2011 were used. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to detect Pfmdr1 SNPs N86Y, Y184F and D1246Y. RESULTS: There were variations in the distribution of Pfmdr1 polymorphisms among regions. Tanga region had exceptionally high prevalence of mutant alleles, while Mbeya had the highest prevalence of wild type alleles. The haplotype YFY was exclusively most prevalent in Tanga (29.6%) whereas the NYD haplotype was the most prevalent in all other regions. Excluding Tanga and Mbeya, four, most common Pfmdr1 haplotypes did not vary between the remaining four regions (chi2 = 2.3, p = 0.512). The NFD haplotype was the second most prevalent haplotype in all regions, ranging from 17% - 26%. CONCLUSION: This is the first country-wide survey on Pfmdr1 mutations associated with ACT resistance. Distribution of individual Pfmdr1 mutations at codons 86, 184 and 1246 varies throughout Tanzanian regions. There is a general homogeneity in distribution of common Pfmdr1 haplotypes reflecting strict implementation of ALu policy in Tanzania with overall prevalence of NFD haplotype ranging from 17 to 26% among other haplotypes. With continuation of ALu as first-line drug this haplotype is expected to keep rising, thus there is need for continued pharmacovigilance studies to monitor any delayed parasite clearance by the drug.

Kavishe, Reginald A; Paulo, Petro

2014-01-01

220

Breakfast and Snacks: Associations with Cognitive Failures, Minor Injuries, Accidents and Stress  

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Full Text Available One strategy for examining effects of nutrients on cognitive function is to initially investigate foods that contain many different nutrients. If effects are demonstrated with these foods then further studies can address the role of specific nutrients. Breakfast foods (e.g., cereals, dairy products and fruit provide many important nutrients and consumption of breakfast has been shown to be associated with beneficial effects on cognitive function. Isolating effects of specific constituents of breakfast has proved more difficult and it is still unclear what impact breakfast has on real-life performance. The present study provided initial information on associations between breakfast consumption and cognitive failures and accidents. A second aim was to examine associations between consumption of snacks which are often perceived as being unhealthy (chocolate, crisps and biscuits. A sample of over 800 nurses took part in the study. The results showed that frequency of breakfast consumption (varied breakfasts: 62% cereal was associated with lower stress, fewer cognitive failures, injuries and accidents at work. In contrast, snacking on crisps, chocolate and biscuits was associated with higher stress, more cognitive failures and more injuries outside of work. Further research requires intervention studies to provide a clearer profile of causality and underlying mechanisms.

Katherine Chaplin

2011-05-01

 
 
 
 
221

Computed tomography of traumatic abdominal wall hernia and associated deceleration injuries  

International Nuclear Information System (INIS)

We retrospectively reviewed the computed tomographic CT examinations of 15 cases of abdominal wall hernia due to abdominal trauma; 13 patients had been injured in motor vehicle accidents (11 of those were belted in). All hernias were correctly identified on CT and confirmed intraoperatively. Traumatic abdominal wall hernia proved an important indicator of associated visceral injury, especially to the bowel (n = 6) and mesentery (n = 10). Careful review of the bowel and mesentery should thus be undertaken when disruption of the abdominal wall is documented. Radiologists should be aware, however, that CT findings may correlate poorly with severity of injury in these areas. In these instances, close clinical correlation and, sometimes, rescanning may be necessary. (author)

222

Computed tomography of traumatic abdominal wall hernia and associated deceleration injuries  

Energy Technology Data Exchange (ETDEWEB)

We retrospectively reviewed the computed tomographic CT examinations of 15 cases of abdominal wall hernia due to abdominal trauma; 13 patients had been injured in motor vehicle accidents (11 of those were belted in). All hernias were correctly identified on CT and confirmed intraoperatively. Traumatic abdominal wall hernia proved an important indicator of associated visceral injury, especially to the bowel (n = 6) and mesentery (n = 10). Careful review of the bowel and mesentery should thus be undertaken when disruption of the abdominal wall is documented. Radiologists should be aware, however, that CT findings may correlate poorly with severity of injury in these areas. In these instances, close clinical correlation and, sometimes, rescanning may be necessary. (author)

Hickey, N.A.; Ryan, M.F.; Hamilton, P.A.; Bloom, C.; Murphy, J.P. [Sunnybrook and Women' s College Health Sciences Centre, Univ. of Toronto, Dept. of Medical Imaging, Toronto, Ontario (Canada); Brenneman, F. [Sunnybrook and Women' s College Health Sciences Centre, Univ. of Toronto, Dept. of Surgery, Toronto, Ontario (Canada)

2002-06-01

223

Bone signal abnormality, as seen on knee joint MRI : relationship between its location and associated injury  

International Nuclear Information System (INIS)

The purpose of the study was to evaluate the relationship between the location of bone signal abnormality and associated injury, as seen on MR, in patients with acute knee joint injury. Materials and Methods: Thirty-six patients with acute knee injury and bone signal abnormalities on MR were included in this study. The femur and tibia were each divided into six compartments, namely the anteromedial, medial, posteromedial,anterolateral, lateral, and posterolateral ; these were obtained in each knee joint. We evaluated the location of bone signal abnormality and the corresponding arthroscopic or operative findings of injury to ligaments and menisci. Cases with signal abnormalities involving more than three compartments were excluded. Results : Bone signal abnormalities were demonstrated in 51 compartments. Most(84%, 43/51) were noted in the lateral half of the knee joint, the most common location being the tibio- posterolateral compartment(13/51). The femoro-lateral(11/51) and tibio- anterolateral compartment(8/51) were the next most common locations. All cases(13/13)with bone signal abnormality in the tibio- posterolateral compartment had tears at the anterior cruciate ligament,while 9 of 11 cases(81%) with abnormality in the femoro- lateral compartment had tears at the anterior cruciate ligament. Six of eight cases(75%) with signal abnormality in the tibio- anterolateral compartment had tears at the posterior cruciate ligament ; 31 of 43 cases (72%) with abnormality in the lateral half of the knee joint had tears at the medial collateral ligament. Six of eight cases(75%) with signal abnormality in the medial half of the knee joint had tears at the medial meniscus, but no lateral meniscal tear was found. Among patients with signal abnormality in the lateral half of the knee joint, the tear was lateral meniscal in nine of 43 cases(21%) and medial meniscal in six of 43(14%). Conclusion : The location of bone signal abnormality, as seen on knee MR, inpatients with acute knee joint injury could be an important finding suggesting associated injury

224

Etiology, incidence and patterns of mid-face fractures and associated ocular injuries.  

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A prospective study on mid-face fractures was carried out in the Department of Oral and Maxillofacial Surgery at College of Dentistry, Indore, from August 2007 to September 2009 to analyze etiology, incidence and patterns of midface fractures and associated ocular injuries. Two hundred patients were included in this study, amongst those who reported to the Department of OMFS, College of Dentistry, Indore. After confirmed diagnosis of mid face fracture all the patients were stratified according to age, sex, cause of the accident, influence of alcohol, location, type of fractures and associated ocular injuries. The study included 200 patients with a mean age of 29.6 years. The most frequently injured patients belonged to the 21-30 year-old age group. The male predilection was 76 %. Road traffic accident was the most common causative factor (64 %), followed by assault (21 %), cases of fall (9.5 %) and other causes (5.5 %). The most common fracture in this study was found to be zygomatic complex fractures (62.5 %) (more in the age group of 21-30 years). This was followed by Lefort II fractures (23 %), multiple fractures (10 %) and Lefort I fractures (6 %), Lefort III fractures (4.5 %) and Naso-ethmoidal fractures (4 %) in descending order. 84.5 % subjects were having ocular involvement. Subconjunctival hemorrhage was present mostly in 83.5 % followed by remaining as corneal injury 15 %, reduced acuity 11.5 %, diplopia 10.5 %, enophthalmos 8.5 %, telecanthus 5 %, hyphema 3.5 %, blindness 3 % and proptosis 0.5 %. Zygomatic complex fractures were the most frequent type of injury that was complicated by blindness or a serious eye injury (61 %). Collection of data regarding the epidemiology of maxillofacial fractures is important because it may assist healthcare providers to provide necessary information for the development and evaluation of preventive measures. Ocular injuries should have an early ophthalmological examination at the time of trauma to detect any kind of ocular dysfunction. PMID:24822001

Septa, Dilip; Newaskar, Vilas P; Agrawal, Deepak; Tibra, Shailendra

2014-06-01

225

Avaliação da evolução de lesões associadas à lesão do ligamento cruzado anterior / Progress assessment of injuries associated to anterior cruciate ligament injuries  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese PROPOSTA: Revisamos 71 pacientes com diagnóstico de lesão do ligamento cruzado anterior em 72 joelhos. Foi avaliado a incidência de lesões associadas (meniscais ou condrais) de acordo com o tempo até a cirurgia de reconstrução do ligamento. TIPO DE ESTUDO: Estudo retrospectivo de série de casos. MÉT [...] ODOS: Realizado análise estatística do efeito do tempo até a cirurgia com o aumento de lesões associadas. RESULTADOS: Não houve alteração, estatisticamente significante, da incidência de lesões condrais e meniscais avaliadas nos períodos 2 a 3 meses, 4 a 6 meses, 7 a 12 meses, 13 a 24 meses e mais que 24 meses. CONCLUSÕES: Embora haja uma tendência de aumento de lesões meniscais após 6 meses e de lesões condrais após 12 meses da lesão do ligamento cruzado anterior, tal fato não mostrou significância estatistica. Abstract in english PURPOSE: We reviewed 71 patients diagnosed with anterior cruciate ligament (ACL) injury on 72 knees. The incidence of associated injuries (meniscal and joint cartilage injuries) were evaluated according to the time elapsed until ACL reconstruction. STUDY DESIGN: Retrospective case series. METHODS: S [...] tatistical analysis of the relationship between the time elapsed until surgery and the increase of associated lesions. RESULTS: There was no statistically significant difference on the incidence of joint-cartilage and meniscal injuries assessed for the periods within 2-3 months, 4-6 months, 7-12 months, 13-24 months and above 24 months. CONCLUSION: Although a trend towards a higher number of meniscal injuries after 6 months, and of joint-cartilage injuries after 12 months since the primary anterior cruciate ligament injury, such fact showed no statistical significance.

Ivan Dias da, Rocha; Tomás Mosaner de Souza, Moraes; Márcia Uchoa de, Rezende; José Ricardo, Pécora.

226

Avaliação da evolução de lesões associadas à lesão do ligamento cruzado anterior Progress assessment of injuries associated to anterior cruciate ligament injuries  

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Full Text Available PROPOSTA: Revisamos 71 pacientes com diagnóstico de lesão do ligamento cruzado anterior em 72 joelhos. Foi avaliado a incidência de lesões associadas (meniscais ou condrais de acordo com o tempo até a cirurgia de reconstrução do ligamento. TIPO DE ESTUDO: Estudo retrospectivo de série de casos. MÉTODOS: Realizado análise estatística do efeito do tempo até a cirurgia com o aumento de lesões associadas. RESULTADOS: Não houve alteração, estatisticamente significante, da incidência de lesões condrais e meniscais avaliadas nos períodos 2 a 3 meses, 4 a 6 meses, 7 a 12 meses, 13 a 24 meses e mais que 24 meses. CONCLUSÕES: Embora haja uma tendência de aumento de lesões meniscais após 6 meses e de lesões condrais após 12 meses da lesão do ligamento cruzado anterior, tal fato não mostrou significância estatistica.PURPOSE: We reviewed 71 patients diagnosed with anterior cruciate ligament (ACL injury on 72 knees. The incidence of associated injuries (meniscal and joint cartilage injuries were evaluated according to the time elapsed until ACL reconstruction. STUDY DESIGN: Retrospective case series. METHODS: Statistical analysis of the relationship between the time elapsed until surgery and the increase of associated lesions. RESULTS: There was no statistically significant difference on the incidence of joint-cartilage and meniscal injuries assessed for the periods within 2-3 months, 4-6 months, 7-12 months, 13-24 months and above 24 months. CONCLUSION: Although a trend towards a higher number of meniscal injuries after 6 months, and of joint-cartilage injuries after 12 months since the primary anterior cruciate ligament injury, such fact showed no statistical significance.

Ivan Dias da Rocha

2007-01-01

227

The carcinoma-associated fibroblast expressing fibroblast activation protein and escape from immune surveillance.  

Science.gov (United States)

The fibroblastic element of the tumor microenvironment has been of great interest to cancer biologists but less so to cancer immunologists. Yet, the sharing of a common mesenchymal cell type in the stroma of tumors and at sites of chronic inflammatory lesions, some of which have an autoimmune basis, has been a strong hint that this cellular component of the tumor microenvironment may have an immunologic function. Recent studies have confirmed this possibility. These fibroblast-like cells, which are termed carcinoma-associated fibroblasts (CAF), can be identified by their expression of the membrane protein, fibroblast activation protein-? (FAP). The conditional depletion of the FAP(+) CAF permits immune control not only of an artificial, transplanted tumor, but also of an autochthonous model of pancreatic ductal adenocarcinoma (PDA) that replicates the molecular, histologic, clinical, and immunologic characteristics of the human disease. Immune suppression by the FAP(+) CAF is mediated by CXCL12, the chemokine that binds to cancer cells and excludes T cells by a mechanism that depends on signaling by the CXCL12 receptor CXCR4. Inhibition of CXCR4 leads to the elimination of cancer cells by enabling the rapid, intratumoral accumulation of preexisting, PDA-specific CD8(+) T cells, and reveals the antitumor efficacy of the T-cell checkpoint antagonist anti-PD-L1. Recent studies have also shown that the FAP(+) CAF is related to FAP-expressing stromal cells of normal tissues, demonstrating that cancers recruit a member of an essential stromal cell lineage that is involved not only in wound repair but also in normal tissue homeostasis. These findings extend the concept introduced by cancer biologists that the fibroblastic component of tumors has a critical role in the adaptation of the cancer to the host. PMID:24778314

Fearon, Douglas T

2014-03-01

228

Healthcare-associated infections in pediatric cancer patients: results of a prospective surveillance study from university hospitals in Germany and Switzerland  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Pediatric cancer patients face an increased risk of healthcare-associated infection (HAI. To date, no prospective multicenter studies have been published on this topic. Methods Prospective multicenter surveillance for HAI and nosocomial fever of unknown origin (nFUO with specific case definitions and standardized surveillance methods. Results 7 pediatric oncology centers (university facilities participated from April 01, 2001 to August 31, 2005. During 54,824 days of inpatient surveillance, 727 HAIs and nFUOs were registered in 411 patients. Of these, 263 (36% were HAIs in 181 patients, for an incidence density (ID (number of events per 1,000 inpatient days of 4.8 (95% CI 4.2 to 5.4; range 2.4 to 11.7; P Conclusion Our study confirmed that pediatric cancer patients are at an increased risk for specific HAIs. The prospective surveillance of HAI and comparison with cumulative multicenter results are indispensable for targeted prevention of these adverse events of anticancer treatment.

Rutkowski Stefan

2008-05-01

229

The association between hospitalisation for childhood head injury and academic performance: evidence from a population e-cohort study  

Science.gov (United States)

Background Childhood head injury has the potential for lifelong disability and burden. This study aimed to establish the association between admission to hospital for childhood head injury and early academic performance. Methods The Wales Electronic Cohort for Children (WECC) study is comprised of record-linked routinely collected data, on all children born or residing in Wales. Anonymous linking fields are used to link child and maternal health, environment and education records. Data from WECC were extracted for children born between September 1998 and August 2001. A Generalised Estimating Equation model, adjusted for clustering based on the maternal identifier as well as other key confounders, was used to establish the association between childhood head injury and performance on the Key Stage 1 (KS1) National Curriculum assessment administered to children aged 5–7?years. Head injury was defined as an emergency admission for >24?h for concussion, skull fracture or intracranial injury prior to KS1 assessment. Results Of the 101?892 eligible children, KS1 results were available for 90?661 (89%), and 290 had sustained a head injury. Children who sustained an intracranial injury demonstrated significantly lower adjusted odds of achieving a satisfactory KS1 result than children who had not been admitted to hospital for head injury (adjusted OR 0.46, 95% CI 0.30 to 0.72). Conclusions The findings of this population e-cohort study quantify the impact of head injury on academic performance, highlighting the need for enhanced head injury prevention strategies. The results have implications for the care and rehabilitation of children admitted to hospital with head injury. PMID:24419234

Gabbe, Belinda J; Brooks, Caroline; Demmler, Joanne C; Macey, Steven; Hyatt, Melanie A; Lyons, Ronan A

2014-01-01

230

Fast pitch softball injuries.  

Science.gov (United States)

The popularity of fast pitch softball in the US and throughout the world is well documented. Along with this popularity, there has been a concomitant increase in the number of injuries. Nearly 52% of cases qualify as major disabling injuries requiring 3 weeks or more of treatment and 2% require surgery. Interestingly, 75% of injuries occur during away games and approximately 31% of traumas occur during nonpositional and conditioning drills. Injuries range from contusions and tendinitis to ligamentous disorders and fractures. Although head and neck traumas account for 4 to 12% of cases, upper extremity traumas account for 23 to 47% of all injuries and up to 19% of cases involve the knee. Approximately 34 to 42% of injuries occur when the athlete collides with another individual or object. Other factors involved include the quality of playing surface, athlete's age and experience level, and the excessive physical demands associated with the sport. Nearly 24% of injuries involve base running and are due to poor judgement, sliding technique, current stationary base design, unorthodox joint and extremity position during ground impact and catching of cleats. The increasing prevalence of overtraining syndrome among athletes has been attributed to an unclear definition of an optimal training zone, poor communication between player and coach, and the limited ability of bone and connective tissue to quickly respond to match the demands of the sport. This has led routinely to arm, shoulder and lumbar instability, chronic nonsteroidal anti-inflammatory drug (NSAID) use and time loss injuries in 45% of pitching staff during a single season. Specific attention to a safer playing environment, coaching and player education, and sport-specific training and conditioning would reduce the risk, rate and severity of fast pitch traumas. Padding of walls, backstops, rails and dugout areas, as well as minimising use of indoor facilities, is suggested to decrease the number of collision injuries. Coaches should be cognisant of overtraining, vary day-to-day training routines to decrease repetitive musculoskeletal stress, focus on motor skills with equal emphasis on speed and efficiency of movement, and use drills that reinforce sport-specific, decision making processes to minimise mental mistakes. Conditioning programs that emphasise a combination of power, acceleration, flexibility, technical skill, functional capacity and injury prevention are recommended. Due to the limited body of knowledge presently available on this sport, a greater focus on injury surveillance would provide a clearer picture of injury causation and effective management procedures, leading toward safer participation and successful player development. PMID:11219502

Meyers, M C; Brown, B R; Bloom, J A

2001-01-01

231

Prevalence of and factors associated with hock, knee, and neck injuries on dairy cows in freestall housing in Canada.  

Science.gov (United States)

Injuries are a widespread problem in the dairy industry. The objective of this study was to determine the prevalence of and explore the animal-based and environmental factors associated with hock, knee, and neck injuries on dairy cows in freestall housing in Ontario and Alberta, Canada. Freestall dairy farms in the provinces of Ontario (n=40) and Alberta (n=50) were visited for cross-sectional data collection. A purposive sample of 40 lactating Holstein cows was selected for detailed observation on each farm. Cows were scored for hock, knee, and neck injuries on a 3- or 4-point scale, combining the attributes of hair loss, broken skin, and swelling and with a higher score indicating a more severe injury. The highest hock and highest knee score were used in the analysis. Animal-based and environmental measures were taken to explore which factors were associated with injury. Overall, the prevalence of cows with at least one hock, knee, and neck injury was 47, 24, and 9%, respectively. Lame cows had a greater odds of hock injury [odds ratio (OR)=1.46] than nonlame cows, whereas cows with fewer days in milk (DIM) had reduced odds of hock injury compared with those >120 DIM (OR=0.47, 0.64, and 0.81 for farms where any cows were observed slipping or falling when moving into the holding area for milking (OR=2.69) and lower on farms with rubber flooring in the alley along the feed bunk compared with bare concrete floors (OR=0.19). These results demonstrate that individual animal characteristics, as well as barn design and animal management, are associated with hock, knee, and neck injuries. These data can help to guide investigations into causes and prevention of injuries. PMID:24359942

Zaffino Heyerhoff, J C; LeBlanc, S J; DeVries, T J; Nash, C G R; Gibbons, J; Orsel, K; Barkema, H W; Solano, L; Rushen, J; de Passillé, A M; Haley, D B

2014-01-01

232

Management of Traumatic Injury to Maxillary Central Incisors associated with Inverted Mesiodens: A Case Report  

Science.gov (United States)

ABSTRACT Maxillary incisors are the most frequently injured teeth in the primary and permanent dentition. Stage of adolescence show a significant number of dental injuries as they engage in contact sports. Children with accident prone profile, i.e. class II division I or class I type II malocclusion are more prone for injuries because of the proclined maxillary incisors. Supernumerary teeth are those that are additional to the normal complement. They occur in single or multiple, unilateral or bilateral in either of the jaws. This paper reports the presence of an inverted supernumerary tooth in the right maxillary central incisor region with trauma involving both maxillary central incisors and also the management of the supernumerary tooth and traumatized teeth in a 14-year-old boy. How to cite this article: Pavuluri C, Nuvvula S. Management of Traumatic Injury to Maxillary Central Incisors associated with Inverted Mesiodens: A Case Report. Int J Clin Pediatr Dent 2013;6(1):30-32. PMID:25206184

Nuvvula, Sivakumar

2013-01-01

233

Severe Vitamin E deficiency exacerbates acute hyperoxic lung injury associated with increased oxidative stress and inflammation.  

Science.gov (United States)

Hyperoxia causes acute lung injury along with an increase of oxidative stress and inflammation. It was hypothesized that vitamin E deficiency might exacerbate acute hyperoxic lung injury. This study used alpha-tocopherol transfer protein knockout (alpha-TTP KO) mice fed a vitamin E-deficient diet (KO E(-) mice) as a model of severe vitamin E deficiency. Compared with wild-type (WT) mice, KO E(-) mice showed a significantly lower survival rate during hyperoxia. After 72 h of hyperoxia, KO E(-) mice had more severe histologic lung damage and higher values of the total cell count and the protein content of bronchoalveolar lavage fluid (BALF) than WT mice. IL-6 mRNA expression in lung tissue and the levels of 8-iso-prostaglandin F(2alpha) (8-iso-PGF(2alpha)) in both lungs and BALF were higher in KO E(-) mice than in WT mice. It was concluded that severe vitamin E deficiency exacerbates acute hyperoxic lung injury associated with increased oxidative stress or inflammation. PMID:18569018

Yamaoka, Shigeo; Kim, Han-Suk; Ogihara, Tohru; Oue, Shinya; Takitani, Kimitaka; Yoshida, Yasukazu; Tamai, Hiroshi

2008-06-01

234

Early-onset ventilator-associated pneumonia incidence in intensive care units: a surveillance-based study  

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Full Text Available Abstract Background The incidence of ventilator-associated pneumonia (VAP within the first 48 hours of intensive care unit (ICU stay has been poorly investigated. The objective was to estimate early-onset VAP occurrence in ICUs within 48 hours after admission. Methods We analyzed data from prospective surveillance between 01/01/2001 and 31/12/2009 in 11 ICUs of Lyon hospitals (France. The inclusion criteria were: first ICU admission, not hospitalized before admission, invasive mechanical ventilation during first ICU day, free of antibiotics at admission, and ICU stay ? 48 hours. VAP was defined according to a national protocol. Its incidence was the number of events per 1,000 invasive mechanical ventilation-days. The Poisson regression model was fitted from day 2 (D2 to D8 to incident VAP to estimate the expected VAP incidence from D0 to D1 of ICU stay. Results Totally, 367 (10.8% of 3,387 patients in 45,760 patient-days developed VAP within the first 9 days. The predicted cumulative VAP incidence at D0 and D1 was 5.3 (2.6-9.8 and 8.3 (6.1-11.1, respectively. The predicted cumulative VAP incidence was 23.0 (20.8-25.3 at D8. The proportion of missed VAP within 48 hours from admission was 11% (9%-17%. Conclusions Our study indicates underestimation of early-onset VAP incidence in ICUs, if only VAP occurring ? 48 hours are considered to be hospital-acquired. Clinicians should be encouraged to develop a strategy for early detection after ICU admission.

Lepape Alain

2011-09-01

235

Excessive progression in weekly running distance and risk of running-related injuries: an association which varies according to type of injury.  

Science.gov (United States)

Study Design An explorative, 1-year prospective cohort study. Objective To examine whether an association between a sudden change in weekly running distance and running-related injury varies according to injury type. Background It is widely accepted that a sudden increase in running distance is strongly related to injury in runners. But the scientific knowledge supporting this assumption is limited. Methods A volunteer sample of 874 healthy novice runners who started a self-structured running regimen were provided a global-positioning-system watch. After each running session during the study period, participants were categorized into 1 of the following exposure groups, based on the progression of their weekly running distance: less than 10% or regression, 10% to 30%, or more than 30%. The primary outcome was running-related injury. Results A total of 202 runners sustained a running-related injury. Using Cox regression analysis, no statistically significant differences in injury rates were found across the 3 exposure groups. An increased rate of distance-related injuries (patellofemoral pain, iliotibial band syndrome, medial tibial stress syndrome, gluteus medius injury, greater trochanteric bursitis, injury to the tensor fascia latae, and patellar tendinopathy) existed in those who progressed their weekly running distance by more than 30% compared with those who progressed less than 10% (hazard ratio = 1.59; 95% confidence interval: 0.96, 2.66; P = .07). Conclusion Novice runners who progressed their running distance by more than 30% over a 2-week period seem to be more vulnerable to distance-related injuries than runners who increase their running distance by less than 10%. Owing to the exploratory nature of the present study, randomized controlled trials are needed to verify these results, and more experimental studies are needed to validate the assumptions. Still, novice runners may be well advised to progress their weekly distances by less than 30% per week over a 2-week period. Level of Evidence Prognosis, level 1b-. J Orthop Sports Phys Ther 2014;44(10):739-747. Epub 25 August 2014. doi:10.2519/jospt.2014.5164. PMID:25155475

Nielsen, Rasmus Østergaard; Parner, Erik Thorlund; Nohr, Ellen Aagaard; SØrensen, Henrik; Lind, Martin; Rasmussen, Sten

2014-10-01

236

Excessive progression in weekly running distance and risk of running-related injuries : an association which varies according to type of injury  

DEFF Research Database (Denmark)

Study Design An explorative, 1-year prospective cohort study. Objective To examine whether an association between a sudden change in weekly running distance and running-related injury varies according to injury type. Background It is widely accepted that a sudden increase in running distance is strongly related to injury in runners. But the scientific knowledge supporting this assumption is limited. Methods A volunteer sample of 874 healthy novice runners who started a self-structured running regimen were provided a global-positioning-system watch. After each running session during the study period, participants were categorized into 1 of the following exposure groups, based on the progression of their weekly running distance: less than 10% or regression, 10% to 30%, or more than 30%. The primary outcome was running-related injury. Results A total of 202 runners sustained a running-related injury. Using Cox regression analysis, no statistically significant differences in injury rates were found across the 3 exposure groups. An increased rate of distance-related injuries (patellofemoral pain, iliotibial band syndrome, medial tibial stress syndrome, gluteus medius injury, greater trochanteric bursitis, injury to the tensor fascia latae, and patellar tendinopathy) existed in those who progressed their weekly running distance by more than 30% compared with those who progressed less than 10% (hazard ratio = 1.59; 95% confidence interval: 0.96, 2.66; P = .07). Conclusion Novice runners who progressed their running distance by more than 30% over a 2-week period seem to be more vulnerable to distance-related injuries than runners who increase their running distance by less than 10%. Owing to the exploratory nature of the present study, randomized controlled trials are needed to verify these results, and more experimental studies are needed to validate the assumptions. Still, novice runners may be well advised to progress their weekly distances by less than 30% per week over a 2-week period. Level of Evidence Prognosis, level 1b-. J Orthop Sports Phys Ther 2014;44(10):739-747. Epub 25 August 2014. doi:10.2519/jospt.2014.5164.

Nielsen, Rasmus Østergaard; Parner, Erik Thorlund

2014-01-01

237

Factors associated with whole carcass condemnation rates in provincially-inspected abattoirs in Ontario 2001-2007: implications for food animal syndromic surveillance  

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Full Text Available Abstract Background Ontario provincial abattoirs have the potential to be important sources of syndromic surveillance data for emerging diseases of concern to animal health, public health and food safety. The objectives of this study were to: (1 describe provincially inspected abattoirs processing cattle in Ontario in terms of the number of abattoirs, the number of weeks abattoirs process cattle, geographical distribution, types of whole carcass condemnations reported, and the distance animals are shipped for slaughter; and (2 identify various seasonal, secular, disease and non-disease factors that might bias the results of quantitative methods, such as cluster detection methods, used for food animal syndromic surveillance. Results Data were collected from the Ontario Ministry of Agriculture, Food and Rural Affairs and the Ontario Cattlemen's Association regarding whole carcass condemnation rates for cattle animal classes, abattoir compliance ratings, and the monthly sales-yard price for various cattle classes from 2001-2007. To analyze the association between condemnation rates and potential explanatory variables including abattoir characteristics, season, year and commodity price, as well as animal class, negative binomial regression models were fit using generalized estimating equations (GEE to account for autocorrelation among observations from the same abattoir. Results of the fitted model found animal class, year, season, price, and audit rating are associated with condemnation rates in Ontario abattoirs. In addition, a subset of data was used to estimate the average distance cattle are shipped to Ontario provincial abattoirs. The median distance from the farm to the abattoir was approximately 82 km, and 75% of cattle were shipped less than 100 km. Conclusions The results suggest that secular and seasonal trends, as well as some non-disease factors will need to be corrected for when applying quantitative methods for syndromic surveillance involving these data. This study also demonstrated that animals shipped to Ontario provincial abattoirs come from relatively local farms, which is important when considering the use of spatial surveillance methods for these data.

Alton Gillian D

2010-08-01

238

An immunohistochemical panel to assess ultraviolet radiation-associated oxidative skin injury.  

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Ultraviolet (UV) radiation results in a significant loss in years of healthy life, approximately 1.5 million disability-adjusted life years (DALYs), and is associated with greater than 60,000 deaths annually worldwide that are attributed to melanoma and other skin cancers. Currently, there are no standardized biomarkers or assay panels to assess oxidative stress skin injury patterns in human skin exposed to ionizing radiation. Using biopsy specimens from chronic solar UV-exposed and UV-protected skin, we demonstrate that UV radiation-induced oxidative skin injury can be evaluated by an immunohistochemical panel that stains 8-hydroxydeoxyguanosine (8-OH-dG) to assess DNA adducts, 4-hydroxy-2-nonenal (HNE) to assess lipid peroxidation, and advanced glycation end products (AGEs) to assess protein damage. We believe this panel contains the necessary cellular biomarkers to evaluate topical agents, such as sunscreens and anti-oxidants that are designed to prevent oxidative skin damage and may reduce UV-associated skin aging, carcinogenesis, and inflammatory skin diseases. We envision that this panel will become an important tool for researchers developing topical agents to protect against UV radiation and other oxidants and ultimately lead to reductions in lost years of healthy life, DALYs, and annual deaths associated with UV radiation. PMID:24809881

Mamalis, Andrew; Fiadorchanka, Natallia; Adams, Lauren; Serravallo, Melissa; Heilman, Edward; Siegel, Daniel; Brody, Neil; Jagdeo, Jared

2014-05-01

239

Predictors of pediatric abdominal injury risk.  

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Although previous research has linked poor seat belt fit to abdominal organ injury for children, few have studied the pattern of pediatric abdominal injuries and its relationship to key characteristics beyond this primary association. In this study, data were obtained from a probability sample of 19,125 children, representing 243,540 children, under age 16 years who were enrolled in an on-going crash surveillance system which links insurance claims data to validated telephone survey and crash investigation data. The risk of AIS2+ abdominal injury was estimated for various crash, restraint, vehicle and child correlates and multivariate logistic regression was used to identify the relative importance of these predictors. Children 4-8 years of age were at the highest risk of abdominal injury: they were 24.5 times and 2.6 times more likely to sustain an AIS2+ abdominal injury than those 0-3 years and 9-15 years, respectively. The injury risk for children 4-8 years of age was 6 and 10 times higher in passenger cars and SUVs, respectively, compared to minivans. No reduction in abdominal injury risk was seen with rear seating. The role of direction of impact on injury risk varied by child age indicating diverse injury sources influenced by developmental differences and changes in restraint practices among the age groups. The data suggested a trade-off between head/face injury and abdominal injury: for those restrained in vehicle seat belts in rear seats, those with an AIS2+ head/face injury were nearly 90% less likely to sustain an abdominal injury than those without a head/face injury. These findings suggest mechanistic hypotheses to be tested with additional in-depth data. PMID:17230279

Arbogast, Kristy B; Chen, Irene; Nance, Michael L; Durbin, Dennis R; Winston, Flaura K

2004-11-01

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A road traffic injury surveillance system using combined data sources in Peru / Sistema de vigilancia de traumatismos por accidentes de tránsito con fuentes de datos combinadas en el Perú  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: English Abstract in spanish Con el liderazgo del Ministerio de Salud, en el 2007 se estableció un sistema hospitalario nacional de vigilancia de traumatismos no mortales por accidentes de tránsito en unidades centinela de todo el Perú. Los datos de vigilancia se extraen de tres fuentes diferentes (registros hospitalarios, info [...] rmes policiales e informes del seguro del vehículo) e incluyen los traumatismos no mortales por accidentes de tránsito atendidos inicialmente en las salas de urgencia. Se usa un único formulario de recopilación de datos para registrar la información sobre los heridos, las características del hecho relacionadas con el conductor o los conductores de los vehículos y del vehículo o los vehículos involucrados. Los datos se analizan periódicamente y se comunican a todos los participantes del sistema de vigilancia. Los resultados indicaron que los hombres adultos jóvenes (de 15 a 29 años) fueron los más afectados por traumatismos no mortales por accidentes de tránsito y con mayor frecuencia eran los conductores de los vehículos que participaron en la colisión. Los ocupantes de vehículos de cuatro ruedas representaron la mitad de los casos en la mayoría de las zonas del país y los peatones lesionados en el hecho representaron prácticamente la otra mitad. El sistema establecido en el Perú podría servir de modelo del uso de múltiples fuentes de datos para la vigilancia a nivel nacional de traumatismos no mortales por accidentes de tránsito. Según los resultados de este estudio, los retos de un sistema de este tipo consisten en mantener y aumentar la participación de las unidades de vigilancia de todo el país y determinar las intervenciones de prevención adecuadas en el nivel local según los datos obtenidos. Abstract in english A national hospital-based nonfatal road traffic injury surveillance system was established at sentinel units across Peru in 2007 under the leadership of the Ministry of Health. Surveillance data are drawn from three different sources (hospital records, police reports, and vehicle insurance reports) [...] and include nonfatal road traffic injuries initially attended at emergency rooms. A single data collection form is used to record information about the injured, event characteristics related to the driver of the vehicle(s), and the vehicle(s). Data are analyzed periodically and disseminated to all surveillance system participants. Results indicated young adult males (15-29 years old) were most affected by nonfatal road traffic injuries and were most often the drivers of the vehicles involved in the collision. Four-wheeled vehicle occupants comprised one-half of cases in most regions of the country, and pedestrians injured in the event accounted for almost another half. The system established in Peru could serve as a model for the use of multiple data sources in national nonfatal road traffic injury surveillance. Based on this study, the challenges of this type of system include sustaining and increasing participation among sentinel units nationwide and identifying appropriate prevention interventions at the local level based on the resulting data.

Yliana Rojas, Medina; Victoria, Espitia-Hardeman; Ann M., Dellinger; Manuel, Loayza; Rene, Leiva; Gloria, Cisneros.

2011-03-01

 
 
 
 
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Association between the cerebral inflammatory and matrix metalloproteinase responses after severe traumatic brain injury in humans.  

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An increasing number of preclinical investigations have suggested that the degree of expression of the matrix metalloproteinase (MMP) family of endopeptidases may explain some of the variability in neurological damage after traumatic brain injury (TBI). As cytokines are a prominent stimulus for MMP expression in animals, we conducted a prospective multimodal monitoring study and determined their association with temporal MMP expression after severe TBI in eight critically ill adults. High cutoff, cerebral microdialysis (n=8); external ventricular drainage (n=3); and arterial and jugular venous bulb catheters were used to measure the concentration of nine cytokines and eight MMPs in microdialysate, cerebrospinal fluid (CSF), and plasma over 6 days. Severe TBI was associated with a robust central inflammatory response, which was largely similar between microdialysate and CSF. At all time points after injury, this response was predominated by the pro-inflammatory cytokines interleukin-6 (IL-6) and IL-8. Use of univariate generalized estimating equations suggested that the concentration of several MMPs varied with cytokine levels in microdialysate. The largest of these changes included increases in microdialysate concentrations of MMP-8 and MMP-9 with increases in the levels of IL-1? and -2 and IL-1? and -2 and TNF-?, respectively. In contrast, the microdialysate level of MMP-7 decreased with increases in microdialysate concentrations of IL-1?, -2, and -6. These findings support the observations of animal studies that cross-talk exists between the neuroinflammatory and MMP responses after acute brain injury. Further study is needed to determine whether this link between cerebral inflammation and MMP expression may have clinical relevance to the care of patients with TBI. PMID:23799281

Roberts, Derek J; Jenne, Craig N; Léger, Caroline; Kramer, Andreas H; Gallagher, Clare N; Todd, Stephanie; Parney, Ian F; Doig, Christopher J; Yong, V Wee; Kubes, Paul; Zygun, David A

2013-10-15

242

Associated Injuries in Patients with Maxillofacial Trauma at the Hospital S?o Vicente de Paulo, Passo Fundo, Brazil  

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ABSTRACT Objectives This study aimed to identify the occurrence, type and severity of body injuries associated in patients with facial trauma, referred to the Hospital São Vicente de Paulo (HSVP) in the city of Passo Fundo - RS, Brazil. Material and Methods The study analyzed medical records of 1385 patients who were treated in the Department of Oral and Maxillofacial Surgery at HSVP during the period from 1991 to 2010. Results According to the results of this study we observed that 35% of cases of facial fractures were associated with a body injury. It was recorded a higher incidence of facial fractures in the male population (82.6%), aged between 20 and 39 years. The main etiologic factors for this association were car accidents, falls and assaults. Most fractures were recorded in the mandible and the main body injury found was the abrasion associated in some region of the body, however, when considering fractures of the face middle third the main body injury was more associated with cranioencephalic trauma. Conclusions Concomitant injuries in areas other than the face should be expected first and foremost after high-speed trauma mechanisms and in association with severe facial fractures. The results underscore the importance of multiprofessional collaboration in diagnosis and sequencing of treatment who have sustained facial fractures. PMID:24422034

Scherbaum Eidt, Joao Matheus; De Bortoli, Manoela Moura; Engelmann, Janessa Luiza; Rocha, Franciele Dalamaria

2013-01-01

243

Association of chronic vascular changes with functional outcome after traumatic brain injury in rats.  

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We tested the hypothesis that vascular remodeling in the cortex, hippocampus, and thalamus is associated with long-term functional recovery after traumatic brain injury (TBI). We induced TBI with lateral fluid-percussion (LFP) injury in adult rats. Animals were followed-up for 9 months, during which we tested motor performance using a neuroscore test, spatial learning and memory with a Morris water maze, and seizure susceptibility with a pentylenetetrazol (PTZ) test. At 8 months, they underwent structural MRI, and cerebral blood flow (CBF) was assessed by arterial spin labeling (ASL) MRI. Then, rats were perfused for histology to assess the density of blood vessels. In the perilesional cortex, the CBF decreased by 56% (p?associated with a remarkable increase in vessel density (78%, p?associated with vascular changes. Instead, poor performance in the Morris water maze correlated with enhanced thalamic vessel density (r?=?-0.81, p?associated with reduced CBF in the ipsilateral hippocampus (r?=?0.78, p?Association of thalamic hypervascularity to epileptogenesis warrants further studies. Finally, hippocampal hypoperfusion may predict later seizure susceptibility in the LFP injury model of TBI, which could be of value for pre-clinical antiepileptogenesis trials. PMID:20839948

Hayward, Nick M E A; Immonen, Riikka; Tuunanen, Pasi I; Ndode-Ekane, Xavier Ekolle; Gröhn, Olli; Pitkänen, Asla

2010-12-01

244

Medial patellofemoral ligament injury patterns and associated pathology in lateral patella dislocation: an MRI study  

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Full Text Available Abstract Background Lateral Patella dislocations are common injuries seen in the active and young adult populations. Our study focus was to evaluate medial patellofemoral ligament (MPFL injury patterns and associated knee pathology using Magnetic Resonance Imaging studies. Methods MRI studies taken at one imaging site between January, 2007 to January, 2008 with the final diagnosis of patella dislocation were screened for this study. Of the 324 cases that were found, 195 patients with lateral patellar dislocation traumatic enough to cause bone bruises on the lateral femoral trochlea and the medial facet of the patella were selected for this study. The MRI images were reviewed by three independent observers for location and type of MPFL injury, osteochondral defects, loose bodies, MCL and meniscus tears. The data was analyzed as a single cohort and by gender. Results This study consisted of 127 males and 68 females; mean age of 23 yrs. Tear of the MPFL at the patellar attachment occurred in 93/195 knees (47%, at the femoral attachment in 50/195 knees (26%, and at both the femoral and patella attachment sites in 26/195 knees (13%. Attenuation of the MPFL without rupture occurred in 26/195 knees (13%. Associated findings included loose bodies in 23/195 (13%, meniscus tears 41/195 (21%, patella avulsion/fracture in 14/195 (7%, medial collateral ligament sprains/tears in 37/195 (19% and osteochondral lesions in 96/195 knees (49%. Statistical analysis showed females had significantly more associated meniscus tears than the males (27% vs. 17%, p = 0.04. Although not statistically significant, osteochondral lesions were seen more in male patients with acute patella dislocation (52% vs. 42%, p = 0.08. Conclusion Patients who present with lateral patella dislocation with the classic bone bruise pattern seen on MRI will likely rupture the MPFL at the patellar side. Females are more likely to have an associated meniscal tear than males; however, more males have underlying osteochondral lesions. Given the high percentage of associated pathology, we recommend a MRI of the knee in all patients who present with acute patella dislocation.

Guerrero Patrick

2009-07-01

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Prevalence and Factors Associated with Needle Stick Injuries among Registered Nurses in Public Sector Tertiary Care Hospitals of Pakistan '  

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Full Text Available Background: Needle stick injuries remain the main cause of Hep B, Hep C and HIV which lead to mortality and morbidity in health care providers especially in nurses all over the world. Although needle stick injuries have been well studied in developed countries, data from developing countries is limited.Aim & Objectives: To estimate the prevalence of needle stick injuries among nurses and its associated factors in public sector tertiary care hospitals of Pakistan. Methods: This cross sectional survey was conducted in 3 major tertiary care hospitals of Rawalpindi, Pakistan. Study duration was from March 2010 to May 2010 (3 months. Two Hundred and Sixteen (216 nurses were selected by simple random sampling with proportionate sampling. All those registered nurses who were working in allied hospitals of Rawalpindi and involved in clinical work were included, while all those who were on administrative positions, students, retired or on maternity leave were excluded from the study. Pre structured questionnaire was used and data was collected by questionnaire having optional choices and few open ended questions. The questionnaire was piloted among thirty nurses in a tertiary care hospital and their comments were incorporated accordingly to redesign the final questionnaire. The data was analysed using SPSS 16.Results: Sixty Seven (67% of nurses got needle stick injury during job. Almost all (99% nurses said that they didn’t report their injury because of no reporting system in their hospital (p value < 0.05. Injection and needles (72% are the most injury causing instrument and needle stick injuries mostly occurred (81% at bedside and ward (p value < 0.05. Sixty six percent (66% of nurses said that they didn’t attended any educational session, seminar or workshop related to needle stick injuries during their job. Conclusion: The frequency of needle stick injuries among nurses is quite high in public sector hospitals of Rawalpindi Pakistan. Non-reporting and less health education are the main factors leading to needle stick injuries.

Haris Habib

2011-02-01

246

Central line-associated bloodstream infections in neonates with gastrointestinal conditions: developing a candidate definition for mucosal barrier injury bloodstream infections.  

Science.gov (United States)

Objective.?To develop a candidate definition for central line-associated bloodstream infection (CLABSI) in neonates with presumed mucosal barrier injury due to gastrointestinal (MBI-GI) conditions and to evaluate epidemiology and microbiology of MBI-GI CLABSI in infants. Design.?Multicenter retrospective cohort study. Setting.?Neonatal intensive care units from 14 US children's hospitals and pediatric facilities. Methods.?A multidisciplinary focus group developed a candidate MBI-GI CLABSI definition based on presence of an MBI-GI condition, parenteral nutrition (PN) exposure, and an eligible enteric organism. CLABSI surveillance data from participating hospitals were supplemented by chart review to identify MBI-GI conditions and PN exposure. Results.?During 2009-2012, 410 CLABSIs occurred in 376 infants. MBI-GI conditions and PN exposure occurred in 149 (40%) and 324 (86%) of these 376 neonates, respectively. The distribution of pathogens was similar among neonates with versus without MBI-GI conditions and PN exposure. Fifty-nine (16%) of the 376 initial CLABSI episodes met the candidate MBI-GI CLABSI definition. Subsequent versus initial CLABSIs were more likely to be caused by an enteric organism (22 of 34 [65%] vs 151 of 376 [40%]; P = .009) and to meet the candidate MBI-GI CLABSI definition (19 of 34 [56%] vs 59 of 376 [16%]; P definition of MBI-GI CLABSI. The high proportion of MBI-GI CLABSIs among subsequent infections suggests that infants with MBI-GI CLABSI should be a population targeted for further surveillance and interventional research. PMID:25333434

Coffin, Susan E; Klieger, Sarah B; Duggan, Christopher; Huskins, W Charles; Milstone, Aaron M; Potter-Bynoe, Gail; Raphael, Bram; Sandora, Thomas J; Song, Xiaoyan; Zerr, Danielle M; Lee, Grace M

2014-11-01

247

The association between dietary lifestyles and hepatocellular injury in Japanese workers.  

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Elevated alanine aminotransferase (ALT) in serum, relevant to nonalcoholic fatty liver disease, has been often reported from Asian countries and the U.S., and it may be associated with lifestyle behavior. To clarify whether specific dietary behavior is associated with hepatocellular injury, we explored liver markers and dietary lifestyles (e.g., breakfast-skipping, eating for lunch, and snacking) in 1,809 male employees, aged 19-59 years, belonging to a health insurance union of automobile dealerships in Japan. ALT, ?-glutamyltransferase, and asparate aminotransferase (AST) were positively correlated with age and body mass index (BMI) (P 30 IU/L), after adjusting for possible confounders including age, BMI, and drinking, were 1.33 (95% confidence interval, 1.01-1.75) at 1-2 times/week and 1.47 (1.07-2.01) at ? 3 times/week, compared to those who seldom ate instant noodles. Likewise, the OR of the ingestion at ? 3 times/week to ?-glutamyltransferase elevation (> 50 IU/L) was 1.42 (1.02-1.99), but the OR to elevated AST (> 30 IU/L) was not statistically significant. Habitual ethanol intake was significantly associated with hepatocellular injury, though the threshold of daily ethanol intake differed among liver markers. Despite the low OR, habitual instant noodle ingestion for lunch is associated with ALT elevation. Since the average content of saturated fatty acids in instant noodles is considerably high among cereal foods in Japan, workers with this habit should be advised to avoid having unbalanced diets. PMID:24284330

Iwata, Toyoto; Arai, Kaori; Saito, Norimitsu; Murata, Katsuyuki

2013-01-01

248

Popliteal Artery Injury Associated with Blunt Trauma to the Knee without Fracture or Dislocation  

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Full Text Available Popliteal artery injuries are frequently seen with fractures, dislocations, or penetrating injuries. Concern about arterial injury and early recognition of the possibility of arterial injury is crucial for the salvage of the extremity. This article provides an outline of the diagnostic challenges related to these rare vascular injuries and emphasizes the necessity for a high level of suspicion, even in the absence of a significant penetrating injury, knee dislocation, fracture, or high-velocity trauma mechanism. The importance of a detailed vascular examination of a blunt trauma patient is emphasized. [West J Emerg Med. 2014;15(2:145–148.

Ahmet Imerci

2014-03-01

249

Analysis of 127 peripartum hypoxic brain injuries from closed claims registered by the Danish Patient Insurance Association  

DEFF Research Database (Denmark)

BACKGROUND: One of the most feared complications in medicine is hypoxic brain damage to a newborn. The authors investigated the circumstances of registered peripartum hypoxic brain injuries in order to identify potential opportunities to improve patient safety and prevent injuries. METHODS: The authors retrospectively investigated peripartum hypoxic brain injuries registered by the Danish Patient Insurance Association. RESULTS: From 1992 to 2004, 127 approved claims concerning peripartum hypoxic brain injuries were registered and subsequently analysed. Thirty-eight newborns died, and a majority of the 89 surviving children suffered from major handicaps, primarily cerebral palsy. In 69 of the cases, misinterpretation of or late action on an abnormal cardiotocography (CTG) were the reasons for the majority of the hypoxic brain injuries. CONCLUSIONS: All injuries could potentially have been avoided using established obstetric practice. CTGs are often misinterpreted. In the authors' opinion, education and training in CTG interpretation is essential. The use of ST-analysis of the fetus ECG (STAN) could probably reduce the number of these injuries Udgivelsesdato: 2008

Bock, J.; Christoffersen, J.K.

2008-01-01

250

Significance of magnetic resonance imaging in the diagnosis of vertebral artery injury associated with blunt cervical spine trauma  

International Nuclear Information System (INIS)

Vertebral artery injury associated with non-penetrating cervical trauma is rare. We report 11 cases of vertebral artery injury diagnosed with magnetic resonance imaging (MRI) after blunt trauma to the cervical spine and discuss about the importance of MRI in the diagnosis of this injury. Seven cases were caused by motor vehicle accidents, three by diving accidents, and one by static compression of the neck. All of the patients had documented cervical spine fractures and dislocations. In three patients, the diagnosis of complete occlusion of the vertebral artery was made on the basis of MRI and digital subtraction angiography (DSA). In the other patients, mural injuries of the vertebral artery were demonstrated with DSA. These 11 patients presented with acute, nonspecific changes in neurological status. Two had infarctions of the cerebellum and brainstem. None were treated with anticoagulants. All of them survived and were discharged to other hospitals for physical and occupational therapy. Although DSA remains the gold standard for diagnosing vertebral artery injuries, MRI is a newer modality for assessing cervical cord injury, and it may be useful for evaluating the presence of vertebral injury after blunt cervical spine trauma. (author)

251

Amended annual report for Brookhaven National Laboratory: Epidemiologic surveillance - 1994  

Energy Technology Data Exchange (ETDEWEB)

Epidemiologic surveillance at DOE facilities consists of regular and systematic collection, analysis, and interpretation of data on absences due to illness and injury in the work force. Its purpose is to provide an early warning system for health problems occurring among employees at participating sites. Data are collected by coordinators at each site and submitted to the Epidemiologic Surveillance Data Center, located at the Oak Ridge Institute for Science and Education, where quality control procedures and analyses are carried out. Rates of absences and rates of diagnoses associated with absences are analyzed by occupation and other relevant variables. They may be compared with the disease experience of different groups within the DOE work force and with populations and do not work for DOE to identify disease patterns or clusters that may be associated work activities. This report provides a final summary for BNL.

NONE

1998-12-31

252

ATLAS OF INJURIES IN THE U.S. ARMED FORCES  

Science.gov (United States)

The database was initiated to determine the size of the problem of injuries in the military; document rates and trends of injury fatalities, disabilities, and hospitalizations; and identify information sources with potential for use in conducting injury surveillance and preventio...

253

PET/CT surveillance in patients with Hodgkin lymphoma in first remission is associated with low positive predictive value and high costs  

DEFF Research Database (Denmark)

Background. The value of performing post-therapy routine surveillance imaging in patients with Hodgkin lymphoma is controversial. This study evaluates the utility of positron emission tomography / computed tomography using 2-[18F]fluoro-2-deoxyglucose (PET/CT) for this purpose and in situations with suspected lymphoma relapse. Design and Methods. We conducted a multicenter retrospective study. Patients with newly diagnosed Hodgkin lymphoma achieving at least a partial remission on first-line therapy were eligible if they received PET/CT surveillance during follow-up. Two types of surveillance PET/CTs were analyzed; routine PET/CT when patients showed no signs of relapse at referral to PET/CT, and clinically indicated PET/CT when recurrence was suspected. Results. A total of 211 routine and 88 clinically indicated PET/CTs were performed in 161 patients. In ten of 22 patients with Hodgkin lymphoma recurrence, a routine PET/CT was the primary tool for the diagnosis of relapse. Extranodal disease, interim PET positive lesions and PET activity at response evaluation were all associated with a PET/CT diagnosed preclinical relapse. The true positive rates of routine PET/CT vs. clinically indicated PET/CT were 5 and 13%, respectively (p=0.02). The overall positive predictive value and negative predictive value of PET/CT was 28% and 100%, respectively. The estimated cost per routine PET/CT diagnosed relapse was 50.778 USD. Conclusions. A negative PET/CT reliably rules out a relapse. The high false positive rate, however, is an important limitation and a confirmatory biopsy is mandatory for the diagnosis of a relapse. With no proven survival benefit for patients with a pre-clinically diagnosed relapse, the high costs and low positive predictive value make PET/CT unfit for routine surveillance of Hodgkin lymphoma patients.

El-Galaly, Tarec Christoffer; Mylam, Karen Juul

2012-01-01

254

Sports Injuries in Youth: Surveillance Strategies. Proceedings of a Conference at the National Institutes of Health (Bethesda, MD, April 8-9, 1991).  

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This conference was convened to develop guidelines for programs to monitor the rates and costs of youth sports injuries. Following the Preface (L. E. Shulman), Introduction (D. G. Murray), and Summary (D. G. Murray), "Subjects for Further Research or Implementation" are listed. The 19 papers presented at the conference were: (1) "Funding Sources…

Centers for Disease Control (DHHS/PHS), Atlanta, GA.

255

TUBERCULOSIS SURVEILLANCE REPORTS  

Science.gov (United States)

The TB Surveillance Reports contain tabular and graphic information about reported TB cases collected from 59 reporting areas (the 50 states, the District of Columbia, New York City, U.S. dependencies and possessions, and independent nations in free association with the United St...

256

Vigilância para acidentes e violência: instrumento para estratégias de prevenção e controle Injury surveillance: a tool for prevention and control strategies  

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Full Text Available A rápida e expressiva elevação da morbi-mortalidade por acidentes e violência constituiu um dos pontos mais relevantes da transição epidemiológica no Brasil, a partir dos anos 80. A complexidade do problema implica a aplicação de medidas no âmbito de políticas sociais, elaboração de legislação específica e desenvolvimento de instrumentos de intervenção voltados à prevenção, ao tratamento e à reabilitação dos atingidos, o que pressupõe a identificação de grupos e fatores de risco. O objetivo deste texto é discutir aspectos conceituais e operacionais da utilização da vigilância em eventos adversos à saúde relacionados a acidentes e à violência. Apresentados os conceitos, características comuns e aspectos relativos à operacionalização dos sistemas de vigilância, independente do evento adverso à saúde a que se destinam, foram discutidas algumas questões específicas relativas à elaboração de definições de caso, à identificação de fontes de informação e à coleta dos dados de interesse, buscando identificar diferenças da utilização da vigilância para acidentes e violência se comparadas com a aplicação deste instrumento para doenças infecciosas, salientando entre elas que, para a identificação de fatores de risco, geralmente, se faz necessário complementar os resultados obtidos pela vigilância com pesquisas epidemiológicas.The fast and important increase in morbidity and mortality due to accidents and violence has been one of the most relevant aspects of the epidemiological transition in Brazil since the 80s. This intricate problem calls for social and political measures, and the development of specific legislation and tools for intervening in terms of prevention, treatment, and rehabilitation of those affected, so that risk groups and factors can be identified. The aim of the present paper is to discuss conceptual and operational aspects of using surveillance in adverse health events related to accidents and violence/trauma. Some specific issues related to case definition, identification of sources of information and collecting relevant data are discussed after presenting the concepts, common features and operational aspects related to surveillance systems, regardless of the adverse health events they are aimed at. These issues are discussed in order to try to identify the differences of applying surveillance to accidents and violence in comparison to applying it to infectious diseases. Among the differences one must point out that it is generally necessary to supplement results obtained through surveillance with epidemiological studies in order to identify risk factors.

Eliseu Alves Waldman

1999-01-01

257

Vigilância para acidentes e violência: instrumento para estratégias de prevenção e controle / Injury surveillance: a tool for prevention and control strategies  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: Portuguese Abstract in portuguese A rápida e expressiva elevação da morbi-mortalidade por acidentes e violência constituiu um dos pontos mais relevantes da transição epidemiológica no Brasil, a partir dos anos 80. A complexidade do problema implica a aplicação de medidas no âmbito de políticas sociais, elaboração de legislação espec [...] ífica e desenvolvimento de instrumentos de intervenção voltados à prevenção, ao tratamento e à reabilitação dos atingidos, o que pressupõe a identificação de grupos e fatores de risco. O objetivo deste texto é discutir aspectos conceituais e operacionais da utilização da vigilância em eventos adversos à saúde relacionados a acidentes e à violência. Apresentados os conceitos, características comuns e aspectos relativos à operacionalização dos sistemas de vigilância, independente do evento adverso à saúde a que se destinam, foram discutidas algumas questões específicas relativas à elaboração de definições de caso, à identificação de fontes de informação e à coleta dos dados de interesse, buscando identificar diferenças da utilização da vigilância para acidentes e violência se comparadas com a aplicação deste instrumento para doenças infecciosas, salientando entre elas que, para a identificação de fatores de risco, geralmente, se faz necessário complementar os resultados obtidos pela vigilância com pesquisas epidemiológicas. Abstract in english The fast and important increase in morbidity and mortality due to accidents and violence has been one of the most relevant aspects of the epidemiological transition in Brazil since the 80s. This intricate problem calls for social and political measures, and the development of specific legislation an [...] d tools for intervening in terms of prevention, treatment, and rehabilitation of those affected, so that risk groups and factors can be identified. The aim of the present paper is to discuss conceptual and operational aspects of using surveillance in adverse health events related to accidents and violence/trauma. Some specific issues related to case definition, identification of sources of information and collecting relevant data are discussed after presenting the concepts, common features and operational aspects related to surveillance systems, regardless of the adverse health events they are aimed at. These issues are discussed in order to try to identify the differences of applying surveillance to accidents and violence in comparison to applying it to infectious diseases. Among the differences one must point out that it is generally necessary to supplement results obtained through surveillance with epidemiological studies in order to identify risk factors.

Eliseu Alves, Waldman; Maria Helena de, Mello Jorge.

258

Vigilância para acidentes e violência: instrumento para estratégias de prevenção e controle / Injury surveillance: a tool for prevention and control strategies  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A rápida e expressiva elevação da morbi-mortalidade por acidentes e violência constituiu um dos pontos mais relevantes da transição epidemiológica no Brasil, a partir dos anos 80. A complexidade do problema implica a aplicação de medidas no âmbito de políticas sociais, elaboração de legislação espec [...] ífica e desenvolvimento de instrumentos de intervenção voltados à prevenção, ao tratamento e à reabilitação dos atingidos, o que pressupõe a identificação de grupos e fatores de risco. O objetivo deste texto é discutir aspectos conceituais e operacionais da utilização da vigilância em eventos adversos à saúde relacionados a acidentes e à violência. Apresentados os conceitos, características comuns e aspectos relativos à operacionalização dos sistemas de vigilância, independente do evento adverso à saúde a que se destinam, foram discutidas algumas questões específicas relativas à elaboração de definições de caso, à identificação de fontes de informação e à coleta dos dados de interesse, buscando identificar diferenças da utilização da vigilância para acidentes e violência se comparadas com a aplicação deste instrumento para doenças infecciosas, salientando entre elas que, para a identificação de fatores de risco, geralmente, se faz necessário complementar os resultados obtidos pela vigilância com pesquisas epidemiológicas. Abstract in english The fast and important increase in morbidity and mortality due to accidents and violence has been one of the most relevant aspects of the epidemiological transition in Brazil since the 80s. This intricate problem calls for social and political measures, and the development of specific legislation an [...] d tools for intervening in terms of prevention, treatment, and rehabilitation of those affected, so that risk groups and factors can be identified. The aim of the present paper is to discuss conceptual and operational aspects of using surveillance in adverse health events related to accidents and violence/trauma. Some specific issues related to case definition, identification of sources of information and collecting relevant data are discussed after presenting the concepts, common features and operational aspects related to surveillance systems, regardless of the adverse health events they are aimed at. These issues are discussed in order to try to identify the differences of applying surveillance to accidents and violence in comparison to applying it to infectious diseases. Among the differences one must point out that it is generally necessary to supplement results obtained through surveillance with epidemiological studies in order to identify risk factors.

Eliseu Alves, Waldman; Maria Helena de, Mello Jorge.

259

Occupational injuries for consecutive and cumulative shifts among hospital registered nurses and patient care associates: a case-control study.  

Science.gov (United States)

Nontraditional work shifts for hospital registered nurses and patient care associates and associated injuries were examined through a case-control study. Inpatient care requires that many staff work nontraditional shifts, including nights and 12-hour shifts, but some characteristics remain unexplored, especially consecutive shifts. A total of 502 cases (injured workers) were matched to single controls based on their hospital, unit type, job type, gender, and age (± 5 years). Conditional logistic regression was used for the analysis, controlling for weekly hours scheduled. For both, consecutive shifts of 2 or more days and some various cumulative shifts over a week and month period, especially night shifts, were associated with increased odds of injury. More investigations on the phenomenon of consecutive shifts are recommended. Additionally, the assessment of shift policy and subsequent injury outcomes is necessary before implementing intervention strategies. PMID:22998692

Hopcia, Karen; Dennerlein, Jack Tigh; Hashimoto, Dean; Orechia, Terry; Sorensen, Glorian

2012-10-01

260

Posterior cruciate ligament injury: characteristics and associations of most frequent injuries / Lesoes do ligamento cruzado posterior: caracteristicas e associacoes mais frequentes  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese OBJETIVO: Pesquisar a prevalência das lesões do ligamento cruzado posterior (LCP) e suas combinações e correlações com o mecanismo e a ocorrência de luxação evidente e fratura associada. MÉTODO: Estudo retrospectivo de 85 lesões do LCP operadas entre 2003 e 2010. Diagnóstico por meio do exame [...] físico e da radiografia dinâmica, confrontados com achados cirúrgicos. RESULTADOS: Lesões que envolveram o LCP foram mais prevalentes nos homens (78,8%) com média de idade de 33 anos. A causa principal foi o acidente de trânsito (73,80%), dos quais 49,4% de motocicleta. Lesão isolada do LCP ocorreu em 15,3% dos casos e combinada em 84,7%. Dentre as lesões isoladas, nove foram avulsões ósseas (10,6%). O ligamento mais associado às lesões do LCP foi o cruzado anterior (48,2%), seguido da lesão combinada do LCP com o ligamento colateral lateral/canto póstero-lateral (22,4%). Fraturas estiveram mais associadas à combinação LCP + LCL/CPL e não apareceram nas lesões do LCP + ligamento colateral medial/canto póstero-medial. Complicações além de fraturas: lesão de nervo periférico (4,8%) e vascular (1,2%). Luxação evidente no primeiro atendimento (16,7%), mais prevalente na combinação LCP + LCA + LCM/CPM (44,4%). Metade dos pacientes foi operada na fase aguda. Houve diferença estatística significativa (p Abstract in english OBJECTIVE: To investigate the prevalence and combinations of PCL injuries and their correlations with the mechanism, the occurrence of evident dislocation and associated fracture. METHOD: A retrospective study of 85 lesions of PCL operated between 2003 and 2010. Diagnosis by physical examinati [...] on and dynamic radiography, compared with surgical findings. RESULTS: Injuries involving the PCL were more prevalent in men (78.8%) with a mean age of 33 years. The main cause was traffic accidents (73.80%), and (49.4%) motorcycle. Isolated PCL injury occurred in (15.3%) cases, and combined (84.7%). Among the isolated lesions, bone avulsions were nine (10.6%). The most associated PCL injuries were the ACL (48.2%), followed by LCL PCL/PLC (22.4%). Fractures were more associated with combining PCL + LCL/PLC injuries and did not appear in the PCL + MCL/PMC. Complications beyond fractures: peripheral nerve injury (4.8%) and vascular (1.2%). Evident dislocation in primary care (16.7%) was more prevalent in combined ACL + PCL + MCL/PMC (44.4%). Half the patients were operated during the acute phase. There was a statistically significant difference (p

Marco Tulio Lopes, Caldas; Gilberto Ferreira, Braga; Samuel Lopes, Mendes; Juliano Martins da, Silveira; Robson Massi, Kopke.

2013-09-01

 
 
 
 
261

INJURIES IN AUSTRALIAN RULES FOOTBALL: A Review of the Literature  

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Background: Australian Rules Football is one of the most popular sports in Australia. Successful injury prevention relies on injury surveillance to establish the extent of injuries, to monitor injury patterns and to evaluate prevention strategies. Despite the popularity of participation at the community level, few injury surveillance studies have been published, so a detailed review of the literature is vital. There is limited information available outside of the elite level. Injury statistic...

Hoskins, Wayne T.; Pollard, Henry

2003-01-01

262

Negative first-term outcomes associated with lower extremity injury during recruit training among female Marine Corps graduates.  

Science.gov (United States)

This study assessed the impact of lower extremity injuries and stress fractures during recruit training on first-term outcomes among female Marine Corps graduates. Injury data were collected from women recruits at Parris Island, South Carolina (1995-1999) and negative first-term outcomes were obtained from the Career History Archival Medical and Personnel System. The three negative outcomes included (1) failure to complete first-term of service, (2) failure to achieve rank of corporal, and (3) failure to reenlist. Overall, 22% did not complete their first-term enlistment and 12% of those who did were not promoted to corporal. After adjustment for demographic characteristics, not completing first term and not being promoted to corporal were both associated with injuries or stress fracture during training. Reenlistment was not associated with training injuries. Our findings indicate lower extremity injuries among women undergoing Marine Corps recruit training are associated with poor first-term outcomes even among those who graduate. PMID:17274273

Trone, Daniel W; Villaseñor, Adriana; Macera, Caroline A

2007-01-01

263

Acute Care Clinical Indicators Associated with Discharge Outcomes in Children with Severe Traumatic Brain Injury  

Science.gov (United States)

Objective The relationship between acute care clinical indicators in the first severe Pediatric traumatic brain injury (TBI) Guidelines and outcomes have not been examined. We aimed to develop a set of acute care guideline-influenced clinical indicators of adherence and tested the relationship between these indicators during the first 72 hours after hospital admission and discharge outcomes. Design Retrospective multicenter cohort study Setting Five regional pediatric trauma centers affiliated with academic medical centers. Patients Children under 17 years with severe TBI (admission Glasgow coma scale (GCS) score ? 8, ICD-9 diagnosis codes of 800.0-801.9, 803.0-804.9, 850.0-854.1, 959.01, 950.1-950.3, 995.55, maximum head abbreviated injury severity score ? 3) who received tracheal intubation for at-least 48 hours in the intensive care unit (ICU) between 2007 -2011 were examined. Interventions None Measurements and Main Results Total percent adherence to the clinical indicators across all treatment locations (pre-hospital [PH], emergency department [ED], operating room [OR], and intensive care unit [ICU]) during the first 72 hours after admission to study center were determined. Main outcomes were discharge survival and Glasgow outcome scale (GOS) score. Total adherence rate across all locations and all centers ranged from 68-78%. Clinical indicators of adherence were associated with survival (aHR 0.94; 95 % CI 0.91, 0.96). Three indicators were associated with survival: absence of PH hypoxia (aHR 0.20; 95% CI 0.08, 0.46), early ICU start of nutrition (aHR 0.06; 95% CI 0.01, 0.26), and ICU PaCO2 >30 mm Hg in the absence of radiographic or clinical signs of cerebral herniation (aHR 0.22; 95% CI 0.06, 0.8). Clinical indicators of adherence were associated with favorable GOS among survivors, (aHR 0.99; 95% CI 0.98, 0.99). Three indicators were associated with favorable discharge GOS: all OR CPP >40 mm Hg (aRR 0.64; 95% CI 0.55, 0.75), all ICU CPP > 40mm Hg (aRR 0.74; 95% CI 0.63, 0.87), and no surgery (any type; aRR 0.72; 95% CI 0.53, 0.97). Conclusions Acute care clinical indicators of adherence to the Pediatric Guidelines were associated with significantly higher discharge survival and improved discharge GOS. Some indicators were protective, regardless of treatment location, suggesting the need for an interdisciplinary approach to the care of children with severe TBI. PMID:25083982

Vavilala, Monica S.; Kernic, Mary A.; Wang, Jin; Kannan, Nithya; Mink, Richard B.; Wainwright, Mark S.; Groner, Jonathan I.; Bell, Michael J.; Giza, Christopher C.; Zatzick, Douglas F.; Ellenbogen, Richard G.; Boyle, Linda Ng; Mitchell, Pamela H.; Rivara, Frederick P.

2014-01-01

264

Australian football: injury profile at the community level.  

Science.gov (United States)

Successful injury prevention relies on injury surveillance to establish the extent of the problem, to monitor injury patterns and to evaluate prevention strategies. Despite the popularity of participation in Australian football at the community level, few injury surveillance studies have been published describing the pattern of injuries at this level of participation. In contrast, ongoing injury surveillance at the elite-level is well established. Reliance on injury data from the elite-level of Australian football to guide injury prevention at the community level may not be appropriate due to differences across the levels with respect to exposure, fitness and skill level. Therefore, specific injury surveillance at the community level of Australian football is warranted. This study describes the epidemiology of community level Australian football injuries. Injury surveillance was undertaken in five amateur Australian football clubs over the 1999 season. The 320 participating players sustained 421 injuries over the season. The overall rate of injury was 27 injuries per 1000 player hours. Injuries were most commonly sustained at the start of the season and during the second quarter of match participation. Hamstring muscle strains were the most common injury sustained, followed by thigh haematomas and lateral ligament sprains of the ankle. The injury surveillance system used in this study was well accepted by the clubs and provides detailed data for the prioritisation of future injury prevention research at the community level of Australian football. PMID:12188087

Gabbe, B; Finch, C; Wajswelner, H; Bennell, K

2002-06-01

265

Mortality associated with extremity injuries compared with other types of trauma  

Directory of Open Access Journals (Sweden)

Full Text Available José Eduardo Arantes Sanches1, José Maria Pereira de Godoy3, André Luciano Baitello2, Alceu Gomes Chueire11Departments of Orthopedic and Traumatology, 2Trauma, 3Cardiology and Cardiovascular Surgery, Faculty of Medicine, São Jose do Rio Preto, BrazilBackground: The aim of this study was to evaluate one-month hospital mortality in victims with injuries of the extremities.Methods: All accident victims admitted to the Hospital de Base in São José do Rio Preto, Brazil, during the period from July 2004 to June 2005, were evaluated in an observational study. Patients were classified using the Abbreviated Injury Scale (AIS. Patients with severe injuries of the extremities (AIS 3–4 were compared with those without injuries or with minor extremity injuries (AIS 0–2.Results: A total of 3489 accident victims were evaluated; 3244 (92.98% did not suffer injuries or had minor injuries of the extremities (AIS 0–2 and 245 (7.02% had severe injuries (AIS 3–4. Of the 245 patients with AIS 3–4 extremity injuries, 13 (5.31% patients died, and of those without severe injuries to the extremities, 34 (1.05% died (Fisher’s Exact test P = 0.0000, relative risk 5.063, 95% confidence interval [CI]: 2.707–9.467.Conclusion: Patients with injuries of the extremities are at greater risk of death than accident victims with other types of trauma.Keywords: trauma, extremities, mortality, Brazil

Sanches JEA

2011-04-01

266

Trigeminal nerve injury associated with injection of local anesthetics: needle lesion or neurotoxicity?  

DEFF Research Database (Denmark)

BACKGROUND: The authors used comprehensive national registry and clinical data to conduct a study of adverse drug reactions (ADRs), in particular neurosensory disturbance (NSD), associated with local anesthetics used in dentistry METHODS: The study included data sets of annual sales of local anesthetics (from 1995 through 2007), 292 reports to the Danish Medicines Agency, Copenhagen, Denmark, of adverse reactions to local anesthetic drugs, and a clinical sample of 115 patients with NSD associated with local anesthetics. The authors assessed lidocaine 2 percent, mepivacaine 2 percent and 3 percent, prilocaine 3 percent, and articaine 4 percent sold in cartridges. RESULTS: The study results showed a highly significant overrepresentation of NSDs associated with articaine 4 percent, in particular with mandibular blocks. CONCLUSIONS: The distribution of NSDs was disproportionate to the market share of three of the four drugs in both national registry data and clinical data. These findings indicate that the main cause of injury was neurotoxicity resulting from administration of the local anesthetic rather than the needle penetration. CLINICAL IMPLICATIONS: Clinicians may consider avoiding use of high-concentration (4 percent) anesthetic formulations fo

Hillerup, SØren; Jensen, Rigmor H

2011-01-01

267

Trigeminal nerve injury associated with injection of local anesthetics : Needle lesion or neurotoxicity?  

DEFF Research Database (Denmark)

Background. The authors used comprehensive national registry and clinical data to conduct a study of adverse drug reactions (ADRs), in particular neurosensory disturbance (NSD), associated with local anesthetics used in dentistry. Methods. The study included data sets of annual sales of local anesthetics (from 1995 through 2007), 292 reports to the Danish Medicines Agency, Copenhagen, Denmark, of adverse reactions to local anesthetic drugs, and a clinical sample of 115 patients with NSD associated with local anesthetics. The authors assessed lidocaine 2 percent, mepivacaine 2 percent and 3 percent, prilocaine 3 percent, and articaine 4 percent sold in cartridges. Results. The study results showed a highly significant overrepresentation of NSDs associated with articaine 4 percent, in particular with mandibular blocks. Conclusions. The distribution of NSDs was disproportionate to the market share of three of the four drugs in both national registry data and clinical data. These findings indicate that the main cause of injury was neurotoxicity resulting from administration of the local anesthetic rather than the needle penetration. Clinical Implications. Clinicians may consider avoiding use of high-concentration (4 percent) anesthetic formulations for blockanesthesia in the trigeminal area in cases in which there are viable alternatives.

ErsbØll, Bjarne Kjær

2011-01-01

268

Evaluating the association of workplace psychosocial stressors with occupational injury, illness, and assault.  

Science.gov (United States)

This research project characterizes occupational injuries, illnesses, and assaults (OIIAs) as a negative outcome associated with worker exposure to generalized workplace abuse/harassment, sexual harassment, and job threat and pressure. Data were collected in a nationwide random-digit-dial telephone survey conducted during 2003-2004. There were 2151 study interviews conducted in English and Spanish. Analyses included cross tabulation with Pearson's Chi-Square and logistic regression analyses. Three hundred and fifty-one study participants reported having an OIIA during the 12 months preceding the study. Occurrences of generalized workplace harassment (OR = 1.53; CI = 1.33-1.75, p ? 0.05); sexual harassment (OR = 1. 18; CI = 1.04-.34, p ? 0.05); and job pressure and threat (OR = 1.26; CI = 1.10-1.45, p ? 0.05) were significantly associated with reporting an OIIA. The psychosocial environment is significantly associated with an increased risk of OIIA. Further research is needed to understand causal pathways and to explore potential interventions. PMID:21154106

Brown, Lezah P; Rospenda, Kathleen M; Sokas, Rosemary K; Conroy, Lorraine; Freels, Sally; Swanson, Naomi G

2011-01-01

269

Identification and validation of a logistic regression model for predicting serious injuries associated with motor vehicle crashes.  

Science.gov (United States)

A multivariate logistic regression model, based upon National Automotive Sampling System Crashworthiness Data System (NASS-CDS) data for calendar years 1999-2008, was developed to predict the probability that a crash-involved vehicle will contain one or more occupants with serious or incapacitating injuries. These vehicles were defined as containing at least one occupant coded with an Injury Severity Score (ISS) of greater than or equal to 15, in planar, non-rollover crash events involving Model Year 2000 and newer cars, light trucks, and vans. The target injury outcome measure was developed by the Centers for Disease Control and Prevention (CDC)-led National Expert Panel on Field Triage in their recent revision of the Field Triage Decision Scheme (American College of Surgeons, 2006). The parameters to be used for crash injury prediction were subsequently specified by the National Expert Panel. Model input parameters included: crash direction (front, left, right, and rear), change in velocity (delta-V), multiple vs. single impacts, belt use, presence of at least one older occupant (? 55 years old), presence of at least one female in the vehicle, and vehicle type (car, pickup truck, van, and sport utility). The model was developed using predictor variables that may be readily available, post-crash, from OnStar-like telematics systems. Model sensitivity and specificity were 40% and 98%, respectively, using a probability cutpoint of 0.20. The area under the receiver operator characteristic (ROC) curve for the final model was 0.84. Delta-V (mph), seat belt use and crash direction were the most important predictors of serious injury. Due to the complexity of factors associated with rollover-related injuries, a separate screening algorithm is needed to model injuries associated with this crash mode. PMID:21094304

Kononen, Douglas W; Flannagan, Carol A C; Wang, Stewart C

2011-01-01

270

Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort study  

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Full Text Available Abstract Background Acute kidney injury is among the most serious complications after cardiac surgery and is associated with an impaired outcome. Multiple factors may concur in the development of this disease. Moreover, severe renal failure requiring renal replacement therapy (RRT presents a high mortality rate. Consequently, we studied a Spanish cohort of patients to assess the risk factors for RRT in cardiac surgery-associated acute kidney injury (CSA-AKI. Methods A retrospective case-cohort study in 24 Spanish hospitals. All cases of RRT after cardiac surgery in 2007 were matched in a crude ratio of 1:4 consecutive patients based on age, sex, treated in the same year, at the same hospital and by the same group of surgeons. Results We analyzed the data from 864 patients enrolled in 2007. In multivariate analysis, severe acute kidney injury requiring postoperative RRT was significantly associated with the following variables: lower glomerular filtration rates, less basal haemoglobin, lower left ventricular ejection fraction, diabetes, prior diuretic treatment, urgent surgery, longer aortic cross clamp times, intraoperative administration of aprotinin, and increased number of packed red blood cells (PRBC transfused. When we conducted a propensity analysis using best-matched of 137 available pairs of patients, prior diuretic treatment, longer aortic cross clamp times and number of PRBC transfused were significantly associated with CSA-AKI. Patients requiring RRT needed longer hospital stays, and suffered higher mortality rates. Conclusion Cardiac-surgery associated acute kidney injury requiring RRT is associated with worse outcomes. For this reason, modifiable risk factors should be optimised and higher risk patients for acute kidney injury should be identified before undertaking cardiac surgery.

Garcia-Fernandez Nuria

2009-09-01

271

Nox-4 deletion reduces oxidative stress and injury by PKC-?-associated mechanisms in diabetic nephropathy.  

Science.gov (United States)

Current treatments for diabetic nephropathy (DN) only result in slowing its progression, thus highlighting a need to identify novel targets. Increased production of reactive oxygen species (ROS) is considered a key downstream pathway of end-organ injury with increasing data implicating both mitochondrial and cytosolic sources of ROS. The enzyme, NADPH oxidase, generates ROS in the kidney and has been implicated in the activation of protein kinase C (PKC), in the pathogenesis of DN, but the link between PKC and Nox-derived ROS has not been evaluated in detail in vivo. In this study, global deletion of a NADPH-oxidase isoform, Nox4, was examined in mice with streptozotocin-induced diabetes (C57Bl6/J) in order to evaluate the effects of Nox4 deletion, not only on renal structure and function but also on the PKC pathway and downstream events. Nox4 deletion attenuated diabetes-associated increases in albuminuria, glomerulosclerosis, and extracellular matrix accumulation. Lack of Nox4 resulted in a decrease in diabetes-induced renal cortical ROS derived from the mitochondria and the cytosol, urinary isoprostanes, and PKC activity. Immunostaining of renal cortex revealed that major isoforms of PKC, PKC-? and PKC-?1, were increased with diabetes and normalized by Nox4 deletion. Downregulation of the PKC pathway was observed in tandem with reduced expression of vascular endothelial growth factor (VEGF), transforming growth factor (TGF)-?1 and restoration of the podocyte slit pore protein nephrin. This study suggests that deletion of Nox4 may alleviate renal injury via PKC-dependent mechanisms, further strengthening the view that Nox4 is a suitable target for renoprotection in diabetes. PMID:25367693

Thallas-Bonke, Vicki; Jha, Jay C; Gray, Stephen P; Barit, David; Haller, Hermann; Schmidt, Harald H H W; Coughlan, Melinda T; Cooper, Mark E; Forbes, Josephine M; Jandeleit-Dahm, Karin A M

2014-11-01

272

Association between age at diagnosis and degree of liver injury in hepatitis C  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Introduction: A population-based survey conducted in Brazilian capital cities found that only 16% of the population had ever been tested for hepatitis C. These data suggest that much of the Brazilian population with HCV infection remains undiagnosed. The distribution of age ranges at diagnosis and [...] its association with the degree of hepatitis C are still unknown in Brazilian patients. Material and methods: Patients with HCV infection, diagnosed by HCV RNA (Amplicor-HCV, Roche), were included in the study. Patients with HBV or HIV coinfection, autoimmune diseases, or alcohol intake > 20 g/day were excluded. HCV genotyping was performed by sequence analysis, and viral load by quantitative RT-PCR (Amplicor, Roche). The METAVIR classification was used to assess structural liver injury. The Chi-square (?2) test and student's t-test were used for between-group comparisons. Spearman's rank correlation coefficient were used for analysing the correlation between parameters. Results: A total of 525 charts were reviewed. Of the patients included, 49.5% were male, only 10% of the patients were aged less than 30 years; peak prevalence of HCV infection occurred in the 51-to-60 years age range. Genotype 1 accounted for 65.4% of the cases. Information on HCV subtype was obtained in 227 patients; 105 had subtype 1a and 122 had 1b. According to the degree of structural liver injury, 8.3% had F0, 23.4% F1, 19.8% F2, 11.9% F3, and 36.5% F4. Age at diagnosis of hepatitis correlated significantly with fibrosis (rs = 0.307, p

Ana Cláudia de, Oliveira; Ana Clara, Bortotti; Nathália Neves, Nunes; Ibrahin A.H. El, Bacha; Edison Roberto, Parise.

2014-09-01

273

Use of consomic rats for genomic insights into ventilator-associated lung injury.  

Science.gov (United States)

Increasing evidence supports the contribution of genetic influences on susceptibility/severity in acute lung injury (ALI), a devastating syndrome requiring mechanical ventilation with subsequent risk for ventilator-associated lung injury (VALI). To identify VALI candidate genes, we determined that Brown Norway (BN) and Dahl salt-sensitive (SS) rat strains were differentially sensitive to VALI (tidal volume of 20 ml/kg, 85 breaths/min, 2 h) defined by bronchoalveolar lavage (BAL) protein and leukocytes. We next exploited differential sensitivities and phenotyped both the VALI-sensitive BN and the VALI-resistant SS rat strains by expression profiling coupled to a bioinformatic-intense candidate gene approach (Significance Analysis of Microarrays, i.e., SAM). We identified 106 differentially expressed VALI genes representing gene ontologies such as "transcription" and "chemotaxis/cell motility." We mapped the chromosomal location of the differentially expressed probe sets and selected consomic SS rats with single BN introgressions of chromosomes 2, 13, and 16 (based on the highest density of probe sets) while also choosing chromosome 20 (low probe sets density). VALI exposure of consomic rats with introgressions of BN chromosomes 13 and 16 resulted in significant increases in both BAL cells and protein (compared to parental SS strain), whereas introgression of BN chromosome 2 displayed a large increase only in BAL protein. Introgression of BN chromosome 20 had a minimal effect. These results suggest that genes residing on BN chromosomes 2, 13, and 16 confer increased sensitivity to high tidal volume ventilation. We speculate that the consomic-microarray-SAM approach is a time- and resource-efficient tool for the genetic dissection of complex diseases including VALI. PMID:17468131

Nonas, Stephanie A; Moreno-Vinasco, Liliana; Vinasco, Liliana Moreno; Ma, Shwu Fan; Jacobson, Jeffrey R; Desai, Ankit A; Dudek, Steven M; Flores, Carlos; Hassoun, Paul M; Sam, Lee; Ye, Shui Q; Moitra, Jaideep; Barnard, Joe; Grigoryev, Dmitry N; Lussier, Yves A; Garcia, Joe G N

2007-08-01

274

Association between age at diagnosis and degree of liver injury in hepatitis C  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Introduction: A population-based survey conducted in Brazilian capital cities found that only 16% of the population had ever been tested for hepatitis C. These data suggest that much of the Brazilian population with HCV infection remains undiagnosed. The distribution of age ranges at diagnosis and [...] its association with the degree of hepatitis C are still unknown in Brazilian patients. Material and methods: Patients with HCV infection, diagnosed by HCV RNA (Amplicor-HCV, Roche), were included in the study. Patients with HBV or HIV coinfection, autoimmune diseases, or alcohol intake > 20 g/day were excluded. HCV genotyping was performed by sequence analysis, and viral load by quantitative RT-PCR (Amplicor, Roche). The METAVIR classification was used to assess structural liver injury. The Chi-square (?2) test and student's t-test were used for between-group comparisons. Spearman's rank correlation coefficient were used for analysing the correlation between parameters. Results: A total of 525 charts were reviewed. Of the patients included, 49.5% were male, only 10% of the patients were aged less than 30 years; peak prevalence of HCV infection occurred in the 51-to-60 years age range. Genotype 1 accounted for 65.4% of the cases. Information on HCV subtype was obtained in 227 patients; 105 had subtype 1a and 122 had 1b. According to the degree of structural liver injury, 8.3% had F0, 23.4% F1, 19.8% F2, 11.9% F3, and 36.5% F4. Age at diagnosis of hepatitis correlated significantly with fibrosis (rs = 0.307, p

Ana Cláudia de, Oliveira; Ana Clara, Bortotti; Nathália Neves, Nunes; Ibrahin A.H. El, Bacha; Edison Roberto, Parise.

275

Weekend catch-up sleep is independently associated with suicide attempts and self-injury in Korean adolescents.  

Science.gov (United States)

The current study aims to determine the associations of insufficient sleep with suicide attempts and self-injury in a large, school-based Korean adolescent sample. A sample of 4553 middle- and high-school students (grades 7-10) was recruited in this study. Finally, 4145 students completed self-report questionnaires including items on sleep duration (weekday/weekend), self-injury, suicide attempts during the past year, the Suicidal Ideation Questionnaire (SIQ), and the Beck Depression Inventory (BDI). A multiple linear regression model showed that higher SIQ scores were associated with longer weekend catch-up sleep duration (p=0.009), higher BDI score (p<0.001), and longer time spent in a private educational institute (p=0.025). The multiple logistic regression analysis revealed that longer weekend catch-up sleep duration (p=0.011), higher BDI score (p<0.001), longer time spent in a private educational institute (p=0.046), and poorer academic record (p=0.029) were associated with suicide attempt and self-injury during the past year. The present results suggest that weekend catch-up sleep duration--which is an indicator of insufficient weekday sleep--might be associated with suicide attempts and self-injury in Korean adolescents. PMID:24267542

Kang, Seung-Gul; Lee, Yu Jin; Kim, Seog Ju; Lim, Weonjeong; Lee, Heon-Jeong; Park, Young-Min; Cho, In Hee; Cho, Seong-Jin; Hong, Jin Pyo

2014-02-01

276

The Impact of School Connectedness on Violent Behavior, Transport Risk-Taking Behavior, and Associated Injuries in Adolescence  

Science.gov (United States)

Adolescents engage in many risk-taking behaviors that have the potential to lead to injury. The school environment has a significant role in shaping adolescent behavior, and this study aimed to provide additional information about the benefits associated with connectedness to school. Early adolescents aged 13 to 15 years (N=509, 49% boys) were…

Chapman, Rebekah L.; Buckley, Lisa; Sheehan, Mary C.; Shochet, Ian M.; Romaniuk, Madeline

2011-01-01

277

Association of plasma level of thiobarbituric acid reactive substances with extent of hepatocellular injury in preterm infants with cholestatic jaundice  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The present study was designed to determine the association between extent of hepatocellular injury and plasma level of thiobarbituric acid reactive substances (TBARS) in pre term infants with cholestasis. Preterm infants (2 mg/dl) (n=25) or in the control group (n=16). Blood samples for measurement of TBARS...

Bhutia, Rinchen D.; Upadhyay, Bhumika; Maneesh, M.

2006-01-01

278

Air surveillance  

Energy Technology Data Exchange (ETDEWEB)

This section of the 1994 Hanford Site Environmental Report summarizes the air surveillance and monitoring programs currently in operation at that Hanford Site. Atmospheric releases of pollutants from Hanford to the surrounding region are a potential source of human exposure. For that reason, both radioactive and nonradioactive materials in air are monitored at a number of locations. The influence of Hanford emissions on local radionuclide concentrations was evaluated by comparing concentrations measured at distant locations within the region to concentrations measured at the Site perimeter. This section discusses sample collection, analytical methods, and the results of the Hanford air surveillance program. A complete listing of all analytical results summarized in this section is reported separately by Bisping (1995).

Patton, G.W.

1995-06-01

279

Rinderpest surveillance  

International Nuclear Information System (INIS)

Rinderpest is probably the most lethal virus disease of cattle and buffalo and can destroy whole populations; damaging economies; undermining food security and ruining the livelihood of farmers and pastoralists. The disease can be eradicated by vaccination and control of livestock movement. The Department of Technical Co-operation is sponsoring a programme, with technical support from the Joint FAO/IAEA Division to provide advice, training and materials to thirteen states through the 'Support for Rinderpest Surveillance in West Asia' project. (IAEA)

280

Socioeconomic and clinical factors associated with traumatic dental injuries in Brazilian preschool children  

Directory of Open Access Journals (Sweden)

Full Text Available The aim of this paper was to assess the epidemiology of traumatic dental injury (TDI in preschool children and its relation to socioeconomic and clinical factors. This study was carried out in Santa Maria, Brazil, during National Children's Vaccination Day, and 441 children aged 12 to 59 months were included. Data about socioeconomic status were collected through a semi-structured questionnaire administered to parents. Calibrated examiners evaluated the prevalence of TDI, overjet, and lip coverage. Data were analyzed with a Poisson regression model (PR; 95% confidence intervals. The TDI prevalence was 31.7%. The maxillary central incisors were the most frequently traumatized teeth. The most common TDI was enamel fracture. No association was found between TDI prevalence and the socioeconomic status of children. After adjustments were performed, the eldest children with an overjet > 3 mm were more likely to have TDI than their counterparts. The data indicated a high prevalence of TDI. Only overjet was a strong predictor for TDI, whereas socioeconomic factors were not associated with TDI in this age group.

Chaiana Piovesan

2012-10-01

 
 
 
 
281

Volar dislocation of the index carpometacarpal joint in association with a Bennett's fracture of the thumb: a rare injury pattern.  

LENUS (Irish Health Repository)

We describe a case of volar dislocation of the index carpometacarpal (CMC) joint in association with a Bennett\\'s fracture of the thumb following a motorcycle accident. Volar dislocation of the index carpometacarpal joint is an exceedingly rare but easily missed injury, with only a few reported cases in the literature. This report highlights the importance of a true lateral radiograph and close scrutiny of the film to detect this injury. Closed reduction supplemented with Kirschner wire fixation restored normal anatomical relations and achieved an excellent clinical result.

Dillon, J P

2012-02-03

282

The Economy of Surveillance  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Surveillance is integral to modern societies. This paper considers the economic forces behind surveillance, the use of surveillance in the private sector, and the social consequences for the continued growth of surveillance over the past several centuries. It argues that the demand for surveillance of people will grow, while the cost of providing surveillance continues to fall. As a result, surveillance will feed upon itself, with detrimental social consequences.

Lipartito, Kenneth

2010-01-01

283

Examination for sexual assault: Is the documentation of physical injury associated with the laying of charges? A retrospective cohort study  

Digital Repository Infrastructure Vision for European Research (DRIVER)

BACKGROUND: Few studies have examined whether there is an association between individual medical findings and legal outcome in cases of sexual assault. This study was undertaken to determine the relation between the extent of documented physical injury and a positive legal outcome in cases of sexual assault and to determine other factors associated with the laying of charges in such cases. METHODS: In this retrospective cohort study, the authors reviewed the charts and medicolegal reports for...

Mcgregor, M. J.; Le, G.; Marion, S. A.; Wiebe, E.

1999-01-01

284

Characterization of early and terminal complement proteins associated with polymorphonuclear leukocytes in vitro and in vivo after spinal cord injury  

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Full Text Available Abstract Background The complement system has been suggested to affect injury or disease of the central nervous system (CNS by regulating numerous physiological events and pathways. The activation of complement following traumatic CNS injury can also result in the formation and deposition of C5b-9 membrane attack complex (C5b-9/MAC, causing cell lysis or sublytic effects on vital CNS cells. Although complement proteins derived from serum/blood-brain barrier breakdown can contribute to injury or disease, infiltrating immune cells may represent an important local source of complement after injury. As the first immune cells to infiltrate the CNS within hours post-injury, polymorphonuclear leukocytes (PMNs may affect injury through mechanisms associated with complement-mediated events. However, the expression/association of both early and terminal complement proteins by PMNs has not been fully characterized in vitro, and has not observed previously in vivo after traumatic spinal cord injury (SCI. Method We investigated the expression of complement mRNAs using rt-PCR and the presence of complement proteins associated with PMNs using immunofluroescence and quantitative flow cytometry. Results Stimulated or unstimulated PMNs expressed mRNAs encoding for C1q, C3, and C4, but not C5, C6, C7 or C9 in culture. Complement protein C1q or C3 was also detected in less than 30% of cultured PMNs. In contrast, over 70% of PMNs that infiltrated the injured spinal cord were associated with C1q, C3, C7 and C5b-9/MAC 3 days post-SCI. The localization/association of C7 or C5b-9/MAC with infiltrating PMNs in the injured spinal cord suggests the incorporation or internalization of C7 or C5b-9/MAC bound cellular debris by infiltrating PMNs because C7 and C5b-9/MAC were mostly localized to granular vesicles within PMNs at the spinal cord epicenter region. Furthermore, PMN presence in the injured spinal cord was observed for many weeks post-SCI, suggesting that this infiltrating cell population could chronically affect complement-mediated events and SCI pathogenesis after trauma. Conclusion Data presented here provide the first characterization of early and terminal complement proteins associated with PMNs in vitro and in vivo after SCI. Data also suggest a role for PMNs in the local internalization or deliverance of complement and complement activation in the post-SCI environment.

Galvan Manuel D

2008-06-01

285

Beyond tissue injury-damage-associated molecular patterns, toll-like receptors, and inflammasomes also drive regeneration and fibrosis.  

Science.gov (United States)

Tissue injury initiates an inflammatory response through the actions of immunostimulatory molecules referred to as damage-associated molecular patterns (DAMPs). DAMPs encompass a group of heterogenous molecules, including intracellular molecules released during cell necrosis and molecules involved in extracellular matrix remodeling such as hyaluronan, biglycan, and fibronectin. Kidney-specific DAMPs include crystals and uromodulin released by renal tubular damage. DAMPs trigger innate immunity by activating Toll-like receptors, purinergic receptors, or the NLRP3 inflammasome. However, recent evidence revealed that DAMPs also trigger re-epithelialization upon kidney injury and contribute to epithelial-mesenchymal transition and, potentially, to myofibroblast differentiation and proliferation. Thus, these discoveries suggest that DAMPs drive not only immune injury but also kidney regeneration and renal scarring. Here, we review the data from these studies and discuss the increasingly complex connection between DAMPs and kidney diseases. PMID:24762401

Anders, Hans-Joachim; Schaefer, Liliana

2014-07-01

286

High school athletic departments as sentinel surveillance sites for community-associated methicillin-resistant staphylococcal infections.  

Science.gov (United States)

Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging infection in athletes. Our study assessed MRSA burden in Texas 4A and 5A high school athletic departments by contacting 447 licensed athletic trainers (LATs) regarding skin infections in athletes; 186 (41.6%) responded. Sixty LATs reported MRSA in their athletic departments. The largest MRSA outbreak (23 infected persons) occurred in football players. The trainers also reported MRSA in wrestlers, volleyball players, cross-country runners, nonathlete students, and adults. Students and adults involved in high school athletics require MRSA intervention because of their large numbers and extensive contacts. Physicians should be aware of the potential for MRSA and should culture rather than treat empirically, communicate with school health staff to maximize surveillance for affected students when MRSA occurs in their student community, and contact their health department when the number of students with MRSA meets the unusual group expression, outbreak, or unusual severity criteria. PMID:17128759

Barr, Beth; Felkner, Marilyn; Diamond, Pamela M

2006-04-01

287

Non-fatal conductive energy device-related injuries treated in US emergency departments, 2005-2008.  

Science.gov (United States)

This paper provides the first US estimates and rates of non-fatal conductive energy device (CED)-related (eg, Taser) injuries relative to other types of legal intervention injuries treated in hospital emergency departments (EDs). The data used for this study were from the National Electronic Injury Surveillance System (NEISS), including the Firearm Injury Surveillance Study (NEISS-FISS) and the All Injury Program (NEISS-AIP). Of an average annual 75,000 suspects treated for non-fatal legal intervention injuries, 11% had injuries that were associated with the use of a CED or Taser. Of the suspects with non-fatal CED-related injuries, 90.1% were males, 72.6% were 20-44 years of age, and 55.2% were injured to the trunk. Most suspects with CED-related injuries (93.6%) were treated and released from the hospital ED. The authors conclude that NEISS is a useful data source for CED-related injuries in the US; estimates from NEISS emphasise the importance of implementing CED safety guidelines by law enforcement officers and training of medical personnel to help reduce the risk of severe injury and potential adverse health consequences. PMID:21257680

Haileyesus, Tadesse; Annest, Joseph L; Mercy, James A

2011-04-01

288

Melatonin attenuates acute pancreatitis-associated lung injury in rats by modulating interleukin 22  

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Full Text Available AIM: To investigate whether therapeutic treatment with melatonin could protect rats against acute pancreatitis and its associated lung injury. METHODS: Seventy-two male Sprague-Dawley rats were randomly divided into three groups: the sham operation (SO, severe acute pancreatitis (SAP, and melatonin treatment (MT groups. Acute pancreatitis was induced by infusion of 1 mL/kg of sodium taurocholate (4% solution into the biliopancreatic duct. Melatonin (50 mg/kg was administered 30 min before pancreatitis was induced, and the severity of pancreatic and pulmonary injuries was evaluated 1, 4 and 8 h after induction. Serum samples were collected to measure amylase activities, and lung tissues were removed to measure levels of mRNAs encoding interleukin 22 (IL-22 and T helper cell 22 (Th22, as well as levels of IL-22. RESULTS: At each time point, levels of mRNAs encoding IL-22 and Th22 were significantly higher (P < 0.001 in the MT group than in the SAP group (0.526 ± 0.143 vs 0.156 ± 0.027, respectively, here and throughout, after 1 h; 0.489 ± 0.150 vs 0.113 ± 0.014 after 4 h; 0.524 ± 0.168 vs 0.069 ± 0.013 after 8 h, 0.378 ± 0.134 vs 0.122 ± 0.015 after 1 h; 0.205 ± 0.041 vs 0.076 ± 0.019 after 4 h; 0.302 ± 0.108 vs 0.045 ± 0.013 after 8 h, respectively and significantly lower (P < 0.001 in the SAP group than in the SO group (0.156 ± 0.027 vs 1.000 ± 0.010 after 1 h; 0.113 ± 0.014 vs 1.041 ± 0.235 after 4 h; 0.069 ± 0.013 vs 1.110 ± 0.213 after 8 h, 0.122 ± 0.015 vs 1.000 ± 0.188 after 1 h; 0.076 ± 0.019 vs 0.899 ± 0.125 after 4 h; 0.045 ± 0.013 vs 0.991 ± 0.222 after 8 h, respectively. The mean pathological scores for pancreatic tissues in the MT group were significantly higher (P < 0.01 than those for samples in the SO group (1.088 ± 0.187 vs 0.488 ± 0.183 after 1 h; 2.450 ± 0.212 vs 0.469 ± 0.242 after 4 h; 4.994 ± 0.184 vs 0.513 ± 0.210 after 8 h, but were significantly lower (P < 0.01 than those for samples in the SAP group at each time point (1.088 ± 0.187 vs 1.969 ± 0.290 after 1 h; 2.450 ± 0.212 vs 3.344 ± 0.386 after 4 h; 4.994 ± 0.184 vs 6.981 ± 0.301 after 8 h. The severity of SAP increased significantly (P < 0.01 over time in the SAP group (1.088 ± 0.187 vs 2.450 ± 0.212 between 1 h and 4 h after inducing pancreatitis; and 2.450 ± 0.212 vs 4.994 ± 0.184 between 4 and 8 h after inducing pancreatitis. CONCLUSION: Melatonin protects rats against acute pancreatitis-associated lung injury, probably through the upregulation of IL-22 and Th22, which increases the innate immunity of tissue cells and enhances their regeneration.

Jia-Ping Huai

2012-01-01

289

Alkaline phosphatase: a possible treatment for sepsis-associated acute kidney injury in critically ill patients.  

Science.gov (United States)

Acute kidney injury (AKI) is a common disease in the intensive care unit and accounts for high morbidity and mortality. Sepsis, the predominant cause of AKI in this setting, involves a complex pathogenesis in which renal inflammation and hypoxia are believed to play an important role. A new therapy should be aimed at targeting both these processes, and the enzyme alkaline phosphatase, with its dual mode of action, might be a promising candidate. First, alkaline phosphatase is able to reduce inflammation through dephosphorylation and thereby detoxification of endotoxin (lipopolysaccharide), which is an important mediator of sepsis. Second, adenosine triphosphate, released during cellular stress caused by inflammation and hypoxia, has detrimental effects but can be converted by alkaline phosphatase into adenosine with anti-inflammatory and tissue-protective effects. These postulated beneficial effects of alkaline phosphatase have been confirmed in animal experiments and two phase 2a clinical trials showing that kidney function improved in critically ill patients with sepsis-associated AKI. Because renal inflammation and hypoxia also are observed commonly in AKI induced by other causes, it would be of interest to investigate the therapeutic effect of alkaline phosphatase in these nephropathies as well. PMID:24462020

Peters, Esther; Heemskerk, Suzanne; Masereeuw, Rosalinde; Pickkers, Peter

2014-06-01

290

Changes in purine levels associated with cellular brain injury in gerbils experimentally infected with Neospora caninum.  

Science.gov (United States)

The present study was carried out in order to assess the possible alterations in purine levels of brain, associated neuronal lesions in gerbils experimentally infected with Neospora caninum. For that, gerbils (Meriones unguiculatus) were inoculated with Nc-1 strain of N. caninum, composing two different experiments: Experiment I (EI) and experiment II (EII), where purine levels were measured along with the histopathologic study, on days 7 (EI), 15 and 30 (EII), post-infection (PI). As a result, it was possible to observe that the purine levels (ATP, ADP, AMP, adenosine, inosine and xanthine) in brain in EI are significantly reduced (p?injuries observed in EII. PMID:24702899

Tonin, Alexandre A; Da Silva, Aleksandro S; Thomé, Gustavo R; Schirmbeck, Gabriel H; Cardoso, Valesca V; Casali, Emerson A; Toscan, Gustavo; Vogel, Fernanda F; Flores, Mariana M; Fighera, Rafael; Lopes, Sonia T A

2014-06-01

291

Protective effect of diltiazem on myocardial ischemic injury associated with .OH generation.  

Science.gov (United States)

We examined the protective effect of diltiazem, a calcium antagonist, on myocardial ischemic injury associated with generation of hydroxyl free radicals (.OH). Salicylic acid in Ringer's solution (0.5 nmol.microliter-1.min-1) was infused directly through a microdialysis probe to detect the generation of .OH as reflected by the formation of 2,3-dihydroxybenzoic acid (DHBA) in the myocardium. Cardiac dialysate was assayed for 2,3-DHBA by a high-performance liquid chromatographic-electrochemical (HPLC-EC) procedure. The heart was subjected to myocardial ischemia for 15 min by occlusion of left anterior descending artery (LAD). The presence of .OH was indicated in the ischemic reperfused rat heart. However, when heart was reperfused, the elevation of 2,3-DHBA by 15-min ischemia was not observed in the ischemic zone following systemic administration of diltiazem (100 micrograms.min-1.kg-1), a calcium antagonist. When corresponding experiments were performed with allopurinol (10 mg.kg-1) administration of i.v. injection, the elevation of 2,3-DHBA was not observed. These results suggest that diltiazem may suppress the .OH generation from xanthine-xanthine oxidase system by ischemia-reperfusion. PMID:9172383

Obata, T; Yamanaka, Y

1997-06-01

292

Paragliding injuries.  

Science.gov (United States)

Regulations controlling the sport of paragliding were issued in April 1987 by the German Department of Transportation. The growing popularity of this sport has led to a steady increase in the number of associated injuries. This study presents the incidence, localization and degree of injuries associated with paragliding documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218 paragliders were documented in the period 1987-1989: 181 occurred during landing, 28 during starting procedures and nine during flight. The mean patient age was 29.6 years. There were 34.9% spinal injuries, 13.4% upper extremity injuries and 41.3% lower limb injuries. Over half of these injuries were treated surgically and in 54 instances permanent disability remained. In paragliding the lower extremities are at greatest risk of injury during landing. Proper equipment, especially sturdy footwear, exact training in landing techniques as well as improved instruction in procedures during aborted or crash landings is required to reduce the frequency of these injuries. Images p99-a p100-a p100-b p100-c PMID:1751899

Kruger-Franke, M; Siebert, C H; Pforringer, W

1991-01-01

293

Self-injurious behaviours are associated with alterations in the somatosensory system in children with autism spectrum disorder.  

Science.gov (United States)

Children with autism spectrum disorder (ASD) frequently engage in self-injurious behaviours, often in the absence of reporting pain. Previous research suggests that altered pain sensitivity and repeated exposure to noxious stimuli are associated with morphological changes in somatosensory and limbic cortices. Further evidence from postmortem studies with self-injurious adults has indicated alterations in the structure and organization of the temporal lobes; however, the effect of self-injurious behaviour on cortical development in children with ASD has not yet been determined. Thirty children and adolescents (mean age = 10.6 ± 2.5 years; range 7-15 years; 29 males) with a clinical diagnosis of ASD and 30 typically developing children (N = 30, mean age = 10.7 ± 2.5 years; range 7-15 years, 26 males) underwent T1-weighted magnetic resonance and diffusion tensor imaging. No between-group differences were seen in cerebral volume, surface area or cortical thickness. Within the ASD group, self-injury scores negatively correlated with thickness in the right superior parietal lobule t = 6.3, p diffusion tensor imaging analysis between SI and the VP nucleus and found that children who engaged in self-injury had significantly lower fractional anisotropy (r = -0.4, p = 0.04) and higher mean diffusivity (r = 0.5, p = 0.03) values in the territory of the left posterior limb of the internal capsule. Additionally, greater incidence of self-injury was associated with increased radial diffusivity values in bilateral posterior limbs of the internal capsule (left: r = 0.5, p = 0.02; right: r = 0.5, p = 0.009) and corona radiata (left: r = 0.6, p = 0.005; right: r = 0.5, p = 0.009). Results indicate that self-injury is related to alterations in somatosensory cortical and subcortical regions and their supporting white-matter pathways. Findings could reflect use-dependent plasticity in the somatosensory system or disrupted brain development that could serve as a risk marker for self-injury. PMID:23644587

Duerden, Emma G; Card, Dallas; Roberts, S Wendy; Mak-Fan, Kathleen M; Chakravarty, M Mallar; Lerch, Jason P; Taylor, Margot J

2014-07-01

294

Barefoot-simulating footwear associated with metatarsal stress injury in 2 runners.  

Science.gov (United States)

Stress-related changes and fractures in the foot are frequent in runners. However, the causative factors, including anatomic and kinematic variables, are not well defined. Footwear choice has also been implicated in contributing to injury patterns with changes in force transmission and gait analyses reported in the biomechanical literature. Despite the benefits of footwear, there has been increased interest among the running community in barefoot running with proposed benefits including a decreased rate of injury. We report 2 cases of metatarsal stress fracture in experienced runners whose only regimen change was the adoption of barefoot-simulating footwear. One was a 19-year-old runner who developed a second metatarsal stress reaction along the entire diaphysis. The second case was a 35-year-old ultra-marathon runner who developed a fracture in the second metatarsal diaphysis after 6 weeks of use of the same footwear. While both stress injuries healed without long-term effects, these injuries are alarming in that they occurred in experienced male runners without any other risk factors for stress injury to bone. The suspected cause for stress injury in these 2 patients is the change to barefoot-simulating footwear. Runners using these shoes should be cautioned on the potential need for gait alterations from a heel-strike to a midfoot-striking pattern, as well as cautioned on the symptoms of stress injury. PMID:21717998

Giuliani, Jeffrey; Masini, Brendan; Alitz, Curtis; Owens, Brett D

2011-07-01

295

Upper Gastrointestinal Bleeding Associated with Myocardial Injury in Egyptian Patients: Frequency and Risk Factors  

Directory of Open Access Journals (Sweden)

Full Text Available AIM: The frequency and risk factors of myocardial injury afterupper gastrointestinal bleeding in our community are unknown. Theaim of this study was to investigate the frequency of myocardialinjury in patients with first episode of upper gastrointestinalbleeding and to determine the risk factors for this simultaneousaffection.METHOD: One hundred and five patients with first episode ofupper gastrointestinal bleeding were included. All patients weresubjected to thorough history taking, clinical examination, routineinvestigations, treatment with blood transfusion and pharmacologicagents, abdominal ultrasonography, upper GIT endoscopy and studiesof myocardial injury including electrocardiography (ECG, transthoracicechocardiography (TTE and cardiac enzymes includingcreatine kinase (CK, creatine kinase-MB (CK-MB and Troponin I(TnI. All patients were assessed for occurrence of myocardial injury,determination of risk factors and length of hospital stay.RESULTS: A total of 39 patients (37.1% developed myocardialinjury. Patients with first episode of upper gastrointestinal bleedingwith a history of liver cirrhosis, systemic hypertension, smoking, highbody mass index (BMI and hypertriglyceridaemia had a high riskof developing myocardial injury and longer hospital stay. IncreasedC-reactive protein, CK, CK-MB and Troponin I and deviated STsegment-T wave of ECG were the markers of this injury.CONCLUSION: 37.1% of adult patients with first episode ofupper gastrointestinal bleeding developed myocardial injury. Livercirrhosis, smoking, systemic hypertension and higher BMI were thepredictors of this injury.

Emad F Hamid

2013-02-01

296

Meningococcal Disease: Surveillance  

Science.gov (United States)

... Vaccine Campaign Podcast: Meningitis Immunization for Adolescents Meningitis Surveillance Share Compartir On this Page Surveillance Systems Disease ... strains") of the disease in the United States. Surveillance Systems Meningococcal disease is a reportable condition in ...

297

Effect of dietary palm olein oil on oxidative stress associated with ischemic-reperfusion injury in isolated rat heart  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Palm olein oil (PO, obtained from refining of palm oil is rich in monounsaturated fatty acid and antioxidant vitamins and is widely used as oil in diet in many parts of the world including India. Palm oil has been reported to have beneficial effects in oxidative stress associated with hypertension and arterial thrombosis. Oxidative stress plays a major role in the etiopathology of myocardial ischemic-reperfusion injury (IRI which is a common sequel of ischemic heart disease. Antioxidants have potent therapeutic effects on both ischemic heart disease and ischemic-reperfusion injury. Information on the effect of PO on ischemic-reperfusion injury is, however, lacking. In the present study, the effect of dietary palm olein oil on oxidative stress associated with IRI was investigated in an isolated rat heart model. Wistar rats (150–200 gm of either sex were divided into three different groups (n = 16. Rats were fed with palm olein oil supplemented commercial rat diet, in two different doses [5% v / w (PO 5 and 10% v / w (PO 10 of diet] for 30 days. Control rats (C were fed with normal diet. After 30 days, half the rats from each group were subjected to in vitro myocardial IRI (20 min of global ischemia, followed by 40 min of reperfusion. Hearts from all the groups were then processed for biochemical and histopathological studies. One way ANOVA followed by Bonferroni test was applied to test for significance and values are expressed as mean ± SE (p Results There was a significant increase in myocardial catalase (CAT, superoxide dismutase (SOD and glutathione peroxidase (GPx activities with no significant change in myocardial thiobarbituric acid reactive substances (TBARS only in group PO 5 as compared to group C. There was no light microscopic evidence of tissue injury. A significant rise in myocardial TBARS and depletion of myocardial endogenous antioxidants (SOD, CAT and GPx along with significant myocyte injury was observed in control rats subjected to ischemia-reperfusion (C IR. Hearts from palm olein oil fed rats subjected to ischemia-reperfusion (PO 5 IR and PO 10 IR were protected from increase in TBARS and depletion of endogenous antioxidants as compared to C IR group. No significant myocyte injury was present in the treated groups. Conclusions The present study demonstrated for the first time that dietary palm olein oil protected rat heart from oxidative stress associated with ischemic-reperfusion injury.

Dinda Amit

2004-11-01

298

Association of plant injury with an air contaminant in a controlled environment facility  

Energy Technology Data Exchange (ETDEWEB)

Gaseous compounds are common, yet seldom recognized contaminants in controlled environments. Injury to several plant species has been observed in the Biotron which uses trichloroethylene as a coolant in its centrally controlled system. Sometimes this compound is present in the rooms at an average level of 2 ppm, as measured by gas chromatography. Injury symptoms, which vary between species, are characteristic of air pollution injury. Present studies with Tagetes patula show a distinctive necrosis on the upper leaf surfaces. Experiments are being conducted to determine whether trichloroethylene is the agent involved and to investigate aspects of the physiology of injury utilizing a procedure which may be applicable to other long-term, low-level pollution studies.

Knudson, L.L.; Tibbitts, T.W.

1974-01-01

299

Traumatic dental injuries and their association with malocclusion in the primary dentition of Irish children.  

LENUS (Irish Health Repository)

This study sought to establish the prevalence of traumatic dental injuries in the primary dentition of Irish children and to investigate the relationship between dental trauma and non-nutritive sucking habits.

Norton, Eimear

2012-02-01

300

Medical expenditures associated with nonfatal occupational injuries among immigrant and U.S.-born workers  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background No national study has investigated whether immigrant workers are less likely than U.S.-workers to seek medical treatment after occupational injuries and whether the payment source differs between two groups. Methods Using the 2004–2009 Medical Expenditure Panel Survey (MEPS) data, we estimated the annual incidence rate of nonfatal occupational injuries per 100 workers. Logistic regression models were fitted to test whether injured immigrant...

Xiang Huiyun; Shi Junxin; Lu Bo; Wheeler Krista; Zhao Weiyan; Wilkins J R; Smith Gary A

2012-01-01

 
 
 
 
301

The spatial epidemiology of trauma: the potential of geographic information science to organize data and reveal patterns of injury and services.  

Science.gov (United States)

Despite important advances in the prevention and treatment of trauma, preventable injuries continue to impact the lives of millions of people. Motor vehicle collisions and violence claim close to 3 million lives each year worldwide. Public health agencies have promoted the need for systematic and ongoing surveillance as a foundation for successful injury control. Surveillance has been used to quantify the incidence of injury for the prioritization of further research, monitor trends over time, identify new injury patterns, and plan and evaluate prevention and intervention efforts. Advances in capability to handle spatial data and substantial increases in computing power have positioned geographic information science (GIS) as a potentially important tool for health surveillance and the spatial organization of health care, and for informing prevention and acute care interventions. Two themes emerge in the trauma literature with respect to GIS theory and techniques: identifying determinants associated with the risk of trauma to guide injury prevention efforts and evaluating the spatial organization and accessibility of acute trauma care systems. We review the current literature on trauma and GIS research and provide examples of the importance of accounting for spatial scale when using spatial analysis for surveillance. The examples illustrate the effect of scale on incident analysis, the geographic variation of major injury across British Columbia's health service delivery areas (HSDAs) and the rates of variation of injury within individual HSDAs. PMID:18841227

Schuurman, Nadine; Hameed, S Morad; Fiedler, Robert; Bell, Nathaniel; Simons, Richard K

2008-10-01

302

Effect of dietary palm olein oil on oxidative stress associated with ischemic-reperfusion injury in isolated rat heart  

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Abstract Background Palm olein oil (PO), obtained from refining of palm oil is rich in monounsaturated fatty acid and antioxidant vitamins and is widely used as oil in diet in many parts of the world including India. Palm oil has been reported to have beneficial effects in oxidative stress associated with hypertension and arterial thrombosis. Oxidative stress plays a major role in the etiopathology of myocardial ischemic-reperfusion injury (IRI) which is a common sequel of is...

Sood Subeena; Narang Deepak

2004-01-01

303

Octacosanol Attenuates Disrupted Hepatic Reactive Oxygen Species Metabolism Associated with Acute Liver Injury Progression in Rats Intoxicated with Carbon Tetrachloride  

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We examined whether octacosanol, the main component of policosanol, attenuates disrupted hepatic reactive oxygen species metabolism associated with acute liver injury progression in rats intoxicated with carbon tetrachloride (CCl4). In rats intoxicated with CCl4 (1 ml/kg, i.p.), the activities of serum transaminases increased 6 h after intoxication and further increased at 24 h. In the liver of CCl4-intoxicated rats, increases in lipid peroxide (LPO) concentration and myeloperoxidase acti...

Ohta, Yoshiji; Ohashi, Koji; Matsura, Tatsuya; Tokunaga, Kenji; Kitagawa, Akira; Yamada, Kazuo

2008-01-01

304

Furosemide is associated with acute kidney injury in critically ill patients  

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Full Text Available Acute kidney injury (AKI is common in critically ill patients. Diuretics are used without any evidence demonstrating a beneficial effect on renal function. The objective of the present study is to determine the incidence of AKI in an intensive care unit (ICU and if there is an association between the use of furosemide and the development of AKI. The study involved a hospital cohort in which 344 patients were consecutively enrolled from January 2010 to January 2011. A total of 132 patients (75 females and 57 males, average age 64 years remained for analysis. Most exclusions were related to ICU discharge in the first 24 h. Laboratory, sociodemographic and clinical data were collected until the development of AKI, medical discharge or patient death. The incidence of AKI was 55% (95%CI = 46-64. The predictors of AKI found by univariate analysis were septic shock: OR = 3.12, 95%CI = 1.36-7.14; use of furosemide: OR = 3.27, 95%CI = 1.57-6.80, and age: OR = 1.02 (95%CI = 1.00-1.04. Analysis of the subgroup of patients with septic shock showed that the odds ratio of furosemide was 5.5 (95%CI = 1.16-26.02 for development of AKI. Age, use of furosemide, and septic shock were predictors of AKI in critically ill patients. Use of furosemide in the subgroup of patients with sepsis/septic shock increased (68.4% the chance of development of AKI when compared to the sample as a whole (43.9%.

T.M. Levi

2012-09-01

305

Furosemide is associated with acute kidney injury in critically ill patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Acute kidney injury (AKI) is common in critically ill patients. Diuretics are used without any evidence demonstrating a beneficial effect on renal function. The objective of the present study is to determine the incidence of AKI in an intensive care unit (ICU) and if there is an association between [...] the use of furosemide and the development of AKI. The study involved a hospital cohort in which 344 patients were consecutively enrolled from January 2010 to January 2011. A total of 132 patients (75 females and 57 males, average age 64 years) remained for analysis. Most exclusions were related to ICU discharge in the first 24 h. Laboratory, sociodemographic and clinical data were collected until the development of AKI, medical discharge or patient death. The incidence of AKI was 55% (95%CI = 46-64). The predictors of AKI found by univariate analysis were septic shock: OR = 3.12, 95%CI = 1.36-7.14; use of furosemide: OR = 3.27, 95%CI = 1.57-6.80, and age: OR = 1.02 (95%CI = 1.00-1.04). Analysis of the subgroup of patients with septic shock showed that the odds ratio of furosemide was 5.5 (95%CI = 1.16-26.02) for development of AKI. Age, use of furosemide, and septic shock were predictors of AKI in critically ill patients. Use of furosemide in the subgroup of patients with sepsis/septic shock increased (68.4%) the chance of development of AKI when compared to the sample as a whole (43.9%).

T.M., Levi; M.S., Rocha; D.N., Almeida; R.T.C., Martins; M.G.C., Silva; N.C.P., Santana; I.T., Sanjuan; C.M.S., Cruz.

306

Furosemide is associated with acute kidney injury in critically ill patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Acute kidney injury (AKI) is common in critically ill patients. Diuretics are used without any evidence demonstrating a beneficial effect on renal function. The objective of the present study is to determine the incidence of AKI in an intensive care unit (ICU) and if there is an association between [...] the use of furosemide and the development of AKI. The study involved a hospital cohort in which 344 patients were consecutively enrolled from January 2010 to January 2011. A total of 132 patients (75 females and 57 males, average age 64 years) remained for analysis. Most exclusions were related to ICU discharge in the first 24 h. Laboratory, sociodemographic and clinical data were collected until the development of AKI, medical discharge or patient death. The incidence of AKI was 55% (95%CI = 46-64). The predictors of AKI found by univariate analysis were septic shock: OR = 3.12, 95%CI = 1.36-7.14; use of furosemide: OR = 3.27, 95%CI = 1.57-6.80, and age: OR = 1.02 (95%CI = 1.00-1.04). Analysis of the subgroup of patients with septic shock showed that the odds ratio of furosemide was 5.5 (95%CI = 1.16-26.02) for development of AKI. Age, use of furosemide, and septic shock were predictors of AKI in critically ill patients. Use of furosemide in the subgroup of patients with sepsis/septic shock increased (68.4%) the chance of development of AKI when compared to the sample as a whole (43.9%).

T.M., Levi; M.S., Rocha; D.N., Almeida; R.T.C., Martins; M.G.C., Silva; N.C.P., Santana; I.T., Sanjuan; C.M.S., Cruz.

2012-09-01

307

Insuficiência renal aguda associada à leptospirose / Leptospirosis-associated acute kidney injury  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A leptospirose é a zoonose mais importante do mundo. Os pacientes são tipicamente homens jovens. Vários fatores estão envolvidos na insuficiência renal aguda (IRA) na leptospirose, incluindo ação nefrotóxica direta da leptospira, hiperbilirrubinemia, rabdomiólise e hipovolemia. Os principais achados [...] histológicos são nefrite intersticial aguda e necrose tubular aguda. A IRA na leptospirose é geralmente não oligúrica e hipocalêmica. Alterações da função tubular precedem a queda na taxa de filtração glomerular, o que poderia explicar a alta frequência de hipocalemia. O tratamento antibiótico é eficaz nas fases precoces e tardias e/ou graves. Para pacientes críticos com IRA na leptospirose, as seguintes condutas são recomendadas: hemodiálise precoce e diária; baixa infusão de volume (devido ao risco de hemorragia pulmonar), e estratégias de proteção pulmonar. A mortalidade na IRA associada à leptospirose está em torno de 22%. Abstract in english Leptospirosis is the most important zoonosis in the world. Patients are typically young men. Several factors are involved in acute kidney injury (AKI) in leptospirosis, including direct nephrotoxic action of the leptospira, hyperbilirubinemia, rhabdomyolysis and hypovolemia. The major histological f [...] indings are acute interstitial nephritis and acute tubular necrosis. Leptospirosis-induced AKI is usually nonoliguric and hypokalemic. Tubular function abnormalities precede a decline in the glomerular filtration rate, which could explain the high frequency of hypokalemia. Antibiotic treatment is efficient in the early and late and/or severe phases. For critically ill leptospirosis patients, the following measures are recommended: early and daily hemodialysis; low volume infusion (due to the risk of pulmonary hemorrhage); and lung-protective strategies. Mortality in leptospirosis-associated AKI is around 22%.

Elizabeth De Francesco, Daher; Krasnalhia Lívia Soares de, Abreu; Geraldo Bezerra da, Silva Junior.

308

Inflammation and nerve injury induce expression of pancreatitis-associated protein-II in primary sensory neurons  

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Full Text Available Abstract Pancreatitis-associated protein (PAP-I and -II, lectin-related secretory proteins, are members of the regenerating gene (Reg family. Although expression of PAP-I was found in the dorsal root ganglion (DRG neurons following peripheral nerve injury and cystitis, whether PAP-II could be expressed in DRG neurons in chronic pain models remains unclear. The present study shows an inflammation- and nerve injury-triggered expression of PAP-II in rat DRG neurons. In situ hybridization showed that only a few DRG neurons normally contained PAP-I and -II mRNAs. After peripheral inflammation, PAP-I and -II mRNAs were present in over half of small DRG neurons. Such an elevated expression of PAP-I and -II reached the peak level on the second day. Immunostaining showed that the expression of PAP-II was mostly increased in the isolectin B4-positive subset of small DRG neurons after inflammation. Furthermore, the expression of PAP-II was also induced in DRG neurons after peripheral nerve injury. Interestingly, PAP-II expression was shifted from small neurons on day 2 to large DRG neurons that expressed neuropeptide Y during the later post-injury days. These results suggest that PAP-II may play potential roles in the modulation of spinal sensory pathways in pathological pain states.

Bao Lan

2010-04-01

309

Adaptive changes in the dominant shoulders of female professional overhead athletes: mutual association and relation to shoulder injury.  

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The aim of our study was to evaluate adaptive changes in the dominant shoulders of female professional overhead athletes, their mutual association, and relation between adaptive changes and shoulder injury. Thirty-six female professional volleyball and handball players were divided into two groups: 14 athletes were included in the symptomatic group (positive shoulder injury history and specific shoulder tests) and 22 athletes were included in the asymptomatic group (negative shoulder injury history and specific shoulder tests). Clinical examinations with specific shoulder tests, evaluation of rotational mobility, and symptoms of malposition and dyskinesis of the dominant scapula (SICK scapula syndrome) were performed. Glenohumeral rotators were isokinetically tested at 60 and 150°/s, with evaluation of stability ratios and rotator fatigability. On average, the participants had decreased internal rotation (Pscapular lateralization (?=0.340, P=0.042), higher spiking ratios at 60°/s (?=0.349, P=0.037) and 150°/s (?=0.330, P=0.049), and lower cocking ratios at 60°/s (?=-0.477, P=0.003). Decreased dominant ER, higher deficit of dominant eccentric ER peak torques, and higher dominant rotator fatigability correlate with previous shoulder pain/injury. Different adaptive changes (rotational mobility, SICK scapula signs, and glenohumeral muscular imbalance) are inter-related. As a form of both prevention and rehabilitation for the athletes at risk, we recommend individually adjusted shoulder training on the basis of clinical and isokinetic testing. PMID:23282669

Tonin, Katarina; Stražar, Klemen; Burger, Helena; Vidmar, Gaj

2013-09-01

310

Time to add a new priority target for child injury prevention? The case for an excess burden associated with sport and exercise injury: population-based study  

Science.gov (United States)

Objective To determine the population-level burden of sports injuries compared with that for road traffic injury for children aged activity codes to identify sports-related cases and ICD-10-AM cause and location codes to identify road traffic injuries; and injury presentations to 38 Victorian public hospital emergency departments, using a combination of activity, cause and location codes. Main outcome measures Trends in injury frequency and rate were analysed by log-linear Poisson regression and the population-level injury burden was assessed in terms of years lived with disability (YLD), hospital bed-days and direct hospital costs. Results Over the 7-year period, the annual frequency of non-fatal hospital-treated sports injury increased significantly by 29% (from N=7405 to N=9923; pcosts ($A5.9 millions vs $A2.2 millions). Conclusions The significant 7-year increase in the frequency of hospital-treated sports injury and the substantially higher injury population-health burden (direct hospital costs, bed-day usage and YLD impacts) for sports injury compared with road traffic injury for children aged <15?years indicates an urgent need to prioritise sports injury prevention in this age group. PMID:24993758

Finch, Caroline F; Wong Shee, Anna; Clapperton, Angela

2014-01-01

311

Utility of surveillance imaging after minor blunt head trauma.  

Science.gov (United States)

Object Nonoperative blunt head trauma is a common reason for admission in a pediatric hospital. Adverse events, such as growing skull fracture, are rare, and the incidence of such morbidity is not known. As a result, optimal follow-up care is not clear. Methods Patients admitted after minor blunt head trauma between May 1, 2009, and April 30, 2013, were identified at a single institution. Demographic, socioeconomic, and clinical characteristics were retrieved from administrative and outpatient databases. Clinical events within the 180-day period following discharge were reviewed and analyzed. These events included emergency department (ED) visits, need for surgical procedures, clinic visits, and surveillance imaging utilization. Associations among these clinical events and potential contributing factors were analyzed using appropriate statistical methods. Results There were 937 admissions for minor blunt head trauma in the 4-year period. Patients who required surgical interventions during the index admission were excluded. The average age of the admitted patients was 5.53 years, and the average length of stay was 1.7 days; 15.7% of patients were admitted for concussion symptoms with negative imaging findings, and 26.4% of patients suffered a skull fracture without intracranial injury. Patients presented with subdural, subarachnoid, or intraventricular hemorrhage in 11.6%, 9.19%, and 0.53% of cases, respectively. After discharge, 672 patients returned for at least 1 follow-up clinic visit (71.7%), and surveillance imaging was obtained at the time of the visit in 343 instances. The number of adverse events was small and consisted of 34 ED visits and 3 surgeries. Some of the ED visits could have been prevented with better discharge instructions, but none of the surgery was preventable. Furthermore, the pattern of postinjury surveillance imaging utilization correlated with physician identity but not with injury severity. Because the number of adverse events was small, surveillance imaging could not be shown to positively influence outcomes. Conclusions Adverse events after nonoperative mild traumatic injury are rare. The routine use of postinjury surveillance imaging remains controversial, but these data suggest that such imaging does not effectively identify those who require operative intervention. PMID:25014322

Chern, Joshua J; Sarda, Samir; Howard, Brian M; Jea, Andrew; Tubbs, R Shane; Brahma, Barunashish; Wrubel, David M; Reisner, Andrew; Boydston, William

2014-09-01

312

Brown-Sequard syndrome associated with unusual spinal cord injury by a screwdriver stab wound  

Science.gov (United States)

Introduction: Stab wounds resulting in spinal cord injuries are very rare. In direct central back stabbings, the layers of muscles and the spinal column tends to deflect blades, rarely causing injuries to the spinal cord. We report an unusual case of traumatic spinal cord injury by a screwdriver stab, presented as Brown-Séquard syndrome and discuss possible pitfalls on the surgical treatment. Case report: A 34 year-old man was brought to the emergency department after a group assault with a single screwdriver stab wound on the back. Neurological examination revealed an incomplete Brown-Sequard syndrome, with grade IV motor deficit on the left leg and contralateral hemihypoalgesia below T9 level. Radiological evaluation showed a retained 9 cm screwdriver that entered and trespassed the spinal canal at T6 level, reaching the posterior mediastinum with close relation to the thoracic aorta. Vascular injury could not be excluded. The joint decision between the neurosurgery and the vascular surgery teams was the surgical removal of the screwdriver under direct visualization. A left mini-thoracotomy was performed. Simultaneously, a careful dissection was done and screwdriver was firmly pulled back on the opposite path of entry under direct visualization of the aorta. The neurological deficit was maintained immediately after the surgical procedure. Follow-up visit after 1 year showed minor motor deficit and good healing. Conclusions: It is important to consider all aspects of secondary injury on the surgical planning of penetrating spinal cord injury. The secondary injury can be minimized with multidisciplinary planning of the surgical procedure. PMID:24482724

Beer-Furlan, Andre Luiz; Paiva, Wellingson Silva; Tavares, Wagner Malago; de Andrade, Almir Ferreira; Teixeira, Manoel Jacobsen

2014-01-01

313

Brief report: the association between non-suicidal self-injury, self-concept and acquaintance with self-injurious peers in a sample of adolescents.  

Science.gov (United States)

The current study investigated the association between non-suicidal self-injury (NSSI), self-concept and acquaintance with NSSI peers in a sample of 150 high school students (60% female) with a mean age of 15.56 (SD=2.00) years. Analyses showed that students with NSSI rated themselves lower on academic intelligence, physical attractiveness, social skills and emotional stability than their non-NSSI peers. The self-injurers also had more friends who engaged in NSSI, and having more NSSI acquaintances was negatively related to self-esteem. It could be that adolescents with lower self-esteem are more attracted to self-injuring peers, or that adolescents with low self-esteem are more vulnerable to copy NSSI to deal with their problems or to gain a certain identity in their peer group. Future studies must test these possible NSSI pathways. PMID:19910041

Claes, Laurence; Houben, Adinda; Vandereycken, Walter; Bijttebier, Patricia; Muehlenkamp, Jennifer

2010-10-01

314

Clinical features of gastroduodenal injury associated with long-term low-dose aspirin therapy  

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Full Text Available Low-dose aspirin (LDA is clinically used for the prevention of cardiovascular and cerebrovascular events with the advent of an aging society. On the other hand, a very low dose of aspirin (10 mg daily decreases the gastric mucosal prostaglandin levels and causes significant gastric mucosal damage. The incidence of LDA-induced gastrointestinal mucosal injury and bleeding has increased. It has been noticed that the incidence of LDA-induced gastrointestinal hemorrhage has increased more than that of non-aspirin non-steroidal anti-inflammatory drug (NSAID-induced lesions. The pathogenesis related to inhibition of cyclooxygenase (COX-1 includes reduced mucosal flow, reduced mucus and bicarbonate secretion, and impaired platelet aggregation. The pathogenesis related to inhibition of COX-2 involves reduced angiogenesis and increased leukocyte adherence. The pathogenic mechanisms related to direct epithelial damage are acid back diffusion and impaired platelet aggregation. The factors associated with an increased risk of upper gastrointestinal (GI complications in subjects taking LDA are aspirin dose, history of ulcer or upper GI bleeding, age > 70 years, concomitant use of non-aspirin NSAIDs including COX-2-selective NSAIDs, and Helicobacter pylori (H. pylori infection. Moreover, no significant differences have been found between ulcer and non-ulcer groups in the frequency and severity of symptoms such as nausea, acid regurgitation, heartburn, and bloating. It has been shown that the ratios of ulcers located in the body, fundus and cardia are significantly higher in bleeding patients than the ratio of gastroduodenal ulcers in patients taking LDA. Proton pump inhibitors reduce the risk of developing gastric and duodenal ulcers. In contrast to NSAID-induced gastrointestinal ulcers, a well-tolerated histamine H2-receptor antagonist is reportedly effective in prevention of LDA-induced gastrointestinal ulcers. The eradication of H. pylori is equivalent to treatment with omeprazole in preventing recurrent bleeding. Continuous aspirin therapy for patients with gastrointestinal bleeding may increase the risk of recurrent bleeding but potentially reduces the mortality rates, as stopping aspirin therapy is associated with higher mortality rates. It is very important to prevent LDA-induced gastroduodenal ulcer complications including bleeding, and every effort should be exercised to prevent the bleeding complications.

Junichi Iwamoto

2013-01-01

315

Number of casual male sexual partners and associated factors among men who have sex with men: Results from the National HIV Behavioral Surveillance system  

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Full Text Available Abstract Background In 2006, the majority of new HIV infections were in MSM. We sought to describe numbers of casual sex partners among US MSM. Methods Data are from the first MSM cycle of the National HIV Behavioral Surveillance system, conducted from 2003 to 2005. Relationships between number of casual male sex partners within the previous year and demographic information, self-reported HIV status, and risk behaviors were determined through regression models. Results Among 11,191 sexually active MSM, 76% reported a casual male partner. The median casual partner number was three. Lower number of casual partners was associated with black race, Hispanic ethnicity, and having a main sex partner in the previous year. Factors associated with a higher number included gay identity, exchange sex, both injection and non-injection drug use. Being HIV-positive was associated with more partners among non-blacks only. Age differences in partner number were seen only among chat room users. Conclusions MSM who were black, Hispanic or had a main sex partner reported fewer casual sex partners. Our results suggest specific populations of MSM who may benefit most from interventions to reduce casual partner numbers.

Salazar Laura F

2011-03-01

316

A decreased volume of the medial tibial spine is associated with an increased risk of suffering an anterior cruciate ligament injury for males but not females.  

Science.gov (United States)

Measurements of tibial plateau subchondral bone and articular cartilage slope have been associated with the risk of suffering anterior cruciate ligament (ACL) injury. Such single-plane measures of the tibial plateau may not sufficiently characterize its complex, three-dimensional geometry and how it relates to knee injury. Further, the tibial spines have not been studied in association with the risk of suffering a non-contact ACL injury. We questioned whether the geometries of the tibial spines are associated with non-contact ACL injury risk, and if this relationship is different for males and females. Bilateral MRI scans were acquired on 88 ACL-injured subjects and 88 control subjects matched for sex, age and sports team. Medial and lateral tibial spine geometries were characterized with measurements of length, width, height, volume and anteroposterior location. Analyses of females revealed no associations between tibial spine geometry and risk of ACL injury. Analyses of males revealed that an increased medial tibial spine volume was associated with a decreased risk of ACL injury (OR?=?0.667 per 100?mm(3) increase). Smaller medial spines could provide less resistance to internal rotation and medial translation of the tibia relative to the femur, subsequently increasing ACL strains and risk of ACL injury. PMID:24962098

Sturnick, Daniel R; Argentieri, Erin C; Vacek, Pamela M; DeSarno, Michael J; Gardner-Morse, Mack G; Tourville, Timothy W; Slauterbeck, James R; Johnson, Robert J; Shultz, Sandra J; Beynnon, Bruce D

2014-11-01

317

The Moderating Effects of Sex and Age on the Association between Traumatic Brain Injury and Harmful Psychological Correlates among Adolescents  

Science.gov (United States)

Background Although it is well established that sex is a risk factor in acquiring a traumatic brain injury (TBI) among adolescents, it has not been established whether it also moderates the influence of other TBI psychological health correlates. Methods and Findings Data were derived from a 2011 population-based cross-sectional school survey, which included 9,288 Ontario 7th–12th graders who completed anonymous self-administered questionnaires in classrooms. Response rate was 62%. Preliminary analyses found no evidence of nonresponse bias in the reporting of TBI. TBI was defined as a hit or blow to the head that resulted in a 5 minutes loss of consciousness or at least one overnight hospitalization due to symptoms associated with it. Reports of lifetime TBI were more common among males than females (23.1%, 95% CI: 20.5, 25.8 vs. 17.1%, 95% CI: 14.7, 19.8). Thirteen correlates were examined and included cigarette smoking, elevated psychological distress, suicide ideation, bully victimization (at school, as well as cyber bullying), bullying others, cannabis use, cannabis dependence and drug use problems, physical injuries, daily smoking, drinking alcohol, binge drinking, use of cannabis, and poor academic performance. Among the outcomes examined, sex moderated the relationship between lifetime TBI and cigarette smoking. In addition, sex and age jointly moderated the relationship between lifetime TBI and daily smoking, alcohol use and physical injuries. Late adolescent males who reported lifetime TBI, relative to females, displayed elevated daily smoking and injuries, whereas their females counterparts displayed elevated past year drinking. Possible bias related to self-report procedures and the preclusion of causal inferences due to the cross-sectional nature of the data are limitations of this study. Conclusions TBI differences in outcomes need to be assessed for potential moderating effects of sex and age. Results have important implications for more tailored injury prevention efforts. PMID:25268238

Ilie, Gabriela; Adlaf, Edward M.; Mann, Robert E.; Boak, Angela; Hamilton, Hayley; Asbridge, Mark; Colantonio, Angela; Turner, Nigel E.; Rehm, Jurgen; Cusimano, Michael D.

2014-01-01

318

Life-threatening neurovascular injuries associated with recreational use of "banana" boats.  

Science.gov (United States)

Banana boat rides are a popular form of recreation worldwide. Recommendations that speed should not exceed 15 mph, passengers should wear protective gear, and an observer should be present on the towing boat are generally ignored. Medical personnel at tourist venues and general practitioners may not be attuned to the risk of serious injury. We present our experience in the management carotid- and vertebral artery dissections sustained by 44- and 23-year-old males during banana boat rides. In both cases, the dissections were misdiagnosed until patients presented to the Emergency Department two days after injury. In the first patient, medical management failed and endovascular treatment was required due to neurological deterioration. In patient two, anticoagulation therapy prevented embolic sequelae. Boat operators, passengers, and the medical personnel who are first to see these patients should be aware of the risk of arterial dissection to facilitate early detection of these potentially life-threatening injuries. PMID:22784874

Cohen, José E; Moscovici, Samuel; Rosenthal, Guy; Benifla, Mony; Itshayek, Eyal

2012-09-01

319

Surveillance and enforcement  

Energy Technology Data Exchange (ETDEWEB)

Various agencies of the Australian Federal and State Governments conduct surveillance and law enforcement over a coastline of approximately 37,000 kilometres and in the enormous maritime area (approximately 11.9 million sq. km) for which Australia has either sovereignty or sovereign resource rights, and responsibility on behalf of the international community for the protection and preservation of the marine environment. The roles of the two major maritime agencies responsible for maritime surveillance and enforcement of Australia`s laws of the sea, Coastwatch and the Australian Customs Service, are described. In addition to these a number of other Government departments and authorities also have regulatory and enforcement powers in the marine environment. The maritime surveillance and enforcement situation in Australia is complicated by a Federal system of government which gives the State Governments jurisdiction over the first three miles of territorial sea, and hence responsibility for inshore tasks, including boating safety and local search and rescue. This means that the legal situation with maritime regulation and enforcement in Australia is difficult. The paper proposes the possible rationalization of the current organizational arrangements and responsibilities. The model suggested is that of an Australian Coastguard and issues are canvassed associated with establishing such an organization in Australia. (author). 3 figs., refs.

Bateman, S. [Wollongong Univ., NSW (Australia)

1996-12-31

320

Propositions for the implementation and reinforcement of surveillance activities of exposure and risks associated to radon inhalation  

International Nuclear Information System (INIS)

This report treats exclusively of exposure by inhalation. It expresses the propositions relative to the implantation and the development of an information network allowing to characterize the radon exposures by inhalation and associated risks. (N.C.)

 
 
 
 
321

Running injuries.  

Science.gov (United States)

Overuse is the primary culprit in most running injuries, with biomechanical factors playing a much smaller role. A review of some of the most common and recalcitrant injuries in adults and adolescents is presented. Discussion of the pathophysiology of tendon injuries, stress fractures of the lower extremities, and apophysitis in adolescents is undertaken, and treatment strategies are proposed. Additionally, non-musculoskeletal events that may be related to a musculoskeletal injury such as exercise-associated amenorrhea and chronic fatigue or depression are reviewed. That running may promulgate osteoarthritis is still controversial. Most studies are limited by their retrospective design. However, the preponderance of data gives insufficient credence to the idea of osteoarthritis as a complication of long-distance running. With regard to treatment, nonsteroidal anti-inflammatory drugs appear to play little or no effective role in the management of running injuries. PMID:8024968

Paty, J G

1994-03-01

322

A Practical Guide to the Study of Sport Related Injuries.  

Science.gov (United States)

A comprehensive injury surveillance system enables local administrators to effectively target their countermeasures, thereby reducing injury risk and increasing the benefits of athletic competition and leisure activity. This article offers a guide to such a system. (MT)

Alles, Wesley F.; And Others

1985-01-01

323

Incidence of Road Traffic Injury and Associated Factors among Patients Visiting the Emergency Department of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia  

Science.gov (United States)

Background. Road traffic injuries are a major public health issue. The problem is increasing in Africa. Objective. To assess the incidence of road traffic injury and associated factors among patients visiting the emergency department of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia. Methods. Institutional based cross-sectional study design was conducted. A total of 356 systematically selected study subjects were included in the study. Bivariate and multivariate logistic regressions were performed to identify associated factors with road traffic injury. Odds ratios with 95% confidence interval were computed to determine the level of significance. Results. The incidence of road traffic injury in the emergency department of Tikur Anbessa Specialized Teaching Hospital was 36.8%. Being a farmer (AOR = 3.3; 95% CI = 1.06–10.13), conflict with family members (AOR = 7.7; 95% CI = 3.49–8.84), financial problem (AOR = 9.91; 95% CI = 4.79–6.48), psychological problem (AOR = 17.58; 95% CI = 7.70–12.14), and alcohol use (AOR = 2.98; 95% CI = 1.61–5.27) were independently associated with road traffic injury. Conclusion and Recommendation. In this study the incidence of road traffic injury was high. Alcohol is one of the most significant factors associated with Road Traffic Injury. Thus urgent education on the effect of alcohol is recommended. PMID:25165583

Tiruneh, Bewket Tadesse; Dachew, Berihun Assefa; Bifftu, Berhanu Boru

2014-01-01

324

Analysis of factors associated with traffic injury severity on rural roads in Iran  

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Full Text Available BACKGROUND: Iran is a country with one of the highest rates of traffic crash fatality and injury, and seventy percent of these fatalities happen on rural roads. The objective of this study is to identify the significant factors influencing injury severity among drivers involved in crashes on two kinds of major rural roads in Iran: two-lane, two-way roads and freeways. METHODS: According to the dataset, 213569 drivers were involved in rural road crashes in Iran, over the 3 years from 2006 to 2008. The Classification And Regression Tree method (CART was applied for 13 independent variables, and one target variable of injury severity with 3 classes of no-injury, injury and fatality. Some of the independent variables were cause of crash, collision type, weather conditions, road surface conditions, driver's age and gender and seat belt usage. The CART model was trained by 70% of these data, and tested with the rest. RESULTS: It was indicated that seat belt use is the most important safety factor for two-lane, two-way rural roads, but on freeways, the importance of this variable is less. Cause of crash, also turned out to be the next most important variable. The results showed that for two-lane, two-way rural roads, "improper overtaking" and "speeding", and for rural freeways, "inattention to traffic ahead", "vehicle defect", and "movement of pedestrians, livestock and unauthorized vehicles on freeways" are the most serious causes of increasing injury severity. CONCLUSIONS: The analysis results revealed seat belt use, cause of crash and collision type as the most important variables influencing the injury severity of traffic crashes. To deal with these problems, intensifying police enforcement by means of mobile patrol vehicles, constructing overtaking lanes where necessary, and prohibiting the crossing of pedestrians and livestock and the driving of unauthorized vehicles on freeways are necessary. Moreover, creating a rumble strip on the two edges of roads, and paying attention to the design consistency of roads can be a helpful factor in order to prevent events such as "overturning" and improve the overall safety of freeways.

Andishe Ranjbari

2012-01-01

325

Increasing Incidence of Hospital-Acquired and Healthcare-Associated Bacteremia in Northeast Thailand: A Multicenter Surveillance Study  

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Background Little is known about the epidemiology of nosocomial bloodstream infections in public hospitals in developing countries. We evaluated trends in incidence of hospital-acquired bacteremia (HAB) and healthcare-associated bacteremia (HCAB) and associated mortality in a developing country using routinely available databases. Methods Information from the microbiology and hospital databases of 10 provincial hospitals in northeast Thailand was linked with the national death registry for 2004–2010. Bacteremia was considered hospital-acquired if detected after the first two days of hospital admission, and healthcare-associated if detected within two days of hospital admission with a prior inpatient episode in the preceding 30 days. Results A total of 3,424 patients out of 1,069,443 at risk developed HAB and 2,184 out of 119,286 at risk had HCAB. Of these 1,559 (45.5%) and 913 (41.8%) died within 30 days, respectively. Between 2004 and 2010, the incidence rate of HAB increased from 0.6 to 0.8 per 1,000 patient-days at risk (pThailand, increasing proportions of ESBL-producing isolates, and very high associated mortality. PMID:25310563

Hongsuwan, Maliwan; Srisamang, Pramot; Kanoksil, Manas; Luangasanatip, Nantasit; Jatapai, Anchalee; Day, Nicholas P.; Peacock, Sharon J.; Cooper, Ben S.; Limmathurotsakul, Direk

2014-01-01

326

The short-term association of temperature and rainfall with mortality in Vadu Health and Demographic Surveillance System: a population level time series analysis  

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Full Text Available Background: Research in mainly developed countries has shown that some changes in weather are associated with increased mortality. However, due to the lack of accessible data, few studies have examined such effects of weather on mortality, particularly in rural regions in developing countries. Objective: In this study, we aimed to investigate the relationship between temperature and rainfall with daily mortality in rural India. Design: Daily mortality data were obtained from the Health and Demographic Surveillance System (HDSS in Vadu, India. Daily mean temperature and rainfall data were obtained from a regional meteorological center, India Meteorological Department (IMD, Pune. A Poisson regression model was established over the study period (January 2003–May 2010 to assess the short-term relationship between weather variables and total mortality, adjusting for time trends and stratifying by both age and sex. Result: Mortality was found to be significantly associated with daily ambient temperatures and rainfall, after controlling for seasonality and long-term time trends. Children aged 5 years or below appear particularly susceptible to the effects of warm and cold temperatures and heavy rainfall. The population aged 20–59 years appeared to face increased mortality on hot days. Most age groups were found to have increased mortality rates 7–13 days after rainfall events. This association was particularly evident in women. Conclusion: We found the level of mortality in Vadu HDSS in rural India to be highly affected by both high and low temperatures and rainfall events, with time lags of up to 2 weeks. These results suggest that weather-related mortality may be a public health problem in rural India today. Furthermore, as changes in local climate occur, adaptation measures should be considered to mitigate the potentially negative impacts on public health in these rural communities.

Veena Muralidharan

2012-11-01

327

Status epilepticus after prolonged umbilical cord occlusion is associated with greater neural injury fetal sheep at term-equivalent.  

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The majority of pre-clinical studies of hypoxic-ischemic encephalopathy at term-equivalent have focused on either relatively mild insults, or on functional paradigms of cerebral ischemia or hypoxia-ischemia/hypotension. There is surprisingly little information on the responses to single, severe 'physiological' insults. In this study we examined the evolution and pattern of neural injury after prolonged umbilical cord occlusion (UCO). 36 chronically instrumented fetal sheep at 125-129 days gestational age (term?=?147 days) were subjected to either UCO until mean arterial pressure was associated with a transient secondary increase in cortical impedance (a measure of cytotoxic edema, p<0.05). All fetuses showed moderate to severe neuronal loss in the hippocampus and the basal ganglia but mild cortical cell loss (p<0.05 vs sham occlusion). Status epilepticus was associated with more severe terminal hypotension (p<0.05) and subsequently, greater neuronal loss (p<0.05). In conclusion, profound UCO in term-equivalent fetal sheep was associated with delayed seizures, secondary cytotoxic edema, and subcortical injury, consistent with the predominant pattern after peripartum sentinel events at term. It is unclear whether status epilepticus exacerbated cortical injury or was simply a reflection of a longer duration of asphyxia. PMID:24797081

Drury, Paul P; Davidson, Joanne O; van den Heuij, Lotte G; Wassink, Guido; Gunn, Eleanor R; Booth, Lindsea C; Bennet, Laura; Gunn, Alistair J

2014-01-01

328

Pharmacological blockade of the MaxiK channel attenuates experimental acute pancreatitis and associated lung injury in rats.  

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Increasing evidence has recently demonstrated that soluble heparan sulfate (HS), a degradation product of extracellular matrix produced by elastase, plays a key role in the aggravation of acute pancreatitis (AP) and associated lung injury. However little is known about the detailed mechanism underlying HS-induced inflammatory cascade. Our previous work has provided a valuable clue that a large-conductance K(+) channel (MaxiK) was involved in the HS-stimulated activation of murine macrophages. Here we attempted to ask whether pharmacological inhibition of the MaxiK channel will exert beneficial effects on the treatment of AP and secondary lung injury. The protective effects of paxilline, a specific blocker of MaxiK, on rats against sodium taurocholate induced AP were evaluated. Our data showed that paxilline substantially attenuated AP and resultant lung injury, mainly by limiting the burst of inflammatory responses, as proven by decreased plasma concentrations of tumor necrosis factor-? and macrophage inflammatory protein-2, together with unimpaired pancreatic enzyme activities in rats suffering from AP. Compared with the therapeutic administration, pre-treatment of paxilline showed superior potential to slow down the progress of AP. Furthermore, AP rats received paxilline exhibited improved histopathologic alterations both in the pancreas and the lungs, and even lower lung MPO activity. Taken together, our study provides evidence that MaxiK is involved in the spread of inflammatory responses and the following lung injury during the attack of AP, indicating that this ion channel is a promising candidate as a therapeutic target for AP. PMID:24836752

Ren, Jian-Dong; Xing, Yong-Jun; Fan, Kai-Hua; Yu, Bo-Tao; Jin, Wei-Hua; Jiang, Yan; Jing, Li; Wu, Xue-Chai; Wang, Shi-Hua; Wu, Juan; Chen, Hua

2014-07-01

329

Official incidents of domestic violence: types, injury, and associations with nonofficial couple aggression.  

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Official police reports of intimate partner violence (IPV) were examined in a community sample of young, at-risk couples to determine the degree of mutuality and the relation between IPV arrests and aggression toward a partner (self-reported, partner reported, and observed). Arrests were predominantly of the men. Men were more likely to initiate physical contact, use physical force, and inflict injuries than women, although few injuries required medical attention. In the context of nonofficial aggression toward a partner, overall, women had higher levels of physical and psychological aggression compared to men, and levels of severe physical aggression did not differ by gender. Couples with an IPV arrest were more aggressive toward each other than couples with no IPV arrests; however, nonofficial levels of aggression were not higher for men than for women among couples experiencing an IPV incident. PMID:19694354

Capaldi, Deborah M; Shortt, Joann Wu; Kim, Hyoun K; Wilson, Jane; Crosby, Lynn; Tucci, Shivan

2009-01-01

330

Chronic xerostomia increases esophageal acid exposure and is associated with esophageal injury  

International Nuclear Information System (INIS)

OBJECTIVES: To assess the effects of chronic xerostomia on parameters of gastroesophageal reflux and esophagitis. DESIGN: Observational study of a cohort of male patients with xerostomia and age-matched control subjects. SETTING: Tertiary-care Veterans Affairs Medical Center. SUBJECTS: Sixteen male patients with chronic xerostomia secondary to radiation for head and neck cancers or medications. Nineteen age-matched male control subjects with comparable alcohol and smoking histories. MEASUREMENTS AND MAIN RESULTS: Esophageal motility was similar in patients with xerostomia and controls. Clearance of acid from the esophagus and 24-hour intraesophageal pH were markedly abnormal in patients with xerostomia. Symptoms and signs of esophagitis were significantly more frequent in subjects with xerostomia. CONCLUSIONS: Chronic xerostomia may predispose to esophageal injury, at least in part, by decreasing the clearance of acid from the esophagus and altering 24-hour intraesophageal pH. Esophageal injury is a previously unreported complication of long-term salivary deficiency

331

Work-related injuries and illnesses associated with child labor--United States, 1993.  

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During 1993, an estimated 2.1 million persons aged 16-17 years in the United States were employed. Although many children aged <16 years work, employment data are neither routinely collected nor reported for this age group, and there are no reliable estimates of the number of children in this age group who work. During summer months, when most children are not in school, employment and hours worked by children aged <18 years increase substantially. To characterize workplace-related health and safety hazards for children, CDC's National Institute for Occupational Safety and Health (NIOSH) analyzed 1993 data for workers aged <18 years from the Survey of Occupational Injuries and Illnesses (SOII), a survey administered by the Bureau of Labor Statistics (BLS), U.S. Department of Labor. This report summarizes the results of this analysis and indicates that substantial numbers of persons aged <18 years sustain work-related injuries and illnesses each year. PMID:8622617

1996-06-01

332

Long-term results of the treatment of specific liver injury associated with Hodgkins disease  

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Fifteen patients suffering from Hodgkin's disease and specific liver injury were under observation. The use of modern treatment methods made it possible to achieve complete remissions in 2/3 of the patients. In 6 patients the remissions lasted from 38 to 117 months. The observation over these patients is continued. The author failed to reveal prognostic factors that would point to a more favourable course of Hodgkin's disease in patients with prolonged remissions

333

Unplanned complex suicide by self-strangulation associated with multiple sharp force injuries: a case report.  

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In cases of ligature strangulation, the importance of distinguishing self-inflicted death from homicide is crucial. This entails objective scene investigation, autopsy and anamnesis in order to elucidate the manner of death correctly. The authors report a case of unplanned complex suicide by means of self-strangulation and multiple sharp force injury. The use of more than one suicide method, consecutively--termed unplanned complex suicide--gives this case particular significance. A brief disc...

Palmiere, C.; Risso, E.; Hecke, O.; La Harpe, R.

2007-01-01

334

Factors associated with osteoarthritis of the hip and knee in Hong Kong Chinese: obesity, joint injury, and occupational activities.  

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In 1998, a case-control study was conducted in Hong Kong on hospital patients with osteoarthritis of the hip (n = 138) and osteoarthritis of the knee (n = 658). Age- and sex-matched controls were recruited consecutively from general practice clinics in the same region. The following three risk factors were found to be associated with osteoarthritis of both the hip and the knee: first, a history of joint injury: for osteoarthritis of the hip, the odds ratio = 25.1 (95% confidence interval (CI)...

Lau, Ec; Cooper, C.; Lam, D.; Chan, Vn; Tsang, Kk; Sham, A.

2000-01-01

335

Vertebral artery injury associated with cervical spine fracture-dislocation. Prevention of distal embolism using coil embolization  

International Nuclear Information System (INIS)

This study investigated the efficacy of coil embolization of the injured vertebral artery associated with fracture-dislocation of the cervical spine for the prevention of embolic stroke. Between 2001 and 2010, 27 patients underwent reduction of the dislocation fracture of the cervical spine. In 4 cases, preoperative MRI revealed disappearance of the flow-void signal of the unilateral vertebral artery in the foramen transversarium, and we performed further investigation of the injury of the vertebral artery with digital subtraction angiography. In all 4 cases, digital subtraction angiography revealed occlusion of the unilateral vertebral artery. After conviction of the existence of colateral cerebral blood flow from the contra-lateral vertebral arteries or external carotid arteries, we embolized the proximal part of the occluded vertebral arteries in endovascular procedures with detachable coils for the prevention of the embolic stroke associated with orthopedical procedures. All patients underwent reduction of the cervical dislocation after coil embolization, and the operations were performed uneventfully. During the follow-up period (66.8 months on the average), there were no episodes of vertebrobasilar infarction. Perioperative and postoperative antiplatelet or anticoagulant therapies were not necessary. Dislocation fracture of the cervical spine is frequently associated with injuries of vertebral artery, and the management of the risk for cerebral infarction remains controversial. Preoperative embolization of the injured vertebral artery can be an effective procedure in preventing the embolic stroke caused by orthopedical procedures. (author)

336

Association between perceived insufficient sleep, frequent mental distress, obesity and chronic diseases among US adults, 2009 behavioral risk factor surveillance system  

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Full Text Available Abstract Background Although evidence suggests that poor sleep is associated with chronic disease, little research has been conducted to assess the relationships between insufficient sleep, frequent mental distress (FMD ?14 days during the past 30 days, obesity, and chronic disease including diabetes mellitus, coronary heart disease, stroke, high blood pressure, asthma, and arthritis. Methods Data from 375,653 US adults aged???18 years in the 2009 Behavioral Risk Factor Surveillance System were used to assess the relationships between insufficient sleep and chronic disease. The relationships were further examined using a multivariate logistic regression model after controlling for age, sex, race/ethnicity, education, and potential mediators (FMD and obesity. Results The overall prevalence of insufficient sleep during the past 30 days was 10.4% for all 30 days, 17.0% for 14–29 days, 42.0% for 1–13 days, and 30.6% for zero day. The positive relationships between insufficient sleep and each of the six chronic disease were significant (p? Conclusions Assessment of sleep quantity and quality and additional efforts to encourage optimal sleep and sleep health should be considered in routine medical examinations. Ongoing research designed to test treatments for obesity, mental distress, or various chronic diseases should also consider assessing the impact of these treatments on sleep health.

Liu Yong

2013-01-01

337

Manganese Superoxide Dismutase Therapy in a Murine Hepatitis-Associated Injury  

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Full Text Available We aim to test the hypothesis that Con A-induced hepatitis and cell death can be prevented by the administration of the MnSOD mimetic MnTBAP. Male C57 mice were divided into 3 groups, 1 pretreated with MnTBAP (30 mg/kg for 2 days and then Concanavalin A (Con A (15 mg/kg; 2 pretreated with saline for 2 days and then Con A (15 mg/kg; 3 was the control treated with saline for 3 days. Extensive hepatic necrosis, with a significant increase in apoptosis, lipid peroxidation and decreased MnSOD enzymatic activity was found in the hepatic tissue of Con A-treated mice with significantly attenuation of all factors by pretreatment with MnTBAP. MnTBAP protected hepatocytes from Con A-induced hepatic injury with less degree of liver inflammation—ConA + MnTBAP (2.1 ± 0.4 vs. Con A (2.6 ± 0.3—and significantly less cell death (1.2 ± 0.3 vs. 2.7 ± 0.4, p = 0.03. MnSOD supplementation attenuated the oxidative-induced stress effects of Con A-induced injury and the protective effects of MnSOD supplementation against Con A-induced hepatitis could be through its anti-oxidative properties. Further evaluation of MnSOD manipulation could have the potential to prevent ongoing hepatic injury in hepatitis.

Yan Li

2011-08-01

338

Genotyping as a tool for antibiotic resistance surveillance of Neisseria gonorrhoeae in New Caledonia: evidence of a novel genotype associated with reduced penicillin susceptibility.  

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Antibiotic resistance in Neisseria gonorrhoeae continues to be a major concern in public health. Resistance of N. gonorrhoeae bacteria to penicillin G is widespread in most developed countries, which has necessitated a change to newer drugs for treatment of gonococcal infections. Recent reports indicate that resistance to these newer drugs is increasing, highlighting the need for accurate therapeutic recommendations. In some countries or communities, however, N. gonorrhoeae isolates are still susceptible to penicillin, so the use of this antibiotic for single-dose treatments of medically under-resourced patients is beneficial. In order to evaluate the adequacy and sustainability of this treatment approach, we explored the presence and prevalence of chromosomally mediated resistance determinants in N. gonorrhoeae isolates collected from 2005 to 2007 in New Caledonia. We developed two new real-time PCR assays targeting the penB and mtrR determinants, to be used together with a previously described duplex assay targeting the penA and ponA determinants. The results of this study provided evidence that neither the most-common mtrR determinants nor the most-resistance-associated penB alleles are currently circulating in New Caledonia, suggesting that penicillin should still be considered a valuable treatment strategy. Additionally, using our genotyping assay, we observed an unexpected penB genotype at a relatively high frequency that was associated with a decreased susceptibility to penicillin (average MIC, 0.15 mug/ml). Sequencing revealed that this genotype corresponded to an A102S mutation in the penB gene. The molecular tools developed in this study can be used successfully for prospective epidemiological monitoring and surveillance of penicillin susceptibility. PMID:18591264

Vernel-Pauillac, Frédérique; Nandi, Sobhan; Nicholas, Robert A; Goarant, Cyrille

2008-09-01

339

Glycyrrhizin Represses Total Parenteral Nutrition-Associated Acute Liver Injury in Rats by Suppressing Endoplasmic Reticulum Stress  

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Full Text Available Total parenteral nutrition (TPN is an artificial way to support daily nutritional requirements by bypassing the digestive system, but long-term TPN administration may cause severe liver dysfunction. Glycyrrhizin is an active component of licorice root that has been widely used to treat chronic hepatitis. The aim of this study is to investigate the hepatoprotective effect of glycyrrhizin on TPN-associated acute liver injury in vivo. Liver dysfunction was induced by intravenous infusion of TPN at a flow rate of 20 mL/kg/h for three h in Sprague Dawley rats. The rats were pretreated with Glycyrrhizin (1, 3 and 10 mg/kg intravenously. After receiving TPN or saline (control group for three h, the rats were sacrificed, blood samples were collected for biochemical analyses and liver tissue was removed for histopathological and immunohistochemical examination. We found that aspartate aminotransferase (AST, alanine aminotransferase (ALT, total bilirubin (TB and triglyceride (TG levels were significantly increased in the TPN group without glycyrrhizin pretreatment and decreased in the glycyrrhizin-pretreated TPN group in a dose-dependent manner. The stained liver sections showed that glycyrrhizin relieved acute liver injury. The upregulation of serum protein biomarkers of reactive nitrogen species, including nitrotyrosine and inducible NO synthase (iNOS, were attenuated by glycyrrhizin pretreatment. Levels of endoplasmic reticulum (ER stress factors, such as phosphorylation of JNK1/2, p38 MAPK and CHOP, were decreased by glycyrrhizin pretreatment. In summary, our results suggest that glycyrrhizin decreases TPN-associated acute liver injury factors by suppressing endoplasmic reticulum stress and reactive nitrogen stress.

Jai-Jen Tsai

2013-06-01

340

Heart injury following intestinal ischemia reperfusion in rats is attenuated by association of ischemic preconditioning and adenosine  

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Full Text Available SciELO Brazil | Language: English Abstract in english PURPOSE: To investigate the effect of ischemic preconditioning (IPC) and adenosine as strategies to protect cardiac injury caused by intestinal IR in rats, based on increasing in adenosine bioavailability and improvement of cell energy state by IPC. METHODS: Male Wistar rats were submitted to 6 [...] 0 minutes of intestinal ischemia and 120 minutes of reperfusion. Intravenous injections of saline or Adenosine (AD) was administered five minutes before ischemia, five minutes before reperfusion and after 55 minutes reperfusion. Cardiac samples were obtained, fixed in formalin solution, embedded in paraffin, and sections of 5 ?m were stained by hematoxylin-eosin. Histological analysis of myocardium was performed according occurrence of necrosis signs: piknosis, band contraction, eosinophilic cytoplasm, karyorrhexis and vacuolization (score - zero to 5). RESULTS: The groups submitted to ischemia alone (I=4.0), and reperfusion (IR=4.5) showed highest level of lesion compared to the others (I+IPC=3.3, IR+IPC=3.6, I+AD=3.0, IR+AD=3.8). The most interesting result was association of IPC and AD in IR model (IR+IPC+AD=1.2, p=0.002), showing preservation of the heart tissue, with fibers showing typical cross-striations and nuclei characteristics. Rare and small areas of tissue necrosis was observed and suggestion of capillaries congestion. CONCLUSION: Intestinal ischemia reperfusion promotes cardiac tissue injury. Ischemic preconditioning in association with adenosine is an efficient strategy to protect the heart against ischemia and reperfusion injury.

Micaela Frasson, Montero; Rafael, Saurim; Wesley Guedes Sava, Bonservizi; Marcia Kiyomi, Koike; Murched Omar, Taha.

 
 
 
 
341

Alterations in neuronal calcium levels are associated with cognitive deficits after traumatic brain injury  

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Traumatic brain injury (TBI) survivors often suffer from a post-traumatic syndrome with deficits in learning and memory. Calcium (Ca2+) has been implicated in the pathophysiology of TBI-induced neuronal death. However, the role of long-term changes in neuronal Ca2+ function in surviving neurons and the potential impact on TBI-induced cognitive impairments are less understood. Here we evaluated neuronal death and basal free intracellular Ca2+ ([Ca2+]i) in acutely isolated rat CA3 hippocampal neurons using the Ca2+ indicator, Fura-2, at seven and thirty days after moderate central fluid percussion injury. In moderate TBI, cognitive deficits as evaluated by the Morris Water Maze (MWM), occur after injury but resolve after several weeks. Using MWM paradigm we compared alterations in [Ca2+]i and cognitive deficits. Moderate TBI did not cause significant hippocampal neuronal death. However, basal [Ca2+]i was significantly elevated when measured seven days post-TBI. At the same time, these animals exhibited significant cognitive impairment (F2,25 = 3.43, p < 0.05). When measured 30 days post-TBI, both basal [Ca2+ ]i and cognitive functions had returned to normal. Pretreatment with MK-801 blocked this elevation in [Ca2+]i and also prevented MWM deficits. These studies provide evidence for a link between elevated [Ca2+]i and altered cognition. Since no significant neuronal death was observed, the alterations in Ca2+ homeostasis in the traumatized, but surviving neurons may play a role in the pathophysiology of cognitive deficits that manifest in the acute setting after TBI and represent a novel target for therapeutic intervention following TBI. PMID:18583041

Deshpande, Laxmikant S.; Sun, David A.; Sombati, Sompong; Baranova, Anya; Wilson, Margaret S.; Attkisson, Elisa; Hamm, Robert J.; DeLorenzo, Robert J.

2010-01-01

342

Is there an association between chronicity of patellar instability and patellofemoral cartilage lesions? An arthroscopic assessment of chondral injury.  

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The purpose of this study was to investigate the association between chronicity of patellar instability on the prevalence, grade, and location of chondral lesions in patients with recurrent patellar instability. Patellofemoral chondral status was documented and graded according to the Outerbridge classification in 38 patients who underwent arthroscopic examination at the time of a medial patellofemoral ligament reconstruction procedure. Chondral lesions of any location were observed in 63.2% of patients. Patellar and trochlear lesions were observed in 57.9 and 13.2% of patients, respectively. There was a significantly higher duration of patellar instability in patients with a trochlear lesion versus those without a trochlear lesion (p instability and Outerbridge grade of trochlear chondral injury (p = 0.01). Chi-squared analysis revealed that chronicity of patellar instability greater than 5 years was significantly associated with the likelihood of trochlear lesions (p instability may have a higher likelihood of and higher grade of patellofemoral chondral injuries, specifically for trochlear lesions. PMID:23150352

Franzone, Jeanne M; Vitale, Mark A; Shubin Stein, Beth E; Ahmad, Christopher S

2012-11-01

343

Octacosanol attenuates disrupted hepatic reactive oxygen species metabolism associated with acute liver injury progression in rats intoxicated with carbon tetrachloride.  

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We examined whether octacosanol, the main component of policosanol, attenuates disrupted hepatic reactive oxygen species metabolism associated with acute liver injury progression in rats intoxicated with carbon tetrachloride (CCl(4)). In rats intoxicated with CCl(4) (1 ml/kg, i.p.), the activities of serum transaminases increased 6 h after intoxication and further increased at 24 h. In the liver of CCl(4)-intoxicated rats, increases in lipid peroxide (LPO) concentration and myeloperoxidase activity and decreases in superoxixde dismutase activity and reduced glutathione (GSH) concentration occurred 6 h after intoxication and these changes were enhanced with an increase in xanthine oxidase activity and a decrease in catalase activity at 24 h. Octacosanol (10, 50 or 100 mg/kg) administered orally to CCl(4)-intoxicated rats at 6 h after intoxication attenuated the increased activities of serum transaminases and the increased hepatic myeloperoxidase and xanthine oxidase activities and LPO concentration and the decreased hepatic superoxide dismutase and catalase activities and GSH concentration found at 24 h after intoxication dose-dependently. Octacosanol (50 or 100 mg/kg) administered to untreated rats decreased the hepatic LPO concentration and increased the hepatic GSH concentration. These results indicate that octacosanol attenuates disrupted hepatic reactive oxygen species metabolism associated with acute liver injury progression in CCl(4)-intoxicated rats. PMID:18385828

Ohta, Yoshiji; Ohashi, Koji; Matsura, Tatsuya; Tokunaga, Kenji; Kitagawa, Akira; Yamada, Kazuo

2008-03-01

344

Diseases and injuries associated with mortality of hatchery reared Baltic cod (Gadus morhua L.) larvae  

DEFF Research Database (Denmark)

A cod hatching plant was established in 1992 on the island of Bornholm in the Baltic Sea in order to elucidate the possibilities for restocking of cod fry in this brackishwater system. The disease prevalence in 3 batches of hatchery-reared yolksac larvae from the Baltic cod (Gadus morhua L.) was monitored during the posthatch period. High prevalences of bacteriosis/mycosis, lordosis/scoliosis, injuries and protozoan endoparasitism were recorded. Vibrio sp. and Vibrio anguillarum serovar 04, 06, 08 in addition to nontypable strains and saprolegniaceous fungi were isolated from the larvae. The dinoflagellate-like endoparasites were located in the yolksac of the cod larvae.

Dalsgaard, Inger; Buchmann, K.

1993-01-01

345

Diseases and injuries associated with mortality of hatchery reared Baltic cod (Gadus morhua L.) larvae.  

Science.gov (United States)

A cod hatching plant was established in 1992 on the island of Bornholm in the Baltic Sea in order to elucidate the possibilities for restocking of cod fry in this brackishwater system. The disease prevalence in 3 batches of hatchery-reared yolksac larvae from the Baltic cod (Gadus morhua L.) was monitored during the posthatch period. High prevalences of bacteriosis/mycosis, lordosis/scoliosis, injuries and protozoan endoparasitism were recorded. Vibrio sp. and Vibrio anguillarum serovar 04, 06, 08 in addition to nontypable strains and saprolegniaceous fungi were isolated from the larvae. The dinoflagellate-like endoparasites were located in the yolksac of the cod larvae. PMID:8147291

Buchmann, K; Larsen, J L; Dalsgaard, I

1993-01-01

346

Mechanisms of Injury and Countermeasures for EVA Associated Upper Extremity Medical Issues: Extended Vent Tube Study  

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The goal of this study is to determine the role that moisture plays in the injury to the fingers and fingernails during EVA training operations in the Neutral Buoyancy Laboratory. Current Extravehicular Mobility Unit (EMU, with a PLSS) as configured in the NBL was used for all testing and a vent tube was extended down a single arm of the crewmember during the test; vent tube was moved between left and right arm to serve as experimental condition being investigated and the other arm served as control condition.

Jones, Jeff; Hoffman, Ron; Harvey, Craig; Bowen, C. K.; Hudy, C. E.; Tuxhorn, Jennifer; Gernhardt, Mike; Scheuring, Richard A.

2007-01-01

347

Improved hospital-level risk adjustment for surveillance of healthcare-associated bloodstream infections: a retrospective cohort study  

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Full Text Available Abstract Background To allow direct comparison of bloodstream infection (BSI rates between hospitals for performance measurement, observed rates need to be risk adjusted according to the types of patients cared for by the hospital. However, attribute data on all individual patients are often unavailable and hospital-level risk adjustment needs to be done using indirect indicator variables of patient case mix, such as hospital level. We aimed to identify medical services associated with high or low BSI rates, and to evaluate the services provided by the hospital as indicators that can be used for more objective hospital-level risk adjustment. Methods From February 2001-December 2007, 1719 monthly BSI counts were available from 18 hospitals in Queensland, Australia. BSI outcomes were stratified into four groups: overall BSI (OBSI, Staphylococcus aureus BSI (STAPH, intravascular device-related S. aureus BSI (IVD-STAPH and methicillin-resistant S. aureus BSI (MRSA. Twelve services were considered as candidate risk-adjustment variables. For OBSI, STAPH and IVD-STAPH, we developed generalized estimating equation Poisson regression models that accounted for autocorrelation in longitudinal counts. Due to a lack of autocorrelation, a standard logistic regression model was specified for MRSA. Results Four risk services were identified for OBSI: AIDS (IRR 2.14, 95% CI 1.20 to 3.82, infectious diseases (IRR 2.72, 95% CI 1.97 to 3.76, oncology (IRR 1.60, 95% CI 1.29 to 1.98 and bone marrow transplants (IRR 1.52, 95% CI 1.14 to 2.03. Four protective services were also found. A similar but smaller group of risk and protective services were found for the other outcomes. Acceptable agreement between observed and fitted values was found for the OBSI and STAPH models but not for the IVD-STAPH and MRSA models. However, the IVD-STAPH and MRSA models successfully discriminated between hospitals with higher and lower BSI rates. Conclusion The high model goodness-of-fit and the higher frequency of OBSI and STAPH outcomes indicated that hospital-specific risk adjustment based on medical services provided would be useful for these outcomes in Queensland. The low frequency of IVD-STAPH and MRSA outcomes indicated that development of a hospital-level risk score was a more valid method of risk adjustment for these outcomes.

Jones MA

2009-09-01

348

Wallops Ship Surveillance System  

Science.gov (United States)

Approved as a Wallops control center backup system, the Wallops Ship Surveillance Software is a day-of-launch risk analysis tool for spaceport activities. The system calculates impact probabilities and displays ship locations relative to boundary lines. It enables rapid analysis of possible flight paths to preclude the need to cancel launches and allow execution of launches in a timely manner. Its design is based on low-cost, large-customer- base elements including personal computers, the Windows operating system, C/C++ object-oriented software, and network interfaces. In conformance with the NASA software safety standard, the system is designed to ensure that it does not falsely report a safe-for-launch condition. To improve the current ship surveillance method, the system is designed to prevent delay of launch under a safe-for-launch condition. A single workstation is designated the controller of the official ship information and the official risk analysis. Copies of this information are shared with other networked workstations. The program design is divided into five subsystems areas: 1. Communication Link -- threads that control the networking of workstations; 2. Contact List -- a thread that controls a list of protected item (ocean vessel) information; 3. Hazard List -- threads that control a list of hazardous item (debris) information and associated risk calculation information; 4. Display -- threads that control operator inputs and screen display outputs; and 5. Archive -- a thread that controls archive file read and write access. Currently, most of the hazard list thread and parts of other threads are being reused as part of a new ship surveillance system, under the SureTrak project.

Smith, Donna C.

2011-01-01

349

Secondary Surveillance Radar Antenna  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This paper deals with a secondary surveillance radar (SSR) array antenna, which is intended for a system combining the secondary surveillance radar antenna and the primary surveillance radar antenna. It describes the patch array elements and the synthesis for the secondary surveillance radar array, considering both elevation and azimuth patterns for sum, difference, and sidelobe-suppression beams, and suspended stripline couplers. The utilization of multilayer techniques allows the connection...

Schejbal, Vladimi?r; Bezous?ek, Pavel; Pidanic?, Jan; Chyba, Milan

2013-01-01

350

Ophthalmoplegia associated with transorbital penetrating brainstem injury by broken fishing pole  

Directory of Open Access Journals (Sweden)

Full Text Available Aki Kaneko-Ohtaki, Shigeki Machida, Takeshi Sugawara, Daijiro KurosakaDepartment of Ophthalmology, Iwate Medical University School of Medicine, Iwate, JapanAbstract: We report our findings in a case of ophthalmoplegia caused by a transorbital penetrating brainstem injury. An 8-year-old boy was accidentally injured by a broken fishing fiberglass pole which penetrated through the right orbit and entered the brainstem. Magnetic resonance imaging showed a linear wound that entered and passed through the pons obliquely and reached the fourth cerebral ventricle and cerebellar vermis. He had a left-sided hemiplegia and left facial nerve palsy and was diagnosed with “one-and-a-half syndrome”. His hemiplegia and left facial nerve palsy resolved in 2 weeks leaving only a left abducens nerve palsy. The eye position and eye movements fully recovered within 3 months. These findings suggest a good prognosis for this type of trauma unless life-threatening changes develop.Keywords: penetrating orbitocranial trauma, trauma, penetrating orbitocranial injury

Kaneko-Ohtaki A

2011-07-01

351

Containment and surveillance devices  

International Nuclear Information System (INIS)

The growing acceptance of containment and surveillance as a means to increase safeguards effectiveness has provided impetus to the development of improved surveillance and containment devices. Five recently developed devices are described. The devices include one photographic and two television surveillance systems and two high security seals that can be verified while installed

352

Global gene expression analysis of rodent motor neurons following spinal cord injury associates molecular mechanisms with development of post-injury spasticity  

DEFF Research Database (Denmark)

Spinal cord injury leads to severe problems involving impaired motor, sensory and autonomic functions. After spinal injury there is an initial phase of hypo-reflexia followed by hyper-reflexia, often referred to as spasticity. Previous studies have suggested a relationship between the reappearance of endogenous plateau potentials in motor neurons and the development of spasticity after spinalization. To unravel the molecular mechanisms underlying the increased excitability of motor neurons and the return of plateau potentials below a spinal cord injury we investigated changes in gene expression in this cell population. We adopted a rat tail-spasticity model with a caudal spinal transection that causes a progressive development of spasticity from its onset after two to three weeks until two months post injury. Gene expression changes of fluorescently identified tail motor neurons were studied 21 and 60 days post injury. The motor neurons undergo substantial transcriptional regulation in response to injury. Thepatterns of differential expression show similarities at both time points, though there are 20 % more differentially expressed genes 60 days compared to 21 days post injury. The study identifies targets of regulation relating to both ion channels and receptors implicated in the endogenous expression of plateaux. The regulation of excitatory and inhibitory signal transduction indicates a shift in the balance towards increased excitability, where the glutamatergic NMDA receptor complex together with cholinergic system is up-regulated and the GABAA receptor system is down-regulated. The genes of the pore-forming proteins Cav1.3 and Nav1.6 were not up-regulated, while genes of proteins such as non-pore forming subunits and intracellular pathways known to modulate receptor and channel trafficking, kinetics and conductivity showed marked regulation. On the basis of the identified changes in global gene expression in motor neurons, the present investigation opens up for new potential targets for treatment of motor dysfunction following spinal cord injury.

Wienecke, Jacob; Westerdahl, Ann-Charlotte

2010-01-01

353

Associations between isolated bundle tear of anterior cruciate ligament, time from injury to surgery, and clinical tests.  

Science.gov (United States)

PURPOSE. To evaluate the associations between isolated anteromedial (AM) or posterolateral (PL) bundle tear of the anterior cruciate ligament (ACL), the time from injury to surgery, and various clinical tests. METHODS. 36 women and 189 men aged 16 to 52 (mean, 26.4) years underwent ACL reconstruction of the right (n=107) and left (n=118) knees. Patients were evaluated for the International Knee Documentation Committee Subjective Knee Score, Cincinnati Knee Rating System Score, anterior drawer test, Lachman test, pivot shift test, KT1000 arthrometer measurement, isokinetic muscle tests of the extensors, and functional tests (single leg hop and timed hop test). Examination under anaesthesia (EUA) was also performed, followed by diagnostic arthroscopy. The integrity of the ACL bundles was tested using a probe. The AM and PL bundles were morphologically intact if structurally present, and functionally intact if not lax on probing. RESULTS. Of the 225 patients, 8 had isolated AM bundle tears, 2 had isolated PL bundle tears, and 215 had complete ACL tears in terms of function. The corresponding numbers were 30, 13, and 182 in terms of morphology. Compared with patients with complete ACL tear, the mean time from injury to surgery was significantly shorter in patients with isolated AM or PL bundle tear in terms of function (17.5 vs. 5.6 months, p<0.001) and morphology (17.5 vs. 8.8 months, p<0.001). Compared with patients with complete ACL tear, those with a functionally intact PL bundle had a higher rate of negative pivot shift test in preoperative evaluation (1% vs. 17%, p=0.002) and EUA (1% vs. 63%, p<0.001), and had a higher rate of negative Lachman test in EUA (1% vs. 25%, p=0.02). CONCLUSION. The time from injury to surgery was shorter in patients with isolated bundle ACL tear. In patients with ACL deficiency, the pivot shift test was useful in detecting an intact PL bundle. PMID:25163957

Fok, A Wm; Yau, W P

2014-08-01

354

Preventable maternal mortality: Geographic/rural-urban differences and associated factors from the population-based maternal mortality surveillance system in China  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Most maternal deaths in developing countries can be prevented. China is among the 13 countries with the most maternal deaths; however, there has been a marked decrease in the maternal mortality ratio (MMR over the last 3 decades. China's reduction in the MMR has contributed significantly to the global decline of the MMR. This study examined the geographic and rural-urban differences, time trends and related factors in preventable maternal deaths in China during 1996-2005, with the aim of providing reliable evidence for effective interventions. Methods Data were retrieved from the population-based maternal mortality surveillance system in China. Each death was reviewed by three committees to determine whether it was avoidable. The preventable maternal mortality ratio (PMMR, the ratios of PMMR (risk ratio, RR and 95% confidence intervals (CI were used to analyze regional disparities (coastal, inland and remote regions and rural-urban variations. Time trends in the MMR, along with underlying causes and associated factors of death, were also analysed. Results Overall, 86.1% of maternal mortality was preventable. The RR of preventable maternal mortality adjusted by region was 2.79 (95% CI 2.42-3.21 and 2.38 (95% CI: 2.01-2.81 in rural areas compared to urban areas during the 1996-2000 and 2001-2005 periods, respectively. Meanwhile, the RR was the highest in remote areas, which was 4.80(95%CI: 4.10-5.61 and 4.74(95%CI: 3.86-5.83 times as much as that of coastal areas. Obstetric haemorrhage accounted for over 50% of preventable deaths during the 2001-2005 period. Insufficient information about pregnancy among women in remote areas and out-of-date knowledge and skills of health professionals and substandard obstetric services in coastal regions were the factors frequently associated with MMR. Conclusions Preventable maternal mortality and the distribution of its associated factors in China revealed obvious regional differences. The PMMR was higher in underdeveloped regions. In future interventions in remote and inland areas, more emphasis should be placed on improving women's ability to utilize healthcare services, enhancing the service capability of health institutions, and increasing the accessibility of obstetric services. These approaches will effectively lower PMMR in those regions and narrow the gap among the different regions.

Zhou Rong

2011-04-01

355

Hospitalisations at the end of life: using a sentinel surveillance network to study hospital use and associated patient, disease and healthcare factors  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Hospital deaths following several hospital admissions or long hospital stays may be indicative of a low quality of dying. Although place of death has been extensively investigated at population level, hospital use in the last months of life and its determinants have been studied less often, especially in Europe and with a general end-of-life patient population. In this study we aim to describe hospital use in the last three months of life in Belgium and identify associated patient, disease and healthcare factors. Methods We conducted a retrospective registration study (13 weeks in 2004 with the Belgian Sentinel Network of General Practitioners, an epidemiological surveillance system representative of all GPs in Belgium, covering 1.75% of the total Belgian patient population. All registered non-sudden or expected deaths of patients (aged one year or older at the GPs' practices were included. Bivariate and regression analyses were performed. Results The response rate was 87%. The GPs registered 319 deaths that met inclusion criteria. Sixty percent had been hospitalised at least once in the last three months of life, for a median of 19 days. The percentage of patients hospitalised increased exponentially in the last weeks before death; one fifth was admitted in the final week of life. Seventy-two percent of patients hospitalised at least once in the final three months died in hospital. A palliative treatment goal, death from cardiovascular diseases, the expression of a wish to die in an elderly home and palliative care delivery by the GP were associated with lower hospitalisation odds. Conclusion Hospital care plays a large role in the end of patients' lives in Belgium, especially in the final weeks of life. The result is a high rate of hospital deaths, showing the institutionalised nature of dying. Patients' clinical conditions, the expression of preferences and also healthcare characteristics such as being treated as a palliative care patient, seem to be associated with hospital transfers. It is recommended that hospitalisation decisions are only made after careful consideration. Short admissions in the final days of life should be prevented in order to make dying at home more feasible.

Bilsen Johan

2007-05-01

356

Tank Farm Operations Surveillance Automation Analysis  

International Nuclear Information System (INIS)

The Nuclear Operations Project Services identified the need to improve manual tank farm surveillance data collection, review, distribution and storage practices often referred to as Operator Rounds. This document provides the analysis in terms of feasibility to improve the manual data collection methods by using handheld computer units, barcode technology, a database for storage and acquisitions, associated software, and operational procedures to increase the efficiency of Operator Rounds associated with surveillance activities

357

Sensors for Desert Surveillance  

Directory of Open Access Journals (Sweden)

Full Text Available Various types of sensors–visible, passive night vision, infrared, synthetic aperture radar, etc can be used for desert surveillance. The surveillance capability of these sensors depends to a large extent, on various atmospheric effects, viz., absorption, scattering, aerosol, turbulence, and optical mirage. In this paper, effects of various atmospheric phenomena on the transmission of signals, merits and demerits of different means of surveillance under desert environmental conditions are discussed. Advanced surveillance techniques, ie, multisensor fusion, multi and hyperspectral imaging, having special significance for desert surveillance, have also been discussed.

B.S. Chauhan

2005-10-01

358

Analysis of firetruck crashes and associated firefighter injuries in the United States.  

Science.gov (United States)

Motor vehicle crashes are the second leading cause of death for on-duty firefighters. Firetruck crashes, occurring at a rate of approximately 30,000 crashes per year, have potentially dire consequences for the vehicle occupants and for the community if the firetruck was traveling to provide emergency services. Data from the United States Fire Administration and the National Highway Traffic Safety Administration shows that firefighters neglect to buckle their seatbelts while traveling in a fire apparatus, thus putting themselves at a high risk for injuries if the truck crashes, especially in rollover crashes. Despite national regulations and departmental guidelines aiming to improve safety on fire apparatuses, belt use among firefighters remains dangerously low. The results from this study indicate that further steps need to be taken to improve belt use. One promising solution would be to redesign firetruck seatbelts to improve the ease of buckling and to accommodate wider variations in firefighter sizes. PMID:23169118

Donoughe, Kelly; Whitestone, Jennifer; Gabler, Hampton C

2012-01-01

359

Sevelamer crystals in the gastrointestinal tract (GIT): a new entity associated with mucosal injury.  

Science.gov (United States)

We report the first description of sevelamer crystals (Renagel and Renvela, Genzyme; phosphate-lowering agents) in the gastrointestinal tract. We prospectively collected cases with novel, histologically identical crystals from 4 major academic centers over a 1-year period and studied pertinent clinicopathologic features. Sevelamer usage in the setting of chronic kidney disease was demonstrated in all cases (n=15 total cases, 7 patients). Sites of involvement included the esophagus (n=2), small bowel (n=2), and colon (n=11). The background mucosa was normal in only 1 case. Notable mucosal abnormality included chronic mucosal damage (n=5), acute inflammation (n=4), inflammatory polyp (n=2), extensive ulceration (n=2), ischemia (n=1), and necrosis (n=1). In general, sevelamer crystals displayed broad, curved, and irregularly spaced "fish scales" with a variably eosinophilic to rusty brown color on hematoxylin and eosin (H&E) staining and violet color on periodic acid-Schiff-alcian special staining with diastase (PAS/D). To validate these findings, sevelamer tablets (Renvela) were crushed and submitted for histologic processing; the findings were identical to those in the patient specimens. The possibility of Kayexalate (sodium polystyrene sulfonate) and cholestyramine had been raised in error. However, Kayexalate has narrow, rectangular "fish scales" and is violet on H&E and magenta on PAS/D; cholestyramine lacks internal "fish scales," is bright orange on H&E, variably gray or hot pink on PAS/D, and is unassociated with mucosal injury. Further study is required to determine whether sevelamer plays a causal role in these injuries; however, its crystal is an important mimic of both Kayexalate and choleystyramine. As the history of sevelamer administration was not documented in any pathology requisition, awareness of sevelamer's characteristic morphology is crucial to avoid the diagnostic pitfalls of its mimics. PMID:24061514

Swanson, Benjamin J; Limketkai, Berkeley N; Liu, Ta-Chiang; Montgomery, Elizabeth; Nazari, Kamran; Park, Jason Y; Santangelo, William C; Torbenson, Michael S; Voltaggio, Lysandra; Yearsley, Martha M; Arnold, Christina A

2013-11-01

360