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NATIONAL ELECTRONIC INJURY SURVEILLANCE SYSTEM (NEISS)  

Science.gov (United States)

The National Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention (CDC) is collaborating with the U.S. Consumer Product Safety Commission (CPSC) to expand the National Electronic Injury Surveillance System (NEISS) to collect data on all typ...

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The development of an evaluation framework for injury surveillance systems  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Access to good quality information from injury surveillance is essential to develop and monitor injury prevention activities. To determine if information obtained from surveillance is of high quality, the limitations and strengths of a surveillance system are often examined. Guidelines have been developed to assist in evaluating certain types of surveillance systems. However, to date, no standard guidelines have been developed to specifically evaluate an injury surveillance system. The aim of this research is to develop a framework to guide the evaluation of injury surveillance systems. Methods The development of an Evaluation Framework for Injury Surveillance Systems (EFISS involved a four stage process. First, a literature review was conducted to identify an initial set of characteristics that were recognised as important and/or had been recommended to be assessed in an evaluation of a surveillance system. Second, this set of characteristics was assessed using SMART criteria. Third, those surviving were presented to an expert panel using a two round modified-Delphi study to gain an alternative perspective on characteristic definitions, practicality of assessment, and characteristic importance. Finally, a rating system was created for the EFISS characteristics. Results The resulting EFISS consisted of 18 characteristics that assess three areas of an injury surveillance system – five characteristics assess data quality, nine characteristics assess the system's operation, and four characteristics assess the practical capability of an injury surveillance system. A rating system assesses the performance of each characteristic. Conclusion The development of the EFISS builds upon existing evaluation guidelines for surveillance systems and provides a framework tailored to evaluate an injury surveillance system. Ultimately, information obtained through an evaluation of an injury data collection using the EFISS would be useful for agencies to recommend how a collection could be improved to increase its usefulness for injury surveillance and in the long-term injury prevention.

Williamson Ann M

2009-07-01

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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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2006 Savannah River 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

2008-08-20

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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

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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

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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

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2007 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

2008-07-31

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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 Savannah River 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

2011-09-12

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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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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 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

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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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2010 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

2011-06-29

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Injury prevention program in primary care: process evaluation and surveillance.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

OBJECTIVES: To carry out process evaluation and surveillance in a community oriented primary care program for injury prevention among children 0-2 years old (n = 306). SETTING: Mother and child health clinic in a defined area of Western Jerusalem. METHODS: An injury prevention program was integrated into the routines of the mother and child health clinic. The program consisted of injury surveillance and counselling using a developmental approach, regarding car safety and the prevention of fal...

Gofin, R.; Leon, D.; Knishkowy, B.; Palti, H.

1995-01-01

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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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2007 Savannah River 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

2009-05-05

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Development and use of a population based injury surveillance system: the All Wales Injury Surveillance System (AWISS)  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This report details the development and use of a population based emergency room surveillance system in the UK. Despite some difficulties in accessing high quality data the system has stimulated a considerable number of research and intervention projects. While surveillance systems with high quality data collection and coding parameters remain the gold standard, imperfect systems, particularly if population based, can play a substantial part in stimulating injury prevention initiatives.

Lyons, R.; Jones, S.; Kemp, A.; Sibert, J.; Shepherd, J.; Richmond, P.; Bartlett, C.; Palmer, S.

2002-01-01

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Using mortuary statistics in the development of an injury surveillance system in Ghana  

Directory of Open Access Journals (Sweden)

Full Text Available 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 prospectively 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.

London Jason

2002-01-01

 
 
 
 
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Fatal work-related farm injuries in Canada, 1991-1995. Canadian Agricultural Injury Surveillance Program  

Digital Repository Infrastructure Vision for European Research (DRIVER)

BACKGROUND: Studies from other developed countries have shown that agriculture is among the most dangerous occupational sectors in terms of work-related deaths. The authors describe the occurrence of fatal work-related farm injuries in Canada and compare these rates with those in other Canadian industries. METHODS: The authors present a descriptive, epidemiological analysis of data from the recently established Canadian Agricultural Injury Surveillance Program. The study population comprised ...

Pickett, W.; Hartling, L.; Brison, R. J.; Guernsey, J. R.

1999-01-01

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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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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

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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

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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

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Work-related injury surveillance in Vietnam: a national reporting system model.  

Science.gov (United States)

Developing nations bear a substantial portion of the global burden of injury. Public health surveillance models in developing countries should recognize injury risks for all levels of society and all causes and should incorporate various groups of workers and industries, including subsistence agriculture. However, many developing nations do not have an injury registration system; current data collection methods result in gross national undercounts of injuries, failing to distinguish injuries that occur during work. In 2006, we established an active surveillance system in Vietnam's Xuan Tien commune and investigated potential methods for surveillance of work-related injuries. On the basis of our findings, we recommend a national model for work-related injury surveillance in Vietnam that builds on the existing health surveillance system. PMID:24028255

Marucci-Wellman, Helen; Wegman, David H; Leamon, Tom B; Binh, Ta Thi Tuyet; Diep, Nguyen Bich; Kriebel, David

2013-11-01

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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 ...

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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

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2010 East Tennessee Technology Park 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

30

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

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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

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2010 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

2011-08-31

33

2010 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

2011-08-16

34

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

35

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

36

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

37

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

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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

39

2003 East Tennessee Technology Park Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

Annual Illness and Injury Surveillance Program report for 2003 for the East Tennessee Technology Park (K-25).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

40

Insurance claims data: a possible solution for a national sports injury surveillance system? An evaluation of data information against ASIDD and consensus statements on sports injury surveillance  

Science.gov (United States)

Background Before preventive actions can be suggested for sports injuries at the national level, a solid surveillance system is required in order to study their epidemiology, risk factors and mechanisms. There are guidelines for sports injury data collection and classifications in the literature for that purpose. In Sweden, 90% of all athletes (57/70 sports federations) are insured with the same insurance company and data from their database could be a foundation for studies on acute sports injuries at the national level. Objective To evaluate the usefulness of sports injury insurance claims data in sports injury surveillance at the national level. Method A database with 27?947 injuries was exported to an Excel file. Access to the corresponding text files was also obtained. Data were reviewed on available information, missing information and dropouts. Comparison with ASIDD (Australian Sports Injury Data Dictionary) and existing consensus statements in the literature (football (soccer), rugby union, tennis, cricket and thoroughbred horse racing) was performed in a structured manner. Result Comparison with ASIDD showed that 93% of the suggested data items were present in the database to at least some extent. Compliance with the consensus statements was generally high (13/18). Almost all claims (83%) contained text information concerning the injury. Conclusions Relatively high-quality sports injury data can be obtained from a specific insurance company at the national level in Sweden. The database has the potential to be a solid base for research on acute sports injuries in different sports at the national level.

Aman, Malin; Forssblad, Magnus; Henriksson-Larsen, Karin

2014-01-01

 
 
 
 
41

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

42

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

43

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

44

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

45

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

46

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

47

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

48

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

49

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

50

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

51

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

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

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

54

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

55

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

56

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

57

Occupational injury surveillance: A study in a metal smelting industry.  

Science.gov (United States)

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. PMID:21957374

Saha, Asim; Kumar, Sunil; Vasudevan, D M

2007-09-01

58

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

59

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

60

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

 
 
 
 
61

Injuries associated with housing conditions in Europe: a burden of disease study based on 2004 injury data  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The authors recently undertook a study for the World Health Organization estimating the European burden of injuries that can be attributed to remediable structural hazards in the home. Such estimates are essential for motivating injury prevention efforts as they quantify potential health gains, in terms of injuries prevented, via specific environmental interventions. Methods We combined exposure estimates from existing surveys and scenarios with estimates of the exposure-risk relationship obtained from a structured review of the literature on injury in the home and housing conditions. The resulting attributable fractions were applied to burden of injury data for the WHO European Region. Results This analysis estimated that two specific hazards, lack of window guards at second level and higher, and lack of domestic smoke detectors resulted in an estimated 7,500 deaths and 200,000 disability adjusted life years (DALYs per year. In estimating the environmental burden of injury associated with housing, important deficiencies in injury surveillance data and related limitations in studies of injury risk attributable to the home environment were apparent. The ability to attribute proportions of the home injury burden to features of the home were correspondingly limited, leading to probable severe underestimates of the burden. Conclusions The burden of injury from modifiable home injury exposures is substantial. Estimating this burden in a comprehensive and accurate manner requires improvements to the scope of injury surveillance data and the evidence base regarding the effectiveness of interventions.

Keall Michael D

2011-11-01

62

Trauma Center-Based Surveillance of Nontraffic Pedestrian Injury among California Children  

Science.gov (United States)

Introduction Every year in the United States, thousands of young children are injured by passenger vehicles in driveways or parking areas. Little is known about risk factors, and incidence rates are difficult to estimate because ascertainment using police collision reports or media sources is incomplete. This study used surveillance at trauma centers to identify incidents and parent interviews to obtain detailed information on incidents, vehicles, and children. Methods Eight California trauma centers conducted surveillance of nontraffic pedestrian collision injury to children aged 14 years or younger from January 2005 to July 2007. Three of these centers conducted follow-up interviews with family members. Results Ninety-four injured children were identified. Nine children (10%) suffered fatal injury. Seventy children (74%) were 4 years old or younger. Family members of 21 victims from this study (23%) completed an interview. Of these 21 interviewed victims, 17 (81%) were male and 13 (62%) were 1 or 2 years old. In 13 cases (62%), the child was backed over, and the driver was the mother or father in 11 cases (52%). Fifteen cases (71%) involved a sport utility vehicle, pickup truck, or van. Most collisions occurred in a residential driveway. Conclusion Trauma center surveillance can be used for case ascertainment and for collecting information on circumstances of nontraffic pedestrian injuries. Adoption of a specific external cause-of-injury code would allow passive surveillance of these injuries. Research is needed to understand the contributions of family, vehicular, and environmental characteristics and injury risk to inform prevention efforts.

Rice, Thomas M.; Trent, Roger B.; Bernacki, Kate; Rice, Jennifer K.; Lovette, Bonnie; Hoover, Eileen; Fennell, Janette; Aistrich, Anna Zacher; Wiltsek, Dana; Corman, Ellen; Anderson, Craig L.; Sherck, John

2012-01-01

63

Comparing pediatric intentional injury surveillance data with data from publicly available sources: consequences for a public health response to violence  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objective—A hospital based intentional injury surveillance system for youth (aged 3–18) was compared with other publicly available sources of information on youth violence. The comparison addressed whether locally conducted surveillance provides data that are sufficiently more complete, detailed, and timely that clinicians and public health practitioners interested in youth violence prevention would find surveillance worth conducting.

Stone, D.; Kharasch, S.; Perron, C.; Wilson, K.; Jacklin, B.; Sege, R.

1999-01-01

64

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 exam...

Auer Anna M; Dobmeier Teresa M; Ja, Haglund Bo; Tillgren Per

2011-01-01

65

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...

2007-01-01

66

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

67

A profile of Injury in Fiji: findings from a population-based injury surveillance system (TRIP-10  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Over 90% of injury deaths occur in low-and middle-income countries. However, the epidemiological profile of injuries in Pacific Islands has received little attention. We used a population-based-trauma registry to investigate the characteristics of all injuries in Viti Levu, Fiji. Method The Fiji Injury Surveillance in Hospitals (FISH database prospectively collected data on all injury-related deaths and primary admissions to hospital (?12 hours stay in Viti Levu during 12 months commencing October 2005. Results The 2167 injury-related deaths and hospitalisations corresponded to an annual incidence rate of 333 per 100,000, with males accounting for twice as many cases as females. Almost 80% of injuries involved people aged less than 45 years, and 74% were deemed unintentional. There were 244 fatalities (71% died before admission and 1994 hospitalisations corresponding to crude annual rates of 37.5 per 100,000 and 306 per 100,000 respectively. The leading cause of fatal injury was road traffic injury (29% and the equivalent for injury admissions was falls (30%. The commonest type of injury resulting in death and admission to hospital was asphyxia and fractures respectively. Alcohol use was documented as a contributing factor in 13% of deaths and 12% of admissions. In general, indigenous Fijians had higher rates of injury admission, especially for interpersonal violence, while those of Indian ethnicity had higher rates of fatality, especially from suicide. Conclusions Injury is an important public health problem that disproportionately affects young males in Fiji, with a high proportion of deaths prior to hospital presentation. This study highlights key areas requiring priority attention to reduce the burden of potentially life-threatening injuries in Fiji.

Wainiqolo Iris

2012-12-01

68

Trauma Center-Based Surveillance of Nontraffic Pedestrian Injury among California Children  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: Every year in the United States, thousands of young children are injured by passengervehicles in driveways or parking areas. Little is known about risk factors, and incidence rates aredifficult to estimate because ascertainment using police collision reports or media sources isincomplete. This study used surveillance at trauma centers to identify incidents and parent interviewsto obtain detailed information on incidents, vehicles, and children.Methods: Eight California trauma centers conducted surveillance of nontraffic pedestrian collisioninjury to children aged 14 years or younger from January 2005 to July 2007. Three of these centersconducted follow-up interviews with family members.Results: Ninety-four injured children were identified. Nine children (10% suffered fatal injury. Seventychildren (74% were 4 years old or younger. Family members of 21 victims from this study (23%completed an interview. Of these 21 interviewed victims, 17 (81% were male and 13 (62% were 1 or 2years old. In 13 cases (62%, the child was backed over, and the driver was the mother or father in 11cases (52%. Fifteen cases (71% involved a sport utility vehicle, pickup truck, or van. Most collisionsoccurred in a residential driveway.Conclusion: Trauma center surveillance can be used for case ascertainment and for collectinginformation on circumstances of nontraffic pedestrian injuries. Adoption of a specific external cause-ofinjurycode would allow passive surveillance of these injuries. Research is needed to understand thecontributions of family, vehicular, and environmental characteristics and injury risk to inform preventionefforts.

John Sherck, MD

2012-05-01

69

Surveillance for colitis-associated colon neoplasia  

Directory of Open Access Journals (Sweden)

Full Text Available The risk of developing colon cancer is increased in colitis patients, particularly if the disease is extensive and its duration long-standing. Endoscopic guidelines have been developed with the goal of detecting early neoplastic changes prior to development of advanced malignancy. Unfortunately, the natural history of this superimposed neoplastic process in colitis appears to be very heterogeneous and poorly understood. Moreover, there are numerous confounding variables in colitis patients that limit accurate assessment of the surveillance effectiveness of colonoscopy and multi-site biopsy protocols. Although the clinical challenge posed to even the most experienced clinicians remains significant, evolving methods of endoscopic imaging may facilitate better evaluation of this highly select group of patients.

Hugh James Freeman

2010-10-01

70

Implementing a hospital based injury surveillance system in Africa: lessons learned.  

Science.gov (United States)

A multinational injury surveillance pilot project was carried out in five African countries in the first half of 2007 (Democratic Republic of the Congo, Kenya, Nigeria, Uganda and Zambia). Hospitals were selected in each country and a uniform methodology was applied in all sites, including an injury surveillance questionnaire designed by a joint programme of the Pan American Health Organization and the United States Centres for Disease Control and Prevention. A total of 4207 injury cases were registered in all hospitals. More than half of all injury cases were due to road traffic accidents (58.3%) and 40% were due to interpersonal violence. Self-inflicted injuries were minimal (1.2% of all cases). This report provides an assessment of the implementation of the project and a preliminary comparison between the five African countries on the context in which inter-personal injury cases occurred. Strengths and weaknesses of the project as well as opportunities and threats identified by medical personnel are summarized and discussed. A call is made to transform this pilot project into a sustainable public health strategy. PMID:19065866

Zavalaa, Diego E; Bokongo, Simon; John, I A; Senoga, Ismail Mpanga; Mtonga, Robert E; Mohammed, A Z; Anjango, Walter Odhiambo; Olupot-Olupot, Peter

2008-01-01

71

Development of an occupational illness and injury surveillance database for the electric energy sector.  

Science.gov (United States)

Currently available occupational injury and illness data for electric energy companies provide only overall summary rates. Specific information about types of injury or illnesses, rates by occupational or work environments, and injury costs and severity are generally not readily available. Relevant data such as personnel and claims information are frequently not integrated into a comprehensive health and safety surveillance system suitable for epidemiologic and health and safety research purposes. Epidemiological methods are valuable for identifying key risk factors for work-related injuries and illnesses and assessing their magnitude, as well establishing priorities for health and safety research. Application of such methods can result in long-term reductions in injury and illness rates and their attendant costs. Aggregation of relevant health and safety data across companies improves statistical power for the assessment of rare (yet costly) injuries or illness or specific at-risk subgroups within the electric energy sector. A pilot occupational injury and illness database has been developed that can incorporate and standardize data across a spectrum of companies of differing sizes and configurations. In illustrative data analyses, injury trends were summarized by company size, occupation, and demographic factors, among others. Trends observed in these illustrative analyses were consistent with results previously reported in the epidemiological literature, however, results are considered preliminary pending development of the full database. This study shows that development of a standardized surveillance occupational injury and illness database across companies with different database configurations is feasible. This database will ultimately provide a stable and accurate occupational health and safety assessment tool not currently available for this sector. PMID:11217725

Yager, J W; Kelsh, M A; Zhao, K; Mrad, R

2001-02-01

72

Neonatal brain injury : associated risk factors  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Our research focused on factors which may affect the vulnerability for the development of hypoxic-ischemic (HI) brain injury in preterm and full-term infants. The aim was to improve our understanding of underlying mechanisms of injuries. We investigated factors concerning placental, clinical, and biochemical factors, and genetic susceptibility. In this thesis we have studied risk factors associated with neonatal brain injury in preterm and full-term infants. These risk factors include clin...

Harteman, J. C.

2013-01-01

73

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

74

Discovery of predictive models in an injury surveillance database: an application of data mining in clinical research.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A new, evolutionary computation-based approach to discovering prediction models in surveillance data was developed and evaluated. This approach was operationalized in EpiCS, a type of learning classifier system specially adapted to model clinical data. In applying EpiCS to a large, prospective injury surveillance database, EpiCS was found to create accurate predictive models quickly that were highly robust, being able to classify > 99% of cases early during training. After training, EpiCS cla...

2000-01-01

75

Injuries associated with cycle rickshaws accidents  

Science.gov (United States)

Context: Cycle rickshaw is an important means of transportation in Urban India. Pedestrians, rickshaw users, rickshaw pullers, two wheeled vehicle users and cyclists are among the most vulnerable road user groups in terms of injuries and fatalities resulting from road traffic accidents in India. Our objectives were to study characteristics of crashes and nature of injuries associated with cycle rickshaw. Patients and Methods: Between August 2008 to July 2009, a hospital based observational study was done of patients who presented to King George medical college trauma center with injury sustained due to cycle rickshaw in emergency department. Age, time of trauma, mode of trauma, contributing factors and type of injury were recorded. Results: The mean age of the patient was 32.1. Seventeen patients were rickshaw pullers and the rest were occupants of the rickshaw. Overloading with more than two passengers was found in 24 cases (28.5%). Most common cause of injury was collision with a moving vehicle (56 patients, %) followed by fall from rickshaw. The most common contributing factor was the overloading of rickshaw. On arrival to the hospital, the mean Injury severity score (ISS) was 3.5 ± 2.2 and the mean Glasgow coma scale (GCS) was 13.4 ± 4.3. Nine patients were admitted to ICU (Intensive care unit). The median ICU stay was 4 (1-24 days). Six of the ICU admitted patients had head injury. Conclusion: Rickshaw pullers and occupants are vulnerable to road traffic accidents. Urgent preventive measures targeted towards this group are needed to reduce the morbidity and mortality resulting from injuries involving rickshaws. The need for improved understanding of the risk characteristics of cycle rickshaw is emphasized.

Meena, Sanjay; Barwar, Nilesh; Rastogi, Devarshi; Sharma, Vineet

2014-01-01

76

Implementing a hospital based injury surveillance system in Zambia: a preliminary report.  

Science.gov (United States)

The University Teaching Hospital in Lusaka, Zambia, is the nation's premier tertiary referral hospital and a teaching centre for the University of Zambia as well as a research centre of excellence. It was one of the five sites chosen as part of a multinational injury surveillance project conceived to provide preliminary data in response to observations made by public health agencies such as the World Health Organization, and the United States Centres for Disease Control and Prevention (CDC) on the paucity of such data from third world settings. The study covering a period of 6 months from January 2007 to June 2007, used a pre-tested survey instrument crafted by the Ponce School of Medicine in Puerto Rico in close consultation with the CDC and the Pan-American Health Organization (PAHO). A 24-hour system collected a total of 2714 cases, with due care taken to ensure that all the parameters were entered as required. PMID:19065868

Mtonga, Robert E; Zavala, Diego E

2008-01-01

77

Advancing the science of ventilator-associated pneumonia surveillance  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The landmark Study on the Efficacy of Nosocomial Infection Control definitively demonstrated that infection surveillance and control programs prevent hospital-acquired infections. The rise of public reporting, benchmarking, and pay for performance movements, however, has considerably changed the infection surveillance landscape in the 27 years since this study was published. Clinically nuanced surveillance definitions that served the profession well for many years have fallen into disfavor be...

Klompas, Michael

2012-01-01

78

Dental injuries in association with facial fractures  

Digital Repository Infrastructure Vision for European Research (DRIVER)

PURPOSE: The aim of the study was to investigate the association between dental injuries and facial fractures. MATERIALS AND METHODS: We performed a prospective study of 273 patients examined at a level 1 trauma center in Switzerland from September 2005 until August 2006 who had facial fractures. Medical history and clinical and radiologic examination findings were recorded to evaluate demographics, etiology, presentation, and type of facial fracture, as well as its relationship to dental inj...

Lieger, O.; Zix, J.; Kruse, A.; Iizuka, T.

2009-01-01

79

Whiplash: diagnosis, treatment, and associated injuries  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Study design Focused review of the current literature. Objective To identify and synthesize the most current data pertaining to the diagnosis and treatment of whiplash and whiplash-associated disorders (WAD), and to report on whiplash-related injuries. Methods A search of OVID Medline (1996–January 2007) and the Cochrane database of systematic reviews was performed using the keywords whiplash and WAD. Articles under subheadings for pathology, diagnosis, treatment, and epidemiology were chos...

Yadla, Sanjay; Ratliff, John K.; Harrop, James S.

2008-01-01

80

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 amongst student nurses in Namibia, is of particular concern for nurse educators in that country. The purpose of this study was therefore to determine the incidence of needle-stick injuries and to describe the context of their occurrences. A framework known as Haddon’s matrix made it possible to approach this survey from both an occupational and a nursing education perspective.

The questionnaire was completed by 198 students and it was found that, during 2008 alone, 17% of student nurses sustained needle-stick injuries, but only 55% of these reported it. In addition, in 55% of the occasions on which the student nurses were injured, they were not accompanied by a registered nurse. The recommendations made are based on the three phases of Haddon’s matrix, namely pre-injury, injury and post-injury phases. These recommendations focussed on student accompaniment by registered nurses, the completion of reflective exercises, sensitisation sessions before placement in clinical areas, as well as the utilisation of independent student counsellors.

Opsomming

Enige naaldprik-insident kan ‘n groot omwenteling in ‘n student-verpleegkundige se lewe te weeg bring. Ten spyte hiervan word sodanige insidente nie openlik hanteer nie, en dikwels word dit nie eers gerapporteer nie. Dit mag egter kurrikulering-evaluerings kompliseer want potensiële risiko-aspekte in verpleegonderwys mag dalk nie geidentifisser word nie. Naaldprik-ongelukke is in wese beroepsgesondheidsaspekte, wat inherent voorkombaar is. Dit was dan ook ‘n bron van kommmer onder verpleegopvoeders in Namibië, aangesien geen inligting beskikbaar was oor die voorkoms en konteks van naaldprik-ongelukke onder student-verpleegkundiges in Namibië nie. Die doel van hierdie studie was dus on die voorkoms en konteks waarbinne naaldprik-ongelukke plaasvind te beskryf. Daar was reeds a raamwerk beskikbaar, naamlik die Haddon-matriks. Diè raamwerk het dit moontlik gemaak om die opname te benader vanuit sowel ‘n beroepsgesondheids-perspektief as ‘n verpleegopvoedkundige perspektief.

Die vraelys is voltooi deur 198 studente en van die bevindings was dat gedurende 2008 alleen, 17% van die student-verpleegkundiges naaldprik-insidente gehad het, maar dat slegs 55% van die beseerdes dit aangemeld het. Daar is ook gevind dat in 55% van die gevalle, hulle nie deur ‘n geregistreerde verpleegkundige vergesel was nie. Aanbevelings wat gemaak is, is gebaseer op die drie fases van die Haddon-matriks, naamlik die voor-beserings-fase, die beseringsfase en die na-beserings-fase. Die aanbevelings is gefokus op student-begeleiding, reflektiewe oefeninge, sensitiseringsessies voor die plasings in kliniese areas, asook ondersteuning van ‘n onafhanklike berader.

How to cite this article: Small, L., Pretorius, L., Walters, A. & Ackerman,M.J., 2011, ‘A surveillance of needle-stick injuries amongst student nurses at the University of Namibia’, Health SA Gesondheid 16(1, Art. #507, 8 pages. http://dx.doi.org/doi:10.4102/hsag.v161.507

 

Maria J. Ackerman

2011-02-01

 
 
 
 
81

Intraocular cilia associated with perforating injury  

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Full Text Available Purpose: To report a case series of penetrating injury complicated by occurrence of intraocular cilia. Methods: Retrospective analysis of charts of 11 eyes of 11 patients with penetrating injury and intraocular cilia, presenting between September 1978 and November 1998. Ten eyes underwent surgery for trauma-related problems such as cataract, vitritis, retinal detachment etc., at which time intraocular cilia were removed. One eye did not have surgery and continues to harbour cilia at the posterior perforation site. Results: Metallic wire was responsible for injury in 6 of 11 eyes with intraocular cilia. Five eyes had significant intraocular inflammation. The cilia were located in the anterior segment in 4 eyes; in the posterior segment in 6 eyes and in both in one eye. At the last follow up, 72.7% had 6/18 or better vision. Poor vision in the rest was due to recurrent retinal detachment (2 eyes and macular scarring (1 eye. Conclusion: Intraocular cilia are more commonly associated with injury by a metallic wire. The presentation and management of an injured eye does not seem to be influenced by the presence of cilia in the eye.

Gopal Lingam

2000-01-01

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 (p<0.05), and men were 4 times more likely to present with associated injuries than women (OR 3.9; 95% CI 1.1 to 14) We also found significant differences in the rates of facial fracture. Women who had been kicked by a horse were more likely to sustain bony injuries than men (p<0.05). Our data confirm the association between kicks and facial fracture, and this may provide an impetus for the development of appropriate protective equipment. Patients who sustain facial injuries when falling from a horse often present with associated injuries and this has practical implications for clinicians involved in their management. PMID:24168759

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

2014-02-01

83

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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....

Cinnamon Jonathan; Schuurman Nadine

2010-01-01

84

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

85

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

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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

86

U.S. Department of Energy, Illness and Injury Surveillance Program, Worker Health Summary, 1995-2004  

Energy Technology Data Exchange (ETDEWEB)

The Department of Energy’s (DOE) Illness and Injury Surveillance Program has created an opportunity to assess illness and injury rates and patterns among workers at participating sites for well over a decade. The Worker Health Summary introduces an additional perspective on worker health with the introduction of analyses comparing the experience of sites in different program offices and a focus on time trends covering a decade of worker illness and injury experience. These analyses by program office suggest that illness and injury patterns among National Nuclear Security Administration (NNSA) workers diverge in many ways from those seen among Environmental Management (EM) and Science workers for reasons not yet understood. These differences will receive further investigation in future special focus studies, as will other findings of interest. With the time depth now available in our data, the Worker Health Summary reveals an additional nuance in worker health trends: changing health patterns in a specialized and skilled but aging work force. Older workers are becoming an increasing percentage of the work force, and their absence rates for diseases such as diabetes and hypertension are increasing as well. The impact of these emerging health issues, if properly addressed, can be managed to maintain or even enhance worker health and productivity. Prevention strategies designed to reduce the toll of these health conditions appear warranted, and this report gives us an indication of where to focus them. The analyses that follow reflect the Illness and Injury Surveillance Program’s continued commitment to apply a public health perspective in protecting the health of DOE’s work force.

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

2007-10-01

87

Electronic Implementation of a Novel Surveillance Paradigm for Ventilator-associated Events. Feasibility and Validation.  

Science.gov (United States)

Rationale: Accurate surveillance of ventilator-associated pneumonia (VAP) is hampered by subjective diagnostic criteria. A novel surveillance paradigm for ventilator-associated events (VAEs) was introduced. Objectives: To determine the validity of surveillance using the new VAE algorithm. Methods: Prospective cohort study in two Dutch academic medical centers (2011-2012). VAE surveillance was electronically implemented and included assessment of (infection-related) ventilator-associated conditions (VAC, IVAC) and VAP. Concordance with ongoing prospective VAP surveillance was assessed, along with clinical diagnoses underlying VAEs and associated mortality of all conditions. Consequences of minor differences in electronic VAE implementation were evaluated. Measurements and Main Results: The study included 2,080 patients with 2,296 admissions. Incidences of VAC, IVAC, VAE-VAP, and VAP according to prospective surveillance were 10.0, 4.2, 3.2, and 8.0 per 1000 ventilation days, respectively. The VAE algorithm detected at most 32% of the patients with VAP identified by prospective surveillance. VAC signals were most often caused by volume overload and infections, but not necessarily VAP. Subdistribution hazards for mortality were 3.9 (95% confidence interval, 2.9-5.3) for VAC, 2.5 (1.5-4.1) for IVAC, 2.0 (1.1-3.6) for VAE-VAP, and 7.2 (5.1-10.3) for VAP identified by prospective surveillance. In sensitivity analyses, mortality estimates varied considerably after minor differences in electronic algorithm implementation. Conclusions: Concordance between the novel VAE algorithm and VAP was poor. Incidence and associated mortality of VAE were susceptible to small differences in electronic implementation. More studies are needed to characterize the clinical entities underlying VAE and to ensure comparability of rates from different institutions. PMID:24498886

Klein Klouwenberg, Peter M C; van Mourik, Maaike S M; Ong, David S Y; Horn, Janneke; Schultz, Marcus J; Cremer, Olaf L; Bonten, Marc J M

2014-04-15

88

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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-associa...

2010-01-01

89

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

90

Injuries in Patients with Epilepsy and Some Factors Associated with Injury  

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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

91

U.S. Department of Energy Illness, and Injury Surveillance Program, Worker Health At A Glance, 1995-2004  

Energy Technology Data Exchange (ETDEWEB)

The Department of Energy’s (DOE) Illness and Injury Surveillance Program (IISP) has monitored the health of contractor workers at selected DOE sites since 1990. For the first time, the IISP has sufficient data to describe, in a collective manner, the health trends occurring among workers at a number of DOE sites during a 10-year period. This brief report and the more detailed Worker Health Summary assess illness and injury trends of DOE workers according to gender, age, occupational group, and program office over the 10-year period, 1995 through 2004. During this time, over 137,000 individual contractor workers were employed at the 15 DOE sites participating in the IISP.

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

2007-10-01

92

Injury surveillance in children--usefulness of a centralised database of accident and emergency attendances.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

OBJECTIVE: To assess the usefulness of a centralised injury database in monitoring progress towards nationally set health targets for the reduction of childhood injuries. SETTING: West Glamorgan County, Wales. METHODS: Analysis was undertaken of data held in the West Glamorgan injury database which amalgamates population data with data from the three hospital units covering a population of 370,000. All first attendances due to a new injury in children aged 0-14 occurring in 1993 were analysed...

Lyons, R. A.; Lo, S. V.; Heaven, M.; Littlepage, B. N.

1995-01-01

93

Use of statewide emergency department surveillance data to assess incidence of animal bite injuries among humans in North Carolina.  

Science.gov (United States)

OBJECTIVE--To determine incidence of animal bite injuries among humans in North Carolina by use of statewide emergency department visit data; to evaluate incidence rates on the basis of age, sex, urbanicity, biting species, and month for selected species; and to characterize bite-related emergency department visits. DESIGN--Retrospective cohort and cross-sectional study. SAMPLE--Records of 38,971 incident animal bite-related emergency department visits in North Carolina from 2008 to 2010. PROCEDURES--Emergency department visits were selected for inclusion by means of external-cause-of-injury codes assigned with an international coding system and keyword searches of chief complaint and triage notes. Rates were calculated with denominators obtained from census data. Cross-sectional analysis of incident emergency department visits was performed. RESULTS--By the age of 10, a child in North Carolina had a 1 in 50 risk of dog bite injury requiring an emergency department visit. Incidence rates for dog bites were highest for children ? 14 years of age, whereas the incidence rate for cat bites and scratches was highest among individuals > 79 years of age. Lifetime risk of cat bite or scratch injury requiring an emergency department visit was 1 in 60 for the population studied. Rabies postexposure prophylaxis was administered during 1,664 of 38,971 (4.3%) incident visits. CONCLUSIONS AND CLINICAL RELEVANCE--Emergency department visit surveillance data were used to monitor species-specific bite incidence statewide and in various subpopulations. Emergency department surveillance data may be particularly useful to public health veterinarians. Results may inform and renew interest in targeted animal bite prevention efforts. PMID:24548236

Rhea, Sarah K; Weber, David J; Poole, Charles; Waller, Anna E; Ising, Amy I; Williams, Carl

2014-03-01

94

Incidence of associated knee injury in pediatric tibial eminence fractures.  

Science.gov (United States)

Our intent is to review pediatric tibial eminence fractures treated at a Level I Trauma Center and to note the incidence of associated knee pathology. All pediatric patients treated operatively for a tibial eminence fracture over a 10-year period were identified. A chart review was performed to identify patient demographics, injury pattern, presence of associated pathology, and magnetic resonance imaging (MRI) findings. In our series of 20 pediatric tibial eminence fractures, 6 patients had associated meniscal tears. Meniscal tears occurred more commonly in type III injuries (5 of 13) than type II injuries (1 of 6). Two patients sustained associated ligamentous injury; there were no patients with associated chondral defects. A displaced pediatric tibial eminence fracture is a relatively infrequent injury. The incidence of associated meniscal injury in our study was 30%, and associated ligamentous injury was uncommon. Arthroscopic evaluation before definitive treatment of displaced tibial eminence fractures should be considered given the associated incidence of meniscal tears. MRI does not appear to provide additional information if arthroscopic treatment is pursued. This study is level IV, case series. PMID:24285367

Johnson, Adam C; Wyatt, Jonathan D; Treme, Gehron; Veitch, Andrew J

2014-06-01

95

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

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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 Augu...

Osoro Mogaka Eric; Ng’ang’a Zipporah; Oundo Joseph; Omolo Jared; Luman Elizabeth

2011-01-01

96

Injury associated with methamphetamine use: A review of the literature  

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This paper reviews the literature exploring issues around methamphetamine and injury. There was a paucity of peer reviewed quantitative research and a lack of large scale epidemiological studies. Further sources described cases and others described injury risk as part of an overall review of methamphetamine misuse. Thus, a number of limitations and potential biases exist within the literature. The main areas where associations were noted or extrapolated with methamphetamine use and injury wer...

Sheridan, Janie; Bennett, Sara; Coggan, Carolyn; Wheeler, Amanda; Mcmillan, Karen

2006-01-01

97

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

98

Blunt carotid artery dissection: incidence, associated injuries, screening, and treatment.  

Science.gov (United States)

Blunt carotid dissection (BCD) is a rare injury occurring in less than one in 1,000 victims of blunt injuries. Using a 4-year experience in a trauma system with 14 cases of BCD, we performed a matched blunt trauma patient case-control analysis to determine if there were patterns of injuries that were associated with increased risk of BCD. Patients with combinations of head, facial, and cervical spine injuries with or without extremity fractures proved to be at significantly increased risk for BCD. Duplex scanning appears to be a useful screening tool for these patients. Anticoagulation was the preferred treatment once neurologic deficits were present. PMID:2258964

Davis, J W; Holbrook, T L; Hoyt, D B; Mackersie, R C; Field, T O; Shackford, S R

1990-12-01

99

Maxillofacial injuries associated with intimate partner violence in women  

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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

100

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

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

2011-01-01

 
 
 
 
101

Using mortuary statistics in the development of an injury surveillance system in Ghana.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 prospectively 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...

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

2002-01-01

102

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

Directory of Open Access Journals (Sweden)

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

103

MR imaging of anterior cruciate ligament injury: associated findings  

Energy Technology Data Exchange (ETDEWEB)

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

104

MR imaging of anterior cruciate ligament injury: associated findings  

International Nuclear Information System (INIS)

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 (? < 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)(? < 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

1995-04-01

105

[Healthcare-associated infection rates: measuring and comparing. Experiences from the German National Nosocomial Infection Surveillance System (KISS) and from other surveillance systems].  

Science.gov (United States)

Surveillance of nosocomial infections is meanwhile a cornerstone of infection prevention activities in hospitals. The objective of this article is to compare healthcare-associated infection rates in intensive care patients, neonatal intensive care patients and operated patients (ICU-KISS, OP-KISS, NEO-KISS) of the German nosocomial infection surveillance system (KISS) with the corresponding data of the US American National Healthcare Safety Network (NHSN) and the European Centre for Disease Prevention and Control (ECDC). In general, the methodological differences among the three surveillance systems are minor but there are some exceptions. Therefore, differences between countries have to be interpreted very carefully as they may be due to differences in diagnostics, patient mix, types of interventions, length of stay, selection of participating hospitals, post-discharge surveillance activities and interpretation of case definitions. Organizational aspects, such as mandatory participation with public disclosure on infection rates may also have an impact. PMID:23114434

Gastmeier, P; Behnke, M; Breier, A-C; Piening, B; Schwab, F; Dettenkofer, M; Geffers, C

2012-11-01

106

Relapsing Acute Kidney Injury Associated with Pegfilgrastim  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We report a previously unrecognized complication of severe acute kidney injury (AKI) after the administration of pegfilgrastim with biopsy findings of mesangioproliferative glomerulonephritis (GN) and tubular necrosis. A 51-year-old white female with a history of breast cancer presented to the hospital with nausea, vomiting and dark urine 2 weeks after her third cycle of cyclophosphamide and docetaxel along with pegfilgrastim. She was found to have AKI with a serum creatinine (Cr) level of 6....

Arora, Swati; Bhargava, Arpit; Jasnosz, Katherine; Clark, Barbara

2012-01-01

107

Pathophysiological aspects of severe acute pancreatitis-associated lung injury  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Acute pancreatitis is an inflammatory process which occurs in severe form in 20% of all patients, out of whom 1596-25% will die. The incidence of severe acute pancreatitis-associated lung injury (APALI) varies from 15% to 55% and its severity varies from mild hypoxemia to acute respiratory distress syndrome (ARDS). Acute lung injury (ALI) and ARDS are the most significant manifestations of extra abdominal dysfunctions in severe acute pancreatitis with mortality rate as high as 60% in the firs...

Šurbatovi? Maja; Jovanovi? Krsta; Radakovi? Sonja; Filipovi? Nikola

2005-01-01

108

Complications associated with blood alcohol concentration following injury.  

Science.gov (United States)

Alcohol increases the risk of injuring oneself and others. However, following an injury there appears to be a benefit to alcohol in mediating the body's response to a traumatic injury and reducing mortality. The physiological mechanism underlying this reported association is poorly understood. One approach to explaining the pathways by which alcohol affects acute mortality following a traumatic injury is to identify differential prevalence of medical complications associated with increased mortality. The goal of this study was to evaluate the association between blood alcohol concentration and complications subsequent to a traumatic injury that are associated with increased in-hospital mortality. This study involved a retrospective analysis of traumatic injuries occurring between 2000 and 2009 as reported by all level I and II trauma units in the state of Illinois. The study includes all patients with blood alcohol toxicological examination levels ranging from zero to 500 mg/dL and meeting additional inclusion criteria (n = 84,974). A reduction in complications of cardiac and renal function by 23.5% and 30.0%, respectively, was attributable to blood alcohol concentration. In addition, blood alcohol concentration was associated with fewer cases of pneumothorax and convulsions. However, blood alcohol concentration continued to be positively associated with aspiration pneumonitis and acute pancreatitis in the final models. The net impact of alcohol following an injury is protective, largely attributable to a reduction in complications relating to cardiac and renal function. This study helps to explain the observed protective effect from blood alcohol concentrations in reducing in-hospital mortality after an injury, as reported in many studies. PMID:24835008

Friedman, Lee S

2014-06-01

109

Spinal cord injury and its association with blunt head trauma  

Directory of Open Access Journals (Sweden)

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

110

Swimming overuse injuries associated with triathlon training.  

Science.gov (United States)

Most triathlon overuse injuries occur due to the running and cycling aspects of the sport. By nature of swimming being a non-weight-bearing sport, triathletes have a tendency to use swimming for rehabilitation and recovery. Swimming has a significantly lower injury rate than the other 2 disciplines in a triathlon. Most triathletes use the freestyle stroke, because it is typically the first stroke learned, it is for many the fastest stroke, and by lifting the head the freestyle stroke allows triathletes to sight their direction, which is important in open water swimming. During the freestyle stroke, the shoulder undergoes repetitive overhead motion, and shoulder pain is the most common and well-documented site of musculoskeletal pain in competitive swimmers. It is felt that the pathologic process is attributable to repetitive overhead motion causing microtrauma in the shoulder from either mechanical impingement or generalized laxity or both. Without sufficient rest and recovery, the development of inflammation and pain may result. Depending on the age of the triathlete and the exact etiology of the shoulder pain, treatment options range from nonsurgical to surgical in nature. PMID:23147088

Bales, James; Bales, Karrn

2012-12-01

111

Reducing injury risks associated with underground coal mining equipment  

Energy Technology Data Exchange (ETDEWEB)

The project work encompassed analyses of NSW and US injury narratives for equipment related injuries, visits by project staff to fourteen Australian underground coal mines, a US underground coal mine, an Australian lead mine, as well as seven manufacturing sites in Australia and the USA. Reports on related topics previously compiled for US, European, and South African agencies were reviewed, and a draft generic equipment injury risk assessment tool prepared and circulated for comment. Injury hazards associated with underground coal mining equipment have been described and control measures identified. An outstanding issue relating to the appropriate design of bolting controls was identified for further research. Some of the project work was undertaken during a 6 month period the team leader spent at the NIOSH Pittsburgh Research Laboratory as a National Academy of Sciences Senior Research Associate. The project results have been progressively disseminated through presentations at industry conferences, and papers in industry magazines and academic journals. A list of presentations and papers arising from the project is provided. A one day seminar which formed part of the project was held on October 17, 2006 in Pokolbin, and was attended by 100 people from mining companies, contractors and manufacturers. Slides and papers from this seminar are available at burgess-limerick.com. The final outcome of the project is a 'Handbook for the Control of Injury Risks Associated with Underground Coal Mining Equipment' which documents the injury risks, controls, and outstanding issues. The handbook (Appendix A) also incorporates a generic equipment injury risk assessment tool, and a training DVD. 5 refs., 1 tab., 1 photo., 1 app.

Robin Burgess-Limerick [Burgess-Limerick & Associates (Australia)

2007-02-15

112

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

Directory of Open Access Journals (Sweden)

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

113

Central Line-Associated Bloodstream Infection Surveillance outside the Intensive Care Unit: A Multicenter Survey  

Science.gov (United States)

Objective The success of central line–associated bloodstream infection (CLABSI) prevention programs in intensive care units (ICUs) has led to the expansion of surveillance at many hospitals. We sought to compare non-ICU CLABSI (nCLABSI) rates with national reports and describe methods of surveillance at several participating US institutions. Design and Setting An electronic survey of several medical centers about infection surveillance practices and rate data for non-ICU patients. Participants Ten tertiary care hospitals. Methods In March 2011, a survey was sent to 10 medical centers. The survey consisted of 12 questions regarding demographics and CLABSI surveillance methodology for non-ICU patients at each center. Participants were also asked to provide available rate and device utilization data. Results Hospitals ranged in size from 238 to 1,400 total beds (median, 815). All hospitals reported using Centers for Disease Control and Prevention (CDC) definitions. Denominators were collected by different means: counting patients with central lines every day (5 hospitals), indirectly estimating on the basis of electronic orders (n = 4), or another automated method (n = 1). Rates of nCLABSI ranged from 0.2 to 4.2 infections per 1,000 catheter-days (median, 2.5). The national rate reported by the CDC using 2009 data from the National Healthcare Surveillance Network was 1.14 infections per 1,000 catheter-days. Conclusions Only 2 hospitals were below the pooled CLABSI rate for inpatient wards; all others exceeded this rate. Possible explanations include differences in average central line utilization or hospital size in the impact of certain clinical risk factors notably absent from the definition and in interpretation and reporting practices. Further investigation is necessary to determine whether the national benchmarks are low or whether the hospitals surveyed here represent a selection of outliers.

Son, Crystal H.; Daniels, Titus L.; Eagan, Janet A.; Edmond, Michael B.; Fishman, Neil O.; Fraser, Thomas G.; Kamboj, Mini; Maragakis, Lisa L.; Mehta, Sapna A.; Perl, Trish M.; Phillips, Michael S.; Price, Connie S.; Talbot, Thomas R.; Wilson, Stephen J.; Sepkowitz, Kent A.

2013-01-01

114

Individual and social factors associated with workplace injuries  

Directory of Open Access Journals (Sweden)

Full Text Available 636,000 Australians injured themselves in a work-related injury in the period 2009-2010. Of these injured Australians, 88% continued to work in their same place, 5.2% had to change their jobs, and 6.9% were no longer employed. Men continue to be the most injured individuals in workplace injuries (56% with the highest rates of injury in the 45-49 years (72 per 1000 people and 20-24 years (63 per 1000 people age groups. Furthermore, 59% of these 636,000 Australians injured in workplace injuries received financial assistance from workers compensation claims, 36% did not apply for financial assistance and 5% applied but did not receive any financial assistance. The most common types of workplace injuries incurred were: sprains and strains (30%, chronic joint/muscle conditions (18% and cuts/open wounds (16% (Australian Bureau of Statistics, 2010. The total economic cost from workplace injuries in Australia for the 2005-06 financial year was estimated at $57.5 billion, representing 5.9% of GDP for the financial year (Australian Safety and Compensation Council, 2009. Workplace injuries also incur immeasurable personal costs to Australian workers and their families. Individual lives are altered, even lost; individual hopes and dreams of a better life are shattered. Family roles, responsibilities and relationships become strained due to changes in income earnings and the imposed challenging needs for increased social support and increased caring needs within the home due to workplace injury. Why do Australian workers get injured in their workplaces? Is it due to their individual worker factors, or is it due to social factors associated with their work and workplace? While individual worker factors, such as: gender, age, personality, ethnicity, and substance use, do contribute to workplace injuries and fatalities, broader social and organizational workplace factors, such as: workload, work hours, work environment, safety culture, provision of quality supervision, and provision of occupational health and safety training, socially structure, and influence individual worker attitudes and behaviours in workplace injury and fatalities.

Ashwin Kumar

2011-08-01

115

Pathophysiological aspects of severe acute pancreatitis-associated lung injury  

Directory of Open Access Journals (Sweden)

Full Text Available Acute pancreatitis is an inflammatory process which occurs in severe form in 20% of all patients, out of whom 1596-25% will die. The incidence of severe acute pancreatitis-associated lung injury (APALI varies from 15% to 55% and its severity varies from mild hypoxemia to acute respiratory distress syndrome (ARDS. Acute lung injury (ALI and ARDS are the most significant manifestations of extra abdominal dysfunctions in severe acute pancreatitis with mortality rate as high as 60% in the first week of the onset of illness. Different pathophysiological mechanisms of severe acute pancreatitis-associated lung injury have been described. The role of enzymes, adhesion molecules, neutrophils, fibronectin and various inflammatory mediators has been emphasized. Mechanism of the acute lung injury associated with the acute pancreatitis is very complex and has not been clear yet. There is no specific therapeutic procedure and mortality rate is very high. Therefore, further studies are necessary to address this acute and growing problem in intensive medicine.

Šurbatovi? Maja

2005-01-01

116

Factors associated with surgical site infection in colorectal surgery: the Japan nosocomial infections surveillance.  

Science.gov (United States)

Objective.?Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). This study aims to assess factors associated with SSI after colorectal surgery in Japan, using a Japanese national database for HAIs. Design.?A retrospective nationwide surveillance-based study. Setting.?Japanese healthcare facilities. Methods.?Data on colon and rectal surgeries performed from 2008 through 2010 were extracted from a national monitoring system for healthcare-associated infections, the Japan Nosocomial Infections Surveillance (JANIS). Factors associated with SSI after colon and rectal surgery were assessed using multivariate logistic regression. Results.?The cumulative incidence of SSI for colon and rectal surgery was 15.0% (6,691 of 44,751) and 17.8% (3,230 of 18,187), respectively. Traditional risk factors included in the National Nosocomial Infections Surveillance (NNIS) modified risk index were significant in predicting SSI in the final model for both colon and rectal surgery. Among the additional variables routinely collected in JANIS were factors independently associated with the development of SSI, such as male sex (adjusted odds ratio [aOR], 1.20 [95% confidence interval (CI), 1.14-1.27]), ileostomy or colostomy placement (aOR, 1.13 [95% CI, 1.04-1.21]), emergency operation (aOR, 1.40 [95% CI, 1.29-1.52]), and multiple procedures (aOR, 1.22 [95% CI, 1.13-1.33]) for colon surgery as well as male sex (aOR, 1.43 [95% CI, 1.31-1.55]), ileostomy or colostomy placement (aOR, 1,63 [95% CI, 1.51-1.79]), and emergency operation (aOR, 1.43 [95% CI, 1.20-1.72]) for rectal surgery. Conclusions.?For colorectal operations, inclusion of additional variables routinely collected in JANIS can more accurately predict SSI risk than can the NNIS risk index alone. PMID:24799642

Morikane, Keita; Honda, Hitoshi; Yamagishi, Takuya; Suzuki, Satowa; Aminaka, Mayumi

2014-06-01

117

Open bicondylar Hoffa fracture associated with extensor mechanism injury.  

Science.gov (United States)

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

118

Reducing injury risks associated with underground coal mining equipment  

Energy Technology Data Exchange (ETDEWEB)

This paper describes the initial stages of an ongoing project aimed at reducing injury risks associated with underground coal mining equipment. An analysis of the full-text field of 1000 compensation claims associated with underground coal mining equipment is reported. This analysis suggests that a relatively small number of equipment types account for the majority of claims. Development equipment is especially likely to be involved, particularly continuous miner, load-haul-dump, shuttle car and portable bolting rigs. Personnel transport is also commonly involved. Together these categories of equipment accounted for more than 93% of equipment related injuries. The analysis of injury statistics was supplemented by observation of development equipment in use at two very different two mines, as well as interviews with miners and engineers at these sites and elsewhere. Subsequent stages of the project involve undertaking systematic audits of development equipment injury risks at 12-16 sites in Queensland and New South Wales to identify existing controls and disseminate these to the industry as a whole. Where uncontrolled risks remain, the aim of the project is to facilitate communication between sites, companies, manufacturers and ergonomists both nationally and internationally to develop, trial and implement suitable design controls. 10 refs., 6 figs., 2 tabs.

Burgess-Limerick, R. [Burgess-Limerick & Associates, Qld. (Australia)

2005-07-01

119

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)

1993-09-01

120

Nutritional parameters are associated with mortality in acute kidney injury  

Science.gov (United States)

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 Botucatu 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.

Berbel, Marina Nogueira; de Goes, Cassiana Regina; Balbi, Andre Luis; Ponce, Daniela

2014-01-01

 
 
 
 
121

Metformin-Associated Acute Kidney Injury and Lactic Acidosis  

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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 ...

Arroyo, David; Melero, Rosa; Panizo, Nayara; Goicoechea, Marian; Rodri?guez-beni?tez, Patrocinio; Vinuesa, Soledad Garci?a; Verde, Eduardo; Tejedor, Alberto; Lun?o, Jose?

2011-01-01

122

Environmental reduplication associated with right frontal and parietal lobe injury.  

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Four patients with environmental reduplication, a specific form of spatial disorientation and confabulation are described. The patients maintained that their hospital rooms were located in their homes. Each patients had evidence of right frontal or right parietal injury based upon computed tomography, neurosurgery, and neuropsychological testing. The factors associated with environmental reduplication were: impaired spatial perception and visual memory, inability of the patients to recognise ...

1981-01-01

123

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

124

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

125

Reducing injury risks associated with underground coal mining equipment  

Energy Technology Data Exchange (ETDEWEB)

The paper is a condensed version of material prepared as part of a project funded by the Australian Coal Association Research Program. The complete project report C14016 is now available. The overall project aim was to identify injury risks associated with the ergonomics of underground mining equipment, assess how these could be reduced, and disseminate the findings to a manufacturer and mine sites. The article reports particularly on risks and risk control of accidents with continuos miners, load-haul-dump vehicles, shuttle cars and personnel transport in underground mines. 2 photos.

Burgess-Limerick, R. [Burgess-Limerick and Associates, Qld. (Australia)

2007-08-15

126

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

127

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.

128

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.

129

Surveillance of febrile patients in a district and evaluation of their spatiotemporal associations: a pilot study  

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Full Text Available Abstract Background Fever is an undifferentiated clinical feature that may enhance the sensitivity of syndromic surveillance systems. By studying the spatiotemporal associations of febrile patients, it may allow early detection of case clustering that indicates imminent threat of infectious disease outbreaks in the community. Methods We captured consecutive emergency department visits that led to hospitalization in a district hospital in Hong Kong during the period of 12 Sep 2005 to 14 Oct 2005. We recorded demographic data, provisional diagnoses, temperature on presentation and residential location for each patient-episode, and geocoded the residential addresses. We applied Geographical Information System technology to study the geographical distribution these cases, and their associations within a 50-m buffer zone spatially. A case cluster was defined by three or more spatially associated febrile patients within each three consecutive days. Results One thousand and sixty six patient-episodes were eligible for analysis; 42% of them had fever (>37°C; oral temperature on presentation. Two hundred and four patient-episodes (19.1% came from residential care homes for elderly (RCHE. We detected a total of 40 case clusters during the study period. Clustered cases were of older age; 57 (33.3% were residents of RCHE. We found a median of 3 patients (range: 3 - 8 and time span of 3 days (range: 2 - 8 days in each cluster. Twenty five clusters had 2 or more patients living in the same building block; 18 of them were from RCHE. Conclusions It is technically feasible to perform surveillance on febrile patients and studying their spatiotemporal associations. The information is potentially useful for early detection of impending infectious disease threats.

Lee Lap-yip

2010-02-01

130

Facebook surveillance of former romantic partners: associations with postbreakup recovery and personal growth.  

Science.gov (United States)

Previous research has found that continuing offline contact with an ex-romantic partner following a breakup may disrupt emotional recovery. The present study examined whether continuing online contact with an ex-partner through remaining Facebook friends and/or engaging in surveillance of the ex-partner's Facebook page inhibited postbreakup adjustment and growth above and beyond offline contact. Analysis of the data provided by 464 participants revealed that Facebook surveillance was associated with greater current distress over the breakup, more negative feelings, sexual desire, and longing for the ex-partner, and lower personal growth. Participants who remained Facebook friends with the ex-partner, relative to those who did not remain Facebook friends, reported less negative feelings, sexual desire, and longing for the former partner, but lower personal growth. All of these results emerged after controlling for offline contact, personality traits, and characteristics of the former relationship and breakup that tend to predict postbreakup adjustment. Overall, these findings suggest that exposure to an ex-partner through Facebook may obstruct the process of healing and moving on from a past relationship. PMID:22946958

Marshall, Tara C

2012-10-01

131

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.

132

Cranial nerve injuries associated with carotid endarterectomy. A prospective study.  

Science.gov (United States)

To determine the incidence and nature of cranial nerve damage in connection with carotid artery surgery, 139 patients were studied before and after 162 operations. Nerve damage was detected in association with 19.8% of the operations. The hypoglossal nerve was most commonly affected. The injuries were of benign character and usually resolved within 4 to 6 weeks. Apart from damage to the great auricular nerve, all lesions resolved within 5 months. The incidence of nerve disturbance was greater than that found in a retrospective study from the same hospital. Gentleness of technique is important in carotid artery surgery, in order to avoid nerve damage. PMID:4090884

Forssell, C; Takolander, R; Bergqvist, D; Bergentz, S E; Gramming, P; Kitzing, P

1985-01-01

133

Interleukin-1 Receptor–Associated Kinase 3 Gene Associates with Susceptibility to Acute Lung Injury  

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Sepsis is the most common cause of acute lung injury (ALI), leading to organ dysfunction and death in critically ill patients. Previous studies associated variants of interleukin-1 receptor–associated kinase genes (IRAKs) with differential immune responses to pathogens and with outcomes during sepsis, and revealed that increased expression levels of the IRAK3 gene were correlated with poor outcomes during sepsis. Here we explored whether common variants of the IRAK3 gene were associated wit...

Pino-yanes, Mari?a; Ma, Shwu-fan; Sun, Xiaoguang; Tejera, Paula; Corrales, Almudena; Blanco, Jesu?s; Pe?rez-me?ndez, Lina; Espinosa, Elena; Muriel, Arturo; Blanch, Lluis; Garcia, Joe G. N.; Villar, Jesu?s; Flores, Carlos

2011-01-01

134

The impact of surveillance and rapid reduction in immunosuppression to control BK virus-related graft injury in kidney transplantation.  

Science.gov (United States)

We prospectively screened 609 consecutive kidney (538) and kidney-pancreas (71) transplant recipients for BK viremia over a 4-year interval using polymerase chain reaction viral load detection and protocol kidney biopsies. We found that BK viremia is common at our center: total cases 26.7%, cases during first year 21.3% (mean 4 months), and recipients with ? 10 000 copies/ml 12.3%. We found few predictive clinical or demographic risk factors for any BK viremia or viral loads ? 10,000 copies/ml, other than prior treatment of biopsy confirmed acute rejection and/or higher immunosuppressive blood levels of tacrolimus (P = 0.001) or mycophenolate mofetil (P = 0.007). Viral loads at diagnosis (185 000 copies/ml at diagnosis were predictive of BK virus-associated nephropathy (BKVAN; OR: 113.25, 95% CI: 17.22-744.6, P leflunomide or ciprofloxacin to immunosuppressive dose reduction did not result in greater rates of viral clearance. These data support the role of early surveillance for BK viremia to limit the impact on transplant outcome, although the most effective schedule for screening awaits further investigation. PMID:23763289

Elfadawy, Nissreen; Flechner, Stuart M; Liu, Xiaobo; Schold, Jesse; Tian, Devin; Srinivas, Titte R; Poggio, Emilio; Fatica, Richard; Avery, Robin; Mossad, Sherif B

2013-08-01

135

Injury surveillance in Portugal  

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In Portugal, the National Health Service (NHS) is responsible for providing health care to its ten and a half million inhabitants. Health service planning and regulation take largely place at the central level in the Ministry of Health (MoH) and its institutions, through its National Health Plan. The management of the NHS is devolved to the 5 health regions, Norte, Centro, Lisboa e Vale do Tejo, Alentejo and Algarve, and to the 2 autonomous regions, Açores and Madeira.

Contreiras, Teresa

2012-01-01

136

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

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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...

2013-01-01

137

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.

138

Aggravating andmitigating factors associated with cyclist injury severity in Denmark  

DEFF Research Database (Denmark)

Denmark is one of the leading cycling nations, where cycling trips constitute a large share of the total trips, and cycling safety assumes a top priority position in the agenda of policy makers. The current study sheds light on the aggravating and mitigating factors associated with cyclist injury severity on Danish roads by examining a comprehensive set of accidents involving a cyclist and a collision partner between 2007 and 2011. Method: This study estimates a generalized ordered logit model of the severity of cyclist injuries because of its ability to accommodate the ordered-response nature of severity while relaxing the proportional odds assumption. Results: Model estimates show that cyclist fragility (children under 10 years old and elderly cyclists over 60 years of age) and cyclist intoxication are aggravating individual factors,while helmet use is a mitigating factor. Speed limits above 70â??80 km/h, slippery road surface, and location of the crash on road sections are aggravating infrastructure factors, while the availability of cycling paths and dense urban development are mitigating factors. Heavy vehicle involvement and conflicts between cyclists going straight or turning left and other vehicles going straight are aggravating vehicle involvement factors. Practical applications: The results are discussed in the context of applied policies, engineering, and traffic management solutions for bicycle safety in Denmark.

Kaplan, Sigal; Prato, Carlo Giacomo

2014-01-01

139

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

140

Association between mental health and fall injury in Canadian immigrants and non-immigrants.  

Science.gov (United States)

The study was to determine the association between mental health and the incidence of injury among Canadian immigrants and non-immigrants. We used data from 15,405 individuals aged 12 years or more, who were living in British Columbia, Canada, and participated in the 2007-2008 Canadian Community Health Survey (CCHS). We calculated a 12-month cumulative incidence of fall injury based on self-reporting. Logistic regression model was used to examine the association of the 12-month cumulative incidence of fall injury with immigration status and mental health before and after adjustment for covariates. The results show that self-reported mood and anxiety disorders were significantly associated with an increased incidence of fall injury. The adjusted odds ratios were 1.81 (95% CI: 1.37, 2.38) for mood disorder and 1.55 (95% CI: 1.12, 2.13) for anxiety disorder. Immigrant status was a significant effect modifier for the association between mental health and fall injury, with stronger associations in immigrants than in non-immigrants especially in elderly people. People with poor self perceived health were more likely to have a fall injury. Both mental health and general health were related to fall injury. There was a stronger association between mental health and fall injury in immigrants compared with non-immigrants in the elderly. More attention should be paid to mental health in immigrants associated with fall injury. PMID:23810953

Chen, Yue; Mo, Frank; Yi, Qilong; Morrison, Howard; Mao, Yang

2013-10-01

 
 
 
 
141

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

142

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

143

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

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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...

Simon Arne; Ammann Roland A; Bode Udo; Fleischhack Gudrun; Wenchel Hans-Martin; Schwamborn Dorothee; Gravou Chara; Schlegel Paul-Gerhardt; Rutkowski Stefan; Dannenberg Claudia; Körholz Dieter; Laws Hans; Kramer Michael H

2008-01-01

144

Facebook Surveillance of Former Romantic Partners: Associations with PostBreakup Recovery and Personal Growth  

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Previous research has found that continuing offline contact with an ex-romantic partner following a breakup may disrupt emotional recovery. The present study examined whether continuing online contact with an ex-partner through remaining Facebook friends and/or engaging in surveillance of the ex-partner's Facebook page inhibited postbreakup adjustment and growth above and beyond offline contact. Analysis of the data provided by 464 participants revealed that Facebook surveillance was associat...

Marshall, Tara C.

2012-01-01

145

In Vitro Echinocandin Susceptibility of Aspergillus Isolates from Patients Enrolled in the Transplant-Associated Infection Surveillance Network?  

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We determined the echinocandin minimum effective concentration (MEC) values for caspofungin, micafungin, and anidulafungin against 288 Aspergillus isolates prospectively collected from transplant patients with proven or probable invasive aspergillosis between 2001 and 2006 as part of the Transplant-Associated Infection Surveillance Network (TRANSNET). We demonstrated that the vast majority of Aspergillus isolates had MEC values at or below the epidemiological cutoff values for caspofungin, mi...

Lockhart, Shawn R.; Zimbeck, Alicia J.; Baddley, John W.; Marr, Kieren A.; Andes, David R.; Walsh, Thomas J.; Kauffman, Carol A.; Kontoyiannis, Dimitrios P.; Ito, James I.; Pappas, Peter G.; Chiller, Tom

2011-01-01

146

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Nair Shalini; Sen Nagamani; Peter John; Raj John; Brahmadathan K

2008-01-01

147

Bloodstream Infections and Clinical Significance of Healthcare-associated Bacteremia: A Multicenter Surveillance Study in Korean Hospitals  

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Recent changes in healthcare systems have changed the epidemiologic paradigms in many infectious fields including bloodstream infection (BSI). We compared clinical characteristics of community-acquired (CA), hospital-acquired (HA), and healthcare-associated (HCA) BSI. We performed a prospective nationwide multicenter surveillance study from 9 university hospitals in Korea. Total 1,605 blood isolates were collected from 2006 to 2007, and 1,144 isolates were considered true pathogens. HA-BSI ac...

2010-01-01

148

Acromioclavicular joint dislocation with associated brachial plexus injury.  

Science.gov (United States)

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

149

Sodium bicarbonate to prevent cardiac surgery-associated kidney injury: the end of a dream?  

Science.gov (United States)

ABSTRACT: The rationale of urine alkalinization through intravenous sodium bicarbonate to prevent cardiac surgery-associated acute kidney injury relies on several pathophysiological arguments. Urine alkalinization is easily feasible in the ICU setting and is often considered to be associated with few side effects. In a previous issue of Critical Care, a retrospective study evaluates the effect of routine intravenous bicarbonate use to prevent cardiac surgery-associated acute kidney injury with cardiopulmonary bypass. This commentary discusses recent data on the use of bicarbonate to prevent cardiac surgery-associated acute kidney injury. PMID:23234469

Hougardy, Jean-Michel; De Backer, Daniel

2012-12-12

150

Device-associated nosocomial infection surveillance in a Turkish pediatric intensive care unit  

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Full Text Available Aim: The aim of the study was to investigate invasive device-related nosocomial infection rate in a Turkish pediatric intensive care unit (PICU. Material and Method: Two hundred forty patient included in the prospective active surveillance study that was conducted in Bak?rköy Dr. Sadi Konuk Research and Training Hospital PICU department between January 2008 and July 2009. Center of Disease Control methodology has been used for data collecting and calculating rates. Results: Eleven invasive device related nosocomial infection were detected in 240 patients and 2909 patient days for overall rate of 4.58% and 3.78 infections per 1000 days. Ventilator utilisation rate was found to be 53% and ventilator-associated pneumonia per 1000 ventilator day was 4.53. Urinary catheter utilization rate was 14%, urinary catheter related urinary system infection rate was 4.75/1000 urinary catheter days. Central catheter utilization rate was 22%, central catheter related bloodstream infection rate was 3.16/1000 catheter days. Coagulase-negative stafilococcus (%26.09, Pseudomonas aeruginosa (%13.04, Escherichia coli (%13.04, Staphylococcus aureus (%8.70, Candida spp (%8.70, Acinetobacter baumannii (%4.35, Enterobacter aerogenes (%4.35, enterococcus faecium (%4.35, Proteus mirabilis (%4.35 were the most common microorganisms isolated. Ceftriaxon, cefaperazon-sulbactam and piperacilllin-tazobactam were the most effective antibiotics against gram-negative bacteria. The overall methicillin resistance rate was 100% among gram positive bacteria and all of them were sensitive to vancomycine. Conclusions: To best of our knowledge, this is the first study in Turkey to document that the invasive device related nosocomial infection in PICU. Invasive device related infection rates of our PICU were similar to those reported in many developed countries.(Turk Arch Ped 2010; 45: 13-7

Esra ?evketo?lu

2010-03-01

151

Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes.  

Science.gov (United States)

Anterior cruciate ligament injury rates are four to eight times higher in women than in men. Because of estrogen's direct effect on collagen metabolism and behavior and because neuromuscular performance varies during the menstrual cycle, it is logical to question the menstrual cycle's effect on knee injury rates. Of 40 consecutive female athletes with acute anterior cruciate ligament injuries (less than 3 months), 28 (average age, 23 +/- 11 years) met the study criteria of regular menstrual periods and noncontact injury. Details concerning mechanism of injury, menstrual cycle, contraceptive use, and previous injury history were collected. A chi-square test was used to compute observed and expected frequencies of anterior cruciate ligament injury based on three different phases of the menstrual cycle: follicular (days 1 to 9), ovulatory (days 10 to 14), and luteal (day 15 to end of cycle). A significant statistical association was found between the stage of the menstrual cycle and the likelihood for an anterior cruciate ligament injury (P = 0.03). In particular, there were more injuries than expected in the ovulatory phase of the cycle. In contrast, significantly fewer injuries occurred in the follicular phase. These hormones may be a factor in the knee ligament injury dilemma in women. PMID:9784805

Wojtys, E M; Huston, L J; Lindenfeld, T N; Hewett, T E; Greenfield, M L

1998-01-01

152

Penetrating bladder trauma: a high risk factor for associated rectal injury.  

Science.gov (United States)

Demographics and mechanisms were analyzed in prospectively maintained level one trauma center database 1990-2012. Among 2,693 trauma laparotomies, 113 (4.1%) presented bladder lesions; 51.3% with penetrating injuries (n = 58); 41.3% (n = 24) with rectal injuries, males corresponding to 95.8%, mean age 29.8 years; 79.1% with gunshot wounds and 20.9% with impalement; 91.6% arriving the emergence room awake (Glasgow 14-15), hemodynamically stable (average systolic blood pressure 119.5?mmHg); 95.8% with macroscopic hematuria; and 100% with penetrating stigmata. Physical exam was not sensitive for rectal injuries, showing only 25% positivity in patients. While 60% of intraperitoneal bladder injuries were surgically repaired, extraperitoneal ones were mainly repaired using Foley catheter alone (87.6%). Rectal injuries, intraperitoneal in 66.6% of the cases and AAST-OIS grade II in 45.8%, were treated with primary suture plus protective colostomy; 8.3% were sigmoid injuries, and 70.8% of all injuries had a minimum stool spillage. Mean injury severity score was 19; mean length of stay 10 days; 20% of complications with no death. Concomitant rectal injuries were not a determinant prognosis factor. Penetrating bladder injuries are highly associated with rectal injuries (41.3%). Heme-negative rectal examination should not preclude proctoscopy and eventually rectal surgical exploration (only 25% sensitivity). PMID:24527030

Pereira, B M; Reis, L O; Calderan, T R; de Campos, C C; Fraga, G P

2014-01-01

153

Towards improved animal models of neonatal white matter injury associated with cerebral palsy  

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Newborn neurological injuries are the leading cause of intellectual and motor disabilities that are associated with cerebral palsy. Cerebral white matter injury is a common feature in hypoxic-ischemic encephalopathy (HIE), which affects full-term infants, and in periventricular leukomalacia (PVL), which affects preterm infants. This article discusses recent efforts to model neonatal white matter injury using mammalian systems. We emphasize that a comprehensive understanding of oligodendrocyte...

Silbereis, John C.; Huang, Eric J.; Back, Stephen A.; Rowitch, David H.

2010-01-01

154

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

Science.gov (United States)

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

155

Individual and social factors associated with workplace injuries  

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636,000 Australians injured themselves in a work-related injury in the period 2009-2010. Of these injured Australians, 88% continued to work in their same place, 5.2% had to change their jobs, and 6.9% were no longer employed. Men continue to be the most injured individuals in workplace injuries (56%) with the highest rates of injury in the 45-49 years (72 per 1000 people) and 20-24 years (63 per 1000 people) age groups. Furthermore, 59% of these 636,000 Australians injured in workplace injur...

2011-01-01

156

Health surveillance  

International Nuclear Information System (INIS)

The Code includes a number of requirements for the health surveillance of employees associated with the mining and milling of radioactive ores. This guideline is particularly directed at determining the level of fitness of employees and prospective employees, detecting any symptom which might contraindicate exposure to the environment encountered in mine/mill situations, examination of any employee who may have been exposed to radiation in excess of defined limits and the accumulation and provision of data on the health of employees

1981-01-01

157

Cellular therapies for treating pain associated with spinal cord injury  

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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

2012-01-01

158

[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

159

Ventilator-associated pneumonia in a teaching hospital in Tehran and use of the Iranian Nosocomial Infections Surveillance Software.  

Science.gov (United States)

Ventilator-associated pneumonia is the most common health-care-associated infection in the intensive care unit (ICU) and computer-assisted diagnosis and surveillance is called for. The frequency of ventilator-associated pneumonia was assessed prospectively during a 6-month period in the ICUs of a teaching hospital in Tehran, Islamic Republic of Iran. To determine the accuracy of the Iranian Nosocomial Infections Surveillance (INIS) system, patient data were input to the software and compared with physicians' judgement. The frequency of ventilator-associated pneumonia was 21.6%, or 9.96 episodes per 1000 ventilator days. The duration of admission to the ICU, duration of mechanical ventilator and number of re-intubations were significantly higher in patients who developed pneumonia. The INIS system identified 100% of cases, with no false-positive or false-negative results. Compared with developed countries, the frequency of ventilator-associated pneumonia was high in our ICUs, and INIS software was accurate in diagnosing nosocomial infection. PMID:24313153

Afhami, Sh; Hadadi, A; Khorami, E; Seifi, A; Bazaz, N Esmailpour

2013-10-01

160

Surveillance Length and Validity of Benchmarks for Central Line-Associated Bloodstream Infection Incidence Rates in Intensive Care Units  

Science.gov (United States)

Introduction Several national and regional central line-associated bloodstream infections (CLABSI) surveillance programs do not require continuous hospital participation. We evaluated the effect of different hospital participation requirements on the validity of annual CLABSI incidence rate benchmarks for intensive care units (ICUs). Methods We estimated the annual pooled CLABSI incidence rates for both a real regional (CLABSI incidence rate was estimated and compared to the reference rates in terms of validity, bias, and proportion of simulation iterations that presented valid estimates (ideal if?90%). Results All random scenarios generated valid CLABSI incidence rates estimates (bias ?0.37 to 0.07 CLABSI/1000 CVC-days), while non-random scenarios presented a wide range of valid estimates (0 to 100%) and higher bias (?2.18 to 1.27 CLABSI/1000 CVC-days). In random scenarios, the higher the number of participating ICUs, the shorter the participation required to generate ?90% valid replicates. While participation requirements in a countrywide program ranged from 3 to 13 surveillance blocks (1 block?=?28 days), requirements for a regional program ranged from 9 to 13 blocks. Conclusions Based on the results of our model of national CLABSI reporting, the shortening of participation requirements may be suitable for nationwide ICU CLABSI surveillance programs if participation months are randomly chosen. However, our regional models showed that regional programs should opt for continuous participation to avoid biased benchmarks.

Fontela, Patricia S.; Quach, Caroline; Buckeridge, David; Pai, Madukhar; Platt, Robert W.

2012-01-01

 
 
 
 
161

Hepatic ischemia reperfusion injury is associated with acute kidney injury following donation after brain death liver transplantation.  

Science.gov (United States)

Donation after cardiac death liver transplant recipients have an increased frequency of acute kidney injury (AKI). This suggests that hepatic ischemia-reperfusion injury may play a critical role in the pathogenesis of AKI after liver transplantation. The aim of this single-center study was to determine if hepatic ischemia-reperfusion injury, estimated by peak peri-operative serum amino-transferase (AST), is associated with AKI following donation after brain death (DBD) liver transplantation. A total of 296 patients received 298 DBD liver transplants from January 2007 to June 2011. The incidence of AKI was 35.9%. AKI was a risk factor for chronic kidney disease (P = 0.037) and mortality (P = 0.002). On univariate analysis, peak AST correlated with peak creatinine (P < 0.001) and peak change in creatinine from baseline (P < 0.001). Peak AST was higher in AKI patients (P < 0.001). The incidence of AKI in patients with a peak AST of <1500, 1500-2999 and ? 3000 U/l was 26.1%, 39.8% and 71.2%, respectively (P < 0.001). On multiple logistic regression analysis, peak AST was independently associated with the development of AKI (P < 0.001). In conclusion, hepatic ischemia-reperfusion injury demonstrates a strong relationship with peri-operative AKI in DBD liver transplant recipients. PMID:24033747

Leithead, Joanna A; Armstrong, Matthew J; Corbett, Christopher; Andrew, Mark; Kothari, Chirag; Gunson, Bridget K; Muiesan, Paolo; Ferguson, James W

2013-11-01

162

Burn Injury–Induced Alterations in Wound Inflammation and Healing Are Associated with Suppressed Hypoxia Inducible Factor-1? Expression  

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A major complication associated with burn injury is delayed wound healing. While healing of the burn injury site is essential, healing of distal injury sites caused by surgical interventions and other processes also is important. The impact of burn injury on healing of these distal wound sites is not understood clearly. To study this, mice were subjected to major burn injury or a sham procedure. Immediately following, excisional wounds were made on the dorsal surface caudal to the burn site a...

2008-01-01

163

Device-associated nosocomial infection surveillance in a Turkish pediatric intensive care unit  

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Aim: The aim of the study was to investigate invasive device-related nosocomial infection rate in a Turkish pediatric intensive care unit (PICU). Material and Method: Two hundred forty patient included in the prospective active surveillance study that was conducted in Bak?rköy Dr. Sadi Konuk Research and Training Hospital PICU department between January 2008 and July 2009. Center of Disease Control methodology has been used for data collecting and calculating rates. Results: Eleven invasive...

2010-01-01

164

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

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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 ...

Lobb, Ano

2009-01-01

165

MR imaging of tibial plateau fractures : evaluation of fracture types and associated soft tissue injuries  

International Nuclear Information System (INIS)

To evaluate the usefulness of magnetic resonance imaging (MRI) for assessing fracture types and soft tissue injuries associated with tibial plateau fractures. MRI was performed in 38 patients with tibial plateau fractures, each of which was classified according to the Schatzker system. We evaluated MR images and assessed the prevalence of each fracture type and accompanying soft tissue injuries. We also assessed whether ligamentous injury correlated with the extent of articular depression, splitting, and comminution. In 24 patients, diagnosis was based on MRI and operative or arthroscopic findings, and in 14 patients, on MRI alone. The totals of fracture types I, II, III, IV, V and VI were 4(11%), 15(39%), 6(16%), 4(11%), 4(11%), and 5 cases (13%), respectively. In 30 cases (79%), there were associated ligamentous or meniscal injuries. Medial collateral ligaments and lateral menisci were injured in 17(45%) and 14 cases (37%), respectively. Type II and IV fracture patterns were associated with soft tissue injuries in 14 of 15 cases (93%) and 4 of 4 cases (100%), respectively. As the extent of articular depression increased and the extent of bony comminution decreased, there was an increased prevalence of accompanying ligamentous injuries. In tibial plateau fractures, MR imaging is a useful diagnostic modality for the evaluation of both fracture type and accompanying ligamentous or meniscal injuries

1997-05-01

166

[Exercise guideline for prevention of heat injury (Japan Sports Association)].  

Science.gov (United States)

Sports activities in hot environment are high risk for heat injury. Athletes should take rest(at least once every 30 minutes) and water (with 0.1-0.2% salt) frequently during training in hot environment. When wet bulb globe temperature (WBGT) is over 28 degrees C, sports activities should be restricted. When WBGT is over 31 degrees C, sports activities should be stopped. PMID:22690612

Kawahara, Takashi

2012-06-01

167

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

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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 f...

Guerrero Patrick; Li Xinning; Patel Ketan; Brown Michael; Busconi Brian

2009-01-01

168

Polymorphisms in the myeloperoxidase gene locus are associated with acute kidney injury-related outcomes  

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Myeloperoxidase (MPO) is a lysosomal enzyme that may be involved in oxidative stress-mediated kidney injury. Using a 2-step approach, we measured the association of 4 polymorphisms across the length of the MPO gene with systemic markers of oxidative stress; plasma MPO and urinary 15-F2t-isoprostane levels. Adverse outcomes were measured in a primary cohort of 262 adults hospitalized with acute kidney injury, and a secondary cohort of 277 adults undergoing cardiac surgery with cardiopulmonary ...

Perianayagam, Mary C.; Tighiouart, Hocine; Liangos, Orfeas; Kouznetsov, Diana; Wald, Ron; Rao, Fangwen; O’connor, Daniel T.; Jaber, Bertrand L.

2012-01-01

169

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

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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 ...

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

2013-01-01

170

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

171

A roentgenographic study of the posterior urethral injury associated with pelvic bone fracture in male  

International Nuclear Information System (INIS)

The author analyzed detailed pattern of pelvic bone fracture in 52 cases of posterior urethral injury associated with pelvic bone fracture in male. The relationship between fracture and urethral injury was reviewed in 38 cases who received retrograde urethography at the time of injury. The pattern of urethral injury due to pelvic bone fracture was newly classified. The results were as follows: 1. In age distribution, the most common was 5th decade (26.9%). 2 . The most frequent type of pelvic rami fracture was two rami fracture (52%). 3. There was no case with only the superior ramus fracture, and all cases were associated with inferior ramus fracture with or without superior ramus fracture. 4. In inferior ramus fracture, the ratio of ischial ramus fracture to pubic ramus fracture was 46.1 : 17.4. 5. In cases with only the ischial ramus or pubic ramus fracture, unilateral fracture exceed bilateral fracture (44.2 : 19.3). 6. The bladder rupture was found in 10 among the total 52 cases, 9 of which were associated with superior ramus fracture, and 8 were extraperitoneal type. 7. The most common type of urethral injury was Tpye III (73.7%), and followed by Type II (10.5%), Type I (7.9%), and Type IV (7.9%). 8. These results strongly suggested that the superior ramus fracture was related to bladder rapture, and inferior ramus fracture to urethal injury

1983-03-01

172

Acute kidney injury associated with metamizole sodium ingestion.  

Science.gov (United States)

Metamizole sodium, a nonsteroidal anti-inflammatory drug, has been widely used in the last 100 years. Its efficacy as an analgesic and antipyretic is unquestionable. Only few cases of acute kidney injury (AKI) induced by metamizole sodium were reported in the medical literature. We report 11 adult patients with AKI that resulted from metamizole sodium ingestion. The data suggest a good prognosis in these cases of AKI. Renal biopsies, corticosteroids treatment, or renal replacement therapy seem to be not necessary. Hydration was sufficient to ensure spontaneous recovery. PMID:21446784

Hassan, Kamal; Khazim, Khalid; Hassan, Fadi; Hassan, Shadi

2011-01-01

173

Myelinated afferents signal the hyperalgesia associated with nerve injury.  

Science.gov (United States)

Pain to light touching of the skin is a hallmark sign of causalgia. The purpose of this study was to determine whether myelinated or unmyelinated afferent fibers signal this hyperalgesia. Sensory testing was performed in 17 patients with long-standing hyperalgesia after nerve injury. The patients underwent a differential ischemic block of nerve function of the involved area. At a time when touch sensation in adjacent normal skin was eliminated, but when sensibility to warming and cooling stimuli was unaffected, the hyperalgesia to mechanical stimuli was abolished in 15 of the subjects. In 2 of these 15 patients, a differential local anesthetic block of the injured nerve was performed proximal to the site of injury. When temperature sensibility was absent, but when touch sensation was intact, hyperalgesia was present. In a third study, latency measurements in response to 400 micron stepped displacement stimuli were made in two patients who had hyperalgesia on the foot. The mean latency for detection of pain in the hyperalgesic region was 414 +/- 18 msec, compared to 458 +/- 16 msec for the detection of touch to the same stimuli applied to the opposite normal foot. These 3 lines of evidence indicate that myelinated primary afferents, perhaps A beta fibers, signal the hyperalgesic pain in causalgia. These fibers may be sensitized A beta nociceptors or low-threshold mechanoreceptors. PMID:3340426

Campbell, J N; Raja, S N; Meyer, R A; Mackinnon, S E

1988-01-01

174

Self-Injurious Behavior and Eating Disorders: The Extent and Nature of the Association  

Science.gov (United States)

We have reviewed the literature on the association between self-injurious behaviors (SIB) and eating disorders from the psychological-behavioral perspective. Our aims were to investigate the extent and possible reasons for the association. A literature search was conducted using the following electronic databases (1989-2005): Medline, PsychInfo…

Svirko, Elena; Hawton, Keith

2007-01-01

175

Acute kidney injury in non-severe pneumonia is associated with an increased immune response and lower survival  

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While sepsis is a leading cause of acute kidney injury in critically ill patients, the relationship between immune response and acute kidney injury in less severely ill patients with infection is not known. Here we studied the epidemiology, 1-year mortality, and immune response associated with acute kidney injury in 1836 hospitalized patients with community-acquired severe and non-severe pneumonia. Acute kidney injury developed in 631 patients of whom 329 had severe and 302 had non-severe sep...

Murugan, Raghavan; Karajala-subramanyam, Vijay; Lee, Minjae; Yende, Sachin; Kong, Lan; Carter, Melinda; Angus, Derek C.; Kellum, John A.

2010-01-01

176

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.

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

2013-01-01

177

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

1994-03-01

178

Self-injury and aggression in tuberous sclerosis complex: cross syndrome comparison and associated risk markers  

Science.gov (United States)

Background Research reporting prevalence rates of self-injurious and aggressive behaviour in people with tuberous sclerosis complex (TSC) is limited. No studies have compared rates of these behaviours in TSC with those in other syndrome groups matched for degree of disability or investigated risk markers for these behaviours in TSC. Methods Data from the Challenging Behaviour Questionnaire were collected for 37 children, aged 4 to 15 years, with TSC. Odds ratios were used to compare rates of self-injury and aggression in children with TSC with children with idiopathic autism spectrum disorder (ASD), fragile X, Cornelia de Lange and Down syndromes. Characteristics were measured using the Mood Interest and Pleasure Questionnaire, the Activity Questionnaire, the Social Communication Questionnaire, the Repetitive Behaviour Questionnaire, the Wessex Behaviour Schedule and the revised Non-communicating Children Pain Checklist. Mann-Whitney U analyses were used to compare characteristics between individuals with self-injury and aggression and those not showing these behaviours. Results Rates of self-injury and aggression in TSC were 27% and 50%, respectively. These are high but not significantly different from rates in children with Down syndrome or other syndrome groups. Both self-injury and aggression were associated with stereotyped and pain-related behaviours, low mood, hyperactivity, impulsivity and repetitive use of language. Children who engaged in self-injury also had lower levels of interest and pleasure and showed a greater degree of ‘insistence on sameness’ than children who did not self-injure. Aggression was associated with repetitive behaviour. The majority of these associations remained significant when the association with level of adaptive functioning was controlled for. Conclusions Behavioural profiles can be used to identify those most at risk of developing self-injury and aggression. Further research is warranted to understand the influence of such internal factors as mood, ASD symptomatology and pain on challenging behaviour in people with intellectual disability.

2014-01-01

179

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

Energy Technology Data Exchange (ETDEWEB)

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.

Kim, Eui Jong; Ryu, Kyung Nam; Ahn, Jin Whan; Yoon, Yup [Kyung Hee University Hospital, Seoul (Korea, Republic of)

1994-03-15

180

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

Science.gov (United States)

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

 
 
 
 
181

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

International Nuclear Information System (INIS)

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

1997-09-01

182

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 "1"0"6Ru 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

1979-01-01

183

Charges associated with pediatric head injuries: A five-year retrospective review of 41 pediatric hospitals in the US.  

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Full Text Available BACKGROUND: Brain injuries are a significant public health problem, particularly among the pediatric population. Brain injuries account for a significant portion of pediatric injury deaths, and are the highest contributor to morbidity and mortality in the pediatric and young adult populations. Several studies focus on particular mechanisms of brain injury and the cost of treating brain injuries, but few studies exist in the literature examining the highest contributing mechanisms to pediatric brain injury and the billed charges associated with them. METHODS: Data were extracted from the Pediatric Health Information System (PHIS from member hospitals on all patients admitted with diagnosed head injuries and comparisons were made between ICU and non-ICU admissions. Collected data included demographic information, injury information, total billed charges, and patient outcome. RESULTS: Motor vehicle collisions, falls, and assaults/abuse are the three highest contributors to brain injury in terms of total numbers and total billed charges. These three mechanisms of injury account for almost $1 billion in total charges across the five-year period, and account for almost half of the total charges in this dataset over that time period. CONCLUSION: Research focusing on brain injury should be tailored to the areas of the most pressing need and the highest contributing factors. While this study is focused on a select number of pediatric hospitals located throughout the country, it identifies significant contributors to head injuries, and the costs associated with treating them.

Charles Edward McConnel

2013-01-01

184

A review of recent perspectives on biomechanical risk factors associated with anterior cruciate ligament injury.  

Science.gov (United States)

There is considerable evidence to support a number of biomechanical risk factors associated with non-contact anterior cruciate ligament (ACL) injury. This paper aims to review these biomechanical risk factors and highlight future directions relating to them. Current perspectives investigating trunk position and relationships between strength, muscle activity and biomechanics during landing/cutting highlight the importance of increasing hamstring muscle force during dynamic movements through altering strength, muscle activity, muscle length and contraction velocity. In particular, increased trunk flexion during landing/cutting and greater hamstring strength are likely to increase hamstring muscle force during landing and cutting which have been associated with reduced ACL injury risk. Decision making has also been shown to influence landing biomechanics and should be considered when designing tasks to assess landing/cutting biomechanics. Coaches should therefore promote hamstring strength training and active trunk flexion during landing and cutting in an attempt to reduce ACL injury risk. PMID:24650339

Hughes, Gerwyn

2014-01-01

185

A rare presentation of flexor digitorum profundus type V avulsion injury with associated intra-articular fracture: A case report  

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Traumatic avulsions of the flexor digitorum profundus tendon are associated with young adults engaged in athletic activities such as football and rugby. The current report presents a case involving a 30-year-old man with traumatic avulsion of his flexor digitorum profundus and associated intra-articular distal phalangeal fracture secondary to injury during martial arts – an unusual cause of this injury. Increased attention to injuries acquired during this form of sporting activity is sugges...

Rizis, D.; Mahoney, Jl

2011-01-01

186

Postconcussional disorder and PTSD symptoms of military-related traumatic brain injury associated with compromised neurocircuitry.  

Science.gov (United States)

Traumatic brain injury (TBI) is a common combat injury, often through explosive blast, and produces heterogeneous brain changes due to various mechanisms of injury. It is unclear whether the vulnerability of white matter differs between blast and impact injury, and the consequences of microstructural changes on neuropsychological function are poorly understood in military TBI patients. Diffusion tensor imaging (DTI) techniques were used to assess the neurocircuitry in 37 U.S. service members (29 mild, 7 moderate, 1 severe; 17 blast and 20 nonblast), who sustained a TBI while deployed, compared to 14 nondeployed, military controls. High-dimensional deformable registration of MRI diffusion tensor data was followed by fiber tracking and tract-specific analysis along with region-of-interest analysis. DTI results were examined in relation to post-concussion and post-traumatic stress disorder (PTSD) symptoms. The most prominent white matter microstructural injury for both blast and nonblast patients was in the frontal fibers within the fronto-striatal (corona radiata, internal capsule) and fronto-limbic circuits (fornix, cingulum), the fronto-parieto-occipital association fibers, in brainstem fibers, and in callosal fibers. Subcortical superior-inferiorly oriented tracts were more vulnerable to blast injury than nonblast injury, while direct impact force had more detrimental effects on anterior-posteriorly oriented tracts, which tended to cause heterogeneous left and right hemispheric asymmetries of white matter connectivity. The tractography using diffusion anisotropy deficits revealed the cortico-striatal-thalamic-cerebellar-cortical (CSTCC) networks, where increased post-concussion and PTSD symptoms were associated with low fractional anisotropy in the major nodes of compromised CSTCC neurocircuitry, and the consequences on cognitive function were explored as well. PMID:24038816

Yeh, Ping-Hong; Wang, Binquan; Oakes, Terrence R; French, Louis M; Pan, Hai; Graner, John; Liu, Wei; Riedy, Gerard

2014-06-01

187

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

188

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 no threat during opening or when damaged

2008-05-01

189

Impact of availability of guidelines and active surveillance in reducing the incidence of ventilator-associated pneumonia in Europe and worldwide  

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Background To analyse whether the availability of written standards for management of mechanically ventilated patients and/or the existence of a surveillance system for cases of ventilation-associated pneumonia (VAP) are positively associated with compliance with 6 well-established VAP prevention measures. Methods Ecological study based on responses to an online-questionnaire completed by 1730 critical care physicians. Replies were received from 77 different countries, of which the majority, i.e. 1351, came from 36 European countries. Results On a cross-country level, compliance with VAP prevention measures is higher in countries with a large number of prevention standards and/or VAP surveillance systems in place at ICU level., Likewise, implementation of standards and VAP surveillance systems has a significant impact on self-reported total compliance with VAP prevention measures (both p?surveillance system. For instance, a female physician with 10 years of experience in critical care working in a 15-bed ICU in France has a predicted baseline level of VAP prevention measure compliance of 63 per cent. This baseline level increases by 9.5 percentage points (p?surveillance system. Conclusions The existence of written standards for management of mechanically ventilated patients in an ICU and the availability of VAP surveillance systems have shown to be positively associated with compliance with VAP prevention measures and should be fostered on a policy level.

2014-01-01

190

Central Line-Associated Bloodstream Infections in Adult Hematology Patients with Febrile Neutropenia: An Evaluation of Surveillance Definitions Using Differential Time to Blood Culture Positivity  

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We used differential time to positivity between central and peripheral blood cultures to evaluate the positive predictive value (PPV) of the National Healthcare Safety Network central line–associated bloodstream infection (CLABSI) surveillance definition among hematology patients with febrile neutropenia. The PPV was 27.7%, which suggests that, when the definition is applied to this population, CLABSI rates will be substantially overestimated.

Freeman, Joshua T.; Elinder-Camburn, Anna; McClymont, Catherine; Anderson, Deverick J.; Bilkey, Mary; Williamson, Deborah A.; Berkahn, Leanne; Roberts, Sally A.

2013-01-01

191

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

192

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

2007-08-01

193

Protection from radiation-associated small bowel injury with the aid of an absorbable mesh  

International Nuclear Information System (INIS)

Radiation associated small bowel injury results from aggressive treatment of pelvic malignancies with radiation therapy. The incidence increases when radiation therapy follows pelvic surgery due to adhesions that form between the small bowel and the operated site. Application of an absorbable polyglycolic acid mesh to keep the small bowel from descending into the pelvis and around the operated site prevents this complication. Use to date in humans and non-human primates has not been associated with any complications

1986-01-01

194

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

International Nuclear Information System (INIS)

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.

2012-08-01

195

Endothelial ischemia-reperfusion injury in humans: association with age and habitual exercise.  

Science.gov (United States)

Advancing age is a major risk factor for coronary artery disease. Endothelial dysfunction accompanied by increased oxidative stress and inflammation with aging may predispose older arteries to greater ischemia-reperfusion (I/R) injury. Because coronary artery ischemia cannot be induced safely, the effects of age and habitual endurance exercise on endothelial I/R injury have not been determined in humans. Using the brachial artery as a surrogate model of the coronary arteries, endothelial function, assessed by brachial artery flow-mediated dilation (FMD), was measured before and after 20 min of continuous forearm occlusion in young sedentary (n = 10, 24 ± 2 yr) and middle-aged (n = 9, 48 ± 2 yr) sedentary adults to gain insight into the effects of primary aging on endothelial I/R injury. Young (n = 9, 25 ± 1 yr) and middle-aged endurance-trained (n = 9, 50 ± 2 yr) adults were also studied to determine whether habitual exercise provides protection from I/R injury. Fifteen minutes after ischemic injury, FMD decreased significantly by 37% in young sedentary, 35% in young endurance-trained, 68% in middle-aged sedentary, and 50% in middle-aged endurance-trained subjects. FMD returned to baseline levels within 30 min in young sedentary and endurance-trained subjects but remained depressed in middle-aged sedentary and endurance-trained subjects. Circulating markers of antioxidant capacity and inflammation were not related to FMD. In conclusion, advancing age is associated with a greater magnitude and delayed recovery from endothelial I/R injury in humans. Habitual endurance exercise may provide partial protection to the endothelium against this form of I/R injury with advancing age. PMID:21239631

Devan, Allison E; Umpierre, Daniel; Harrison, Michelle L; Lin, Hsin-Fu; Tarumi, Takashi; Renzi, Christopher P; Dhindsa, Mandeep; Hunter, Stacy D; Tanaka, Hirofumi

2011-03-01

196

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

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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

197

Association between ward-specific antimicrobial use density and methicillin-resistant Staphylococcus aureus surveillance: a 60-month study  

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Full Text Available Junichi Yoshida, Tetsuya Kikuchi, Nobuo Matsubara, Ikuko Asano, Nobumichi Ogami Infection Control Committee, Shimonoseki City Hospital, Shimonoseki, Yamaguchi, Japan Abstract: It is not known whether or not ward-specific antimicrobial use density (AUD affects the ratio of methicillin-resistant Staphylococcus aureus (MRSA in culture-positive S. aureus. A 60-month study was attempted to ascertain the association between inpatient MRSA ratio and ward-specific AUDs as well as the former and latter study intervals, specimen types, and ward specialty. During the study, the professionals in infection control regulated the use of broad-spectrum antimicrobials and those for MRSA. By both month and ward, the ratio of inpatients positive for MRSA to those positive for S. aureus was calculated. Factors associated with MRSA ratio included AUDs averaged for the sampling month and its previous month, outpatient MRSA ratio by age, ward specialty, specimen type, and half intervals to represent historical changes. Of a total of 4,245 strains of S. aureus isolated during the 5-year study, 2,232 strains (52.6% were MRSA. By year, outpatient MRSA ratio at age ?15 decreased in later years, as did inpatient MRSA ratio. Multivariate analysis for inpatient MRSA ratio revealed a positive risk in AUDs for meropenem (odds ratio [OR] 1.761; 95% confidence interval [CI] 1.761–2.637, P = 0.01, imipenem-cilastatin (OR 1.583; 95% CI 1.087–2.306, P = 0.02, ampicillin-sulbactam (OR 1.623; 95% CI 1.114–2.365, P = 0.01, and minocycline (OR 1.680; CI 1.135–2.487, P = 0.01, respiratory care ward (OR 2.292; 95% CI 1.085–4.841, P = 0.03, and outpatient MRSA ratio (OR 1.536; 95% CI 1.070–2.206, P = 0.02. Use of broad-spectrum antimicrobials, such as meropenem, imipenem-cilastatin, and ampicillin-sulbactam may increase inpatient MRSA ratio. Ward factor should be included in MRSA surveillance because of the possible effect on AUD and considering patients' backgrounds. Keywords: surveillance, respiratory tract, methicillin-resistant Staphylococcus aureus

Yoshida J

2013-07-01

198

Occult bony lesions associated with anterior cruciate ligament injury; Assessment with MR imaging  

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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).

Nawata, Koji; Toshima, Ryota; Yamamoto, Yoshizo (Tottori Univ., Yonago (Japan). School of Medicine); Suzuki, Toshiro; Date, Shinya

1993-09-01

199

Grb2-associated binder 1 is essential for cardioprotection against ischemia/reperfusion injury.  

Science.gov (United States)

We have shown recently that endothelial Grb-2-associated binder 1 (Gab1), an intracellular scaffolding adaptor, has a protective effect against limb ischemia via mediating angiogenic signaling pathways. However, the role of Gab1 in cardiac ischemia/reperfusion (I/R) injury remains unknown. In this study, we show that Gab1 is required for cardioprotection against I/R injury. I/R injury led to remarkable phosphorylation of Gab1 in cardiomyocytes. Compared with controls, the mice with cardiomyocyte-specific deletion of Gab1 gene (CGKO mice) exhibited an increase in infarct size and a decrease in cardiac function after I/R injury. Consistently, in hearts of CGKO mice subjected to I/R, the activation of caspase 3 and myocardial apoptosis was markedly enhanced whereas the activation of protein kinase B (Akt) and mitogen-activated protein kinase (MAPK), which are critical for cardiomyocyte survival, was attenuated. Oxidative stress is regarded as a major contributor to myocardial I/R injury. To examine the role of Gab1 in oxidative stress directly, isolated adult cardiomyocytes were subject to oxidant hydrogen peroxide and the cardioprotective effects of Gab1 were confirmed. Furthermore, we found that the phosphorylation of Gab1 and Gab1-mediated activation of Akt and MAPK by oxidative stress was suppressed by ErbB receptor and Src kinase inhibitors, accompanied by an increase in apoptotic cell death. In conclusion, our results suggest that Gab1 is essential for cardioprotection against I/R oxidative injury via mediating survival signaling. PMID:24951957

Sun, Lulu; Chen, Chao; Jiang, Beibei; Li, Yanli; Deng, Qiuping; Sun, Min; An, Xiangbo; Yang, Xiao; Yang, Ying; Zhang, Rongli; Lu, Yao; Zhu, De-Sheng; Huo, Yingqing; Feng, Gen-Sheng; Zhang, Youyi; Luo, Jincai

2014-07-01

200

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 â?¥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.

Vainer, Ben; Gerds, Thomas Alexander

2014-01-01

 
 
 
 
201

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

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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

202

Impact of Education and Process Surveillance on Device-Associated Health Care-Associated Infection Rates in a Turkish ICU: Findings of the International Nosocomial Infection Control Consortium (INICC)  

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Objective: The aim of this study was to analyze the impact of process and outcome surveillance on rates of device-associated health care-associated infections (DA-HAI) in an intensive care unit (ICU) in Turkey over a four-year period.Material and Methods: An open label, prospective cohort, active DA-HAI surveillance study was conducted on 685 patients admitted to the ICU of a university hospital in Turkey from January 2004 to December 2007, implementing the methodology developed by the Intern...

2012-01-01

203

National surveillance of dialysis-associated diseases in the United States, 1989.  

Science.gov (United States)

To determine trends in a variety of dialysis-associated diseases and practices, the Centers for Disease Control surveyed 1,867 chronic hemodialysis centers in the United States in 1989 in conjunction with the annual facility survey performed by the Health Care Financing Administration. The response rate to a mailed questionnaire was 92%. These 1,726 centers represented 122,734 patients and 32,486 staff members. The following results were found. 1) During the last 14 years, the incidence of hepatitis B virus (HBV) infection decreased from 3.0 to 0.1% among patients, and from 2.6 to 0.1% among staff members. Over the same time, the prevalence of hepatitis B surface antigen (HBsAg) positivity declined from 7.8 to 1.4% among patients and from 0.9 to 0.3% among staff members. Hepatitis B vaccine was given by 92% of the centers. By the end of 1989, 19% of susceptible patients and 55% of susceptible staff members had received all three doses of hepatitis B vaccine. From 1982 to 1989, as a result of receiving vaccine, the prevalence of antibody to HBsAg (anti-HBs) increased from 12 to 19% among patients and from 18 to 54% among staff. The incidence of non-A, non-B hepatitis in 1989 was reported to be 0.7% among patients and 0.1% among staff members. 2) Twenty-two percent of the centers reported pyrogenic reactions in the absence of septicemia among their patients, and 51% reported septicemia. 3) The reported incidence of dialysis dementia among hemodialysis patients was 0.2%, with a case fatality rate of 23%. 4) In 1989, 68% of centers reported that they reused disposable dialyzers; these centers treated 73% of the dialysis patient population. Among centers that reused disposable dialyzers, the average number of reuses ranged from 1 to 50 (mean, 12) and the maximum number of times a disposable dialyzer was ever reused ranged from 3 to 150 (mean, 28). Chemical germicides used for reprocessing dialyzers included formaldehyde, Renalin (a peracetic acid-hydrogen peroxide-based germicide), and glutaraldehyde-based germicides. Reuse of disposable dialyzers was not associated with any increased risk of acquiring HBV infection among either patients or staff. However, pyrogenic reactions occurring in clusters were reported more frequently in centers that reused conventional dialyzer membranes compared with centers that did not. This increased risk was associated only with centers that used Renalin or glutaraldehyde for reprocessing (not formaldehyde) and occurred with both automated and manual reprocessing systems.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1830208

Alter, M J; Favero, M S; Moyer, L A; Bland, L A

1991-01-01

204

Urine neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute canine kidney injury  

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Abstract Background Biomarkers for the early prediction of canine acute kidney injury (AKI) are clinically important. Recently, neutrophil gelatinase-associated lipocalin (NGAL) was found to be a sensitive biomarker for the prediction of human AKI at a very early stage and the development of AKI after surgery. However, NGAL has not yet been studied with respect to dog kidney diseases. The application of NGAL canine AKI was investigated in this study. Results The...

2012-01-01

205

Furosemide is associated with acute kidney injury in critically ill patients  

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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 (...

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

2012-01-01

206

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

Energy Technology Data Exchange (ETDEWEB)

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 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.

Kim, Soon; Oh, Yeon Hee; Lee, Chang Wook [Dongguk Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Yong Min [Chungbuk Univ. College of Medicine, Chongju (Korea, Republic of); Lee, Hyeon Kyeong; Kim, Seung Hyeon; Lee, Sung Woo [Dongguk Univ. College of Medicine, Seoul (Korea, Republic of)

1997-05-01

207

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

208

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

209

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.

Alifrangis, Michael

2014-01-01

210

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

Science.gov (United States)

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 malaria 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 (?2 =?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.

2014-01-01

211

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

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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

212

Incidence of work injuries amongst Danish adolescents and their association with work environment factors  

DEFF Research Database (Denmark)

BACKGROUND: The objective was to examine the incidence of work accidents that required medical attention among Danish adolescents and to identify possible work environment factors associated with such accidents. METHODS: We collected information in two questionnaire rounds (2004 and 2007) from a birth cohort comprising all adolescents born in 1989 (n = 3,687) living in Ringkjobing County, Denmark. The questionnaire contained items on self-reported number of accidents and number of working hours in both rounds and on work environment factors in the second round. RESULTS: Approximately 5% of the adolescents who held a job, experienced a work injury at the age of 17. This equals an incidence of 65 accidents per million working hours. Most adolescents had decent working conditions, although nearly half reported that their work was heavy, monotonous or psychologically demanding. Heavy work, high psychological demands and low social support increased the risk of experiencing work injuries after adjustment for a number of factors. CONCLUSIONS: The incidence of work injuries among adolescents appears to be higher than the incidence among their older colleagues. Lack of social support from management significantly raised adolescents' risk of experiencing a work injury. This suggests that more direct supervision may be a good way of preventing accidents in this age group

Rasmussen, K.; Hansen, C. D.

2011-01-01

213

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. Cancer Immunol Res; 2(3); 187-93. ©2014 AACR. PMID:24778314

Fearon, Douglas T

2014-03-01

214

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

Directory of Open Access Journals (Sweden)

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

215

Bloodstream infections and clinical significance of healthcare-associated bacteremia: a multicenter surveillance study in Korean hospitals.  

Science.gov (United States)

Recent changes in healthcare systems have changed the epidemiologic paradigms in many infectious fields including bloodstream infection (BSI). We compared clinical characteristics of community-acquired (CA), hospital-acquired (HA), and healthcare-associated (HCA) BSI. We performed a prospective nationwide multicenter surveillance study from 9 university hospitals in Korea. Total 1,605 blood isolates were collected from 2006 to 2007, and 1,144 isolates were considered true pathogens. HA-BSI accounted for 48.8%, CA-BSI for 33.2%, and HCA-BSI for 18.0%. HA-BSI and HCA-BSI were more likely to have severe comorbidities. Escherichia coli was the most common isolate in CA-BSI (47.1%) and HCA-BSI (27.2%). In contrast, Staphylococcus aureus (15.2%), coagulase-negative Staphylococcus (15.1%) were the common isolates in HA-BSI. The rate of appropriate empiric antimicrobial therapy was the highest in CA-BSI (89.0%) followed by HCA-BSI (76.4%), and HA-BSI (75.0%). The 30-day mortality rate was the highest in HA-BSI (23.0%) followed by HCA-BSI (18.4%), and CA-BSI (10.2%). High Pitt score and inappropriate empirical antibiotic therapy were the independent risk factors for mortality by multivariate analysis. In conclusion, the present data suggest that clinical features, outcome, and microbiologic features of causative pathogens vary by origin of BSI. Especially, HCA-BSI shows unique clinical characteristics, which should be considered a distinct category for more appropriate antibiotic treatment. PMID:20592888

Son, Jun Seong; Song, Jae-Hoon; Ko, Kwan Soo; Yeom, Joon Sup; Ki, Hyun Kyun; Kim, Shin-Woo; Chang, Hyun-Ha; Ryu, Seong Yeol; Kim, Yeon-Sook; Jung, Sook-In; Shin, Sang Yop; Oh, Hee Bok; Lee, Yeong Seon; Chung, Doo Ryeon; Lee, Nam Yong; Peck, Kyong Ran

2010-07-01

216

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

Directory of Open Access Journals (Sweden)

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

217

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

Science.gov (United States)

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

218

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

Energy Technology Data Exchange (ETDEWEB)

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.

Kim, Young Nam; Kim, Baek Hyun; Jung, Hoe Seok; Na, Eui Sung; Seol, Hye Young; Cha, In Ho; Lim, Hong Chul [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

1998-07-01

219

Prediction and clinical relevance of pathologic patterns of injury associated with chorioamnionitis.  

Science.gov (United States)

The aim of the present study was to evaluate both prediction and clinical relevance of different patterns of injury associated with chorioamnionitis. Pathologic examination of placentas and umbilical cords were performed in 45 pregnant women who had had diagnostic amniocentesis for suspected intraamniotic infection. A positive correlation was noted between leukocyte account in amniotic fluid and the level of maternal injury (r = 0.46, p = 0.04). The levels of amniotic fluid glucose were significantly reduced in cases of fetal infection (2 mg/dL (1-16 mg/dL)) vs. (20.50 mg/dL (11-29 mg/dL)) (p = 0.03). PMID:24231448

Abehsera, D; Rodrigues, Y; Mingorance, J; Suárez, A; Magdaleno, F; Bartha, J L

2014-01-01

220

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)

2002-06-01

 
 
 
 
221

Matrix metalloproteinase-9 is associated with acute inflammation after olfactory injury  

Science.gov (United States)

We previously reported an increase in matrix metalloproteinase-9 (MMP-9) levels in the olfactory bulb immediately following nerve transection, however its role remains unknown. In this report, we determined the source of MMP-9 by monitoring the infiltration of inflammatory leukocytes in the olfactory bulb following nerve transection. We used myeloperoxidase to identify neutrophils and CD68 to identify macrophages at days 1, 7, and 10. MMP-9 co-localized with neutrophils at all three time points but was not contained in macrophages. This is the first report to demonstrate that MMP-9 is associated with the early inflammatory response following olfactory injury and provides insight into mechanisms underlying olfactory injury and recovery processes.

Bakos, Stephen R.; Costanzo, Richard M.

2011-01-01

222

Semaphoring 3A: an association between traumatic brain injury and enhanced osteogenesis.  

Science.gov (United States)

An accelerated speed of fracture-healing in patients with traumatic brain injury (TBI) is often encountered in clinical practice. However the mechanisms responsible for this phenomenon are remain unclear. After TBI, many cytokines have been reported change their expressions, suggest that the phenomenon of accelerated speed of fracture-healing may be associated with these cytokines. Semaphorin 3A is a secreted cytokine regulated by neural injury, and it is known to guide axon/dendrite growth and neuronal migration. Recent studies suggest that Semaphorin 3A is so far the only molecule that can regulate bone resorption and formation synchronously. However, a Semaphoring 3A which could perhaps induce enhanced osteogenesis under TBI condition has not yet been identified. Therefore, we presume that Semaphoring 3A may play a key role in accelerated fracture-healing under TBI condition, and these will make Sema3A as a promising potential therapeutic target for facilitating fracture healing. PMID:23932049

Zhang, Licheng; Zhang, Lihai; Mao, Zhi; Tang, Peifu

2013-10-01

223

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.

224

Combined effects of sivelestat and resveratrol on severe acute pancreatitis-associated lung injury in rats.  

Science.gov (United States)

ABSTRACT Despite extensive research and clinical efforts made in the management of acute pancre-atitis during the past few decades, to date no effective cure is available and the mortality from severe acute pancre-atitis remains high. Given that lung is the primary cause of early death in acute pancreatitis patients, novel therapeutic approaches aiming to prevent lung injury have become a subject of intensive investigation. In a previous study, we demonstrated that sivelestat, a specific inhibitor of neutrophil elastase, is effective in protecting against lung failure in rats with taurocholate-induced acute pancreatitis. As part of the analyses extended from that study, the present study aimed to evaluate the role of sivelestat and/or resveratrol in the protection against acute pancreatitis-associated lung injury. The extended analyses demonstrated the following: (1) sodium taurocholate induced apparent lung injury and dysfunction manifested by histological anomalies, including vacuolization and apoptosis of the cells in the lung, as well as biochemical aberrations in the blood (an increase in amylase concentration and a decrease in partial arterial oxygen pressure) and increases in activities of reactive oxygen species, interleukin 6, myeloperoxidase, neutrophil elastase, lung edema, bronchotracho alveolar lavage protein concentration, and bronchotracho alveolar lavage cell infiltration in the lung; and (2) in lung tissues, either sivelestat or resveratrol treatment effectively attenuated the taurocholate-induced abnormalities in all parameters analyzed except for serum amylase concentration. In addition, combined treatment with both sivelestat and resveratrol demonstrated additive protective effects on pancreatitis-associated lung injury compared with single treatment. PMID:24785170

Wang, Houhong; Wang, Shuai; Tang, Amao; Gong, Huihui; Ma, Panpan; Chen, Li

2014-08-01

225

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.

226

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  

Directory of Open Access Journals (Sweden)

Full Text Available 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.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, informes 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.

Yliana Rojas Medina

2011-03-01

227

Burn-injury affects gut-associated lymphoid tissues derived CD4+ T cells?  

Science.gov (United States)

After scald burn-injury, the intestinal immune system responds to maintain immune balance. In this regard CD4+T cells in Gut-Associated Lymphoid Tissues (GALT), like mesenteric lymph nodes (MLN) and Peyer's patches (PP) respond to avoid immune suppression following major injury such as burn. Therefore, we hypothesized that the gut CD4+T cells become dysfunctional and turn the immune homeostasis towards depression of CD4+ T cell-mediated adaptive immune responses. In the current study we show down regulation of mucosal CD4+ T cell proliferation, IL-2 production and cell surface marker expression of mucosal CD4+ T cells moving towards suppressive-type. Acute burn-injury lead to up-regulation of regulatory marker (CD25+), down regulation of adhesion (CD62L, CD11a) and homing receptor (CD49d) expression, and up-regulation of negative co-stimulatory (CTLA-4) molecule. Moreover, CD4+CD25+ T cells of intestinal origin showed resistance to spontaneous as well as induced apoptosis that may contribute to suppression of effector CD4+ T cells. Furthermore, gut CD4+CD25+ T cells obtained from burn-injured animals were able to down-regulate naïve CD4+ T cell proliferation following adoptive transfer of burn-injured CD4+CD25+ T cells into sham control animals, without any significant effect on cell surface activation markers. Together, these data demonstrate that the intestinal CD4+ T cells evolve a strategy to promote suppressive CD4+ T cell effector responses, as evidenced by enhanced CD4+CD25+ T cells, up-regulated CTLA-4 expression, reduced IL-2 production, tendency towards diminished apoptosis of suppressive CD4+ T cells, and thus lose their natural ability to regulate immune homeostasis following acute burn-injury and prevent immune paralysis.

Fazal, Nadeem; Shelip, Alla; Alzahrani, Alhusain J.

2013-01-01

228

Syndesmosis injuries.  

Science.gov (United States)

Traumatic injuries to the distal tibiofibular syndesmosis commonly result from high-energy ankle injuries. They can occur as isolated ligamentous injuries and can be associated with ankle fractures. Syndesmotic injuries can create a diagnostic and therapeutic challenge for musculoskeletal physicians. Recent literature has added considerably to the body of knowledge pertaining to injury mechanics and treatment outcomes, but there remain a number of controversies regarding diagnostic tests, implants, techniques, and postoperative protocols. Use of the novel suture button device has increased in recent years and shows some promise in clinical and cadaveric studies. This article contains a review of syndesmosis injuries, including anatomy and biomechanics, diagnosis, classification, and treatment options. PMID:23949902

Hunt, Kenneth J

2013-12-01

229

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

230

C/EBP homologous protein deficiency aggravates acute pancreatitis and associated lung injury  

Digital Repository Infrastructure Vision for European Research (DRIVER)

AIM: To investigate the pathophysiological role of C/EBP homologous protein (CHOP) in severe acute pancreatitis and associated lung injury. METHODS: A severe acute pancreatitis model was induced with 6 injections of cerulein (Cn, 50 ?g/kg) at 1-h intervals, then intraperitoneal injection of lipopolysaccharide (LPS, 7.5 mg/kg) in CHOP-deficient (Chop-/-) mice and wild-type (WT) mice. Animals were sacrificed under anesthesia, 3 h or 18 h after LPS injection. Serum amylase, lipase, and cyt...

Te-I Weng; Hsiao-Yi Wu; Bo-Lin Chen; Jie-Yang Jhuang; Kuo-How Huang; Chih-Kang Chiang; Shing-Hwa Liu

2013-01-01

231

Collapsing glomerulopathy and hemolytic uremic syndrome associated with falciparum malaria: completely reversible acute kidney injury.  

Science.gov (United States)

Acute kidney injury (AKI) is one of the most dreaded complications of severe malaria. Herein, we report a case of spontaneous resolution of AKI due to collapsing glomerulopathy (CG) and hemolytic-uremic syndrome (HUS) associated with P. falciparum malaria. Our case report highlights the fact that early intervention on the triggering cause of CG without a long course of steroids may obtain a remission of this severe subset of CG and may obtain a remission of HUS without therapeutic plasmapheresis The etiologic treatment of CG and HUS may avoid progression to end-stage renal disease. PMID:24431586

Kute, Vivek Balkrishna; Trivedi, Hargovind L; Vanikar, Aruna V; Shah, Pankaj R; Gumber, Manoj R; Kanodia, Kamal V

2013-10-01

232

Autonomic dysreflexia associated with Charcot spine following spinal cord injury: a case report and literature review  

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We report the case of a 50-year-old man presenting symptoms of autonomic dysreflexia associated with Charcot spine following complete C8 spinal cord injury. After posterior lumbar interbody fusion of L2/3 with simultaneous posterior instrumentation from L1 to L5, the patient recovered from the symptoms of autonomic dysreflexia. Although the patient began to faint when he sat up and transferred after surgery, it began to be resolved by continuous urinary catheterization, setting a limit to act...

Morita, Masahiro; Iwasaki, Motoki; Okuda, Shinya; Oda, Takenori; Miyauchi, Akira

2010-01-01

233

Effect of subcutaneous injection of botulinum toxin A on spinal cord injury-associated neuropathic pain.  

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Study design:Case report.Objective:To present a case of spinal cord injury (SCI)-associated neuropathic pain treated with botulinum toxin A injection.Setting:Outpatient SCI clinic.Case report:Description of a case in the context of relevant literature on the subject.Results:A 51-year-old man with C3 AIS B tetraplegia (American Spinal Injury Association Impairment Scale B) visited our outpatient clinic due to severe ongoing neuropathic pain and associated allodynia and dysesthesia of the lower limbs. He had previously tried combinations of pregabalin, gabapentin and oxycontin but all failed to alleviate his neuropathic pain during the 2 years post trauma. With the patient's consent, he was treated with subcutaneous injections of clostridium type A botulinum toxin. Ten units of type A botulinum toxin subcutaneously injected into 10 most painful sites of each sole. The patient was reassessed at 4 and 8 weeks after his injection with botulinum toxin with significant improvement of his neuropathic pain.Conclusion:Subcutaneous injection of type A botulinum toxin was effective without side effects, on one case of refractory neuropathic pain due to SCI. This is the first article to report the use of type A botulinum toxin in neuropathic pain related to traumatic SCI. PMID:24902645

Han, Z A; Song, D H; Chung, M E

2014-06-01

234

Nitrotyrosine Level Was Associated with Mortality in Patients with Acute Kidney Injury  

Science.gov (United States)

Background To examine the characteristics of oxidative stress in patients with acute kidney injury (AKI) and investigate the association between plasma nitrotyrosine levels and 90-day mortality in patients with AKI. Methodology/Principal Findings 158 patients with hospital-acquired AKI were recruited to this prospective cohort study according to RIFLE (Risk, Injury, Failure, Lost or End Stage Kidney) criteria. Twelve critically ill patients without AKI and 15 age and gender-matched healthy subjects served as control. Plasma 3-nitrotyrosine was analyzed in relation to 90-day all cause mortality of patients with AKI. The patients with AKI were followed up for 90 days and grouped according to median plasma 3-nitrotyrosine concentrations. Highest 3-NT/Tyr was detected in patients with AKI compared with healthy subjects, and critically ill patients without AKI (ANOVA p<0.001). The 90-day survival curves of patients with high 3-NT/Tyr showed significant differences compared with the curves of individuals with low 3-NT/Tyr (p?=?0.001 by log rank test). Multivariate analysis (Cox regression) revealed that 3-NT/Tyr (p?=?0.025) was independently associated with mortality after adjustment for age, gender, sepsis and Acute Physiology and Chronic Health Evaluation (APACHE) II score. Conclusions/Significance There is excess plasma protein oxidation in patients with AKI, as evidenced by increased nitrotyrosine content. 3-NT/Tyr level was associated with mortality of AKI patients independent of the severity of illness.

Zhu, Qiuyu; Ma, Shuai; Zhou, Ying; Zheng, Ying; Liu, Junfeng; Kuang, Dingwei; Gu, Yong; Hao, Chuanming; Ding, Feng

2013-01-01

235

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

Science.gov (United States)

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

236

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 ope [...] radas 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 < 0,05) na comparação de cada combinação de lesões de ligamentos com a presença de fratura, luxação evidente ou mecanismo do trauma. CONCLUSÃO: Lesões do LCP submetidas a tratamento cirúrgico em centro de atenção ao trauma ortopédico foram na sua maioria multiligamentares e envolveram principalmente o LCA. Houve associação significativa entre o tipo de lesão com o mecanismo de trauma, a forma de apresentação do joelho, se luxado ou reduzido, e a presença de fratura associada. 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 < 0.05) comparing each combination of ligament injuries with the presence of fracture, dislocation or clear mechanism of injury. CONCLUSION: Surgical treatment of PCL injuries in a center for orthopedic trauma care was mostly multiligament and mainly involving the ACL. A significant association was seen between the type of injury with mechanism of injury, presentation of the knee, if dislocated or reduced, and the presence of associated fracture.

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

237

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; Mylam, Karen Juul

2012-01-01

238

Peripheral nerve injury is associated with chronic, reversible changes in global DNA methylation in the mouse prefrontal cortex.  

Science.gov (United States)

Changes in brain structure and cortical function are associated with many chronic pain conditions including low back pain and fibromyalgia. The magnitude of these changes correlates with the duration and/or the intensity of chronic pain. Most studies report changes in common areas involved in pain modulation, including the prefrontal cortex (PFC), and pain-related pathological changes in the PFC can be reversed with effective treatment. While the mechanisms underlying these changes are unknown, they must be dynamically regulated. Epigenetic modulation of gene expression in response to experience and environment is reversible and dynamic. Epigenetic modulation by DNA methylation is associated with abnormal behavior and pathological gene expression in the central nervous system. DNA methylation might also be involved in mediating the pathologies associated with chronic pain in the brain. We therefore tested a) whether alterations in DNA methylation are found in the brain long after chronic neuropathic pain is induced in the periphery using the spared nerve injury modal and b) whether these injury-associated changes are reversible by interventions that reverse the pathologies associated with chronic pain. Six months following peripheral nerve injury, abnormal sensory thresholds and increased anxiety were accompanied by decreased global methylation in the PFC and the amygdala but not in the visual cortex or the thalamus. Environmental enrichment attenuated nerve injury-induced hypersensitivity and reversed the changes in global PFC methylation. Furthermore, global PFC methylation correlated with mechanical and thermal sensitivity in neuropathic mice. In summary, induction of chronic pain by peripheral nerve injury is associated with epigenetic changes in the brain. These changes are detected long after the original injury, at a long distance from the site of injury and are reversible with environmental manipulation. Changes in brain structure and cortical function that are associated with chronic pain conditions may therefore be mediated by epigenetic mechanisms. PMID:23383129

Tajerian, Maral; Alvarado, Sebastian; Millecamps, Magali; Vachon, Pascal; Crosby, Cecilia; Bushnell, M Catherine; Szyf, Moshe; Stone, Laura S

2013-01-01

239

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

Science.gov (United States)

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.

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

2013-01-01

240

Skin injuries on the body and thigh of dairy cows : associations with season, claw health, disease treatment, and other cow characteristics.  

DEFF Research Database (Denmark)

An epidemiological study was conducted in 18 dairy herds with the objective to characterize those groups of cows where skin injuries to the body and thighs occurred most frequently. Data were analyzed with multivariable logistic regression. The epidemiologic patterns were different in first and later lactations. In first lactation some degree of injury occurred among 7.7% of 1793 cows. For most cows occurrence of sole ulcer was positively associated with injury while occurrence of heel horn erosion was negatively associated with injury. The association between injury and body weight differed depending on month of calving (significant interaction). Injuries occurred most frequently among high yielding cows. Severe reproductive, metabolic, and/or infectious diseases were associated with injuries. In later lactations some degree of injury occurred among 13.4% of 832 cows in lactations 2 to 9 where severity of injury increased with lactation number. Injuries occurred least frequently at examinations made in the January to March. They occurred most frequently among cows with sole ulcers. Calving in March through October was associated with injuries especially if the cows were treated for limb disorders. Most cases of injuries occurred early or late in lactation or among high or very low yielding cows in lactations 2 to 9.

Enevoldsen, Carsten; Gröhn, Y.T.

1994-01-01

 
 
 
 
241

[Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO)].  

Science.gov (United States)

In recent years, much attention has been paid to respiratory complications of transfusion. Transfusion related acute lung injury (TRALI) is defined as an acute lung injury that is temporally associated with blood transfusion. TRALI is one of the leading causes of mortality. Although the etiology of TRALI is not fully understood, one of its main causes is thought to be anti-leukocyte antibodies, such as HLA antibody or HNA antibody. A precautionary male-predominant plasma strategy has been implemented in many developed countries, which has resulted in considerable achievements in reducing the incidence of TRALI. Meanwhile, transfusion-associated circulatory overload (TACO) has emerged as a major differential diagnosis of TRALI. TACO is a well-known complication of transfusion, which has been considered not as a side effect of transfusion but a result of erroneous medical practice. It has long been an under-reported complication of transfusion and has not been investigated scientifically. Recent data on transfusion mortality from the Food and Drug Administration revealed that TACO was the second highest cause of death in the United States. Our data also suggested a steep increase in the reported cases of TACO in Japan. Precautionary measures should also be implemented for this emerging complication. PMID:23947178

Okazaki, Hitoshi

2013-05-01

242

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

Directory of Open Access Journals (Sweden)

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

243

Identification of indicator proteins associated with flooding injury in soybean seedlings using label-free quantitative proteomics.  

Science.gov (United States)

Flooding injury is one of the abiotic constraints on soybean growth. An experimental system established for evaluating flooding injury in soybean seedlings indicated that the degree of injury is dependent on seedling density in floodwater. Dissolved oxygen levels in the floodwater were decreased by the seedlings and correlated with the degree of injury. To understand the molecular mechanism responsible for the injury, proteomic alterations in soybean seedlings that correlated with severity of stress were analyzed using label-free quantitative proteomics. The analysis showed that the abundance of proteins involved in cell wall modification, such as polygalacturonase inhibitor-like and expansin-like B1-like proteins, which may be associated with the defense system, increased dependence on stress at both the protein and mRNA levels in all organs during flooding. The manner of alteration in abundance of these proteins was distinct from those of other responsive proteins. Furthermore, proteins also showing specific changes in abundance in the root tip included protein phosphatase 2A subunit-like proteins, which are possibly involved in flooding-induced root tip cell death. Additionally, decreases in abundance of cell wall synthesis-related proteins, such as cinnamyl-alcohol dehydrogenase and cellulose synthase-interactive protein-like proteins, were identified in hypocotyls of seedlings grown for 3 days after flooding, and these proteins may be associated with suppression of growth after flooding. These flooding injury-associated proteins can be defined as indicator proteins for severity of flooding stress in soybean. PMID:23659366

Nanjo, Yohei; Nakamura, Takuji; Komatsu, Setsuko

2013-11-01

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

245

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

246

Neutrophil gelatinase-associated lipocalin: a novel biomarker in acute kidney injury.  

Science.gov (United States)

Acute kidney injury (AKI) is a frequent complication in critically ill patients and is associated with high morbidity and mortality; therefore, its prophylaxis, diagnosis and intervention positively impact patient evolution. Neutrophil gelatinase-associated lipocalin (NGAL) or lipocalin, a protein synthesized by renal tubular cells, has the property to transport lipophilic molecules such as vitamins, hormones and antigenic agents. It is a novel biomarker of AKI of several etiologies and is increased in both serum and urine 48 h before the increase of creatinine. It has a strong correlation with early diagnosis of AKI. NGAL is of the most investigated and promising biomarkers for early diagnosis of AKI in different clinical scenarios, most notably in sepsis, cardiorenal syndrome, cardiac surgery, kidney transplant, contrast nephropathy and hemolytic uremic syndrome. Lipocalin guides the early institution of therapeutic interventions to improve prognosis in AKI of several etiologies. PMID:22169379

Carrillo-Esper, Raúl; Castillo-Albarrán, Fátima Martha; Pérez-Jáuregui, José

2011-01-01

247

Annual report for Brookhaven National Laboratory 1994 epidemiologic surveillance  

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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 that do not work for DOE to identify disease patterns or clusters that may be associated with work activities. In this annual report, the 1994 morbidity data for BNL are summarized. These analyses focus on absences of 5 or more consecutive workdays occurring among workers aged 16-80 years. They are arranged in five sets of tables that present: (1) the distribution of the labor force by occupational category and salary status; (2) the absences per person, diagnoses per absence, and diagnosis rates for the whole work force; (3) diagnosis rates by type of disease or injury; (4) diagnosis rates by occupational category; and (5) relative risks for specific types of disease or injury by occupational category.

NONE

1997-01-01

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

Haplotype analysis of ApoAI gene and sepsis-associated acute lung injury  

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Background Apolipoprotein A1 (ApoA1) is the major apoprotein constituent of high density lipoprotein (HDL) which exerts innate protective effects in systemic inflammation. However, its role in the acute lung injury (ALI) has not been well studied. In the present study we investigated the association between polymorphisms of ApoA1 gene and ALI in a Chinese population. Methods Three polymorphisms of the ApoA1 gene (rs11216153, rs2070665, and rs632153) were genotyped by TaqMan method in 290 patients with sepsis-associated ALI, 285 patients sepsis alone and 330 age- and sex-matched healthy controls. Results We found rs11216153 polymorphism of ApoA1 was associated with ALI, the GG genotype and G allele was common in the ALI patients (76.9%, 88.1%, respectively) than both in the control subjects (55.8%, 75.8%, respectively) and in the sepsis alone patients (58.2%, 78.4%, respectively). Haplotype consisting of these three SNPs strengthened the association with ALI susceptibility. The frequency of haplotype GTG in the ALI samples was significantly higher than that in the healthy control group (OR?=?2.261, 95% CI: 1.735?~?2.946, P sepsis alone group (OR?=?1.789, 95% CI: 1.373?~?2.331.P?sepsis alone group (OR?=?0.491, 95% CI: 0.356?~?0.676, P sepsis-associated ALI in Han Chinese population.

2014-01-01

250

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

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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 (pweekday 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

251

Association between risk factors for injurious falls and new benzodiazepine prescribing in elderly persons  

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Full Text Available Abstract Background Benzodiazepines are frequently prescribed to elderly patients' despite concerns about adverse effects leading to injurious falls. Previous studies have not investigated the extent to which patients with pre-existing risk factors for falls are prescribed benzodiazepines. The objective of this study is to assess if some of the risk factors for falls are associated with new benzodiazepine prescriptions in elderly persons. Methods Using provincial administrative databases, elderly Quebec residents were screened in 1989 for benzodiazepine use and non-users were followed for up to 5 years. Logistic regression models were used to evaluate potential predictors of new benzodiazepine use among patient baseline characteristics. Results In the 252,811 elderly patients who had no benzodiazepine prescription during the baseline year (1989, 174,444 (69% never filled a benzodiazepine prescription and 78,367 (31% filled at least one benzodiazepine prescription. In the adjusted analysis, several risk factors for falls were associated with statistically significant increases in the risk of receiving a new benzodiazepine prescription including the number of prescribing physicians seen at baseline (OR: 1.12; 95% CI 1.11–1.13, being female (OR: 1.20; 95% CI 1.18–1.22 or a diagnosis of arthritis (OR: 1.11; 95% CI 1.09–1.14, depression (OR: 1.42; 95% CI 1.35–1.49 or alcohol abuse (OR: 1.24; 95% CI 1.05–1.46. The strongest predictor for starting a benzodiazepine was the use of other medications, particularly anti-depressants (OR: 1.85; 95% CI 1.75–1.95. Conclusion Patients with pre-existing conditions that increase the risk of injurious falls are significantly more likely to receive a new prescription for a benzodiazepine. The strength of the association between previous medication use and new benzodiazepine prescriptions highlights an important medication safety issue.

Sylvestre Marie-Pierre

2009-01-01

252

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)

2003-01-01

253

Evaluation of the criteria for angiotomography indications in the diagnosis of carotid and vertebral arterial injury associated with blunt trauma  

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Full Text Available Abstract Background Blunt carotid and vertebral artery injury (BCVI occur infrequently. The incidence of this type of injury is difficult to determine as many emergency room patients are neurologically asymptomatic. The statistics have not been reported in Brazil. The objectives of the current study were: To evaluate the accuracy of criteria used to recommend angiotomography in the diagnosis of cervical BCVI in 100 patients with blunt cervical trauma in the trauma services section of a Brazilian quaternary care hospital. Methods During a 30-month (2006-2008, all patients admitted to the emergency room of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo with blunt cervical trauma and potential risk of cervical vessel injury, were subjected to cervical angiotomography to diagnose BCVI. The data analyzed are presented as mean ± standard deviation, and statistical analyses included Chi-square and Fisher's exact tests, and the Mann-Whitney test. Results During the study period 2467 blunt trauma patients were admitted. In 100 patients that met the criteria for inclusion in the study, angiotomography identified 23 with BCVI, including 17 males and six females. The mean patient age was 34.81 ± 14.84 years. Car crash (49% and car-pedestrian accidents (24% were the most frequent causes of injury. Ten patients had internal carotid artery injuries, two patients had common carotid artery injuries, and 11 patients had vertebral artery injuries. Seven patients presented with Degree I arterial injuries, 10 patients presented with Degree II artery injuries, four patients presented with Degree IV artery injuries, one patient presented with a Degree V artery injury, and one patient had a carotid fistula. Seven out of the 23 patients with BCVI (30.4% presented with cervical vertebrae fractures, and 11 out of the 23 patients with BCVI (47.8% presented with facial fractures (LeFort II and III. Conclusions Although there is no consensus regarding the criteria that should be used to indicate angiotomography for BCVI diagnosis, we conclude that the criteria used in the current study led to a diagnosis of BCVI in 0.93% of 2,467 trauma patients, BCVI injuries were associated with more severe traumas and did not affect mortality.

Almerindo Júnior

2010-06-01

254

Treatment with ginkgo biloba extract protects rats against acute pancreatitis-associated lung injury by modulating alveolar macrophage  

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Introduction Acute pancreatitis (AP) protease release induces lung parenchymal destruction via inflammatory mediators. Ginkgo biloba has been reported to have anti-inflammatory effects. Aim To evaluate the effect of ginkgo biloba extract on experimental acute pancreatitis-associated lung injury in the rat and to investigate the underlying mechanisms. Material and methods Acute pancreatitis was induced in rats by injection of 5% sodium taurocholate into the biliary pancreatic duct. Ginkgo biloba extract (GBE) was administered and pancreas and lung injury were assessed by histological examination. Alveolar macrophages were harvested by bronchoalveolar lavage. Specificity fluorescent probe DAF-FM-DA was applied to observe nitric oxide (NO) bioavailability in alveolar macrophage. The expression of tumour necrosis factor ? (TNF-?) and macrophage migration inhibitory factor (MIF) protein in alveolar macrophage was studied by ELISA. Results In sodium taurocholate-induced acute pancreatitis, treatment with GBE significantly protected rats against lung injury associated with pancreatitis in histological sections. Ginkgo biloba extract had a tendency to down-regulate NO bioavailability compared with the AP group, but without statistical significance. Moreover, TNF-? and MIF at protein levels in alveolar macrophage with GBE treatment were decreased compared with the AP group. Conclusions These results suggest that GBE could effectively protect rats against acute pancreatitis-associated lung injury. The GBE may inhibit excessive activation of alveolar macrophages from acute pancreatitis-associated lung injury through down-regulation of generation of NO, TNF-? and MIF. These findings suggest that ginkgo biloba extract is a suitable candidate as an effective strategy against acute pancreatitis-associated lung injury.

Xu, Xiao-Wu; Yang, Xiao-Min; Bai, Yong-Heng; Zhao, Yan-Rong; Shi, Gong-Sheng; Zhang, Jian-Guo

2014-01-01

255

Oxidative Stress and Modification of Renal Vascular Permeability Are Associated with Acute Kidney Injury during P. berghei ANKA Infection  

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Malaria associated-acute kidney injury (AKI) is associated with 45% of mortality in adult patients hospitalized with severe form of the disease. However, the causes that lead to a framework of malaria-associated AKI are still poorly characterized. Some clinical studies speculate that oxidative stress products, a characteristic of Plasmodium infection, as well as proinflammatory response induced by the parasite are involved in its pathophysiology. Therefore, we aimed to investigate the develop...

Elias, Rosa Maria; Correa-costa, Matheus; Barreto, Claudiene Rodrigues; Silva, Reinaldo Correia; Hayashida, Caroline Y.; Castoldi, A?ngela; Gonc?alves, Giselle Martins; Braga, Tarcio Teodoro; Barboza, Renato; Rios, Francisco Jose?; Keller, Alexandre Castro; Cenedeze, Marcos Antonio; Hyane, Meire Ioshie; D Impe?rio-lima, Maria Regina; Figueiredo-neto, Anto?nio Martins

2012-01-01

256

Circulating Markers of Vascular Injury and Angiogenesis in ANCA-Associated Vasculitis  

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Objective To identify biomarkers that distinguish between active ANCA-associated vasculitis (AAV) and remission in a manner superior or complementary to established markers of systemic inflammation. Methods Markers of vascular injury and angiogenesis were measured before and after treatment in a large clinical trial in AAV. 163 subjects enrolled in the Rituximab in ANCA-Associated Vasculitis (RAVE) trial were studied. Serum levels of E-selectin, ICAM-3, MMP1, MMP3, MMP9, P-selectin, thrombomodulin, and VEGF were measured at study screening (time of active disease) and at month 6. ESR and CRP levels had been measured at the time of the clinical visit. The primary outcome was the difference in marker level between screening and month 6 among patients in remission (BVAS/WG score of 0) at month 6. Results All subjects had severe active vasculitis (mean BVAS/WG score 8.6 +/? 3.2 SD) at screening. Among the 123 subjects clinically in remission at month 6, levels of all markers except E-selectin showed significant declines. MMP3 levels were also higher among the 23 subjects with active disease at month 6 than among the 123 subjects in remission. MMP3 levels correlated weakly with ESR and CRP. Conclusion Many markers of vascular injury and angiogenesis are elevated in severe active AAV and decline with treatment, but MMP3 appears to distinguish active AAV from remission better than the other markers studied. Further study of MMP3 is warranted to determine its clinical utility in combination with conventional markers of inflammation and ANCA titers.

Monach, Paul A; Tomasson, Gunnar; Specks, Ulrich; Stone, John H; Cuthbertson, David; Krischer, Jeffrey; Ding, Linna; Fervenza, Fernando C; Fessler, Barri J; Hoffman, Gary S; Ikle, David; Kallenberg, Cees GM; Langford, Carol A; Mueller, Mark; Seo, Philip; St.Clair, E William; Spiera, Robert; Tchao, Nadia; Ytterberg, Steven R; Gu, Yi-Zhong; Snyder, Ronald D; Merkel, Peter A

2011-01-01

257

U.S. Department of Energy Office of Health, Safety and Security Illness and Injury Surveillance Program Worker Health at a Glance, 2000-2009  

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The Worker Health at a Glance, 2000 – 2009 provides an overview of selected illness and injury patterns among the current DOE contractor workforce that have emerged over the 10-years covered by this report. This report is a roll-up of data from 16 individual DOE sites, assigned to one of three program offices (Office of Environmental Management, Office of Science and the National Nuclear Security Administration). In this report, an absences is defined as 40 or more consecutive work hours (5+ calendar days) off the job. Shorter absences were not included.

none,

2013-01-23

258

Mortality associated with extremity injuries compared with other types of trauma  

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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

259

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

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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

260

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

 
 
 
 
261

Nail gun injuries among construction workers.  

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Pneumatic nail guns greatly increase worker productivity and are extensively used in wood frame building construction, with especially high use in residential construction. One surveillance report of nail gun injuries in Washington State has been published; however, other literature consists largely of case reports and case series in trauma journals. The major objective of the current study was to investigate the occurrence of nail gun-associated injuries among construction workers and to identify preventable work-related factors associated with these injuries. Nail gun-related injuries occurring among a cohort of 13,347 carpenters in Ohio who worked union hours during the time period January 1, 1994, until September 30, 1997, were identified by matching the cohort with workers' compensation claims made to the Ohio Bureau of Workers' Compensation. We also analyzed workers' compensation claims for North Carolina Home Builders Association members for the period July 1996-November 1999 to identify nail gun-related injuries. Analyses included stratified analyses of claims by nature and body part injured, calculation of nail gun injury rates, and analyses of free text descriptions of injuries. Overall, nail gun injuries were responsible for 3.9 percent of workers' compensation claims with 8.3 percent to 25.5 percent of claims involving paid lost work time. The overall rate of nail gun injuries (cases per 200,000 work hours) was 0.33 in North Carolina and 0.26 in Ohio, reflecting the greater concentration of wood frame construction workers in the North Carolina population studied. Higher rates of injury were observed for carpenters in North Carolina and among residential carpenters in Ohio. The predominant body part injured was the hands/fingers, with 80 to 89 percent of injuries being nail punctures. Analyses of free text information for puncture injuries found approximately 70 percent of injuries to occur during the framing/sheathing stage of construction. Our data suggest that approximately 69 percent of puncture injuries may be due to an inadvertent gun discharge or misfire, preventable in large part by the use of sequential triggers. Worker training and education also are important components of nail gun injury prevention. PMID:12746081

Dement, John M; Lipscomb, Hester; Li, Leiming; Epling, Carol; Desai, Tejas

2003-05-01

262

Phytosterols Promote Liver Injury and Kupffer Cell Activation in Parenteral Nutrition-Associated Liver Disease  

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Parenteral nutrition–associated liver disease (PNALD) is a serious complication of PN in infants who do not tolerate enteral feedings, especially those with acquired or congenital intestinal diseases. Yet, the mechanisms underlying PNALD are poorly understood. It has been suggested that a component of soy oil (SO) lipid emulsions in PN solutions, such as plant sterols (phytosterols), may be responsible for PNALD, and that use of fish oil (FO)–based lipid emulsions may be protective. We used a mouse model of PNALD combining PN infusion with intestinal injury to demonstrate that SO-based PN solution causes liver damage and hepatic macrophage activation and that PN solutions that are FO-based or devoid of all lipids prevent these processes. We have furthermore demonstrated that a factor in the SO lipid emulsions, stigmasterol, promotes cholestasis, liver injury, and liver macrophage activation in this model and that this effect may be mediated through suppression of canalicular bile transporter expression (Abcb11/BSEP, Abcc2/MRP2) via antagonism of the nuclear receptors Fxr and Lxr, and failure of up-regulation of the hepatic sterol exporters (Abcg5/g8/ABCG5/8). This study provides experimental evidence that plant sterols in lipid emulsions are a major factor responsible for PNALD and that the absence or reduction of plant sterols is one of the mechanisms for hepatic protection in infants receiving FO-based PN or lipid minimization PN treatment. Modification of lipid constituents in PN solutions is thus a promising strategy to reduce incidence and severity of PNALD.

El Kasmi, Karim C.; Anderson, Aimee L.; Devereaux, Michael W.; Vue, Padade M.; Zhang, Wujuan; Setchell, Kenneth D. R.; Karpen, Saul J.; Sokol, Ronald J.

2014-01-01

263

Orbital blow-out fractures: long-term visual outcome of associated ocular injuries.  

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Severe ocular injuries are uncommon in patients with pure orbital blow-out fractures. Over a 3-year period, 45 patients with radiologically proved blow-out fractures were reviewed by an ophthalmologist. Decrease in visual acuity was the main clinical finding accompanying significant eye injury. Although most eye injuries were transient, early ophthalmic assessment is recommended to exclude potentially serious complications such as traumatic optic neuropathy. Troublesome diplopia may delay rap...

Jayamanne, D. G.; Igillie, R. F.

1995-01-01

264

The Association Between Neuronal Nitric Oxide Synthase and Neuronal Sensitivity in the Brain After Brain Injury  

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Injury to the central nervous system is the leading cause of disability in the United States. Neuronal death is one of the causes of disability. Among patients who survive this type of injury, various degrees of recovery in brain function are observed. The molecular basis of functional recovery is poorly understood. Clinical observations and research using experimental injury models have implicated several metabolites in the cascade of events that lead to neuronal degeneration. The levels of ...

Liu, Philip K.; Robertson, Claudia S.; Valadka, Alex

2002-01-01

265

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

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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

266

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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 wer [...] e 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; Renata Saraiva, Guedes; Luciano, Casagrande; Thiago Machado, Ardenghi.

267

The role of endocrine mechanisms in ventilator-associated lung injury in critically ill patients.  

Science.gov (United States)

The critically ill subjects are represented by a heterogeneous group of patients suffering from a life-threatening event of different origin, e.g. trauma, cardiopulmonary failure, surgery or sepsis. The majority of these patients are dependent on the artificial lung ventilation, which means a life-saving chance for them. However, the artificial lung ventilation may trigger ventilation-associated lung injury (VALI). The mechanical ventilation at higher volumes (volutrauma) and pressure (barotrauma) can cause histological changes in the lungs including impairments in the gap and adherens junctions and desmosomes. The injured lung epithelium may lead to an impairment of the surfactant production and function, and this may not only contribute to the pathophysiology of VALI but also to acute respiratory distress syndrome. Other components of VALI are atelectrauma and toxic effects of the oxygen. Collectively, all these effects may result in a lung inflammation associated with a subsequent profibrotic changes, endothelial dysfunction, and activation of the local and systemic endocrine responses such as the renin-angiotensin system (RAS). The present review is aimed to describe some of the pathophysiologic aspects of VALI providing a basis for novel therapeutic strategies in the critically ill patients. PMID:22808908

Penesova, A; Galusova, A; Vigas, M; Vlcek, M; Imrich, R; Majek, M

2012-07-01

268

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

269

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

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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 o...

He, Shao-qiu; Yao, Jun-ru; Zhang, Fang-xiong; Wang, Qiong; Bao, Lan; Zhang, Xu

2010-01-01

270

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

271

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

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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

272

A Pilot Study of Factors Associated With Falls in Individuals With Incomplete Spinal Cord Injury  

Science.gov (United States)

Background/Objective: To determine factors associated with falls among a sample of ambulatory individuals with incomplete spinal cord injury (SCI). Study Design: Cross-sectional mail survey. Methods: A survey instrument of participant characteristics and fall-related variables was developed using relevant items from existing measures and was mailed to 221 individuals with incomplete SCI, who were identified from records of a large specialty hospital in the southeastern United States. Of the 221 prospective participants, 119 completed the questionnaire (54%). Multivariable logistic regression models were used to determine factors that were independently associated with having had a fall in the past year. Results: After adjusting for covariates, having fallen in the past year was significantly (P < 0.05) associated with greater numbers of medical conditions (odds ratio [OR] = 1.3; 95% confidence interval [CI] = 1.0–1.7), having arthritis (OR = 3.4, 95% CI = 1.2–9.6), experiencing dizziness (OR = 5.6, 95% CI = 1.1–27.7), greater numbers of days with poor physical health (OR = 1.1; 95% CI = 1.0–1.3), and the restriction of community activities because of fear of falling (OR = 1.5, 95% CI = 1.1–2.1). The multivariable models also showed that the odds of having fallen were significantly lower among those with better current perceived physical health (OR = 0.5; 95% CI = 0.3–0.9), those with better perceived health compared to a year ago (OR = 0.4; 95% CI = 0.2–0.8), individuals who exercised more frequently (OR = 0.2; 95% CI = 0.1–0.7), and those who used a walker (OR = 0.3; 95% CI = 0.1–0.9). Conclusions: Results suggest that interventions that address exercise frequency, walker use, and dizziness have promise for reducing falls for individuals with incomplete SCI.

Brotherton, Sandra S; Krause, James S; Nietert, Paul J

2007-01-01

273

Rye grass is associated with fewer non-contact anterior cruciate ligament injuries than bermuda grass  

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Objective: To assess the contribution of ground variables including grass type to the rate of anterior cruciate ligament (ACL) injury in the Australian Football League (AFL), specifically which factors are primarily responsible for previously observed warm season and early season biases for ACL injuries.

Orchard, J.; Chivers, I.; Aldous, D.; Bennell, K.; Seward, H.

2005-01-01

274

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

275

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

276

Functional disability of adult individuals with spinal cord injury and its association with socio-demographic characteristics.  

Science.gov (United States)

The aim was to investigate the Functional Disability degree in adults with spinal cord injury and its association with socio-demographic characteristics. The Barthel Index was used and 75 subjects answered a questionnaire with socio-demographic variables. The Chi-Square, Cronbach's Alpha and Fisher tests were used in the analysis. The mean age was 42.23 years. Cronbach's Alpha for the Barthel Index was 0.807. The activities that were more difficult to perform were Climbing and Descending Stairs (92%) and Walking (82.7%). The mean Barthel Index score was 64 points. The tests of association demonstrated values with p>0.05. Even though this population demonstrated a low degree of dependency and no association was identified between the socio-demographic variables and Functional Disability, the study contributes to nursing care for individuals with spinal cord injury, considering the limitations the condition imposes on their self-care. PMID:22481725

Coura, Alexsandro Silva; França, Inacia Sátiro Xavier de; Enders, Bertha Cruz; Barbosa, Mayara Lima; Souza, Juliana Raquel Silva

2012-01-01

277

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

278

Urine neutrophil gelatinase-associated lipocalin (NGAL as a biomarker for acute canine kidney injury  

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Full Text Available Abstract Background Biomarkers for the early prediction of canine acute kidney injury (AKI are clinically important. Recently, neutrophil gelatinase-associated lipocalin (NGAL was found to be a sensitive biomarker for the prediction of human AKI at a very early stage and the development of AKI after surgery. However, NGAL has not yet been studied with respect to dog kidney diseases. The application of NGAL canine AKI was investigated in this study. Results The canine NGAL gene was successfully cloned and expressed. Polyclonal antibodies against canine NGAL were generated and used to develop an ELISA for measuring NGAL protein in serum and urine samples that were collected from 39 dogs at different time points after surgery. AKI was defined by the standard method, namely a serum creatinine increase of greater than or equal to 26.5 ?mol/L from baseline within 48 h. At 12 h after surgery, compared to the group without AKI (12 dogs, the NGAL level in the urine of seven dogs with AKI was significantly increased (median 178.4 pg/mL vs. 88.0 pg/mL, and this difference was sustained to 72 h. Conclusion As the increase in NGAL occurred much earlier than the increase in serum creatinine, urine NGAL seems to be able to serve as a sensitive and specific biomarker for the prediction of AKI in dogs.

Lee Ya-Jane

2012-12-01

279

FK 506 ameliorates the hepatic injury associated with ischemia and reperfusion in rats.  

Science.gov (United States)

The effect of FK 506 on regeneration of the liver was studied in rats after a two-thirds partial hepatectomy after 60 min of ischemia of the unresected liver. The animals were divided into three distinct groups of 10 rats each. Group 1 (controls) received 0.5 ml saline solution intravenously 30 min after the induction of ischemia. Groups 2 and 3 were injected with FK 506 (0.3 mg/kg) intravenously 30 min after and 24 min before the induction of hepatic ischemia, respectively. The hepatic content of ATP and serum levels of ALT and lactate dehydrogenase were determined on each animal. In addition, the histological appearance and mitotic activity of the remnant liver was determined at regular 24-hr intervals after hepatic ischemia. All 10 control animals died within 72 hr. Treatment with FK 506 resulted in improved survival in groups 2 and 3 (30% and 80%, respectively). The improved survival seen in the FK 506-treated animals was reflected by a restoration of hepatic ATP content, a reduction in the serum levels of ALT and lactate dehydrogenase, an amelioration of hepatic necrosis and neutrophilic infiltration and an increase in the mitotic activity of the liver. These results suggest that FK 506 ameliorates the hepatic injury associated with ischemia/reperfusion and has a potent stimulatory effect on liver cell regeneration that may make it valuable as a hepatoprotective agent when administered to organ donors before graft harvesting. PMID:1709412

Sakr, M F; Zetti, G M; Hassanein, T I; Farghali, H; Nalesnik, M A; Gavaler, J S; Starzl, T E; Van Thiel, D H

1991-05-01

280

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

 
 
 
 
281

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 < 0.0001, bilateral primary somatosensory cortices (SI) (right: t = 4.4, p = 0.02; left: t = 4.48, p = 0.004) and the volume of the left ventroposterior (VP) nucleus of the thalamus (r = -0.52, p = 0.008). Based on these findings, we performed an atlas-based region-of-interest 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

282

Unusual presentation of Lisfranc fracture dislocation associated with high-velocity sledding injury: a case report and review of the literature  

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Abstract Introduction Lisfranc fracture dislocations of the foot are rare injuries. A recent literature search revealed no reported cases of injury to the tarsometatarsal (Lisfranc) joint associated with sledding. Case presentation A 19-year-old male college student presented to the emergency department with a Lisfranc fracture dislocation of the foot as a result of a high-velocity sledding injury. The patient underwent an immediate open reduction and internal f...

Benejam Christopher E; Potaczek Steven G

2008-01-01

283

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

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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

284

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

285

Peat Bog Wildfire Smoke Exposure in Rural North Carolina Is Associated with Cardiopulmonary Emergency Department Visits Assessed through Syndromic Surveillance  

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Background: In June 2008, burning peat deposits produced haze and air pollution far in excess of National Ambient Air Quality Standards, encroaching on rural communities of eastern North Carolina. Although the association of mortality and morbidity with exposure to urban air pollution is well established, the health effects associated with exposure to wildfire emissions are less well understood.

Rappold, Ana G.; Stone, Susan L.; Cascio, Wayne E.; Neas, Lucas M.; Kilaru, Vasu J.; Carraway, Martha Sue; Szykman, James J.; Ising, Amy; Cleve, William E.; Meredith, John T.; Vaughan-batten, Heather; Deyneka, Lana; Devlin, Robert B.

2011-01-01

286

Penetrating eye injuries from writing instruments  

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Simon P Kelly, Graham MB ReevesThe Royal Bolton Hospital, Bolton, UKPurpose: To consider the potential for ocular injury from writing implements by presenting four such cases, and to consider the incidence of such eye injuries from analysis of a national trauma database.Methods: The Home and Leisure Accident Surveillance System was searched for records of eye injuries from writing instruments to provide UK estimates of such injuries. Four patients with ocular penetrating injury from pens or p...

2011-01-01

287

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

288

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

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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...

2012-01-01

289

Endothelial ischemia-reperfusion injury in humans: association with age and habitual exercise  

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Advancing age is a major risk factor for coronary artery disease. Endothelial dysfunction accompanied by increased oxidative stress and inflammation with aging may predispose older arteries to greater ischemia-reperfusion (I/R) injury. Because coronary artery ischemia cannot be induced safely, the effects of age and habitual endurance exercise on endothelial I/R injury have not been determined in humans. Using the brachial artery as a surrogate model of the coronary arteries, endothelial func...

Devan, Allison E.; Umpierre, Daniel; Harrison, Michelle L.; Lin, Hsin-fu; Tarumi, Takashi; Renzi, Christopher P.; Dhindsa, Mandeep; Hunter, Stacy D.; Tanaka, Hirofumi

2011-01-01

290

Mandibular alveolar neurovascular bundle injury associated with impacted third molar surgery  

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Inferior alveolar neurovascular bundle (IANB) injury is one of the most common complications of third molar removal and involves important medicolegal issues. An accurate preoperative radiographic assessment of surgical difficulty is necessary to correctly plan the removal of impacted third molars and to estimate the risk of IANB injury. Therefore, the preoperative knowledge of the exact location of the third molar roots in relation to the mandibular canal is mandatory. A direct contact betwe...

Gallesio, Cesare

2010-01-01

291

Blocking leukotriene synthesis attenuates the pathophysiology of traumatic brain injury and associated cognitive deficits.  

Science.gov (United States)

Neuroinflammation is a component of secondary injury following traumatic brain injury (TBI) that can persist beyond the acute phase. Leukotrienes are potent, pro-inflammatory lipid mediators generated from membrane phospholipids. In the absence of injury, leukotrienes are undetectable in the brain, but after trauma they are rapidly synthesized by a transcellular event involving infiltrating neutrophils and endogenous brain cells. Here, we investigate the efficacy of MK-886, an inhibitor of 5-lipoxygenase activating protein (FLAP), in blocking leukotriene synthesis, secondary brain damage, synaptic dysfunction, and cognitive impairments after TBI. Male Sprague Dawley rats (9-11weeks) received either MK-886 or vehicle after they were subjected to unilateral moderate fluid percussion injury (FPI) to assess the potential clinical use of FLAP inhibitors for TBI. MK-886 was also administered before FPI to determine the preventative potential of FLAP inhibitors. MK-886 given before or after injury significantly blocked the production of leukotrienes, measured by reverse-phase liquid chromatography coupled to tandem mass spectrometry (RP LC-MS/MS), and brain edema, measured by T2-weighted magnetic resonance imaging (MRI). MK-886 significantly attenuated blood-brain barrier disruption in the CA1 hippocampal region and deficits in long-term potentiation (LTP) at CA1 hippocampal synapses. The prevention of FPI-induced synaptic dysfunction by MK-886 was accompanied by fewer deficits in post-injury spatial learning and memory performance in the radial arm water maze (RAWM). These results indicate that leukotrienes contribute significantly to secondary brain injury and subsequent cognitive deficits. FLAP inhibitors represent a novel anti-inflammatory approach for treating human TBI that is feasible for both intervention and prevention of brain injury and neurologic deficits. PMID:24681156

Corser-Jensen, Chelsea E; Goodell, Dayton J; Freund, Ronald K; Serbedzija, Predrag; Murphy, Robert C; Farias, Santiago E; Dell'Acqua, Mark L; Frey, Lauren C; Serkova, Natalie; Heidenreich, Kim A

2014-06-01

292

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 nonofficia...

Capaldi, D. M.; Shortt, J. W.; Kim, H. K.; Wilson, J.; Crosby, L.; Tucci, S.

2009-01-01

293

The first description of severe anemia associated with acute kidney injury and adult minimal change disease: a case report  

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Abstract Introduction Acute kidney injury in the setting of adult minimal change disease is associated with proteinuria, hypertension and hyperlipidemia but anemia is usually absent. Renal biopsies exhibit foot process effacement as well as tubular interstitial inflammation, acute tubular necrosis or intratubular obstruction. We recently managed a patient with unique clinical and pathological features of minimal change disease, who presented with severe anemia and acute kidne...

2009-01-01

294

Factors associated with antenatal care adequacy in rural and urban contexts-results from two health and demographic surveillance sites in Vietnam  

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Full Text Available Abstract Background Antenatal Care (ANC is universally considered important for women and children. This study aims to identify factors, demographic, social and economic, possibly associated with three ANC indicators: number of visits, timing of visits and content of services. The aim is also to compare the patterns of association of such factors between one rural and one urban context in northern Vietnam. Methods Totally 2,132 pregnant women were followed from identification of pregnancy until birth in two Health and Demographic Surveillance Sites (HDSS. Information was obtained through quarterly face to face interviews. Results Living in the rural area was significantly associated with lower adequate use of ANC compared to living in the urban area, both regarding quantity (number and timing of visits and content. Low education, living in poor households and exclusively using private sector ANC in both sites and self employment, becoming pregnant before 25 years of age and living in poor communities in the rural area turned out to increase the risk for overall inadequate ANC. High risk pregnancy could not be demonstrated to be associated with ANC adequacy in either site. The medical content of services offered was often inadequate, in relation to the national recommendations, especially in the private sector. Conclusion Low education, low economic status, exclusive use of private ANC and living in rural areas were main factors associated with risk for overall inadequate ANC use as related to the national recommendations. Therefore, interventions focussing on poor and less educated women, especially in rural areas should be prioritized. They should focus the importance of early attendance of ANC and sufficient use of core services. Financial support for poor and near poor women should be considered. Providers of ANC should be educated and otherwise influenced to provide sufficient core services. Adherence to ANC content guidelines must be improved through enhanced supervision, particularly in the private sector.

Tran Toan K

2012-02-01

295

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.)

2003-01-01

296

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

297

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

Scientific Electronic Library Online (English)

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%.

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

298

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.

299

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

300

Difference between pre-operative and cardiopulmonary bypass mean arterial pressure is independently associated with early cardiac surgery-associated acute kidney injury  

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Abstract Background Cardiac surgery-associated acute kidney injury (CSA-AKI) contributes to increased morbidity and mortality. However, its pathophysiology remains incompletely understood. We hypothesized that intra-operative mean arterial pressure (MAP) relative to pre-operative MAP would be an important predisposing factor for CSA-AKI. Methods We performed a prospective observational study of 157 consecutive high-risk patients undergoing cardiac surgery with c...

Kanji Hussein D; Schulze Costas J; Hervas-Malo Marilou; Wang Peter; Ross David B; Zibdawi Mohamad; Bagshaw Sean M

2010-01-01

 
 
 
 
301

Peat Bog Wildfire Smoke Exposure in Rural North Carolina Is Associated with Cardiopulmonary Emergency Department Visits Assessed Through Syndromic Surveillance  

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In June 2008 burning deposits of peat produced haze and air pollution far in excess of National Ambient Air Quality Standards, encroaching on rural communities of eastern North Carolina (NC). While the association of mortality and morbidity with exposure to urban air pollution is...

302

C/EBP homologous protein deficiency aggravates acute pancreatitis and associated lung injury  

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Full Text Available AIM: To investigate the pathophysiological role of C/EBP homologous protein (CHOP in severe acute pancreatitis and associated lung injury. METHODS: A severe acute pancreatitis model was induced with 6 injections of cerulein (Cn, 50 ?g/kg at 1-h intervals, then intraperitoneal injection of lipopolysaccharide (LPS, 7.5 mg/kg in CHOP-deficient (Chop-/- mice and wild-type (WT mice. Animals were sacrificed under anesthesia, 3 h or 18 h after LPS injection. Serum amylase, lipase, and cytokines [interleukin (IL-6 and tumor necrosis factor (TNF-?], pathological changes, acute lung injury, and apoptosis in the pancreas were evaluated. Serum amylase and lipase activities were detected using a medical automatic chemical analyzer. Enzyme-linked immunosorbent assay kits were used to evaluate TNF-? and IL-6 levels in mouse serum and lung tissue homogenates. Apoptotic cells in sections of pancreatic tissues were determined by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL analysis. The mouse carotid arteries were cannulated and arterial blood samples were collected for PaO2 analysis. The oxygenation index was expressed as PaO2/FiO2. RESULTS: Administration of Cn and LPS for 9 and 24 h induced severe acute pancreatitis in Chop-/- and WT mice. When comparing Chop-/- mice and WT mice, we observed that CHOP-deficient mice had greater increases in serum TNF-? (214.40 ± 19.52 pg/mL vs 150.40 ± 16.70 pg/mL; P = 0.037, amylase (4236.40 ± 646.32 U/L vs 2535.30 ± 81.83 U/L; P = 0.041, lipase (1678.20 ± 170.57 U/L vs 1046.21 ± 35.37 U/L; P = 0.008, and IL-6 (2054.44 ± 293.81 pg/mL vs 1316.10 ± 108.74 pg/mL; P = 0.046 than WT mice. The histopathological changes in the pancreases and lungs, decreased PaO2/FiO2 ratio, and increased TNF-? and IL-6 levels in the lungs were greater in Chop-/- mice than in WT mice (pancreas: Chop-/- vs WT mice, hemorrhage, P = 0.005; edema, P = 0.005; inflammatory cells infiltration, P = 0.005; total scores, P = 0.006; lung: hemorrhage, P = 0.017; edema, P = 0.017; congestion, P = 0.017; neutrophil infiltration, P = 0.005, total scores, P = 0.001; PaO2/FiO2 ratio: 393 ± 17.65 vs 453.8, P = 0.041; TNF-?: P = 0.043; IL-6, P = 0.040. Results from TUNEL analysis indicated increased acinar cell apoptosis in mice following the induction of acute pancreatitis. However, Chop-/- mice displayed significantly reduced pancreatic apoptosis compared with the WT mice (201.50 ± 31.43 vs 367.00 ± 47.88, P = 0.016. CONCLUSION: These results suggest that CHOP can exert protective effects against acute pancreatitis and limit the spread of inflammatory damage to the lungs.

Te-I Weng

2013-01-01

303

Association between nationality and occupational injury risk on Danish non-passenger merchant ships  

DEFF Research Database (Denmark)

BACKGROUND: Maritime occupational accidents can be determined by several factors, among which human characteristics play a crucial role. Worker's safety behaviour depends on individual physical and mental characteristics as well as on his/her social and cultural background. The aim of this study is to investigate the frequency of workplace injuries in the Danish merchant fleet in the period 2010-2012, and to characterise its nationality dependence. MATERIALS AND METHODS: Occupational injuries data reported from ships registered in the Danish International Ship Register to the Danish Maritime Authority were collected. Publicly available employment data were used to calculate the cumulative incidence rates for Danish, non-Danish European Union (EU) and non-EU employees working on non-passenger ships. Crude injury rates and rates adjusted for occupational status were statistically compared. RESULTS: The majority of accidents happened to Danish and non-EU workers on non-passenger ships. The injury rate varied around 70 per 1000 among Danish seafarers, while the rate for non-Danish employees was about 30 per 1000. Crude and adjusted relative risk was found significantly lower for EU (0.33-0.46;0.26-0.39) and for non-EU (0.41-0.53; 0.54-0.65) workers compared to Danish seafarers. The difference decreased, but remained significant in most cases for serious injuries. CONCLUSIONS: Occupational injury rates show considerable nationality differences as reported from non-passenger ships registered under the Danish flag. The differences can only be partly explained by varying reporting practices. The findings confirm the results of previous studies and point out the need for effective interventions in the high-risk groups.

Adam, B.

2013-01-01

304

Neuromuscular and hormonal factors associated with knee injuries in female athletes. Strategies for intervention.  

Science.gov (United States)

Female athletes who participate in jumping and cutting sports are 4 to 6 times more likely to sustain a serious knee injury than male athletes participating in the same sports. More than 30,000 serious knee injuries are projected to occur in female intercollegiate and high school athletics in the US each year. The majority of these injuries occur by non-contact mechanisms, most often during landing from a jump or making a lateral pivot while running. Knee instability, due possibly to decreased neuromuscular strength and coordination or increased ligamentous laxity, may underlie the increased incidence of knee injury in females. Neuromuscular training can significantly increase dynamic knee stability in female athletes. Female sex hormones (i.e. estrogen, progesterone and relaxin) fluctuate radically during the menstrual cycle and are reported to increase ligamentous laxity and decrease neuromuscular performance and, thus, are a possible cause of decreases in both passive and active knee stability in female athletes. Oral contraceptives stabilise hormone levels during the menstrual cycle and may function to either passively or actively stabilise the knee joint. The long term objective of clinicians and researchers should be to determine the factors that make women more susceptible than men to knee ligament injury and to develop treatment modalities to aid in the prevention of these injuries. The immediate objectives of this review are to examine how female and male athletes differ in neuromuscular and ligamentous control of the lower extremity. The review will examine the effects of neuromuscular training on knee stability. The effects of female hormone levels and oral contraceptives on neuromuscular control of the female athletes' knee will also be discussed. PMID:10840866

Hewett, T E

2000-05-01

305

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

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Full Text Available 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 workers were less likely than U.S.-born workers to seek professional medical treatment after occupational injuries. We also estimated the average mean medical expenditures per injured worker during the 2?year MEPS reference period using linear regression analysis, adjusting for gender, age, race, marital status, education, poverty level, and insurance. Types of service and sources of payment were compared between U.S.-born and immigrant workers. Results A total of 1,909 injured U.S.-born workers reported 2,176 occupational injury events and 508 injured immigrant workers reported 560 occupational injury events. The annual nonfatal incidence rate per 100 workers was 4.0% (95% CI: 3.8%-4.3% for U.S.-born workers and 3.0% (95% CI: 2.6%-3.3% for immigrant workers. Medical treatment was sought after 77.3% (95% CI: 75.1%-79.4% of the occupational injuries suffered by U.S.-born workers and 75.6% (95% CI: 69.8%-80.7% of the occupational injuries suffered by immigrant workers. The average medical expenditure per injured worker in the 2?year MEPS reference period was $2357 for the U.S.-born workers and $2,351 for immigrant workers (in 2009 U.S. dollars, P?=?0.99. Workers’ compensation paid 57.0% (95% CI: 49.4%-63.6% of the total expenditures for U.S.-born workers and 43.2% (95% CI: 33.0%-53.7% for immigrant workers. U.S.-born workers paid 6.7% (95% CI: 5.5%-8.3% and immigrant workers paid 7.1% (95% CI: 5.2%-9.6% out-of-pocket. Conclusions Immigrant workers had a statistically significant lower incidence rate of nonfatal occupational injuries than U.S.-born workers. There was no significant difference in seeking medical treatment and in the mean expenditures per injured worker between the two groups. The proportion of total expenditures paid by workers’ compensation was smaller (marginally significant for immigrant workers than for U.S.-born workers.

Xiang Huiyun

2012-08-01

306

Pathways to neuronal injury and apoptosis in HIV-associated dementia.  

Science.gov (United States)

Human immunodeficiency virus-1 (HIV-1) can induce dementia with alarming occurrence worldwide. The mechanism remains poorly understood, but discovery in brain of HIV-1-binding sites (chemokine receptors) provides new insights. HIV-1 infects macrophages and microglia, but not neurons, although neurons are injured and die by apoptosis. The predominant pathway to neuronal injury is indirect through release of macrophage, microglial and astrocyte toxins, although direct injury by viral proteins might also contribute. These toxins overstimulate neurons, resulting in the formation of free radicals and excitotoxicity, similar to other neurodegenerative diseases. Recent advances in understanding the signalling pathways mediating these events offer hope for therapeutic intervention. PMID:11309629

Kaul, M; Garden, G A; Lipton, S A

2001-04-19

307

New thoughts on the origin of Pellegrini-Stieda: the association of PCL injury and medial femoral epicondylar periosteal stripping  

International Nuclear Information System (INIS)

For the past 100 years, Pellegrini-Stieda disease has been described as calcification and ossification within the tibial collateral ligament, although these typical radiographic findings are often located more superior than the most proximal extent of the ligament. In this article, we demonstrate four magnetic resonance imaging cases of knee trauma with complete posterior cruciate ligament tear or avulsion, each demonstrating that injury to the medial collateral ligamentous complex can involve significant stripping of the tissue proximal to the medial epicondyle. Classic radiographic findings of Pellegrini-Stieda calcifications can be caused by stripping of the femoral periosteum proximal to the femoral attachment of the tibial collateral ligament, which appears to be associated with a complete posterior cruciate ligament injury. (orig.)

2009-02-01

308

New thoughts on the origin of Pellegrini-Stieda: the association of PCL injury and medial femoral epicondylar periosteal stripping  

Energy Technology Data Exchange (ETDEWEB)

For the past 100 years, Pellegrini-Stieda disease has been described as calcification and ossification within the tibial collateral ligament, although these typical radiographic findings are often located more superior than the most proximal extent of the ligament. In this article, we demonstrate four magnetic resonance imaging cases of knee trauma with complete posterior cruciate ligament tear or avulsion, each demonstrating that injury to the medial collateral ligamentous complex can involve significant stripping of the tissue proximal to the medial epicondyle. Classic radiographic findings of Pellegrini-Stieda calcifications can be caused by stripping of the femoral periosteum proximal to the femoral attachment of the tibial collateral ligament, which appears to be associated with a complete posterior cruciate ligament injury. (orig.)

McAnally, James L.; Southam, Samuel L.; Mlady, Gary W. [University of New Mexico, Department of Radiology, Albuquerque, NM (United States)

2009-02-15

309

The first description of severe anemia associated with acute kidney injury and adult minimal change disease: a case report  

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Full Text Available Abstract Introduction Acute kidney injury in the setting of adult minimal change disease is associated with proteinuria, hypertension and hyperlipidemia but anemia is usually absent. Renal biopsies exhibit foot process effacement as well as tubular interstitial inflammation, acute tubular necrosis or intratubular obstruction. We recently managed a patient with unique clinical and pathological features of minimal change disease, who presented with severe anemia and acute kidney injury, an association not previously reported in the literature. Case presentation A 60-year-old Indian-American woman with a history of hypertension and diabetes mellitus for 10 years presented with progressive oliguria over 2 days. Laboratory data revealed severe hyperkalemia, azotemia, heavy proteinuria and progressively worsening anemia. Urine eosinophils were not seen. Emergent hemodialysis, erythropoietin and blood transfusion were initiated. Serologic tests for hepatitis B, hepatitis C, anti-nuclear antibodies, anti-glomerular basement membrane antibodies and anti-neutrophil cytoplasmic antibodies were negative. Complement levels (C3, C4 and CH50 were normal. Renal biopsy unexpectedly displayed 100% foot process effacement. A 24-hour urine collection detected 6.38 g of protein. Proteinuria and anemia resolved during six weeks of steroid therapy. Renal function recovered completely. No signs of relapse were observed at 8-month follow-up. Conclusion Adult minimal change disease should be considered when a patient presents with proteinuria and severe acute kidney injury even when accompanied by severe anemia. This report adds to a growing body of literature suggesting that in addition to steroid therapy, prompt initiation of erythropoietin therapy may facilitate full recovery of renal function in acute kidney injury.

Qian Yimei

2009-01-01

310

Denervation alters mRNA levels of repair-associated genes in a rabbit medial collateral ligament injury model.  

Science.gov (United States)

Previous experiments revealed that denervation impairs healing of the MCL. This suggested the hypothesis that denervation would decrease repair-associated mRNA levels in the injured MCL when compared with normally innervated injured MCL. Adult, skeletally mature female rabbits were assigned to one of four groups: unoperated control, femoral nerve transection alone (denervated controls), MCL partial tear or denervated MCL partial tear. At three days, two weeks, six weeks or sixteen weeks post-surgery, cohorts of 6 rabbits from each experimental group were killed. Ligaments were harvested, RNA extracted and RT-PCR was performed using rabbitspecific primers. In the denervated injury group, mRNA levels for the angiogenesis-associated gene MMP-13, matrix components Collagen I and III, growth factor TGF-beta and angiogenesis inhibitors TIMP-3, and TSP-1 had all increased by two-weeks post-injury, in comparison to the non-denervated injury group (p < or = 0.01). An increased level of TSP-1 mRNA was also detected in the denervated injured group at sixteen weeks post injury (p < or = 0.01). Contrary to the initial hypothesis, denervation led to increased mRNA levels for many relevant molecules during the early stages of MCL healing. Thus, inappropriate timing of over-expression of some molecules may potentially contribute to the decreased quality of the scar tissue, particularly molecules such as TSP-1. Neuronal derived factors strongly influence the in vivo metabolic activity of ligament and scar fibroblasts in the initial phases of healing. PMID:16865716

Beye, Jasmine A; Hart, David A; Bray, Robert C; Seerattan, Ruth A; McDougall, Jason J; Leonard, Catherine A; Reno, Carol R; Salo, Paul T

2006-09-01

311

Risk of leukemia associated with the first course of cancer treatment: an analysis of the Surveillance, Epidemiology, and End Results Program experience  

International Nuclear Information System (INIS)

The risk of leukemia associated with the first course of cancer treatment was evaluated in over 440,000 patients diagnosed during 1973-80 (average follow-up . 1.91 yr) from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Although the reporting of the first course of therapy probably was incomplete, 34 acute nonlymphocytic leukemias (ANLL) developed compared with 7.6 expected among 70,674 patients known to receive initial chemotherapy [relative risk (RR) . 4.5, 95% confidence interval (Cl) . 3.1-6.3]. Significant ANLL excesses were observed following chemotherapy for breast cancer (RR . 8.1), ovarian cancer (RR . 22.2), and multiple myeloma (RR . 9.5). Patients initially treated with radiation (with no record of chemotherapy) also had a significantly increased ANLL risk; 45 leukemias occurred versus 17.9 expected (RR . 2.5, 95% Cl . 1.8-3.4). In this group, excess ANLL were found following irradiation for uterine corpus cancer (RR . 4.0). Kidney and renal pelvis cancer patients had a twofold leukemia risk (all types) that was unrelated to treatment (RR . 2.2)

1984-01-01

312

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

313

Risk of leukemia associated with the first course of cancer treatment: an analysis of the Surveillance, Epidemiology, and End Results Program experience  

Energy Technology Data Exchange (ETDEWEB)

The risk of leukemia associated with the first course of cancer treatment was evaluated in over 440,000 patients diagnosed during 1973-80 (average follow-up . 1.91 yr) from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Although the reporting of the first course of therapy probably was incomplete, 34 acute nonlymphocytic leukemias (ANLL) developed compared with 7.6 expected among 70,674 patients known to receive initial chemotherapy (relative risk (RR) . 4.5, 95% confidence interval (Cl) . 3.1-6.3). Significant ANLL excesses were observed following chemotherapy for breast cancer (RR . 8.1), ovarian cancer (RR . 22.2), and multiple myeloma (RR . 9.5). Patients initially treated with radiation (with no record of chemotherapy) also had a significantly increased ANLL risk; 45 leukemias occurred versus 17.9 expected (RR . 2.5, 95% Cl . 1.8-3.4). In this group, excess ANLL were found following irradiation for uterine corpus cancer (RR . 4.0). Kidney and renal pelvis cancer patients had a twofold leukemia risk (all types) that was unrelated to treatment (RR . 2.2).

Curtis, R.E.; Hankey, B.F.; Myers, M.H.; Young, J.L. Jr.

1984-03-01

314

Role of drug-independent stress factors in liver injury associated with diclofenac intake.  

Science.gov (United States)

Although a basic understanding of the chemical and biological events leading to idiosyncratic drug toxicity is still lacking, it appears that drug-independent risk factors that increase reactive metabolite formation or alter cellular stress and immune response may be critical determinants in the response to an otherwise non-toxic drug. Thus, we were interested to determine the impact of various drug-independent stress factors - lipopolysaccharide (LPS), poly I:C (PIC) or glutathione depletion via buthionine sulfoximine (BSO) - on the toxicity of diclofenac (Dcl), a model drug associated with rare but significant cases of serious hepatotoxicity, and to understand if enhanced toxicity occurs through alterations of drug metabolism and/or modulation of stress response pathways. Co-treatment of rats repeatedly given therapeutic doses of Dcl for 7 days with a single dose of LPS 2h before the last Dcl dose resulted in severe liver toxicity. Neither LPS nor diclofenac alone or in combination with PIC or BSO had such an effect. While it is thought that bioactivation to reactive Dcl acyl glucuronides (AG) and subsequent protein adduct formation contribute to Dcl induced liver injury, LC-MS/MS analyses did not reveal increased formation of 4'- and 5-hydroxy-Dcl, Dcl-AG or Dcl-AG dependent protein adducts in animals treated with LPS/Dcl. Hepatic gene expression analysis suggested enhanced activation of NF?B and MAPK pathways and up-regulation of co-stimulatory molecules (IL-1?, TNF-?, CINC-1) by LPS/Dcl and PIC/Dcl, while protective factors (HSPs, SOD2) were down-regulated. LPS/Dcl led to extensive release of pro-inflammatory cytokines (IL-1?, IL-6, IFN-?, TNF-?) and factors thought to constitute danger signals (HMGB1, CINC-1) into plasma. Taken together, our results show that Dcl enhanced the inflammatory response induced by LPS - and to a lesser extent by PIC - through up-regulation of pro-inflammatory molecules and down-regulation of protective factors. This suggests sensitization of cells to cellular stress mediated by non-drug-related risk factors by therapeutic doses of Dcl, rather than potentiation of Dcl toxicity by the stress factors. PMID:23939143

Ramm, Susanne; Mally, Angela

2013-10-01

315

Renal neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 expression in children with acute kidney injury and Henoch-Sch?nlein purpura nephritis  

Science.gov (United States)

The aim of this study was to investigate the expression of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in the serum, urine and renal tissues of children with acute kidney injury (AKI) and Henoch-Schönlein purpura nephritis (A-on-C). A prospective single-center evaluation of the serum, urine and renal NGAL and KIM-1 levels was performed in a cohort of children. Blood and 5-ml urine samples were collected from each patient for the analysis of NGAL and KIM-1 levels using an ELISA. In addition, the expression of NGAL and KIM-1 in the kidney was examined using immunohistochemistry in patients with A-on-C and HSPN. The expression of serum cystatin C, ?2-macroglobulin and serum creatinine (SCr), as well as urinary ?2-MG and SCr, in the patients with A-on-C was significantly higher than that of HSPN patients, and the expression of NGAL and KIM-1 in the serum and urine in the A-on-C patients was also significantly higher than that of HSPN patients. However, there were no significant differences in the urine protein levels between the two groups. NGAL and KIM-1 were expressed in renal tubular epithelial cells, and the expression of NGAL and KIM-1 in the A-on-C patients was significantly higher than that in HSPN patients. In addition, the urine NGAL and KIM-1 levels were negatively correlated with glomerular filtration rate, but there was no significant correlation between the urine NGAL/KIM-1 and urine protein levels. The changes in serum and urine NGAL and KIM-1 levels may be applied to the diagnosis of A-on-C.

DU, YUE; HOU, LING; GUO, JINJIE; SUN, TINGTING; WANG, XIULI; WU, YUBIN

2014-01-01

316

Factors associated with increased propensity for hamstring injury in English Premier League soccer players.  

Science.gov (United States)

The aim of this study was to concurrently model the influence of a number of physical and performance parameters on subsequent incidence of hamstring injury in a squad of English Premier League soccer players. Thirty six healthy, male, elite, professional soccer players (age 22.6+/-5.2 years, height 1.81+/-0.08 m, mass 75.8+/-9.4 kg, lean mass 69.0+/-8.0 kg) were assessed during the first week of pre-season training for anthropometry, flexibility, lower limb strength and power, speed and agility. Over the subsequent 45 week competitive season all hamstring injuries were diagnosed and recorded. Multiple logistic regression analysis was performed to link individual physical and performance capabilities with propensity to sustain a hamstring injury. A model containing age, lean mass, non-counter movement jump (NCM) performance and active hip flexion range of movement (ROM) was significantly (psoccer players are at greater risk of sustaining a hamstring injury. Support staff should identify such individuals and make appropriate interventions to minimise risk without compromising performance capabilities. PMID:19800844

Henderson, Gary; Barnes, Christopher A; Portas, Matthew D

2010-07-01

317

Respiratory dysfunction associated with traumatic injury to the central nervous system.  

Science.gov (United States)

Pulmonary dysfunction is a common complication of head trauma and spinal cord injury. Abnormal breathing patterns reflect the influence of altered neural integration. Early arterial hypoxemia can result from ventilation-perfusion mismatching, microatelectasis, aspiration, fat embolism, or the development of the adult respiratory distress syndrome. Significant changes in lung volumes, ventilation, and gas exchange can occur in spinal cord injury as a result of the loss of diaphramatic or intercostal muscle function. Recruitment of accessory respiratory muscles plays an important role in stabilizing the rib cage and improving expiratory function. Strength training improves expiratory muscle function in quadriplegics and should be continued indefinitely. Most importantly, survival of patients with CNS injuries improves with meticulous and vigorous pulmonary hygiene. The pulmonary hygiene program should include regular changes in the patient's position, assisted coughing and deep breathing exercises, incentive spirometer, bronchodilators, fiberoptic bronchoscopy when indicated, and frequent monitoring of pulmonary mechanics. Long-term survival of the patient with head trauma or spinal cord injury is correlated to successful weaning from mechanical ventilation. Various forms of mechanical ventilator support can be adopted for the patient's ventilatory needs, and many patients will achieve some degree of freedom from mechanical ventilation. Newer ventilatory assist devices that do not require tracheostomy should be considered. PMID:7867288

Slack, R S; Shucart, W

1994-12-01

318

Podocyte-specific RAP1GAP expression contributes to focal segmental glomerulosclerosis-associated glomerular injury  

Science.gov (United States)

Injury to the specialized epithelial cells of the glomerulus (podocytes) underlies the pathogenesis of all forms of proteinuric kidney disease; however, the specific genetic changes that mediate podocyte dysfunction after injury are not fully understood. Here, we performed a large-scale insertional mutagenic screen of injury-resistant podocytes isolated from mice and found that increased expression of the gene Rap1gap, encoding a RAP1 activation inhibitor, ameliorated podocyte injury resistance. Furthermore, injured podocytes in murine models of disease and kidney biopsies from glomerulosclerosis patients exhibited increased RAP1GAP, resulting in diminished glomerular RAP1 activation. In mouse models, podocyte-specific inactivation of Rap1a and Rap1b induced massive glomerulosclerosis and premature death. Podocyte-specific Rap1a and Rap1b haploinsufficiency also resulted in severe podocyte damage, including features of podocyte detachment. Over-expression of RAP1GAP in cultured podocytes induced loss of activated ?1 integrin, which was similarly observed in kidney biopsies from patients. Furthermore, preventing elevation of RAP1GAP levels in injured podocytes maintained ?1 integrin–mediated adhesion and prevented cellular detachment. Taken together, our findings suggest that increased podocyte expression of RAP1GAP contributes directly to podocyte dysfunction by a mechanism that involves loss of RAP1-mediated activation of ?1 integrin.

Potla, Uma; Ni, Jie; Vadaparampil, Justin; Yang, Guozhe; Leventhal, Jeremy S.; Campbell, Kirk N.; Chuang, Peter Y.; Morozov, Alexei; He, John C.; D'Agati, Vivette D.; Klotman, Paul E.; Kaufman, Lewis

2014-01-01

319

Constipation Associated with Self-Injurious and Aggressive Behavior Exhibited by a Child Diagnosed with Autism  

Science.gov (United States)

A functional analysis was conducted to identify the role environmental variables had on the maintenance of self-injury and aggression. At the outset of the evaluation, an abdominal x-ray showed a moderate to large amount of stool throughout the colon (i.e., constipation). Consequently, medication was administered to promote bowel emptying. Initial…

Christensen, Tory J.; Ringdahl, Joel E.; Bosch, Joni J.; Falcomata, Terry S.; Luke, Jeffrey R.; Andelman, Marc S.

2009-01-01

320

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

Directory of Open Access Journals (Sweden)

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

 
 
 
 
321

Cognitive capacity: no association with recovery of sensibility by Semmes Weinstein test score after peripheral nerve injury of the forearm.  

Science.gov (United States)

In the recovery process of sensibility after repair of a peripheral nerve injury of the forearm, not only age but also surgical repair techniques are of importance. If regenerating axons are misdirected, reorganisation or other adaptic processes are needed at the level of the somatosensory brain cortex. These processes are thought to be dependent on the patient's cognitive capacity. We conducted a prospective multicentre study to assess the association between cognitive capacity and recovery of sensibility after peripheral nerve damage of the forearm. Patients with a traumatic peripheral nerve lesion of the forearm and consecutive surgical repair were included. After 12 months, the patients were assessed with respect to recovery of sensibility (Semmes-Weinstein monofilaments) and cognitive capacity, with four tests assessing different aspects of cognitive functioning. Twenty-eight patients (25 male, three female; median age: 28.5 years; range: 15-79 years) with median and/or ulnar nerve injury of the forearm were included in the study. Younger age showed a positive association with sensory recovery (beta =-0.845, 95% CI: -1.456 to -0.233; p=0.01). No association was found between the cognitive-capacity tests used and sensory recovery. The present prospective study did not reveal any association between recovery of sensibility measured by Semmes-Weinstein test score and cognitive capacity. Further studies should be performed to confirm these results. PMID:19054722

Boender, Z J; Ultee, J; Hovius, S E R

2010-02-01

322

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

323

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

1978-10-06

324

Repeated mild traumatic brain injury causes chronic neuroinflammation, changes in hippocampal synaptic plasticity, and associated cognitive deficits.  

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Repeated mild traumatic brain injury (mTBI) can cause sustained cognitive and psychiatric changes, as well as neurodegeneration, but the underlying mechanisms remain unclear. We examined histologic, neurophysiological, and cognitive changes after single or repeated (three injuries) mTBI using the rat lateral fluid percussion (LFP) model. Repeated mTBI caused substantial neuronal cell loss and significantly increased numbers of activated microglia in both ipsilateral and contralateral hippocampus on post-injury day (PID) 28. Long-term potentiation (LTP) could not be induced on PID 28 after repeated mTBI in ex vivo hippocampal slices from either hemisphere. N-Methyl-D-aspartate (NMDA) receptor-mediated responses were significantly attenuated after repeated mTBI, with no significant changes in ?-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor-mediated responses. Long-term potentiation was elicited in slices after single mTBI, with potentiation significantly increased in ipsilateral versus contralateral hippocampus. After repeated mTBI, rats displayed cognitive impairments in the Morris water maze (MWM) and novel object recognition (NOR) tests. Thus, repeated mTBI causes deficits in the hippocampal function and changes in excitatory synaptic neurotransmission, which are associated with chronic neuroinflammation and neurodegeneration. PMID:24756076

Aungst, Stephanie L; Kabadi, Shruti V; Thompson, Scott M; Stoica, Bogdan A; Faden, Alan I

2014-07-01

325

Unusual presentation of Lisfranc fracture dislocation associated with high-velocity sledding injury: a case report and review of the literature  

Science.gov (United States)

Introduction Lisfranc fracture dislocations of the foot are rare injuries. A recent literature search revealed no reported cases of injury to the tarsometatarsal (Lisfranc) joint associated with sledding. Case presentation A 19-year-old male college student presented to the emergency department with a Lisfranc fracture dislocation of the foot as a result of a high-velocity sledding injury. The patient underwent an immediate open reduction and internal fixation. Conclusion Lisfranc injuries are often caused by high-velocity, high-energy traumas. Careful examination and thorough testing are required to identify the injury properly. Computed tomography imaging is often recommended to aid in diagnosis. Treatment of severe cases may require immediate open reduction and internal fixation, especially if the risk of compartment syndrome is present, followed by a period of immobilization. Complete recovery may take up to 1 year.

Benejam, Christopher E; Potaczek, Steven G

2008-01-01

326

Enterovirus Surveillance - Summary 1970-1979.  

Science.gov (United States)

The purpose of undertaking national enteroviral surveillance was to monitor trends in the circulation of these viral agents, many of which are associated with severe clinical illness. Through in-depth analysis of the national data base containing both epi...

1981-01-01

327

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

328

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.

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

329

Critical factors associated with the successful supported employment placement of patients with severe traumatic brain injury.  

Science.gov (United States)

A number of investigations have recently demonstrated the effectiveness of supported employment programmes in improving the vocational status of clients with traumatic brain injuries. The present study investigated a sample of 39 individuals participating in a return to work programme emphasizing a supported employment approach to identify key functional characteristics which differentiated successful and unsuccessful clients. Clinical ratings of employment specialists were used to identify two groups of individuals rated least and most difficult to place and maintain. Results indicated that the two groups differed markedly on key employment outcomes. Individuals rated most difficult tended to be younger, possess functional limitations such as visual and fine motor impairments, and display significant deficits in numerous work-related skills. Recommendations are made for applying these findings to assessment, placement, and training activities within vocational rehabilitation programmes for persons with traumatic brain injuries. PMID:8425114

Wehman, P; Kregel, J; Sherron, P; Nguyen, S; Kreutzer, J; Fry, R; Zasler, N

1993-01-01

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

1991-01-01

331

Processing speed deficits associated with traumatic brain injury: processing inefficiency or cautiousness?  

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This study used speed-accuracy trade-off (SAT) methodology to test competing explanations for processing speed deficits due to traumatic brain injury (TBI): fixed limited capacity and volition. Twenty TBI participants and 20 comparison participants performed a visual scanning task with processing times controlled by the experimenter using a response deadline procedure. Results of the study demonstrated marked differences in SAT functions between the two groups. Participants who had TBIs were significantly slower on information accrual across processing deadlines (supporting a fixed limit explanation), but when early responding was allowed they chose to hold off responding despite being no more accurate in their responses with the additional time (a finding supporting a volitional explanation). Results of the study are discussed in terms of a resource allocation model that incorporates the influences of both processing capacity and volitional processes for individuals who suffer from brain injuries. PMID:18443943

Battistone, Melanie; Woltz, Dan; Clark, Elaine

2008-01-01

332

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)

2011-12-01

333

Cognitive improvement of mice induced by exercise prior to traumatic brain injury is associated with cytochrome c oxidase.  

Science.gov (United States)

Though the evidence demonstrated that voluntary exercise programs could be implemented to enhance recovery of cognitive function induced by traumatic brain injury (TBI), the exact mechanisms were still not known. We proposed that the cognitive improvement induced by exercise in TBI mice is associated with cytochrome c oxidase (COX). To demonstrate this hypothesis, adult mice were housed with or without access to a running wheel (RW) for three weeks followed by TBI operation. Acquisition of spatial learning and memory retention was assessed by using the Morris Water Maze (MWM) on days 15 post TBI. The synaptic density was measured by Golji staining. Immunohistochemistry (IHC) for NeuN, GFAP and growth associated protein 43 (GAP43) were also performed. Using Western blot, the expressions of COX I, II, III, BDNF, synapsin I, synaptophysin (SYP) and GAP43 in hippocampus of TBI mice were determinated. Lastly, CcO activity and ATP amount were also detected. Results showed that voluntary exercise prior TBI: (i) counteracted the cognitive deficits and neuron and synaptic density loss associated with the injury; (ii) increased the levels of COX I, II, III, BDNF, synapsin I, SYP and GAP43; (iii) switched the mitochondrial CcO activity and ATP amounts. These studies demonstrated that the COX plays an important role in exercise's cognitive effects in TBI model and also provide evidence that RW training is a promise exercise for traumatically injured mice. PMID:24746931

Gu, Ying Li; Zhang, Li Wei; Ma, Ning; Ye, Lin Lin; Wang, De Xin; Gao, Xu

2014-06-01

334

Identification of regeneration-associated genes after central and peripheral nerve injury in the adult rat  

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Abstract Background It is well known that neurons of the peripheral nervous system have the capacity to regenerate a severed axon leading to functional recovery, whereas neurons of the central nervous system do not regenerate successfully after injury. The underlying molecular programs initiated by axotomized peripheral and central nervous system neurons are not yet fully understood. Results To gain insight into the molecular mechanisms underlying the process of...

Schmitt Andreas B; Breuer Sebastian; Liman Jan; Buss Armin; Schlangen Christiane; Pech Katrin; Hol Elly M; Brook Gary A; Noth Johannes; Schwaiger Franz-Werner

2003-01-01

335

Macrophage Migration Inhibitory Factor in Acute Lung Injury: Expression, Biomarker and Associations  

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Macrophage migration inhibitory factor (MIF), a proinflammatory cytokine central to the response to endotoxemia, is a putative biomarker in acute lung injury (ALI). To explore MIF as a molecular target and candidate gene in ALI, we examined MIF gene and protein expression in murine and canine models of ALI (high tidal volume mechanical ventilation, endotoxin exposure) and in patients with either sepsis or sepsis-induced ALI. MIF gene expression and protein levels were significantly increased ...

Gao, Li; Flores, Carlos; Ma, Shwu-fan; Miller, Edmund J.; Moitra, Jaideep; Moreno, Liliana; Wadgaonkar, Raj; Simon, Brett; Brower, Roy; Sevransky, Jonathan; Tuder, Rubin M.; Maloney, James P.; Moss, Marc; Shanholtz, Carl; Yates, C. Ryan

2007-01-01

336

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

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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 t...

Junichi Iwamoto; Yoshifumi Saito; Akira Honda; Yasushi Matsuzaki

2013-01-01

337

Manganese Superoxide Dismutase Therapy in a Murine Hepatitis-Associated Injury  

Directory of Open Access Journals (Sweden)

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

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

2000-01-01

339

Active surveillance for adverse events following immunization.  

Science.gov (United States)

Comprehensive surveillance of adverse events following immunization (AEFI) is required to detect potential serious adverse events that may not be identified in prelicensure vaccine trials. Surveillance systems have traditionally been passive, relying upon spontaneous reporting, but increasingly active surveillance and supplemental strategies are being incorporated into vaccine safety programs. These include active screening for targeted conditions of interest (e.g., hospitalization), monitoring of new data sources and real-time methodologies to detect changes in vaccine safety data in these sources. The role of improved causality assessment in AEFI surveillance is discussed, with its important role in determining whether a temporal association may have occurred by chance alone. Strong local vaccine safety networks are required to support national immunization programs, with recent progress in developing a framework for low- and middle-income countries. Global collaboration is increasingly required to address challenges in active AEFI surveillance, particularly for rare serious adverse events. PMID:24350637

Crawford, Nigel W; Clothier, Hazel; Hodgson, Kate; Selvaraj, Gowri; Easton, Mee Lee; Buttery, Jim P

2014-02-01

340

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

 
 
 
 
341

Oxidative Stress and Modification of Renal Vascular Permeability Are Associated with Acute Kidney Injury during P. berghei ANKA Infection  

Science.gov (United States)

Malaria associated-acute kidney injury (AKI) is associated with 45% of mortality in adult patients hospitalized with severe form of the disease. However, the causes that lead to a framework of malaria-associated AKI are still poorly characterized. Some clinical studies speculate that oxidative stress products, a characteristic of Plasmodium infection, as well as proinflammatory response induced by the parasite are involved in its pathophysiology. Therefore, we aimed to investigate the development of malaria-associated AKI during infection by P. berghei ANKA, with special attention to the role played by the inflammatory response and the involvement of oxidative stress. For that, we took advantage of an experimental model of severe malaria that showed significant changes in the renal pathophysiology to investigate the role of malaria infection in the renal microvascular permeability and tissue injury. Therefore, BALB/c mice were infected with P. berghei ANKA. To assess renal function, creatinine, blood urea nitrogen, and ratio of proteinuria and creatininuria were evaluated. The products of oxidative stress, as well as cytokine profile were quantified in plasma and renal tissue. The change of renal microvascular permeability, tissue hypoxia and cellular apoptosis were also evaluated. Parasite infection resulted in renal dysfunction. Furthermore, we observed increased expression of adhesion molecule, proinflammatory cytokines and products of oxidative stress, associated with a decrease mRNA expression of HO-1 in kidney tissue of infected mice. The measurement of lipoprotein oxidizability also showed a significant increase in plasma of infected animals. Together, our findings support the idea that products of oxidative stress, as well as the immune response against the parasite are crucial to changes in kidney architecture and microvascular endothelial permeability of BALB/c mice infected with P. berghei ANKA.

Elias, Rosa Maria; Correa-Costa, Matheus; Barreto, Claudiene Rodrigues; Silva, Reinaldo Correia; Hayashida, Caroline Y.; Castoldi, Angela; Goncalves, Giselle Martins; Braga, Tarcio Teodoro; Barboza, Renato; Rios, Francisco Jose; Keller, Alexandre Castro; Cenedeze, Marcos Antonio; Hyane, Meire Ioshie; D'Imperio-Lima, Maria Regina; Figueiredo-Neto, Antonio Martins; Reis, Marlene Antonia; Marinho, Claudio Romero Farias; Pacheco-Silva, Alvaro; Camara, Niels Olsen Saraiva

2012-01-01

342

Prevention of NSAID-Associated Gastroduodenal Injury in Healthy Volunteers-A Randomized, Double-Blind, Multicenter Study Comparing DA-9601 with Misoprostol  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In addition to inhibiting cyclooxygenase and prostaglandin, nonsteroidal anti-inflammatory drugs (NSAIDs) may cause gastroduodenal injuries due to reactive oxygen species produced by recruited inflammatory cells. DA-9601 is a novel antioxidant with anti-inflammatory and cyto-protective effects. This study was conducted to compare the efficacy and safety of DA-9601 with misoprostol for preventing NSAID-associated gastroduodenal injury. In this randomized, double-blind, multicenter, noninferior...

Lee, Kang Nyeong; Lee, Oh Young; Choi, Myung-gyu; Choi, Seok Reyol; Lee, Dong Ho; Lee, Yong Chan; Kim, Tae Nyeun; Choi, Suck Chei; Rew, Jong Sun; Seol, Sang-yong

2011-01-01

343

Is a single item stress measure independently associated with subsequent severe injury: a prospective cohort study of 16,385 forest industry employees  

Science.gov (United States)

Background A previous review showed that high stress increases the risk of occupational injury by three- to five-fold. However, most of the prior studies have relied on short follow-ups. In this prospective cohort study we examined the effect of stress on recorded hospitalised injuries in an 8-year follow-up. Methods A total of 16,385 employees of a Finnish forest company responded to the questionnaire. Perceived stress was measured with a validated single-item measure, and analysed in relation recorded hospitalised injuries from 1986 to 2008. We used Cox proportional hazard regression models to examine the prospective associations between work stress, injuries and confounding factors. Results Highly stressed participants were approximately 40% more likely to be hospitalised due to injury over the follow-up period than participants with low stress. This association remained significant after adjustment for age, gender, marital status, occupational status, educational level, and physical work environment. Conclusions High stress is associated with an increased risk of severe injury.

2014-01-01

344

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

Science.gov (United States)

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 discussion on this uncommon method of suicide is presented, particularly relevant to the attending forensic physician. In addition, a short overview of the entity of complex suicide is given. PMID:17725243

Palmiere, Cristian; Risso, Enrico; van Hecke, Oliver; La Harpe, Romano

2007-07-01

345

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

346

Massive pulmonary embolism with liver injury associated with chest compressions during cardiac resuscitation.  

Science.gov (United States)

A 34-year-old man was admitted to our hospital because of sudden respiratory failure caused by massive pulmonary embolism. After arrival in the hospital, the patient experienced cardiopulmonary arrest, and we promptly initiated percutaneous cardiopulmonary support, in addition to sternal compressions for cardiopulmonary resuscitation. Computed tomography revealed massive pulmonary embolisms and intraperitoneal bleeding due to liver injury. After interventional hemostasis of the hepatic arteries, we performed emergent pulmonary embolectomy and hemostasis of the liver with gauze packing. Absence of further intraperitoneal bleeding was confirmed 2 days later on a second look. The patient was discharged 2 month later without neurologic sequelae. PMID:24996708

Yamasaki, Manabu; Misumi, Hiroyasu; Abe, Kohei; Kuwauchi, Shintaro; Ito, Joji; Kawazoe, Kohei

2014-07-01

347

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

Science.gov (United States)

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

348

Perioperative anaesthetic management of penetrating neck injury associated with Rh blood type in a young adult.  

Science.gov (United States)

We describe here a young adult patient with penetrating neck injuries (PNI) with an Rh negative blood type and discuss the perioperative anaesthetic management of single-stage surgical exploration under general anaesthesia and extracorporeal circulation in this patient. The patient had zone II PNI and he was in a haemodynamically progressive unstable state, and the knife penetrated the left internal jugular vein, superior thyroid artery and recurrent laryngeal nerve; the trachea and the oesophagus were swelling at a rapid rate. Eight weeks after operation, the patient was discharged from the hospital without any complications. PMID:23429024

Wang, Tao; Zhou, Yeting; Shi, Jiaohui; Wang, Zhichun

2013-01-01

349

Post-partum sequential occurrence of two diverse transfusion reactions (transfusion associated circulatory overload and transfusion related acute lung injury).  

Science.gov (United States)

Transfusion associated circulatory overload (TACO) and transfusion related acute lung injury (TRALI) are two dissimilar pathological conditions associated with transfusion of blood products where the time course of the events and clinical presentation overlap leading to uncertainty in establishing the diagnosis and initiating the treatment, which otherwise differs. We encountered a case where a patient of post-partum hemorrhage developed TACO in the immediate post-operative period due to aggressive resuscitative attempts with blood products. The patient's condition was appropriately diagnosed and was managed according to the clinical scenario, and the condition abated. Subsequently, on the third post-operative day the patient again required blood product transfusions following which the patient developed TRALI, the diagnosis of which was also established and adequate treatment strategy was undertaken. PMID:24339663

Haldar, Rudrashish; Samanta, Sukhen

2013-10-01

350

The association between self-injurious behaviors and autism spectrum disorders  

Directory of Open Access Journals (Sweden)

Full Text Available Noha F Minshawi,1 Sarah Hurwitz,2 Jill C Fodstad,1 Sara Biebl,3 Danielle H Morriss,4 Christopher J McDougle51Department of Psychiatry, Indiana University School of Medicine, Christian Sarkine Autism Treatment Center, James Whitcomb Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA; 2School of Education, Indiana University, Bloomington, IN, USA; 3Child and Adolescent Behavioral Health, Sanford Health, Fargo, ND, USA; 4Medical College of South Carolina, Charleston, SC, USA; 5Departments of Psychiatry and Pediatrics, Lurie Center for Autism, Massachusetts General Hospital and MassGeneral Hospital for Children, Harvard Medical School, Boston, MA, USAAbstract: A key area of concern in children with autism spectrum disorders (ASDs are self-injurious behaviors (SIBs. These are behaviors that an individual engages in that may cause physical harm, such as head banging, or self-biting. SIBs are more common in children with ASD than those who are typically developing or have other neurodevelopmental disabilities. Therefore, it is important that clinicians who work with children with ASD have a solid understanding of SIB. The purpose of this paper is to review the research on the epidemiology of SIB in children with ASD, factors that predict the presence of SIB in this population, and the empirically supported behavioral treatments available.Keywords: self-injury, autism spectrum disorders, applied behavior analysis

Minshawi NF

2014-04-01

351

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

352

Psychosocial consequences of predictive genetic testing for Lynch syndrome and associations to surveillance behaviour in a 7-year follow-up study.  

Science.gov (United States)

We evaluated long-term psychosocial consequences of predictive genetic testing, and surveillance behaviour in Lynch syndrome (LS). We conducted a longitudinal study of 208 participants (62 LS mutation carriers and 146 non-carriers) who provided information on general anxiety (State-Trait Anxiety Inventory), fear of cancer and dying, satisfaction with life, risk and test perceptions, and surveillance behaviour in the baseline questionnaire before testing, and 1 month, 1 year and 7 years post-test. At 7 years, most of the psychosocial variables remained unchanged, regardless of mutation status. Carriers tended to underestimate their colorectal cancer risk but were more worried about their cancer risk than their counterparts. Non-carriers reported a higher degree of satisfaction with their testing decisions (P < 0.05), but had more doubts concerning test result validity than carriers (P < 0.05). All carriers attended a post-test colonoscopy surveillance, while 16% of non-carriers reported colonoscopy examinations. Those non-carriers with doubts about test validity were more likely (P = 0.019) to report post-test colonoscopy. Of the carriers, 17% had an interval longer than 3 years between their colonoscopies. Fear of dying soon, measured at 1-month post-test follow-up was the only psychosocial variable predicting non-compliance in recommended surveillance. No adverse psychosocial consequences were detected, and respondents were satisfied with their decision to testing 7 years post-test. Among the carriers, solely fear of dying soon predicted non-compliance in recommended surveillance. Some non-carriers were still worried about their risk and had doubts about the validity of their genetic testing results predicting post-test colonoscopy. PMID:23512527

Aktan-Collan, Katja; Kääriäinen, Helena; Järvinen, Heikki; Peltomäki, Päivi; Pylvänäinen, Kirsi; Mecklin, Jukka-Pekka; Haukkala, Ari

2013-12-01

353

Urological injuries following trauma  

International Nuclear Information System (INIS)

Blunt renal trauma is the third most common injury in abdominal trauma following splenic and hepatic injuries, respectively. In the majority, such injuries are associated with other abdominal organ injuries. As urological injuries are not usually life-threatening, and clinical signs and symptoms are non-specific, diagnosis is often delayed. We present a practical approach to the diagnosis and management of these injuries based on our experience in a busy inner city trauma hospital with a review of the current evidence-based practice. Diagnostic imaging signs are illustrated

2008-12-01

354

Smart sensing surveillance system  

Science.gov (United States)

Unattended ground sensor (UGS) networks have been widely used in remote battlefield and other tactical applications over the last few decades due to the advances of the digital signal processing. The UGS network can be applied in a variety of areas including border surveillance, special force operations, perimeter and building protection, target acquisition, situational awareness, and force protection. In this paper, a highly-distributed, fault-tolerant, and energyefficient Smart Sensing Surveillance System (S4) is presented to efficiently provide 24/7 and all weather security operation in a situation management environment. The S4 is composed of a number of distributed nodes to collect, process, and disseminate heterogeneous sensor data. Nearly all S4 nodes have passive sensors to provide rapid omnidirectional detection. In addition, Pan- Tilt- Zoom- (PTZ) Electro-Optics EO/IR cameras are integrated to selected nodes to track the objects and capture associated imagery. These S4 camera-connected nodes will provide applicable advanced on-board digital image processing capabilities to detect and track the specific objects. The imaging detection operations include unattended object detection, human feature and behavior detection, and configurable alert triggers, etc. In the S4, all the nodes are connected with a robust, reconfigurable, LPI/LPD (Low Probability of Intercept/ Low Probability of Detect) wireless mesh network using Ultra-wide band (UWB) RF technology, which can provide an ad-hoc, secure mesh network and capability to relay network information, communicate and pass situational awareness and messages. The S4 utilizes a Service Oriented Architecture such that remote applications can interact with the S4 network and use the specific presentation methods. The S4 capabilities and technologies have great potential for both military and civilian applications, enabling highly effective security support tools for improving surveillance activities in densely crowded environments and near perimeters and borders. The S4 is compliant with Open Geospatial Consortium - Sensor Web Enablement (OGC-SWE®) standards. It would be directly applicable to solutions for emergency response personnel, law enforcement, and other homeland security missions, as well as in applications requiring the interoperation of sensor networks with handheld or body-worn interface devices.

Hsu, Charles; Chu, Kai-Dee; O'Looney, James; Blake, Michael; Rutar, Colleen

2010-04-01

355

Smart sensing surveillance system  

Science.gov (United States)

An effective public safety sensor system for heavily-populated applications requires sophisticated and geographically-distributed infrastructures, centralized supervision, and deployment of large-scale security and surveillance networks. Artificial intelligence in sensor systems is a critical design to raise awareness levels, improve the performance of the system and adapt to a changing scenario and environment. In this paper, a highly-distributed, fault-tolerant, and energy-efficient Smart Sensing Surveillance System (S4) is presented to efficiently provide a 24/7 and all weather security operation in crowded environments or restricted areas. Technically, the S4 consists of a number of distributed sensor nodes integrated with specific passive sensors to rapidly collect, process, and disseminate heterogeneous sensor data from near omni-directions. These distributed sensor nodes can cooperatively work to send immediate security information when new objects appear. When the new objects are detected, the S4 will smartly select the available node with a Pan- Tilt- Zoom- (PTZ) Electro-Optics EO/IR camera to track the objects and capture associated imagery. The S4 provides applicable advanced on-board digital image processing capabilities to detect and track the specific objects. The imaging detection operations include unattended object detection, human feature and behavior detection, and configurable alert triggers, etc. Other imaging processes can be updated to meet specific requirements and operations. In the S4, all the sensor nodes are connected with a robust, reconfigurable, LPI/LPD (Low Probability of Intercept/ Low Probability of Detect) wireless mesh network using Ultra-wide band (UWB) RF technology. This UWB RF technology can provide an ad-hoc, secure mesh network and capability to relay network information, communicate and pass situational awareness and messages. The Service Oriented Architecture of S4 enables remote applications to interact with the S4 network and use the specific presentation methods. In addition, the S4 is compliant with Open Geospatial Consortium - Sensor Web Enablement (OGC-SWE) standards to efficiently discover, access, use, and control heterogeneous sensors and their metadata. These S4 capabilities and technologies have great potential for both military and civilian applications, enabling highly effective security support tools for improving surveillance activities in densely crowded environments. The S4 system is directly applicable to solutions for emergency response personnel, law enforcement, and other homeland security missions, as well as in applications requiring the interoperation of sensor networks with handheld or body-worn interface devices.

Hsu, Charles; Chu, Kai-Dee; O'Looney, James; Blake, Michael; Rutar, Colleen

2010-04-01

356

Is Financial Hardship Associated with Reduced Health in Disability? The Case of Spinal Cord Injury in Switzerland  

Science.gov (United States)

Objective To investigate socioeconomic inequalities in a comprehensive set of health indicators among persons with spinal cord injury in a wealthy country, Switzerland. Methods Observational cross-sectional data from 1549 participants of the Swiss Spinal Cord Injury Cohort Study (SwiSCI), aged over 16 years, and living in Switzerland were analyzed. Socioeconomic circumstances were operationalized by years of formal education, net equivalent household income and financial hardship. Health indicators including secondary conditions, comorbidities, pain, mental health, participation and quality of life were used as outcomes. Associations between socioeconomic circumstances and health indicators were evaluated using ordinal regressions. Results Financial hardship was consistently associated with more secondary conditions (OR 3.37, 95% CI 2.18–5.21), comorbidities (OR 2.88, 95% CI 1.83–4.53) and pain (OR 3.32, 95% CI 2.21–4.99), whereas mental health (OR 0.23, 95% CI 0.15–0.36), participation (OR 0.30, 95% CI 0.21–0.43) and quality of life (OR 0.22, 95% CI 0.15–0.33) were reduced. Persons with higher education reported better mental health (OR 1.04, 95% CI 1.00–1.07) and higher quality of life (OR 1.06, 95% CI 1.02–1.09); other health indicators were not associated with education. Household income was not related to any of the studied health indicators when models were controlled for financial hardship. Conclusions Suffering from financial hardship goes along with significant reductions in physical health, functioning and quality of life, even in a wealthy country with comprehensive social and health policies.

Fekete, Christine; Siegrist, Johannes; Reinhardt, Jan D.; Brinkhof, Martin W. G.

2014-01-01

357

The management of femur shaft fracture associated with severe traumatic brain injury.  

Science.gov (United States)

The aim of this article is to describe the management of femoral shaft fractures in patients with severe traumatic brain injury (TBI). This is a major problem and two questions remain currently of interest: When and how to perform orthopedic surgery in severe TBI patients? The main point of perioperative management remains the prevention of secondary brain insults and the monitoring of intracranial pressure is essential especially in patients with intracranial lesions on the CT-scan. The "double hit" concept, suggesting that surgery by itself might increase the preexisting systemic inflammatory response, gives argument for very early or delayed surgery. Early definitive femoral osteosynthesis, if requires lengthy surgical procedure, does not seem appropriate in this context and "damage-control orthopedics" with external fixation seems to be a good alternative. PMID:23910064

Mrozek, S; Gaussiat, F; Geeraerts, T

2013-01-01

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

Microvascular injury of the peribiliary plexus associated with transarterial chemoembolization: a study of surgical specimens  

Energy Technology Data Exchange (ETDEWEB)

We attempted to evaluate the relationship between transarteiral chemoembolization (TACE) and injury to the peribiliary plexus by evaluating the number of microvessels in peribiliary plexus of surgical specimen. Surgical specimens were obtained from 78 hepatocellular carcinoma patients and 22 patients with liver metastases. They were divided into 4 groups (Group 1; hepatocellular carcinoma without TACE [n=30], Group 2; hepatocellular carcinoma receiving preoperative TACE once [n=37], Group 3; hepatocellular carcinoma receiving preoperative TACE more than two times [n=11] and Group 4; metastatic carcinoma of the liver patients without a history of liver disease [n=22]). Immunohistochemical staining for factor VIII-related antigen was performed in all the specimens and the number of microvessels in the inner capillary layer and the outer venous layer of the bile duct (> 200 {mu} m in diameter) was counted. The mean numbers of microvessels in the inner capillary layer were 4.50, 4.08, 1.64 and 2.05, and those in the outer venous layer were 25.23, 20.00, 18.36 and 12.32 for the 4 groups, respectively. The number of microvessels in group 4 was statistically fewer than that of group 1 ({rho} < 0.01). In the hepatocellular carcinoma patients, the number of microvessels was decreased as the number of TACE sessions was increased. The number of microvessels in the peribiliary plexus is increased in chronic liver disease patients. It may be from the increased portal pressure and flow stagnation in the sinusoidal and portal venules. TACE can have an effect on microvascular injury of the peibiliary plexus, and this can be a cause of bile duct necrosis and biloma.

Park, Won Kyu; Bae, Young Kyung; Hwang, Tae Yoon; Cho, Jae Ho; Chang, Jay Chun; Kim, Jae Woon; Jang, Han Won [College of Medicine, Yeungnam University, Daegu (Korea, Republic of)

2006-11-15

360

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

 
 
 
 
361

Higher diastolic blood pressure at admission and antiedema therapy is associated with acute kidney injury in acute ischemic stroke patients  

Directory of Open Access Journals (Sweden)

Full Text Available Hasan Micozkadioglu Department of Nephrology, Faculty of Medicine Hospital of Adana, Baskent University School of Medicine, Adana, Turkey Abstract: Antiedema therapy with mannitol and furosemide is widely used for prevention and management of cerebral edema, elevated intracranial pressure, and cerebral hernia. There are some reports about mannitol and furosemide as risk factors of acute kidney injury (AKI. We investigated the risk factors for AKI including antiedema therapy in acute ischemic stroke patients. The subjects were 129 patients with acute ischemic stroke including 56 females and 73 males with a mean age 68.16±12.29 years. Patients were divided into two groups: patients with AKI and without AKI according to Acute Kidney Injury Network criteria. All patients had undergone cranial, carotid, and vertebral artery evaluation with magnetic resonance imaging. The number of patients with AKI was 14 (10.9%. Subjects experiencing atrial fibrillation (P=0.043 and higher diastolic blood pressure (DBP (P=0.032 treated with mannitol (P=0.019 and furosemide (P=0.019 disclosed significant association with AKI. Regression analysis revealed that higher DBP (P=0.029 and management with mannitol (P=0.044 were the risk factors for AKI. Higher DBP at admission is the most important risk factor for AKI. However antiedema therapy should be used carefully in patients with acute ischemic stroke. Serum creatinine levels or estimated glomerular filtration rate should be watched frequently to prevent AKI. Keywords: furosemide, mannitol, renal failure, cerebrovascular disease

Micozkadioglu H

2014-02-01

362

ETHOS, a Health Surveillance Data Base System  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The basic purpose of a health surveillance system is to detect changes in an employee's health status. These changes may uncover health threats from newly introduced or existing industrial/consumer substances. Stewart-Todd Associates has provided employee health monitoring services to a variety of industries for over 10 years. From these experiences the company developed a computerized health surveillance system called ETHOS. Advanced features of ETHOS include its adaptability to a variety of...

Stewart, W. Wayne; Allen, James W.; Bilella, James; O Neill, Pat

1982-01-01

363

US NRC surveillance dosimetry improvement program  

International Nuclear Information System (INIS)

The USNRC has established the LWR-PV Surveillance Dosimetry Improvement Program in order to improve and standardize the procedures for dosimetry, damage correlation and associated reactor analysis used for predicting the integrated effect of neutron exposure to LWR pressure vessels. The multilaboratory international program is developing and validating a series of 15 standard procedures for neutron surveillance dosimetry and embrittlement evaluation, and is establishing a series of experimental benchmark experiments for neutron physics calculations, dosimetry measurements and embrittlement predictions. (orig./RW)

1980-10-10

364

Environmental surveillance master sampling schedule  

International Nuclear Information System (INIS)

Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the U.S. Department of Energy (DOE). This document contains the planned 1994 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP), Drinking Water Project, and Ground-Water Surveillance Project. Samples are routinely collected for the SESP and analyzed to determine the quality of air, surface water, soil, sediment, wildlife, vegetation, foodstuffs, and farm products at Hanford Site and surrounding communities. The responsibility for monitoring onsite drinking water falls outside the scope of the SESP. PNL conducts the drinking water monitoring project concurrent with the SESP to promote efficiency and consistency, utilize expertise developed over the years, and reduce costs associated with management, procedure development, data management, quality control, and reporting. The ground-water sampling schedule identifies ground-water sampling .events used by PNL for environmental surveillance of the Hanford Site. Sampling is indicated as annual, semi-annual, quarterly, or monthly in the sampling schedule. Some samples are collected and analyzed as part of ground-water monitoring and characterization programs at Hanford (e.g. Resources Conservation and Recovery Act (RCRA), Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), or Operational). The number of samples planned by other programs are identified in the sampling schedule by a number in the analysis column and a project designation in the Cosample column. Well sampling events may be merged to avoid redundancy in cases where sampling is planned by both-environmental surveillance and another program

1995-01-01

365

No association between q-angle and foot posture with running-related injuries : a 10 week prospective follow-up study  

DEFF Research Database (Denmark)

There is a paucity of knowledge on the association between different foot posture quantified by Foot Posture Index (FPI) and Quadriceps angle (Q-angle) with development of running-related injuries. Earlier studies investigating these associations did not include an objective measure of the amount of running performed. Therefore, the purpose of this study was to investigate if kilometers to running-related injury (RRI) differ among novice runners with different foot postures and Q-angles when running in a neutral running shoe.

Ramskov, Daniel; Jensen, M L

2013-01-01

366

Increases in cerebrospinal fluid caffeine concentration are associated with favorable outcome after severe traumatic brain injury in humans.  

Science.gov (United States)

Caffeine, the most widely consumed psychoactive drug and a weak adenosine receptor antagonist, can be neuroprotective or neurotoxic depending on the experimental model or neurologic disorder. However, its contribution to pathophysiology and outcome in traumatic brain injury (TBI) in humans is undefined. We assessed serial cerebrospinal fluid (CSF) concentrations of caffeine and its metabolites (theobromine, paraxanthine, and theophylline) by high-pressure liquid chromatography/ultraviolet in 97 ventricular CSF samples from an established bank, from 30 adults with severe TBI. We prospectively selected a threshold caffeine level of > or = 1 micromol/L (194 ng/mL) as clinically significant. Demographics, Glasgow Coma Scale (GCS) score, admission blood alcohol level, and 6-month dichotomized Glasgow Outcome Scale (GOS) score were assessed. Mean time from injury to initial CSF sampling was 10.77+/-3.13 h. On initial sampling, caffeine was detected in 24 of 30 patients, and the threshold was achieved in 9 patients. Favorable GOS was seen more often in patients with CSF caffeine concentration > or = versus blood alcohol level, and admission systolic arterial blood pressure did not differ between patients with CSF caffeine concentration > or = versus concentrations of the caffeine metabolites theobromine and paraxanthine were also associated with favorable outcome (P=0.018 and 0.056, respectively). Caffeine and its metabolites are commonly detected in CSF in patients with severe TBI and in an exploratory assessment are associated with favorable outcome. We speculate that caffeine may be neuroprotective by long-term upregulation of adenosine A1 receptors or acute inhibition of A2a receptors. PMID:17684518

Sachse, Kathleen T; Jackson, Edwin K; Wisniewski, Stephen R; Gillespie, Delbert G; Puccio, Ava M; Clark, Robert S B; Dixon, C Edward; Kochanek, Patrick M

2008-02-01

367

Injury incidence and injury patterns in qualification runs versus final runs in FIS World Cup snowboard cross and ski cross  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: No previous studies have investigated the injury incidence in individual qualification runs vs. final runs in heats of 4 or more athletes in FIS World Cup (WC) Snowboard Cross (SBX) and Ski Cross (SX). Objective: To investigate the injury incidence and injury patterns in individual qualification runs vs. final runs of SBX and SX during four seasons of the FIS WC. Methods: Injuries were recorded by the FIS Injury Surveillance System (FIS ISS) through retrospective athlete interview...

Steenstrup, Sophie Elspeth

2011-01-01

368

Association between Peripheral Oxidative Stress and White Matter Damage in Acute Traumatic Brain Injury  

Science.gov (United States)

The oxidative stress is believed to be one of the mechanisms involved in the neuronal damage after acute traumatic brain injury (TBI). However, the disease severity correlation between oxidative stress biomarker level and deep brain microstructural changes in acute TBI remains unknown. In present study, twenty-four patients with acute TBI and 24 healthy volunteers underwent DTI. The peripheral blood oxidative biomarkers, like serum thiol and thiobarbituric acid-reactive substances (TBARS) concentrations, were also obtained. The DTI metrics of the deep brain regions, as well as the fractional anisotropy (FA) and apparent diffusion coefficient, were measured and correlated with disease severity, serum thiol, and TBARS levels. We found that patients with TBI displayed lower FAs in deep brain regions with abundant WMs and further correlated with increased serum TBARS level. Our study has shown a level of anatomic detail to the relationship between white matter (WM) damage and increased systemic oxidative stress in TBI which suggests common inflammatory processes that covary in both the peripheral and central reactions after TBI.

Lin, Wei-Ming; Chen, Meng-Hsiang; Wang, Hung-Chen; Lu, Cheng-Hsien; Chen, Pei-Chin; Chen, Hsiu-Ling; Tsai, Nai-Wen; Su, Yu-Jih; Li, Shau-Hsuan; Kung, Chia-Te; Chiu, Tsui-Min; Weng, Hsu-Huei; Lin, Wei-Che

2014-01-01