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1

Enhancing severe injury surveillance: the association between severe injury events and fatalities in US coal mines.  

UK PubMed Central (United Kingdom)

This report evaluates the potential of using high degree (or severe) injuries as a proxy for fatal events. Injuries occurring at bituminous coal mines within the United States during the years 1996-2006 were classified by the degree of severity according to the Abbreviated Injury Scale (AIS). Using multivariate discrete and logistic models (via generalized estimating equations) and adjusting for number of employees and underground v. surface status, high degree (AIS?3) injuries in the prior year were associated with an increased risk (OR 2.02, 95% CI 1.17 to 3.46) of fatalities within the same mine. While there is a need for improvements and standardization of injury surveillance and reporting, the findings support the study hypothesis that mining conditions resulting in high degree injuries can also result in fatalities, thus expanding the use and versatility of high degree injury surveillance data. With an improved understanding of the conditions and activities behind these two injury event types, these results enhance the ability for industry to more readily identify and develop technological advancements for safety and mitigating disasters.

Poplin GS; Miller H; Sottile J; Hu C; Hill JR; Burgess JL

2013-02-01

2

Bodygraphic Injury Surveillance System  

Science.gov (United States)

This paper proposes a new technology,``a bodygraphic injury surveillance system (BISS)'' that not only accumulates accident situation data but also represents injury data based on a human body coordinate system in a standardized and multilayered way. Standardized and multilayered representation of injury enables accumulation, retrieval, sharing, statistical analysis, and modeling causalities of injury across different fields such as medicine, engineering, and industry. To confirm the effectiveness of the developed system, the authors collected 3,685 children's injury data in cooperation with a hospital. As new analyses based on the developed BISS, this paper shows bodygraphically statistical analysis and childhood injury modeling using the developed BISS and Bayesian network technology.

Tsuboi, Toshiki; Kitamura, Koji; Nishida, Yoshihumi; Motomura, Yoichi; Takano, Tachio; Yamanaka, Tatsuhiro; Mizoguchi, Hiroshi

3

Descriptive epidemiology of collegiate men's football injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To review 16 years of National Collegiate Athletic Association (NCAA) injury surveillance data for men's football and identify potential areas for injury prevention initiatives. BACKGROUND: Football is a high-velocity collision sport in which injuries are expected. Football tends to have one of the highest injury rates in sports. Epidemiologic data helps certified athletic trainers and other clinicians identify injury trends and patterns to appropriately design and institute injury prevention protocols and then measure their effects. MAIN RESULTS: During the 16-year reporting period, about 19% of the Division I, II, and III NCAA institutions sponsoring football participated in the Injury Surveillance System. The results from the 16-year study period show little variation in the injury rates over time: games averaged 36 injuries per 1000 athlete-exposures (A-Es); fall practice, approximately 4 injuries per 1000 A-Es; and spring practice, about 10 injuries per 1000 A-Es. The game injury rate was more than 9 times higher than the in-season practice injury rate (35.90 versus 3.80 injuries per 1000 A-Es, rate ratio = 9.1, 95% confidence interval = 9.0, 9.2), and the spring practice injury rate was more than 2 times higher than the fall practice injury rate (9.62 versus 3.80 injuries per 1000 A-Es, rate ratio = 2.5, 95% confidence interval = 2.5, 2.6). The rate ratio for games versus fall practices was greatest for upper leg contusions (18.1 per 1000 A-Es), acromioclavicular joint sprains (14.0 per 1000 A-Es), knee internal derangements (13.4 per 1000 A-Es), ankle ligament sprains (12.0 per 1000 A-Es), and concussions (11.1 per 1000 A-Es). RECOMMENDATIONS: Football is a complex sport that requires a range of skills performed by athletes with a wide variety of body shapes and types. Injury risks are greatest during games. Thus, injury prevention measures should focus on position-specific activities to reduce the injury rate. As equipment technology improves for the helmet, shoulder pads, and other protective devices, appropriate injury surveillance procedures should be performed to determine the effect of the new equipment on injury rates. A consistent evaluation of injury trends and patterns will assist decision makers in designing injury prevention techniques in areas that warrant the greatest attention and suggesting rule changes and modifications based on the data.

Dick R; Ferrara MS; Agel J; Courson R; Marshall SW; Hanley MJ; Reifsteck F

2007-04-01

4

Epidemiology of syndesmosis injuries in intercollegiate football: incidence and risk factors from National Collegiate Athletic Association injury surveillance system data from 2004-2005 to 2008-2009.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To describe the incidence and risk factors for high ankle sprains (ie, syndesmosis injuries) among National Collegiate Athletic Association (NCAA) football players. DESIGN: Descriptive epidemiologic study. SETTING: Data were examined from the NCAA's Injury Surveillance System (ISS) for 5 football seasons (from 2004-2005 to 2008-2009). PARTICIPANTS: All NCAA men's football programs participating in the ISS. ASSESSMENT OF RISK FACTORS: No additional risk factors were introduced as a result of this analysis. MAIN OUTCOME MEASURES: For partial and complete syndesmosis injuries, outcome measures included incidence, time lost from participation, and requirement for surgical repair. RESULTS: The overall incidence of high ankle sprains in NCAA football players was 0.24 per 1000 athlete exposures, accounting for 24.6% of all ankle sprains. Athletes were nearly 14 times more likely to sustain the injury during games compared with practice; complete syndesmosis injuries resulted in significantly greater time lost compared with partial injuries (31.3 vs 15.8 days). Less than 3% of syndesmosis injuries required surgical intervention. There was a significantly higher injury incidence on artificial surfaces compared with natural grass. The majority of injuries (75.2%) occurred during contact with another player. CONCLUSIONS: Our data suggest a significantly higher incidence of syndesmosis injuries during games, during running plays, and to running backs and interior defensive linemen. The wide range in time lost from participation for complete syndesmosis injuries underscores the need for improved understanding of injury mechanism and classification of injury severity such that prevention, safe return to play protocols, and outcomes can be further improved.

Hunt KJ; George E; Harris AH; Dragoo JL

2013-07-01

5

TRAUMATIC BRAIN INJURY SURVEILLANCE SYSTEM (TBISS)  

Science.gov (United States)

The National Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention (CDC) had developed and maintains a surveillance system to understand the magnitude and characteristics of hospitalized and fatal traumatic brain injuries in the United State...

6

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...

7

Injury surveillance in the World Football Tournaments 1998-2012.  

UK PubMed Central (United Kingdom)

BACKGROUND: International sports bodies should protect the health of their athletes, and injury surveillance is an important pre-requisite for injury prevention. The Fédération International de Football Association (FIFA) has systematically surveyed all football injuries in their tournaments since 1998. AIMS: Analysis of the incidence, characteristics and changes of football injury during international top-level tournaments 1998-2012. METHODS: All newly incurred football injuries during the FIFA tournaments and the Olympic Games were reported by the team physicians on a standardised injury report form after each match. The average response rate was 92%. RESULTS: A total of 3944 injuries were reported from 1546 matches, equivalent to 2.6 injuries per match. The majority of injuries (80%) was caused by contact with another player, compared with 47% of contact injuries by foul play. The most frequently injured body parts were the ankle (19%), lower leg (16%) and head/neck (15%). Contusions (55%) were the most common type of injury, followed by sprains (17%) and strains (10%). On average, 1.1 injuries per match were expected to result in absence from a match or training. The incidence of time-loss injuries was highest in the FIFA World Cups and lowest in the FIFA U17 Women's World Cups. The injury rates in the various types of FIFA World Cups had different trends over the past 14 years. CONCLUSIONS: Changes in the incidence of injuries in top-level tournaments might be influenced by the playing style, refereeing, extent and intensity of match play. Strict application of the Laws of the Games is an important means of injury prevention.

Junge A; Dvorak J

2013-08-01

8

Strengthening injury surveillance system in iran.  

UK PubMed Central (United Kingdom)

Objective: To strengthen the current Injury Surveillance System (IS System) in order to better monitor injury conditions, improve protection ways and promote safety. Methods: At first we carried out a study to evaluate the frameworks of IS System in the developed countries. Then all the available documents from World Health Organization, Eastern Mediterranean Regional Organization, as well as Minister of Health and Medical Education concerning Iran were reviewed. Later a national stakeholder's consultation was held to collect opinions and views. A national workshop was also intended for provincial representatives from 41 universities to identify the barriers and limitations of the existing program and further to strengthen injury surveillance.Results: The evaluation of the current IS System revealed many problems, mainly presented as lack of accurate pre- and post-hospital death registry, need of precise injury data registry in outpatient medical centers, incomplete injury data registry in hospitals and lack of accuracy in definition of variables in injury registry. The five main characteristics of current IS System including flexibility, acceptability, simplicity, usefulness and timeliness were evaluated as moderate by experts. Conclusions: Major revisions must be considered in the current IS System in Iran. The following elements should be added to the questionnaire: identifier, manner of arrival to the hospital, situation of the injured patient, consumption of alcohol and opioids, other involved participants in the accident, intention, severity and site of injury, side effects of surgery and medication, as well as one month follow-up results. Data should be collected from 10% of all hospitals in Iran and analyzed every 3 months. Simultaneously data should be online to be retrieved by researches.

Motevalian SA; Haddadi M; Akbari H; Khorramirouz R; Saadat S; Tehrani A; Rahimi-Movaghar V

2011-12-01

9

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.

Mitchell Rebecca J; Williamson Ann M; O'Connor Rod

2009-01-01

10

Pediatric Genital Injury: An Analysis of the National Electronic Injury Surveillance System.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To describe the characteristics of pediatric genital injuries presenting to United States emergency departments (EDs). METHODS: A retrospective cohort study utilizing the U.S. Consumer Product Safety Commission (CPSC) National Electronic Injury Surveillance System (NEISS) from 1991-2010 to evaluate pediatric genital injuries was performed. RESULTS: Pediatric genital injuries represented 0.6% of all pediatric injuries with the incidence of injuries rising through the period studied, 1991-2010. The mean age at injury was 7.1 years old and was distributed 56.6% girls and 43.4% boys. A total of 43.3% had lacerations and 42.2% had contusions/abrasions. The majority of injuries occurred at home (65.9%), and the majority of patients (94.7%) were treated and released from the hospital. The most common consumer products associated with pediatric genital trauma were: bicycles (14.7% of all pediatric genital injuries), bathtubs (5.8%), daywear (5.6%), monkey bars (5.4%), and toilets (4.0%). CONCLUSION: Although pediatric genital injuries represent a small proportion of overall injuries presenting to the emergency department, genital injuries continue to rise despite public health measures targeted to decrease childhood injury. Our results can be used to guide further prevention strategies for pediatric genital injury.

Casey JT; Bjurlin MA; Cheng EY

2013-08-01

11

Refining the focus of construction injury surveillance.  

UK PubMed Central (United Kingdom)

We conducted two studies of construction injury occurring at Denver International Airport (DL4), whose construction required 31 million work hours. Initially we conducted a retrospective cohort study that allowed estimation of injury and workers' compensation (WC) payment rates for strata such as size of employer and type of work; risk factors were also estimated. The second study examined written injury reports for 4,000 injuries at DIA. We modified Haddon's matrix to classify factors contributing to injury. We identified 108 factors within 4 broad categories: human, object, environment and organization. This approach provided information on rates at which each factor contributed to injury and the WC payment rates for each factor. A study shortcoming was that injury reports varied in completeness and quality. In a third ongoing study, to compensate for the shortcomings of injury reports, particularly to improve consistency and completeness of data, we designed a worker questionnaire completed immediately after injury, which included questions specific to hazards associated with each type of injury. Upon completion, the interviewer (a safety professional) uses the modified Haddon's matrix to note contributors to the injury and explain briefly the reasons for each notation. This requires the interviewer to consider a full set of possible factors and determine whether they contributed to injury. This process elicits richer data and places specific factors within the four higher-level categories. This process confer advantages on both contractors and researchers. Contractors can become immediately aware of contributing factors and ameliorate them quickly. The data can also be used in post hoc analysis of injury etiology. Moreover, the data are sufficiently flexible and complete that they can be coded into schemes describing sequences of events leading to injury, as well as those simply identifying factors contributing to injury. Haddon's matrix is invaluable in such analysis because it leads to a fuller understanding of the origins of the most proximate contributors to injury than would otherwise occur. Particularly for contractors and owners with significant safety infrastructures, this approach may be attractive, because it allows for more complete and quicker correction of specific hazards and, with systematic evaluation, recognition of more general safety concerns present on many construction sites.

Glazner J; Lipscomb H; Bondy J

2006-03-01

12

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

13

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

14

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

15

2006 Pantex Plant Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2008-05-19

16

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

17

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

18

2007 Hanford Site Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

U.S. Department of Energy, Office of Health, Safety, and Security

2009-07-16

19

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

20

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

 
 
 
 
21

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

22

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

23

2006 Nevada Test Site Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2008-04-24

24

2006 Kansas City Plant Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2008-06-13

25

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

26

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

27

2007 Pantex Plant Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2008-07-31

28

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

29

2009 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 epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

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

2010-12-01

30

2009 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-11-24

31

2008 Idaho National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-11-23

32

2008 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2009-12-10

33

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

34

2008 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

2009-09-29

35

2007 Sandia National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2009-02-04

36

2008 Nevada Test Site Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2009-10-05

37

2007 Nevada Test Site Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2009-06-30

38

2009 Pantex Plant Annual Illness and Injury Surveillance  

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-12-15

39

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

40

2008 Kansas City Plant Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2009-09-22

 
 
 
 
41

2008 Sandia National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2009-09-17

42

2009 Argonne National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-08-19

43

Disparity surveillance of nonfatal motor vehicle crash injuries.  

UK PubMed Central (United Kingdom)

Objective: The lack of race information for nonfatal motor vehicle crash injuries in the United States has limited the understanding of racial disparities in motor vehicle crashes (MVCs). In this article, we describe a pilot surveillance project in Nebraska that linked crash reports and driver's license records to investigate racial disparity among nonfatal MVC injuries. Methods: The project linked 43,157 severely and nonseverely injured drivers from crash reports between 2006 and 2010 to the corresponding state driver's license database so that drivers' race information from each MVC could be retrieved. A log rate model was used to examine the likelihood of MVC injuries by drivers' race along the dimensions of age, sex, and place of residence. Results: Black drivers had 31.6 and 87 percent more severe and nonsevere injuries, respectively, than white drivers. Rural residents were more likely than urban residents to have severe MVC injuries. Controlling for residence status, age, and sex did not alter the basic pattern that black drivers had higher rates of nonfatal MVC injuries. Conclusions: The linkage approach provides an effective way to obtain additional information for MVC injury disparity surveillance. To reduce racial disparities in severe and nonsevere MVC injuries, race-sex-, race-age-, and race-location-specific interventions should be considered based on their significant contributions to disparity.

Zhang Y; Lin G

2013-01-01

44

Tumor-Associated Glycans and Immune Surveillance  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Changes in cell surface glycosylation are a hallmark of the transition from normal to inflamed and neoplastic tissue. Tumor-associated carbohydrate antigens (TACAs) challenge our understanding of immune tolerance, while functioning as immune targets that bridge innate immune surveillance and adaptiv...

Behjatolah Monzavi-Karbassi; Anastas Pashov; Thomas Kieber-Emmons

45

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; Tuyet Binh, Ta Thi; Diep, Nguyen Bich; Kriebel, David

2013-09-12

46

Limitations of child injury data from the CPSC's National Electronic Injury Surveillance System: the case of baby walker related data.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

OBJECTIVES: The US Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) is a primary source for children's consumer product injury surveillance data in the US. Differing interpretations of the emergency department based NEISS baby walker data by various parties...

Weiss, H. B.

47

Tumor-Associated Glycans and Immune Surveillance  

Directory of Open Access Journals (Sweden)

Full Text Available Changes in cell surface glycosylation are a hallmark of the transition from normal to inflamed and neoplastic tissue. Tumor-associated carbohydrate antigens (TACAs) challenge our understanding of immune tolerance, while functioning as immune targets that bridge innate immune surveillance and adaptive antitumor immunity in clinical applications. T-cells, being a part of the adaptive immune response, are the most popular component of the immune system considered for targeting tumor cells. However, for TACAs, T-cells take a back seat to antibodies and natural killer cells as first-line innate defense mechanisms. Here, we briefly highlight the rationale associated with the relative importance of the immune surveillance machinery that might be applicable for developing therapeutics.

Behjatolah Monzavi-Karbassi; Anastas Pashov; Thomas Kieber-Emmons

2013-01-01

48

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; Balraj V; Muliyil J

2009-01-01

49

Brain Injury Association of America  

Science.gov (United States)

Welcome to the Brain Injury Association of America Brain injury is not an event or an outcome. It is the start of a ... misunderstood, under-funded neurological disease. Individuals who sustain brain injuries must have timely access to expert trauma ...

50

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

51

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

52

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

53

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

54

2007 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

2009-07-13

55

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

56

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2008-05-13

57

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

58

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

59

2006 Los Alamos National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2008-06-13

60

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

 
 
 
 
61

Epidemiology of fireworks injuries: the National Electronic Injury Surveillance System, 1980-1989.  

UK PubMed Central (United Kingdom)

STUDY OBJECTIVES: To estimate the annual fireworks injury rates in the United States over the past decade (1980 through 1989) and to describe the epidemiology of fireworks-related trauma. DESIGN: Retrospective analysis of fireworks-related injuries reported from the National Electronic Injury Surveillance System of the Consumer Product Safety Commission. RESULTS: During the study period, nearly 10,000 Americans were injured annually by fireworks. The rates were highest in the young, with a peak of 22.3 per 100,000 persons per year for males age 10 to 14. Males outnumbered females by 2.5:1. Half of the fireworks injuries occurred around the week of July 4. The hand was the most frequently injured body part, followed by the eyes and the face. Active participants consistently were the major victims in all "personal-use" fireworks and had more severe injuries than bystanders. Rockets were the most dangerous device among class C fireworks. CONCLUSION: Fireworks injuries are a health hazard to the public. Young persons are at the highest risk to suffer injuries, mainly due to personal-use fireworks. A majority of victims are injured during the week of July 4. Class B fireworks and rockets appear to be very dangerous.

See LC; Lo SK

1994-07-01

62

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

UK PubMed Central (United Kingdom)

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

Zia N; Khan UR; Razzak JA; Puvanachandra P; Hyder AA

2012-01-01

63

Automated surveillance for healthcare-associated infections: opportunities for improvement.  

UK PubMed Central (United Kingdom)

Surveillance of healthcare-associated infections is a cornerstone of infection prevention programs, and reporting of infection rates is increasingly required. Traditionally, surveillance is based on manual medical records review; however, this is very labor intensive and vulnerable to misclassification. Existing electronic surveillance systems based on classification algorithms using microbiology results, antibiotic use data, and/or discharge codes have increased the efficiency and completeness of surveillance by preselecting high-risk patients for manual review. However, shifting to electronic surveillance using multivariable prediction models based on available clinical patient data will allow for even more efficient detection of infection. With ongoing developments in healthcare information technology, implementation of the latter surveillance systems will become increasingly feasible. As with current predominantly manual methods, several challenges remain, such as completeness of postdischarge surveillance and adequate adjustment for underlying patient characteristics, especially for comparison of healthcare-associated infection rates across institutions.

van Mourik MS; Troelstra A; van Solinge WW; Moons KG; Bonten MJ

2013-07-01

64

Pediatric injuries associated with fireplaces, United States, 2002-2007.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To examine injuries among pediatric patients treated in an emergency department (ED) related to contact with a fireplace. METHODS: Data were obtained from the National Electronic Injury Surveillance System for the years 2002 through 2007. National estimates of ED visits for injuries associated with fireplaces were analyzed. Average annual rates were calculated, and logistic regression analyses were used to determine risk estimates for patient demographic characteristics related to ED visits for injuries associated with fireplaces. RESULTS: From 2002 through 2007, there were an estimated 8000 ED visits annually for injuries related to fireplaces in the United States, with an average annual rate of 18.8 ED visits per 100,000 children aged birth through 10 years. The most common injuries involved lacerations (66%), burns (10%), and contusions (10%). Most injuries occurred to the face (46%) or head (31%). Most patients (98%) were treated and released the same day. Results of logistic regression analyses revealed that children aged birth to 3 years (odds ratio, 12.2; 95% confidence interval, 9.1-16.5) and children aged 4 to 6 years (odds ratio, 4.8; 95% confidence interval, 3.5-6.5) were more likely present in an ED for a fireplace-related injury when compared with older children aged 7 to 10 years. CONCLUSIONS: Further research is warranted in the areas of etiology, injury prevention interventions, health communications, and surveillance to facilitate more effective injury prevention efforts.

Hammig BJ; Henry J

2011-02-01

65

Claims-Based Surveillance to Identify Injury Precursors. Project Period: Sept. 30, 1999 - Sept. 29, 2003.  

Science.gov (United States)

The purpose of this project is to improve workplace safety and health through research aimed at developing a cost-effective claims-based injury and illness surveillance system which has broad applicability. A database and prospective record linking system...

D. J. Tollerud

2004-01-01

66

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.

Cinnamon Jonathan; Schuurman Nadine

2010-01-01

67

2009 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

2010-07-09

68

2008 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 epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

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

2010-10-26

69

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

70

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

71

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

72

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

73

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

74

2008 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2009-12-14

75

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

76

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

77

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

78

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2007-10-04

79

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; Kumar Sunil; Vasudevan D

2007-01-01

80

The burden of childhood injuries and evidence based strategies developed using the injury surveillance system in Pasto, Colombia.  

UK PubMed Central (United Kingdom)

OBJECTIVE: This article characterises the burden of childhood injuries and provides examples of evidence-based injury prevention strategies developed using a citywide injury surveillance system in Pasto, Colombia. METHODS: Fatal (2003-2007) and non-fatal (2006-2007) childhood injury data were analysed by age, sex, cause, intent, place of occurrence, and disposition. RESULTS: Boys accounted for 71.5% of fatal and 64.9% of non-fatal injuries. The overall fatality rate for all injuries was 170.8 per 100,000 and the non-fatal injury rate was 4,053 per 100,000. Unintentional injuries were the leading causes of fatal injuries for all age groups, except for those 15-19 years whose top four leading causes were violence-related. Among non-fatal injuries, falls was the leading mechanism in the group 0-14 years. Interpersonal violence with a sharp object was the most important cause for boys aged 15-19 years. Home was the most frequent place of occurrence for both fatal and non-fatal injuries for young children 0-4 years old. Home, school and public places became an important place for injuries for boys in the age group 5-15 years. The highest case-fatality rate was for self-inflicted injuries (8.9%). CONCLUSIONS: Although some interventions have been implemented in Pasto to reduce injuries, it is necessary to further explore risk factors to better focus prevention strategies and their evaluation. We discuss three evidence-based strategies developed to prevent firework-related injuries during festival, self-inflicted injuries, and road traffic-related injuries, designed and implemented based on the injury surveillance data.

Espitia-Hardeman V; Borse NN; Dellinger AM; Betancourt CE; Villareal AN; Caicedo LD; Portillo C

2011-02-01

 
 
 
 
81

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; Dobmeier Teresa M; Haglund Bo JA; Tillgren Per

2011-01-01

82

Evaluation of a Remote Computerized Injury Surveillance System in Youth Soccer.  

Science.gov (United States)

The need for an injury surveillance system within the sports medicine community has been well documented. Recent advances in hand-held computing devices offer the opportunity to collect and enter the data at the location of the injurious event. Direct dat...

C. Bir D. Sherman G. Schultz

2004-01-01

83

Liver injury associated with antidepressants.  

UK PubMed Central (United Kingdom)

Antidepressants are commonly prescribed and used in the management of depression, anxiety disorders, and other psychiatric illnesses. Antidepressants used in therapeutic dosing ranges are associated with causing several adverse drug reactions including hepatotoxicity. Paroxetine, fluoxetine, fluvoxamine, citalopram, mirtazapine and venlafaxine are associated with reversible liver injury upon discontinuation of the agent. Patient cases of hepatotoxicity involving the use of nefazodone, trazodone, duloxetine, bupropion, and sertraline are linked to causing death in its users. Due to the idiosyncratic nature of hepatotoxicity, monitoring of liver function tests and immediate discontinuation upon abnormal lab findings or signs and symptoms of liver dysfunction are crucial since most cases of hepatic damage are reversible when detected early. Onset of antidepressant-associated hepatotoxicity varies from 5 days to 3 years. Antidepressant-induced liver injury can occur in the absence of identifiable, underlying risk factors such as cirrhosis and hepatitis infection; only a few cases of hepatic injury involve patients with chronic hepatitis infection. Some of these cases involve possible drug interactions between antidepressants and concomitant agents that increase the risk for liver injury. Understanding druginduced liver injury associated with antidepressants and the importance of safety monitoring is essential to optimize outcomes for antidepressant treatment.

Park SH; Ishino R

2013-07-01

84

Orthopaedic injuries associated with skimboarding.  

UK PubMed Central (United Kingdom)

BACKGROUND: Skimboarding is a beachside water sport that is enjoying increasing popularity among both dedicated enthusiasts and casual beachgoers. Although many consider this sport to be similar to its "sister" sport, surfing, the technique, the environment in which it is performed, and the skills required differ dramatically from that of surfing. Moreover, the pattern of injuries seen in skimboarders differs substantially from those sustained while surfing. HYPOTHESIS: A better understanding of the injuries encountered in this sport will allow improved participant education and facilitate the implementation of preventative measures. STUDY DESIGN: Descriptive epidemiology study. METHODS: A case series was generated by performing a single retrospective chart review of skimboarding injuries referred for orthopaedic evaluation over a 2-year period at 2 medical treatment facilities, one on the East Coast and one on the West Coast of the United States; demographic data, injury type, and treatments rendered were documented. RESULTS: Sixty-one patients were identified and analyzed. Average patient age was 19.1 years. Fractures represented 93.4% of all acute injuries. The most common sites of injury were the ankle (41%) and wrist (36%). Rotation about a planted lower extremity was the most common mechanism of injury (30/61, 49%), followed by falls onto an outstretched hand (26/61, 43%). CONCLUSION: Fractures of the ankle and wrist comprise a high proportion of skimboarding injuries. Knowledge of potential hazards associated with this sport should be made available to participants. To decrease the risk of orthopaedic injury, the use of protective equipment or instruction in proper techniques of the activity may be warranted.

Sciarretta KH; McKenna MJ; Riccio AI

2009-07-01

85

Skateboard-associated injuries: participation-based estimates and injury characteristics.  

UK PubMed Central (United Kingdom)

BACKGROUND: Skateboarding is a popular recreational activity but has attendant associated risks. To place this risk in perspective, participation-based rates of injury were determined and compared with those of other selected sports. Skateboard-associated injuries were evaluated over time to determine participation-based trends in injury prevalence. METHODS: Rates of skateboard-associated injury were studied for the 12-year period 1987 to 1998 for participants aged 7 years or older. The National Electronic Injury Surveillance System provided injury estimates for skateboarding and the selected additional sporting activities. The National Sporting Goods Association annual survey of nationally representative households provided participation estimates. A participation-based rate of injury was calculated from these data sets for the selected sports for the year 1998. RESULTS: The 1998 rate of emergency department-treated skateboard-associated injuries-8.9 injuries per 1,000 participants (95% confidence interval [CI], 6.2, 11.6)-was twice as high as in-line skating (3.9 [95% CI, 3.1, 4.8]) and half as high as basketball (21.2 [95% CI, 18.3, 24.1]). The rate of skateboard-associated injuries declined from 1987 to 1993 but is again increasing: the 1998 rate was twice that of 1993 (4.5 [95% CI, 1.6, 7.4] and 8.9 [95% CI, 6.2, 11.6], respectively). Increases occurred primarily among adolescent and young adult skateboarders. The most frequent injuries in 1998 were ankle strain/sprain and wrist fracture: 1.2 (95% CI, 0.8, 1.6) and 0.6 (95% CI, 0.4, 0.8) per 1,000, respectively. Skateboard-associated injuries requiring hospitalization occurred in 2.9% and were 11.4 (95% CI, 7.5, 17.5) times more likely to have occurred as a result of a crash with a motor vehicle than injuries in those patients not hospitalized. CONCLUSION: This study is the first to relate skateboarding and other sport injuries to participation exposures. We found that skateboarding is a comparatively safe sport; however, increased rates of injury are occurring in adolescent and young adult skateboarders. The most common injuries are musculoskeletal; the more serious injuries resulting in hospitalization typically involve a crash with a motor vehicle. This new methodology that uses participation-based injury rates might contribute to more effective injury control initiatives.

Kyle SB; Nance ML; Rutherford GW Jr; Winston FK

2002-10-01

86

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

UK PubMed Central (United Kingdom)

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 TM; Trent RB; Bernacki K; Rice JK; Lovette B; Hoover E; Fennell J; Aistrich AZ; Wiltsek D; Corman E; Anderson CL; Sherck J

2012-05-01

87

Feasibility of National Surveillance of Health-Care-Associated Infections in Home-Care Settings  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This article examines the rationale and strategies for surveillance of health-care-associated infections in home-care settings, the challenges of nonhospital-based surveillance, and the feasibility of developing a national surveillance system.

Manangan, Lilia P.; Pearson, Michele L.; Tokars, Jerome I.; Miller, Elaine; Jarvis, William R.

88

Advancing the science of ventilator-associated pneumonia surveillance.  

Science.gov (United States)

ABSTRACT: 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 because their complexity and subjectivity allow for conscious and subconscious gaming. These limitations make it very difficult to determine whether changes in surveillance rates represent true changes in disease incidence or artifacts of definition subjectivity, external reporting pressures, and internal biases. Surveillance definitions need to be revised to enhance objectivity and to ensure that they detect clinically meaningful events associated with compromised outcomes. The US Centers for Disease Control and Prevention recently released modified definitions for ventilator-associated events that have the potential to make safety surveillance for ventilated patients more credible and useful once again. PMID:23113957

Klompas, Michael

2012-10-31

89

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

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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; Kafoa Berlin; Kool Bridget; Herman Josephine; McCaig Eddie; Ameratunga Shanthi

2012-01-01

90

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

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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.

Thomas M. Rice, MPH, PhD; Roger B. Trent, PhD; Kate Bernacki, MPH; Jennifer K. Rice, MPH; Bonnie Lovette, RN, MS, PNP; Eileen Hoover, RN, MS; Janette Fennell; Anna Zacher Aistrich, MPH; Dana Wiltsek, MSW; Ellen Corman, MRA; Craig L. Anderson, PhD, MPH; John Sherck, MD

2012-01-01

91

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

UK PubMed Central (United Kingdom)

BACKGROUND: Occupational injuries research and surveillance is important for prevention and public health protection. A new occupational surveillance system based on linkage of work histories calculated from the Italian National Social Security Institute (INPS) and occupational injuries provided by the National Insurance Institute for Occupational Injuries (INAIL) was created and assessed. METHODS: It has been extracted a 1% sample of individuals from INPS. For each subject, a detailed description of the career has been compiled between 1985 and 2004, and matched on an individual basis to work injuries between 1994 and 2003. It has been calculated injury rates and risks by economic activity, gender, age, job tenure, country of birth, and firm size. RESULTS: The linkage success is very high both in engineering than in the construction sector. The comparison with Eurostat statistics is very positive. The injury risks calculated by job tenure, country of birth, and firm size are consistent with literature. The high injury rate for short work contracts remain unvaried also after controlling by age. CONCLUSIONS: It is finally possible to describe injuries based on some main characteristics of the recent changes in the labor market, such as precarization, ageing of workers, migration, that databases currently available in Italy do not allow. The sample is longitudinal and can contribute to describing the development of the phenomena over time. The Ministry of Health is completing procedures to extend the sample and to increase the health outcomes for which a follow-up is available.

Bena A; Leombruni R; Giraudo M; Costa G

2012-07-01

92

Eye injury surveillance in the U.S. Department of Defense, 1996-2005.  

UK PubMed Central (United Kingdom)

BACKGROUND: Consistent with the public health approach to prevention, surveillance analyses are needed to fully understand a health problem. U.S. military eye injury rates have not been fully described using medical surveillance data. METHODS: Medical visit data on active duty personnel, 1996-2005, and causes of eye injury hospitalizations (identified by Standard NATO Agreement injury cause codes) were obtained from the Defense Medical Surveillance System. Eye injury-related ICD-9-CM codes beyond the traditional 800-999 injury code set were included. Rates by age and gender are reported for 1996-2005, along with the frequency of causes of injury hospitalizations and leading eye injury diagnoses for 2005. RESULTS: Eye injury rates among active duty military personnel increased from 1996 to 2005 among both men and women (p<0.001), with the highest rates in 2004 (26/1000 person-years and 21/1000 person-years, women and men, respectively). Women consistently had 7%-21% higher rates than men (rate ratios=1.07; 95% CI=1.04, 1.11) to 1.21 (95% CI= 1.17, 1.25). From 1996-2005, eye injury rates increased among all age groups (p<0.001). From 2002-2005, rates were highest for those aged > or =40 years compared to those aged 17-19 years (rate ratios=1.17 [95% CI=1.11, 1.24] to 1.24 [95% CI=1.18, 1.31]). Leading causes of eye injury hospitalizations were ordnance handling (16.9%), enemy action (13.1%), and fighting (11.9%). CONCLUSIONS: Medical surveillance data enable the assessment and monitoring of overall active duty eye injury rates, trends, and causes. Outpatient data could be improved with the addition of cause of injury codes and eye protection use. Current data suggest that continued use of eye protection during ordnance handling, combat, motor vehicle use, and sports could help reduce eye injury rates.

Hilber D; Mitchener TA; Stout J; Hatch B; Canham-Chervak M

2010-01-01

93

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

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

Razzak Junaid; Shamim Muhammad; Mehmood Amber; Hussain Syed; Ali Mir; Jooma Rashid

2012-01-01

94

Ventilator-associated lung injury.  

UK PubMed Central (United Kingdom)

Mechanical ventilation of disease-affected lungs, as well as being an inadequate mode of ventilation for initially healthy lungs, can cause significant changes in their structure and function. In order to differentiate these processes, two terms are used: ventilator-associated lung injury (VALI) and ventilator-induced lung injury (VILI). In both cases, lung injury primarily results from differences in transpulmonary pressure - a consequence of an imbalance between lung stress and strain. This paper focuses on changes in lung structure and function due to this imbalance. Moreover, in this context, barotrauma, volutrauma and atelectrauma are interpreted, and the importance of signal transduction as a process inducing local and systemic inflammatory responses (biotrauma), is determined. None of the assessed methods of reducing VALI and VILI has been found to be entirely satisfactory, yet studies evaluating oscillatory ventilation, liquid ventilation, early ECMO, super-protective ventilation or noisy ventilation and administration of certain drugs are under way. Low tidal volume ventilation and adequately adjusted PEEP appear to be the best preventive measures of mechanical ventilation in any setting, including the operating theatre. Furthermore, this paper highlights the advances in VILI/VALI prevention resulting from better understanding of pathophysiological phenomena.

Kuchnicka K; Maciejewski D

2013-07-01

95

[Ventilator associated acute lung injury].  

UK PubMed Central (United Kingdom)

Mechanical ventilation plays a central role in the critical care setting; but its use is closely related with some life threatening complications as nosocomial pneumonia and low cardiac performance. One of the most severe complications is called ventilator-associated lung injury (VALI) and it includes: Barotrauma, volutrauma, atelectrauma, biotrauma and oxygen-mediated toxic effects and it is related with an inflammatory response secondary to the stretching and recruitment process of alveoli within mechanical ventilation. The use of some protective ventilatory strategies has lowered the mortality rate 10% approximately.

Namendys-Silva SA; Posadas-Calleja JG

2005-05-01

96

[Ventilator associated acute lung injury].  

Science.gov (United States)

Mechanical ventilation plays a central role in the critical care setting; but its use is closely related with some life threatening complications as nosocomial pneumonia and low cardiac performance. One of the most severe complications is called ventilator-associated lung injury (VALI) and it includes: Barotrauma, volutrauma, atelectrauma, biotrauma and oxygen-mediated toxic effects and it is related with an inflammatory response secondary to the stretching and recruitment process of alveoli within mechanical ventilation. The use of some protective ventilatory strategies has lowered the mortality rate 10% approximately. PMID:16187708

Namendys-Silva, Silvio Antonio; Posadas-Calleja, Juan Gabriel

97

Surveillance of work-related musculoskeletal injuries among union carpenters.  

UK PubMed Central (United Kingdom)

Combined data sources, including union administrative records and workers' compensation claims, were used to construct event histories for a dynamic cohort of union carpenters from Washington State during the period 1989-1992. Person-time at risk and the events of interest were stratified by age, sex, time in the union, and predominant type of carpentry work. Poisson regression techniques were used to identify subgroups at greatest risk of filing claims for a variety of musculoskeletal disorders defined by ANSI codes for body part injured and injury nature. Distinguishing different kinds of musculoskeletal disorders, even crudely with ANSI codes, led to different conclusions about the effects of the explanatory variables. Among older workers, the rates of fractures of the foot were higher, while rates of contusions of the hand and foot were lower. Women had higher rates of sprain/strains and nerve conditions of the wrist/forearm. Higher rates of injuries to the axial skeleton were seen among carpenters who did predominantly light commercial and drywall work, while piledrivers had lower rates of these injuries. Drywall workers had higher rates of sprains to the ankle/lower leg. Workers who were members of the union as long as four years had lower risks for the vast majority of musculoskeletal disorders studied. Similar patterns were seen for more serious claims that resulted in paid lost time from work.

Lipscomb HJ; Dement JM; Loomis DP; Silverstein B; Kalat J

1997-12-01

98

Surveillance of work-related musculoskeletal injuries among union carpenters.  

Science.gov (United States)

Combined data sources, including union administrative records and workers' compensation claims, were used to construct event histories for a dynamic cohort of union carpenters from Washington State during the period 1989-1992. Person-time at risk and the events of interest were stratified by age, sex, time in the union, and predominant type of carpentry work. Poisson regression techniques were used to identify subgroups at greatest risk of filing claims for a variety of musculoskeletal disorders defined by ANSI codes for body part injured and injury nature. Distinguishing different kinds of musculoskeletal disorders, even crudely with ANSI codes, led to different conclusions about the effects of the explanatory variables. Among older workers, the rates of fractures of the foot were higher, while rates of contusions of the hand and foot were lower. Women had higher rates of sprain/strains and nerve conditions of the wrist/forearm. Higher rates of injuries to the axial skeleton were seen among carpenters who did predominantly light commercial and drywall work, while piledrivers had lower rates of these injuries. Drywall workers had higher rates of sprains to the ankle/lower leg. Workers who were members of the union as long as four years had lower risks for the vast majority of musculoskeletal disorders studied. Similar patterns were seen for more serious claims that resulted in paid lost time from work. PMID:9358920

Lipscomb, H J; Dement, J M; Loomis, D P; Silverstein, B; Kalat, J

1997-12-01

99

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

UK PubMed Central (United Kingdom)

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

Rosen T; Mack KA; Noonan RK

2013-01-01

100

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

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

Tony Rosen; Karin Ann Mack; Rita Noonan

2013-01-01

 
 
 
 
101

Surveillance  

Science.gov (United States)

... that is what he knows best. Your radiation oncologist will want to zap you, again because that ... he does. Others like me or your medical oncologist may tell you to consider surveillance. This is ...

102

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

UK PubMed Central (United Kingdom)

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

Berchialla P; Scarinzi C; Snidero S; Rahim Y; Gregori D

2012-04-01

103

Competition injuries in taekwondo: a literature review and suggestions for prevention and surveillance.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To review competition injuries in taekwondo and use this information to develop recommendations to reduce the number and severity of injuries in taekwondo competition. METHODS: The available literature was searched for prospective studies on taekwondo injuries in adult athletes. An injury was defined as any circumstance for which the athlete sought the assistance of the on-site medical personnel. Injury rates were expressed per athlete-exposures (A-E) and 95% CIs calculated. RESULTS: Total injury rates for elite men varied from 20.6/1000 A-E (95% CI 11.8 to 29.3) to 139.5/1000 A-E (95% CI 94.0 to 185.1). For elite women, the rates varied from 25.3/1000 A-E (95% CI 3.1 to 47.4) to 105.5/1000 A-E (95% CI 89.8 to 121.1). About one-third of all injuries (29.6%) in the men were to the head and neck region, while almost half of the injuries (44.5%) were to the lower extremities. In women, 15.2% of injuries were to the head and neck and 53.1% to the lower extremities. The vast majority of all injuries were contusions (42.7% in the men and 62.7% in the women). Point estimates of rates of head injuries and concussions were found to be higher in taekwondo than in other contact sports such as football (soccer) and American gridiron football. Time-loss injury rates in the men varied from 6.9/1000 A-E (95% CI 1.8 to 11.9) to 33.6/1000 A-E (95% CI 18.9 to 48.3). In the women, they varied from 2.4/1000 A-E (95% CI 2.3 to 7.2) to 23.0/1000 A-E (95% CI 15.7 to 30.4). The turning kick was most often involved in causing injury: 56.9% of all injuries in the men and 49.8% in the women. Lack of blocking skills was identified as one of the main injury mechanisms. CONCLUSIONS: Rule changes should be considered and it is recommended that governing bodies employ qualified medical personnel. Establishing an ongoing injury surveillance system in taekwondo should be the first priority.

Pieter W; Fife GP; O'Sullivan DM

2012-06-01

104

Limitations of child injury data from the CPSC's National Electronic Injury Surveillance System: the case of baby walker related data.  

UK PubMed Central (United Kingdom)

OBJECTIVES: The US Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) is a primary source for children's consumer product injury surveillance data in the US. Differing interpretations of the emergency department based NEISS baby walker data by various parties prompted this detailed examination, reclassification, and analysis of the NEISS data to explain these discrepancies. METHODS: Case selection was performed by searching the NEISS 1982-91 database for the baby walker product code and various text strings for children less than 24 months old. False negative and false positive cases were identified and reclassified. Adjusted population rates were computed and the types and locations of hospitals contributing to the sample were examined. RESULTS: One per cent false positive and 4% false negative misclassification rates were observed. In 1991, two children's hospitals reported 14% of the baby walker related injuries, though these hospitals made up just 2% of the sample frame. Through random allocation, one state currently contains four acute care hospitals and the only two children's hospitals reporting to the NEISS system. These six hospitals contributed 18% of the walker cases whereas the state represents only 3% of the US infant population. CONCLUSIONS: Misclassification in NEISS baby walker reports is minimal, with false negatives outweighing false positives. For trend analysis of product related injuries at the frequency of occurrence observed for baby walkers, NEISS suffers from low sensitivity due to sampling error. For children's injuries, NEISS' estimates have been affected by children's hospitals coming in and out of the sample and currently reflects a random geographic imbalance because one state contributes both of the reporting children's hospitals. To overcome these problems improved multiple product coding, a unique baby walker code, and stratification of children's hospitals in an enlarged NEISS sample is recommended.

Weiss HB

1996-03-01

105

Surveillance of healthcare-associated infections in Indonesian hospitals.  

UK PubMed Central (United Kingdom)

A cross-sectional surveillance of healthcare-associated infections (HAIs) and exposure to risk factors was undertaken in two Indonesian teaching hospitals (Hospitals A and B). Patients from internal medicine, surgery, obstetrics and gynaecology, paediatrics, a class department and intensive care were included. Patient demographics, antibiotic use, culture results, presence of HAI [phlebitis, surgical site infection (SSI), urinary tract infection (UTI) and septicaemia] and risk factors were recorded. To check for interobserver variation, a validation study was performed in Hospital B. In Hospitals A and B, 1,334 and 888 patients were included, respectively. Exposure to invasive devices and surgery was 59%. In Hospital A, 2.8% of all patients had phlebitis, 1.7% had SSI, 0.9% had UTI and 0.8% had septicaemia. In Hospital B, 3.8% had phlebitis, 1.8% had SSI, 1.1% had UTI and 0.8% had septicaemia. In the validation study, the prevalence as recorded by the first team was 2.6% phlebitis, 1.8% SSI, 0.9% UTI and no septicaemia, and that recorded by the second team was 2.2% phlebitis, 2.6% SSI, 3.5% UTI and 0.9% septicaemia. This study is the first to report on HAI in Indonesia. Prevalence rates are comparable to those in other countries. The reliability of the surveillance was insufficient as a considerable difference in prevalence rates was found in the validation study. The surveillance method used is a feasible tool for hospitals in countries with limited healthcare resources to estimate their level of HAI and make improvements in infection control. Efficiency can be improved by restricting the surveillance to include only those patients with invasive procedures. This can help to detect 90% of all infections while screening only 60% of patients.

Duerink DO; Roeshadi D; Wahjono H; Lestari ES; Hadi U; Wille JC; De Jong RM; Nagelkerke NJ; Van den Broek PJ

2006-02-01

106

Injuries in women associated with a periodized strength training and running program.  

UK PubMed Central (United Kingdom)

Forty-five women participated in a 24-week physical training program designed to improve lifting, load carriage, and running performance. Activities included weightlifting, running, backpacking, lift and carry drills, and sprint running. Physicians documented by passive surveillance all training-related injuries. Thirty-two women successfully completed training program. Twenty-two women (48.9%) suffered least 1 injury during training, but only 2 women had to drop out of the study because of injuries. The rate of injury associated with lost training time was 2.8 injuries per 1,000 training hours of exposure. Total clinic visits and days lost from training were 89 and 69, respectively. Most injuries were the overuse type involving the lower back, knees, and feet. Weightlifting accounted for a majority of the lost training days. A combined strength training and running program resulted in significant performance gains in women. Only 2 out of 45 participants left the training program cause of injuries.

Reynolds KL; Harman EA; Worsham RE; Sykes MB; Frykman PN; Backus VL

2001-02-01

107

Renal tract ultrasonography for routine surveillance in spinal cord injury patients.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To report the efficacy of a urinary tract surveillance regime based on annual renal tract ultrasound without routine use of urodynamic testing (UDS) in our population of spinal cord injury (SCI) patients managed with clean intermittent catheterization (CIC). METHODS: Data was gathered retrospectively from the records of 48 SCI patients (40 males and 8 females). After establishing a safe system with initial urodynamics, renal ultrasonography was done annually for surveillance. UDS was repeated only when patients presented with new symptoms. The primary endpoint was the report of ultrasound findings at last follow-up. Findings of dilatation, calculi, scarring, and reflux were noted. RESULTS: Mean follow-up was 6.8 years. By final follow-up, pelvicaliectasis was present in 4 (8%) subjects. Mild-moderate hydronephrosis was present in 3 (6%) subjects: 1 stable and 2 (4%) new compared to initial assessment. No severe cases of hydronephrosis were noted. Six (13%) subjects had renal/ureteral calculi. No new cases of renal cortical scarring or thinning were noted. One (2%) subject had high-grade reflux on UDS secondary to a double J stent. CONCLUSIONS: Data relating to the efficacy of sequential surveillance studies in SCI patients are scarce, thus there is great variability in urologic surveillance methods worldwide. Upper tract abnormalities detected in our patients were early consequences of acute obstruction rather than late manifestations of detrusor changes and could not have been prevented with more regular urodyamic testing. These results suggest that annual ultrasound monitoring without routine urodynamic testing is an effective surveillance strategy in SCI patients managed with CIC.

Edokpolo LU; Foster HE Jr

2013-01-01

108

Evaluation of healthcare-associated infection surveillance in Pennsylvania hospitals.  

UK PubMed Central (United Kingdom)

OBJECTIVE: In Pennsylvania, reporting of healthcare-associated infections (HAIs) was mandated in 2007, and hospitals were encouraged to implement qualified electronic surveillance (QES) systems to assist HAI detection. This study evaluated the usefulness of these systems in reducing HAIs. DESIGN: Online survey and retrospective cohort study. Eligible facilities had a QES or manual system in place for the entire study period and sufficient data in selected hospital units. METHODS: Surveys were sent to infection preventionists (IPs) in all Pennsylvania hospitals to gather qualitative information about their systems. National Healthcare Safety Network data from Pennsylvania hospitals for July 2008 through June 2010 were used to compare catheter-associated urinary tract infection (CAUTI) rates in facilities with and without a QES system. PARTICIPANTS: IPs from 174 facilities responded to the survey. Data from 119 of 234 hospitals were analyzed. RESULTS: IPs in facilities with a QES system reported spending as much time on data management and education as IPs in hospitals with manual surveillance. Significant interaction was observed in CAUTI rates over time between groups of facilities with and without a QES system after controlling for device-utilization ratio, location within hospital, and licensed bed size (P < .01). QES hospitals showed a significant decline in CAUTI rates (P < .01) manual surveillance facilities showed no change in rates (P > .05). CONCLUSIONS: Over the 2-year period, a significant decline in CAUTI rates was observed in facilities with a QES system. This suggests that electronic systems may aid in reducing HAI rates. Additional data are needed to see whether these improvements and trends persist.

Palumbo AJ; Loveless PA; Moll ME; Ostroff S

2012-02-01

109

Macroglossia Associated with Brainstem Injury.  

UK PubMed Central (United Kingdom)

BACKGROUND: Macroglossia has been reported in patients undergoing posterior fossa neurosurgical procedures and is thought to be as a result of venous engorgement from intubation or mechanical positioning during these prolonged procedures. METHODS: We report three patients who developed macroglossia and dysautonomia of central neurogenic origin following brainstem injury. RESULTS: The three patients developed macroglossia and dysautonomia with wide hemodynamic fluctuations in the setting of posterior fossa injury of the lower brainstem structures, necessitating tracheostomy placement. Macroglossia was managed with dexamethasone and there was complete resolution of dysautonomia while treated with beta-blockers and gabapentin. CONCLUSIONS: Neurointensivists should be aware of macroglossia with dysautonomia complicating brainstem injury, which may have perilous consequences in the setting of cerebral edema or intracranial hypertension.

Iwuchukwu I; Ardelt A; Cueva W; Reshi R; Goldenberg F; Frank J

2013-09-01

110

[Associated factors to severe sport injuries].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To identify the risk factors associated to severe sport injuries. MATERIAL AND METHODS: Case-control study, with non probabilistic of consecutive sample cases. The risk factors criteria for severe injuries were established by experts' consensus in patients diagnosed with injury caused during sports practice between July 2004 and March 2005. These patients were attended in the emergency room at the Magdalena de las Salinas High Medical Specialty Unit in Mexico City. RESULTS: There were included 131 patients with sport injuries; there were 76.3% men and 23.7% women. The mean age was 21.6+/-8.6. There were non severe injuries, (concussions, muscle strains, sprained) in 55% of patients and 45% of patients had severe injuries (fractures, dislocation, fracture-dislocation, physeal injury). In the case of severe injuries, it was associated with working out in a non reglamentary area [odd ratio (OR) of 2.5, p=0.01, CI (1.2-5.1)], soccer practice [OR of 2.4, p=0.01, CI (1.2-4.8)], body axis injury [OR of 5.9, p=0.004, CI (1.6-21.9)], indirect injury mechanism [OR of 2.2, p=0.04, CI (0.9-5.2)], sport practiceinjuries with statistical significance, the other factors here studied did not show statistical significance, but had clinical significance. In following studies we recommended to use a bigger sample than we used in this study.

Díaz de León-Miranda E; Redondo-Aquino G; Bueno-Olmos ME; Arriaga-Páez MA; Rodríguez-Cabrera R; Torres-González R

2007-01-01

111

Coagulopathy associated with traumatic brain injury.  

Science.gov (United States)

Coagulopathy is often observed after traumatic brain injury (TBI), but the pathogenic mechanisms of this phenomenon remain elusive. Brain injury is the leading cause of trauma deaths, and the development of coagulopathy after TBI is associated with increased morbidity and mortality in these patients. The coagulopathy after TBI comprises a hypocoagulable and a hypercoagulable state with hemorrhagic and thrombotic phenotypes that are both associated with worse outcome. Some theories of its pathogenesis include massive release of tissue factor, altered protein C homeostasis, microparticle upregulation, and platelet hyperactivity. This article aims to examine the coagulopathy associated with blunt head injury, to review its effect on progression of hemorrhagic injury, and to discuss the possible relevant pathophysiological mechanisms. PMID:24046182

Kumar, Monisha A

2013-11-01

112

How adequate are emergency department home and leisure injury surveillance systems for cross-country comparisons in Europe?  

UK PubMed Central (United Kingdom)

The objective of this study was to assess whether the emergency department (ED) injury surveillance systems in Europe are suitable for cross-country comparisons. For this, the ED injury surveillance systems in Austria, Denmark, Greece, Ireland, the Netherlands, Norway and the UK (England, Wales) were considered. Standardised injury incidence and healthcare utilisation indices were calculated and the influence of measurement bias due to data collection and sampling differences, as well as trauma policy and health systems characteristics were assessed. The results showed that there was an over 3-fold variation of the grossly estimated incidence for home and leisure injuries (HLIs), with the highest values observed in England and Greece (111 and 104 per 1000 person years), and the lowest in Ireland and the Netherlands (27 and 48 per 1000 person years). The ranking of countries changed, however, when only injuries with an inherent need for ED treatment were considered (selected radiological verifiable fractures) with Austria topping the table followed by Greece and England. Thus, it is concluded that the naive use of ED injury surveillance systems for cross-country comparisons should be discouraged, as this is subject to measurement bias. Nevertheless, the observed variation in the healthcare utilisation and injury incidence, particularly among children and older people, indicates the potential to reduce the burden of HLI in Europe.

Meerding WJ; Polinder S; Lyons RA; Petridou ET; Toet H; van Beeck F; Mulder S

2010-03-01

113

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

114

Emergency department presentations for injuries associated with inflatable amusement structures, Canada, 1990-2009.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Inflatable amusement attractions, structures that are air-supported and inflated by a blower, have recently gained popularity. The purpose of this study was to describe the epidemiology of inflatable-related injuries presenting to Canadian emergency departments. METHODS: The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) is an injury and poisoning surveillance system presently operating in the emergency departments of all 11 pediatric and 4 general hospitals across Canada. The CHIRPP was searched for cases of injuries associated with commercial inflatable amusement structures. RESULTS: Overall, 674 cases were identified over the 20-year surveillance period, during which time the average annual percent increase was 24.6% (95% CI: 21.6, 27.7). Children aged 2 to 9 years were the most frequently injured (59.3/100,000 CHIRPP cases), and fractures accounted for 34.5% of all injuries. DISCUSSION: A sharp increase in emergency department visits for injuries associated with commercial inflatable amusement structures has been observed in recent years. Injury mechanisms could be mitigated by product design modifications and stricter business operational practices.

McFaull SR; Keays G

2013-06-01

115

Lightning-associated injuries and deaths among military personnel--United States, 1998-2001.  

UK PubMed Central (United Kingdom)

After flooding, lightning is the second leading cause of weather-related death in the United States; approximately 300 injuries and 100 deaths are associated annually with lightning strikes in the United States. To characterize lightning-associated injuries and deaths among U.S. Armed Forces personnel, the U.S. Army and CDC analyzed data from the Defense Medical Surveillance System (DMSS). This that the highest lightning-related injury rates during 1998-2001 occurred among male U.S. military members who were aged <40 years, single, with a high school education or less, stationed near the Gulf of Mexico or the East Coast, and in the U.S. Army. The findings suggest that the risk for lightning-associated injury depends primarily on the frequency, timing, duration, and nature of outdoor exposure to thunderstorms. Military personnel should be aware of severe weather onset and take reasonable precautions to protect themselves and their companions from exposure to lightning.

2002-09-01

116

Injury severity associated with nonfatal construction falls.  

UK PubMed Central (United Kingdom)

This study evaluated injury severity in a group of construction workers who sustained nonfatal falls at work. The sample consisted of 255 adults who were identified from Doctor's First Reports (DFRs) submitted to the California Department of Industrial Relations. For those that fell from heights (n = 195), the mean height of fall was 9.2 feet (SD = 7.1). The mean number of lost work days was 44.3 days (SD = 58.6) and the median was 10 days. Two measures of injury severity were used--the Injury Severity Score and the disability section of the Health Assessment Questionnaire (HAQ). Seventeen participants (7%; 95% CI, 4-10%) were deemed permanently disabled. A simultaneous multiple regression model, using five independent variables, explained approximately 21% of the variance in HAQ scores. Nonunion status and safety climate scores indicating increased risk were positively correlated with higher functional limitation as measured by HAQ scores, as were greater heights and impact on concrete surface. Higher scores on both injury severity measures were significantly and moderately associated with a greater number of days lost from work. These findings suggest that injury severity and permanent disability associated with falls in construction are notable, and identify key target areas for intervention and prevention.

Gillen M; Faucett JA; Beaumont JJ; McLoughlin E

1997-12-01

117

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.OpsommingEnige 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 

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

2011-01-01

118

Cardiac arrhythmias associated with spinal cord injury.  

UK PubMed Central (United Kingdom)

Context/Objectives: To review the current literature to reveal the incidence of cardiac arrhythmias and its relation to spinal cord injury (SCI). METHODS: Data source: MEDLINE database, 304 hits, and 32 articles were found to be relevant. The relevant articles all met the inclusion criteria: (1) contained original data (2) on cardiac arrhythmias (3) in humans with (4) traumatic SCI. RESULTS: In the acute phase of SCI (1-14 days after injury) more cranial as well as more severe injuries seemed to increase the incidence of bradycardia. Articles not covering the first 14 days after injury, thus describing the chronic phase of SCI, showed that individuals with SCI did not have a higher incidence of cardiac arrhythmias compared with able-bodied controls. Furthermore, their heart rate did not differ significantly. Penile vibro-stimulation was the procedure investigated most likely to cause bradycardia, which in turn was associated with episodes of autonomic dysreflexia. The incidence of bradycardia was found to be 17-77% for individuals with cervical SCI. For individuals with thoracolumbar SCI, the incidence was 0-13%. CONCLUSION: Bradycardia was commonly seen in the acute stage after SCI as well as during procedures such as penile vibro-stimulation and tracheal suction. These episodes of bradycardia were seen more often in individuals with cervical injuries. Longitudinal studies with continuous electrocardiogram recordings are needed to uncover the true relation between cardiac arrhythmias and SCI.

Hector SM; Biering-Sørensen T; Krassioukov A; Biering-Sørensen F

2013-04-01

119

Injuries associated with the use of riding mowers in the United States, 2002-2007.  

UK PubMed Central (United Kingdom)

CONTEXT: To examine injuries among patients treated in an emergency department (ED) related to the use of a riding lawn mower. DESIGN AND SETTING: Data were obtained from the National Electronic Injury Surveillance System for the years 2002-2007. National estimates of ED visits for injuries associated with the use of a riding lawn mower were analyzed. Narrative text entries were categorized to provide a detailed record of the circumstances precipitating the injury. Average annual rates were calculated and logistic regression analyses were employed to determine risk estimates for patient disposition and demographic characteristics related to ED visits for injuries associated with riding mowers. RESULTS: From 2002 through 2007, there were an estimated 66,341 ED visits for injuries related to the use of riding lawnmowers in the U.S., with an average annual rate of 6.0 ED visits per 100,000 males, and 1.6 ED visits per 100,000 females. Older adults had higher rates of ED visits for injuries (7.2/100,000) than younger age groups. The most common injuries involved contusions (24%); sprains/strains (22%) and fractures (17%). The majority of patients (90%) were treated and released the same day. Results of logistic regression analyses revealed that older adults were more likely to be hospitalized when compared to younger age groups; and incidents involving rollovers [OR=5.45 (95% CI=3.22-9.23)] and being run over [6.01 (95% CI 3.23-11.17)] were more likely to result in hospitalization when compared to all other circumstances of injury. CONCLUSIONS: Riding mowers present injury patterns and circumstances that are different than those reported for push mowers. Circumstances related to injuries and age groups affected were varied, making prevention of riding mower injuries challenging. APPLICATION/IMPACT: Findings support the need to increase awareness and/or change the design of riding mowers with respect to risk of rollover injuries.

Hammig B; Childers E; Jones C

2009-10-01

120

FARM FAMILY HEALTH AND HAZARD SURVEILLANCE  

Science.gov (United States)

The NIOSH Farm Family Health and Hazard Surveillance (FFHHS) Cooperative Agreement Program was developed to respond to Congress's concern that agricultural workers and their families experience a disproportionate share of disease and injury associated with the chemical, biologica...

 
 
 
 
121

Incidence and risk factors associated with meniscal injuries among active-duty US military service members.  

UK PubMed Central (United Kingdom)

CONTEXT: Few population-based studies have examined the incidence of meniscal injuries, and limited information is available on the influence of patient's demographic and occupational factors. OBJECTIVE: To examine the incidence of meniscal injuries and the influence of demographic and occupational factors among active-duty US service members between 1998 and 2006. DESIGN: Cohort study. SETTING: Using the International Classification of Diseases (9th revision) codes 836.0 (medial meniscus), 836.1 (lateral meniscus), and 836.2 (meniscus unspecified), we extracted injury data from the Defense Medical Surveillance System to identify all acute meniscal injuries among active-duty military personnel. PATIENTS OR OTHER PARTICIPANTS: Active-duty military personnel serving in all branches of military service during the study period. MAIN OUTCOME MEASURE(S): Incidence rate (IR) per 1000 person-years at risk and crude and adjusted rates by strata for age, sex, race, rank, and service. RESULTS: During the study period, 100201 acute meniscal injuries and 12115606 person-years at risk for injury were documented. The overall IR was 8.27 (95% confidence interval [CI] = 8.22, 8.32) per 1000 person-years. Main effects were noted for all demographic and occupational variables (P < .001), indicating that age, sex, race, rank, and service were associated with the incidence of meniscal injuries. Men were almost 20% more likely to experience an acute meniscal injury than were women (incidence rate ratio = 1.18, 95% CI = 1.15, 1.20). The rate of meniscal injury increased with age; those older than 40 years of age experienced injuries more than 4 times as often as those under 20 years of age (incidence rate ratio = 4.25, 95% CI=4.08,4.42). CONCLUSIONS: The incidence of meniscal injury was substantially higher in this study than in previously reported studies. Male sex, increasing age, and service in the Army or Marine Corps were factors associated with meniscal injuries.

Jones JC; Burks R; Owens BD; Sturdivant RX; Svoboda SJ; Cameron KL

2012-01-01

122

A closer look at orthopedic injuries associated with maxillofacial trauma.  

UK PubMed Central (United Kingdom)

Although orthopedic injury has been reported to be the most frequent injury associated with facial trauma, their relationship has not been sufficiently evaluated in the literature. To evaluate this relationship, we compared 263 patients with concomitant facial and orthopedic injuries with 2006 patients with facial injuries alone. The rate of associated orthopedic injuries was 11.5%. Motor vehicle accidents, falls, mandibular fractures, and Le Fort I fractures increased the chance of sustaining orthopedic injuries nearly 17-, 15-, 10-, 4.4-, and 4.5-fold, respectively. Most fractures occurred in large bones with their inherent potential to cause severe, life-threatening complications. The high rates of mortality and morbidities associated with orthopedic injuries and the frequent occurrence of these injuries in patients with facial trauma emphasize upon the fact that maxillofacial surgeons, residents, and trauma nurses need more training in early diagnosis and appropriate management of associated orthopedic injuries.

Zandi M; Saleh M

2013-04-01

123

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

International Nuclear Information System (INIS)

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

1996-01-01

124

Association Rules and Data Mining in Hospital Infection Control and Public Health Surveillance  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Objectives: The authors consider the problem of identifying new, unexpected, and interesting patterns in hospital infection control and public health surveillance data and present a new data analysis process and system based on association rules to address this problem.

Brossette, Stephen E.; Sprague, Alan P.; Hardin, J. Michael; Waites, Ken B.; Jones, Warren T.; Moser, Stephen A.

125

TBI surveillance using the common data elements for traumatic brain injury: a population study.  

UK PubMed Central (United Kingdom)

BACKGROUND: To characterize the patterns of presentation of adults with head injury to the Emergency Department. METHODS: This is a cohort study that sought to collect injury and outcome variables with the goal of characterizing the very early natural history of traumatic brain injury in adults. This IRB-approved project was conducted in collaboration with our Institution's Center for Translational Science Institute. Data were entered in REDCap, a secure database. Statistical analyses were performed using JMP 10.0 pro for Windows. RESULTS: The cohort consisted of 2,394 adults, with 40% being women and 79% Caucasian. The most common mechanism was fall (47%) followed by motor vehicle collision (MVC) (36%). Patients sustaining an MVC were significantly younger than those whose head injury was secondary to a fall (P < 0.0001). Ninety-one percent had CT imaging; hemorrhage was significantly more likely with worse severity as measured by the Glasgow Coma Score (chi-square, P < 0.0001). Forty-four percent were admitted to the hospital, with half requiring ICU admission. In-hospital death was observed in 5.4%, while neurosurgical intervention was required in 8%. For all outcomes, worse TBI severity per GCS was significantly associated with worse outcomes (logistic regression, P < 0.0001, adjusted for age). CONCLUSION: These cohort data highlight the burden of TBI in the Emergency Department and provide important demographic trends for further research.

Stead LG; Bodhit AN; Patel PS; Daneshvar Y; Peters KR; Mazzuoccolo A; Kuchibhotla S; Pulvino C; Hatchitt K; Lottenberg L; Elie-Turenne MC; Hoelle RM; Vedula A; Gabrielli A; Miller BD; Slish JH; Falgiani M; Falgiani T; Tyndall JA

2013-01-01

126

Biopsy features associated with prostate cancer progression in active surveillance patients: comparison of three statistical models.  

UK PubMed Central (United Kingdom)

UNLABELLED: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Active surveillance is an established management option for patients with favourable-risk prostate cancer. However, about 25-30% of active surveillance patients demonstrate biopsy progression within the first 3-5 years of follow-up. Although several factors, such as the results of the diagnostic and surveillance biopsies, are known to be associated with the risk of progression, our ability to accurately predict this risk remains limited. Our analysis demonstrated that the overall number of positive cores in the diagnostic and first surveillance biopsies is strongly associated with the risk of progression in active surveillance patients. Furthermore, combined results of diagnostic and first surveillance biopsies provide more information about the probability of progression than they do separately. The most important variable affecting the progression-free survival was the overall number of cores positive for cancer. By 3 years of active surveillance, most of the patients who had four positive cores in the diagnostic and surveillance biopsies progressed, while those who had only one positive core had an excellent prognosis. These findings could be used to improve the accuracy of assessments of the prognosis of patients with low-risk prostate cancer and to help them make informed decisions about their treatment. OBJECTIVE: To analyse the prognostic importance of information provided by the diagnostic biopsy, the first surveillance biopsy and a combination thereof to identify active surveillance patients with a particularly high risk of progression. MATERIALS AND METHODS: The present study included 161 active surveillance patients who had at least two surveillance biopsies. The first surveillance biopsy was performed within 1 year of the diagnosis. Further surveillance biopsies usually took place every 1-2 years. Progression on the surveillance biopsy was defined as the presence of Gleason 4/5 cancer, > two positive cores or >20% involvement of any core. Cox proportional hazards regression analysis was used to examine the relationship between biopsy characteristics and progression. Three distinct statistical models were built using characteristics of diagnostic biopsies, surveillance biopsies, and a combination thereof. Harrell's c-index was used to quantify the predictive accuracy of each multivariate Cox model. RESULTS: The median follow-up was 3.6 years; 46 (28.6%) patients progressed. In multivariate analysis the major factor associated with progression was the number of positive cores. The model based on the combined results of diagnostic and first surveillance biopsies was significantly more predictive than the models based on the individual results of each biopsy. Patients with four positive cores in the diagnostic and first surveillance biopsies had estimated 5-year progression rate of 100%. CONCLUSION: The total number of positive cores in the diagnostic and first surveillance biopsies provides important information about the risk of prostate cancer progression in active surveillance patients.

Iremashvili V; Manoharan M; Rosenberg DL; Soloway MS

2013-04-01

127

SURVEILLANCE REPORTS  

Science.gov (United States)

Surveillance reports are designed to provide useful data to researchers, planners, policymakers, and other professionals interested in alcohol abuse and its associated illnesses and mortality. Other surveillance report topics include apparent per capita consumption of alcoholic b...

128

The effect of playing surface on the incidence of ACL injuries in National Collegiate Athletic Association American Football.  

UK PubMed Central (United Kingdom)

BACKGROUND: Artificial playing surfaces are widely used for American football practice and competition and anterior cruciate ligament (ACL) injuries are common. This study analyzed the National Collegiate Athletic Association (NCAA) Injury Surveillance System (ISS) men's football ACL injury database from 2004-2005 through 2008-2009 to determine the effect of playing surface on ACL injury in NCAA football athletes. METHODS: This database was reviewed from the 2004-2005 through 2008-2009 seasons using the specific injury code, "Anterior cruciate ligament (ACL) complete tear." The injury rate was computed for competition and practice exposures. Ninety-five percent confidence intervals were calculated using assumptions of a Poisson distribution. Pair-wise, two-sample tests of equality of proportions with a continuity correction were used to estimate the associations of risk factors. RESULTS: There was an incidence rate of 1.73 ACL injuries per 10,000 athlete-exposures (A-Es) (95% CI 1.47-2.0) on artificial playing surfaces compared with a rate of 1.24 per 10,000 A-Es (1.05-1.45, p<0.001) on natural grass. The rate of ACL injury on artificial surfaces is 1.39 times higher than the injury rate on grass surfaces. Non-contact injuries occurred more frequently on artificial turf surfaces (44.29%) than on natural grass (36.12%). CONCLUSIONS: NCAA football players experience a greater number of ACL injuries when playing on artificial surfaces.

Dragoo JL; Braun HJ; Harris AH

2013-06-01

129

Real-Time Pharmacy Surveillance and Clinical Decision Support to Reduce Adverse Drug Events in Acute Kidney Injury  

Science.gov (United States)

Objectives Clinical decision support (CDS), such as computerized alerts, improves prescribing in the setting of acute kidney injury (AKI), but considerable opportunity remains to improve patient safety. The authors sought to determine whether pharmacy surveillance of AKI patients could detect and prevent medication errors that are not corrected by automated interventions. Methods The authors conducted a randomized clinical trial among 396 patients admitted to an academic, tertiary care hospital between June 1, 2010 and August 31, 2010 with an acute 0.5 mg/dl change in serum creatinine over 48 hours and a nephrotoxic or renally cleared medication order. Patients randomly assigned to the intervention group received surveillance from a clinical pharmacist using a web-based surveillance tool to monitor drug prescribing and kidney function trends. CDS alerting and standard pharmacy services were active in both study arms. Outcome measures included blinded adjudication of potential adverse drug events (pADEs), adverse drug events (ADEs) and time to provider modification or discontinuation of targeted nephrotoxic or renally cleared medications. Results Potential ADEs or ADEs occurred for 104 (8.0%) of control and 99 (7.1%) of intervention patient-medication pairs (p=0.4). Additionally, the time to provider modification or discontinuation of targeted nephrotoxic or renally cleared medications did not differ between control and intervention patients (33.4 hrs vs. 30.3hrs, p=0.3). Conclusions Pharmacy surveillance had no incremental benefit over previously implemented CDS alerts

McCoy, A.B.; Cox, Z.L.; Neal, E.B.; Waitman, L.R.; Peterson, N.B.; Bhave, G.; Siew, E.D.; Danciu, I.; Lewis, J.B.; Peterson, J.F.

2012-01-01

130

Association rules and data mining in hospital infection control and public health surveillance.  

UK PubMed Central (United Kingdom)

OBJECTIVES: The authors consider the problem of identifying new, unexpected, and interesting patterns in hospital infection control and public health surveillance data and present a new data analysis process and system based on association rules to address this problem. DESIGN: The authors first illustrate the need for automated pattern discovery and data mining in hospital infection control and public health surveillance. Next, they define association rules, explain how those rules can be used in surveillance, and present a novel process and system--the Data Mining Surveillance System (DMSS)--that utilize association rules to identify new and interesting patterns in surveillance data. RESULTS: Experimental results were obtained using DMSS to analyze Pseudomonas aeruginosa infection control data collected over one year (1996) at University of Alabama at Birmingham Hospital. Experiments using one-, three-, and six-month time partitions yielded 34, 57, and 28 statistically significant events, respectively. Although not all statistically significant events are clinically significant, a subset of events generated in each analysis indicated potentially significant shifts in the occurrence of infection or antimicrobial resistance patterns of P. aeruginosa. CONCLUSION:The new process and system are efficient and effective in identifying new, unexpected, and interesting patterns in surveillance data. The clinical relevance and utility of this process await the results of prospective studies currently in progress.

Brossette SE; Sprague AP; Hardin JM; Waites KB; Jones WT; Moser SA

1998-07-01

131

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

Directory of Open Access Journals (Sweden)

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

Chini Francesco; Farchi Sara; Ciaramella Ivana; Antoniozzi Tranquillo; Rossi Paolo; Camilloni Laura; Valenti Massimo; Borgia Piero

2009-01-01

132

Rugby injuries.  

UK PubMed Central (United Kingdom)

OBJECTIVES: The purpose of this chapter is to review critically the existing studies on the epidemiology of pediatric rugby injuries and discuss suggestions for injury prevention and further research. DATA SOURCES: Data were sourced from the sports medicine and science literature mainly since 1990, and from a prospective injury surveillance project in rugby undertaken by the University of New South Wales (UNSW) in Sydney during 2002. Literature searches were performed using Medline and SportsDiscus. MAIN RESULTS: Reported injury rates were between 7 and 18 injuries per 1,000 hours played, with the rate of injuries resulting in loss of playing or training time measured at 6.5-10.6 per 1,000 hours played. Injury rates increased with age and level of qualification. Head injury and concussion accounted for 10-40% of all injuries. In the UNSW study, concussion accounted for 25% of injuries resulting in loss of playing or training time in the under 13 year age group. Upper and lower extremity injuries were equally apportioned, with musculoskeletal injuries being the main type of injury. Fractures were observed in the upper extremity and ankle, and joint/ligament injuries affected the shoulder, knee and ankle. The tackle was associated with around 50% of all injuries. The scrum produced fewer injuries, but is historically associated with spinal cord injury. CONCLUSIONS: Rugby is a contact sport with injury risks related to physical contact, primarily in the tackle. Most injuries affect the musculoskeletal system, with the exception of concussion. Spinal cord injury is rare, but catastrophic. Research is required to understand better injury risks and to reduce the incidence of shoulder, knee and ankle joint injuries, concussion and spinal injury.

McIntosh AS

2005-01-01

133

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

134

Using Surveillance Data to Inform Community Action: The Effect of Alcohol Sale Restrictions on Intentional Injury-related Ambulance Pickups.  

UK PubMed Central (United Kingdom)

Youth violence disproportionately affects inner city, urban minority communities in the USA. This article illustrates the use of surveillance data to inform and evaluate community action directed at this serious problem. Community efforts in response to surveillance data indicating high rates of violence surrounding convenience stores with unrestricted alcohol beverage licenses provided a natural experiment to examine the impact of imposing licensing restrictions on intentional injury rates. Rates of ambulance pickups for intentional injuries in the 15- to 24-year-old population in five census tracts where alcoholic beverage sales were restricted were compared to five census tracts with similar demographic characteristics near stores where restrictions were not instituted. Time periods included an 18-month baseline period, a 6-month period during which restrictions were in effect in the intervention communities, and an 18-month period following lifting of this restriction resulting from legal action by store owners. The monthly average rate of ambulance pickups for violent injuries showed a significantly greater baseline-to-intervention phase decrease in the intervention communities (i.e., from 19.6 to 0 per 1,000) than in the control communities (i.e., 7.4 to 3.3 per 1,000). This rate subsequently increased to 11.4 in the intervention communities after the restriction was removed. This study illustrates the potential value of surveillance data for guiding community mobilization efforts and for evaluating the impact of such efforts. It also demonstrates the potential impact of restricting inexpensive, single-serve alcoholic beverages on rates of violence.

Masho SW; Bishop DL; Edmonds T; Farrell AD

2013-02-01

135

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

Directory of Open Access Journals (Sweden)

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

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

2009-01-01

136

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

137

Occupational injuries, duty status, and factors associated with injuries among firefighters.  

Science.gov (United States)

The aim of this study was to assess the type of occupational injuries, duty status, and factors associated with injuries among firefighters. A total of 437 firefighters from three U.S. states participated in an Internet-based survey. Approximately 66% of firefighters experienced occupational injuries and 56% reported multiple injuries. The most commonly reported injuries were muscle strains and sprains (74%), extremity injuries (60%), back injuries (54%), and burns (28%). A significant number of firefighters reported no duty (58%) or modified duty (46%). Firefighters with more than 17 years in fire services were more likely to report injuries (odds ratio [OR] = 2.96; 95% confidence interval [CI] = 1.92-4.58) and multiple injuries (OR = 2.47; 95% CI = 1.49-4.10). Hispanics (OR = 0.34; 95% CI = 0.15-0.76) and those with stronger organizational commitments (OR = 0.54; 95% CI = 0.35-0.84) were less likely to report injuries. Several factors were associated with injuries. These factors should be incorporated into interventions to reduce occupational injuries. PMID:23163314

Hong, Oisaeng; Chin, Dal Lae; Phelps, Stephanie; Feld, Jamie; Vogel, Stephen

2012-11-27

138

Can we bridge the definition diversity in healthcare-associated infection surveillance? From IT-supported surveillance to IT-supported infection prevention and control.  

UK PubMed Central (United Kingdom)

Expectations and requirements of the surveillance of healthcare-associated infections (HAIs) trigger a growing differentiation of HAI surveillance approaches. In an attempt to bridge this diversity of definitions and to serve the needs of different user groups, we have enhanced MONI (identification, monitoring, and reporting of nosocomial infections) not only to create better reports, but also to output overviews on complex clinical matters, as well as to generate alerts and reminders for the clinicians' bedside work.

Koller W; Blacky A; Mandl H; Rappelsberger A; Adlassnig KP

2013-01-01

139

Injury associated with methamphetamine use: A review of the literature  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract 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 were around driving and violence. Other associations with injury related to methamphetamine manufacture. There was also circumstantial evidence for third party injury (that is injury to those not specifically involved in drug use or drug manufacture); however, the available data are inadequate to confirm these associations/risks.

Sheridan Janie; Bennett Sara; Coggan Carolyn; Wheeler Amanda; McMillan Karen

2006-01-01

140

Etiologic factors associated with selected running injuries.  

Science.gov (United States)

The purpose of this study was to determine whether a relationship exists between selected biomechanical, anthropometric, and training variables and runners afflicted with one of the following injuries: iliotibial (IT) band friction syndrome, shin splints, and plantar fasciitis. Competitive and recreational runners were divided into a non-injured control group (N = 19), an IT band friction syndrome injury group (N = 13), a shin splint injury group (N = 17), and a plantar fasciitis injury group (N = 15). Discriminant function analysis of the biomechanical data revealed two significant (P less than 0.05) discriminators between the control and shin splint groups; maximum pronation velocity and maximum pronation. Analysis of the anthropometric and training data revealed that plantar flexion range of motion was a significant (P less than 0.05) discriminator between the control and plantar fasciitis groups. In addition, analysis of the descriptive statistics (mean +/- SE) identified some non-significant (P greater than 0.05) trends between the injury and control groups: maximum pronation, total rearfoot movement, and maximum velocity of pronation were greater in the injury groups; the injury groups showed a trend toward a higher arch; dorsiflexion range of motion was less in the shin splint group; a greater percentage of injured runners had a leg length difference (greater than 0.64 cm); 20% more runners in the injury groups ran hills; and 20% more of the runners in the IT band friction syndrome group ran on crowned roads. PMID:3193867

Messier, S P; Pittala, K A

1988-10-01

 
 
 
 
141

Etiologic factors associated with selected running injuries.  

UK PubMed Central (United Kingdom)

The purpose of this study was to determine whether a relationship exists between selected biomechanical, anthropometric, and training variables and runners afflicted with one of the following injuries: iliotibial (IT) band friction syndrome, shin splints, and plantar fasciitis. Competitive and recreational runners were divided into a non-injured control group (N = 19), an IT band friction syndrome injury group (N = 13), a shin splint injury group (N = 17), and a plantar fasciitis injury group (N = 15). Discriminant function analysis of the biomechanical data revealed two significant (P less than 0.05) discriminators between the control and shin splint groups; maximum pronation velocity and maximum pronation. Analysis of the anthropometric and training data revealed that plantar flexion range of motion was a significant (P less than 0.05) discriminator between the control and plantar fasciitis groups. In addition, analysis of the descriptive statistics (mean +/- SE) identified some non-significant (P greater than 0.05) trends between the injury and control groups: maximum pronation, total rearfoot movement, and maximum velocity of pronation were greater in the injury groups; the injury groups showed a trend toward a higher arch; dorsiflexion range of motion was less in the shin splint group; a greater percentage of injured runners had a leg length difference (greater than 0.64 cm); 20% more runners in the injury groups ran hills; and 20% more of the runners in the IT band friction syndrome group ran on crowned roads.

Messier SP; Pittala KA

1988-10-01

142

Associated injuries in children and adolescents with spinal trauma.  

UK PubMed Central (United Kingdom)

BACKGROUND: Over half of children and adolescents with spinal trauma have associated injuries, most commonly involving the appendicular skeleton, head and neck, and thorax. The incidence and characteristics of these associated injuries have been well described, but to our knowledge there has been no evaluation of the relationship between the injury characteristics and the patient age. METHODS: Data were obtained from the trauma registries of the local pediatric and adult level 1 trauma centers, and patients aged 0 to 19 years with spinal trauma were identified. For analysis, patients were divided into 3 age groups: 0 to 3, 4 to 12, and 13 to 19 years. Associated injuries were divided into 5 groups: head, thoracic, abdominal, appendicular skeletal fracture, and neurological. RESULTS: Overall, 25 patients had isolated dislocations and 307 patients had 366 spinal fractures or fracture-dislocations: 36% cervical, 31% thoracic, and 51% lumbar. Most (84%) of the injuries occurred in the 13- to 19-year-old group. Sixty-two percent of patients had associated injuries, most commonly thoracic injuries (pulmonary contusion, pneumothorax, rib fracture); 45% had multilevel spinal fractures, 39% of which were noncontiguous. Nearly three fourths of the noncontiguous fractures occurred in a different spinal region; cervical fracture with concomitant thoracic fracture was the most frequent pattern. CONCLUSIONS: This large series of consecutive patients highlights several important concepts concerning pediatric spinal fractures, including age-related patterns of injury, frequent associated injuries, and a high rate of multiple spinal injuries, especially noncontiguous injuries. It also emphasizes the importance of careful full-body examination and imaging of the entire spine in children and adolescents with a known spinal injury. LEVEL OF EVIDENCE: Level IV-case series.

Rush JK; Kelly DM; Astur N; Creek A; Dawkins R; Younas S; Warner WC Jr; Sawyer JR

2013-06-01

143

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

International Nuclear Information System (INIS)

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

1996-01-01

144

Surveillance data on pesticide and agricultural chemical releases and associated public health consequences in selected US states, 2003-2007.  

UK PubMed Central (United Kingdom)

BACKGROUND: While pesticides and agricultural chemicals are used to increase crop production and to reduce the spread of disease, their toxic nature also has the potential to threaten human health. Releases of pesticides and agricultural chemicals have resulted in human illness and death. This analysis examines releases of pesticides and agricultural chemicals and their associated injuries captured by the Hazardous Substances Emergency Events Surveillance (HSEES) system from 2003-2007. METHODS: Simple descriptive statistics are presented. Comparisons were made to data from all HSEES events when possible. RESULTS: Analysis of the data shows that farm workers are at particular risk for injury and that the most frequent months for releases of pesticides and agricultural chemicals were the spring planting months of April through June. Releases of pesticides and agricultural chemicals occurred more often during transport, had higher frequencies of patient decontamination associated with them, and lower frequencies of evacuation and shelter-in place orders compared with all HSEES events. CONCLUSION: Since exposures are precipitated by behavioral and environmental factors, especially in occupational settings, future interventions targeting employers, and transporters of agricultural chemicals, as well as physicians, are recommended. These interventions should be customized to fit local conditions.

Saw L; Shumway J; Ruckart P

2011-06-01

145

Lightning-associated injuries and deaths among military personnel--United States, 1998-2001.  

Science.gov (United States)

After flooding, lightning is the second leading cause of weather-related death in the United States; approximately 300 injuries and 100 deaths are associated annually with lightning strikes in the United States. To characterize lightning-associated injuries and deaths among U.S. Armed Forces personnel, the U.S. Army and CDC analyzed data from the Defense Medical Surveillance System (DMSS). This that the highest lightning-related injury rates during 1998-2001 occurred among male U.S. military members who were aged <40 years, single, with a high school education or less, stationed near the Gulf of Mexico or the East Coast, and in the U.S. Army. The findings suggest that the risk for lightning-associated injury depends primarily on the frequency, timing, duration, and nature of outdoor exposure to thunderstorms. Military personnel should be aware of severe weather onset and take reasonable precautions to protect themselves and their companions from exposure to lightning. PMID:12363338

2002-09-27

146

Injuries in Patients with Epilepsy and Some Factors Associated with Injury  

Directory of Open Access Journals (Sweden)

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

Mukadder MOLLAO?LU; Ertu?rul BOLAYIR

2013-01-01

147

Popliteal artery injury associated with knee dislocations.  

UK PubMed Central (United Kingdom)

Since the Vietnam War experience we have known that there is a high association between knee dislocations and popliteal artery injuries. In an effort to improve the quality of care we asked whether every patient with a knee dislocation needs an arteriogram. This is a retrospective chart review of all injured patients who presented to Louisiana State University Health Science Center with knee dislocations between January 1, 1993 and March 31, 1998. Twenty-one patients met the study criteria. There were no deaths in this series. Twelve patients presented with normal palpable pulses. Nine of these 12 patients underwent an arteriogram. There was only one abnormal arteriogram (intimal defect) in this group. None of the patients who presented with normal pulses were operated on. There were no in-hospital complications from this nonoperative management. In the group of patients with either diminished pulses or no pulses arteriograms were performed on all patients. Fifty-five per cent of these arteriograms were abnormal, and one-third of these patients (two) were taken to the operating room for repair. In the group of patients who present with knee dislocations and normal peripheral vascular examination arteriograms are not helpful.

Martinez D; Sweatman K; Thompson EC

2001-02-01

148

Popliteal artery injury associated with knee dislocations.  

Science.gov (United States)

Since the Vietnam War experience we have known that there is a high association between knee dislocations and popliteal artery injuries. In an effort to improve the quality of care we asked whether every patient with a knee dislocation needs an arteriogram. This is a retrospective chart review of all injured patients who presented to Louisiana State University Health Science Center with knee dislocations between January 1, 1993 and March 31, 1998. Twenty-one patients met the study criteria. There were no deaths in this series. Twelve patients presented with normal palpable pulses. Nine of these 12 patients underwent an arteriogram. There was only one abnormal arteriogram (intimal defect) in this group. None of the patients who presented with normal pulses were operated on. There were no in-hospital complications from this nonoperative management. In the group of patients with either diminished pulses or no pulses arteriograms were performed on all patients. Fifty-five per cent of these arteriograms were abnormal, and one-third of these patients (two) were taken to the operating room for repair. In the group of patients who present with knee dislocations and normal peripheral vascular examination arteriograms are not helpful. PMID:11243542

Martinez, D; Sweatman, K; Thompson, E C

2001-02-01

149

Tenoxicam-associated hepatic injury: a case report and review.  

UK PubMed Central (United Kingdom)

A 51-year-old woman developed jaundice while taking tenoxicam. A full evaluation, including ultrasound, computed tomography, endoscopic cholangiography and liver biopsy, confirmed the diagnosis of mixed hepatic injury. The patient's jaundice and all other liver function abnormalities normalized 1 month after she discontinued taking tenoxicam. This is the first case report of mixed hepatic injury, confirmed with biopsy, associated with tenoxicam. Tenoxicam should be considered as a potential cause of hepatic injury when other more common aetiologies have been excluded.

Katsinelos P; Katsos I; Patsiaoura K; Xiarchos P; Goulis I; Eugenidis N

1997-04-01

150

Tracing the utility of injury surveillance data in Pretoria (South Africa) and Boras (Sweden).  

UK PubMed Central (United Kingdom)

Our research attempted to study the factors that influenced the use of injury data in two cities, representing different injury and socio-economic profiles. In Pretoria, the South African capital city, injury data uptake was constrained by, among other factors, the transitional institutional environment, stakeholders' suspicion of research and the absence of safety promotion champions. In the Swedish city of Borås, injury data uptake was facilitated by well-established research agency-municipality partnerships, injury prevention champions, a receptive political and knowledge driven environment and dedicated resources. The study signified the role of a range of content issues, contextual arrangements, social actors who may or may not operate from a perspective of sufficient consensus and institutional communication processes that may either facilitate or hinder the multiple employment and rapid movement of data along the 'ladder of knowledge utilisation'. Safety promotion researchers may need to expand their roles beyond data production to improve data utility.

Gouveia J; Seedat MA; Ekman R; Ekman DS; Bowman B

2011-03-01

151

Multiple associated injuries are common with spine fractures during war.  

UK PubMed Central (United Kingdom)

BACKGROUND CONTEXT: The nature of concomitant injuries associated with spine fractures in American military personnel engaged in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) has been poorly documented in the literature. PURPOSE: To characterize the incidence and epidemiology of associated injuries (AIs) in American military personnel with spine fractures sustained during OEF and OIF from 2001 to 2009. STUDY DESIGN: Retrospective study. PATIENT SAMPLE: American military personnel who were injured in a combat zone and whose medical data were abstracted in the Joint Theater Trauma Registry (JTTR). OUTCOME MEASURES: Not applicable. METHODS: The JTTR was queried using International Statistical Classification of Disease, Ninth Revision codes to identify all individuals who sustained spine injuries in OEF or OIF from October 2001 to December 2009. Medical records of all identified service members were abstracted to ensure accuracy and avoid duplication. Demographic information, including sex, age, and military rank, were obtained for all patients. Information regarding fracture type, spine region, mechanism of injury, and the presence of AIs was collected for all patients. RESULTS: Seventy-eight percent of patients with a spine fracture sustained at least one AI, with an average of 3.4 AIs per patient. Musculoskeletal injuries were most common, followed by chest, abdomen, and traumatic brain injuries. Most patients were injured by an explosive mechanism (62%). Head and face traumas were more common with cervical fractures, chest with thoracic injuries, and abdominopelvic injuries with lumbosacral fractures. Pelvis and acetabulum fractures were common after helicopter crashes, tibia/fibula injuries after explosions, thoracoabdominal injuries after gunshot wounds, and traumatic brain injuries after falls. Most patients (76%) sustained multiple spine fractures. CONCLUSION: Spine fractures sustained in OEF and OIF have high rates of AIs. Musculoskeletal AIs are the most common, but visceral injuries adjacent to the spine fracture frequently occur. Multiple spine injuries are more prevalent after military trauma.

Patzkowski JC; Blair JA; Schoenfeld AJ; Lehman RA; Hsu JR

2012-09-01

152

Hepatic Injury Associated with Nitrofurantoin Therapy.  

Science.gov (United States)

The clinical and biochemical findings on two patients who developed hepatic injury while taking nitrofurantoin are described. In both patients the main biochemical abnormality was elevation of serum transaminase values. Clinical and biochemical findings r...

L. I. Goldstein K. G. Ishak W. Burns

1974-01-01

153

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

Science.gov (United States)

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

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

2013-06-14

154

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

UK PubMed Central (United Kingdom)

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

Scott D; Walker S; Fraser JA; Valmuur K

2013-06-01

155

Surveillance of injuries in Eastern North Carolina following Hurricane Irene using emergency department data.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Our objective was to characterize nonfatal injuries, by age groups, that were seen in emergency departments (EDs) in 29 selected counties in Eastern North Carolina following Hurricane Irene. METHODS: A descriptive evaluation using data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) was performed to identify the numbers and types of nonfatal injuries among individuals who sought treatment at hospital EDs. Percentages of reported ED visits related to external injuries in the 7 most severely impacted counties were compared with results in the entire 29-county region and with data from a reference period in 2010. RESULTS: The total number of individuals who sought treatment at an ED for an external cause of injury was 22.3% greater during the week following Hurricane Irene than during the 2010 reference week. In the 29-county region, the increases were primarily due to falls; in the 7-county region, they were primarily due to cutting and piercing incidents. Following the storm, injuries related to falls, adverse effects of health care, or being struck by an object accounted for higher proportions of injury-related ED visits in the 7-county disaster region than in the 29-county region. LIMITATIONS: The inability to identify the patient's home address and the county where treatment was sought was a spatial limitation. Furthermore, data for urgent care visits, primary care doctor visits, and injuries treated at home were not included. Additionally, cautious inference should be made to distinguish between injuries that occurred as a direct result of the storm and those that occurred incidentally. CONCLUSION: Data from NC DETECT can be used to estimate the most common types of injuries seen in EDs following a natural disaster.

Miller JA; Kearney GD; Proescholdbell SK

2013-07-01

156

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.

Saddki Norkhafizah; Suhaimi Adlin A; Daud Razak

2010-01-01

157

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

UK PubMed Central (United Kingdom)

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.

Mogaka EO; Ng'ang'a Z; Oundo J; Omolo J; Luman E

2011-01-01

158

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

2011-01-01

159

Positioning injuries associated with robotic assisted urological surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: Nerve injury associated with patient positioning during surgery is well documented. With the development of robotic surgery, surgeons are faced with new surgical positioning, requiring attention to ensure patient safety. Published reports that address positioning injury during robotic surgery are sparse and none address the overall incidence. In this study we determine the incidence of positioning injury during robotic assisted urological surgery, identify risk factors and describe the time to resolution of the neurological injury. MATERIALS AND METHODS: We reviewed all adult urological cases at our institution that used the da Vinci® Si and da Vinci Standard® Surgical System from January 2010 to December 2011. We characterized risk factors into the 4 domains of positioning, operative, patient specific and anesthesia related. Within these 4 categories we collected data on 13 specific aspects of patient care to determine their association with positioning injury. RESULTS: Of 334 operations 22 positioning injuries (6.6%) were documented. Of these injuries 13 (59.1%) resolved within 1 month, 4 (18.2%) resolved between 1 and 6 months, and 5 (22.7%) persisted beyond 6 months. We found operative time (p <0.0001), in-room time (p <0.0001) and ASA (American Society of Anesthesiologists) class (p = 0.0033) were significantly associated with injury. CONCLUSIONS: Positioning injuries are under recognized in robotic assisted urological surgery and may persist beyond 6 months. Consideration must be given to counseling patients about the risks of positioning injuries, especially for long operations. Patients with multiple medical comorbidities (ASA class 4) are particularly at risk for these injuries.

Mills JT; Burris MB; Warburton DJ; Conaway MR; Schenkman NS; Krupski TL

2013-08-01

160

[Vascular injuries associated with dislocation of the knee: diagnosis protocol].  

UK PubMed Central (United Kingdom)

INTRODUCTION: Knee dislocation is an unusual condition, and can have catastrophic consequences, such as vascular and neurological complications, in addition to the ligament injuries. OBJECTIVE: The aim of this study is to analyse the effectiveness of a protocol of early diagnosis of vascular injuries associated with knee dislocations. MATERIALS AND METHODS: A retrospective study was conducted which included acute knee dislocations treated in our institution, with a minimum of 12 months follow-up, between 1999-2010. A diagnostic protocol based on physical examination and ankle-brachial index was used in order to detect vascular injuries. RESULTS: Ten dislocations, 30% with popliteal artery injury, were diagnosed early and received emergency treatment within 8 hours. There were associated neurological injuries in two patients. There were no amputations. CONCLUSIONS: The systematic use of this protocol has avoided consequences of late diagnosis and has drastically reduced the abusive use of invasive tests, such as arteriography.

López-Hualda A; Valencia-García H; Martínez-Martín J

2012-07-01

 
 
 
 
161

Inferior alveolar nerve injuries associated with mandibular fractures.  

Science.gov (United States)

The study evaluates the incidence of inferior alveolar nerve injuries in mandibular fractures, the duration of their recovery, and the factors associated with them. Fifty-two patients with mandibular fractures involving the ramus, angle, and body regions were included in this study; the inferior alveolar nerve was examined for neurological deficit posttraumatically using sharp/blunt differentiation method, and during the follow-up period the progression of neural recovery was assessed. The incidence of neural injury of the inferior alveolar nerve was 42.3%, comminuted and displaced linear fractures were associated with higher incidence of inferior alveolar nerve injury and prolonged recovery time, and recovery of inferior alveolar nerve function occurred in 91%.Fractures of the mandible involving the ramus, angle, and body regions, and comminuted and displaced linear fractures are factors that increase the incidence of inferior alveolar nerve injuries. Missile injuries can be considered as another risk factor. PMID:23147318

Bede, Salwan Yousif Hanna; Ismael, Waleed Khaleel; Al-Assaf, Dhuha A; Omer, Saad Salem

2012-11-01

162

Associations between childhood obesity and upper and lower extremity injuries.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To estimate the overall and age-specific associations between obesity and extremity musculoskeletal injuries and pain in children. METHODS: This cross-sectional study used information from electronic medical records of 913178 patients aged 2-19 years enrolled in an integrated health plan in the period 2007-2009. Children were classified as underweight, normal weight, overweight, or moderately/extremely obese and, using multivariable logistic regression methods, the associations between weight class and diagnosis of upper or lower extremity fractures, sprains, dislocations and pain were calculated. RESULTS: Overweight (OR 1.18, 95% CI 1.15 to 1.20), moderately obese (OR 1.24, 95% CI 1.20 to 1.27) and extremely obese (OR 1.34, 95% CI 1.30 to 1.39) children had statistically significantly higher odds of lower extremity injuries/pain compared to normal weight, adjusted for sex, age, race/ethnicity and insurance status. Age-stratified analyses yielded similar results. No consistent association was observed between body mass index and injuries/pain of the upper extremities. CONCLUSIONS: Greater body mass index is associated with increased odds of lower extremity injuries and pain issues. Because the benefits of physical activity may still outweigh the risk of injury, attention should be paid to injury prevention strategies for these children at greater risk for lower extremity injuries.

Adams AL; Kessler JI; Deramerian K; Smith N; Black MH; Porter AH; Jacobsen SJ; Koebnick C

2013-06-01

163

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 (?

1995-01-01

164

Rule-based healthcare-associated bloodstream infection classification and surveillance system.  

UK PubMed Central (United Kingdom)

Healthcare-associated infections (HAIs) are a major patient safety issue. These adverse events add to the burden of resource use, promote resistance to antibiotics, and contribute to patient deaths and disability. A rule-based HAI classification and surveillance system was developed for automatic integration, analysis, and interpretation of HAIs and related pathogens. Rule-based classification system was design and implement to facilitate healthcare-associated bloodstream infection (HABSI) surveillance. Electronic medical records from a 2200-bed teaching hospital in Taiwan were classified according to predefined criteria of HABSI. The detailed information in each HABSI was presented systematically to support infection control personnel decision. The accuracy of HABSI classification was 0.94, and the square of the sample correlation coefficient was 0.99.

Tseng YJ; Wu JH; Lin HC; Chiu HJ; Huang BC; Shang RJ; Chen MY; Chen WH; Chen HT; Lai F; Chen YC

2013-01-01

165

Rule-based healthcare-associated bloodstream infection classification and surveillance system.  

Science.gov (United States)

Healthcare-associated infections (HAIs) are a major patient safety issue. These adverse events add to the burden of resource use, promote resistance to antibiotics, and contribute to patient deaths and disability. A rule-based HAI classification and surveillance system was developed for automatic integration, analysis, and interpretation of HAIs and related pathogens. Rule-based classification system was design and implement to facilitate healthcare-associated bloodstream infection (HABSI) surveillance. Electronic medical records from a 2200-bed teaching hospital in Taiwan were classified according to predefined criteria of HABSI. The detailed information in each HABSI was presented systematically to support infection control personnel decision. The accuracy of HABSI classification was 0.94, and the square of the sample correlation coefficient was 0.99. PMID:23542986

Tseng, Yi-Ju; Wu, Jung-Hsuan; Lin, Hui-Chi; Chiu, Hsiang-Ju; Huang, Bo-Chiang; Shang, Rung-Ji; Chen, Ming-Yuan; Chen, Wei-Hsin; Chen, Huai-Te; Lai, Feipei; Chen, Yee-Chun

2013-01-01

166

Orthopedic injuries associated with backyard trampoline use in children.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Trampolining on an outdoor oval or circular trampoline is a popular activity for children but is associated with a number of orthopedic injuries, especially in children between the ages of 5 and 15 years. In this paper we review the orthopedic injuries in children associated with backyard trampoline use, through our experience with a series of children admitted to the Winnipeg Children's Hospital, the only tertiary care pediatric centre in Manitoba. METHODS: We reviewed the charts, x-ray films and operative reports for 80 children under 16 years old (mean 9 yr, with 14 [18%] children between 2 and 4 yr) with an orthopedic injury sustained when using a trampoline in the backyard. We noted the mechanism of injury and type and severity of orthopedic injury sustained. RESULTS: Fifty-two (65%) children were injured on the trampoline mat, and 24 (30%) were injured when they were ejected from the trampoline. Sixty (75%) children sustained a fracture or fracture-dislocation. Forty-eight (80%) orthopedic injuries occurred in the upper extremity. No child died as a result of a trampoline injury. CONCLUSION: The use of the "backyard" trampoline by young children can cause significant orthopedic injury.

Black GB; Amadeo R

2003-06-01

167

Kidney injury during pregnancy: associated comorbid conditions and outcomes.  

UK PubMed Central (United Kingdom)

PURPOSE: To investigate the characteristics of women who have kidney injury during pregnancy. METHODS: Medical records of all women who gave birth at our institution between January 1, 2005, and December 31, 2010, were retrospectively reviewed electronically. We identified those who incurred a kidney injury [defined by modified Acute Kidney Injury Network (AKIN) criteria: serum creatinine (sCr) increase ?0.3 mg/dL] during pregnancy or within 30 days postpartum. Identified case records were reviewed in detail. RESULTS: During the study period, 54 women had a kidney injury (0.4 % estimated incidence) with a mean (SD) increase in sCr of 0.46 (0.29) mg/dL; most injuries were AKIN stage 1 with transient increases in sCr. Most of the women (n = 48, 87.3 %) had substantial preexisting or pregnancy-associated comorbid conditions (e.g., kidney disease, hypertension, diabetes), complications (e.g., preeclampsia, HELLP syndrome), or a complicated obstetric course (hemorrhage, infections) that could have contributed to the development of a kidney injury. Two patients had AKIN stage 3 injuries: a previously healthy patient who had a massive hemorrhage during cesarean delivery, and a patient with a renal transplant who had deterioration and eventual postpartum failure of her transplanted kidney. CONCLUSIONS: The majority of pregnancy-associated kidney injuries were transient and occurred in women with substantial comorbid conditions or complicated pregnancies.

Gurrieri C; Garovic VD; Gullo A; Bojani? K; Sprung J; Narr BJ; Weingarten TN

2012-09-01

168

MR imaging of anterior cruciate ligament injury: associated findings  

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

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

1995-04-15

169

Colorectal cancer surveillance after index colonoscopy: guidance from the Canadian Association of Gastroenterology.  

UK PubMed Central (United Kingdom)

BACKGROUND: Differences between American (United States [US]) and European guidelines for colonoscopy surveillance may create confusion for the practicing clinician. Under- or overutilization of surveillance colonoscopy can impact patient care. METHODS: The Canadian Association of Gastroenterology (CAG) convened a working group (CAG-WG) to review available guidelines and provide unified guidance to Canadian clinicians regarding appropriate follow-up for colorectal cancer (CRC) surveillance after index colonoscopy. A literature search was conducted for relevant data that postdated the published guidelines. RESULTS: The CAG-WG chose the 2012 US Multi-Society Task Force (MSTF) on Colorectal Cancer to serve as the basis for the Canadian position, primarily because the US approach was the simplest and comprehensively addressed the issue of serrated polyps. Aspects of other guidelines were incorporated where relevant. The CAG-WG recommendations differed from the US MSTF guidelines in three main areas: patients with negative index colonoscopy should be followed-up at 10 years using any of the appropriate screening tests, including colonoscopy, for average-risk individuals; among patients with >10 adenomas, a one-year interval for subsequent colonoscopy is recommended; and for long-term follow-up, patients with low-risk adenomas on both the index and first follow-up procedures can undergo second follow-up colonoscopy at an interval of five to 10 years. DISCUSSION: The CAG-WG adapted the US MSTF guidelines for colonoscopy surveillance to the Canadian health care environment with a few modifications. It is anticipated that the present article will provide unified guidance that will enhance physician acceptance and encourage appropriate utilization of recommended surveillance intervals.

Leddin D; Enns R; Hilsden R; Fallone CA; Rabeneck L; Sadowski DC; Singh H

2013-04-01

170

Strategies to reduce ventilator-associated lung injury (VALI).  

UK PubMed Central (United Kingdom)

Optimal management of the acute respiratory distress syndrome (ARDS) requires prompt recognition, treatment of the underlying cause and the prevention of secondary injury. Ventilator-associated lung injury (VALI) is one of the several iatrogenic factors that can exacerbate lung injury and ARDS. Reduction of VALI by protective low tidal volume ventilation is one of the only interventions with a proven survival benefit in ARDS. There are, however, several factors inhibiting the widespread use of this technique in patients with established lung injury. Prevention of ARDS and VALI by detecting at-risk patients and implementing protective ventilation early is a feasible strategy. Detection of injurious ventilation itself is possible, and potential biological markers of VALI have been investigated. Finally, facilitation of protective ventilation, including techniques such as extracorporeal support, can mitigate VALI.

Salman D; Finney SJ; Griffiths MJ

2013-03-01

171

Injury surveillance during a national female youth football tournament in Kenya  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: Participation of girls in football is growing in Kenya. Football in Kenya is not only a leisure time activity it is also used as a tool for community and individual development. Injuries in developing countries are often neglected. Most epidemiological studies on female youth football pl...

Lislevand, Marianne

172

Analysis of soft tissue injuries associated with distal radius fractures.  

UK PubMed Central (United Kingdom)

BACKGROUND: Soft tissue injuries associated with distal radius fractures have been reported by some authors. Arthroscopy can be used to evaluate the condition of the articular surface and intracarpal soft tissues and as an aid to treatment. There are three intracarpal soft tissues of particular importance: the triangular fibrocartilage complex (TFCC), the scapholunate interosseous ligament (SLIL), and the lunotriquetral interosseous ligament (LTIL). The purpose of this study was to evaluate intracarpal soft tissue injuries and their relationships with fracture types during arthroscopic surgical treatment of distal radius fractures. METHODS: Eighty-nine patients in our hospital underwent surgical treatment by arthroscopy for a fracture of the distal end of the radius. They ranged in age from 17 to 92 years (mean, 62.2 years), and comprised 20 men (mean age, 45.6 years) and 69 women (mean age, 66.5 years). The AO classification data on plain radiographs indicated A2 fracture in four patients, A3 fracture in 10 patients, C1 fracture in two patients, C2 fracture in 24 patients, and C3 fracture in 49 patients. Wrist arthroscopy was performed with vertical traction, and intracarpal soft tissues were examined. For assessment of the TFCC in the radiocarpal space, the Palmar classification was used. For assessment of the SLIL and LTIL in the midcarpal space, the Geissler classification was used. RESULTS: TFCC injury was present in 59% of cases, SLIL injury in 54.5% of cases, and LTIL injury in 34.5% of cases. Only 17.1% of patients (14/82 patients) were negative for all three types of injury. In 81% of cases (72/89 patients), some intracarpal soft tissue injury was present in association with the fracture. CONCLUSIONS: The fracture was complicated by TFCC injury in 59% of patients, SLIL injury in 54.5% of patients, and LTIL injury in 34.5% of patients, irrespective of the fracture type.

Ogawa T; Tanaka T; Yanai T; Kumagai H; Ochiai N

2013-09-01

173

Urinary Dysfunctions Associated With Spinal Cord Injury  

Directory of Open Access Journals (Sweden)

Full Text Available After the Second World War, urinary dysfunctions due to spinal cord injury had gained more importance and the life expectancy and quality of life of the patients had increased due to the improvements in this field. The management and follow-up period of urinary dysfunctions can be examined in three stages: initial stage after the injury, rehabilitation stage and long-term follow-up stage. Urodynamic and videourodynamic evaluations are the gold standards in the diagnosis. Bladder filling pressure, bladder compliance and bladder sphincter dyssynergia are the important prognostic factors during the management of neurogenic bladder. The aim of the treatment is to protect upper urinary tract, to lower the complications in the lower urinary tract and to improve the quality of life of the patient. Recently, botulinum toxin injections and improved surgical techniques become good treatment options besides clean intermittent catheterization and oral medical agents. The success of the treatment is based on long-term follow-up of the patients with appropriate treatment strategy. In this review, the current developments in the diagnosis and management of urinary dysfunctions seen after spinal cord injury will be discussed. Turk J Phys Med Rehab 201;58 Suppl 1: 10-5.

Serdar KOÇER; Belgin ERHAN

2012-01-01

174

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

International Nuclear Information System (INIS)

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

1998-01-01

175

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

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

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

1998-02-01

176

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

UK PubMed Central (United Kingdom)

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

Murakami R; Tajima H; Ichikawa K; Kobayashi Y; Sugizaki K; Yamamoto K; Kurokawa A; Kumazaki T

1998-01-01

177

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

Science.gov (United States)

A rare case of traumatic injury of the distal descending aorta associated with thoracic spine injury is reported. A 21-year-old man was admitted after a traffic accident. Thoracic CT and angiography demonstrated a false aneurysm of the distal descending aorta and a compression fracture of the eleventh thoracic vertebra. At emergency surgery, a transverse linear tear at the level of the aortic hiatus was confirmed and repaired. PMID:9442131

Murakami, R; Tajima, H; Ichikawa, K; Kobayashi, Y; Sugizaki, K; Yamamoto, K; Kurokawa, A; Kumazaki, T

1998-01-01

178

Microglia: Multiple roles in surveillance, circuit shaping, and response to injury.  

UK PubMed Central (United Kingdom)

Microglial cells are the immune cells in the CNS and represent approximately 10% of the total brain cell population. Their morphologic characterization by Pio del Rio-Hortega was first published almost a century ago, but the understanding of their function in the normal and injured CNS is still incomplete. Classically, microglia have been classified into 2 main types: "resting" microglia, with a ramified morphology, present in the uninjured CNS; and "activated" microglia, with an amoeboid morphology, present at the sites of injury. However, morphologic, molecular, and genetic studies indicate that this subdivision is a misleading oversimplification. Resting microglia actively survey their environment; activated microglia constitute a heterogeneous population that dynamically changes in phenotype depending on the type of stimulus and microenvironment, participating not only in mechanisms of injury but also in neuroprotection, repair, and circuit refinement in the CNS. The primary role of microglia is therefore to maintain cellular, synaptic, and myelin homeostasis both during development and normal function of the CNS and in response to CNS injury. Microglia have been implicated in mechanisms of CNS trauma, stroke, infection, demyelination, neoplasm, and neurodegeneration. Microglial dysfunction may also contribute to genetic neurobehavioral disorders, such as Rett syndrome. There are several comprehensive reviews on all these topics.(1-12.)

Benarroch EE

2013-09-01

179

Spinal cord injury and its association with blunt head trauma  

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

Paiva WS; Oliveira AMP; de Andrade AF; Amorim RL; Lourenço L; Teixeira MJ

2011-01-01

180

Swimming overuse injuries associated with triathlon training.  

UK PubMed Central (United Kingdom)

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.

Bales J; Bales K

2012-12-01

 
 
 
 
181

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

182

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

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

Judith C Bruce; Shelley Schmollgruber; Jocelyn Eales; Jasmin Gassiep; Vanessa Doubell

2003-01-01

183

Efficacy of BTA stat, cytology, and survivin in bladder cancer surveillance over 5 years in patients with spinal cord injury.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To evaluate three urine markers, BTA stat, cytology, and urinary survivin levels, in the spinal cord injury (SCI) population. The incidence of bladder cancer in patients with SCI is up to 20 times greater than in the general population. However, bladder cancer biomarkers have not been assessed in this population. METHODS: Between April 1999 and April 2004, 457 patients with SCI enrolled at the HealthSouth Harmarville Rehabilitation Spinal Cord Clinic donated their urine to our SCI urine repository. BTA stat tests and the survivin assay were performed according to published standards. Cytology specimens were sent to our cytopathology laboratory for analysis. RESULTS: A total of 1075 urine specimens from 457 patients were analyzed. Of the 1073 BTA stat tests, 119 showed positive reactions and 954 were negative. In the survivin assays, 47 samples had a score of 1, 38 a score of 2, and 9 a score of 3. No cytology specimens were noted to have malignant cells. During the past 5 years, 3 patients were diagnosed with bladder cancer by cystoscopy and treated for superficial disease. For these patients, none of these three tests (BTA stat, survivin assay, and cytology) was positive before the diagnosis of bladder cancer. CONCLUSIONS: The BTA stat, survivin assay, and urine cytology were unable to predict bladder cancer cases in our cohort of patients with SCI. Cystoscopy, therefore, remains the gold standard for bladder cancer surveillance in patients with SCI.

Davies B; Chen JJ; McMurry T; Landsittel D; Lewis N; Brenes G; Getzenberg RH

2005-10-01

184

Factors associated with sexuality following traumatic brain injury.  

UK PubMed Central (United Kingdom)

BACKGROUND: Previous research has demonstrated that sexuality is compromised following traumatic brain injury (TBI). OBJECTIVES: The aim of this study was to determine the association between sexuality following TBI and demographic, injury-related, and postinjury variables (age, gender, time since injury, posttraumatic amnesia duration, independence in activities of daily activities (ADL), antidepressant use, depression, and self-esteem). METHODS: Participants included 986 individuals with predominantly moderate to severe TBI, who completed the Brain Injury Questionnaire of Sexuality (BIQS), the Hospital Anxiety and Depression Scale, and the Rosenberg Self-Esteem Scale and an ADL assessment on 1 or more occasions, providing a total of 1673 assessments across 1, 2, 3, 5, 10, and 20 years postinjury. RESULTS: Being depressed, older in age, at shorter time postinjury, and less independent in ADL significantly predicted poorer overall BIQS scores as well as the Sexual Functioning subscale score. Poorer Relationship Quality and Self-esteem scores on the BIQS were predicted by older age at injury and higher levels of depression. Lower Mood score on the BIQS was associated with shorter posttraumatic amnesia duration, younger age, and higher levels of depression. Self-esteem was associated positively with sexuality outcome. CONCLUSIONS: Therapeutic interventions for sexuality need to focus on depression where indicated and self-esteem and address specific barriers to social participation and opportunities for sexual contact in individuals who are less independent in ADL.

Ponsford JL; Downing MG; Stolwyk R

2013-05-01

185

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

UK PubMed Central (United Kingdom)

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 (<10 000 copies/ml) demonstrated little impact on graft function or survival. However, rising copy numbers demand early reductions in immunosuppressive drug doses of at least 30-50%. Viral loads >185 000 copies/ml at diagnosis were predictive of BK virus-associated nephropathy (BKVAN; OR: 113.25, 95% CI: 17.22-744.6, P < 0.001). Surveillance for BK viremia and rapid reduction of immunosuppression limited the incidence of BKVAN to 1.3%. The addition of 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.

Elfadawy N; Flechner SM; Liu X; Schold J; Tian D; Srinivas TR; Poggio E; Fatica R; Avery R; Mossad SB

2013-08-01

186

[Associations of occupational safety atmosphere and behaviors with unintentional injuries].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate the associations of perception of safety atmosphere at workplace, occupational safety attitude and behaviors with occupational unintentional injury among manufacturing workers. METHODS: A cross-sectional study was performed and a self-administered questionnaire was used to inquire socio-demographic characteristics, perceived safety atmosphere, occupational safety attitudes, occupational safety behaviors and occupational unintentional injuries among 10585 manufacturing workers selected from 46 enterprises in Guangdong. Structural equation modeling was applied to assess the relationship of the perception of safety atmosphere at workplace, occupational safety attitude, and occupational safety behaviors with occupational unintentional injury. RESULTS: Among 24 pathways supposed in structural equation model, 20 pathways (except for the attitude toward occupational safety, the attitude toward managers' support, the work posture and individual protection) were significantly related to the occupational unintentional injuries. The further analysis indicated that the perceived safety atmosphere might impact the occupational unintentional injuries by the attitude toward occupational safety and occupational safety behaviors. CONCLUSION: Workers' perception of safety atmosphere indirectly influenced on occupational unintentional injuries through occupational safety attitudes and occupational safety behaviors.

Xiao YN; Huang ZX; Huang SB; Cao XO; Chen XM; Liu XH; Chen WQ

2012-07-01

187

Factors associated with the hospital admission of consumer product-related injuries treated in U.S. hospital emergency departments.  

UK PubMed Central (United Kingdom)

While unintentional injuries and hazard patterns involving consumer products have been studied extensively in recent years, little attention has focused on the characteristics of those who are hospitalized after treatment in emergency departments, as opposed to those treated and released. This study quantifies the impact of the age and sex of the injury victims, and other factors, on the likelihood of hospitalization. The analysis focuses on consumer product injuries, and was based on approximately 400,000 injury cases reported through the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System, a national probability sample of U.S. hospital emergency departments. Logistic regression was used to quantify the factors associated with the likelihood of hospitalization. The analysis suggests a smooth U-shaped relationship between the age of the victim and the likelihood of hospitalization, declining from about 3.4% for children under age 5 years to 1.9% for 15-24 year-olds, but then rising to more than 25% for those ages 75 years and older. The likelihood of hospitalization was also significantly affected by the victim's sex, as well as by the types of products involved, fire involvement, and the size and type of hospital at which the injury was treated. This study shows that the probability of hospitalization is strongly correlated with the characteristics of those who are injured, as well as other factors.

Schroeder TJ; Rodgers GB

2013-10-01

188

Health care-associated infections in hematology-oncology patients with neutropenia: A method of surveillance.  

UK PubMed Central (United Kingdom)

We present a prospective method of surveillance of health care-associated infection in hematology-oncology inpatients with neutropenia. Incidence rates were calculated on the basis of the number of hospitalized patients, the duration of hospital stay (in days), the number of days of neutropenia, and (in cases of central line-associated blood stream infection) the number of central line-days. We detected 11.4 and 66.4 episodes of febrile neutropenia per 1,000 hospital-days and per 1,000 days of neutropenia, respectively. The incidence of central line-associated blood stream infection was 2.6 per 1,000 central line-days. Gram-negative bacteria were the most prevalent pathogens. Efforts should be made to monitor infection rates on hematology-oncology wards.

Ibrahim KY; Pierrotti LC; Freire MP; Gutierrez PP; Duarte LD; Bellesso M; Pereira J; de Alencar Fischer Chamone D; Abdala E

2013-06-01

189

Progression to detrusor muscle invasion during Urothelial carcinoma surveillance is associated with poor prognosis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate survival in cystectomy patients who presented with non-muscle-invasive urothelial carcinoma and progressed to muscle invasion during surveillance. Our secondary objective was to evaluate the association between pre-cystectomy clinical factors and survival. PATIENTS AND METHODS: Nine-hundred and eighty-one consecutive Mayo Clinic cystectomy patients without a history of radiation or systemic chemotherapy were reviewed. Of these, 190 had cystectomy after they progressed from non-muscle invasive disease to muscle invasion (progressed to ?pT2). These patients were compared to 310 patients who had cystectomy prior to muscle invasion (?pT1), and 481 patients who had muscle invasion at initial presentation (presented with ?pT2). Survival estimates were generated using the Kaplan-Meier method and compared using the log-rank test while adjusted analyses were performed using Cox proportional hazard regression models. RESULTS: Patients who progressed to muscle invasion on surveillance had higher risk of death compared to patients who initially presented with muscle invasion (overall survival HR 1.3; 95%CI 1.0, 1.5). Estimated 5-year cancer-specific survival was 85.4% for patients presenting with ?pT1, 52.9% for patients who progressed to ?pT2, and 62.4% for patients who presented with ?pT2 (p<0.001). The corresponding 5-year overall survival rates were 70.0%, 42.1%, and 49.5% (p<0.001). Of the patients who initially presented with non-muscle-invasive disease, progression to muscle invasion was associated with increased risk of cancer-specific death (adjusted HR 2.38; 95% CI 1.6, 3.5). Lack of information about patients who presented without muscle invasion and never received cystectomy is the major limitation of this study. CONCLUSION: Despite close surveillance, many patients who progress to muscle invasion will die from bladder cancer. Patients who progress to muscle invasion on surveillance seem to have particularly aggressive disease and may benefit from multimodal treatments.

Breau R; Karnes R; Farmer S; Thapa P; Cagiannos I; Morash C; Frank I

2013-08-01

190

Rationale for accuracy and consistency in applying standardized definitions for surveillance of health care-associated infections.  

UK PubMed Central (United Kingdom)

As legislative mandates for disclosure of data on health care-associated infections (HAIs) to the public escalate, with both economic and reputational implications for hospitals, the development of a valid national surveillance system has become imperative. Recent studies have identified interinstitutional variability of surveillance techniques. These inconsistencies affect the validity of publicly reported HAI data, which has as a primary goal the advancement of patient safety through the reduction of HAIs. The continued funding of state validation studies, the expansion of qualitative research to further assess interrater bias, the endorsement of educational materials to assist infection preventionists with application of National Healthcare Safety Network criteria, and the development of automated surveillance methods are all necessary to ensure a national HAI surveillance system that can be used for public reporting.

Hebden JN

2012-06-01

191

Baby walker associated scalding injuries seen at University Hospital Kuala Lumpur.  

UK PubMed Central (United Kingdom)

Baby walker associated injuries are occurring in Malaysia. Most are not noticed as paediatricians are more concerned with the treatment of the injury and forget the preventive measures required to overcome this problem. We believe that baby walkers should be banned in Malaysia as the risks of injury far outweighs any benefits. We present 4 cases of baby walker associated scalding injuries.

Sendut IH; Tan KK; Rivara F

1995-06-01

192

Baby walker associated scalding injuries seen at University Hospital Kuala Lumpur.  

Science.gov (United States)

Baby walker associated injuries are occurring in Malaysia. Most are not noticed as paediatricians are more concerned with the treatment of the injury and forget the preventive measures required to overcome this problem. We believe that baby walkers should be banned in Malaysia as the risks of injury far outweighs any benefits. We present 4 cases of baby walker associated scalding injuries. PMID:7565196

Sendut, I H; Tan, K K; Rivara, F

1995-06-01

193

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

2011-01-01

194

Pathophysiological aspects of severe acute pancreatitis-associated lung injury  

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

2005-01-01

195

Data-Driven Decision Making in Practice: The NCAA Injury Surveillance System  

Science.gov (United States)

Putting data-driven decision making into practice requires the use of consistent and reliable data that are easily accessible. The systematic collection and maintenance of accurate information is an important component in developing policy and evaluating outcomes. Since 1982, the National Collegiate Athletic Association (NCAA) has been collecting…

Klossner, David; Corlette, Jill; Agel, Julie; Marshall, Stephen W.

2009-01-01

196

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

UK PubMed Central (United Kingdom)

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

Johnson LR; Gould LH; Dunn JR; Berkelman R; Mahon BE

2011-09-01

197

Factors associated with early mortality after cervical spinal cord injury  

Science.gov (United States)

Background A relatively high early mortality rate (<30 days post-injury) for cervical spinal cord injury (SCI) has been observed. Objective To investigate this early mortality rate observed after cervical SCI and analyze the associated influential factors. Methods Medical records for 1163 patients with cervical SCI were reviewed, and the number of patients with early mortality was documented. Through logistic regression analysis, the effects of age, gender, occupation, cause of injury, severity of injury, highest involved spinal cord segment, nutritional condition during hospitalization, surgical treatment, tracheotomy, etc., on early mortality were assessed. Implementation of early treatment (i.e. surgery, tracheotomy, and nutritional support) and its effect on patient prognosis were also analyzed. Results Early mortality occurred in 109 of 1163 patients (9.4%). Four factors affected the early mortality rate, including level and severity of SCI, whether or not surgery was performed, the time interval between SCI and surgery, malnutrition, and tracheotomy. Patients with an American Spinal Injury Association grade of A, a high cervical SCI (C1–C3), and/or no surgical intervention were statistically more likely to have early mortality (P < 0.001). Conclusion Severe cervical SCI, upper-level cervical cord injury, malnutrition, and inappropriate tracheotomy are risk factors for early mortality in patients with cervical SCI. Surgery can reduce early mortality. Early tracheotomy should be performed in patients with complete upper-level cervical SCI, but patients with incomplete cervical SCI or complete low-level cervical SCI should initially be treated surgically to maintain smooth airway flow.

Shao, Jiang; Zhu, Wei; Chen, Xiongsheng; Jia, Lianshun; Song, Dianwen; Zhou, Xuhui; Yan, Wangjun; Zhang, Yong

2011-01-01

198

Fatal acute pulmonary injury associated with everolimus.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To report a case of fatal alveolar hemorrhage associated with the use of everolimus in a patient who underwent a solid organ transplant. CASE SUMMARY: In a 71-year-old cardiac transplant patient, cyclosporine was replaced with everolimus because of worsening renal function. Over the following weeks, the patient developed nonproductive cough and increasing dyspnea. His condition deteriorated to acute respiratory failure with hemoptysis, requiring hospital admission. Bilateral patchy alveolar infiltrates were apparent on chest X-ray and computed tomography. Cardiac failure was ruled out and empiric antimicrobial therapy was initiated. Additional extensive workup could not document opportunistic infection. Everolimus was discontinued and high-dose corticosteroid therapy was initiated. Despite this, the patient required invasive mechanical ventilation and died because of refractory massive hemoptysis. Autopsy revealed diffuse alveolar hemorrhage. DISCUSSION: Everolimus is a mammalian target of rapamycin inhibitor approved for use as an immunosuppressant and antineoplastic agent. Its main advantage over calcineurin inhibitors (tacrolimus and cyclosporine) is a distinct safety profile. Although it has become clear that everolimus induces pulmonary toxicity more frequently than initially thought, most published cases thus far represented mild and reversible disease, and none was fatal. Here, we report a case of pulmonary toxicity developing over weeks following the introduction of everolimus, in which a fatal outcome could not be prevented by drug withdrawal and corticosteroid treatment. The association of everolimus and this syndrome was probable according to the Naranjo probability scale. CONCLUSIONS: This case indicates that with the increasing use of everolimus, clinicians should be aware of the rare, but life-threatening manifestation of pulmonary toxicity.

Depuydt P; Nollet J; Benoit D; Praet M; Caes F

2012-03-01

199

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

2012-09-04

200

Real-time pharmacy surveillance and clinical decision support to reduce adverse drug events in acute kidney injury: a randomized, controlled trial.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Clinical decision support (CDS), such as computerized alerts, improves prescribing in the setting of acute kidney injury (AKI), but considerable opportunity remains to improve patient safety. The authors sought to determine whether pharmacy surveillance of AKI patients could detect and prevent medication errors that are not corrected by automated interventions. METHODS: The authors conducted a randomized clinical trial among 396 patients admitted to an academic, tertiary care hospital between June 1, 2010 and August 31, 2010 with an acute 0.5 mg/dl change in serum creatinine over 48 hours and a nephrotoxic or renally cleared medication order. Patients randomly assigned to the intervention group received surveillance from a clinical pharmacist using a web-based surveillance tool to monitor drug prescribing and kidney function trends. CDS alerting and standard pharmacy services were active in both study arms. Outcome measures included blinded adjudication of potential adverse drug events (pADEs), adverse drug events (ADEs) and time to provider modification or discontinuation of targeted nephrotoxic or renally cleared medications. RESULTS: Potential ADEs or ADEs occurred for 104 (8.0%) of control and 99 (7.1%) of intervention patient-medication pairs (p=0.4). Additionally, the time to provider modification or discontinuation of targeted nephrotoxic or renally cleared medications did not differ between control and intervention patients (33.4 hrs vs. 30.3 hrs, p=0.3). CONCLUSIONS: Pharmacy surveillance had no incremental benefit over previously implemented CDS alerts.

McCoy AB; Cox ZL; Neal EB; Waitman LR; Peterson NB; Bhave G; Siew ED; Danciu I; Lewis JB; Peterson JF

2012-01-01

 
 
 
 
201

Real-time pharmacy surveillance and clinical decision support to reduce adverse drug events in acute kidney injury: a randomized, controlled trial.  

Science.gov (United States)

OBJECTIVES: Clinical decision support (CDS), such as computerized alerts, improves prescribing in the setting of acute kidney injury (AKI), but considerable opportunity remains to improve patient safety. The authors sought to determine whether pharmacy surveillance of AKI patients could detect and prevent medication errors that are not corrected by automated interventions. METHODS: The authors conducted a randomized clinical trial among 396 patients admitted to an academic, tertiary care hospital between June 1, 2010 and August 31, 2010 with an acute 0.5 mg/dl change in serum creatinine over 48 hours and a nephrotoxic or renally cleared medication order. Patients randomly assigned to the intervention group received surveillance from a clinical pharmacist using a web-based surveillance tool to monitor drug prescribing and kidney function trends. CDS alerting and standard pharmacy services were active in both study arms. Outcome measures included blinded adjudication of potential adverse drug events (pADEs), adverse drug events (ADEs) and time to provider modification or discontinuation of targeted nephrotoxic or renally cleared medications. RESULTS: Potential ADEs or ADEs occurred for 104 (8.0%) of control and 99 (7.1%) of intervention patient-medication pairs (p=0.4). Additionally, the time to provider modification or discontinuation of targeted nephrotoxic or renally cleared medications did not differ between control and intervention patients (33.4 hrs vs. 30.3 hrs, p=0.3). CONCLUSIONS: Pharmacy surveillance had no incremental benefit over previously implemented CDS alerts. PMID:22719796

McCoy, Allison B; Cox, Zachary L; Neal, Erin B; Waitman, Lemuel R; Peterson, Neeraja B; Bhave, Gautam; Siew, Edward D; Danciu, Ioana; Lewis, Julia B; Peterson, Josh F

2012-06-13

202

White matter integrity following traumatic brain injury: the association with severity of injury and cognitive functioning.  

Science.gov (United States)

Traumatic brain injury (TBI) frequently results in impairments of memory, speed of information processing, and executive functions that may persist over many years. Diffuse axonal injury is one of the key pathologies following TBI, causing cognitive impairments due to the disruption of cortical white matter pathways. The current study examined the association between injury severity, cognition, and fractional anisotropy (FA) following TBI. Two diffusion tensor imaging techniques-region-of-interest tractography and tract-based spatial statistics-were used to assess the FA of white matter tracts. This study examined the comparability of these two approaches as they relate to injury severity and cognitive performance. Sixty-eight participants with mild-to-severe TBI, and 25 healthy controls, underwent diffusion tensor imaging analysis. A subsample of 36 individuals with TBI also completed cognitive assessment. Results showed reduction in FA values for those with moderate and severe TBI, compared to controls and individuals with mild TBI. Although FA tended to be lower for individuals with mild TBI no significant differences were found compared to controls. Information processing speed and executive abilities were most strongly associated with the FA of white matter tracts. The results highlight similarities and differences between region-of-interest tractography and tract-based spatial statistics approaches, and suggest that they may be used together to explore pathology following TBI. PMID:23532465

Spitz, Gershon; Maller, Jerome J; O'Sullivan, Richard; Ponsford, Jennie L

2013-03-27

203

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

204

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).

1993-01-01

205

Factors associated with injuries occurred on slope intersections and in snow parks compared to on-slope injuries.  

UK PubMed Central (United Kingdom)

In alpine winter sports, external risk factors as snow and weather conditions as well as slope characteristics (width, steepness, slope intersections, and snow parks) should be considered when investigating potential risk factors. Therefore, ski patrol injury reports were used to compare factors associated with injuries occurred on slope intersections and in snow parks compared to on-slope injuries. Multivariate regression analysis revealed that in comparison to injuries occurring on ski slopes, collisions with other persons (OR: 2.1, 95% CI: 1.3-3.4) and arm injuries (OR: 2.1, 95% CI: 1.3-3.5) were more likely associated with injuries occurring on slope intersections while male gender (OR: 3.5, 95% CI: 2.1-5.7), younger age (OR: 1.1, 95% CI: 1.0-1.1), slushy/soft snow conditions (OR: 1.9, 95% CI: 1.1-3.3), knee injuries (OR: 0.4, 95% CI: 0.2-0.8) and back injuries (OR: 5.5, 95% CI: 3.0-10.2) were more likely associated with injuries which occurred in snow parks. In conclusion, injuries on slope intersections and in snow parks differ in some factors from injuries sustained on ski slopes.

Ruedl G; Kopp M; Sommersacher R; Woldrich T; Burtscher M

2013-01-01

206

Association of injury visits in children and child maltreatment reports.  

UK PubMed Central (United Kingdom)

Injuries are a leading cause of childhood morbidity and are also common manifestations of child maltreatment, especially among young children. In an effort to determine whether injury-related Emergency Department (ED) visits among children aged 0 to 4 years were associated with child maltreatment reports, we identified all children with at least one injury-related ED visit in Missouri during 2000. Data on these injured children were linked to Missouri Child Protective Services (CPS) child abuse and neglect reports for 2000 and 2001. There were 50,068 children with at least one injury-related ED visit. Using children with one injury-related ED visit as the reference category, we calculated the relative risk of having a CPS report (or a substantiated report) for children with two, three, and four or more ED visits before a CPS report (or substantiated report). Compared to children with one visit, children with two visits were more likely to have a CPS report (relative risk [RR] 1.9; 95% confidence interval [CI] 1.8-2.0) and a substantiated report (RR 2.5; 95% CI 2.1-2.9). For children with four or more visits, the relative risk of a report and substantiated report was 3.8 (95% CI 3.0-4.7) and 4.7 (95% CI 2.4-9.2), respectively. Children with two or more injury-related ED visits in 1 year are more likely to be reported for child maltreatment and to have a substantiated report.

Spivey MI; Schnitzer PG; Kruse RL; Slusher P; Jaffe DM

2009-02-01

207

Respiratory complications and mortality risk associated with thoracic spine injury.  

UK PubMed Central (United Kingdom)

BACKGROUND: Cervical spinal cord injury (SCI) has a well-established association with a high risk of respiratory complications. We sought to determine whether high-thoracic (HT) SCI was associated with a similar increased risk of respiratory complications and death. METHODS: This was a retrospective cohort study of all adult patients with thoracolumbar injuries entered into the Pennsylvania Trauma System Foundation registry between January 1993 and December 2002. Records were reviewed for the documentation of respiratory complications (intubation, tracheostomy, bronchoscopy, pneumonia) and mortality. The data were then evaluated controlling for age, sex, Glasgow Coma Scale, and Injury Severity Score. RESULTS: In all, 11,080 patients met inclusion criteria: 4,258 patients had thoracic spine fractures and 6,226 patients had lumbar spine fractures, all without SCI; and 596 patients had thoracic SCI (T1 to T6, 231; T7 to T12, 365). Respiratory complications occurred in 51.1% of patients with T1 to T6 SCI (versus 34.5% in T7 to T12 SCI and 27.5% in thoracic fractures). The need for intubation, the risk of pneumonia, and risk of death were significantly greater for patients with T1- to T6-level spinal cord injuries. Among patients with an Injury Severity Score less than 17 (n = 6427), the relative mortality risk was 26.7 times higher among those who developed respiratory complications (9.9% versus 0.4%). CONCLUSION: Compared with patients with low thoracic SCI or thoracolumbar fractures, patients with HT-SCI have an increased risk of pneumonia and death. Respiratory complications significantly increase the mortality risk in less severely injured patients. The current findings suggest that HT-SCI patients warrant intensive monitoring and aggressive pulmonary care and attention, similar to that given for patients with cervical SCI.

Cotton BA; Pryor JP; Chinwalla I; Wiebe DJ; Reilly PM; Schwab CW

2005-12-01

208

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

Directory of Open Access Journals (Sweden)

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

Vilma Pinheiro Gawryszewski; 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

2006-01-01

209

An analysis of the association between cancer-related information seeking and adherence to breast cancer surveillance procedures.  

UK PubMed Central (United Kingdom)

BACKGROUND: Breast cancer surveillance is important for women with a known history of breast cancer. However, relatively little is known about the prevalence and determinants of adherence to surveillance procedures, including associations with seeking of cancer-related information from medical and nonmedical sources. METHODS: We conducted a longitudinal cohort study of breast cancer patients diagnosed in Pennsylvania in 2005. Our main analyses included 352 women who were eligible for surveillance and participated in both baseline (~1 year after cancer diagnosis) and follow-up surveys. Outcomes were self-reported doctor visits and physical examination, mammography, and breast self-examination (BSE) at 1-year follow-up. RESULTS: Most women underwent two or more physical examinations according to recommended guidelines (85%). For mammography, 56% of women were adherent (one mammogram in a year) while 39% reported possible overuse (two or more mammograms). Approximately 60% of respondents reported regular BSE (? 5 times in a year). Controlling for potential confounders, higher levels of cancer-related information seeking from nonmedical sources at baseline was associated with regular BSE (OR, 1.52; 95% CI, 1.01-2.29; P, 0.046). There was no significant association between information-seeking behaviors from medical or nonmedical sources and surveillance with physical examination or mammography. CONCLUSIONS: Seeking cancer-related information from nonmedical sources is associated with regular BSE, a surveillance behavior that is not consistently recommended by professional organizations. IMPACT: Findings from this study will inform clinicians on the contribution of active information seeking toward breast cancer survivors' adherence to different surveillance behaviors.

Tan AS; Moldovan-Johnson M; Gray SW; Hornik RC; Armstrong K

2013-01-01

210

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.

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

2013-01-01

211

Transcription-induced chromatin association of RNA surveillance factors mediates facultative heterochromatin formation in fission yeast.  

UK PubMed Central (United Kingdom)

Facultative heterochromatin is reversibly established and disrupted during differentiation, but its regulation remains mechanistically unclear. Here, we show that two meiotic gene loci in fission yeast, mei4 and ssm4, comprise facultative heterochromatin that is regulated in a developmental stage-dependent manner. This heterochromatin coordinates expression levels by associating with a chromodomain protein Chp1 and an antisilencing factor Epe1. It has been recently shown that an RNA surveillance machinery for eliminating meiotic gene transcripts, which involves a cis-element called the determinant of selective removal (DSR) and transacting factors, Mmi1 and Red1, also participates in heterochromatin formation at the meiotic genes, but the molecular mechanism underlying the process is largely unknown. By dissecting the mei4 gene, we identified a region that promotes DSR-dependent methylation of histone H3 lysine 9 (H3K9). Integration of this mei4 region together with DSR into an unrelated gene results in ectopic H3K9 methylation. Moreover, our results suggest that transcription of these elements induces chromatin association of Mmi1, which, in turn, recruits Red1 interacting with Clr4/Suv39h H3K9 methyltransferase. Mmi1 remains associated in cells lacking Red1, suggesting that the recruitment of Red1 follows the chromatin association of Mmi1. Overall, we provide detailed insights into the facultative heterochromatin regulation in fission yeast.

Tashiro S; Asano T; Kanoh J; Ishikawa F

2013-04-01

212

Surveillance programme for multidrug-resistant bacteria in healthcare-associated infections: an urban perspective in South Brazil.  

UK PubMed Central (United Kingdom)

Multidrug-resistant bacteria (MDRB) have emerged as a public health problem and the World Health Organization recommends actions to control MDRB in healthcare-associated infections (HCAIs). This study describes a surveillance programme for MDRB in HCAIs at Curitiba, Brazil. MDRB in pneumonia, bloodstream, urinary tract and surgical site infections has been surveyed since January 2010. Carbapenem-resistant Acinetobacter baumannii and third generation resistant Klebsiella pneumoniae were the most frequent MDRB in HCAIs. Infection control strategies enrolling hospitals and public health have been developed. The data presented describe MDRB prevalence and the feasibility of this municipal MDRB surveillance programme in Brazil.

Toledo PV; Arend LN; Pilonetto M; Costa Oliveira JC; Luhm KR

2012-04-01

213

Association Between Infantile Spasms and Nonaccidental Head Injury.  

UK PubMed Central (United Kingdom)

Infantile spasms constitute a severe epileptic encephalopathy of infancy with poor long-term developmental outcome. Many diverse etiologies have been associated with infantile spasms, but the pathophysiological process is still not fully understood. We describe 2 cases of previously healthy 1- and 3-month-old infants who suffered a nonaccidental head injury with extensive cerebral lesions. Both presented with acute focal seizures rapidly controlled with phenobarbital. Nevertheless, they developed infantile spasms after a latency period of 3-4 months. Spasms were rapidly controlled with vigabatrin. Both children manifested with developmental delay, either exacerbated (case 1) or elicited (case 2) by infantile spasms. Our report highlights nonaccidental head injury as a risk factor for developing infantile spasms following a seizure-free latency period. A better understanding of the pathophysiology linking accidental brain trauma with infantile spasms could lead to more effective neuroprotective strategies. In the meantime, increased awareness and follow-up are warranted.

Birca A; D'Anjou G; Carmant L

2013-04-01

214

Association Between Infantile Spasms and Nonaccidental Head Injury.  

Science.gov (United States)

Infantile spasms constitute a severe epileptic encephalopathy of infancy with poor long-term developmental outcome. Many diverse etiologies have been associated with infantile spasms, but the pathophysiological process is still not fully understood. We describe 2 cases of previously healthy 1- and 3-month-old infants who suffered a nonaccidental head injury with extensive cerebral lesions. Both presented with acute focal seizures rapidly controlled with phenobarbital. Nevertheless, they developed infantile spasms after a latency period of 3-4 months. Spasms were rapidly controlled with vigabatrin. Both children manifested with developmental delay, either exacerbated (case 1) or elicited (case 2) by infantile spasms. Our report highlights nonaccidental head injury as a risk factor for developing infantile spasms following a seizure-free latency period. A better understanding of the pathophysiology linking accidental brain trauma with infantile spasms could lead to more effective neuroprotective strategies. In the meantime, increased awareness and follow-up are warranted. PMID:23580697

Birca, Ala; D'Anjou, Guy; Carmant, Lionel

2013-04-11

215

Danger-associated molecular patterns (DAMPs) in acute lung injury.  

UK PubMed Central (United Kingdom)

Danger-associated molecular patterns (DAMPs) are host-derived molecules that can function to regulate the activation of pathogen recognition receptors (PRRs). These molecules play a critical role in modulating the lung injury response. DAMPs originate from multiple sources, including injured and dying cells, the extracellular matrix, or exist as immunomodulatory proteins within the airspace and interstitium. DAMPs can function as either toll-like receptor (TLR) agonists or antagonists, and can modulate both TLR and nod-like receptor (NLR) signalling cascades. Collectively, this diverse group of molecules may represent important therapeutic targets in the prevention and/or treatment of acute lung injury (ALI) and its more severe form, acute respiratory distress syndrome (ARDS).

Tolle LB; Standiford TJ

2013-01-01

216

Methods to prevent ventilator-associated lung injury: a summary.  

UK PubMed Central (United Kingdom)

Mechanical ventilation can cause ventilator-associated lung injury (VALI). This may manifest itself in various forms such as pneumothorax or, at the most extreme level, multi-system organ failure. The exact mechanisms by which the injury occurs are not known but appear to involve the conversion of mechanical stimulation of alveolar membranes into intracellular signalling, with subsequent upregulation of inflammatory mediators that produce the damage. This has been termed biotrauma. Furthermore, disruption of alveolar-capillary membranes may allow the release of these mediators into the systemic circulation that underpins the systemic inflammatory response syndrome. Various protective ventilatory strategies may be employed in order to reduce the lung damage and shall be discussed in this paper.

Cooper SJ

2004-12-01

217

Methods to prevent ventilator-associated lung injury: a summary.  

Science.gov (United States)

Mechanical ventilation can cause ventilator-associated lung injury (VALI). This may manifest itself in various forms such as pneumothorax or, at the most extreme level, multi-system organ failure. The exact mechanisms by which the injury occurs are not known but appear to involve the conversion of mechanical stimulation of alveolar membranes into intracellular signalling, with subsequent upregulation of inflammatory mediators that produce the damage. This has been termed biotrauma. Furthermore, disruption of alveolar-capillary membranes may allow the release of these mediators into the systemic circulation that underpins the systemic inflammatory response syndrome. Various protective ventilatory strategies may be employed in order to reduce the lung damage and shall be discussed in this paper. PMID:15567677

Cooper, Sarah J

2004-12-01

218

Results of 2 decades of injury surveillance and public release of data in the Australian Football League.  

UK PubMed Central (United Kingdom)

BACKGROUND: Injuries are common in all professional football codes (including soccer, rugby league and union, American football, Gaelic football, and Australian football). PURPOSE: To report the epidemiology of injuries in the Australian Football League (AFL) from 1992-2012 and to identify changes in injury patterns during that period. STUDY DESIGN: Descriptive epidemiology study. METHODS: The AFL commenced surveying injuries in 1992, with all teams and players included since 1996. An injury was defined as "any physical or medical condition that causes a player to miss a match in the regular season or finals (playoffs)." Administrative records of injury payments (which are compulsory as part of salary cap compliance) to players who do not play matches determined the occurrence of an injury. The seasonal incidence was measured in units of new injuries per club (of 40 players) per season (of 22 matches). RESULTS: There were 4492 players listed over the 21-year period who suffered 13,606 new injuries/illnesses and 1965 recurrent injuries/illnesses, which caused 51,919 matches to be missed. The lowest seasonal incidence was 30.3 new injuries per club per season recorded in 1993, and the highest was 40.3 recorded in 1998. The injury prevalence (missed matches through injury per club per season) varied from a low of 116.3 in 1994 to a high of 157.1 in 2011. The recurrence rate of injuries was highest at 25% in 1992 and lowest at 9% in 2012 and has steadily fallen across the 21 years (P < .01). The most frequent and prevalent injury was hamstring strain (average of 6 injuries per club per season, resulting in 20 missed matches per club per season; recurrence rate, 26%), although the rate of hamstring injuries has fallen in the past 2 seasons after a change to the structure of the interchange bench (P < .05). The rate of knee posterior cruciate ligament injuries fell in the years after a rule change to prevent knee-to-knee collisions in ruckmen (P < .01). CONCLUSION: Annual public reporting (by way of media release and reports available freely online) of injury rates, using units easily understood by laypeople, has been well received. It has also paved the way for rule changes with the primary goal of improving player safety.

Orchard JW; Seward H; Orchard JJ

2013-04-01

219

Missed viral surveillance testing visits associate with full blown viral diseases in children receiving kidney transplants.  

Science.gov (United States)

Surveillance testing for major viral infections such as CMV, EBV, and BKV early in their natural history course may allow for early intervention and prevention of FBVD, but the testing is expensive and optimal interval/frequency are uncertain. At our center we initiated routine monthly viral surveillance for CMV, EBV, and BKV in July 2008 for the first 12 months post-transplant. Here, we retrospectively analyzed for outcome of the patients who missed three or more surveillance tests in the first 12 months post-transplant vs. those who did not. Of 21 patients, five missed three or more surveillance tests. Two of those five developed FBVD (one BKV nephropathy and one EBV-PTLD). None of the 16 patients with more regular surveillance testing developed FBVD. The incidence of viral replication was similar in both groups. The odds ratio for FBVD if viral surveillance tests were missed was 23.57 (p-value of 0.047). In this small group of contemporaneous patients on identical immunosuppression, those patients who missed regular viral surveillance were more likely to develop FBVD. Prospective randomized trials to confirm the benefit of regular viral testing are recommended. PMID:22905915

Al Khasawneh, Eihab; Araya, Carlos E; Dharnidharka, Vikas R

2012-08-20

220

Missed viral surveillance testing visits associate with full blown viral diseases in children receiving kidney transplants.  

UK PubMed Central (United Kingdom)

Surveillance testing for major viral infections such as CMV, EBV, and BKV early in their natural history course may allow for early intervention and prevention of FBVD, but the testing is expensive and optimal interval/frequency are uncertain. At our center we initiated routine monthly viral surveillance for CMV, EBV, and BKV in July 2008 for the first 12 months post-transplant. Here, we retrospectively analyzed for outcome of the patients who missed three or more surveillance tests in the first 12 months post-transplant vs. those who did not. Of 21 patients, five missed three or more surveillance tests. Two of those five developed FBVD (one BKV nephropathy and one EBV-PTLD). None of the 16 patients with more regular surveillance testing developed FBVD. The incidence of viral replication was similar in both groups. The odds ratio for FBVD if viral surveillance tests were missed was 23.57 (p-value of 0.047). In this small group of contemporaneous patients on identical immunosuppression, those patients who missed regular viral surveillance were more likely to develop FBVD. Prospective randomized trials to confirm the benefit of regular viral testing are recommended.

Al Khasawneh E; Araya CE; Dharnidharka VR

2013-03-01

 
 
 
 
221

Thermal injury associated with infant walking-aids.  

UK PubMed Central (United Kingdom)

Leicester Royal Infirmary and Government statistics have shown that an increase in the use of baby-walkers has been accompanied by a rise in the incidence of burns associated with their use. These burns tend to be more severe than the average for this age-group. Three case histories are presented as illustrations. The head, neck and hands are particularly affected. Three mechanisms of injury are identified. Safety guidelines are unrealistic and not enforced, testing is inadequate, and the devices hinder normal motor development.

Birchall MA; Henderson HP

1988-06-01

222

Thermal injury associated with infant walking-aids.  

Science.gov (United States)

Leicester Royal Infirmary and Government statistics have shown that an increase in the use of baby-walkers has been accompanied by a rise in the incidence of burns associated with their use. These burns tend to be more severe than the average for this age-group. Three case histories are presented as illustrations. The head, neck and hands are particularly affected. Three mechanisms of injury are identified. Safety guidelines are unrealistic and not enforced, testing is inadequate, and the devices hinder normal motor development. PMID:3167590

Birchall, M A; Henderson, H P

1988-06-01

223

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

Directory of Open Access Journals (Sweden)

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

2008-01-01

224

Healthcare-associated infection in pediatric patients on extracorporeal life support: The role of multidisciplinary surveillance.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To describe the use of a multidisciplinary approach to sepsis surveillance and evaluate impact on outcome. DESIGN: Prospective clinical study or clinical audit cycle. SETTING: Tertiary pediatric extracorporeal membrane oxygenation (ECMO) center. PATIENTS: Patients were 215 children supported with ECMO January 1999 to December 2004. INTERVENTIONS: A multidisciplinary team met monthly to evaluate cases of bloodstream infection and mediastinitis, review trends, and update unit policies. Changes in practice were made at the end of 2001 in order to address a perceived high rate of sepsis: a) reeducation; b) introduction of electively preprimed ECMO circuits; and c) preference for neck rather than chest cannulation in cardiac patients. Prophylactic antibiotics were used from preprocedure for 24 hrs only throughout the study. MEASUREMENTS AND MAIN RESULTS: Over the entire study period, 39 children had 47 septic episodes, with a rate of 24.9 per 1000 ECMO days. Multiple logistic regression analyses indicated that infection was associated with duration of ECMO support (odds ratio 1.24; 95% confidence interval 1.15, 1.35 per day) and case type: Closed vs. open chest was protective in cardiac patients (odds ratio 0.08; 95% confidence interval 0.01, 0.50). Infection increased the odds of death by 2.01 (95% confidence interval 1.00, 4.05), but this effect was less important than case type and ECMO days. After policy changes were implemented, there was a reduction in sepsis from 29.3 to 20.1 episodes per 1000 ECMO days. There was reduced sepsis in respiratory patients: neonates from 28.0 to 6.6 and pediatric patients from 42.4 to 16.9 episodes per 1000 ECMO days. Despite policy changes, sepsis remained a problem in cardiac patients with open sternum: 65.1 per 1000 ECMO days. CONCLUSIONS: ECMO support is a high-risk setup for nosocomial infection, in particular for cardiac patients with open sternum for whom antibiotic prophylaxis is justified. Multidisciplinary surveillance offers an excellent approach for quality improvement in this challenging field.

Brown KL; Ridout DA; Shaw M; Dodkins I; Smith LC; O'Callaghan MA; Goldman AP; Macqueen S; Hartley JC

2006-11-01

225

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

Directory of Open Access Journals (Sweden)

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; Ya-ping XU; Mei-liang GONG; Zhi-ping DING; Zhong-qiang YAN; Li-ming CHEN

2012-01-01

226

Serum neutrophil gelatinase-associated lipocalin in ballistic injuries: a comparison between blast injuries and gunshot wounds.  

UK PubMed Central (United Kingdom)

UNLABELLED: Neutrophil gelatinase-associated lipocalin (NGAL) is part of a functionally diverse family of proteins that generally bind small, hydrophobic ligands. Neutrophil gelatinase-associated lipocalin is expressed in a number of human tissues including gastrointestinal, respiratory, and urinary tracts and tends to rise in response to inflammation. For this reason, we hypothesized that levels of NGAL might be expressed at higher levels after blast injury compared with other ballistic injury. PURPOSE: The purpose of this study is to test the hypothesis that NGAL may be a marker of injury severity in blast injury. MATERIALS: Twenty-three combat casualties (13 blast, 10 gunshot wounds) admitted to the multinational role 3 facility in Helmand province were studied. Serum NGAL was measured using a Biosite Triage point-of-care monitor at 5 time points after injury. RESULTS: Neutrophil gelatinase-associated lipocalin rose in both groups of casualties and was significantly predictive of death or renal failure at intensive care unit admission, 12 and 24 hours after injury. CONCLUSIONS: Neutrophil gelatinase-associated lipocalin is not a specific marker of blast injury but is predictive of both renal failure and poor outcome.

Mellor AJ; Woods D

2012-08-01

227

Cholestatic hepatitis with small duct injury associated with celecoxib.  

UK PubMed Central (United Kingdom)

Drug-induced liver injury (DILI) is a common clinical entity but is underreported due to various reasons. Cyclooxygenase-2 inhibitors like Celecoxib have been proven to be associated with lesser incidence of adverse drug reactions compared to other nonsteroidal anti-inflammatory drugs (NSAID). However, Celecoxib has been rarely reported to be associated with cholestasis and hepatitis. We present a young Hispanic female presented with cholestatic liver chemistries who has been taking Celecoxib for 3 weeks. Extensive workup did not support diagnosis of viral, autoimmune, or metabolic liver diseases. Liver biopsy revealed findings suggestive of secondary sclerosing cholangitis. Imaging studies were negative for large duct involvement, and endoscopy ruled out inflammatory bowel disease. Liver chemistries normalized after cessation of medication. We recommend that physician should be aware of this rare complication when prescribing Celecoxib.

Nayudu SK; Badipatla S; Niazi M; Balar B

2013-01-01

228

Injury Statistics  

Science.gov (United States)

... Statistics NEISS Injury Data Consumer Opinion Surveys Injury Statistics Home  /   Research & Statistics  / & ... Maintenance and Construction Injury Statistics Nursery Products Injury Statistics December 31, 2012 Injuries and Deaths Associated with ...

229

Physical injuries in patients with epilepsy and their associated risk factors.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To determine the frequency, nature, and risk factors associated with physical injuries in patients with epilepsy. METHODS: In this retrospective cohort study, patients 18years of age and older with active epilepsy for at least 1year were included. A questionnaire (including age, gender, education, type of epilepsy, seizure frequency, having aura, drug compliance, polypharmacy, comorbidity, type and place of injury) was completed from patients and healthy individuals. Statistical analyses were performed using multiple logistic regression and Chi-square tests. RESULTS: 264 patients with epilepsy and 289 healthy participants were studied. Among patients, 8.7% reported severe injuries and 44.3% had mild injuries. Most patients reported soft tissue injuries, followed by dental injury, burn, and head injury. Severe injuries were 2.9 times more frequent among patients having generalized tonic-clonic seizures (GTCS) compared to healthy control; this was not statistically significant (P=0.07). No patient reported having severe injuries due to SPS, myoclonic or absence seizures. Mild injuries were 10.3 times more frequent among those with GTCS compared to healthy control (P=0.001). The relative risk for having injury in patients compared to control group was 3.42 (95% confidence interval: 2.50-4.69). Injury was significantly related to having GTCSs, illiteracy, having fall with seizures, comorbidity and having uncontrolled seizures. CONCLUSION: Physical injuries are common in patients with epilepsy; however most of these injuries are mild. Severe injuries rarely occur in patients with seizures other than GTCS.

Asadi-Pooya AA; Nikseresht A; Yaghoubi E; Nei M

2012-04-01

230

Lifting tasks are associated with injuries during the early portion of a deployment to Afghanistan.  

UK PubMed Central (United Kingdom)

U.S. Army soldiers spend months at a time working in austere environments during deployments. The numerous physical demands placed on them during deployment can lead to musculoskeletal injuries. These injuries account for the majority of medical evacuations and lost duty days, seriously affecting mission readiness. Because of limited electronic injury data, little research has been done on physical demands associated with injury in deployed environments. To this end, this study conducted a survey on 263 soldiers in a Stryker Brigade Combat Team during their third month of deployment to Afghanistan. In the third month, 23% sustained an injury and 43% of injuries affected the low-back, shoulder, or knee. Dismounted patrolling and lifting were reported to account for 36% of injuries. Wearing heavy loads and lifting tasks were identified as injury risk factors. Wearing heavier equipment and lifting objects higher may increase physical demands and may result in injury.

Roy TC; Ritland BM; Knapik JJ; Sharp MA

2012-06-01

231

Necrotizing enterocolitis is associated with neonatal intestinal injury.  

UK PubMed Central (United Kingdom)

PURPOSE: We hypothesized that a subset of premature newborns has subclinical, intestinal mucosal compromise that predisposes to the development of necrotizing enterocolitis (NEC) days or weeks later. METHODS: Fifty-five newborns of 23 to 36 weeks' gestational age were identified, and urine was collected over the first 90 hours of life. The urinary concentration of intestinal fatty acid binding protein (iFABP(u)), a sensitive marker for intestinal injury, was determined. The diagnosis of NEC was based upon clinical condition, pathology, and/or imaging findings. RESULTS: Neonatal iFABP(u) exceeded 800 pg/mL in 27 subjects, including 9 of 9 who subsequently developed stage 2 or 3 NEC. This degree of iFABP(u) elevation, but not asphyxia, was significantly associated with the development of NEC (P < .01). CONCLUSION: In this population of premature newborns, there was a substantial incidence of intestinal mucosal compromise. All infants who subsequently developed stage 2 or 3 NEC had an elevated iFABP(u). This finding suggests a model for the pathogenesis of some cases of NEC, whereby perinatal mucosal injury predisposes to further damage when feedings are initiated. In addition, neonatal iFABP(u) assessment may represent a tool to identify infants at the highest risk for NEC and allow for the institution of focused, preventive measures.

Mannoia K; Boskovic DS; Slater L; Plank MS; Angeles DM; Gollin G

2011-01-01

232

Postmarketing surveillance.  

UK PubMed Central (United Kingdom)

Postmarketing drug surveillance refers to the monitoring of drugs once they reach the market after clinical trials. It evaluates drugs taken by individuals under a wide range of circumstances over an extended period of time. Such surveillance is much more likely to detect previously unrecognized positive or negative effects that may be associated with a drug. The majority of postmarketing surveillance concern adverse drug reactions (ADRs) monitoring and evaluation. Other important postmarketing surveillance components include unapproved or off-label drug use, problems with orphan drugs, and lack of paediatric formulations, as well as issues concerning international clinical trials in paediatric population. The process of evaluating and improving the safety of medicines used in paediatric practice is referred to as paediatric pharmacovigilance. It requires special attention. Childhood diseases and disorders may be qualitatively and quantitatively different from their adult equivalents. This may affect either benefit or risk of therapies (or both), with a resulting impact on the risk/benefit balance. In addition, chronic conditions may require chronic treatment and susceptibility to ADRs may change throughout the patient's lifetime according to age and stage of growth and development. Therefore, paediatric pharmacovigillance aspects need to be tailored to a number of variables based on heterogeneity of paediatric population. This chapter will summarize and discuss the key issues.

Vlahovi?-Pal?evski V; Mentzer D

2011-01-01

233

Prevalence of poor outcomes soon after injury and their association with the severity of the injury.  

UK PubMed Central (United Kingdom)

Little is known of injury outcomes among non-hospitalised injured populations. This study examined the occurrence of poor outcomes 3 months after injury among the 2856 participants in the Prospective Outcomes of Injury Study, most of whom had sustained injuries considered of minor severity (by injury severity scoring) and had not received treatment at a hospital facility. The prevalence of poor outcomes was high across all health, physical functioning and social functioning domains and expectation characteristics examined, including for those participants with the 'least severe' injuries. Approximately half of the cohort reported experiencing moderate to high pain or psychological distress and reduced social participation, and three-quarters did not consider themselves recovered. Our findings demonstrate that, to obtain an accurate understanding of injury burden, injury outcome research should not focus only on those injured persons who are hospitalised.

Wilson SJ; Derrett S; Cameron ID; Samaranayaka A; Davie G; Langley J

2013-04-01

234

Prevalence of poor outcomes soon after injury and their association with the severity of the injury.  

Science.gov (United States)

Little is known of injury outcomes among non-hospitalised injured populations. This study examined the occurrence of poor outcomes 3 months after injury among the 2856 participants in the Prospective Outcomes of Injury Study, most of whom had sustained injuries considered of minor severity (by injury severity scoring) and had not received treatment at a hospital facility. The prevalence of poor outcomes was high across all health, physical functioning and social functioning domains and expectation characteristics examined, including for those participants with the 'least severe' injuries. Approximately half of the cohort reported experiencing moderate to high pain or psychological distress and reduced social participation, and three-quarters did not consider themselves recovered. Our findings demonstrate that, to obtain an accurate understanding of injury burden, injury outcome research should not focus only on those injured persons who are hospitalised. PMID:23563274

Wilson, Suzanne J; Derrett, Sarah; Cameron, Ian D; Samaranayaka, Ari; Davie, Gabrielle; Langley, John

2013-04-01

235

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

Directory of Open Access Journals (Sweden)

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; Bülent Durdu; Özlem Aç?kgöz; Leyla Günay; Aysun Bulgur; Sami Hatipo?lu

2010-01-01

236

Factors associated with intensive care unit admission in patients with traumatic thoracic injury.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To identify factors associated with intensive care unit (ICU) admission in patients with traumatic thoracic injury. METHODS: Data for consecutive patients with thoracic trauma were collected prospectively. Outcomes were requirement for ICU care and prolonged (>7 days) ICU care. RESULTS: The study included 1333 patients, 484 (36.3%) of whom received ICU care: 125 of these (25.8%) received prolonged ICU care. Head injury, abdominal injury, injury severity score ?16, haemothorax, chest tube placement and spinal surgery were significantly associated with ICU care. Head injury, number of rib fractures, chest drain placement, spinal surgery and extremity surgery were independent risk factors for prolonged ICU care. CONCLUSIONS: Associated injury factors played a more prominent role than thoracic factors in the need for ICU and prolonged ICU care. A multidisciplinary trauma team (involving neurosurgeons, abdominal surgeons, orthopaedic surgeons and thoracic surgeons) is essential for the care of patients with traumatic thoracic injury.

Lin FC; Tsai SC; Li RY; Chen HC; Tung YW; Chou MC

2013-08-01

237

Galeazzi injury with an associated fracture of the radial head.  

UK PubMed Central (United Kingdom)

A 36-year-old man sustained an injury that was a combination of Essex-Lopresti and Galeazzi fractures. His injuries consisted of a distal radial shaft fracture, a radial head fracture, and disruption of the distal radioulnar joint. These injuries are uncommon and this combination seems not to have been reported. The mechanism of the causative forces and the position of the forearm on impact is different in each of these injuries. These differences may explain the rarity of the combination.

Khurana JS; Kattapuram SV; Becker S; Mayo-Smith W

1988-09-01

238

Feasibility of road traffic injury surveillance integrating police and health insurance data sets in the Dominican Republic.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To assess the feasibility of semiautomated linking of road traffic injury (RTI) cases in different data sets in low- and middle-income countries. METHODS: The study population consisted of RTI cases in the Dominican Republic in 2010 and were identified in police and health insurance data sets. After duplicates were removed and fatality reporting was corrected by using forensic data, police and health insurance RTI records were linked if they had the same province, collision date, and gender of RTI cases and similar age within five years. A multinomial logistic regression model assessed the likelihood of being in only one of the data sets. RESULTS: One of five records was a duplicate, including 21.1% of 6 396 police and 16.2% of 6 178 insurance records. Health insurance data recorded 43 of 417 deaths as only injured. Capture - recapture estimated that both data sets recorded one of five RTI cases. Characteristics associated with increased likelihood (P < 0.05) of being only in the police data set were female gender [adjusted odds ratio (OR) = 2.5], age ? 16 years (OR = 1.7), collision in the regions of Cibao Northeast (OR = 4.1) and Valdesia (OR = 6.4), day of occurrence from Tuesday to Saturday (ORs from 1.5 to 2.9), month of occurrence from October to December (ORs from 1.6 to 4.5), and occupant of four-wheeled vehicles (OR = 5.4) or trucks (OR = 5.3). CONCLUSIONS: Consistent semiautomated linking procedures were feasible to ascertain the RTI burden in the Dominican Republic and could be improved by standardized coding of police and health insurance RTI reporting.

Puello A; Bhatti J; Salmi LR

2013-07-01

239

Toxic inhalational injury-associated interstitial lung disease in children.  

Science.gov (United States)

Interstitial lung disease in children (chILD) is a group of disorders characterized by lung inflammation and interstitial fibrosis. In the past recent years, we noted an outbreak of child in Korea, which is possibly associated with inhalation toxicity. Here, we report a series of cases involving toxic inhalational injury-associated chILD with bronchiolitis obliterans pattern in Korean children. This study included 16 pediatric patients confirmed by lung biopsy and chest computed tomography, between February 2006 and May 2011 at Asan Medical Center Children's Hospital. The most common presenting symptoms were cough and dyspnea. The median age at presentation was 26 months (range: 12-47 months), with high mortality (44%). Histopathological analysis showed bronchiolar destruction and centrilobular distribution of alveolar destruction by inflammatory and fibroproliferative process with subpleural sparing. Chest computed tomography showed ground-glass opacities and consolidation in the early phase and diffuse centrilobular nodular opacity in the late phase. Air leak with severe respiratory difficulty was associated with poor prognosis. Although respiratory chemicals such as humidifier disinfectants were strongly considered as a cause of this disease, further studies are needed to understand the etiology and pathophysiology of the disease to improve the prognosis and allow early diagnosis and treatment. PMID:23772158

Lee, Eun; Seo, Ju-Hee; Kim, Hyung Young; Yu, Jinho; Jhang, Won-Kyoung; Park, Seong-Jong; Kwon, Ji-Won; Kim, Byoung-Ju; Do, Kyung-Hyun; Cho, Young Ah; Kim, Sun-A; Jang, Se Jin; Hong, Soo-Jong

2013-06-03

240

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

2013-06-14

 
 
 
 
241

Acute kidney injury in patients with acute lung injury: impact of fluid accumulation on classification of acute kidney injury and associated outcomes.  

UK PubMed Central (United Kingdom)

OBJECTIVE: It has been suggested that fluid accumulation may delay recognition of acute kidney injury. We sought to determine the impact of fluid balance on the incidence of nondialysis requiring acute kidney injury in patients with acute lung injury and to describe associated outcomes, including mortality. DESIGN: Analysis of the Fluid and Catheter Treatment Trial, a factorial randomized clinical trial of conservative vs. liberal fluid management and of management guided by a central venous vs. pulmonary artery catheter. SETTING: Acute Respiratory Distress Syndrome Network hospitals. PATIENTS: One thousand patients. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The incidence of acute kidney injury, defined as an absolute rise in creatinine of ?0.3 mg/dL or a relative change of >50% over 48 hrs, was examined before and after adjustment of serum creatinine for fluid balance. The incidence of acute kidney injury before adjustment for fluid balance was greater in those managed with the conservative fluid protocol (57% vs. 51%, p = .04). After adjustment for fluid balance, the incidence of acute kidney injury was greater in those managed with the liberal fluid protocol (66% vs. 58%, p = .007). Patients who met acute kidney injury criteria after adjustment of creatinine for fluid balance (but not before) had a mortality rate that was significantly greater than those who did not meet acute kidney injury criteria both before and after adjustment for fluid balance (31% vs. 12%, p < .001) and those who had acute kidney injury before but not after adjustment for fluid balance (31% vs. 11%, p = .005). The mortality of those patients meeting acute kidney injury criteria after but not before adjustment for fluid balance was similar to patients with acute kidney injury both before and after adjustment for fluid balance (31% vs. 38%, p = .18). CONCLUSIONS: Fluid management influences serum creatinine and therefore the diagnosis of acute kidney injury using creatinine-based definitions. Patients with "unrecognized" acute kidney injury that is identified after adjusting for positive fluid balance have higher mortality rates, and patients who have acute kidney injury before but not after adjusting for fluid balance have lower mortality rates. Future studies of acute kidney injury should consider potential differences in serum creatinine caused by changes in fluid balance and the impact of these differences on diagnosis and prognosis.

Liu KD; Thompson BT; Ancukiewicz M; Steingrub JS; Douglas IS; Matthay MA; Wright P; Peterson MW; Rock P; Hyzy RC; Anzueto A; Truwit JD

2011-12-01

242

Surveillance system of hemodialysis-associated infections in a pediatric unit.  

UK PubMed Central (United Kingdom)

The bloodstream infection surveillance system proposed by the Centers for Disease Control and Prevention (CDC) was prospectively conducted in a pediatric hemodialysis unit. Thirty patients were included; 73% had a catheter for vascular access at enrollment. Vascular access infection rate was 21.1 per 100 patient-months, well above those observed in adult patient surveys. Staphylococcus aureus was most frequently isolated (23%).

Sucupira C; Abramczyk ML; de Abreu Carvalhaes JT; de Moraes-Pinto MI

2012-05-01

243

Factors associated with cervical spine injury in children after blunt trauma.  

UK PubMed Central (United Kingdom)

STUDY OBJECTIVE: Cervical spine injuries in children are rare. However, immobilization and imaging for potential cervical spine injury after trauma are common and are associated with adverse effects. Risk factors for cervical spine injury have been developed to safely limit immobilization and radiography in adults, but not in children. The purpose of our study is to identify risk factors associated with cervical spine injury in children after blunt trauma. METHODS: We conducted a case-control study of children younger than 16 years, presenting after blunt trauma, and who received cervical spine radiographs at 17 hospitals in the Pediatric Emergency Care Applied Research Network (PECARN) between January 2000 and December 2004. Cases were children with cervical spine injury. We created 3 control groups of children free of cervical spine injury: (1) random controls, (2) age and mechanism of injury-matched controls, and (3) for cases receiving out-of-hospital emergency medical services (EMS), age-matched controls who also received EMS care. We abstracted data from 3 sources: PECARN hospital, referring hospital, and out-of-hospital patient records. We performed multiple logistic regression analyses to identify predictors of cervical spine injury and calculated the model's sensitivity and specificity. RESULTS: We reviewed 540 records of children with cervical spine injury and 1,060, 1,012, and 702 random, mechanism of injury, and EMS controls, respectively. In the analysis using random controls, we identified 8 factors associated with cervical spine injury: altered mental status, focal neurologic findings, neck pain, torticollis, substantial torso injury, conditions predisposing to cervical spine injury, diving, and high-risk motor vehicle crash. Having 1 or more factors was 98% (95% confidence interval 96% to 99%) sensitive and 26% (95% confidence interval 23% to 29%) specific for cervical spine injury. We identified similar risk factors in the other analyses. CONCLUSION: We identified an 8-variable model for cervical spine injury in children after blunt trauma that warrants prospective refinement and validation.

Leonard JC; Kuppermann N; Olsen C; Babcock-Cimpello L; Brown K; Mahajan P; Adelgais KM; Anders J; Borgialli D; Donoghue A; Hoyle JD Jr; Kim E; Leonard JR; Lillis KA; Nigrovic LE; Powell EC; Rebella G; Reeves SD; Rogers AJ; Stankovic C; Teshome G; Jaffe DM

2011-08-01

244

Severe rhabdomyolysis without renal injury associated with lightning strike.  

UK PubMed Central (United Kingdom)

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

Aldana NN

2013-05-01

245

Severe rhabdomyolysis without renal injury associated with lightning strike.  

Science.gov (United States)

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

Aldana, Norberto Navarrete

246

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

247

Dosimetry associated with the surveillance program of EDF reactors pressure vessel  

International Nuclear Information System (INIS)

[en] The surveillance dosimetry program of Electricite de France's reactors pressure vessel built by Framatome consists of neutronic computation by means of ANISN-DOT procedure on the one hand and of two experimental parts on the other hand. For the first one, a light instrumentation with activation wires was put outside the pressure vessel (PV) of one power plant, during the first 18 months cycle at nominal power. This instrumentation is described: it gave the possibility to do measurements along two vertical lines and an horizontal diameter under the vessel. Experimental and computed results are compared respectively for thermal, epithermal and fast neutrons. For the second experimental part, the first surveillance capsules have been extracted from six power plants and the dosimeters have been measured. The difficulties encountered during some steps of the process are described. The reproducibility of the different results is excellent. Their consistency and agreement with the calculations are discussed

1982-01-01

248

ASTM standards associated with PWR and BWR power plant licensing, operation and surveillance  

Energy Technology Data Exchange (ETDEWEB)

This paper considers ASTM Standards that are available, under revision, and are being considered in support of Pressurized Water Reactor (PWR) and Boiling Water Reactor (BWR) Nuclear Power Plant (NPP) licensing, regulation, operation, surveillance and life attainment. The current activities of ASTM Committee E10 and its Subcommittees E10.02 and current activities of ASTM Committee E10 and its Subcommittees E10.02 and E10.05 and their Task Groups (TG) are described. A very important aspect of these efforts is the preparation, revision, and balloting of standards identified in the ASTM E706 Standard on Master Matrix for Light Water Reactor (LWR) Pressure Vessel (PV) Surveillance Standards. The current version (E706-87) of the Master Matrix identifies 21 ASTM LWR physics-dosimetry-metallurgy standards for Reactor Pressure Vessel (RPV) and Support Structure (SS) surveillance programs, whereas, for the next revision 34 standards are identified. The need for national and international coordination of Standards Technology Development, Transfer and Training (STDTT) is considered in this and other Symposium papers that address specific standards related physics-dosimetry-metallurgy issues. 69 refs.

McElroy, W.N. [Consultants and Technology Services, Richland, WA (United States); McElroy, R.J. [AEA Reactor Services, Harwell (United Kingdom); Gold, R. [Metrology Control Corp., Richland, WA (United States); Lippincott, E.P. [Westinghouse Electric Corp., Pittsburgh, PA (United States); Lowe, A.L. Jr. [BW Nuclear Technologies, Lynchburg, VA (United States)

1994-12-31

249

ASTM standards associated with PWR and BWR power plant licensing, operation and surveillance  

International Nuclear Information System (INIS)

This paper considers ASTM Standards that are available, under revision, and are being considered in support of Pressurized Water Reactor (PWR) and Boiling Water Reactor (BWR) Nuclear Power Plant (NPP) licensing, regulation, operation, surveillance and life attainment. The current activities of ASTM Committee E10 and its Subcommittees E10.02 and current activities of ASTM Committee E10 and its Subcommittees E10.02 and E10.05 and their Task Groups (TG) are described. A very important aspect of these efforts is the preparation, revision, and balloting of standards identified in the ASTM E706 Standard on Master Matrix for Light Water Reactor (LWR) Pressure Vessel (PV) Surveillance Standards. The current version (E706-87) of the Master Matrix identifies 21 ASTM LWR physics-dosimetry-metallurgy standards for Reactor Pressure Vessel (RPV) and Support Structure (SS) surveillance programs, whereas, for the next revision 34 standards are identified. The need for national and international coordination of Standards Technology Development, Transfer and Training (STDTT) is considered in this and other Symposium papers that address specific standards related physics-dosimetry-metallurgy issues. 69 refs

1993-09-03

250

The diversity of wound presentation associated with freon contact frostbite injury.  

UK PubMed Central (United Kingdom)

The authors report two cases of patients presenting with chemical frostbite-like injuries to the hands and wrists after contact exposure to Freon liquid. Although the history and initial physical presentations were quite similar, the severity of these injuries varied widely from superficial bullae to deep tissue injuries, requiring skin grafting and amputation of several digits. Freon is a widely used coolant in refrigerators, air conditioners, freezers, and water coolers, with a boiling point of -41°C. Although several cases of Freon-induced inhalational injury have been reported, few case reports of Freon-associated contact skin injury exist in the literature. The authors detail the broad diversity of injuries resulting from Freon contact as well as the first report of severe Freon injury necessitating skin grafting and amputation of multiple digits.

Wisler JW; Wisler JR; Coffey R; Miller SF

2010-09-01

251

Apophysomyces trapeziformis infection associated with a tornado-related injury.  

Science.gov (United States)

This report defines the role of Apophysomyces as an aggressive fungal pathogen seen after a tornado injury. Clinical and laboratory manifestations of infections after environmentally contaminated wounds incurred during a tornado are outlined, emphasizing mechanism of injury, comorbidities, and diagnostic and treatment challenges. Therapy with systemic antifungal therapy and aggressive serial tissue debridement was successful in achieving cure. PMID:22301481

Weddle, Gina; Gandy, Kimberly; Bratcher, Denise; Pahud, Barbara; Jackson, Mary Anne

2012-06-01

252

Apophysomyces trapeziformis infection associated with a tornado-related injury.  

UK PubMed Central (United Kingdom)

This report defines the role of Apophysomyces as an aggressive fungal pathogen seen after a tornado injury. Clinical and laboratory manifestations of infections after environmentally contaminated wounds incurred during a tornado are outlined, emphasizing mechanism of injury, comorbidities, and diagnostic and treatment challenges. Therapy with systemic antifungal therapy and aggressive serial tissue debridement was successful in achieving cure.

Weddle G; Gandy K; Bratcher D; Pahud B; Jackson MA

2012-06-01

253

Spinal cord injury and its association with blunt head trauma  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Paiva WS; Oliveira AMP; de Andrade AF; Amorim RL; Lourenço L; Teixeira MJ

254

Airway injury associated with cervical bite wounds in dogs and cats: 56 cases.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the frequency of airway injury and damage to other vital structures associated with cervical bite wounds in dogs and cats and the implications for management and outcome. METHODS: A retrospective search of electronic patient records was used to identify dogs and cats suffering cervical bite wounds that were presented to a large multidisciplinary veterinary hospital over a four year period. RESULTS: Complete records were available for 55 animals, with one animal suffering two separate injuries. Fourteen animals (25%) had injuries to vital structures, including airway injury in nine (17%) which was surgically confirmed and treated in six (11%). Airway injuries were associated with either subcutaneous or mediastinal emphysema in all affected animals. Other structures injured included the jugular vein, pharynx, oesophagus and spine. Airway injuries were treated with primary repair in five animals and a fasciomuscular patch in one. Temporary tracheostomy was performed in three animals. Median duration of hospitalisation was one day (0-19) with 53 animals (54 cases) (96%) surviving to discharge. Long-term follow-up (16-114 months) revealed that 43 of 49 animals were alive with six that died due to unrelated reasons. CLINICAL SIGNIFICANCE: Cervical bite wounds are associated with significant injury to vital structures. Up to 17% of animals may have injury to their airway. Identification and treatment of airway injury is vital and was associated with an excellent outcome in six animals.

Jordan CJ; Halfacree ZJ; Tivers MS

2013-01-01

255

Rollerblading injuries in young people.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To study injuries in young people associated with the use of rollerblades, draw comparisons with skateboarding and rollerskating injuries, and suggest strategies for injury prevention. METHODOLOGY: Injuries associated with the use of rollerblades, skateboards and rollerskates in young people aged < or = 14 years recorded on the Victorian Injury Surveillance System database since its inception in 1989 were examined to identify secular trends. All injuries associated with these pastimes recorded on the database by three sentinel hospitals during a 1 year period were examined in detail. Medical notes were perused to verify features of the event and obtain further information. A semi-structured telephone interview of a sample of 10-14 year old rollerbladers, the most commonly injured age-group, was carried out to obtain more specific information. RESULTS: There has been a marked increase in the absolute numbers of injuries associated with the use of rollerblades since 1989. In 1992, they were most common in the 10-14 year age group, which sustained 59% of all injuries; 47% of injuries were fractures of the forearm and wrist. Of a sample of 33 of those injured in the 10-14 year age group, 10 (30%) had been using rollerblades for the first time. There is some evidence to suggest a concomitant fall in skateboarding injuries. CONCLUSIONS: Injury surveillance data collected in Melbourne suggest an increasingly important contribution by rollerblading to the pattern of injury seen in young people. Preventive strategies require further evaluation but could include learning basic techniques in a controlled setting, separation from road traffic and the wearing of helmets and wrist, elbow and knee guards.

Heller DR; Routley V; Chambers S

1996-02-01

256

Hypothyroidism and acute kidney injury: an unusual association.  

UK PubMed Central (United Kingdom)

Association between severe hypothyroidism and acute kidney injury (AKI) is rare. A 40-year-old woman presented with 15 days history of generalised muscle pain, weakness, weight gain and oedema. Medical history: hypertension and hypothyroidism. Physical examination: dry skin, peripheral/periorbital oedema, slow thought and speaking, thyroid increased. Laboratory examinations: high levels of creatine kinase , creatinine, uric acid and lactate dehydrogenase. Free T4 was very low (<0.3 ng/dL) and thyroid-stimulating hormone was high (21.7 µIU/mL). Urinalysis showed haem pigment without haematuria. We performed the diagnosis of AKI secondary to hypothyroidism-induced rhabdomyolysis. Intravenous fluids were started, urinary alkalisation and increased l-thyroxine dose replacement. On the day after admission, forced diuresis with furosemide was introduced leading to a progressive improvement of symptoms. Although hypothyroidism and AKI is unusual, it should be suspected in patients presenting decrease of renal function and high creatine kinase in the absence of other causes of rhabdomyolysis.

Neves PD; Bridi RA; Balbi AL; Ponce D

2013-01-01

257

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

Science.gov (United States)

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

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

2013-01-01

258

Inflammatory signalling associated with brain dead organ donation: from brain injury to brain stem death and posttransplant ischaemia reperfusion injury.  

UK PubMed Central (United Kingdom)

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

Watts RP; Thom O; Fraser JF

2013-01-01

259

Association between preseason functional tests and injuries in youth football: a prospective follow-up.  

UK PubMed Central (United Kingdom)

This prospective cohort study aimed at identifying player-related risk factors for injuries in youth football as determined by extensive preseasonal screening. All male U15-U19 players from a regional football school (season 2007-2008; n?=?67) underwent preseason evaluations assessing physical fatigue, emotional stress and injury history (questionnaire), anthropometric variables, general joint laxity (Beighton score), lower limb coordination (functional hop tests), aerobic fitness (shuttle run test), strength of knee extensor and flexor muscles (isokinetic tests), static and dynamic balance (force plate tests), and explosive strength (jump tests on force plate). Football exposure and all football-related injuries (n =?163) were recorded during the entire subsequent season (44 weeks). Total injury incidence was 10.4 injuries/1000 ?h and was higher in competition than in training [relative risk?=?3.3; CI(95%) (2.39; 4.54); P injuries were most frequent (87%). Acute contact injuries represented 37%, while intrinsic (noncontact and chronic) injuries amounted to 63%. Of all the variables tested, only physical fatigue was significantly associated with injury, as revealed by univariate and multivariate analyses. The same result was observed when considering only intrinsic injuries as outcome. A single preseason test session may be of limited interest in the framework of an injury prevention strategy.

Frisch A; Urhausen A; Seil R; Croisier JL; Windal T; Theisen D

2011-12-01

260

Taser and Taser associated injuries: a case series.  

UK PubMed Central (United Kingdom)

Taser devices were introduced in 1974 and are increasingly used by law enforcement agencies. Taser use theoretically reduces the risk of injury and death by decreasing the use of lethal force. We report a spectrum of injuries sustained by four patients subdued with Taser devices. Injuries identified in our review included: 1) a basilar skull fracture, right subarachnoid hemorrhage, and left-sided epidural hemorrhage necessitating craniotomy; 2) a concussion, facial laceration, comminuted nasal fracture, and orbital floor fracture; 3) penetration of the outer table and cortex of the cranium by a Taser probe with seizure-like activity reported by the officer when the Taser was activated; and 4) a forehead hematoma and laceration. The Taser operator's manual states that these devices are designed to incapacitate a target from a safe distance without causing death or permanent injury. However, individuals may be exposed to the potential for significant injury. These devices represent a new mechanism for potential injury. Trauma surgeons and law enforcement agencies should be aware of the potential danger of significant head injuries as a result of loss of neuromuscular control.

Mangus BE; Shen LY; Helmer SD; Maher J; Smith RS

2008-09-01

 
 
 
 
261

Clinicopathological features of ulcerative colitis-associated colorectal cancer pointing to efficiency of surveillance colonoscopy in a large retrospective Japanese cohort.  

UK PubMed Central (United Kingdom)

PURPOSE: Cancer surveillance has been conducted in patients with ulcerative colitis (UC), and the number of operative cases of ulcerative colitis-associated colorectal cancer (UC-CRC) has been increasing. The aim of this study was to clarify the clinicopathological features and prognoses of UC-CRC patients and the relationship between surveillance colonoscopy and UC-CRC. METHODS: The clinical records of 1,274 UC patients who required surgery between 1984 and 2010 at a single institution were reviewed retrospectively. Of these, 83 patients had CRC (107 sections). All cases were extracted from the database, along with their clinicopathological data. RESULTS: The 5-year survival rate of the UC-CRC group was 89 %. The 5-year survival rate was 100 % in stages 0 and II, 96 % in stage I, 56 % in stage III, and 0 % in stage IV. Surveillance colonoscopy was performed for 40 of the 83 patients. Of 40 patients, 30 with UC who underwent surveillance colonoscopies and 22 of 43 patients without surveillance colonoscopies were in stages 0 to I (P?=?0.04). CONCLUSION: The number of UC-CRC patients who are diagnosed by surveillance colonoscopy is increasing, and many of them are detected in the very early stages (stages 0 or I). Thus, the survival rate of UC-CRC is better than before. Surveillance colonoscopy proofs efficient as CRC are detected in earlier stages.

Matsuoka H; Ikeuchi H; Uchino M; Bando T; Takesue Y; Nishigami T; Tomita N

2013-06-01

262

Brachial plexus injury associated with extracorporeal membrane oxygenation.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) is a cardiopulmonary support system. We present 2 patients of ECMO-related brachial plexus injury. METHODS: Patients were selected from a registry of 154 patients treated with ECMO from January 2002 to September 2011. RESULTS: Five patients had unilateral arm weakness after the initiation of ECMO therapy. There was no neurological examination or electrophysiological testing data available for 3 patients. Diagnosis of brachial plexus injury was confirmed in 2 patients, one based on neurological examination and one based on electrophysiological testing. DISCUSSION: Axillary artery cannulation resulting in hematoma formation was identified as a probable risk factor for brachial plexus injury in our 2 patients.

Mittal MK; Schears GJ; Wijdicks EF

2013-09-01

263

Fire characteristics associated with firefighter injury on large federal wildland fires.  

UK PubMed Central (United Kingdom)

PURPOSE: Wildland fires present many injury hazards to firefighters. We estimate injury rates and identify fire-related factors associated with injury. METHODS: Data from the National Interagency Fire Center from 2003 to 2007 provided the number of injuries in which the firefighter could not return to his or her job assignment, person-days worked, and fire characteristics (year, region, season, cause, fuel type, resistance to control, and structures destroyed). We assessed fire-level risk factors of having at least one reported injury using logistic regression. Negative binomial regression was used to examine incidence rate ratios associated with fire-level risk factors. RESULTS: Of 867 fires, 9.5% required the most complex management and 24.7% required the next-highest level of management. Fires most often occurred in the western United States (82.8%), during the summer (69.6%), caused by lightening (54.9%). Timber was the most frequent fuel source (40.2%). Peak incident management level, person-days of exposure, and the fire's resistance to control were significantly related to the odds of a fire having at least one reported injury. However, the most complex fires had a lower injury incidence rate than less complex fires. CONCLUSIONS: Although fire complexity and the number of firefighters were associated with the risk for at least one reported injury, the more experienced and specialized firefighting teams had lower injury incidence.

Britton C; Lynch CF; Torner J; Peek-Asa C

2013-02-01

264

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

Science.gov (United States)

There is a growing number of case reports of hepatoxicity from the widely marketed weight-loss supplement Hydroxycut, which contains the botanical ingredient Garcinia cambogia. These case reports may substantially undercount the true magnitude of harm. Based on the past experience with harmful dietary supplements, US regulators should assume the more precautionary approach favored by Canada and Europe. Lacking effective adverse event surveillance for supplements, or the requirements to prove safety prior to coming to the market, case reports such as those summarized here assume added importance. PMID:19360927

Lobb, Ano

2009-04-14

265

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

Directory of Open Access Journals (Sweden)

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

Ano Lobb

2009-01-01

266

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

UK PubMed Central (United Kingdom)

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

Lobb A

2009-04-01

267

Factors associated with abdominal injury in frontal, farside, and nearside crashes.  

Science.gov (United States)

The NASS-CDS (1998-2008) and CIREN datasets were analyzed to identify factors contributing to abdominal injury in crash environments where belt use and airbag deployment are common. In frontal impacts, the percentage of occupants sustaining abdominal injury is three times higher for unbelted compared to belted front-row adult occupants (p<0.0001) at both AIS2+ and AIS3+ injury levels. Airbag deployment does not substantially affect the percentage of occupants who sustain abdominal injuries in frontal impacts (p=0.6171), while belt use reduces the percentage of occupants sustaining abdominal injury in both nearside and farside crashes (p<0.0001). Right-front passengers in right-side impacts have the highest risk (1.91%) of AIS 3+ abdominal injury (p=0.03). The percentage of occupants with AIS 3+ abdominal injuries does not vary with age for frontal, nearside, or farside impacts. If an occupant sustains AIS 2+ rib fractures, the odds of the occupant sustaining an AIS 2+ abdominal injury increase dramatically. The percentage of occupants with AIS2+ abdominal injury decreases 67% for occupants in 2001-2009 model-year vehicles compared to occupants in 1985-1992 model-year vehicles. For drivers in frontal impacts, the most common vehicle-component contacts associated with abdominal injury are the steering-wheel and the lap/shoulder belt, whereas the lap/shoulder belt is the most common contact associated with abdominal injuries for right-front passengers. For occupants in nearside impacts with both liver and spleen injuries, the mean lateral door intrusion is nearly 33 cm,, while mean door intrusions range from 26 to 30 cm for occupants with only liver or only spleen injury. PMID:21512904

Klinich, Kathleen D; Flannagan, Carol A C; Nicholson, Kristen; Schneider, Lawrence W; Rupp, Jonathan D

2010-11-01

268

Factors associated with abdominal injury in frontal, farside, and nearside crashes.  

UK PubMed Central (United Kingdom)

The NASS-CDS (1998-2008) and CIREN datasets were analyzed to identify factors contributing to abdominal injury in crash environments where belt use and airbag deployment are common. In frontal impacts, the percentage of occupants sustaining abdominal injury is three times higher for unbelted compared to belted front-row adult occupants (p<0.0001) at both AIS2+ and AIS3+ injury levels. Airbag deployment does not substantially affect the percentage of occupants who sustain abdominal injuries in frontal impacts (p=0.6171), while belt use reduces the percentage of occupants sustaining abdominal injury in both nearside and farside crashes (p<0.0001). Right-front passengers in right-side impacts have the highest risk (1.91%) of AIS 3+ abdominal injury (p=0.03). The percentage of occupants with AIS 3+ abdominal injuries does not vary with age for frontal, nearside, or farside impacts. If an occupant sustains AIS 2+ rib fractures, the odds of the occupant sustaining an AIS 2+ abdominal injury increase dramatically. The percentage of occupants with AIS2+ abdominal injury decreases 67% for occupants in 2001-2009 model-year vehicles compared to occupants in 1985-1992 model-year vehicles. For drivers in frontal impacts, the most common vehicle-component contacts associated with abdominal injury are the steering-wheel and the lap/shoulder belt, whereas the lap/shoulder belt is the most common contact associated with abdominal injuries for right-front passengers. For occupants in nearside impacts with both liver and spleen injuries, the mean lateral door intrusion is nearly 33 cm,, while mean door intrusions range from 26 to 30 cm for occupants with only liver or only spleen injury.

Klinich KD; Flannagan CA; Nicholson K; Schneider LW; Rupp JD

2010-11-01

269

[Injury of the knee joint associated with popliteal artery injury--case report].  

Science.gov (United States)

In this paper we consider that it is necessary to neglect injuries of blood vessels, because often the surgeon pays all his attention to the instability of knee and in every luxation of injury of knee joint is necessary to take care of vascular status. Necessary is the operative treatment in the optimal time, in team work with the determined order in treatment. Everything done contrary to this, surely leads to the amputation of extremities. PMID:2093777

Solakovi?, E; Hadziahmetovi?, Z

1990-01-01

270

[Injury of the knee joint associated with popliteal artery injury--case report  

UK PubMed Central (United Kingdom)

In this paper we consider that it is necessary to neglect injuries of blood vessels, because often the surgeon pays all his attention to the instability of knee and in every luxation of injury of knee joint is necessary to take care of vascular status. Necessary is the operative treatment in the optimal time, in team work with the determined order in treatment. Everything done contrary to this, surely leads to the amputation of extremities.

Solakovi? E; Hadziahmetovi? Z

1990-01-01

271

Popliteal artery injury associated with knee dislocation: improved outlook?  

UK PubMed Central (United Kingdom)

Popliteal artery injury due to knee dislocation is an injury complex that is being reported with increasing frequency. A review of the literature from 1974 to 1978 reveals 40 new cases. Of these cases, 85 per cent underwent successful arterial repair, an encouraging figure. although few, large individual series exist, it is felt that an improved prognosis may be expected. Four case reports from the last year at the author's institution are presented. Various aspects of diagnosis and treatment are analyzed and recommended.

Savage R

1980-11-01

272

Cellular therapies for treating pain associated with spinal cord injury  

Directory of Open Access Journals (Sweden)

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

Leung Lawrence

2012-01-01

273

Hepatotoxicity associated with sulfasalazine in inflammatory arthritis: A case series from a local surveillance of serious adverse events  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Spontaneous reporting systems for adverse drug reactions (ADRs) are handicapped by under-reporting and limited detail on individual cases. We report an investigation from a local surveillance for serious adverse drug reactions associated with disease modifying anti-rheumatic drugs that was triggered by the occurrence of liver failure in two of our patients. Methods Serious ADR reports have been solicited from local clinicians by regular postcards over the past seven years. Patients', who had hepatotoxicity on sulfasalazine and met a definition of a serious ADR, were identified. Two clinicians reviewed structured case reports and assessed causality by consensus and by using a causality assessment instrument. The likely frequency of hepatotoxicity with sulfasalazine was estimated by making a series of conservative assumptions. Results Ten cases were identified: eight occurred during surveillance. Eight patients were hospitalised, two in hepatic failure – one died after a liver transplant. All but one event occurred within 6 weeks of treatment. Seven patients had a skin rash, three eosinophilia and one interstitial nephritis. Five patients were of Black British of African or Caribbean descent. Liver enzymes showed a hepatocellular pattern in four cases and a mixed pattern in six. Drug-related hepatotoxicity was judged probable or highly probable in 8 patients. The likely frequency of serious hepatotoxicity with sulfasalazine was estimated at 0.4% of treated patients. Conclusion Serious hepatotoxicity associated with sulfasalazine appears to be under-appreciated and intensive monitoring and vigilance in the first 6 weeks of treatment is especially important.

Jobanputra Paresh; Amarasena Roshan; Maggs Fiona; Homer Dawn; Bowman Simon; Rankin Elizabeth; Filer Andrew; Raza Karim; Jubb Ronald

2008-01-01

274

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

Science.gov (United States)

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

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

2005-01-01

275

MR imaging of the posterior cruciate ligament: normal, abnormal, and associated injury patterns.  

UK PubMed Central (United Kingdom)

The posterior cruciate ligament (PCL) of the knee has received little attention in the radiology literature, but its importance in knee stability has come under close scrutiny in recent years. Unrepaired injury of the PCL can lead to chronic instability and early joint degeneration. Three major mechanisms of trauma that involves the PCL are posterior displacement of the tibia in a flexed knee, hyperextension, and rotation combined with an adduction or abduction force. The spectrum of PCL injuries includes partial tear or intrasubstance injury, complete ligamentous rupture, and avulsion of the PCL insertion site on the posterior tibia. Associated injuries include injury of other ligaments, meniscal tear, bone injury, and joint effusion. PCL rupture is easily identified with magnetic resonance (MR) imaging by using simple signal intensity and structural characteristics. Because clinical and arthroscopic assessment of the PCL can be difficult, MR imaging can be valuable for evaluating the acutely injured knee when operative repair of the PCL is being considered.

Sonin AH; Fitzgerald SW; Hoff FL; Friedman H; Bresler ME

1995-05-01

276

A loss control surveillance system  

Energy Technology Data Exchange (ETDEWEB)

During the past decade many U.S. industries have realized the importance of a total loss control program; the bituminous coal mining industry is no exception to this trend. Oftentimes, it is realized that the circumstances surrounding a ''near miss'' (an incident which does not result in personal injury or property damage) are practically identical to those associated with a fatality, disabling injury, or major property damage. And, many organizations suffer enormous financial losses in cases where no one is injured or property damaged but costly delays in production result. Detailed analyses of both injury and non-injury cases can provide valuable input into those engineering, behavioral, and management controls that are necessary to prevent their recurrence. The purpose of this paper is to describe a comprehensive loss control surveillance system (LCSS) that will enhance management control in preventing personnel, property, and production losses, thereby, maximizing profit. The next section describes the components of this LCSS. The authors present a practical example of how this management tool can be used to minimize loss through safety and training programs.

Bennett, J.D.; Passmore, D.L.

1985-01-01

277

Single nucleotide polymorphisms associated with non-contact soft tissue injuries in elite professional soccer players: influence on degree of injury and recovery time  

Science.gov (United States)

Background The biological mechanisms involved in non-contact musculoskeletal soft tissue injuries (NCMSTI) are poorly understood. Genetic risk factors may be associated with susceptibility to injuries, and may exert marked influence on recovery times. Methods Data on type and degree of injury and recovery time were collected in 73 male professional soccer players (43 White, 11 Black Africans and 19 Hispanics) who suffered total of 242 injuries (203 muscle, 24 ligament, and 15 tendon injuries). One single nucleotide polymorphism (SNPs) in the following genes were analyzed: Elastin (ELN); Titin (TTN); SRY-related HMG-box (SOX15); Insulin-like growth factor 2 (IGF2); Chemokine, CC motif, ligand 2 (CCL2); Collagen type 1 alpha 1(COL1A1); Collagen type 5 alpha 1 (COL5A1), and Tenascin C (TNC). Results There was evidence of a statistically significant association between the degree of injury and the IGF2 genotype (P?=?0.034). In addition, there was evidence of a statistically significant association between the degree of muscle injury and CCL2 (P?=?0.026) Finally, there was evidence of a statistically significant association between ELN and degree of injury (p?=?0.009) and recovery time (P?=?0.043). There was no evidence of a statistically significant association between any of the genes studied and degree of injury or recovery time for tendon injuries. Conclusion SNPs in the IGF2, CCL2, and ELN genes may be associated to the degree and recovery time of NCMSTI.

2013-01-01

278

Single nucleotide polymorphisms associated with non-contact soft tissue injuries in elite professional soccer players: influence on degree of injury and recovery time.  

UK PubMed Central (United Kingdom)

BACKGROUND: The biological mechanisms involved in non-contact musculoskeletal soft tissue injuries (NCMSTI) are poorly understood. Genetic risk factors may be associated with susceptibility to injuries, and may exert marked influence on recovery times. METHODS: Data on type and degree of injury and recovery time were collected in 73 male professional soccer players (43 White, 11 Black Africans and 19 Hispanics) who suffered total of 242 injuries (203 muscle, 24 ligament, and 15 tendon injuries). One single nucleotide polymorphism (SNPs) in the following genes were analyzed: Elastin (ELN); Titin (TTN); SRY-related HMG-box (SOX15); Insulin-like growth factor 2 (IGF2); Chemokine, CC motif, ligand 2 (CCL2); Collagen type 1 alpha 1(COL1A1); Collagen type 5 alpha 1 (COL5A1), and Tenascin C (TNC). RESULTS: There was evidence of a statistically significant association between the degree of injury and the IGF2 genotype (P?=?0.034). In addition, there was evidence of a statistically significant association between the degree of muscle injury and CCL2 (P?=?0.026) Finally, there was evidence of a statistically significant association between ELN and degree of injury (p?=?0.009) and recovery time (P?=?0.043). There was no evidence of a statistically significant association between any of the genes studied and degree of injury or recovery time for tendon injuries. CONCLUSION: SNPs in the IGF2, CCL2, and ELN genes may be associated to the degree and recovery time of NCMSTI.

Pruna R; Artells R; Ribas J; Montoro B; Cos F; Muñoz C; Rodas G; Maffulli N

2013-01-01

279

Injuries to air force personnel associated with lifting, handling, and carrying objects.  

UK PubMed Central (United Kingdom)

BACKGROUND: The U.S. Air Force (USAF) active duty and civilian populations experience a substantial number of lost-workday injuries while lifting, handling, and carrying objects. Back injuries are most frequently reported. PURPOSE: The purpose of this study is to describe the hazard scenarios of lift-handle-carry injuries to better identify effective countermeasures. METHODS: The data were derived from safety reports obtained from the USAF Ground Safety Automated System. Lift-handle-carry injuries for the years 1993-2002 that resulted in at least one lost workday were included in the study. A total of 4085 lost-workday injuries resulting in 24,940 lost workdays for USAF military and civilian members met the criteria for inclusion. Objects associated with these injuries were identified and aggregated to determine the most common causes of lift-handle-carry injuries. RESULTS: Twelve distinct objects or type of objects were identified as the most common source of lift-handle-carry injuries. Among the most common sources of injury were lifting aircraft components, boxes, and furniture. Most importantly, lifting one group of objects, aircraft components, was associated with 33% of all lift-handle-carry injuries. CONCLUSIONS: Safety report data can be used to identify the most common object or object types causing lift-handle-carry injuries. The information included in this report suggests countermeasures that should be considered for implementation and evaluation studies. Countermeasures to address the most common lift-handle-carry injuries, such as lifting aircraft components among aircraft maintenance workers, are warranted.

Kemp PA; Burnham BR; Copley GB; Shim MJ

2010-01-01

280

Foul play is associated with injury incidence: an epidemiological study of three FIFA World Cups (2002-2010).  

UK PubMed Central (United Kingdom)

BACKGROUND: Foul play has been considered as one of the most important known extrinsic risk factors for injuries in football. AIMS: To compare the incidence and characteristics of foul play injuries and non-foul injuries. METHODS: Team physicians' postmatch injury reports and official match statistics were obtained from all matches of the 2002, 2006 and 2010 Fédération Internationale de Football Association World Cups. RESULTS: The number of injuries was associated with the number of fouls in a match. The incidence of foul play injuries (20.6/1000 match-hours, 95% CI 17.3 to 24.4) was significantly lower than that of non-foul injuries (42.6, 37.7 to 47.9), which also applied to all playing positions. The causation of injury (foul/non-foul), match period and teams' drawing/losing/winning status were associated with the injury incidence. The interactions between the causation of injury (foul/non-foul) and match time, as well as the teams' drawing/losing/winning status or playing position were not statistically significant. The median (IQR) days of absence resulting from foul play injuries were significantly shorter than that of non-foul injuries. The lower leg and ankle were more common locations for foul play injuries than for non-foul injuries, whereas the opposite was observed for thigh injuries. Contusions were a more common type of foul play injuries than non-foul injuries, while the opposite was found for muscle strains/ruptures/tears. CONCLUSIONS: The numbers of injuries and fouls in a match were significantly associated. No significant differences in the variation of foul play and non-foul injury incidences regarding match period, teams' current winning/drawing/losing status and playing position were observed, suggesting that foul play injuries and non-foul injuries may share similar underlying risk factors.

Ryynänen J; Junge A; Dvorak J; Peterson L; Kautiainen H; Karlsson J; Börjesson M

2013-10-01

 
 
 
 
281

Minor injuries, cognitive failures and accidents at work: incidence and associated features.  

UK PubMed Central (United Kingdom)

BACKGROUND: There is a dearth of information examining minor injuries and cognitive failures in the workplace. AIMS: This study aims to describe the incidence of, and characteristics associated with, minor injuries, cognitive failures and accidents in the workplace. METHODS: The study was a community based postal questionnaire survey of people selected at random from the Electoral Registers of Cardiff and Merthyr Tydfil; 7980 questionnaires were returned. RESULTS: Frequent/very frequent minor injuries were reported by 9.8% of the workers and frequent/very frequent cognitive failures (e.g. problems of memory, attention or action) by 10.5%. Work accidents requiring treatment were reported by 5.6% of the workers. Minor injuries, cognitive failures and accidents were associated with a number of demographic and health factors. In addition, minor injuries, cognitive failures and accidents were found to be related to each other. CONCLUSIONS: A large number of workers experience accidents and minor injuries at work. Minor injuries are not recorded by official sources but could have implications in productivity and worker health. Factors identified in this study, as associated with injuries or accidents, could be addressed by specific workplace policies or by raising individual awareness of the risks.

Simpson SA; Wadsworth EJ; Moss SC; Smith AP

2005-03-01

282

Hepatic histological findings in suspected drug-induced liver injury: Systematic evaluation and clinical associations.  

UK PubMed Central (United Kingdom)

Drug induced liver injury (DILI) is considered to be a diagnosis of exclusion. Liver biopsy may contribute to diagnostic accuracy, but the histological features of DILI and their relationship to biochemical parameters and outcomes are not well defined. We have classified the pathological pattern of liver injury and systematically evaluated histological changes in liver biopsies obtained from 249 patients with suspected DILI enrolled in the prospective, observational study conducted by the Drug Induced Liver Injury Network. Histological features were analyzed for their frequency within different clinical phenotypes of liver injury and to identify associations between clinical and laboratory findings and histological features. The most common histological patterns were acute (21%) and chronic hepatitis (14%), acute (9%) and chronic cholestasis (10%) and cholestatic hepatitis (29%). Liver histology from 128 patients presenting with hepatocellular injury had more severe inflammation, necrosis and apoptosis and more frequently demonstrated lobular disarray, rosette formation and hemorrhage than those with cholestasis. Conversely, histology of the 73 patients with cholestatic injury more often demonstrated bile plugs and duct paucity. Severe or fatal hepatic injury in 46 patients was associated with higher degrees of necrosis, fibrosis stage, microvesicular steatosis and ductular reaction among other findings, while eosinophils and granulomas were found more often in those with milder injury. In summary, we describe an approach for evaluating liver histology in DILI and demonstrate numerous associations between pathological findings and clinical presentations that may serve as a foundation for future studies correlating DILI pathology with its causality and outcome. (Hepatology 2013;).

Kleiner DE; Chalasani NP; Lee WM; Fontana RJ; Bonkovsky HL; Watkins PB; Hayashi PH; Davern TJ; Navarro V; Reddy R; Talwalkar JA; Stolz A; Gu J; Barnhart H; Hoofnagle JH

2013-08-01

283

Circular saw-associated fatality mimicking gunshot injury.  

UK PubMed Central (United Kingdom)

A 61-year-old man was found dead in the yard of his house with penetrating injury of the trunk. Initial examination of the body revealed a single penetrating injury on his chest with a collar abrasion-the injury pattern that is similar to a gunshot entry wound or shored exit wound. According to witnesses, the man had cut wooden frames from old windows with a circular saw. X-rays of the torso revealed a contrast object resembling a projectile in the left scapular region. The internal examination disclosed an isolated trunk trauma involving the left lung. In the soft tissue, between the inner edge of the left scapula and thoracic spine, the fragment of a metal nail was found. The autopsy confirmed that the wound on the chest was a non-firearm-related injury. The death of deceased was attributed to massive internal hemorrhage. Further investigation revealed that the pseudo-gunshot wound injury of the trunk of the victim was caused by a fast-flying metal object thrown against the man's trunk from a circular saw while cutting the wooden beams of old windows.

Hejna P; Zátopková L; Safr M; Straka L

2013-01-01

284

Circular saw-associated fatality mimicking gunshot injury.  

Science.gov (United States)

A 61-year-old man was found dead in the yard of his house with penetrating injury of the trunk. Initial examination of the body revealed a single penetrating injury on his chest with a collar abrasion-the injury pattern that is similar to a gunshot entry wound or shored exit wound. According to witnesses, the man had cut wooden frames from old windows with a circular saw. X-rays of the torso revealed a contrast object resembling a projectile in the left scapular region. The internal examination disclosed an isolated trunk trauma involving the left lung. In the soft tissue, between the inner edge of the left scapula and thoracic spine, the fragment of a metal nail was found. The autopsy confirmed that the wound on the chest was a non-firearm-related injury. The death of deceased was attributed to massive internal hemorrhage. Further investigation revealed that the pseudo-gunshot wound injury of the trunk of the victim was caused by a fast-flying metal object thrown against the man's trunk from a circular saw while cutting the wooden beams of old windows. PMID:23181567

Hejna, Petr; Zátopková, Lenka; Safr, Miroslav; Straka, Lubomír

2012-11-26

285

Tetanus Surveillance  

Science.gov (United States)

... to... Añadir en... Favorites Delicious Digg Google Bookmarks Surveillance Reported tetanus cases have declined more than 95%, ... date on their 10-year booster shots. National surveillance for tetanus is monitored by the National Notifiable ...

286

Bladder injury associated with rupture of the uterus.  

UK PubMed Central (United Kingdom)

Rupture of the uterus is still a very common obstetric emergency in developing countries, and the urinary bladder is often injured in these patients. This fact is not fully documented in the literature. One hundred consecutive cases of rupture of the uterus in patients admitted during a 10-year period to the King George Hospital, Visakhapatnam, India, were analyzed. Bladder injury occurred in 22%. Thus, uterine rupture constitutes one of the important causes of bladder injury. In uterine rupture cases the most common clinical signs of concomitant bladder damage are hematuria and meconium-stained urine. Instillation of methylene blue solution into the bladder during surgery can help to identify small bladder rents. Routine postoperative drainage of the bladder by indwelling catheter in all cases of ruptured uterus with suspected bladder injury is an important aid to healing of the contused, devitalized bladder and can avert vesicovaginal fistula formation.

Raghavaiah NV; Devi AI

1975-11-01

287

Participation in organized sports is positively associated with employment in adults with spinal cord injury.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The aim of this study was to determine the association between participation in organized sports programs and employment in adults with chronic spinal cord injury. DESIGN: This is a cross-sectional study of 149 adults with chronic spinal cord injury. Motor level and completeness of injury were confirmed by physical examination. Information related to demographics, employment, level of education, body mass index, duration of injury, participation in individually planned exercise, and participation in organized sports was obtained using a standardized questionnaire. Multivariable logistic regression analyses were used to assess factors associated with employment. RESULTS: In univariate analyses, employment was associated with younger age (P = 0.001) and a higher level of education (P = 0.01), whereas obesity decreased the likelihood of employment (P = 0.04). Participation in organized sports approached significance (P = 0.06). In the multivariable analysis and after adjusting for age, education, and body mass index, participation in organized sports was significantly associated with employment (odds ratio, 2.4; P = 0.04). Sex, duration of injury, wheelchair use, and participation in individually planned exercise were not significantly associated with employment (P = 0.16-0.94). CONCLUSIONS: In the adults with chronic spinal cord injury, participation in organized sports was positively associated with employment. Further studies are necessary to determine the causative nature of this association and how various factors related to sports participation may contribute.

Blauwet C; Sudhakar S; Doherty AL; Garshick E; Zafonte R; Morse LR

2013-05-01

288

78 FR 28546 - Secondary Service Connection for Diagnosable Illnesses Associated With Traumatic Brain Injury  

Science.gov (United States)

...VETERANS AFFAIRS 38 CFR Part 3 RIN 2900-AN89 Secondary Service Connection for Diagnosable Illnesses Associated With Traumatic Brain Injury Correction In proposed rule document 2012-29709 beginning on page 73366 in the issue of Monday, December...

2013-05-15

289

[Serological, molecular and virological analyses associated with yellow fever surveillance in Colombia].  

UK PubMed Central (United Kingdom)

INTRODUCTION: Yellow fever is an immunopreventable viral hemorrhagic fever that causes high morbidity and mortality in tropical and sub-tropical regions. In Colombia, approximately 5 million persons are at risk of becoming infected with yellow fever virus. OBJECTIVE: The serological, molecular and virological analyses on the yellow fever surveillance samples were summarized in order to indicate the importance of appropriate and timely sampling in the process of case confirmation. MATERIALS AND METHODS: The survey was based on samples received at the Arbovirus Laboratory, Virology Group, Instituto Nacional de Salud, Bogotá, during years 2006 to 2008. A total of 2,096 serum and tissue samples were tested for IgM antibodies against yellow fever by capture enzyme-linked immunosorbent assay, viral isolation-indirect fluorescence antibody technique, and reverse transcriptase-polymerase chain reaction. Positive samples were correlated with the clinical and epidemiological findings for their interpretation and confirmation. RESULTS: Of the 15 yellow fever cases confirmed in Colombia during 2006-2008 by histopathological techniques, 82% were confirmed at the Arbovirus Laboratory using serologic and molecular techniques. The positive cases were distributed in the rainforest region and in the foothills of the eastern chain of the Andes mountains. CONCLUSION: The case distribution and prognosis illustrated the necessity of maintaining and strengthening the surveillance processes in those regions where the yellow fever virus is circulating. The cases must be recruited and diagnosed sufficiently early in order to use the above techniques in samples from live patients, in contrast to the histopathological procedures that require samples from fatal cases.

Múnera GI; Méndez JA; Rey GJ

2010-07-01

290

Major burn injury is not associated with acute traumatic coagulopathy.  

UK PubMed Central (United Kingdom)

BACKGROUND: The pathophysiology and time course of coagulopathy after major burns are inadequately understood. Our study objectives were to determine whether acute traumatic coagulopathy (ATC) is seen in burn patients at admission and to determine the changes in international normalized ratio (INR), activated partial thromboplastin time (aPTT), platelet count (PLT), and hemoglobin (Hgb) in the first 7 days after injury. METHODS: We conducted a retrospective study of patients with burn injury of at least 15% total body surface area who presented to the University of North Carolina. Data on patient demographics, injury characteristics, and laboratory data (INR, aPTT, PLT, and Hgb) at admission and within the first 7 days after injury were recorded. We defined ATC as INR of 1.3 or greater, aPTT of 1.5 or greater times the mean normal limit, and normal PLT at admission. RESULTS: We studied the hematologic profile of 102 patients with burn injury of 15% to 100% total body surface area but did not identify a single patient with ATC at admission. The screening hematologic profile at admission was not influenced by burn severity. In the first 7 days after injury, the INR and aPTT were relatively preserved, while the PLT quickly recovered to baseline after an early decline and the Hgb remained stable at around 10 g/dL; all these changes occurred during the time when the burn patients had received large amounts of fluid resuscitation. CONCLUSION: The screening hematologic profile of burn patients at admission is normal, and the standard screening assays do not suggest the existence of ATC at admission. While this is a relatively small study, it provides evidence to suggest that ATC is unique to trauma patients. LEVEL OF EVIDENCE: Prognostic study, level III.

Lu RP; Ni A; Lin FC; Ortiz-Pujols SM; Adams SD; Monroe DM 3rd; Whinna HC; Cairns BA; Key NS

2013-06-01

291

Popliteal artery injury associated with knee dislocation: improved outlook?  

Science.gov (United States)

Popliteal artery injury due to knee dislocation is an injury complex that is being reported with increasing frequency. A review of the literature from 1974 to 1978 reveals 40 new cases. Of these cases, 85 per cent underwent successful arterial repair, an encouraging figure. although few, large individual series exist, it is felt that an improved prognosis may be expected. Four case reports from the last year at the author's institution are presented. Various aspects of diagnosis and treatment are analyzed and recommended. PMID:7436140

Savage, R

1980-11-01

292

Peat bog wildfire smoke exposure in rural North Carolina is associated with cardiopulmonary emergency department visits assessed through syndromic surveillance.  

UK PubMed Central (United Kingdom)

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. OBJECTIVE: We investigated the effects of exposure on cardiorespiratory outcomes in the population affected by the fire. METHODS: We performed a population-based study using emergency department (ED) visits reported through the syndromic surveillance program NC DETECT (North Carolina Disease Event Tracking and Epidemiologic Collection Tool). We used aerosol optical depth measured by a satellite to determine a high-exposure window and distinguish counties most impacted by the dense smoke plume from surrounding referent counties. Poisson log-linear regression with a 5-day distributed lag was used to estimate changes in the cumulative relative risk (RR). RESULTS: In the exposed counties, significant increases in cumulative RR for asthma [1.65 (95% confidence interval, 1.25-2.1)], chronic obstructive pulmonary disease [1.73 (1.06-2.83)], and pneumonia and acute bronchitis [1.59 (1.07-2.34)] were observed. ED visits associated with cardiopulmonary symptoms [1.23 (1.06-1.43)] and heart failure [1.37 (1.01-1.85)] were also significantly increased. CONCLUSIONS: Satellite data and syndromic surveillance were combined to assess the health impacts of wildfire smoke in rural counties with sparse air-quality monitoring. This is the first study to demonstrate both respiratory and cardiac effects after brief exposure to peat wildfire smoke.

Rappold AG; Stone SL; Cascio WE; Neas LM; Kilaru VJ; Carraway MS; Szykman JJ; Ising A; Cleve WE; Meredith JT; Vaughan-Batten H; Deyneka L; Devlin RB

2011-10-01

293

Treatment of upper limb nerve war injuries associated with vascular trauma.  

Science.gov (United States)

During a 4-year period, in the Departments of Plastic Surgery and Vascular Surgery at the Clinical Hospital Centre in Zagreb, 151 upper limb nerve injuries caused by war weapons were treated using microsurgical procedures, and 119 patients have been assessed. Among them, 44 patients with 58 nerve injuries had associated arterial injuries. It is of great importance that peripheral nerve as well as vessel injuries should be considered in all extremity war wounds. Every effort should be made to perform immediate revascularization of a damaged artery, as this is the best guarantee for long-term arterial patency. Reconstruction with autologous vein has been the method of choice for arterial war injuries. Injured peripheral nerves, at the time of vascular repair, were marked and left for secondary reconstruction. Primary repair of such injuries was contraindicated because it was impossible to determine the exact proximal and distal extent of injury. Functional results were obtained in only 44.8 per cent of cases with concomitant nerve and arterial war injuries, an outcome that could be explained by insufficient vascularization at the site of nerve repair (using both mechanisms of graft revascularization), as well as proximal levels of injury and extent of nerve damage, which resulted in long nerve defects. PMID:9509088

Stanec, S; Tonkovi?, I; Stanec, Z; Tonkovi?, D; Dzepina, I

1997-09-01

294

Occult knee ligament injuries associated with femoral shaft fractures.  

Science.gov (United States)

Recognition of ligamentous injuries of the knee in the acute phase is essential for optimum treatment and prognosis. A multitraumatized patient with a fractured femur and occult knee ligament damage presents a difficult diagnostic challenge. This paper retrospectively reviews 52 patients with 54 midshaft femoral fractures. The high incidence (48%) of ipsilateral knee ligament damage, particularly of a severe nature (30%) evident at followup (mean 24.5 months) is alarming. In the 26 cases of knee ligament damage, the mean time from injury to documentation of instability is 12.8 months. Motor vehicle and athletic injuries and falls account for all of the injuries. The majority are dashboard impacts treated in balanced traction with subsequent case bracing. The anterior cruciate ligament (50%) is most often injured followed by the medial collateral ligament (31%), lateral collateral ligament (13%), and posterior cruciate ligament (6%). A Lachman test, aspiration of the effusions, examinations under anesthesia including stress films, and arthroscopy are recommended as diagnostic procedures. Acute ipsilateral knee instability is a strong relative indication for primary rigid immobilization of the fracture femur to allow early ligamentous repair. PMID:7377448

Walker, D M; Kennedy, J C

295

Occult knee ligament injuries associated with femoral shaft fractures.  

UK PubMed Central (United Kingdom)

Recognition of ligamentous injuries of the knee in the acute phase is essential for optimum treatment and prognosis. A multitraumatized patient with a fractured femur and occult knee ligament damage presents a difficult diagnostic challenge. This paper retrospectively reviews 52 patients with 54 midshaft femoral fractures. The high incidence (48%) of ipsilateral knee ligament damage, particularly of a severe nature (30%) evident at followup (mean 24.5 months) is alarming. In the 26 cases of knee ligament damage, the mean time from injury to documentation of instability is 12.8 months. Motor vehicle and athletic injuries and falls account for all of the injuries. The majority are dashboard impacts treated in balanced traction with subsequent case bracing. The anterior cruciate ligament (50%) is most often injured followed by the medial collateral ligament (31%), lateral collateral ligament (13%), and posterior cruciate ligament (6%). A Lachman test, aspiration of the effusions, examinations under anesthesia including stress films, and arthroscopy are recommended as diagnostic procedures. Acute ipsilateral knee instability is a strong relative indication for primary rigid immobilization of the fracture femur to allow early ligamentous repair.

Walker DM; Kennedy JC

1980-05-01

296

Injury profile in elite female basketball athletes at the Women's National Basketball Association combine.  

UK PubMed Central (United Kingdom)

BACKGROUND: Anterior cruciate ligament (ACL) and meniscus injuries are common in female athletes participating in cutting and pivoting sports such as basketball. The epidemiological characteristics of injury in athletes seen at the Women's National Basketball Association (WNBA) combine and the effect of ACL reconstruction and meniscus surgery on longevity in the WNBA are unknown. PURPOSE: To evaluate the details and spectrum of injuries in athletes entering the WNBA combine and to assess the potential effect of specific injuries on the round drafted into the WNBA and career length. STUDY DESIGN: Descriptive epidemiology study. METHODS: Demographic data and the documented collegiate injury profile were reviewed from the WNBA database for all players entering the WNBA combine in 2000-2008. The study included injury data on 506 athletes. Complete demographic data were available for 496 players. RESULTS: Of the athletes taking part in the combine, 45.2% were guards, 33.7% were forwards, and 21.1% were centers. Ankle sprain (47.8% of players), hand injury (20.8%), patellar tendinitis (17.0%), ACL injury (15.0%), meniscus injury (10.5%), stress fracture (7.3%), and concussion (7.1%) were the most common injuries reported. Seventy-three athletes (14.4%) reported ACL reconstruction before entering the WNBA combine, and meniscus surgery was the next most common surgery (n = 50 players; 9.9%). There were no differences in ACL or meniscus surgery when analyzed by player position or round drafted. History of ACL or meniscus surgery did not affect career length in the WNBA. Excluding ACL and meniscus surgery, other reported surgical procedures were knee arthroscopic surgery (11.7%), ankle reconstruction (2.6%), and shoulder stabilization (2.0%). CONCLUSION: The ankle is the most common site of injury and ACL reconstruction is the most common surgery in elite female athletes participating in the WNBA combine. A history of injury or surgery did not affect the round drafted or career length.

McCarthy MM; Voos JE; Nguyen JT; Callahan L; Hannafin JA

2013-03-01

297

Electronic Surveillance  

Science.gov (United States)

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

Leske, Cavin.

298

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

UK PubMed Central (United Kingdom)

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

2013-09-01

299

Hidden spears: handlebars as injury hazards to children.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To delineate the mechanism of serious bicycle handlebar-related injuries in children and make recommendations for preventive strategies. METHODS: Prospective cross-sectional surveillance system of seriously injured child bicyclists supplemented by in-depth, on-site crash investigation to delineate specific injury mechanisms. Interdisciplinary analyses involved engineers, clinicians, epidemiologists, and biostatisticians. SETTING: The emergency department and in-patient trauma service of an urban level one pediatric trauma center between October 1995 and September 1997. PARTICIPANTS: Patients under 18 years of age who were treated for serious bicycle-related injuries (Abbreviated Injury Scale scores of 2 or greater). RESULTS: The surveillance system identified two distinct circumstances for serious child bicyclist injury: 1) handlebar-related injuries associated with minor incidents (falls from bicycles) and 2) nonhandlebar-related injuries associated with severe incidents (bicycle-motor vehicle crashes). Crash investigations explored the minor incidents that resulted in serious handlebar-associated injuries. In the typical mechanism, as the child lost control of the bicycle and began to fall, the front wheel rotated into a plane perpendicular to the child's body. The child then landed on the end of the handlebar resulting in serious truncal injuries. CONCLUSIONS: A discordancy exists between the apparently minor circumstances and serious injuries sustained by child bicyclists who impact bicycle handlebars. Recognition of the mechanism of handlebar-related injuries might aid the practitioner in early diagnosis of serious abdominal injuries in child bicyclists. This injury mechanism may be avoided through bicycle redesign that would involve both limiting rotation of the front wheel and modifying the ends of handlebars. An integrated approach involving a surveillance system to identify an injury hazard supplemented by in-depth, on-site crash investigations effectively provided the detailed mechanism of injury needed to develop interventions.

Winston FK; Shaw KN; Kreshak AA; Schwarz DF; Gallagher PR; Cnaan A

1998-09-01

300

Using trauma center data to identify missed bicycle injuries and their associated costs.  

UK PubMed Central (United Kingdom)

BACKGROUND: Recently, there has been a 58% increase in the number of observed cyclists in San Francisco. In 2009, 3.2% of commuters were traveling by bicycle in this city, which is well above the national average of less than 1%. Police reports are the industry standard for assessing transportation-related collisions and informing policies and interventions that address the issue. Previous studies have suggested that police reports miss a substantial portion of bicycle crashes not involving motor vehicles. No study to date has explored the health and economic impact of cyclist-only (CO) injuries for adults in the United States. Our objective was to use trauma registry data to investigate possible underrepresentation of certain cyclist injuries and characterize cost. METHODS: We reviewed hospital and police records for 2,504 patients treated for bicycle-related injuries at San Francisco General Hospital (SFGH). We compared incidence, injury severity, admission rate, and cost of injury for CO and auto-versus-bicycle (AVB) injuries treated at SFGH. We then calculated the cost of injury. RESULTS: Of all bicycle-related injuries at SFGH, 41.5% were CO injuries and 58.5% were AVB injuries. Those with CO injuries were more than four times as likely to be required of hospital admission compared with those with AVB injuries (odds ratio, 4.76; 95% confidence interval, 3.93-5.76; p < 0.0001). From 2000 to 2009, 54.5% of bicycle injuries treated at SFGH were not associated with a police report, revealing that bicycle crashes and injuries are underrecognized in San Francisco. Costs for care were significantly higher for AVB injuries and increased dramatically over time; total cost for CO and AVB injuries were $12.6 and $17.8 million. CONCLUSION: Based on this study, we conclude that trauma centers can play a key role in future collaborations to define issues and develop prevention strategies for CO crashes. LEVEL OF EVIDENCE: Epidemiologic study, level II.

Lopez DS; Sunjaya DB; Chan S; Dobbins S; Dicker RA

2012-12-01

 
 
 
 
301

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

International Nuclear Information System (INIS)

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

1979-01-01

302

Spectrum of injuries associated with paediatric ACL tears: an MRI pictorial review.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Magnetic resonance imaging (MRI) findings in anterior cruciate ligament (ACL) injury are well known, but most published reviews show obvious examples of associated injuries and give little focus to paediatric patients. Here, we demonstrate the spectrum of MRI appearances at common sites of associated injury in adolescents with ACL tears, emphasising age-specific issues. METHODS: Pictorial review using images from children with surgically confirmed ACL tears after athletic injury. RESULTS: ACL injury usually occurs with axial rotation in the valgus near full extension. The MRI findings can be obvious and important to management (ACL rupture), subtle but clinically important (lateral meniscus posterior attachment avulsion), obvious and unimportant to management (femoral condyle impaction injury), or subtle and possibly important (medial meniscocapsular junction tear). Paediatric-specific issues of note include tibial spine avulsion, normal difficulty visualising a thin ACL and posterolateral corner structures, and differentiation between incompletely closed physis and impaction fracture. CONCLUSION: ACL tear is only the most obvious sign of a complex injury involving multiple structures. Awareness of the spectrum of secondary findings illustrated here and the features distinguishing them from normal variation can aid in accurate assessment of ACL tears and related injuries, enabling effective treatment planning and assessment of prognosis. TEACHING POINTS: • The ACL in children normally appears thin or attenuated, while thickening and oedema suggest tear. • Displaced medial meniscal tears are significantly more common later post-injury than immediately. • The meniscofemoral ligaments merge with the posterior lateral meniscus, complicating tear assessment. • Tibial plateau impaction fractures can be difficult to distinguish from a partially closed physis. • Axial MR sequences are more sensitive/specific than coronal for diagnosis of medial collateral ligament (MCL) injury.

Jaremko JL; Guenther ZD; Jans LB; Macmahon PJ

2013-06-01

303

[Quality indicators in an intensive care unit: a two-year healthcare-associated infection surveillance program].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To estimate quality healthcare indicators in an intensive care unit (ICU). METHODS: A prospective observational study was conducted on all patients referred to the medical ICU of Ramón y Cajal hospital (Madrid) for more than 48 hours, from January 1 2008 to December 31 2009. RESULTS: A total of 503 patients were included, of whom 7.4% developed a healthcare-associated infection (HAI) attributable to their stay in the ICU. The median length of stay was 5 days. A ventilator-associated pneumonia (VAP) was observed in 1.9% of patients, with a VAP rate of 3.8 per 1,000 ventilator-days. A catheter-associated urinary tract infection (CAUTI) was found in 3.6% of the patients, with a CAUTI rate of 4.5 per 1,000 catheter-days. The cumulative incidence of central line-associated bloodstream infection (CLABSI) was 1.8%, with a CLABSI rate of 2.2 per 1,000 central line-days. CONCLUSIONS: Our results are similar to those of other studies using the same methodology. An HAI surveillance system is a key factor for implementing a healthcare quality improvement system. The obtained indicators allow intra-comparison over time and with other similar hospitals, the monitoring of infection control measures, and thus an effective improvement in healthcare quality and patient safety.

Pita MJ; Díaz-Agero C; Robustillo A; Prieto I; Gómez P; Monge V

2012-03-01

304

Illness and injury in athletes during the competition period at the London 2012 Paralympic Games: development and implementation of a web-based surveillance system (WEB-IISS) for team medical staff.  

UK PubMed Central (United Kingdom)

BACKGROUND: In this study we describe (1) the implementation of a novel web-based injury and illness surveillance system (WEB-IISS) for use by a team of physicians at multisport events and (2) the incidence and characteristics of injuries and illness in athletes during the London 2012 Paralympic Games. METHODS: Overall, 3565 athletes from 160 of the 164 participating countries were followed daily over a 14-day period, consisting of a precompetition period (3 days), and a competition period (11 days) (49 910 athlete-days). Daily injury and illness data were obtained from teams with their own medical support (78 teams, 3329 athletes) via the WEB-IISS, and without their own medical support through the London Organising Committee of the Olympic Games and Paralympic Games database (82 teams and 236 athletes). RESULTS: There were no differences between incidence rates (IR) of injury and illness, or between the precompetition and competition periods. The IR of injury during the competition period was 12.1/1000 athlete-days, with an incidence proportion (IP) of 11.6% (95% CI 11.0% to 13.3%). Upper limb injuries (35%), particularly of the shoulder (17%) were most common. The IR of illness during the competition period was 12.8/1000 athlete-days (95% CI 12.18 to 1421), with an IP of 10.2%. The IP was highest in the respiratory system (27.4%), skin (18.3%) and the gastrointestinal (14.5%) systems. CONCLUSIONS: During the competition period, the IR and IP of illness and injury at the Games were similar and comparable to the observed rates in other elite competitions. In Paralympic athletes, the IP of upper limb injuries is higher than that of lower limb injuries and non-respiratory illnesses are more common.

Derman W; Schwellnus M; Jordaan E; Blauwet CA; Emery C; Pit-Grosheide P; Marques NA; Martinez-Ferrer O; Stomphorst J; Van de Vliet P; Webborn N; Willick SE

2013-05-01

305

Prevalence and factors associated with percutaneous injuries and splash exposures among health-care workers in a provincial hospital, Kenya, 2010.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Accidental occupational exposure of healthcare workers to blood and body fluids after skin injury or mucous membrane contact constitutes a risk for transmission of blood-borne pathogens. Such pathogens include Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV). We conducted a study to determine the prevalence and associated factors for percutaneous injuries and splash exposures among health-care workers in Rift Valley provincial hospital. METHODS: A cross-sectional study was carried out from October to November 2010. Self reported incidents, circumstances surrounding occupational exposure and post-exposure management were sought by use of interviewer administered questionnaire. Descriptive, bivariate and multiple logistic regression (forward stepwise procedure) analyses were performed. The level of significance was set at 0.05. RESULTS: Twenty five percent of health-care workers interviewed (N=305) reported having been exposed to blood and body fluids in the preceding 12 months. Percutaneous injuries were reported by 19% (n=305) and splash to mucous membrane by 7.2%. Higher rates of percutaneous injuries were observed among nurses (50%), during stitching (30%), and in obstetric and gynecologic department (22%). Health workers aged below 40 years were more likely to experience percutaneous injuries (OR=3.7; 95% CI=1.08-9.13) while previous training in infection prevention was protective (OR=0.52; 95% CI=0.03-0.90). Forty eight percent (n=83) reported the incidents with 20% (n=83) taking PEP against HIV. CONCLUSION: Percutaneous injuries and splashes are common in Rift Valley Provincial hospital. Preventive measures remain inadequate. Health institutions should have policies, institute surveillance for occupational risks and enhance training of health care workers.

Mbaisi EM; Ng'ang'a Z; Wanzala P; Omolo J

2013-01-01

306

Risk of injury associated with body checking among youth ice hockey players.  

UK PubMed Central (United Kingdom)

CONTEXT: Ice hockey has one of the highest sport participation and injury rates in youth in Canada. Body checking is the predominant mechanism of injury in leagues in which it is permitted. OBJECTIVE: To determine if risk of injury and concussion differ for Pee Wee (ages 11-12 years) ice hockey players in a league in which body checking is permitted (Alberta, Canada) vs a league in which body checking is not permitted (Quebec, Canada). DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study conducted in Alberta and Quebec during the 2007-2008 Pee Wee ice hockey season. Participants (N = 2154) were players from teams in the top 60% of divisions of play. MAIN OUTCOME MEASURES: Incidence rate ratios adjusted for cluster based on Poisson regression for game- and practice-related injury and concussion. RESULTS: Seventy-four Pee Wee teams from Alberta (n = 1108 players) and 76 Pee Wee teams from Quebec (n = 1046 players) completed the study. In total, there were 241 injuries (78 concussions) reported in Alberta (85 077 exposure-hours) and 91 injuries (23 concussions) reported in Quebec (82 099 exposure-hours). For game-related injuries, the Alberta vs Quebec incidence rate ratio was 3.26 (95% confidence interval [CI], 2.31-4.60 [n = 209 and n = 70 for Alberta and Quebec, respectively]) for all injuries, 3.88 (95% CI, 1.91-7.89 [n = 73 and n = 20]) for concussion, 3.30 (95% CI, 1.77-6.17 [n = 51 and n = 16]) for severe injury (time loss, >7 days), and 3.61 (95% CI, 1.16-11.23 [n=14 and n=4]) for severe concussion (time loss, >10 days). The estimated absolute risk reduction (injuries per 1000 player-hours) that would be achieved if body checking were not permitted in Alberta was 2.84 (95% CI, 2.18-3.49) for all game-related injuries, 0.72 (95% CI, 0.40-1.04) for severe injuries, 1.08 (95% CI, 0.70-1.46) for concussion, and 0.20 (95% CI, 0.04-0.37) for severe concussion. There was no difference between provinces for practice-related injuries. CONCLUSION: Among 11- to 12-year-old ice hockey players, playing in a league in which body checking is permitted compared with playing in a league in which body checking is not permitted was associated with a 3-fold increased risk of all game-related injuries and the categories of concussion, severe injury, and severe concussion.

Emery CA; Kang J; Shrier I; Goulet C; Hagel BE; Benson BW; Nettel-Aguirre A; McAllister JR; Hamilton GM; Meeuwisse WH

2010-06-01

307

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

Directory of Open Access Journals (Sweden)

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

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

2006-01-01

308

Survival of patients with BRCA1-associated breast cancer diagnosed in an MRI-based surveillance program.  

UK PubMed Central (United Kingdom)

We report the 5- and 10-year survival rate of women diagnosed with breast cancer in the context of an annual MRI-based surveillance program. In 2001, as part of a national initiative, women in Norway with a BRCA1 mutation were offered annual screening with breast MRI in addition to mammography. 802 women with a BRCA1 mutation were screened one or more times and followed for a mean of 4.2 years. As of December 2011, 68 of 802 women in the screening program were diagnosed with DCIS or invasive breast cancer (8.5 %), including eight prevalent, 50 incident screen-detected and eight interval cancers. Two latent cancers were detected at prophylactic mastectomy. Sixty-three of the cancers were invasive and five were in situ. The mean tumour size was 1.4 cm (range 0.2-4.5 cm), and 85 % of the patients were node-negative. Ten of the 68 patients died of cancer in the follow-up period. The 5-year breast cancer-specific survival for women with cancer was 75 % (95 % CI 56-86 %) and the 10-year survival was 69 % (95 % CI: 48-83 %). The 5-year survival for women with Stage 1 breast cancer was 82 % compared to 98 % in the population. The 5- and 10-year survival of women with a BRCA1-associated breast cancer detected in a national MRI-based screening program in BRCA1 mutation carriers Norway was less than anticipated. The benefit of annual MRI surveillance on reducing breast cancer mortality in BRCA1 mutation carriers remains to be proven.

Møller P; Stormorken A; Jonsrud C; Holmen MM; Hagen AI; Clark N; Vabø A; Sun P; Narod SA; Mæhle L

2013-05-01

309

MR imaging of associated brain injuries in cases of acute extradural hematoma  

International Nuclear Information System (INIS)

To assess the efficacy of magnetic resonance (MR) imaging for detection of associated brain injuries in cases of extradural hematoma (EDH), 32 patients with EDH were examined by MR. CT detected associated lesion in eleven patients (34%), while MR detected them in 24 patients (75%). MR is more sensitive than CT in detecting associated lesions, especially when T2-weighted imaging is used. Non-hemorrhagic contusions adjacent to EDH and near the cranial base were well shown by MR; however, they tended to be missed by CT. EEG findings were clearly related to abnormalities detected by MR. Coupling between functional change and organic change was confirmed. The improved detection and anatomic localization of associated brain injuries by MR should allow more accurate assessment of brain injuries, and sophisticated management of EDH patient. The authors also discuss the cardiorespiratory monitoring and support during MRI examination in critically ill patients. (author).

1993-01-01

310

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.

1983-01-01

311

Needlestick injuries among nursing staff: association with shift-level staffing.  

UK PubMed Central (United Kingdom)

BACKGROUND: Despite the advent of safety measures to protect the health care workforce from contracting blood-borne diseases, nurses still sustain percutaneous injuries. We investigated the association between shift-level staffing and needlestick injuries. METHODS: Shift-level staffing, patient occupancy, and acuity data were collected between 2003 and 2006 for the Military Nursing Outcomes Database (MilNOD), a multisite project that examined nurse staffing and adverse patient and nurse events. Data on needlestick injuries were obtained from occupational health/risk management reports and merged with MilNOD specific shift data. Hierarchical logistic regression, with Bayesian modeling, was used to analyze shift-level staffing, patient acuity, and workload as associated with needlestick injuries among nursing staff. RESULTS: Of 108,000 shifts, 80 (<0.1%) had at least one needlestick injury occurrence, with 62 (78%) involving a contaminated needle. There was no difference in rate by unit type. Factors associated with needlestick occurrences on shifts were lower RN skill mix, a lower percentage of experienced staff, and fewer nursing care hours per patient per shift. CONCLUSION: Needlestick injuries continue to occur. An organizational culture of safety should emphasize the need for adequate staffing on every shift and extra vigilance during periods of high workload.

Patrician PA; Pryor E; Fridman M; Loan L

2011-08-01

312

Incidences, types, and influencing factors of snow disaster-associated injuries in Ningbo, China, 2008.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The incidence, types, and influencing factors of injuries due to snow-ice disasters are essential for public health preparedness. This study was designed to assess such factors of injuries during the 22-day snowstorm in Ningbo, Zhejiang Province, China, in 2008. METHODS: A multistage cluster probability sampling method was applied to select the study population in urban, rural, and mountainous areas. Data including sociodemographic characteristics, frequency, and types of injuries during the snowstorm between January 20 and February 10, 2008, were obtained by face-to-face interviews using a structured questionnaire and by checking the participants' medical records. Univariate and multivariate regression analyses were used to determine the factors significantly associated with the risk of injuries. RESULTS: A total of 3169 residents of 1416 families took part in this survey. In 581 residents, 602 injuries were identified. Incidences of frostbite, falling injury, and traffic accident-related injury were 12.78%, 5.30%, and 0.50%, respectively. Injury occurred more frequently in women than in men (odds ratio [OR], 1.42; 95% CI, 1.19-1.70). Frostbite occurred more frequently in women than in men (adjusted OR, 1.86; 95% CI, 1.43-2.41) and more frequently in urban areas than in other areas (adjusted OR, 1.65; 95% CI, 1.24-2.20). Travel by bus or car, wearing a scarf, wearing gloves, wearing a raincoat, reducing outdoor activity, and performing regular physical exercise were independent protective factors of frostbite, with an adjusted OR (95% CI) of 0.35 (0.20-0.61), 0.45 (0.33-0.62), 0.35 (0.26-0.48), 0.45 (0.33-0.61), 0.36 (0.27-0.48), and 0.18 (0.13-0.24), respectively. Falling injury occurred more often in mountainous areas than in other areas (adjusted OR, 1.74; 95% CI, 1.27-2.42). Age 45 years or older, working outside more than 15 days, and wearing a raincoat were independent risk factors of falling injury, with an adjusted OR (95% CI) of 2.30 (1.60-3.32), 1.92 (1.36-2.72), and 2.21 (1.56-3.11), respectively. Falling and traffic accident-related injuries were mainly due to slippery roads. CONCLUSIONS: Frostbite and falling injury were the major injuries caused by an unprecedented snow-ice disaster. Keeping warm and maintaining regular physical exercise appeared to reduce frostbite risk. Public health intervention also reduced the risk of falling and traffic accident-related injuries.

Xu G; Ying Y; Liu Y; Chang W; Ni H; Zhu Y; Xu R; Dong H; Shi N; Ma X; Xu L; Cai Y; Ping J; Han Y; Cao G

2012-12-01

313

Repetitive and self-injurious behaviors: associations with caudate volume in autism and fragile X syndrome.  

UK PubMed Central (United Kingdom)

BACKGROUND: Following from previous work suggesting that neurobehavioral features distinguish fragile X and idiopathic variants of autism, we investigated the relationships between four forms of repetitive behavior (stereotypy, self-injury, compulsivity, ritual behavior) and caudate nuclei volume in two groups: boys with fragile X syndrome, a subset of whom met criteria for autism, and a comparison group of boys with idiopathic autism. METHODS: Bilateral caudate nuclei volumes were measured in boys aged 3 to 6 years with fragile X syndrome (n = 41), the subset of boys with fragile X syndrome and autism (n = 16), and boys with idiopathic autism (n = 30). Repetitive behaviors were measured using the Repetitive Behavior Scales-Revised. RESULTS: For boys with idiopathic autism, left caudate volume was modestly associated with self-injury, while both compulsive and ritual behaviors showed significant positive correlations with bilateral caudate nuclei volumes, replicating previous results. For boys with fragile X syndrome, there was no such association between caudate volume and compulsive behaviors. However, we did identify significant positive correlations between self-injury total scores and number of self-injury topographies with bilateral caudate nuclei volumes. CONCLUSIONS: These findings suggest a specific role for the caudate nucleus in the early pathogenesis of self-injurious behavior associated with both idiopathic autism and fragile X syndrome. Results further indicate that the caudate may be differentially associated with compulsive behavior, highlighting the utility of isolating discrete brain-behavior associations within and between subtypes of autism spectrum disorder.

Wolff JJ; Hazlett HC; Lightbody AA; Reiss AL; Piven J

2013-01-01

314

Renal inflammatory changes in acute hepatic failure-associated acute kidney injury.  

UK PubMed Central (United Kingdom)

BACKGROUND/AIMS: Acute kidney injury (AKI) is a common complication in advanced liver dysfunction. Our aim is to clarify the mechanisms of acute hepatic failure (AHF)-associated AKI. METHODS: We examined the mechanisms of AHF-associated AKI, which is characterized by AKI in AHF and hyperbilirubinemia, following DA-to-Lewis rat liver transplantation. RESULTS: During the progression of AHF and hyperbilirubinemia in liver graft rejection, AHF-associated AKI gradually developed by day 11. Degeneration and apoptotic cells were apparent in tubular epithelial cells with bile pigment accumulation and mitochondrial degeneration. Injury of peritubular capillaries (PTCs) was also noted with apoptotic endothelial cells, decreased expression of endothelial nitric oxide synthase, accumulation of ?-smooth muscle actin+ pericytes and/or myofibroblasts, and inflammation. Angiogenic factors including vascular endothelial growth factor, angiopoietin-1, and angiopoietin-2 in the cortex were decreased on day 11. In addition, a marked reduction in the velocity of red blood cells in PTCs was evident in vivo. CONCLUSIONS: AHF-associated AKI seems to be mediated by renal tubular epithelial cell injury with bile pigment accumulation, impaired microcirculation caused by PTC endothelial cell injury with depletion of endothelial nitric oxide synthase and angiogenic factors, and by a decrease in RBC velocity and renal inflammation. Multiple mechanisms including tubular and PTC injuries and renal inflammation may be involved in the development of AHF-associated AKI.

Shimizu A; Ishii E; Masuda Y; Sato A; Piao H; Kunugi S; Takahashi M; Terasaki M; Nagasaka S; Terasaki Y; Ohashi R; Morioka T; Fukuda Y

2013-01-01

315

The Role of Particulate Matter-Associated Zinc in Cardiac Injury in Rats  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: Exposure to particulate matter (PM) has been associated with increased cardiovascular morbidity; however, causative components are unknown. Zinc is a major element detected at high levels in urban air.Objective We investigated the role of PM-associated zinc in cardiac injury. Methods: We...

Kodavanti, Urmila P.; Schladweiler, Mette C.; Gilmour, Peter S.; Wallenborn, J. Grace; Mandavilli, Bhaskar S.

316

The Etiology, Associated Injuries and Clinical Presentation of Post Traumatic Diaphragmatic Hernia  

Directory of Open Access Journals (Sweden)

Full Text Available Objectives: The aim of this study was to evaluate the etiology, associated injurers and clinical presentation of post traumatic diaphragmatic hernia.Methods: This study was a cross-sectional study being conducted in the department of Cardiovascular, thoracic surgery (CVTS) and Pediatric Surgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Kashmir, India. All patients of post traumatic diaphragmatic hernia who were admitted in the department of CVTS and Pediatric Surgery, SKIMS, during the course of study (May 2009 to Nov. 2011) were included.Results: From the commencement of the study 21 patients had traumatic diaphragmatic hernia. Most common presenting symptoms in traumatic diaphragmatic hernia were, chest discomfort and pain abdomen presented in 81% of patients, followed by breathlessness in 61.9% and vomiting in 47.6%. Common associated injuries in traumatic diaphragmatic hernia in our study group were, rib fracture in 47.6%, splenic injury in 28.6%, head injury in 23.8%, soft tissue injury in 23.8%, gut perforation in 19%, limb fracture in 14.3%, liver injury in 9.5%, pancreatic injury in 4.8% and renal injury in 4.8%.Conclusion: Usually the patients of Post traumatic diaphragmatic hernia presents as emergency, early recognition and prompt surgical treatment is needed for better outcome. The Incidence of post traumatic diaphragmatic hernia when associated with blunt trauma abdomen and chest is very high (81%). A high level of suspicion is needed in these injuries. The 9.5% of traumatic diaphragmatic hernia may have delayed presentation. Early diagnosis of traumatic diaphragmatic hernia is most difficult when herniation is delayed.

Farooq Ahmad Gaine; Ghulam Nabi Lone; Mushtaq Ahmad Chowdhary; Hafeezula Lone

2013-01-01

317

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish OBJETIVO: Determinar la frecuencia y naturaleza de las lesiones infantiles y explorar sus factores de riesgo en países de bajos ingresos, utilizando para ello los datos de vigilancia de los departamentos de urgencias (DU). MÉTODOS: Este estudio piloto representa la fase inicial de un proyecto plurinacional de vigilancia mundial de las lesiones infantiles no intencionales y se basó en una muestra secuencial de menores de 11 años, de ambos sexos, que se presentaron en 2 (more) 007 en DU seleccionados de Bangladesh, Colombia, Egipto y Pakistán a lo largo de un periodo de 3 a 4 meses, variable según el centro. RESULTADOS: De 1559 niños lesionados observados en todos los centros, 1010 (65%) eran varones; 941 (60%) tenían³ 5 años, y 32 (2%) Abstract in english OBJECTIVE: To determine the frequency and nature of childhood injuries and to explore the risk factors for such injuries in low-income countries by using emergency department (ED) surveillance data. METHODS: This pilot study represents the initial phase of a multi-country global childhood unintentional injury surveillance (GCUIS) project and was based on a sequential sample of children (more) a, Egypt and Pakistan over a 3-4 month period, which varied for each site, in 2007. FINDINGS: Of 1559 injured children across all sites, 1010 (65%) were male; 941 (60%) were aged > 5 years, 32 (2%) were

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

2009-05-01

318

Association of age-dependent liver injury and fibrosis with immune cell populations.  

UK PubMed Central (United Kingdom)

BACKGROUND & AIMS: The liver's response to injury is fibrosis, and when chronic, cirrhosis. Age is a critical factor impacting many immune-mediated processes, potentially including the liver's wounding response to injury. METHODS: The effects of age on acute and chronic liver injury were evaluated using a carbon tetrachloride model in mice. Lymphocyte and macrophage populations were assessed by flow cytometry and immunohistochemical analysis. RESULTS: Acute liver injury was greater in 18-month-old (old) mice than in 9-month-old (middle-aged) mice as judged by changes in aminotransferases. Similarly, livers of 18-month-old mice had a significantly greater fibrogenic response to injury than did livers of 9-month-old mice after chronic injury (assessed by col1?1 mRNA expression, morphometric analysis and hydroxyproline measurement). Interestingly, livers from young mice (6 weeks old) also exhibited an increase in fibrogenesis compared to 9-month-old mice, albeit not to the same degree as in old mice. Consistent with a role for macrophages in fibrogenesis, the number of liver macrophages in young and 9-month-old mice increased, while in chronically injured livers of 18-month-old mice, the number of macrophages was reduced, and was less than in the livers of young and 9-month-old injured livers. CONCLUSIONS: Our data indicate that the fibrogenic response to injury varies substantially with age, and moreover that macrophage recruitment and dynamics may be an important component in differential age-associated fibrotic disease.

Collins BH; Holzknecht ZE; Lynn KA; Sempowski GD; Smith CC; Liu S; Parker W; Rockey DC

2013-09-01

319

Neural injuries associated with supracondylar fractures of the humerus in children.  

UK PubMed Central (United Kingdom)

A retrospective review of displaced extension-type supracondylar fractures of the humerus in 101 children who were seen consecutively revealed eighteen associated neural injuries in thirteen children. Nine of the neural injuries in eight patients spontaneously resolved at a mean of 2.5 months (range, 1.5 to five months) after injury. The remaining nine lesions in five patients were explored at a mean of 7.5 months (range, five to fourteen months) after injury, because clinical and electromyographic studies showed no return of function. Neurolysis was performed on eight of the nerves that were explored (in five patients), and the remaining radial nerve was found to be completely lacerated and needed nerve-grafting. The length of follow-up after neurolysis averaged twenty-five months (range, thirteen to forty-four months). All five patients had functional recovery, as documented by range-of-motion, grip-strength and lateral pinch-strength, and von Frey and two-point-discrimination sensory testing. The patient who had had nerve-grafting never recovered neural function, and tendon transfers were needed. We concluded that observation and supportive therapy is the preferred initial approach for children who have a neural injury associated with a closed, displaced supracondylar fracture of the humerus. However, if there is no clinical or electromyographic evidence of return of neural function at five months after injury, exploration and neurolysis should be performed. If the nerve is in continuity, the prognosis after neurolysis is excellent.

Culp RW; Osterman AL; Davidson RS; Skirven T; Bora FW Jr

1990-09-01

320

Acute cervical cord injury associated with ossification of the posterior longitudinal ligament.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Patients with ossification of the posterior longitudinal ligament (OPLL) sometimes present with acute spinal cord injury caused by only minor trauma. In the present study, we reviewed our experience of acute cervical cord injury associated with OPLL to understand the pathomechanisms and to provide clinical information for management of this disorder. METHODS: Twenty-eight patients were retrospectively analyzed. There were 26 men and 2 women, aged 45 to 78 years (mean, 63.0 yr). Most patients experienced incomplete spinal cord injury (Frankel Grade A, 3; B, 1; C, 15; and D, 9). RESULTS: Radiological studies revealed continuous- or mixed-type OPLL in 14 patients and segmental-type OPLL in 14 patients. The sagittal diameter of the spinal canal was reduced to 4.1 to 10 mm at the narrowest level as a result of OPLL. Developmental size of the spinal canal was significantly smaller in the group with segmental OPLL. Magnetic resonance imaging scans revealed that spinal cord injury occurred predominantly at the caudal edge of continuous-type OPLL or at the disc levels. Surgery was performed in 24 patients either by posterior (18 patients) or anterior (6 patients) decompression at various time intervals after the trauma. Twenty patients (71%) displayed improvement in Frankel grade. CONCLUSION: The present study demonstrates the preexisting factors and pathomechanisms of acute spinal cord injury associated with cervical OPLL. Magnetic resonance imaging is useful to understand the level and mechanism of injury. Further investigation will be needed to elucidate the role of surgical decompression.

Koyanagi I; Iwasaki Y; Hida K; Imamura H; Fujimoto S; Akino M

2003-10-01

 
 
 
 
321

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

Science.gov (United States)

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

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

2013-01-10

322

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

UK PubMed Central (United Kingdom)

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 A; Kosuta I; Skrtic A; Kanizaj TF; Vrhovac R

2013-01-01

323

Risk of acute kidney injury associated with the use of fluoroquinolones.  

UK PubMed Central (United Kingdom)

BACKGROUND: Case reports indicate that the use of fluoroquinolones may lead to acute kidney injury. We studied the association between the use of oral fluoroquinolones and acute kidney injury, and we examined interaction with renin-angiotensin-system blockers. METHODS: We formed a nested cohort of men aged 40-85 enrolled in the United States IMS LifeLink Health Plan Claims Database between 2001 and 2011. We defined cases as men admitted to hospital for acute kidney injury, and controls were admitted to hospital with a different presenting diagnosis. Using risk-set sampling, we matched 10 controls to each case based on hospital admission, calendar time (within 6 wk), cohort entrance (within 6 wk) and age (within 5 yr). We used conditional logistic regression to assess the rate ratio (RR) for acute kidney injury with current, recent and past use of fluoroquinolones, adjusted by potential confounding variables. We repeated this analysis with amoxicillin and azithromycin as controls. We used a case-time-control design for our secondary analysis. RESULTS: We identified 1292 cases and 12 651 matched controls. Current fluoroquinolone use had a 2.18-fold (95% confidence interval [CI] 1.74-2.73) higher adjusted RR of acute kidney injury compared with no use. There was no association between acute kidney injury and recent (adjusted RR 0.87, 95% CI 0.66-1.16) or past (RR 0.86, 95% CI 0.66-1.12) use. The absolute increase in acute kidney injury was 6.5 events per 10 000 person-years. We observed 1 additional case per 1529 patients given fluoroquinolones or per 3287 prescriptions dispensed. The dual use of fluoroquinolones and renin-angiotensin-system blockers had an RR of 4.46 (95% CI 2.84-6.99) for acute kidney injury. Our case-time-control analysis confirmed an increased risk of acute kidney injury with fluoroquinolone use (RR 2.16, 95% CI 1.52-3.18). The use of amoxicillin or azithromycin was not associated with acute kidney injury. INTERPRETATION: We found a small, but significant, increased risk of acute kidney injury among men with the use of oral fluoroquinolones, as well as a significant interaction between the concomitant use of fluoroquinolones and renin-angiotensin-system blockers.

Bird ST; Etminan M; Brophy JM; Hartzema AG; Delaney JA

2013-07-01

324

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.

1994-01-01

325

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

326

Management of ureteral injuries associated with vaginal surgery for pelvic organ prolapse.  

Science.gov (United States)

Due to the anatomic proximity of the urinary and genital tracts, iatrogenic ureteral injury during pelvic organ prolapse repairs is a serious complication that we have managed in increasing number at our institution. However, few centers have reported on their experience with ureteric injuries associated with gynecologic reconstructive surgery. These ureteral injuries may lead to much morbidity, in particular the formation of ureterovaginal fistula, and the potential loss of renal function especially when diagnosed postoperatively. It is necessary, therefore, for surgeons to have a thorough knowledge of ureteral anatomy and to take precautions to prevent such injuries. The purpose of this article is to review this pertinent anatomy and the key principles of management of ureteric complications of transvaginal surgery for pelvic organ prolapse. The present study illustrates the application of our treatment algorithm based on the time of presentation and the patient condition. PMID:16317499

Kim, Ja-Hong; Moore, Courtenay; Jones, J Stephen; Rackley, Raymond; Daneshgari, Firouz; Goldman, Howard; Vasavada, Sandip

2005-11-30

327

Management of ureteral injuries associated with vaginal surgery for pelvic organ prolapse.  

UK PubMed Central (United Kingdom)

Due to the anatomic proximity of the urinary and genital tracts, iatrogenic ureteral injury during pelvic organ prolapse repairs is a serious complication that we have managed in increasing number at our institution. However, few centers have reported on their experience with ureteric injuries associated with gynecologic reconstructive surgery. These ureteral injuries may lead to much morbidity, in particular the formation of ureterovaginal fistula, and the potential loss of renal function especially when diagnosed postoperatively. It is necessary, therefore, for surgeons to have a thorough knowledge of ureteral anatomy and to take precautions to prevent such injuries. The purpose of this article is to review this pertinent anatomy and the key principles of management of ureteric complications of transvaginal surgery for pelvic organ prolapse. The present study illustrates the application of our treatment algorithm based on the time of presentation and the patient condition.

Kim JH; Moore C; Jones JS; Rackley R; Daneshgari F; Goldman H; Vasavada S

2006-09-01

328

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

Directory of Open Access Journals (Sweden)

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; Kikuchi T; Matsubara N; Asano I; Ogami N

2013-01-01

329

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

UK PubMed Central (United Kingdom)

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.

van den Ban E; Souverein P; Meijer W; van Engeland H; Swaab H; Egberts T; Heerdink E

2013-06-01

330

Factors associated with back pain after physical injury: a survey of consecutive major trauma patients.  

UK PubMed Central (United Kingdom)

STUDY DESIGN: Cross-sectional survey. OBJECTIVE: To measure the association between physical and psychosocial factors, and symptoms of back pain after major physical injury. The study was conducted at a major metropolitan trauma center. SUMMARY OF BACKGROUND DATA: Persistence of back pain has been associated more with psychosocial factors, such as job satisfaction and stress, than with physical factors, such as injury characteristics. Predictors of back pain after major accidental, non-self-inflicted injury have not previously been reported. METHODS: Consecutive adult patients presenting to a single institution with accidental major trauma over a 5-year period were surveyed between 1 and 6 years postinjury (mean, 41 months; range, 12-74 months). Data pertaining to general factors, injury severity, and psychosocial factors were gathered from the hospital trauma registry and the follow-up questionnaire. The main outcome was symptomatic back pain at follow-up derived from the SF-36 bodily pain subscale. Multivariate analysis was performed to determine which factors were independently associated with back pain at follow-up. RESULTS: Back pain after major trauma was not associated with measures of injury severity, such as the Injury Severity Score or the presence of a spinal fracture. Back pain was also not associated with patient-specific factors, such as age, gender, or occupation. Back pain was significantly associated with the presence of posttraumatic stress disorder, the use of a lawyer, the presence of chronic illnesses, and lower education levels. CONCLUSIONS: This study highlights the importance of psychosocial factors as predictors of symptomatic back pain after major physical trauma. The findings do not support physical factors as important contributors to future low back pain.

Harris IA; Young JM; Rae H; Jalaludin BB; Solomon MJ

2007-06-01

331

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

Directory of Open Access Journals (Sweden)

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

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

2011-01-01

332

Facial fractures with concomitant open globe injury: mechanisms and fracture patterns associated with blindness.  

UK PubMed Central (United Kingdom)

BACKGROUND: Treatment of facial fractures in the setting of open-globe injuries poses a management dilemma because of the often disparate treatment priorities of multidisciplinary trauma teams and the lack of prognostic data regarding visual outcomes. METHODS: Patients in the University of Maryland Shock Trauma Registry sustaining facial fractures with concomitant open-globe injuries from January of 1998 to August of 2010 were identified. Odds ratios were calculated to identify demographic and clinical variables associated with blindness, and multivariate regression analysis was performed. RESULTS: A total of 99 patients were identified with 105 open-globe injuries. Seventy-nine percent of injuries were blinding, whereas 4.8 percent of globes achieved a final visual acuity greater than or equal to 20/400. Blindness was associated with penetrating injury, increasing number of facial fractures, zygomaticomaxillary complex fracture, admission Glasgow Coma Scale score less than or equal to 8, and globe injury spanning all three eye zones. Fracture repair was performed more frequently (62.5 percent) and more quickly (average time to fracture repair, 4.5 days) in cases of primary globe enucleation/evisceration when compared with complete (21.2 percent; 8 days; p=0.35) or incomplete (42.9 percent; 11 days; p=0.058) primary globe repair. CONCLUSIONS: Penetrating injury mechanism and zone of eye injury appear to be better indicators of visual prognosis than facial fracture patterns. Given the high rates of blindness, secondary enucleation, and delay of fracture repair in patients that were not primarily enucleated, the authors recommend that orbital fracture repair not be delayed in the hopes of eventual visual recovery in cases of high-velocity projectile trauma. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.

Vaca EE; Mundinger GS; Kelamis JA; Dorafshar AH; Christy MR; Manson PN; Rodriguez ED

2013-06-01

333

Association of the dominant hand and needle stick injuries for Healthcare Workers in Taiwan.  

UK PubMed Central (United Kingdom)

BACKGROUND: Healthcare workers face the risk of acquiring blood-borne infections from patients through needle stick injuries. Understanding the factors that are associated with increased risk, for example, the role of the dominant hand, is important so that preventive measures can be focused. METHODS: The EPINet (Exposure Prevention, Information Network-a trade mark of Virginia University) questionnaire was used to collect the data. The EPInet system started 2003 in Taiwan under C-MESH. When healthcare workers sustain sharp injury, they complete the injury report form, and report to infection control personnel, who then transmitted the data to EPINet website monthly. RESULTS: 93.5% of the healthcare workers reported being right handed and only 6.5% reported being left handed. About two-thirds (65%) of the reported injuries were by self, 30% injuries were by others and 5% were reported as injured by unknown.There was an association between the dominant hand injury and the needle stick original HCW user, p<0.0001. There is a significant difference between the dominant hand and the needlestick original HCW user. HCW whose dominant hand was the right hand were most likely at risk to be injured by "others" than "self" or "unknown HCW"; OR? 18.39; CI (0.42 ± 2.33). CONCLUSION: Needlestick injuries among health care workers in Taiwan continue to pose a serious occupational problem. Historically, prevention has focused on the use of protective wear than assessment of which hand may be at greater risk than the other. There is a greater need to prevent hand injuries as the dominant hand remains the most used and injured in process of patient care.

Mbirimtengerenji N; Schaio J; Guo L; Muula A

2012-09-01

334

Association of asthma therapy and Churg-Strauss syndrome: an analysis of postmarketing surveillance data.  

UK PubMed Central (United Kingdom)

BACKGROUND: Churg-Strauss syndrome (CSS), also known as allergic granulomatous angiitis (AGA), is a rare vasculitis that occurs in patients with bronchial asthma. The nature of the association of CSS with various asthma therapies is unclear. OBJECTIVE: This study investigated the associations of different multidrug asthma therapy regimens and the reporting of AGA (the preferred code for CSS in the coding dictionary for the Adverse Event Reporting System [AERS]) by applying an iterative method of disproportionally analysis to th AERS database maintained by the US Food and Drug Administration. METHODS: The public-release version of the AERS database was used to identify reports of AGA in patients receiving asthma therapy. Reporting of AGA was examined using iterative disproportionality methods in patients receiving > or =1 of the following drug classes: inhaled corticosteroid (ICS), leukotriene receptor antagonist (LTRA), short-acting beta(2)-agonist (SABA), or long-acting beta(2)-agonist (LABA). The Bayesian data-mining algorithm known as the multi-item gamma poisson shrinker was used to determine the relative reporting rates by calculation of the empirical Bayes geometric mean (EBGM) and its 90% CI (EB05 = lower limit and EB95 = upper limit) for each drug. Subset analyses were performed for each drug with different medication combinations to differentiate the relative reporting of AGA for each. RESULTS: A strong association was found between LTRA use and AGA (EBGM = 104.0, EB05 = 95.0, EB95 = 113.8) that persisted with all combinations of therapy studied. AGA was also associated with the ICS, SABA and LABA classes (EBGM values of 27.8, 14.6 and 40.4, respectively). However, the latter associations were mostly dependent on the presence of concurrent LTRA and, to a lesser extemt, oral corticosteroid therapy and became negligible (ie, EB05 < 2) for patients who were not receiving these concurrent treatments. CONCLUSIONS: Differences based on relative reporting were observed in the patterns of association of AGA with LTRA, ICS, and beta(2)-agonist therapies. A strong association between LTRA use and AGA was present regardless of the use of other asthma drugs.

DuMouchel W; Smith ET; Beasley R; Nelson H; Yang X; Fram D; Almenoff JS

2004-07-01

335

Dura mater-associated Creutzfeldt-Jakob disease: experience from surveillance in the UK.  

Science.gov (United States)

Between 1970 and 2003, seven cases of human dura mater-associated Creutzfeldt-Jakob disease (CJD) were identified in the UK. Furthermore, we identified a case of CJD in a porcine dura graft recipient. The mean incubation period of the human dura mater cases was 93 (range 45-177) months. The clinico-pathological features of the cases are described and compared with cases previously reported in the world literature. PMID:16627534

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

2006-04-20

336

Popliteal artery injuries associated with fractures and dislocations about the knee.  

UK PubMed Central (United Kingdom)

The authors present the results of a retrospective review of popliteal artery injuries associated with fractures and dislocations about the knee. They treated 41 patients with popliteal artery injuries associated with either fractures about the knee or knee dislocations. Thirty-five of the patients were males, 6 females; the mean age was 23 years. The delay before accessing the hospital was 17 hours (range: 3 hours to 10 days). Thirty-two fractures were open. Together with the vascular injury, 12 femoral fractures, 20 tibial and fibular fractures, 5 knee dislocations, 4 femoral + tibial fractures were identified. Twenty-three patients underwent external fixation, 8 internal fixation, 6 plaster cast immobilization, 4 minimal osteosynthesis and plaster cast immobilization. The arterial injury was treated by end-to-end anastomosis in 5 cases, saphenous vein anastomosis in 29 cases and thrombectomy in 7 cases. Nine patients were amputated. Delay in surgery, blunt trauma, extensive soft tissue defect and bone fracture or dislocation, are associated with high amputation rate following popliteal artery injury. The influence of each of these factors alone on the amputation rate could not be evaluated in this study, as no statistically significant correlation could be demonstrated.

Subasi M; Cakir O; Kesemenli C; Arslan H; Necmioglu S; Eren N

2001-06-01

337

Popliteal artery injuries associated with fractures and dislocations about the knee.  

Science.gov (United States)

The authors present the results of a retrospective review of popliteal artery injuries associated with fractures and dislocations about the knee. They treated 41 patients with popliteal artery injuries associated with either fractures about the knee or knee dislocations. Thirty-five of the patients were males, 6 females; the mean age was 23 years. The delay before accessing the hospital was 17 hours (range: 3 hours to 10 days). Thirty-two fractures were open. Together with the vascular injury, 12 femoral fractures, 20 tibial and fibular fractures, 5 knee dislocations, 4 femoral + tibial fractures were identified. Twenty-three patients underwent external fixation, 8 internal fixation, 6 plaster cast immobilization, 4 minimal osteosynthesis and plaster cast immobilization. The arterial injury was treated by end-to-end anastomosis in 5 cases, saphenous vein anastomosis in 29 cases and thrombectomy in 7 cases. Nine patients were amputated. Delay in surgery, blunt trauma, extensive soft tissue defect and bone fracture or dislocation, are associated with high amputation rate following popliteal artery injury. The influence of each of these factors alone on the amputation rate could not be evaluated in this study, as no statistically significant correlation could be demonstrated. PMID:11486689

Subasi, M; Cakir, O; Kesemenli, C; Arslan, H; Necmioglu, S; Eren, N

2001-06-01

338

Surgical Treatment of Ideberg Type III Glenoid Fractures With Associated Superior Shoulder Suspensory Complex Injury.  

Science.gov (United States)

Ideberg type III glenoid fractures with associated superior shoulder suspensory complex (SSSC) injuries are rare, and related treatments have not been reported in the literature. The purpose of this study was to evaluate the clinical outcomes of such injuries treated with open reduction and internal fixation (ORIF). Between July 2007 and April 2012, ten patients with Ideberg type III glenoid fractures were surgically treated using ORIF with 2 cannulated screws or a screw combined with a metacarpal plate through an anterior approach. Patients with associated SSSC injuries underwent ORIF with K-wires or plates. Information was available for 9 patients with a mean follow-up of 24.1±18.2 months. Mean bone-healing time was 8.4±2.2 weeks. At last follow-up, mean forward flexion of the operative shoulder was 157.8°±7.5°, mean external rotation was 62.9°±7.9°, and mean internal rotation was thoracic level T6±0.8. Mean Constant score was 84.1±3.7 points, which was a mean of 92.7%±3.4% of that seen in the contralateral shoulder. Mean UCLA score and Disabilities of the Arm, Shoulder and Hand score were 33.6±1.7 and 16.6±7.7, respectively. The results show that Ideberg type III glenoid fractures with associated SSSC injuries can be successfully treated using ORIF through an anterior approach. Glenoid fractures and SCCC injuries should be treated simultaneously. PMID:24093698

Qin, Hui; Hu, Chuan-Zhen; Zhang, Xian-Long; Shen, Long-Xiang; Xue, Zi-Chao; An, Zhi-Quan

2013-10-01

339

Race is associated with discontinuation of active surveillance of low-risk prostate cancer: results from the Duke Prostate Center.  

UK PubMed Central (United Kingdom)

BACKGROUND: Active surveillance (AS) is increasingly utilized in low-risk prostate cancer (PC) patients. Although black race has traditionally been associated with adverse PC characteristics, its prognostic value for patients managed with AS is unclear. METHODS: A retrospective review identified 145 patients managed with AS at the Duke Prostate Center from January 2005 to September 2011. Race was patient-reported and categorized as black, white or other. Inclusion criteria included PSA <10 ng ml(-1), Gleason sum ? 6, and ? 33% of cores with cancer on diagnostic biopsy. The primary outcome was discontinuation of AS for treatment due to PC progression. In men who proceeded to treatment after AS, the trigger for treatment, follow-up PSA and biopsy characteristics were analyzed. Time to treatment was analyzed with univariable and multivariable Cox proportional hazards models and also stratified by race. RESULTS: In our AS cohort, 105 (72%) were white, 32 (22%) black and 8 (6%) another race. Median follow-up was 23.0 months, during which 23% percent of men proceeded to treatment. The demographic, clinical and follow-up characteristics did not differ by race. There was a trend toward more uninsured black men (15.6% black, 3.8% white, 0% other, P = 0.06). Black race was associated with treatment (hazard ratio (HR) 2.93, P = 0.01) as compared with white. When the analysis was adjusted for socioeconomic and clinical parameters at the time of PC diagnosis, black race remained the sole predictor of treatment (HR 3.08, P = 0.01). Among men undergoing treatment, the trigger was less often patient driven in black men (8 black, 33 white, 67% other, P = 0.05). CONCLUSIONS: Black race was associated with discontinuation of AS for treatment. This relationship persisted when adjusted for socioeconomic and clinical parameters.

Abern MR; Bassett MR; Tsivian M; Bañez LL; Polascik TJ; Ferrandino MN; Robertson CN; Freedland SJ; Moul JW

2013-03-01

340

Active surveillance cultures of methicillin-resistant Staphylococcus aureus as a tool to predict methicillin-resistant S. aureus ventilator-associated pneumonia.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Ventilator-associated pneumonia is one of the most common infections in the intensive care unit and methicillin-resistant Staphylococcus aureus has emerged as a common cause of ventilator-associated pneumonia. We sought to study the performance characteristics of once weekly active surveillance culture of methicillin-resistant S. aureus colonization in predicting the development of methicillin-resistant S. aureus ventilator-associated pneumonia. DESIGN: Prospective observational study. SETTING: Eighty-nine-bed surgical and medical intensive care units in a university-affiliated urban teaching hospital and level I trauma and burn center. PATIENTS: All patients?16 yrs old admitted to the intensive care unit on mechanical ventilation?48 hrs who met diagnostic criteria for ventilator-associated pneumonia by quantitative lower respiratory tract cultures obtained through bronchoscopic alveolar lavage or brush specimen between January 2008 and October 2010 were included. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Nine hundred twenty-four episodes of suspected ventilator-associated pneumonia were evaluated, and 388 patients with bronchoalveolar lavage-confirmed ventilator-associated pneumonia were included. Surveillance cultures were taken from the nares, oropharynx or trachea, and any open wound routinely on admission to the intensive care unit, every 7 days afterward, and at intensive care unit discharge. Of the 388 patients, 37 (9.5%) had methicillin-resistant S. aureus ventilator-associated pneumonia and 54 (13.9%) had methicillin-resistant S. aureus colonization documented by active surveillance culture before the development of ventilator-associated pneumonia. The sensitivity and specificity of prior methicillin-resistant S. aureus colonization as a predictor for methicillin-resistant S. aureus ventilator-associated pneumonia are 70.3% (95% confidence interval [CI] 52.8-83.6) and 92.0% (95% CI 88.5-94.5), respectively. The positive and negative predictive values are 48.1% (95% CI 34.5- 62.0) and 96.7% (95% CI 94.0-98.3). CONCLUSIONS: In our study, prior methicillin-resistant S. aureus colonization as ascertained by once-weekly active surveillance culture yielded high specificity and negative predictive value, suggesting that negative active surveillance culture can accurately exclude methicillin-resistant S. aureus as an etiology in most patients with ventilator-associated pneumonia and may decrease the need for empirical methicillin-resistant S. aureus coverage in patients with suspected ventilator-associated pneumonia.

Chan JD; Dellit TH; Choudhuri JA; McNamara E; Melius EJ; Evans HL; Cuschieri J; Arbabi S; Lynch JB

2012-05-01

 
 
 
 
341

Factors associated with being lost to follow-up before completing tuberculosis treatment: analysis of surveillance data.  

UK PubMed Central (United Kingdom)

Completion of treatment is key to tuberculosis control. Using national surveillance data we assessed factors associated with tuberculosis patients being lost to follow-up before completing treatment ('lost'). Patients reported in England, Wales and Northern Ireland between 2001 and 2007 who were lost 12 months after beginning treatment were compared to those who completed, or were still on treatment, using univariable and multivariable logistic regression. Of 41 120 patients, men [adjusted odds ratio (aOR) 1·29; 95% confidence interval (CI) 1·23-1·35], 15- to 44-year-olds (P<0·001), and patients with pulmonary sputum smear-positive disease (aOR 1·25, 95% CI 1·12-1·45) were at higher risk of being lost. Those recently arrived in the UK were also at increased risk, particularly those of the White ethnic group (aOR 6·39, 95% CI 4·46-9·14). Finally, lost patients had a higher risk of drug resistance (aOR 1·41, 95% CI 1·17-1·69). Patients at risk of being lost require enhanced case management and novel case retention methods are needed to prevent this group contributing towards onward transmission.

Millett ER; Noel D; Mangtani P; Abubakar I; Kruijshaar ME

2013-06-01

342

Oral bisphosphonate use in the elderly is not associated with acute kidney injury.  

Science.gov (United States)

Intravenous bisphosphonates can cause acute kidney injury; however, this risk was not found with oral bisphosphonates in randomized clinical trials with restrictive eligibility criteria. In order to provide complementary safety data, we studied the risk of acute kidney injury in a population-based cohort of 122,727 patients aged 66 years and older discharged from hospital following a new fragility fracture and no history of bisphosphonate use in the prior year. Bisphosphonate treatment was identified within 120 days after discharge and event rates were measured from 90 days of therapy initiation. The primary outcome was hospitalization with acute kidney injury with secondary outcomes of new nephrology consultation and, in a subset of patients with laboratory values, acute kidney injury was defined as an increase in serum creatinine. We identified 18,286 bisphosphonate users and 104,441 non-users with a mean age of 81 years. Of 5772 patients with laboratory values, 40% had chronic kidney disease (eGFR <60 ml/min per 1.73 m(2)). Overall, there was no statistically significant difference in the risk of acute kidney injury among bisphosphonate users compared to non-users (adjusted odds ratio 1.03), and no significant differences in other outcomes or in subgroups of patients with baseline chronic kidney disease. Thus, in this older population-based cohort, oral bisphosphonate use was not associated with acute kidney injury. PMID:22695327

Shih, Andrew W Y; Weir, Matthew A; Clemens, Kristin K; Yao, Zhan; Gomes, Tara; Mamdani, Muhammad M; Juurlink, David N; Hird, Amanda; Hodsman, Anthony; Parikh, Chirag R; Wald, Ron; Cadarette, Suzanne M; Garg, Amit X

2012-06-13

343

Oral bisphosphonate use in the elderly is not associated with acute kidney injury.  

UK PubMed Central (United Kingdom)

Intravenous bisphosphonates can cause acute kidney injury; however, this risk was not found with oral bisphosphonates in randomized clinical trials with restrictive eligibility criteria. In order to provide complementary safety data, we studied the risk of acute kidney injury in a population-based cohort of 122,727 patients aged 66 years and older discharged from hospital following a new fragility fracture and no history of bisphosphonate use in the prior year. Bisphosphonate treatment was identified within 120 days after discharge and event rates were measured from 90 days of therapy initiation. The primary outcome was hospitalization with acute kidney injury with secondary outcomes of new nephrology consultation and, in a subset of patients with laboratory values, acute kidney injury was defined as an increase in serum creatinine. We identified 18,286 bisphosphonate users and 104,441 non-users with a mean age of 81 years. Of 5772 patients with laboratory values, 40% had chronic kidney disease (eGFR <60 ml/min per 1.73 m(2)). Overall, there was no statistically significant difference in the risk of acute kidney injury among bisphosphonate users compared to non-users (adjusted odds ratio 1.03), and no significant differences in other outcomes or in subgroups of patients with baseline chronic kidney disease. Thus, in this older population-based cohort, oral bisphosphonate use was not associated with acute kidney injury.

Shih AW; Weir MA; Clemens KK; Yao Z; Gomes T; Mamdani MM; Juurlink DN; Hird A; Hodsman A; Parikh CR; Wald R; Cadarette SM; Garg AX

2012-10-01

344

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 (p<0.05) associated with increased propensity for hamstring injury. Odds for sustaining an injury increased x 1.78 for each 1 year increase in age, x 1.47 for each 1cm increase in NCM and x 1.29 for each 1 degrees decrease in active range of hip flexion. Older, more powerful and less flexible soccer 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

2009-10-02

345

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

UK PubMed Central (United Kingdom)

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 (p<0.05) associated with increased propensity for hamstring injury. Odds for sustaining an injury increased x 1.78 for each 1 year increase in age, x 1.47 for each 1cm increase in NCM and x 1.29 for each 1 degrees decrease in active range of hip flexion. Older, more powerful and less flexible soccer 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.

Henderson G; Barnes CA; Portas MD

2010-07-01

346

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

UK PubMed Central (United Kingdom)

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. CONCLUSIONS: 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. © 2013 KUMS, All rights reserved.

Robertson BD; McConnel CE; Green S

2013-01-01

347

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

Directory of Open Access Journals (Sweden)

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.

Brian David Robertson; Charles Edward McConnel; Sally Green

2013-01-01

348

Cycling injuries.  

UK PubMed Central (United Kingdom)

Bicycle-related injuries have increased as cycling has become more popular. Most injuries to recreational riders are associated with overuse or improper fit of the bicycle. Injuries to racers often result from high speeds, which predispose riders to muscle strains, collisions, and falls. Cyclists contact bicycles at the pedals, seat, and handlebars. Each is associated with particular cycling injuries.

Cohen GC

1993-03-01

349

Sub-Regional Hippocampal Injury is Associated with Fornix Degeneration in Alzheimer's Disease.  

UK PubMed Central (United Kingdom)

We examined in vivo evidence of axonal degeneration in association with neuronal pathology in Alzheimer's disease (AD) through analysis of fornix microstructural integrity and measures of hippocampal subfield atrophy. Based on known anatomical topography, we hypothesized that the local thickness of subiculum and CA1 hippocampus fields would be associated with fornix integrity, reflecting an association between AD-related injury to hippocampal neurons and degeneration of associated axon fibers. To test this hypothesis, multi-modal imaging, combining measures of local hippocampal radii with diffusion tensor imaging (DTI), was applied to 44 individuals clinically diagnosed with AD, 44 individuals clinically diagnosed with mild cognitive impairment (MCI), and 96 cognitively normal individuals. Fornix microstructural degradation, as measured by reduced DTI-based fractional anisotropy (FA), was prominent in both MCI and AD, and was associated with reduced hippocampal volumes. Further, reduced fornix FA was associated with reduced anterior CA1 and antero-medial subiculum thickness. Finally, while both lesser fornix FA and lesser hippocampal volume were associated with lesser episodic memory, only the hippocampal measures were significant predictors of episodic memory in models including both hippocampal and fornix predictors. The region-specific association between fornix integrity and hippocampal neuronal death may provide in vivo evidence for degenerative white matter injury in AD: axonal pathology that is closely linked to neuronal injury.

Lee DY; Fletcher E; Carmichael OT; Singh B; Mungas D; Reed B; Martinez O; Buonocore MH; Persianinova M; Decarli C

2012-01-01

350

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

UK PubMed Central (United Kingdom)

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 US 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. Hum Brain Mapp, 2013. © 2013 Wiley Periodicals, Inc.

Yeh PH; Wang B; Oakes TR; French LM; Pan H; Graner J; Liu W; Riedy G

2013-09-01

351

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

Scientific Electronic Library Online (English)

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

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

2011-01-01

352

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

Directory of Open Access Journals (Sweden)

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.

Yusuf Ali ALTUNCI; Servan GOKHAN; Mehmet USTUNDAG; Murat ORAK; Ayhan OZHASENEKLER; Cahfer GULOGLU

2010-01-01

353

Isolated posterior cruciate ligament injuries associated with closed tibial shaft fractures: a report of two cases.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Knee ligament injuries associated with tibia shaft fractures are usually neglected and treatment is delayed. To our knowledge, no case presentation discusses the clinical result of closed tibial shaft fracture with concomitant ipsilateral isolated PCL injury. In this literature, we report the clinical result of two cases that sustained closed tibial shaft fracture with concomitant PCL injury and discuss the treatment options. MATERIALS AND METHODS: We report the clinical result of two cases that sustained closed tibial shaft fracture with concomitant posterior cruciate ligament (PCL) injury. Case 1 received open reduction with plate fixation for the tibial shaft fracture, and he also received arthroscopic reconstruction of PCL with bone-patellar tendon-bone graft due to neglecting PCL injury 5 months later after fracture fixation. Case 2 sustained left tibial-fibular shaft fracture with isolated PCL injury confirmed by magnetic resonance image on the first day of injury. She received tibia fixation with intramedullary nail and conservative treatment with bracing and rehabilitation for PCL injury. RESULTS: In case 1, the male patient only focused on fracture healing without any knee rehabilitation. His knee flexed deeply for protected weight bearing in the injured leg which may have exacerbated the posterior instability and reduced the possibility of PCL healing. The end result of knee function was poor even though PCL reconstruction was done later. In case 2, the female patient with diagnosed posterior cruciate ligament injury on the day of injury, her knee was immobilized in brace with full extension, which improved PCL healing. In addition, she received rehabilitation of quadriceps strengthening, and hamstring muscle contraction was avoided in her daily activity. After rehabilitation, the female patient did not complain of severe subjective instability even with an obvious posterior translation on posterior drawer test. CONCLUSIONS: We need to perform a careful physical examination of ipsilateral knee in cases of leg fractures, and MRI of knee before surgery if any doubt exists. However, a further research is needed to conclude on the best operation and rehabilitation program in patients with combined tibial shaft fracture and PCL injury.

Huang YH; Liu PC; Chien SH; Chou PH; Lu CC

2009-07-01

354

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

Directory of Open Access Journals (Sweden)

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

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

355

Subdural haematoma associated with an arachnoid cyst after repetitive minor heading injury in ball games.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We report the case of a chronic subdural haematoma caused by repetitive heading of a football which led to the diagnosis of a middle fossa arachnoid cyst. The association between arachnoid cysts and subdural haematoma is discussed as are safety implications in sporting injuries.

Demetriades, AK; McEvoy, AW; Kitchen, ND

356

Dysarthria Associated with Traumatic Brain Injury: Speaking Rate and Emphatic Stress  

Science.gov (United States)

Prosodic abnormality is common in the dysarthria associated with traumatic brain injury (TBI), and adjustments of speaking rate and emphatic stress are often used as steps in treating the speech disorder in patients with TBI-induced dysarthria. However, studies to date do not present a clear and detailed picture of how speaking rate and emphatic…

Wang, Y.T.; Kent, R.D.; Duffy, J.R.; Thomas, J.E.

2005-01-01

357

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

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

358

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

Science.gov (United States)

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

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

2012-01-01

359

[Genotype features of norovirus associated with acute gastroenteritis through sentinel surveillance in Guizhou Province, 2011].  

UK PubMed Central (United Kingdom)

To study the genotype of Norovirus associated with acute gastroenteritis in Guizhou Province 2011, the patients' fecal specimens were collected from the Guizhou Province People's Hospital in the period of May to December 2011. Noroviruses in specimens were detected by a real-time reverse transcription polymerase chain reaction (Real-time RT-PCR). VP1 genes of norovirus-positive strains were then cloned and sequenced. Out of 70 clinical samples, the positive rates for norovirus G I (1 strain) and G II (34 strains) were 1.43% and 48.57, respectively. The VP1 sequencing results of seven norovirus G II showed thatthree strains were genotype G II . 4 and four strains were genotype G II . 3 Those genotype GIL . 4 strains were new variants (GII . 4 2011),closest to GII . 4 2006b variant. One amino acid appeared back mutation. Those genotype G II . 3 strains were divided into 2 gene clusters. One cluster was closest to Korean strain (HM635118) and Shanghai strain(GU991355). One cluster was closest to Japaness strain (AB629943) and 2007 Indian strain (EU921389), Four amino acids appeared back mutations.

Yan Y; Wu Y; Guo J; Tian KC; Wang DM

2013-01-01

360

Chronic post-traumatic headache: associations with mild traumatic brain injury, concussion, and post-concussive disorder.  

UK PubMed Central (United Kingdom)

Chronic post-traumatic headache (PTH) always arises from some sort of head injury such as mild traumatic brain injury or concussion. The terminology and definitions for these injuries remain controversial and continue to evolve. This article reviews and updates current terminology and definitions for these head injuries, along with current concepts of pathophysiology. The second portion of this article considers the persistence of the other symptoms associated with chronic PTH, which constitute the post-concussive disorder. PTH is the most common symptom after a head injury, but post-concussive symptoms often complicate the clinical picture and must be considered in the overall management of the chronic PTH patient.

Packard RC

2008-01-01

 
 
 
 
361

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

1997-01-01

362

Vertebral artery injury associated with blunt cervical spine trauma: a multivariate regression analysis.  

UK PubMed Central (United Kingdom)

STUDY DESIGN: Retrospective analysis of prospective registry data. OBJECTIVE: To determine the patient characteristics, risk factors, and fracture patterns associated with vertebral artery injury (VAI) in patients with blunt cervical spine injury. SUMMARY OF BACKGROUND DATA: VAI associated with cervical spine trauma has the potential for catastrophical clinical sequelae. The patterns of cervical spine injury and patient characteristics associated with VAI remain to be determined. METHODS: A retrospective review of prospectively collected data from the American College of Surgeons trauma registries at 3 level-1 trauma centers identified all patients with a cervical spine injury on multidetector computed tomographic scan during a 3-year period (January 1, 2007, to January 1, 2010). Fracture pattern and patient characteristics were recorded. Logistic multivariate regression analysis of independent predictors for VAI and subgroup analysis of neurological events related to VAI was performed. RESULTS: Twenty-one percent of 1204 patients with cervical injuries (n = 253) underwent screening for VAI by multidetector computed tomography angiogram. VAI was diagnosed in 17% (42 of 253), unilateral in 15% (38 of 253), and bilateral in 1.6% (4 of 253) and was associated with a lower Glasgow coma scale (P < 0.001), a higher injury severity score (P < 0.01), and a higher mortality (P < 0.001). VAI was associated with ankylosing spondylitis/diffuse idiopathic skeletal hyperosteosis (crude odds ratio [OR] = 8.04; 95% confidence interval [CI], 1.30-49.68; P = 0.034), and occipitocervical dissociation (P < 0.001) by univariate analysis and fracture displacement into the transverse foramen 1 mm or more (adjusted OR = 3.29; 95% CI, 1.15-9.41; P = 0.026), and basilar skull fracture (adjusted OR = 4.25; 95% CI, 1.25-14.47; P= 0.021), by multivariate regression model. Subgroup analyses of neurological events secondary to VAI occurred in 14% (6 of 42) and the stroke-related mortality rate was 4.8% (2 of 42). Neurological events were associated with male sex (P = 0.024), facet subluxation/dislocation (crude OR = 9.00; 95% CI, 1.51-53.74; P = 0.004) and the diagnosis of ankylosing spondylitis/diffuse idiopathic skeletal hyperosteosis (OR = 40.67; 95% CI, 5.27-313.96; P < 0.001). CONCLUSION: VAI associated with blunt cervical spine injury is a marker for more severely injured patients. High-risk patients with basilar skull fractures, occipitocervical dissociation, fracture displacement into the transverse foramen more than 1 mm, ankylosing spondylitis/diffuse idiopathic skeletal hyperosteosis, and facet subluxation/dislocation deserve focused consideration for VAI screening.

Lebl DR; Bono CM; Velmahos G; Metkar U; Nguyen J; Harris MB

2013-07-01

363

Characteristics of associated craniofacial trauma in patients with head injuries: An experience with 100 cases  

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Full Text Available Background: Facial fractures and concomitant cranial injuries carry the significant potential for mortality and neurological morbidity mainly in young adults. Aims and Objectives: To analyze the characteristics of head injuries and associated facial injuries, the management options and outcome following cranio-facial trauma. Methods: This retrospective review was performed at Justice K. S. Hegde Charitable Hospital, and associated A. B. Shetty Memorial Institute of Dental sciences, Deralakatte, Mangalore. Following Ethical Committee approval, hospital charts and radiographs of 100 consecutive patients of cranio-facial trauma managed at the Department of Oral and Maxillofacial Surgery and Neurosurgery between January 2004 and December 2004 were reviewed. Results: Majority of the patients were in the 2nd to 4th decade (79%) with a male to female ratio of -8.09:1. Road traffic accidents were the common cause of craniofacial trauma in present study (54%) followed by fall from height (30%). Loss of consciousness was the most common clinical symptom (62%) followed by headache (33%). Zygoma was the most commonly fractured facial bone 48.2% (alone 21.2%, in combination 27.2%). Majority of patients had mild head injury and managed conservatively in present series. Causes of surgical intervention for intracranial lesions were compound depressed fracture, contusion and intracranial hematoma. Operative indications for facial fractures were displaced facial bone fractures. Major causes of mortality were associated systemic injuries. Conclusion: Adult males are the most common victims in craniofacial trauma, and road traffic accidents were responsible for the majority. Most of the patients sustained mild head injuries and were managed conservatively. Open reduction and internal fixation with miniplates was used for displaced facial bone fractures.

Rajendra Prasad; Mathew Tony; Agrawal Amit; Sabharawal Gagan

2009-01-01

364

Global estimates of syphilis in pregnancy and associated adverse outcomes: analysis of multinational antenatal surveillance data.  

UK PubMed Central (United Kingdom)

BACKGROUND: The World Health Organization initiative to eliminate mother-to-child transmission of syphilis aims for ? 90% of pregnant women to be tested for syphilis and ? 90% to receive treatment by 2015. We calculated global and regional estimates of syphilis in pregnancy and associated adverse outcomes for 2008, as well as antenatal care (ANC) coverage for women with syphilis. METHODS AND FINDINGS: Estimates were based upon a health service delivery model. National syphilis seropositivity data from 97 of 193 countries and ANC coverage from 147 countries were obtained from World Health Organization databases. Proportions of adverse outcomes and effectiveness of screening and treatment were from published literature. Regional estimates of ANC syphilis testing and treatment were examined through sensitivity analysis. In 2008, approximately 1.36 million (range: 1.16 to 1.56 million) pregnant women globally were estimated to have probable active syphilis; of these, 80% had attended ANC. Globally, 520,905 (best case: 425,847; worst case: 615,963) adverse outcomes were estimated to be caused by maternal syph