WorldWideScience

Sample records for association injury surveillance

  1. Bodygraphic Injury Surveillance System

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

    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.

  2. Strengthening Injury Surveillance System in Iran

    Motevalian Seyed Abbas

    2012-02-01

    Full Text Available 【Abstract】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抯 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. Key words: Wounds and injuries; Population surveillance; Registries; Iran

  3. Strengthening Injury Surveillance System in Iran

    Seyed Abbas Motevalian; Mashyaneh Haddadi; Hesam Akbari; Reza Khorramirouz; Soheil Saadat; Arash Tehrani; Vafa Rahimi-Movaghar

    2011-01-01

    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 OrganizationEastern 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.Contusions: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.

  4. 2003 Nevada Test Site Annual Illness and Injury Surveillance Report

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

    2007-05-23

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

  5. 2006 Nevada Test Site Annual Illness and Injury Surveillance Report

    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

    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.

  6. 2006 Pantex Plant Annual Illness and Injury Surveillance Report

    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

    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.

  7. 2010 Sandia National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  8. 2010 Idaho National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  9. 2007 Hanford Site Annual Illness and Injury Surveillance Report

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

    2009-07-16

    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.

  10. 2010 Pantex Plant Annual Illness and Injury Surveillance Report

    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

    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.

  11. 2010 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  12. 2007 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  13. 2010 Hanford Site Annual Illness and Injury Surveillance Report

    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

    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.

  14. 2010 Savannah River Site Annual Illness and Injury Surveillance Report

    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

    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.

  15. 2010 Kansas City Plant Annual Illness and Injury Surveillance Report

    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

    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.

  16. 2006 Savannah River Site Annual Illness and Injury Surveillance Report

    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

    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.

  17. 2007 Idaho National Laboratory Annual Illness and Injury Surveillance Report

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

    2009-05-04

    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.

  18. 2006 Hanford Site Annual Illness and Injury Surveillance Report

    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

    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.

  19. 2006 Kansas City Plant Annual Illness and Injury Surveillance Report

    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

    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.

  20. 2006 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  1. 2007 Pantex Plant Annual Illness and Injury Surveillance Report

    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

    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.

  2. CPSC’s National Electronic Injury Surveillance System (NEISS)

    US Consumer Product Safety Commission — CPSC’s National Electronic Injury Surveillance System (NEISS) is a national probability sample of hospitals in the U.S. and its territories. Patient information is...

  3. 2008 Nevada Test Site Annual Illness and Injury Surveillance Report

    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

    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.

  4. 2008 Sandia National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  5. 2009 Argonne National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  6. 2007 Kansas City Plant Annual Illness and Injury Surveillance Report

    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

    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.

  7. 2007 Savannah River Site Annual Illness and Injury Surveillance Report

    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

    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.

  8. 2007 Sandia National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  9. 2009 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  10. 2008 Kansas City Plant Annual Illness and Injury Surveillance Report

    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

    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.

  11. 2009 Hanford Site Annual Illness and Injury Surveillance Report

    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

    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.

  12. 2008 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  13. 2009 Pantex Plant Annual Illness and Injury Surveillance

    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

    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.

  14. 2008 Idaho National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  15. 2008 Savannah River Site Annual Illness and Injury Surveillance Report

    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

    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.

  16. 2007 Nevada Test Site Annual Illness and Injury Surveillance Report

    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

    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.

  17. Laboratory test surveillance following acute kidney injury.

    Michael E Matheny

    Full Text Available BACKGROUND: Patients with hospitalized acute kidney injury (AKI are at increased risk for accelerated loss of kidney function, morbidity, and mortality. We sought to inform efforts at improving post-AKI outcomes by describing the receipt of renal-specific laboratory test surveillance among a large high-risk cohort. METHODS: We acquired clinical data from the Electronic health record (EHR of 5 Veterans Affairs (VA hospitals to identify patients hospitalized with AKI from January 1st, 2002 to December 31st, 2009, and followed these patients for 1 year or until death, enrollment in palliative care, or improvement in renal function to estimated GFR (eGFR ≥ 60 L/min/1.73 m(2. Using demographic data, administrative codes, and laboratory test data, we evaluated the receipt and timing of outpatient testing for serum concentrations of creatinine and any as well as quantitative proteinuria recommended for CKD risk stratification. Additionally, we reported the rate of phosphorus and parathyroid hormone (PTH monitoring recommended for chronic kidney disease (CKD patients. RESULTS: A total of 10,955 patients admitted with AKI were discharged with an eGFR<60 mL/min/1.73 m2. During outpatient follow-up at 90 and 365 days, respectively, creatinine was measured on 69% and 85% of patients, quantitative proteinuria was measured on 6% and 12% of patients, PTH or phosphorus was measured on 10% and 15% of patients. CONCLUSIONS: Measurement of creatinine was common among all patients following AKI. However, patients with AKI were infrequently monitored with assessments of quantitative proteinuria or mineral metabolism disorder, even for patients with baseline kidney disease.

  18. A Bayesian hierarchical model for accident and injury surveillance.

    MacNab, Ying C

    2003-01-01

    This article presents a recent study which applies Bayesian hierarchical methodology to model and analyse accident and injury surveillance data. A hierarchical Poisson random effects spatio-temporal model is introduced and an analysis of inter-regional variations and regional trends in hospitalisations due to motor vehicle accident injuries to boys aged 0-24 in the province of British Columbia, Canada, is presented. The objective of this article is to illustrate how the modelling technique can be implemented as part of an accident and injury surveillance and prevention system where transportation and/or health authorities may routinely examine accidents, injuries, and hospitalisations to target high-risk regions for prevention programs, to evaluate prevention strategies, and to assist in health planning and resource allocation. The innovation of the methodology is its ability to uncover and highlight important underlying structure of the data. Between 1987 and 1996, British Columbia hospital separation registry registered 10,599 motor vehicle traffic injury related hospitalisations among boys aged 0-24 who resided in British Columbia, of which majority (89%) of the injuries occurred to boys aged 15-24. The injuries were aggregated by three age groups (0-4, 5-14, and 15-24), 20 health regions (based of place-of-residence), and 10 calendar years (1987 to 1996) and the corresponding mid-year population estimates were used as 'at risk' population. An empirical Bayes inference technique using penalised quasi-likelihood estimation was implemented to model both rates and counts, with spline smoothing accommodating non-linear temporal effects. The results show that (a) crude rates and ratios at health region level are unstable, (b) the models with spline smoothing enable us to explore possible shapes of injury trends at both the provincial level and the regional level, and (c) the fitted models provide a wealth of information about the patterns (both over space and time

  19. 2003 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report

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

    2007-05-23

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

  20. 2004 Hanford Site Annual Illness and Injury Surveillance Report, Revised October 2007

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

    2007-10-24

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

  1. 2003 Idaho National Engineering and Environmental Laboratory Annual Illness and Injury Surveillance Report

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

    2007-05-23

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

  2. Tumor-Associated Glycans and Immune Surveillance

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

    2013-01-01

    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. PMID:26343966

  3. Tumor-Associated Glycans and Immune Surveillance

    Anastas Pashov

    2013-06-01

    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.

  4. Tumor-Associated Glycans and Immune Surveillance

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

    2013-01-01

    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. Howev...

  5. Brain Injury Association of America

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

  6. 2007 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  7. 2006 Los Alamos National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  8. 2007 East Tennessee Technology Park Annual Illness and Injury Surveillance Report

    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

    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.

  9. 2010 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  10. 2010 East Tennessee Technology Park Annual Illness and Injury Surveillance Report

    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

    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.

  11. 2010 Y-12 National Security Complex Annual Illness and Injury Surveillance Report

    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

    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.

  12. 2010 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  13. 2010 Nevada National Security Site Annual Illness and Injury Surveillance Report

    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

    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.

  14. 2006 Y-12 National Security Complex Annual Illness and Injury Surveillance Report

    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

    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.

  15. 2006 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  16. 2006 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  17. 2006 Sandia National Laboratories--Albuquerque Annual Illness and Injury Surveillance Report

    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

    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.

  18. Herb-Induced Liver Injury in the Berlin Case-Control Surveillance Study

    Antonios Douros

    2016-01-01

    Full Text Available Herb-induced liver injury (HILI has recently attracted attention due to increasing reports of hepatotoxicity associated with use of phytotherapeutics. Here, we present data on HILI from the Berlin Case-Control Surveillance Study. The study was initiated in 2000 to investigate the serious toxicity of drugs including herbal medicines. Potential cases of liver injury were ascertained in more than 180 Departments of all 51 Berlin hospitals from October 2002 to December 2011. Drug or herb intake was assessed through a standardized face-to-face interview. Drug or herbal aetiology was assessed based on the updated Council for International Organizations of Medical Sciences scale. In ten of all 198 cases of hepatotoxicity included in the study, herbal aetiology was assessed as probable (once ayurvedic herb or possible (Valeriana five times, Mentha piperita once, Pelargonium sidoides once, Hypericum perforatum once, Eucalyptus globulus once. Mean age was 56.4 ± 9.7 years, and the predominant pattern of liver injury was hepatocellular. No cases of acute liver failure or death were observed. This case series corroborates known risks for ayurvedic herbs, supports the suspected association between Valeriana use and liver injury, and indicates a hepatotoxic potential for herbs such as Pelargonium sidoides, Hypericum perforatum or Mentha piperita that were rarely associated with liver injury before. However, given that possible causality does not prove clinical significance, further studies in this field are needed.

  19. Herb-Induced Liver Injury in the Berlin Case-Control Surveillance Study

    Douros, Antonios; Bronder, Elisabeth; Andersohn, Frank; Klimpel, Andreas; Kreutz, Reinhold; Garbe, Edeltraut; Bolbrinker, Juliane

    2016-01-01

    Herb-induced liver injury (HILI) has recently attracted attention due to increasing reports of hepatotoxicity associated with use of phytotherapeutics. Here, we present data on HILI from the Berlin Case-Control Surveillance Study. The study was initiated in 2000 to investigate the serious toxicity of drugs including herbal medicines. Potential cases of liver injury were ascertained in more than 180 Departments of all 51 Berlin hospitals from October 2002 to December 2011. Drug or herb intake was assessed through a standardized face-to-face interview. Drug or herbal aetiology was assessed based on the updated Council for International Organizations of Medical Sciences scale. In ten of all 198 cases of hepatotoxicity included in the study, herbal aetiology was assessed as probable (once ayurvedic herb) or possible (Valeriana five times, Mentha piperita once, Pelargonium sidoides once, Hypericum perforatum once, Eucalyptus globulus once). Mean age was 56.4 ± 9.7 years, and the predominant pattern of liver injury was hepatocellular. No cases of acute liver failure or death were observed. This case series corroborates known risks for ayurvedic herbs, supports the suspected association between Valeriana use and liver injury, and indicates a hepatotoxic potential for herbs such as Pelargonium sidoides, Hypericum perforatum or Mentha piperita that were rarely associated with liver injury before. However, given that possible causality does not prove clinical significance, further studies in this field are needed. PMID:26784183

  20. 2003 East Tennessee Technology Park Annual Illness and Injury Surveillance Report

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

    2007-05-23

    Annual Illness and Injury Surveillance Program report for 2003 for the East Tennessee Technology Park (K-25).The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  1. 2003 Y-12 National Security Complex Annual Illness and Injury Surveillance Report

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

    2007-05-23

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

  2. 2003 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report, Revised September 2007

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

    2007-10-02

    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.

  3. 2004 Hanford Site Annual Illness and Injury Surveillance Report, Revised October 2007

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

    2007-10-24

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

  4. 2003 Savannah River Site Annual Illness and Injury Surveillance Report, Revised September 2007

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

    2007-10-05

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

  5. 2003 Hanford Site Annual Illness and Injury Surveillance Report, Revised October 2007

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

    2007-10-24

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

  6. 2003 Kansas City Plant Annual Illness and Injury Surveillance Report, Revised September 2007

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

    2007-10-04

    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.

  7. 2003 Los Alamos National Laboratory Annual Illness and Injury Surveillance Report, Revised September 2007

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

    2007-10-04

    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.

  8. 2003 Fernald Environmental Management Project Annual Illness and Injury Surveillance Report, Revised September 2007

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

    2007-10-04

    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.

  9. 2003 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report

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

    2007-05-23

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

  10. 2003 Sandia National Laboratories--Albuquerque Annual Illness and Injury Surveillance Report

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

    2007-05-23

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

  11. 2003 Pantex Plant Annual Illness and Injury Surveillance Report, Revised September 2007

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

    2007-10-05

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

  12. 2008 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  13. 2007 Los Alamos National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  14. 2008 East Tennessee Technology Park Annual Illness and Injury Surveillance Report

    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

    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.

  15. 2008 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  16. 2008 Y-12 National Security Complex Annual Illness and Injury Surveillance Report

    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

    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.

  17. 2007 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report

    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

    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.

  18. 2009 Y-12 National Security Complex Annual Illness and Injury Surveillance Report

    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

    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.

  19. 2007 Y-12 National Security Complex Annual Illness and Injury Surveillance Report

    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

    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.

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

    Schuurman Nadine

    2010-05-01

    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.

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

    Saha Asim

    2007-01-01

    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.

  2. Poisson Regression Analysis of Illness and Injury Surveillance Data

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

    2012-12-12

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

  3. Deployment Surveillance Report: Traumatic Brain Injury Identified from Hospitalization and Air Evacuation Records - Army, 2004-2009

    2012-10-17

    been associated with increased risk of seizures, postconcussion syndrome, deficits in social functioning, and mental health disorders [5]. Though...c) The Armed Forces Health Surveillance Center (AFHSC) classified the DVBIC TBI codes into three functional categories (that is, TBI, postconcussion ...850-854, and Injury Prevention Report No. 12-HF-0F7E-09, 01 Jan 2004-31 Dec 2009 4 950.1-950.3). Postconcussion syndrome includes current effects of

  4. Proposed ICD-10-CM Surveillance Case Definitions for Injury Hospitalizations and Emergency Department Visits.

    Hedegaard, Holly B; Johnson, Renee L; Ballesteros, Michael F

    2017-01-01

    This report describes a collaboration between the National Center for Health Statistics and the National Center for Injury Prevention and Control to develop proposed surveillance case definitions for injury hospitalizations and emergency department (ED) visits for use with administrative data sets coded using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). The proposed ICD-10-CM surveillance case definitions were developed by applying General Equivalence Mappings to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) definitions. As with the ICD-9-CM definitions, there are slight differences between the proposed ICD-10-CM surveillance case definition for injury hospitalizations and the one for ED visits. The inclusion criteria for an injury hospitalization requires a case to have a principal diagnosis of one of the included nature-of-injury (injury diagnosis) codes. The inclusion criteria for an injury ED visit requires the case to have either a principal diagnosis of one of the included nature-of-injury codes or the presence of selected external-cause codes. The ICD-10-CM nature-of-injury and external-cause codes included in the proposed definitions are presented and caveats for use of the proposed definitions are described.

  5. Fireworks-related injury surveillance in the Philippines: trends in 2010–2014

    John Bobbie Roca

    2015-11-01

    Full Text Available Analysis of the annual fireworks-related injury surveillance data collected by the Philippines Department of Health (DOH in 2010–2014 was conducted to describe the profile of such injuries in the Philippines. Surveillance data were collected from DOH’s Online National Electronic Injury Surveillance System and analysed. A case was defined as any person who had sustained injury from fireworks in any form within the 16-day surveillance period (21 December to 5 January and had presented to any of the 50 sentinel hospitals. Of the 4649 cases, there were 4706 fireworks-related injuries involving 5076 anatomic sites in 2010–2014. A significant decrease of cases in 2014 was observed when compared with the previous study years (P = 0.02. The number of cases peaked at public holidays. Males (80% were more commonly injured, and children aged 5 to 14 years were primarily affected (47%. Ignition of illegal fireworks accounted for half (50% of the injuries; most injuries (68% occurred in street settings. The majority of injuries (57% were sustained by fireworks igniters. The most common anatomic injury sites were hands (44%, legs (21% and eyes (14%. Illegal fireworks were related to 100% (4/4 of the deaths and 49% (105/214 of the cases who needed amputations. Fireworks-related injuries declined significantly in 2014. Public awareness campaigns may have contributed to reducing the injury occurrences. As illegal fireworks accounted for all deaths and more than half of the amputations, law enforcement should be directed toward preventing importing, distributing and using illegal fireworks.

  6. Hand injuries as an indicator of other associated severe injuries.

    Vossoughi, Faranak; Krantz, Brent; Fann, Stephen

    2007-07-01

    The purpose of this study was to investigate the incidence of disabling or life-threatening injuries in patients with hand injuries. Retrospective data were collected from a level 1 trauma center registry. A total of 472 patients with hand injuries were admitted to the trauma unit between January 2000 and March 2004. Forty-four per cent of patients with hand injuries had life-threatening injuries. Fifty-one per cent of them had motor vehicle crash-related injuries. Motorcycle crashes were the next most common cause followed by explosions, falls, gunshots, machinery, stabs, bites, crushes, and so on. Frequency of associated injuries was as follows: head injuries, 31 per cent, including skull fractures, 22 per cent; spine injuries, 18 per cent, including spine fractures 18 per cent; chest injuries, 36 per cent, including rib fractures, 15 per cent; and abdominal injuries, 13 per cent. The authors focused on the incidence of disabling or life-threatening injuries in patients with hand injuries. Motor vehicle crashes were most common cause of hand injuries. The most common organs to be injured were chest and head. The most common head injury was skull fracture. Other injuries in decreasing order were spine and rib fractures. These data may be helpful in assessing ambulatory patients in the emergency room, in those hand injuries maybe indicative of other simultaneous life-threatening or disabling injuries.

  7. Automating the surveillance of healthcare-associated infections

    van Mourik, M.S.M.

    2014-01-01

    Healthcare-associated infections (HAI) are among the most common complications of medical care, affecting one in twenty-five hospitalized patients on any given day. Surveillance of HAI by systematically assessing patients for the development of an infection is a key component of successful infection prevention programs, both to measure the effects of an intervention and to assess quality of care. Traditional methods of surveillance, manual review of patients’ medical records, are time-consumi...

  8. Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance

    Alonso, Juan-Manuel; Edouard, Pascal; Fischetto, Giuseppe; Adams, Bob; Depiesse, Frédéric; Mountjoy, Margo

    2012-01-01

    Objective To determine the incidence and characteristics of newly incurred injuries and illnesses during international Athletics Championships, by improving the medical surveillance coverage, in order to determine future prevention strategies. Design Prospective recording of newly occurred injuries and illnesses. Setting 13th International Association of Athletics Federations World Championships in Athletics 2011 in Daegu, Korea. Participants National team and Local Organising Committee physicians; and 1851 registered athletes. Main outcome measures Incidence and characteristics of newly incurred injuries and illnesses. Results 82% of athletes were covered by medical teams participating with a response rate of 94%. A total of 249 injuries were reported, representing an incidence of 134.5 injuries per 1000 registered athletes, and 119 (48%) resulted in time loss from sport. A total of 185 injuries affected the lower limb (74%). Hamstring strain was the main diagnosis and 67% resulted in absence from sport. Overuse (n=148; 59%) was the predominant cause. A total of 126 illnesses were reported, signifying an incidence of 68.1 per 1000 registered athletes. Upper respiratory tract infection was the most common reported diagnosis (18%), followed by exercise-induced dehydration (12%), and gastroenteritis/diarrhoea (10%). The highest incidences of injuries were found in combined events and middle and long-distance events, and of illness in race walking events. Conclusion During elite Athletics World Championships, 135 injuries, 60 time-loss injuries and 68 illnesses per 1000 registered athletes were reported. Higher risks of injuries were found in combined events and long-distance runs. Preventive interventions should focus on overuse injuries and hamstring strains, decreasing the risk of transmission of infectious diseases, appropriate event scheduling and heat acclimatisation. PMID:22522588

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

    Wainiqolo Iris

    2012-12-01

    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.

  10. 75 FR 29561 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Surveillance...

    2010-05-26

    ... No: 2010-12627] DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Surveillance, Natural... Officer, National Center for Chronic Disease Prevention and Health Promotion, Office of the...

  11. Injury surveillance in community sport: Can we obtain valid data from sports trainers?

    Ekegren, C L; Gabbe, B J; Finch, C F

    2015-06-01

    A lack of available injury data on community sports participants has hampered the development of informed preventive strategies for the broad-base of sports participation. In community sports settings, sports trainers or first-aiders are well-placed to carry out injury surveillance, but few studies have evaluated their ability to do so. The aim of this study was to investigate the reporting rate and completeness of sports trainers' injury records and agreement between sports trainers' and players' reports of injury in community Australian football. Throughout the football season, one sports trainer from each of four clubs recorded players' injuries. To validate these data, we collected self-reported injury data from players via short message service (SMS). In total, 210 discrete injuries were recorded for 139 players, 21% by sports trainers only, 59% by players via SMS only, and 21% by both. Completeness of injury records ranged from 95% to 100%. Agreement between sports trainers and players ranged from K = 0.32 (95% confidence interval: 0.27, 0.37) for date of return to football to K = 1.00 for activity when injured. Injury data collected by sports trainers may be of adequate quality for providing an understanding of the profile of injuries. However, data are likely to underestimate injury rates and should be interpreted with caution.

  12. Surveillance

    Albrechtslund, Anders; Coeckelbergh, Mark; Matzner, Tobias;

    Studying surveillance involves raising questions about the very nature of concepts such as information, technology, identity, space and power. Besides the maybe all too obvious ethical issues often discussed with regard to surveillance, there are several other angles and approaches that we should...... like to encourage. Therefore, our panel will focus on the philosophical, yet non-ethical issues of surveillance in order to stimulate an intense debate with the audience on the ethical implications of our enquiries. We also hope to provide a broader and deeper understanding of surveillance....

  13. Efficient national surveillance for health-care-associated infections

    van Bunnik, B. A. D.; Ciccolini, M.; Gibbons, C. L.; Edwards, G.; Fitzgerald, R.; McAdam, P. R.; Ward, M. J.; Laurenson, I. F.; Woolhouse, M. E. J.

    2015-01-01

    Background: Detecting novel healthcare-associated infections (HCAI) as early as possible is an important public health priority. However, there is currently no evidence base to guide the design of efficient and reliable surveillance systems. Here we address this issue in the context of a novel patho

  14. Efficient surveillance for healthcare-associated infections spreading between hospitals

    Ciccolini, Mariano; Donker, Tjibbe; Grundmann, Hajo; Bonten, Marc J. M.; Woolhouse, Mark E. J.

    2014-01-01

    Early detection of new or novel variants of nosocomial pathogens is a public health priority. We show that, for healthcare-associated infections that spread between hospitals as a result of patient movements, it is possible to design an effective surveillance system based on a relatively small numbe

  15. Evaluation of a system for injury surveillance in Swedish emergency care.

    Jansson, B; Svanström, L

    1989-01-01

    A system for continuous and periodic injury surveillance in Swedish emergency care has been evaluated based on a case study of accidental injuries on 2,454 farms during a one year period. The evaluation procedure comprised registry completeness, measurement errors, trend analysis and calculation of risk. The results indicate that the structure of the registry system permits analysis of registry completeness, but further development is needed concerning the staffing and organising problem. The importance of registry inclusion criteria when one is comparing different injury surveillance systems was noted. Limitations applied to calculation of accident frequency rates per million hours work. The results show that there will be a high drop-out rate if the collection of data is not simultaneously combined with an injury control programme. The registry system could serve as a basis for periodic surveys and trend analysis. Further development of a continuous system based on reporting immediately at the injury reception centre should be considered. A coordinated system involving both continuous and periodic data seems to leave the flexibility both to identify certain risk environments or risk groups and to analyse the circumstances involved of specific accidental injuries, e.g. in agriculture.

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

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

    2012-04-01

    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.

  17. Efficient surveillance for healthcare-associated infections spreading between hospitals.

    Ciccolini, Mariano; Donker, Tjibbe; Grundmann, Hajo; Bonten, Marc J M; Woolhouse, Mark E J

    2014-02-11

    Early detection of new or novel variants of nosocomial pathogens is a public health priority. We show that, for healthcare-associated infections that spread between hospitals as a result of patient movements, it is possible to design an effective surveillance system based on a relatively small number of sentinel hospitals. We apply recently developed mathematical models to patient admission data from the national healthcare systems of England and The Netherlands. Relatively short detection times are achieved once 10-20% hospitals are recruited as sentinels and only modest reductions are seen as more hospitals are recruited thereafter. Using a heuristic optimization approach to sentinel selection, the same expected time to detection can be achieved by recruiting approximately half as many hospitals. Our study provides a robust evidence base to underpin the design of an efficient sentinel hospital surveillance system for novel nosocomial pathogens, delivering early detection times for reduced expenditure and effort.

  18. Injury caused by airbag VS. injuries associated with airbag deploys

    M.F. Popa

    2014-02-01

    Full Text Available Implementation of airbags systems in motor vehicles designed to transport of persons led in time to a significant decrease of the rate of death among passengers involved in car accidents. However airbag systems are not harmless, it produces lesions that vary in intensity depending on many factors. But decidedly, we can meet injuries associated with the triggering of the airbag system. Therefore, it must be made a clear difference between the two types of injuries, this being particularly important in terms of medico-legal especially regarding the mechanism of injury.

  19. The impact of injury definition on injury surveillance in novice runners

    Kluitenberg, Bas; van Middelkoop, Marienke; Verhagen, Evert; Hartgens, Fred; Huisstede, Bionka; Diercks, Ron; van der Worp, Henk

    2016-01-01

    Objectives: Despite several consensus statements, different injury definitions are used in the literature. This study aimed to identify the impact of different injury definitions on the nature and incidence of complaints captured during a short-term running program for novice runners. Design: Prospe

  20. Hospital costs associated with pediatric burn injury.

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

    2008-01-01

    Modern burn care is a resource intensive endeavor requiring specialized equipment, personnel, and facilities in order to provide optimum care. The costs associated with burn injury to both patients and society as a whole can be multifaceted and large. The purpose of this study was to evaluate the association between hospital costs, patient characteristics, and injury factors in a cohort of pediatric patients admitted to a regional burn center. We performed a review of the hospital charges accrued by pediatric patients (age dollar costs using an inflation index and a cost to charge ratio. Univariate and multivariate regressions were performed to identify the factors most significantly associated with cost. In addition, we performed a subset cost analysis for patients with burns more than 20% TBSA. A total of 1443 pediatric patients (age dollars was dollars 9026 (SD = dollars 25,483; median = dollars 2138). Area of full thickness burn was the only patient or injury factor significantly associated with greater hospital costs (P < .05) on multivariate analysis. No single anatomic area was associated with increased hospital costs when adjusted for total overall burn size. Injury severity was the most significant factor impacting index hospitalization costs following pediatric burn injury. Further studies defining the long-term societal costs impact of burn injury are needed as are studies that evaluate the impact of burn injury on quality of life.

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

    Christelle Senterre

    2014-01-01

    Full Text Available Objectives. Investigating injuries in terms of occurrences and patient and hospital stay characteristics. Methods. 17370 stays, with at least one E code, were investigated based on data from 13 Belgian hospitals. Pearson’s chi-square and Kruskal-Wallis tests were used to assess the variations between distributions of the investigated factors according to the injury’s types. Results. Major injuries were accidental falls, transport injuries, and self-inflicted injuries. There were more men in the transport injuries group and the accidental falls group was older. For the transport injuries, there were more arrivals with the support of a mobile intensive care unit and/or a paramedic intervention team and a general practitioner was more implicated for the accidental falls. In three-quarters of cases, it was a primary diagnostic related to injury and poisoning which was made. The median length of stay was nearly equal to one week and for accidental falls, this value is three times higher. The median cost, from the social security point of view, for all injuries was equal to €1377 and there was a higher median cost within the falls group. Conclusion. This study based on hospitals data provides important information both on factors associated with and on hospital costs generated by injuries.

  2. Open Calcaneus Fractures and Associated Injuries.

    Worsham, Jacob R; Elliott, Mark R; Harris, Anthony M

    2016-01-01

    Open calcaneus fractures are usually the result of high-energy mechanisms and are associated with other orthopedic and whole body system injures. Understanding the difference between open versus closed fractures is essential for the provider, and they must be vigilant for the associated injuries that present with this condition. We performed a retrospective medical record review of 62 patients (64 calcaneus fractures) with open calcaneus fractures from January 2003 to January 2013 presenting at a level 1 trauma center. Sex, age, laterality, mechanism of injury, wound appearance, initial management, and associated injures were recorded. The most common mechanisms were motor vehicle accidents (35 [56.4%]) and falls from >6 ft (15 [24.1%]). Four (6.4%) patients had a posterior tibial artery transection. Eight (12.9%) patients had a femoral shaft fracture, 14 (22.5%) an ipsilateral ankle fracture, 16 (25.8%) a metatarsal fracture, and 11 (17.7%) had associated midfoot fractures. Of the midfoot fractures, 12 (19.3%) patients had a talus fracture and 5 (8.0%) a cuboid fracture. Spinal fractures were present in 9 (14.5%) of the patients, with lumbar fractures occurring in 6 (9.6%) patients. Fifteen (24.1%) patients had associated upper extremity fractures. Thirteen (20.9%) patients had an associated pulmonary injury, including 8 pneumothoraces. Ten (16.1%) patients had a closed head injury and 6 (9.6%) had an abdominal injury. Fifteen (23.4%) patients were treated with percutaneous wire fixation and 7 (10.9%) with open reduction internal fixation. A total of 44 (68.7%) fractures were treated without internal fixation. Overall, 5 (8.0%) patients with an open calcaneus fracture eventually underwent a below-the-knee amputation. Open calcaneus fractures are severe, high-energy injuries with the potential for considerable morbidity to the patient, given the high rate of concomitant orthopedic and whole body system injuries. Type III open injuries have an increased risk of

  3. Developing a Veterans Health Administration (VHA) Serious Injury Surveillance System that Includes Adverse Event Hospitalizations

    2005-05-01

    types fractures ; sprains; wounds; complications due to procedures or use of medical devices; and medication and other poisoning-related discharges...total discharges coded with an inpatient death over the 5-year period were associated with intracranial injuries (10.6 percent), hip fractures (6...with medication adverse events were associated with psychotropic drugs. Poisonings due to benzodiazepine tranquilizers consistently ranked as the

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

    Maria J. Ackerman

    2011-02-01

    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

     

  5. Contrast-associated Acute Kidney Injury.

    Weisbord, Steven D; Palevsky, Paul M

    2015-10-01

    Contrast-associated acute kidney injury (CAAKI) is a common iatrogenic condition. The principal risk factors for CAAKI are underlying renal impairment; diabetes in the setting of kidney disease; and intravascular volume depletion, effective or absolute. CAAKI is associated with serious adverse short-term and long-term outcomes, including mortality and more rapidly progressive chronic kidney disease, although the causal nature of these associations remains unproved. Patients with chronic kidney disease and other risk factors for CAAKI who present with acute coronary syndrome should undergo indicated angiographic procedures.

  6. Intraocular cilia associated with perforating injury

    Gopal Lingam

    2000-01-01

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

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

    O'Neill, Eoghan

    2009-08-01

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

  8. The National Athletic Treatment, Injury and Outcomes Network (NATION): Methods of the Surveillance Program, 2011–2012 Through 2013–2014

    Dompier, Thomas P.; Marshall, Stephen W.; Kerr, Zachary Y.; Hayden, Ross

    2015-01-01

    Context Previous epidemiologic researchers have examined time-loss (TL) injuries in high school student-athletes, but little is known about the frequency of non–time-loss (NTL) injuries in these athletes. Objective To describe the methods of the National Athletic Treatment, Injury and Outcomes Network (NATION) Surveillance Program and provide descriptive epidemiology of TL and NTL injuries across athletes in 27 high school sports. Design Descriptive epidemiology study. Setting Aggregate injury and exposure data collected from 147 high schools in 26 states. Patients or Other Participants High school student-athletes participating in 13 boys' sports and 14 girls' sports during the 2011–2012 through 2013–2014 academic years. Main Outcome Measure(s) Athletic trainers documented injuries and exposures using commercially available injury-tracking software packages. Standard injury-tracking software was modified by the software vendors to conform to the surveillance needs of this project. The modified software exported a set of common data elements, stripped of personally identifiable information, to a centralized automated verification and validation system before they were included in the centralized research database. Dependent measures were injury and exposure frequencies and injury rates with 95% confidence intervals stratified by sport, sex, and injury type (TL or NTL). Results Over the 3-year period, a total of 2337 team seasons across 27 sports resulted in 47 014 injuries and 5 146 355 athlete-exposures. The NTL injuries accounted for 38 765 (82.45%) and TL injuries for 8249 (17.55%) of the total. Conclusions The NTL injuries accounted for a substantial amount of the total number of injuries sustained by high school student-athletes. This project demonstrates the feasibility of creating large-scale injury surveillance systems using commercially available injury-tracking software. PMID:26067620

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

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

    2014-02-01

    We explored the relation between the causes of facial injuries in equestrians and the presence or absence of associated injuries. Over a 5-year period we retrospectively reviewed all patients who presented to the John Hunter Hospital, New South Wales, with facial injuries that had resulted from activity with horses. We analysed the rates of hard and soft tissue injuries, and of associated injuries by sex and mechanism. A total of 85 patients were included (50 female and 35 male) with an age range of 2-88 years. There was a significant difference in the rate of maxillofacial and associated injuries when groups were analysed for sex and mechanism of injury. Facial injuries caused by falling from a horse were more often associated with other injuries in men than in women (p<0.05), and men were 4 times more likely to present with associated injuries than women (OR 3.9; 95% CI 1.1 to 14) We also found significant differences in the rates of facial fracture. Women who had been kicked by a horse were more likely to sustain bony injuries than men (p<0.05). Our data confirm the association between kicks and facial fracture, and this may provide an impetus for the development of appropriate protective equipment. Patients who sustain facial injuries when falling from a horse often present with associated injuries and this has practical implications for clinicians involved in their management.

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

    Degeneffe, Charles Edmund; Tucker, Mark

    2012-01-01

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

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

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

    2007-10-01

    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.

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

    Grayson W. Armstrong

    2014-09-01

    Full Text Available Introduction: Motor vehicle crashes (MVCs are a leading cause of injury in the United States (U.S.. Detailed knowledge of MVC eye injuries presenting to U.S. emergency departments (ED will aid clinicians in diagnosis and management. The objective of the study was to describe the incidence, risk factors, and characteristics of non-fatal motor vehicle crash-associated eye injuries presenting to U.S. EDs from 2001 to 2008. Methods: Retrospective cross-sectional study using the National Electronic Injury Surveillance System All Injury Program (NEISS-AIP from 2001 to 2008 to assess the risk of presenting to an ED with a MVC-associated eye injury in relation to specific occupant characteristics, including age, gender, race/ethnicity, disposition, and occupant (driver/passenger status. Results: From 2001 to 2008, an estimated 75,028 MVC-associated eye injuries presented to U.S. EDs. The annual rate of ED-treated eye injuries resulting from MVCs declined during this study period. Males accounted for 59.6% of eye injuries (95% confidence interval [CI] 56.2%-63.0%. Rates of eye injury were highest among 15-19 year olds (5.8/10,000 people; CI 4.3-6.0/10,000 and among African Americans (4.5/10,000 people; CI 2.0-7.1/10,000. Drivers of motor vehicles accounted for 62.2% (CI 58.3%-66.1% of ED-treated MVC eye injuries when occupant status was known. Contusion/Abrasion was the most common diagnosis (61.5%; CI 56.5%-66.4%. Among licensed U.S. drivers, 16-24 year olds had the highest risk (3.7/10,000 licensed drivers; CI 2.6-4.8/10,000. Conclusion: This study reports a decline in the annual incidence of ED-treated MVC-associated eye injuries. The risk of MVC eye injury is greatest among males, 15 to 19 year olds and African Americans. [West J Emerg Med. 2014;15(6:693-700

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

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

    2007-10-01

    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.

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

    2014-05-01

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

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

    Emilio Ovuga

    2011-01-01

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

  16. Unintentional childhood injury patterns, odds, and outcomes in Kampala City: an analysis of surveillance data from the National Pediatric Emergency Unit

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

    2011-01-01

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

  17. Cardiac arrhythmias associated with spinal cord injury

    Hector, Sven Magnus; Biering-Sørensen, Tor; Krassioukov, Andrei;

    2013-01-01

    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...... 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....

  18. U. S. Army Operation Enduring Freedom Deployment Injury Surveillance Summary, 1 January-31 December 2012

    2015-06-01

    Infectious and parasitic Neoplasms Respiratory Skin Endocrine Circulatory Nervous system /sensory Genitourinary Muskuloskeletal Digestive Ill-defined...Endocrine Nervous system /sensory Infectious and parasitic Skin Respiratory Mental Health Muskuloskeltal Circulatory Genitourinary Ill-defined Condition...the relative impact of injuries (battle and non-battle) compared to diseases for calendar year (CY) 2012.  Document non-battle injury (NBI) rates

  19. Head Injury Secondary to Suspected Child Maltreatment: Results of a Prospective Canadian National Surveillance Program

    Bennett, Susan; Ward, Michelle; Moreau, Katherine; Fortin, Gilles; King, Jim; MacKay, Morag; Plint, Amy

    2011-01-01

    Objective: We sought to determine the incidence, clinical features, and demographic profile of head injury secondary to suspected child maltreatment (abuse or neglect) in Canada to help inform the development and evaluation of prevention programs for abusive head injuries. Methods: From March 1, 2005 to February 28, 2008, an average of 2,545…

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

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

    2013-12-01

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

  1. Posterior cruciate ligament injury: characteristics and associations of most frequent injuries

    Marco Tulio Lopes Caldas

    2013-09-01

    Full Text Available OBJECTIVE: To investigate the prevalence and combinations of PCL injuries and their correlations with the mechanism, the occurrence of evident dislocation and associated fracture. METHOD: A retrospective study of 85 lesions of PCL operated between 2003 and 2010. Diagnosis by physical examination and dynamic radiography, compared with surgical findings. RESULTS: Injuries involving the PCL were more prevalent in men (78.8% with a mean age of 33 years. The main cause was traffic accidents (73.80%, and (49.4% motorcycle. Isolated PCL injury occurred in (15.3% cases, and combined (84.7%. Among the isolated lesions, bone avulsions were nine (10.6%. The most associated PCL injuries were the ACL (48.2%, followed by LCL PCL/PLC (22.4%. Fractures were more associated with combining PCL + LCL/PLC injuries and did not appear in the PCL + MCL/PMC. Complications beyond fractures: peripheral nerve injury (4.8% and vascular (1.2%. Evident dislocation in primary care (16.7% was more prevalent in combined ACL + PCL + MCL/PMC (44.4%. Half the patients were operated during the acute phase. There was a statistically significant difference (p < 0.05 comparing each combination of ligament injuries with the presence of fracture, dislocation or clear mechanism of injury. CONCLUSION: Surgical treatment of PCL injuries in a center for orthopedic trauma care was mostly multiligament and mainly involving the ACL. A significant association was seen between the type of injury with mechanism of injury, presentation of the knee, if dislocated or reduced, and the presence of associated fracture.

  2. RAISIN - a national programme for early warning, investigation and surveillance of healthcare-associated infection in France.

    Desenclos, Jean-Claude

    2009-11-19

    Surveillance is a key component of the French plan for prevention of healthcare-associated infection (HAI) and has progressively evolved in the past decades. We describe the development and current organisation of surveillance of HAI in France and summarise key achievements and results. Surveillance of HAI is under the auspice of the national institute for public health surveillance through a central coordinating structure, the Reseau d alerte, d investigation et de surveillance des infections nosocomiales (RAISIN), which consists of five regional coordinating structures, two national advisory committees of the Ministry of Health and public health agencies. Surveillance includes the performance of national prevalence surveys every five years (latest in 2006), specific surveillance networks to follow trends and characterise HAI that are national priority, and mandatory reporting of HAI that meet specific criteria for alert purposes. RAISIN prioritises activities, defines technical specifications of surveillance systems, coordinates their implementation, and supports response to alerts, emergences or outbreaks of HAI. We demonstrate that the French surveillance program of HAI has become comprehensive and contributes to evaluating the impact of control and prevention of HAI. Data from RAISIN indicate a general decrease in the risk of HAI in acute care in France. They show a decrease in HAI during recent years, particularly of those related to methicillin-resistant Staphylococcus aureus (MRSA) for which a drop of 38% was documented between 2001 and 2006. RAISIN is also integrated into European surveillance of HAI coordinated by the European Centre for Disease Control.

  3. Dismounted complex blast injuries: patterns of injuries and resource utilization associated with the multiple extremity amputee.

    Fleming, Mark; Waterman, Scott; Dunne, James; D'Alleyrand, Jean-Claude; Andersen, Romney C

    2012-01-01

    The objective of this report is to analyze the resource utilization and injury patterns of complex dismounted blast injuries. A retrospective review of U.S. service members injured in combat between 2007 and 2010 was conducted. Data analyzed included age, injury mechanism, amputated limbs, number and type of associated injuries, blood products utilized, intensive care unit length of stay (ILOS), hospital length of stay (HLOS) and the Injury Severity Score (ISS). Patients were stratified based on the number of amputations. Sixty-three patients comprised the multiple extremity amputation (MEA) group. Ninety-eight percent sustained injuries from an improvised explosive device (IED) and 96% were dismounted. The ISS, number of surgical encounters, blood products utilized and ILOS were all clinically significantly different than controls. Care of multiple extremity amputees involves the utilization of significant resources. This knowledge may better help surgeons and administrators allocate assets at hospitals, both military and civilian, who care for this complex and challenging patient population.

  4. Thoracic spinal trauma associated with closed thoraco-abdominal injury

    路磊; 吴立文; 范广宇

    2003-01-01

    Objective: To explore the management of thoracic spinal trauma (TST) associated with closed thoraco-abdominal injuries (CTAI). Methods: A retrospective study was made on 259 patients with TST admitted to our department as an emergency treatment from January 1996 to June 2001. We summarized the clinical features of TST associated with CTAI. Results: Among 259 patients with thoracic spinal trauma, 112 were associated with CTAI. Traffic accident was the most common cause. The force causing upper TST was more violent than that causing the lower. Pulmonary complications were the leading cause of death in this group. Surgery could not improve neurological function for completely paraplegic patients.Conclusions: The reason that upper TST has the tendency to be associated with CTAI is its special anatomical feature. Routine ultrasonic examination can avoid misdiagnosis of latent closed abdominal injuries associated with spinal injury. The presence of potential injuries, especially CTAI, should be considered when deciding whether or not to perform surgery early.

  5. Genetic association studies in drug-induced liver injury.

    Daly, Ann K; Day, Chris P

    2009-11-01

    Genetic studies on drug-induced liver injury (DILI) have proved challenging, both because of their rarity and their difficulty in replicating observed effects. However, significant progress has now been achieved by both candidate-gene and genome-wide association studies. These two approaches are considered in detail, together with examples of DILI due to specific drugs where consistent associations have been reported. Particular consideration is given to associations between antituberculosis drug-related liver injury and the "slow acetylator" genotype for N-acetyltransferase 2, amoxicillin/clavulanate-related liver injury, and the human leukocyte antigen (HLA) class II DRB1*1501 allele and flucloxacillin-related injury and the HLA class I B*5701 allele. Although these associations are drug-specific, the possibility that additional, more general susceptibility genes for DILI exist requires further investigation, ideally by genome-wide association studies involving international collaboration. The possibility of interethnic variation in susceptibility to DILI also requires further study.

  6. Maxillofacial injuries associated with intimate partner violence in women

    Daud Razak

    2010-05-01

    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.

  7. Inferior alveolar nerve injuries associated with mandibular fractures.

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

    2012-11-01

    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.

  8. Landmine associated injuries in children in Turkey.

    Can, Muhammet; Yildirimcan, Humeyra; Ozkalipci, Onder; Melek, Mehmet; Edirne, Yesim; Bicer, Umit; Uner, Huseyin Bulent

    2009-11-01

    This study aims to examine trends of injuries due to landmines and unexploded ordnance (UXO) and to determine problems during and after the treatment of children and adolescent victims in Turkey. Data from the records of 23 children injured from landmines and UXO were analyzed from April 2001 to October 2008. Cases consist of 21 (91.3%) males and two (8.7%) females with a mean age of 12.8 years. Cause of injury was landmine explosion in 20 (87.0%) and UXO in three (13.0%) cases. Injuries in upper and lower extremities were determined in eight (34.8%) children. Hand amputation was the result in 10 (43.5%) children where in two cases a leg, in one case an eye, in one case a hand and arm, in two cases a hand and leg, in one case an eye and a leg and in three cases a hand and eye were lost. One case of death was recorded from UXO with an autopsy performed. Contaminated areas in our region should be cleared according to international contracts to prevent injuries in children, centers providing rehabilitation services should be established and policies regarding social support for child victims should be ascertained.

  9. Complement activation and kidney injury molecule-1-associated proximal tubule injury in severe preeclampsia.

    Burwick, Richard M; Easter, Sarah Rae; Dawood, Hassan Y; Yamamoto, Hidemi S; Fichorova, Raina N; Feinberg, Bruce B

    2014-10-01

    Kidney injury with proteinuria is a characteristic feature of preeclampsia, yet the nature of injury in specific regions of the nephron is incompletely understood. Our study aimed to use existing urinary biomarkers to describe the pattern of kidney injury and proteinuria in pregnancies affected by severe preeclampsia. We performed a case-control study of pregnant women from Brigham and Women's Hospital from 2012 to 2013. We matched cases of severe preeclampsia (n=25) 1:1 by parity and gestational age to 2 control groups with and without chronic hypertension. Urinary levels of kidney injury molecule-1 and complement components (C3a, C5a, and C5b-9) were measured by enzyme-linked immunosorbent assay, and other markers (albumin, β2 microglobulin, cystatin C, epithelial growth factor, neutrophil gelatinase-associated lipocalin, osteopontin, and uromodulin) were measured simultaneously with a multiplex electrochemiluminescence assay. Median values between groups were compared with the Wilcoxon signed-rank test and correlations with Spearman correlation coefficient. Analysis of urinary markers revealed higher excretion of albumin and kidney injury molecule-1 and lower excretion of neutrophil gelatinase-associated lipocalin and epithelial growth factor in severe preeclampsia compared with chronic hypertension and healthy controls. Among subjects with severe preeclampsia, urinary excretion of complement activation products correlated most closely with kidney injury molecule-1, a specific marker of proximal tubule injury (C5a: r=0.60; P=0.001; and C5b-9: r=0.75; Pkidney injury in severe preeclampsia that is characterized by glomerular impairment and complement-mediated inflammation and injury, possibly localized to the proximal tubule in association with kidney injury molecule-1.

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

    Singh S

    2010-01-01

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

  11. Determining the Incidence of Drug-Associated Acute Kidney Injury in Nursing Home Residents

    Handler, Steven M.; Cheung, Pui Wen; Culley, Colleen M.; Perera, Subashan; Kane-Gill, Sandra L.; Kellum, John A.; Marcum, Zachary A.

    2015-01-01

    Objective Although acute kidney injury (AKI) is well-studied in the acute care setting, investigation of AKI in the nursing home (NH) setting is virtually nonexistent. The goal of this study was to determine the incidence of drug-associated AKI using the RIFLE (Risk, Injury, Failure, Loss of kidney function or End-Stage kidney disease) criteria in NH residents. Design/Setting/Participants/Measurements We conducted a retrospective study between February 9, 2012 and February 8, 2013 for all residents at four UPMC NHs located in Southwest Pennsylvania. The TheraDoc™ Clinical Surveillance System, which monitors laboratory and medication data and fires alerts when patients have a sufficient increase in serum creatinine, was used for automated case detection. An increase in serum creatinine in the presence of an active medication order identified to potentially cause AKI triggered an alert, and drug-associated AKI was staged according to the RIFLE criteria. Data were analyzed by frequency and distribution of alert type by risk, injury, and failure. Results Of the 249 residents who had a drug-associated AKI alert fire, 170 (68.3%) were female, and the mean age was 74.2 years. Using the total number of alerts (n=668), the rate of drug-associated AKI was 0.35 events per 100 resident-months. Based on the RIFLE criteria, there were 191, 70, and 44 residents who were classified as AKI risk, injury, and failure, respectively. The most common medication classes included in the AKI alerts were diuretics, ACEIs/ARBs, and antibiotics. Conclusion Drug-associated AKI was a common cause of potential adverse drug events. The vast majority of the cases were related to the use of diuretics, ACEIs/ARBs and antibiotics. Future studies are needed to better understand patient, provider and facility risk factors as well as strategies to enhance the detection and management of drug-associated AKI in the NH. PMID:24814042

  12. Osseous Injury Associated With Ligamentous Tear of the Knee.

    Lee, Chee Hwee; Tan, Chih Feng; Kim, Okwha; Suh, Kyung Jin; Yao, Min-Szu; Chan, Wing P; Wu, Jim S

    2016-11-01

    One of the most common knee injuries is ligament tear, which may initially manifest as an osseous injury in radiographs. Radiologists should therefore be able to recognize ligament tears of the knee as osseous abnormalities in images. This review focuses on the imaging features of knee ligament injuries and their related osseous injuries: anterior cruciate ligament (ACL) tear with Segond fracture; associated marrow contusion; ACL avulsion fracture; posterior cruciate ligament (PCL) tear with osseous avulsion of the ligament including arcuate sign; reverse Segond fracture; PCL avulsion fracture; medial collateral ligament tear with Pellegrini-Stieda disease; lateral collateral ligament tear with avulsion fracture of the fibular head; and patellar ligament injuries with Osgood-Schlatter and Sinding-Larsen-Johansson.

  13. Urological Surveillance and Medical Complications after Spinal Cord Injury in the United States

    Cameron, Anne P.; Lai, Julie; Saigal, Christopher S.; Clemens, J. Quentin; Wijmenga, T. J.

    2015-01-01

    OBJECTIVE To evaluate the national patterns of urologic follow up after spinal cord injury (SCI) and the occurrence and predictors of urological complications. MATERIALS AND METHODS This retrospective cohort study used a 5% sample of Medicare data 2007-2010. The minimum adequate urologic surveillanc

  14. Classifying injury narratives of large administrative databases for surveillance-A practical approach combining machine learning ensembles and human review.

    Marucci-Wellman, Helen R; Corns, Helen L; Lehto, Mark R

    2017-01-01

    Injury narratives are now available real time and include useful information for injury surveillance and prevention. However, manual classification of the cause or events leading to injury found in large batches of narratives, such as workers compensation claims databases, can be prohibitive. In this study we compare the utility of four machine learning algorithms (Naïve Bayes, Single word and Bi-gram models, Support Vector Machine and Logistic Regression) for classifying narratives into Bureau of Labor Statistics Occupational Injury and Illness event leading to injury classifications for a large workers compensation database. These algorithms are known to do well classifying narrative text and are fairly easy to implement with off-the-shelf software packages such as Python. We propose human-machine learning ensemble approaches which maximize the power and accuracy of the algorithms for machine-assigned codes and allow for strategic filtering of rare, emerging or ambiguous narratives for manual review. We compare human-machine approaches based on filtering on the prediction strength of the classifier vs. agreement between algorithms. Regularized Logistic Regression (LR) was the best performing algorithm alone. Using this algorithm and filtering out the bottom 30% of predictions for manual review resulted in high accuracy (overall sensitivity/positive predictive value of 0.89) of the final machine-human coded dataset. The best pairings of algorithms included Naïve Bayes with Support Vector Machine whereby the triple ensemble NBSW=NBBI-GRAM=SVM had very high performance (0.93 overall sensitivity/positive predictive value and high accuracy (i.e. high sensitivity and positive predictive values)) across both large and small categories leaving 41% of the narratives for manual review. Integrating LR into this ensemble mix improved performance only slightly. For large administrative datasets we propose incorporation of methods based on human-machine pairings such as we

  15. Development, Implementation and Use of Electronic Surveillance for Ventilator-Associated Events (VAE) in Adults.

    Resetar, Ervina; McMullen, Kathleen M; Russo, Anthony J; Doherty, Joshua A; Gase, Kathleen A; Woeltje, Keith F

    2014-01-01

    Mechanical ventilation provides an important, life-saving therapy for severely ill patients, but ventilated patients are at an increased risk for complications, poor outcomes, and death during hospitalization.1 The timely measurement of negative outcomes is important in order to identify potential issues and to minimize the risk to patients. The Centers for Disease Control and Prevention (CDC) created an algorithm for identifying Ventilator-Associated Events (VAE) in adult patients for reporting to the National Healthcare Safety Network (NHSN). Currently, the primarily manual surveillance tools require a significant amount of time from hospital infection prevention (IP) staff to apply and interpret. This paper describes the implementation of an electronic VAE tool using an internal clinical data repository and an internally developed electronic surveillance system that resulted in a reduction of labor efforts involved in identifying VAE at Barnes Jewish Hospital (BJH).

  16. Injuries Associated with Femoral Shaft Fractures with Special Emphasis on Occult Injuries

    E Carlos Rodriguez-Merchan

    2013-12-01

    Full Text Available Background: Fractures of the femoral shaft are mostly the result of high-energy accidents that also cause multiple trauma injuries, in particular ipsilateral knee and hip injuries. The purpose of this study was to investigate the incidence of injuries associated with femoral shaft fractures and how many of them were undetected. Methods: We studied 148 patients (150 femoral shaft fractures with an average age of 52 (range: 18-97. Femoral shaft fractures were treated with antegrade intramedullary nailing in 118 cases (78.7%, and with open reduction and internal fixation in 32 cases (21.3%. Unlocked reamed intramedullary nailing was performed in Winquist type I and type II fractures, while statically locked unreamed intramedullary nailing was carried out in Winquist type III and type IV fractures. Results: There were 70 patients with associated injuries (46.4%. The associated injuries went undetected in 18 out of 70 patients (25.5%. Six femoral nonunions (4% occurred in patients under 70 years of age (high-energy accidents treated by open reduction and internal fixation. Conclusion: Injuries associated with femoral shaft fractures were very frequent (46.4% in our series, with 25.5% undetected. Open reduction and internal fixation was a poor prognostic factor of nonunion in these fractures.

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

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

    2013-01-01

    College student volunteers (n = 142) completed a 580 km road march for 21 consecutive days. Each volunteer carried a backpack that weighed 14.1 ± 1.4 kg on the average. We investigated the incidence and location of blisters associated with the road march using a foot map along with other injuries. Overall, 95.1% of the subjects (135 of 142) sustained one or more injuries. All injured subjects had foot blisters, and 18% had other foot injuries. The most common locations of blister development ...

  18. Acute lung injury probably associated with infusion of propofol emulsion.

    Chondrogiannis, K D; Siontis, G C M; Koulouras, V P; Lekka, M E; Nakos, G

    2007-08-01

    We present a case of acute lung injury associated with propofol infusion in a mechanically ventilated patient with intracerebral haemorrhage. Diagnosis was based on the exclusion of other risk factors inducing acute lung injury and on the clinical improvement after discontinuation of the propofol emulsion. Laboratory data such as the increase in total phospholipids, neutral lipids and free fatty acids in the broncho-alveolar lavage fluid, the remarkably high percentage of alveolar macrophages including fat droplets and the similar lipid composition of propofol and broncho-alveolar lavage fluid support the relationship between propofol and acute lung injury.

  19. Prevention of Infections Associated with Combat-Related Extremity Injuries

    2011-08-01

    segmental/ severely comminuted fractures, or heavily contaminated wounds Type IIIB As a Gustilo Type IIIA injury, but with periosteal stripping and bone...exposure 10–50% Type IIIC Any open fracture with vascular injury requiring repair 25–50% * Tibial fractures are associated with twice the infection...in 20 calcaneous fractures, 4 pilon fractures, and 20 tibial plateau fractures found no infec- tious differences between NPWT and standard wound care

  20. Eye injury risk associated with remote control toy helicopter blades.

    Alphonse, Vanessa D; Kemper, Andrew R; Rowson, Steven; Duma, Stefan M

    2012-01-01

    Eye injuries can be caused by a variety of consumer products and toys. Recently, indoor remote controlled (RC) toy helicopters have become very popular. The purpose of this study is to quantify eye injury risk associated with five commercially available RC toy helicopter blades. An experimental matrix of 25 tests was developed to test five different RC toy helicopter blades at full battery power on six postmortem human eyes. A pressure sensor inserted through the optic nerve measured intraocular pressure. Corneal abrasion was assessed post-impact using fluorescein dye. Intraocular pressure was correlated to injury risk for hyphema, lens damage, retinal damage, and globe rupture using published risk functions. All tests resulted in corneal abrasions; however, no other injuries were observed. The 25 tests produced an increase intraocular pressure between 15.2 kPa and 99.3 kPa (114.3 mmHg and 744.7 mmHg). Calculated blade velocities ranged between 16.0 m/s and 25.4 m/s. Injury risk for hyphema was a maximum of 0.2%. Injury risk for lens damage, retinal damage, and globe rupture was 0.0% for all tests. Blade design parameters such as length and mass did not affect the risk of eye injury. This is the first study to quantify the risk of eye injury from RC toy helicopter blades. While corneal abrasions were observed, more serious eye injuries were neither observed nor predicted to have occurred. Results from this study are critical for establishing safe design thresholds for RC toy helicopter blades so that more serious injuries can be prevented.

  1. Spinal cord injury and its association with blunt head trauma

    Paiva WS

    2011-09-01

    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

  2. Lower limb fractures associated with multiligament knee injury

    Stagnaro, Joaquin; Yacuzzi, Carlos; Barla, Jorge; Zicaro, Juan Pablo; Costa-Paz, Matias

    2017-01-01

    Objectives: Knee ligament injuries related to lower limb fractures are common and frequently unnoticed. Management of acute polytrauma is usually focused in the bone lesion and a complete physical examination might be really difficult. The purpose of this study was to analyze a series of patients who suffered multiligament knee injuries associated to a lower limb fracture. Hypothesis: The use of magnetic resonance imaging (MRI) during the initial management can lead to an early diagnosis of ligament injuries. Methods: A retrospective search was conducted from our hospital´s electronic database. We evaluated the initial diagnosis and acute surgical treatment, and management and functional outcomes after the ligament lesion was diagnosed. Results: Seven patients who presented a knee multiligament injury associated with a lower limb fracture were evaluated. The average age was 29 years. Primary diagnoses were: four tibial plateau fractures; one open fracture-dislocation of the knee; one open leg fracture and ipsilateral hip dislocation; and one bifocal femur fracture. Only three patients had an MRI during the initial management of trauma. Six out of seven patients had to be operated on for the multiligament knee injury. The period between the resolution of the fracture and the ligamentous repair was from 3 to 24 months. Conclusion: Poor functional outcomes are reported in patients with multiligament knee injuries associated with high-energy lower limb fractures. We consider an MRI during the initial management can lead to better outcomes. A trauma surgeon working alongside an arthroscopic surgeon might optimize the results for these lesions.

  3. Swimming overuse injuries associated with triathlon training.

    Bales, James; Bales, Karrn

    2012-12-01

    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.

  4. Association between the location of colon polyps at baseline and surveillance colonoscopy: a retrospective study

    Ana Oliveira

    Full Text Available Introduction: Several factors are used to stratify the probability of polyp recurrence. However, there are no studies correlating the location of the initial polyps and the recurrent ones. The aim of this study was to verify whether the polyp location at the surveillance colonoscopy was correlated with the location of the previously excised polyps at the baseline colonoscopy. Methods: A retrospective study of patients submitted to colonoscopy with presence and excision of all polyps, followed by a surveillance colonoscopy. Polyp location was divided into proximal/distal to splenic flexure and rectum. Characteristics and recurrent rates at the same colon location were also evaluated. Results: Out of the 346 patients who underwent repeated colonoscopy, 268 (77.4% had at least 1 polyp detected. For all the segments there was an increased risk of recurrent polyps in the same location and it was about four times higher in proximal (OR 3.5; CI 2.1-6.0 and distal colon segments (OR 3.8; CI 2.1-6.8, followed by three times higher in the rectum (OR 2.6; CI 1.5-4.6. No difference was found between the rates of recurrence at the same segment, taking into consideration the polyp morphology, size, polypectomy technique employed and histological classification. Conclusion: There seems to be a significant association between polyp location at baseline and surveillance colonoscopy.

  5. Humidifier disinfectant-associated lung injury in adults: Prognostic factors in predicting short-term outcome

    Koo, Hyun Jung; Do, Kyung-Hyun; Chae, Eun Jin [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Songpa-gu, Seoul (Korea, Republic of); Kim, Hwa Jung [University of Ulsan College of Medicine, Cancer Center, Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul (Korea, Republic of); Song, Joon Seon; Jang, Se Jin [University of Ulsan College of Medicine, Department of Pathology, Asan Medical Center, Seoul (Korea, Republic of); Hong, Sang-Bum; Huh, Jin Won [University of Ulsan College of Medicine, Department of Pulmonary and Critical Care Medicine, Asan Medical Center, Seoul (Korea, Republic of); Lee, En [Inje University Haundae Paik Hospital, Department of Pediatrics, Busan (Korea, Republic of); Hong, Soo-Jong [University of Ulsan College of Medicine, Department of Pediatrics, Childhood Asthma and Atopy Center, Environmental Health Center, Asan Medical Center, Seoul (Korea, Republic of)

    2017-01-15

    To identify clinical and radiologic findings that affect disease severity and short-term prognosis of humidifier disinfectant-associated lung injury in adults and to compare computed tomography (CT) findings between the patients with and without death or lung transplantation. Fifty-nine adults (mean age, 34 years; M/F = 12:47) were enrolled in this retrospective study. Medical records and prospective surveillance data were used to assess clinical and radiological factors associated with a poor clinical outcome. Multivariate generalized estimating equation models were used to analyse serial CT findings. Overall cumulative major events including lung transplantation and mortality were assessed using the Kaplan-Meier method. Almost half needed ICU admission (47.5 %) and 17 died (28.8 %). Young age, peripartum and low O{sub 2} saturation were factors associated with ICU admission. On initial chest radiographs, consolidation (P < 0.001) and ground-glass opacity (P = 0.01) were significantly noted in patients who required ICU admission. CT findings including consolidation (odds ratio (OR), 1.02), pneumomediastinum (OR, 1.66) and pulmonary interstitial emphysema (OR, 1.61) were the risk factors for lung transplantation and mortality. Clinical and radiologic findings are related to the risks of lung transplantation and mortality of humidifier disinfectant-associated lung injury. Consolidation, pneumomediastinum and pulmonary interstitial emphysema were short-term prognostic CT findings. (orig.)

  6. Surveillance for Waterborne Disease Outbreaks Associated with Drinking Water - United States, 2011-2012.

    Beer, Karlyn D; Gargano, Julia W; Roberts, Virginia A; Hill, Vincent R; Garrison, Laurel E; Kutty, Preeta K; Hilborn, Elizabeth D; Wade, Timothy J; Fullerton, Kathleen E; Yoder, Jonathan S

    2015-08-14

    Advances in water management and sanitation have substantially reduced waterborne disease in the United States, although outbreaks continue to occur. Public health agencies in the U.S. states and territories* report information on waterborne disease outbreaks to the CDC Waterborne Disease and Outbreak Surveillance System (http://www.cdc.gov/healthywater/surveillance/index.html). For 2011-2012, 32 drinking water-associated outbreaks were reported, accounting for at least 431 cases of illness, 102 hospitalizations, and 14 deaths. Legionella was responsible for 66% of outbreaks and 26% of illnesses, and viruses and non-Legionella bacteria together accounted for 16% of outbreaks and 53% of illnesses. The two most commonly identified deficiencies† leading to drinking water-associated outbreaks were Legionella in building plumbing§ systems (66%) and untreated groundwater (13%). Continued vigilance by public health, regulatory, and industry professionals to identify and correct deficiencies associated with building plumbing systems and groundwater systems could prevent most reported outbreaks and illnesses associated with drinking water systems.

  7. Drowning in a high-income developing country in the Middle East: newspapers as an essential resource for injury surveillance.

    Barss, Peter; Subait, Omer Mohamed; Ali, Mohamed Hassan Al; Grivna, Michal

    2009-01-01

    electronic searching on health terms, including injuries, would be a national asset for surveillance.

  8. [Diagnosis and treatment of associated injuries of the pelvis].

    Ivanov, P A; Faĭn, A M; Smoliar, A N; Shchetkin, V A

    2014-01-01

    The aim of investigation is improvement of treatment results of unstable injuries in the pelvic ring in patients with severe associated injuries. An experience of treatment of 533 patients with unstable pelvic injuries is presented. Diagnostic measures take into account the severity of the condition of the victim. Stage treatment with consecutive performing of temporary external immobilization of the pelvis and following final osteosynthesis was optimal. Replacement of external fixation for submersible osteosynthesis held in stable or terminal condition of the victim. Developed treatment of patients with pelvic injuries decreased mortality to 8.4%, number of general complications to 11.6% and number of local complications to 8.7%. Also it decreased length of hospital stay to 35.5 days and provided excellent and good functional results of treatment in 78.9% of cases.

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

    Yesupalan Rajam S

    2009-01-01

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

  10. Study on acute burn injury survivors and the associated issues

    Jonathan Bayuo; Pius Agbenorku; Richcane Amankwa

    2016-01-01

    Objective: To explore the phenomenon of surviving burn injury and its associated issues and concerns. Methods: A cross sectional survey approach was utilized to obtain data from one hundred burn survivors who were purposely selected. Descriptive statistics and content analysis were used to analyze data. Results: Findings from the study indicate that burns from flames stood out as a major cause of burns. Physical discomfort/pain, anxiety, needing assistance in meeting self-care needs, financial and social limitations were identified as the major impact of the injury. Furthermore, participants perceived the existence of societal stigma. In addition, hope in God or a spiritual being as well as family support were the two key resources participants relied on to cope effectively. Conclusions: Surviving burn injury is associated with varied physical, social and psy-chological factors and survivors may need professional assistance to fully adjust after discharge.

  11. Colorectal Cancer Surveillance after Index Colonoscopy: Guidance from the Canadian Association of Gastroenterology

    Desmond Leddin

    2013-01-01

    Full Text Available 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.

  12. Is Nonsuicidal Self Injury Associated With Parenting and Family Factors?

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

    2014-01-01

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

  13. Individual and social factors associated with workplace injuries

    Ashwin Kumar

    2011-07-01

    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 organisational workplace factors, such as: workload, work hours, work environment, safety culture, provision of quality

  14. Individual and social factors associated with workplace injuries

    Ashwin Kumar

    2011-08-01

    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

  15. Radial head fracture associated with posterior interosseous nerve injury

    Bernardo Barcellos Terra

    Full Text Available ABSTRACT Fractures of the radial head and radial neck correspond to 1.7-5.4% of all fractures and approximately 30% may present associated injuries. In the literature, there are few reports of radial head fracture with posterior interosseous nerve injury. This study aimed to report a case of radial head fracture associated with posterior interosseous nerve injury. CASE REPORT: A male patient, aged 42 years, sought medical care after falling from a skateboard. The patient related pain and limitation of movement in the right elbow and difficulty to extend the fingers of the right hand. During physical examination, thumb and fingers extension deficit was observed. The wrist extension showed a slight radial deviation. After imaging, it became evident that the patient had a fracture of the radial head that was classified as grade III in the Mason classification. The patient underwent fracture fixation; at the first postoperative day, thumb and fingers extension was observed. Although rare, posterior interosseous nerve branch injury may be associated with radial head fractures. In the present case, the authors believe that neuropraxia occurred as a result of the fracture hematoma and edema.

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

    Lee Lap-yip

    2010-02-01

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

  17. Thermal injury patterns associated with electronic cigarettes

    Jiwani, Alisha Z; Williams, James F; Rizzo, Julie A; Chung, Kevin K; King, Booker T; Cancio, Leopoldo C

    2017-01-01

    E-cigarettes are typically lithium-ion battery-operated devices that simulate smoking by heating a nicotine-solution into a vapor that the user inhales. E-cigarette use is becoming rapidly popular as an alternative to traditional cigarette smoking. This report describes an emerging problem associated with e-cigarettes, consisting of 10 thermally injured patients seen at a single burn center over a 2-year period from 2014 to 2016. Our cohort was comprised mainly of young adults who sustained mixed partial and full thickness burns as a result of e-cigarette-related explosions. In many documented scenarios, a malfunctioning or over-heated battery is the cause. Our data support the need for increased awareness among healthcare providers and the general public of the potential harms of e-cigarette use, modification, storage, and charging. PMID:28123861

  18. Association of Socio-economic Status with Injuries in Children Andadolescents:the CASPIAN-IV Study

    Roya Kelishadi

    2016-05-01

    Full Text Available Background:Childhood and adolescence injuries are still frequently occuring in developing countries. This study aims to assess the association  of socio-economic status (SES with injuriesin Iranian children and adolescents. Materials and Methods: This multicentricsurvey was part of a national surveillance program, which was conducted in 2011-2012 amongst 14,880 students aged6-18 years. Participants were randomly selected from urban and rural areas of 30 provinces in Iran. Socio- economic status (SES of participants was categorized to “low”, “middle” ,and “high” by using principle component analysis method by considering parental job and education as well as family assets. Prevalence, types and places of injuries were based on the questionnaire of the World Health Organization- Global School-based student Health Survey (WHO-GSHS.Multivariate modelwas used for comparison of variables between SES groups. Results: Overall, 13486 out of 14880 invited students (response rate: 90.6% participated in this study.Their mean (SD age was12.47 (3.36 years.Boys and urban residents constituted the majority of participants (50.8% and 75.6%, respectively. Compared with low SES group, oddsof sport injury was higher in students with middle (OR=1.44; 95%CI: 0.92-2.26 and highSES (OR=1.96; 95%CI: 1.27-3.01. Compared to participants withlow SES,odds of home injuries was significantly lower in high SES group (OR=0.78; 95%CI: 0.64-0.95. Conclusion: This study revealedconsiderable differences in injuries of children and adolescents according to their SES, with higher prevalence of home injuries in low SES families and higher prevalence of sport injuries in middle and high SES levels. When implementing injury prevention programs, such differences should be taken into account.

  19. Endothelial glycocalyx damage is associated with leptospirosis acute kidney injury.

    Libório, Alexandre Braga; Braz, Marcelo Boecker Munoz; Seguro, Antonio Carlos; Meneses, Gdayllon C; Neves, Fernanda Macedo de Oliveira; Pedrosa, Danielle Carvalho; Cavalcanti, Luciano Pamplona de Góes; Martins, Alice Maria Costa; Daher, Elizabeth de Francesco

    2015-03-01

    Leptospirosis is a common disease in tropical countries, and the kidney is one of the main target organs. Membrane proteins of Leptospira are capable of causing endothelial damage in vitro, but there have been no studies in humans evaluating endothelial glycocalyx damage and its correlation with acute kidney injury (AKI). We performed a cohort study in an outbreak of leptospirosis among military personnel. AKI was diagnosed in 14 of 46 (30.4%) patients. Leptospirosis was associated with higher levels of intercellular adhesion molecule-1 (ICAM-1; 483.1 ± 31.7 versus 234.9 ± 24.4 mg/L, P leptospirosis-associated AKI had increased level of syndecan-1 (112.1 ± 45.4 versus 41.5 ± 11.7 ng/mL, P = 0.021) and ICAM-1 (576.9 ± 70.4 versus 434.9 ± 35.3, P = 0.034) compared with leptospirosis patients with no AKI. Association was verified between syndecan-1 and ICAM-1 with serum creatinine elevation and neutrophil gelatinase-associated lipocalin (NGAL) levels. This association remained even after multivariate analysis including other AKI-associated characteristics. Endothelial injury biomarkers are associated with leptospirosis-associated renal damage.

  20. STUDY OF MICROBIOLOGICAL SURVEILLANCE AND ANTIBIOTIC STEWARDSHIP IN VENTILATOR ASSOCIATED PNEUMONIA

    Ajay Kumar

    2016-04-01

    Full Text Available BACKGROUND Ventilator-Associated Pneumonia (VAP continues to be a major problem in critically ill patients. The objective of this research was to know the burden of ventilator-associated pneumonia and effectiveness of antibiotic stewardship in Medical Intensive Care Unit (MICU of our institution. METHODS This prospective observational study was carried out for one year at our institution. It included all patients more than 18 years of age admitted to MICU who underwent invasive mechanical ventilation for more than 48 hours. Among these, patients who developed VAP as per the CPIS score were identified. Laboratory results were correlated with the patient’s clinical condition and adjunct investigations. The presumptive therapy for treatment of hospital acquired pneumonia was based on surveillance by hospital infection control unit. All patients who received empiric antimicrobial therapy were analysed against bacterial sensitivity. RESULTS The VAP rate was 67 cases per 1000 ventilator days. The incidence of early VAP was 47.5% and incidence of late VAP was 52.5%. Gram negative isolates in particular Acinetobacter baumannii were more frequent than the Gram positive isolates in early and late VAP; 95% Acinetobacter baumannii isolates were resistant to Carbapenem and sensitive to only Colistin in 67.6% cases, Colistin and Tigecycline in 24.3% cases and to other antibiotics in 8.1% cases. There were inappropriate empirical antibiotic prescriptions in 80% of instances and required a change of antibiotics after the culture and sensitivity report. CONCLUSIONS In conclusion, this work demonstrates the importance of an active surveillance program in multi-drug resistance outbreak recognition in our ICU and review of antimicrobial use to prevent emergence of antibiotic resistance strains and to preserve existing therapeutic option for caring for such infections.

  1. A novel data association scheme for LEO space debris surveillance based on a double fence radar system

    Huang, Jian; Hu, Weidong; Xin, Qin; Guo, Weiwei

    2012-12-01

    The increasing amount of space debris threatens to seriously deteriorate and damage space-based instruments in Low Earth Orbit (LEO) environments. Therefore, LEO space debris surveillance systems must be developed to provide situational awareness in space and issue warnings of collisions with LEO space debris. In this paper, a double fence radar system is proposed as an emerging paradigm for LEO space debris surveillance. This system exhibits several unique and promising characteristics compared with existing surveillance systems. In this paper, we also investigate the data association scheme for LEO space debris surveillance based on a double fence radar system. We also perform a theoretical analysis of the performance of our proposed scheme. The superiority and the effectiveness of our novel data association scheme is demonstrated by experimental results. The data used in our experiments is the LEO space debris catalog produced by the North American Air Defense Command (NORAD) up to 2009, especially for scenarios with high densities of LEO space debris, which were primarily produced by the collisions between Iridium 33 and Cosmos 2251. We hope that our work will stimulate and benefit future work on LEO space debris surveillance approaches and enable construction of the double fence radar system.

  2. Death Associated Protein Kinases: Molecular Structure and Brain Injury

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

    2013-01-01

    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 cerebr...

  3. Death Associated Protein Kinases: Molecular Structure and Brain Injury

    Claire Thornton

    2013-07-01

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

  4. Death associated protein kinases: molecular structure and brain injury.

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

    2013-07-04

    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.

  5. Public Health Surveillance Strategies for Mass Gatherings: Super Bowl XLIX and Related Events, Maricopa County, Arizona, 2015.

    Ayala, Aurimar; Berisha, Vjollca; Goodin, Kate; Pogreba-Brown, Kristen; Levy, Craig; McKinney, Benita; Koski, Lia; Imholte, Sara

    2016-01-01

    Super Bowl XLIX took place on February 1, 2015, in Glendale, Arizona. In preparation for this event and associated activities, the Maricopa County Department of Public Health (MCDPH) developed methods for enhanced surveillance, situational awareness, and early detection of public health emergencies. Surveillance strategies implemented from January 22 to February 6, 2015, included enhanced surveillance alerts; animal disease surveillance; review of NFL clinic visits; syndromic surveillance for emergency room visits, urgent care facilities, and hotels; real-time onsite syndromic surveillance; all-hazards mortality surveillance; emergency medical services surveillance, review of poison control center reports; media surveillance; and aberration detection algorithms for notifiable diseases. Surveillance results included increased influenzalike illness activity reported from urgent care centers and a few influenza cases reported in the NFL clinic. A cyanide single event exposure was investigated and determined not to be a public health threat. Real-time field syndromic surveillance documented minor injuries at all events and sporadic cases of gastrointestinal and neurological (mostly headaches) disease. Animal surveillance reports included a cat suspected of carrying plague and tularemia and an investigation of highly pathogenic avian influenza in a backyard chicken flock. Laboratory results in both instances were negative. Aberration detection and syndromic surveillance detected an increase in measles reports associated with a Disneyland exposure, and syndromic surveillance was used successfully during this investigation. Coordinated enhanced epidemiologic surveillance during Super Bowl XLIX increased the response capacity and preparedness of MCDPH to make informed decisions and take public health actions in a timely manner during these mass gathering events.

  6. Potential Misclassification of Urinary Tract-Related Bacteremia Upon Applying the 2015 Catheter-Associated Urinary Tract Infection Surveillance Definition From the National Healthcare Safety Network.

    Greene, M Todd; Ratz, David; Meddings, Jennifer; Fakih, Mohamad G; Saint, Sanjay

    2016-04-01

    The Centers for Disease Control and Prevention recently updated the surveillance definition of catheter-associated urinary tract infection to include only urine culture bacteria of at least 1 × 10(5) colony-forming units/mL. Our findings suggest that the new surveillance definition may fail to capture clinically meaningful catheter-associated urinary tract infections.

  7. Characterization of epidemiological surveillance systems for healthcare-associated infections (HAI) in the world and challenges for Brazil.

    Nogueira Junior, Cassimiro; Mello, Débora Silva de; Padoveze, Maria Clara; Boszczowski, Icaro; Levin, Anna Sara; Lacerda, Rubia Aparecida

    2014-01-01

    Surveillance systems for healthcare-associated infections (HAI) are essential for planning actions in prevention and control. Important models have been deployed in recent decades in different countries. This study aims to present the historical and operational characteristics of these systems and discuss the challenges for Brazil. Various models around the world have drawn on the experience of the United States, which pioneered this process. In Brazil, several initiatives have been launched, but the country still lacks a full national information system on HAI, thus indicating the need to promote action strategies, strengthen the role of States in communication between the Federal and local levels, pursue a national plan to organize surveillance teams with the necessary technological infrastructure, besides updating the relevant legislation for dealing with these challenges. Such measures are essential in the Brazilian context for the unified surveillance of HAI, aimed at healthcare safety and quality.

  8. Association between the number of injuries sustained and 12-month disability outcomes: evidence from the injury-VIBES study.

    Belinda J Gabbe

    Full Text Available To determine associations between the number of injuries sustained and three measures of disability 12-months post-injury for hospitalised patients.Data from 27,840 adult (18+ years participants, hospitalised for injury, were extracted for analysis from the Validating and Improving injury Burden Estimates (Injury-VIBES Study. Modified Poisson and linear regression analyses were used to estimate relative risks and mean differences, respectively, for a range of outcomes (Glasgow Outcome Scale-Extended, GOS-E; EQ-5D and 12-item Short Form health survey physical and mental component summary scores, PCS-12 and MCS-12 according to the number of injuries sustained, adjusted for age, sex and contributing study.More than half (54% of patients had an injury to more than one ICD-10 body region and 62% had sustained more than one Global Burden of Disease injury type. The adjusted relative risk of a poor functional recovery (GOS-E<7 and of reporting problems on each of the items of the EQ-5D increased by 5-10% for each additional injury type, or body region, injured. Adjusted mean PCS-12 and MCS-12 scores worsened with each additional injury type, or body region, injured by 1.3-1.5 points and 0.5 points, respectively.Consistent and strong relationships exist between the number of injury types and body regions injured and 12-month functional and health status outcomes. Existing composite measures of anatomical injury severity such as the NISS or ISS, which use up to three diagnoses only, may be insufficient for characterising or accounting for multiple injuries in disability studies. Future studies should consider the impact of multiple injuries to avoid under-estimation of injury burden.

  9. Aggravating andmitigating factors associated with cyclist injury severity in Denmark

    Kaplan, Sigal; Vavatsoulas,, Konstantinos; Prato, Carlo Giacomo

    2014-01-01

    Denmark is one of the leading cycling nations, where cycling trips constitute a large share of the total trips, and cycling safety assumes a top priority position in the agenda of policy makers. The current study sheds light on the aggravating and mitigating factors associated with cyclist injury...... severity on Danish roads by examining a comprehensive set of accidents involving a cyclist and a collision partner between 2007 and 2011. Method: This study estimates a generalized ordered logit model of the severity of cyclist injuries because of its ability to accommodate the ordered-response nature...... of severity while relaxing the proportional odds assumption. Results: Model estimates show that cyclist fragility (children under 10 years old and elderly cyclists over 60 years of age) and cyclist intoxication are aggravating individual factors,while helmet use is a mitigating factor. Speed limits above 70...

  10. Nutritional parameters are associated with mortality in acute kidney injury

    Marina Nogueira Berbel

    2014-07-01

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

  11. Association between traumatic bone marrow abnormalities of the knee, the trauma mechanism and associated soft-tissue knee injuries

    Berger, Nicole [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); University of Zurich, Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, Zurich (Switzerland); Andreisek, Gustav; Karer, Anissja T.; Manoliu, Andrei; Ulbrich, Erika J. [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Bouaicha, Samy [University Hospital Zurich, Department of Trauma Surgery, Zurich (Switzerland); Naraghi, Ali [University of Toronto, Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, Toronto, ON (Canada); Seifert, Burkhardt [University of Zurich, Epidemiology, Biostatistics and Prevention Institute, Department of Biostatistics, Zurich (Switzerland)

    2017-01-15

    To determine the association between traumatic bone marrow abnormalities, the knee injury mechanism, and associated soft tissue injuries in a larger cohort than those in the published literature. Retrospective study including 220 patients with traumatic knee injuries. Knee MRIs were evaluated for trauma mechanism, soft tissue injury, and the location of bone marrow abnormalities. The locations of the abnormalities were correlated with trauma mechanisms and soft tissue injuries using the chi-square test with Bonferroni correction. One hundred and forty-four valgus injuries, 39 pivot shift injuries, 25 lateral patellar dislocations, 8 hyperextensions, and 4 dashboard injuries were included. Valgus and pivot shift injuries showed traumatic bone marrow abnormalities in the posterolateral regions of the tibia. Abnormalities after patellar dislocation were found in the anterolateral and centrolateral femur and patella. Hyperextension injuries were associated with abnormalities in almost all regions, and dashboard injuries were associated with changes in the anterior regions of the tibia and femur. Our study provides evidence of associations between traumatic bone marrow abnormality patterns and different trauma mechanisms in acute knee injury, and reveals some overlap, especially of the two most common trauma mechanisms (valgus and pivot shift), in a large patient cohort. (orig.)

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

    Nair Shalini

    2008-08-01

    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

  13. Resilience Is Associated with Outcome from Mild Traumatic Brain Injury.

    Losoi, Heidi; Silverberg, Noah D; Wäljas, Minna; Turunen, Senni; Rosti-Otajärvi, Eija; Helminen, Mika; Luoto, Teemu Miikka Artturi; Julkunen, Juhani; Öhman, Juha; Iverson, Grant L

    2015-07-01

    Resilient individuals manifest adaptive behavior and are better able to recover from adversity. The association between resilience and outcome from mild traumatic brain injury (mTBI) is examined, and the reliability and validity of the Resilience Scale and its short form in mTBI research is evaluated. Patients with mTBI (n=74) and orthopedic controls (n=39) completed the Resilience Scale at one, six, and 12 months after injury. Additionally, self-reported post-concussion symptoms, fatigue, insomnia, pain, post-traumatic stress, and depression, as well as quality of life, were evaluated. The internal consistency of the Resilience Scale and the short form ranged from 0.91 to 0.93 for the mTBI group and from 0.86 to 0.95 for controls. The test-retest reliability ranged from 0.70 to 0.82. Patients with mTBI and moderate-to-high resilience reported significantly fewer post-concussion symptoms, less fatigue, insomnia, traumatic stress, and depressive symptoms, and better quality of life, than the patients with low resilience. No association between resilience and time to return to work was found. Resilience was associated with self-reported outcome from mTBI, and based on this preliminary study, can be reliably evaluated with Resilience Scale and its short form in those with mTBIs.

  14. Metformin-Associated Acute Kidney Injury and Lactic Acidosis

    David Arroyo

    2011-01-01

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

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

    Zhe DONG

    2012-03-01

    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.

  16. Surveillance for Waterborne Disease Outbreaks Associated with Drinking Water, United States 2009-2010

    Despite advancements 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 Syst...

  17. A potential causal association mining algorithm for screening adverse drug reactions in postmarketing surveillance.

    Ji, Yanqing; Ying, Hao; Dews, Peter; Mansour, Ayman; Tran, John; Miller, Richard E; Massanari, R Michael

    2011-05-01

    Early detection of unknown adverse drug reactions (ADRs) in postmarketing surveillance saves lives and prevents harmful consequences. We propose a novel data mining approach to signaling potential ADRs from electronic health databases. More specifically, we introduce potential causal association rules (PCARs) to represent the potential causal relationship between a drug and ICD-9 (CDC. (2010). International Classification of Diseases, Ninth Revision (ICD-9). [Online]. Available: http://www.cdc.gov/nchs/icd/icd9.html) coded signs or symptoms representing potential ADRs. Due to the infrequent nature of ADRs, the existing frequency-based data mining methods cannot effectively discover PCARs. We introduce a new interestingness measure, potential causal leverage, to quantify the degree of association of a PCAR. This measure is based on the computational, experience-based fuzzy recognition-primed decision (RPD) model that we developed previously (Y. Ji, R. M. Massanari, J. Ager, J. Yen, R. E. Miller, and H. Ying, "A fuzzy logic-based computational recognition-primed decision model," Inf. Sci., vol. 177, pp. 4338-4353, 2007) on the basis of the well-known, psychology-originated qualitative RPD model (G. A. Klein, "A recognition-primed decision making model of rapid decision making," in Decision Making in Action: Models and Methods, 1993, pp. 138-147). The potential causal leverage assesses the strength of the association of a drug-symptom pair given a collection of patient cases. To test our data mining approach, we retrieved electronic medical data for 16,206 patients treated by one or more than eight drugs of our interest at the Veterans Affairs Medical Center in Detroit between 2007 and 2009. We selected enalapril as the target drug for this ADR signal generation study. We used our algorithm to preliminarily evaluate the associations between enalapril and all the ICD-9 codes associated with it. The experimental results indicate that our approach has a potential to

  18. Plasmodium malariae Infection Associated with a High Burden of Anemia: A Hospital-Based Surveillance Study.

    Siobhan Langford

    2015-12-01

    Full Text Available Plasmodium malariae is a slow-growing parasite with a wide geographic distribution. Although generally regarded as a benign cause of malaria, it has been associated with nephrotic syndrome, particularly in young children, and can persist in the host for years. Morbidity associated with P. malariae infection has received relatively little attention, and the risk of P. malariae-associated nephrotic syndrome is unknown.We used data from a very large hospital-based surveillance system incorporating information on clinical diagnoses, blood cell parameters and treatment to describe the demographic distribution, morbidity and mortality associated with P. malariae infection in southern Papua, Indonesia. Between April 2004 and December 2013 there were 1,054,674 patient presentations to Mitra Masyarakat Hospital of which 196,380 (18.6% were associated with malaria and 5,097 were with P. malariae infection (constituting 2.6% of all malaria cases. The proportion of malaria cases attributable to P. malariae increased with age from 0.9% for patients under one year old to 3.1% for patients older than 15 years. Overall, 8.5% of patients with P. malariae infection required admission to hospital and the median length of stay for these patients was 2.5 days (Interquartile Range: 2.0-4.0 days. Patients with P. malariae infection had a lower mean hemoglobin concentration (9.0 g/dL than patients with P. falciparum (9.5 g/dL, P. vivax (9.6g/dL and mixed species infections (9.3g/dL. There were four cases of nephrotic syndrome recorded in patients with P. malariae infection, three of which were in children younger than 5 years old, giving a risk in this age group of 0.47% (95% Confidence Interval; 0.10% to 1.4%. Overall, 2.4% (n = 16 of patients hospitalized with P. malariae infection subsequently died in hospital, similar to the proportions for the other endemic Plasmodium species (range: 0% for P. ovale to 1.6% for P. falciparum.Plasmodium malariae infection is

  19. Oligodendrocyte Injury and Pathogenesis of HIV-1-Associated Neurocognitive Disorders

    Han Liu

    2016-07-01

    Full Text Available Oligodendrocytes wrap neuronal axons to form myelin, an insulating sheath which is essential for nervous impulse conduction along axons. Axonal myelination is highly regulated by neuronal and astrocytic signals and the maintenance of myelin sheaths is a very complex process. Oligodendrocyte damage can cause axonal demyelination and neuronal injury, leading to neurological disorders. Demyelination in the cerebrum may produce cognitive impairment in a variety of neurological disorders, including human immunodeficiency virus type one (HIV-1-associated neurocognitive disorders (HAND. Although the combined antiretroviral therapy has markedly reduced the incidence of HIV-1-associated dementia, a severe form of HAND, milder forms of HAND remain prevalent even when the peripheral viral load is well controlled. HAND manifests as a subcortical dementia with damage in the brain white matter (e.g., corpus callosum, which consists of myelinated axonal fibers. How HIV-1 brain infection causes myelin injury and resultant white matter damage is an interesting area of current HIV research. In this review, we tentatively address recent progress on oligodendrocyte dysregulation and HAND pathogenesis.

  20. Oligodendrocyte Injury and Pathogenesis of HIV-1-Associated Neurocognitive Disorders

    Liu, Han; Xu, Enquan; Liu, Jianuo; Xiong, Huangui

    2016-01-01

    Oligodendrocytes wrap neuronal axons to form myelin, an insulating sheath which is essential for nervous impulse conduction along axons. Axonal myelination is highly regulated by neuronal and astrocytic signals and the maintenance of myelin sheaths is a very complex process. Oligodendrocyte damage can cause axonal demyelination and neuronal injury, leading to neurological disorders. Demyelination in the cerebrum may produce cognitive impairment in a variety of neurological disorders, including human immunodeficiency virus type one (HIV-1)-associated neurocognitive disorders (HAND). Although the combined antiretroviral therapy has markedly reduced the incidence of HIV-1-associated dementia, a severe form of HAND, milder forms of HAND remain prevalent even when the peripheral viral load is well controlled. HAND manifests as a subcortical dementia with damage in the brain white matter (e.g., corpus callosum), which consists of myelinated axonal fibers. How HIV-1 brain infection causes myelin injury and resultant white matter damage is an interesting area of current HIV research. In this review, we tentatively address recent progress on oligodendrocyte dysregulation and HAND pathogenesis. PMID:27455335

  1. Medical Surveillance Monthly Report (MSMR). Volume 2, Number 4, April 1996

    1996-04-01

    Epidemiology of Injuries Associated with Physical Training Among Young Men in the Army. Medicine and Science in Sports and Exercise . 25:197-203, 1993...available to the Medical Surveillance Activity . Notifiable conditions are reported by date of onset (or date of notification when date of onset is absent...Selected notifiable conditions ....................................... 4 Notifiable sexually transmitted diseases ....................... 6 Injuries

  2. Clonal distribution and associated characteristics of Escherichia coli clinical and surveillance isolates from a military medical center.

    Manges, Amee R; Mende, Katrin; Murray, Clinton K; Johnston, Brian D; Sokurenko, Evgeni V; Tchesnokova, Veronika; Johnson, James R

    2017-04-01

    Antimicrobial-resistant Escherichia coli are a concern for military health services. We studied 100 extended-spectrum beta-lactamase (ESBL)-producing and non-producing E. coli clinical and surveillance isolates from military personnel and civilians at Brooke Army Medical Center (2007-2011). Major E. coli lineages, most prominently ST10 (24%), ST131 (16%), and ST648 (8%), were distributed much as reported for other North American populations. ST131, represented mainly by its resistance-associated ST131-H30 clonal subset, was uniquely associated with a clinical origin, regardless of ESBL status. Thus, clonal background predicted resistance phenotype and clinical versus surveillance origin, and these findings could assist military clinicians and epidemiologists.

  3. Association Between Living Alone and Physical Inactivity Among People With and Without Disability, Florida Behavioral Risk Factor Surveillance System, 2009

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

    2014-01-01

    People with disability may be at risk of developing diseases due to physical inactivity; social support from family and friends is positively related to engaging in regular physical activity. We compared the association between living alone and engagement in physical activity among people with and without disability in Florida. We used multivariate logistical regression to analyze 2009 Florida Behavioral Risk Factor Surveillance System data (n = 10,902) to assess differences in physical activ...

  4. Pattern of midface trauma with associated concomitant injuries in a Nigerian Referral Centre

    Samuel Udeabor

    2014-01-01

    Full Text Available Aim: The aim of this study was to determine the pattern of midface trauma with associated concomitant injuries seen in our environment. Methodology: This was a prospective analysis of trauma patients with midfacial injuries presenting at a referral center in South West Nigeria. In addition to socio-demographic data, the following information was also obtained: Mechanism of injuries, type of midfacial injuries, concomitant/associated injuries and treatment. Results: A total of 101 patients with midfacial injuries were involved. They were made up of 85 males and 16 females. The 20-29 year age group was mostly affected (44.6% and the most common cause of midface injuries was road traffic accident (91.1%. The zygoma was fractured more than any other midfacial bone (46.0%. A total of 144 associated injuries were recorded among these patients, head and ocular injuries accounted for 49 (34% and 35 (24.3% respectively. The patients were mostly treated conservatively or by closed reduction. Conclusion: The rate of head and ocular injuries among patients with midfacial injury was high. Knowledge of these associated injuries provides useful strategies for patient care and prevention of further complications. A multidisciplinary approach is important for optimum management of these patients.

  5. GeoMedStat: an integrated spatial surveillance system to track air pollution and associated healthcare events.

    Faruque, Fazlay S; Li, Hui; Williams, Worth B; Waller, Lance A; Brackin, Bruce T; Zhang, Lei; Grimes, Kim A; Finley, Richard W

    2014-12-01

    Air pollutants, such as particulate matter with a diameter ≤2.5 microns (PM2.5) and ozone (O3), are known to exacerbate asthma and other respiratory diseases. An integrated surveillance system that tracks such air pollutants and associated disease incidence can assist in risk assessment, healthcare preparedness and public awareness. However, the implementation of such an integrated environmental health surveillance system is a challenge due to the disparate sources of many types of data and the implementation becomes even more complicated for a spatial and real-time system due to lack of standardised technological components and data incompatibility. In addition, accessing and utilising health data that are considered as Protected Health Information (PHI) require maintaining stringent protocols, which have to be supported by the system. This paper aims to illustrate the development of a spatial surveillance system (GeoMedStat) that is capable of tracking daily environmental pollutants along with both daily and historical patient encounter data. It utilises satellite data and the groundmonitor data from the US National Aeronautics and Space Administration (NASA) and the US Environemental Protection Agenecy (EPA), rspectively as inputs estimating air pollutants and is linked to hospital information systems for accessing chief complaints and disease classification codes. The components, developmental methods, functionality of GeoMedStat and its use as a real-time environmental health surveillance system for asthma and other respiratory syndromes in connection with with PM2.5 and ozone are described. It is expected that the framework presented will serve as an example to others developing real-time spatial surveillance systems for pollutants and hospital visits.

  6. GeoMedStat: an integrated spatial surveillance system to track air pollution and associated healthcare events

    Fazlay S. Faruque

    2014-12-01

    Full Text Available Air pollutants, such as particulate matter with a diameter ≤2.5 microns (PM2.5 and ozone (O3, are known to exacerbate asthma and other respiratory diseases. An integrated surveillance system that tracks such air pollutants and associated disease incidence can assist in risk assessment, healthcare preparedness and public awareness. However, the implementation of such an integrated environmental health surveillance system is a challenge due to the disparate sources of many types of data and the implementation becomes even more complicated for a spatial and real-time system due to lack of standardised technological components and data incompatibility. In addition, accessing and utilising health data that are considered as Protected Health Information (PHI require maintaining stringent protocols, which have to be supported by the system. This paper aims to illustrate the development of a spatial surveillance system (GeoMedStat that is capable of tracking daily environmental pollutants along with both daily and historical patient encounter data. It utilises satellite data and the groundmonitor data from the US National Aeronautics and Space Administration (NASA and the US Environemental Protection Agenecy (EPA, rspectively as inputs estimating air pollutants and is linked to hospital information systems for accessing chief complaints and disease classification codes. The components, developmental methods, functionality of GeoMedStat and its use as a real-time environmental health surveillance system for asthma and other respiratory syndromes in connection with with PM2.5 and ozone are described. It is expected that the framework presented will serve as an example to others developing real-time spatial surveillance systems for pollutants and hospital visits.

  7. Surveillance length and validity of benchmarks for central line-associated bloodstream infection incidence rates in intensive care units.

    Patricia S Fontela

    Full Text Available INTRODUCTION: Several national and regional central line-associated bloodstream infections (CLABSI surveillance programs do not require continuous hospital participation. We evaluated the effect of different hospital participation requirements on the validity of annual CLABSI incidence rate benchmarks for intensive care units (ICUs. METHODS: We estimated the annual pooled CLABSI incidence rates for both a real regional (<100 ICUs and a simulated national (600 ICUs surveillance program, which were used as a reference for the simulations. We simulated scenarios where the annual surveillance participation was randomly or non-randomly reduced. Each scenario's annual pooled CLABSI incidence rate was estimated and compared to the reference rates in terms of validity, bias, and proportion of simulation iterations that presented valid estimates (ideal if ≥ 90%. RESULTS: All random scenarios generated valid CLABSI incidence rates estimates (bias -0.37 to 0.07 CLABSI/1000 CVC-days, while non-random scenarios presented a wide range of valid estimates (0 to 100% and higher bias (-2.18 to 1.27 CLABSI/1000 CVC-days. In random scenarios, the higher the number of participating ICUs, the shorter the participation required to generate ≥ 90% valid replicates. While participation requirements in a countrywide program ranged from 3 to 13 surveillance blocks (1 block = 28 days, requirements for a regional program ranged from 9 to 13 blocks. CONCLUSIONS: Based on the results of our model of national CLABSI reporting, the shortening of participation requirements may be suitable for nationwide ICU CLABSI surveillance programs if participation months are randomly chosen. However, our regional models showed that regional programs should opt for continuous participation to avoid biased benchmarks.

  8. Seatbelt syndrome associated with an isolated rectal injury: case report.

    Hefny, Ashraf F; Al-Ashaal, Yousef I; Bani-Hashem, Ahmed M; Abu-Zidan, Fikri M

    2010-02-04

    Seatbelt syndrome is defined as a seatbelt sign associated with a lumbar spine fracture and a bowel perforation. An isolated rectal perforation due to seatbelt syndrome is extremely rare. There is only one case reported in the Danish literature and non in the English literature. A 48-year old front seat restrained passenger was involved in a head-on collision. He had lower abdominal pain and back pain. Seatbelt mark was seen across the lower abdomen. Initial trauma CT scan was normal except for a burst fracture of L5 vertebra which was operated on by internal fixation on the same day. The patient continued to have abdominal pain. A repeated abdominal CT scan on the third day has shown free intraperitoneal air. Laparotomy has revealed a perforation of the proximal part of the rectum below the recto sigmoid junction. Hartmann's procedure was performed. The abdomen was left open. Gradual closure of the abdominal fascia over a period of two weeks was performed. Postoperatively, the patient had temporary urinary retention due to quada equina injury which resolved 10 months after surgery. The presence of a seatbelt sign and a lumbar fracture should raise the possibility of a bowel injury.

  9. Seatbelt syndrome associated with an isolated rectal injury: case report

    Bani-Hashem Ahmed M

    2010-02-01

    Full Text Available Abstract Seatbelt syndrome is defined as a seatbelt sign associated with a lumbar spine fracture and a bowel perforation. An isolated rectal perforation due to seatbelt syndrome is extremely rare. There is only one case reported in the Danish literature and non in the English literature. A 48-year old front seat restrained passenger was involved in a head-on collision. He had lower abdominal pain and back pain. Seatbelt mark was seen across the lower abdomen. Initial trauma CT scan was normal except for a burst fracture of L5 vertebra which was operated on by internal fixation on the same day. The patient continued to have abdominal pain. A repeated abdominal CT scan on the third day has shown free intraperitoneal air. Laparotomy has revealed a perforation of the proximal part of the rectum below the recto sigmoid junction. Hartmann's procedure was performed. The abdomen was left open. Gradual closure of the abdominal fascia over a period of two weeks was performed. Postoperatively, the patient had temporary urinary retention due to quada equina injury which resolved 10 months after surgery. The presence of a seatbelt sign and a lumbar fracture should raise the possibility of a bowel injury.

  10. The Association between Blunt Cardiac Injury and Isolated Sternal Fracture

    McMaster, Jason; Desai, Pathik J.; Desai, Sapan S.; Kuy, SreyRam; Mata, Maggy; Cooper, Jamie

    2014-01-01

    The treatment of isolated sternal fractures (ISF) throughout the world is heterogeneous. This study aimed to identify the incidence, morbidity, and mortality associated with isolated fractures of the sternum and describe current practice for diagnosis and management of ISF and cardiac injury at a level I trauma center in the UK. A retrospective cohort study of adult patients (>16 years) with ISF presenting from 2006 to 2010 was conducted. Eighty-eight patients with ISF were identified. Most patients (88%, 77) were admitted to hospital with 66% (58) of them discharged within 48 hours. Two (2%) patients had an ER EKG with abnormality but both resolved to normal sinus rhythm within 6 hours of follow-up. Serum CEs were drawn from 55 (63%) patients with only 2 (2%) having a rise in serum troponin >0.04; however, in both of these patients troponin quickly normalized. Six (7%) patients underwent echocardiograms without significant findings. In all 88 patients with ISF, no cases of clinically significant cardiac injury were identified. Patients presenting with an isolated sternal fracture with no changes on EKG or chest X-ray do not warrant an admission to hospital and may be discharged from the ER. PMID:24653859

  11. The Association between Blunt Cardiac Injury and Isolated Sternal Fracture

    Anahita Dua

    2014-01-01

    Full Text Available The treatment of isolated sternal fractures (ISF throughout the world is heterogeneous. This study aimed to identify the incidence, morbidity, and mortality associated with isolated fractures of the sternum and describe current practice for diagnosis and management of ISF and cardiac injury at a level I trauma center in the UK. A retrospective cohort study of adult patients (>16 years with ISF presenting from 2006 to 2010 was conducted. Eighty-eight patients with ISF were identified. Most patients (88%, 77 were admitted to hospital with 66% (58 of them discharged within 48 hours. Two (2% patients had an ER EKG with abnormality but both resolved to normal sinus rhythm within 6 hours of follow-up. Serum CEs were drawn from 55 (63% patients with only 2 (2% having a rise in serum troponin >0.04; however, in both of these patients troponin quickly normalized. Six (7% patients underwent echocardiograms without significant findings. In all 88 patients with ISF, no cases of clinically significant cardiac injury were identified. Patients presenting with an isolated sternal fracture with no changes on EKG or chest X-ray do not warrant an admission to hospital and may be discharged from the ER.

  12. Kidney injury associated with telavancin dosing regimen in an animal model.

    Tam, Vincent H; Ledesma, Kimberly R; Bowers, Dana R; Zhou, Jian; Truong, Luan D

    2015-05-01

    The elevation of serum creatinine levels is a concern with telavancin therapy. We examined the onset of kidney injury associated with telavancin in an animal model. Urine samples were collected at baseline and daily to determine the concentrations of kidney injury molecule 1 (KIM-1), a marker for early kidney injury. When a clinically relevant exposure of telavancin was given daily to rats, some differences in kidney injury were attributed to the dosing regimen. Further investigations of alternative telavancin dosing regimens are warranted.

  13. Associated injuries in traumatic sternal fractures: a review of the National Trauma Data Bank.

    Oyetunji, Tolulope A; Jackson, Hope T; Obirieze, Augustine C; Moore, Danier; Branche, Marc J; Greene, Wendy R; Cornwell, Edward E; Siram, Suryanarayana M

    2013-07-01

    Sternal fractures occur infrequently with blunt force trauma. The demographics and epidemiology of associated injuries have not been well characterized from a national trauma database. The National Trauma Data Bank was queried for patients with closed sternal fractures. The demographics were analyzed by age, gender, mechanism and indicators of anatomic and physiologic injuries. Types of commonly associated injuries were also determined. A total of 23,985 records were analyzed. Males accounted for 68.3 per cent and whites 70.9 per cent. Motor vehicle crash was the leading mechanism. More than 56 per cent had severe injuries based on Injury Severity Score (greater than 15) and 17 per cent with Glasgow Coma Score 8 or less. Crude mortality was 7.9 per cent. The majority (57.8%) and approximately one-third (33.7%) of the patients had rib fractures and lung contusions, respectively, 22.0 per cent with closed pneumothorax, 21.6 per cent had a closed thoracic vertebra fracture, 16.9 per cent with lumbar spine fracture, 3.9 per cent with concussion, and blunt cardiac injury in 3.6 per cent. Sternal fractures are usually associated with severe blunt trauma. Lung contusion remains the leading associated injury followed by vertebral spine fractures. Cardiac injuries are less frequent and vascular injuries less so. Mechanism of injury and presence of sternal fractures should alert providers to these potential associated injuries.

  14. Associated injuries in patients with facial fractures: a review of 604 patients.

    Béogo, Rasmané; Dakouré, Patrick; Savadogo, Léon Blaise; Coulibaly, Antoine Toua; Ouoba, Kampadilemba

    2013-01-01

    Facial fractures may be associated with concomitant lesions of other parts of body with some of these injuries being life-threatening. This retrospective study reports the types of associated injury and the factors influencing their occurrence, in patients with facial fractures. In 18.2% of 604 patients, one associated injury at least was recorded. The most common associated injury was cranial trauma (9.9%), followed by limbs fractures (9.1%), chest trauma (2%), spine injury (0.5%) and eye ball rupture (0.5%). A poly trauma was recorded in 3.2% of the patients who had sustained a cerebral trauma, a spinal injury or a thoracic trauma. Death occurred in two patients (0.3%) who had respectively a spinal injury and a chest trauma. The occurrence of associated injuries correlated significantly with the fracture type with solitary mandibular fracture being a significant predictor of associated injuries. Although not statistically significant, multiple facial fractures and violence were more associated with concomitant injuries. The findings of this study recall the need for initial full examination of the trauma patients particularly victims of violence, patients presenting with multiple facial fractures or single facial bone fracture involving the mandible, the trauma patients? multidisciplinary management as well as trauma prevention.

  15. 清远市农村儿童伤害监测结果分析%Results analysis of injury surveillance among rural children in Qingyuan City

    朱旭豪; 张铭驱; 何志礼; 胡术贤

    2012-01-01

    [Objective]To analyze the main causes of injury among rural children under 15 years old in Qingyuan City, find out the laws, and evaluate the harm of injuries in this population. [Methods]The data of injury surveillance among children in Qingyuan rural area during 2009-2011 were analyzed descriptively. [Results]During 2009-2011, a total of 980 childrens injuries cases were collected in Qingyuan rural area by the National injury surveillance system, which accounted for 9. 27% of total injuries cases in Qingyuan City. The injuries cases occurred in different genders and all age groups, and proportion of boys was higher than that of girls. The peak season was June to October. 463 (47.29% ) injuries cases occurred in school and public places, followed by home (278cases, 28.34%) and farm/field (150cases, 15.27%). The leading cause of injury was fall. The animal bites, traffic accidents and sharp/blunt injuries ranked front. 917 (93.59%) injuries cases were unintentional, 59 cases (6.02% ) were intentional (violence, attack), and there were 4 (0.41%) cases of self mutilation and suicide. The top 3 injured sites were head (369 cases, 37. 64% ) , upper limbs (214 cases, 21. 82% ) and low limbs (195 cases, 19.93% ). There were 786 (80.21 % ) cases of superficial injury, 145 (14. 77% ) cases of moderate injury, 38 (3. 85% ) cases of severe injury and 11 (1. 17% ) death cases. [ Conclusion] The injury is one of the major risk factors which are harmful to childrens health. The government and society should take effective measures to prevent and control the injury among rural child.%目的 分析清远市15岁及以下农村儿童伤害的原因,找出伤害发生的规律,评价伤害对该人群造成的危害.方法 对清远市农村地区2009-2011年儿童伤害监测资料进行描述性分析.结果 2009-2011年全国伤害监测系统共收集清远市农村儿童伤害病例980例,占清远市伤害总病例的9.27%;不同性别各年龄段均有伤害发生,男童

  16. Is HELICS the right way? Lack of chest radiography limits ventilator-associated pneumonia surveillance in Wales

    Richard Pugh

    2016-08-01

    Full Text Available Introduction: The reported incidence of ventilator-associated pneumonia (VAP in Wales is low compared with surveillance data from other European regions. It is unclear whether this reflects success of the Welsh healthcare-associated infection prevention measures or limitations in the application of European VAP surveillance methods. Our primary aim was to investigate episodes of ventilator-associated respiratory tract infection (VARTI, to identify episodes that met established criteria for VAP, and to explore reasons why others did not, according to the Hospitals in Europe Link for Infection Control through Surveillance (HELICS definitions. Materials and methods: During two 14-day study periods 2012-2014, investigators reviewed all invasively ventilated patients in all 14 Welsh Intensive Care Units (ICUs. Episodes were identified in which the clinical team had commenced antibiotic therapy because of suspected VARTI. Probability of pneumonia was estimated using a modified Clinical Pulmonary Infection Score (mCPIS. Episodes meeting HELICS definitions of VAP were identified, and reasons for other episodes not meeting definitions examined. In the second period, each patient was also assessed with regards to the development of a ventilator-associated event (VAE, according to recent US definitions. Results: The study included 306 invasively ventilated patients; 282 were admitted to ICU for 48 hours or more. 32 (11.3% patients were commenced on antibiotics for suspected VARTI. 10 of these episodes met HELICS definitions of VAP, an incidence of 4.2 per 1000 intubation days. In 48% VARTI episodes, concurrent chest radiography was not performed, precluding the diagnosis of VAP. Mechanical ventilation (16.0 vs. 8.0 days; p=0.01 and ICU stay (25.0 vs. 11.0 days; p=0.01 were significantly longer in patients treated for VARTI compared to those not treated. There was no overlap between episodes of VARTI and of VAE. Discussion: HELICS VAP surveillance

  17. Revisiting acute liver injury associated with herbalife products.

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

    2011-10-27

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

  18. Association Between User-Generated Commuting Data and Population-Representative Active Commuting Surveillance Data - Four Cities, 2014-2015.

    Whitfield, Geoffrey P; Ussery, Emily N; Riordan, Brian; Wendel, Arthur M

    2016-09-16

    Creating environments that support all types of physical activity, including active transportation, is a public health priority (1). Public health surveillance that identifies the locations where community members walk and bicycle (i.e., engage in active transportation) can inform such efforts. Traditional population-representative active transportation surveillance incurs a considerable time lag between data collection and dissemination, and often lacks geographic specificity (2). Conversely, user-generated active transportation data from Global Positioning System (GPS)-based activity tracking devices and mobile applications can provide near real-time information, but might be subject to self-selection bias among users. CDC analyzed the association between GPS-based commuting data from a company that allows tracking of activity with a mobile application (Strava, Inc., San Francisco, California) and population-representative commuting data from the U.S. Census Bureau's American Community Survey (ACS) (3) for four U.S. cities. The level of analysis was the Census block group. The number of GPS-tracked commuters in Strava was associated with the number of ACS active commuters (Spearman's rho = 0.60), suggesting block groups were ranked similarly based on these distinct but related measurements. The correlation was higher in high population density areas. User-generated active transportation data might complement traditional surveillance systems by providing near real-time, location-specific information on where active transportation occurs.

  19. Location of Sternal Fractures as a Possible Marker for Associated Injuries

    Max J. Scheyerer

    2013-01-01

    Full Text Available Introduction. Sternal fractures often occur together with serious and life-threatening additional injuries. This retrospective study was designed to assess concomitant injuries and develop a correlation between fracture location and the severity of injury. Methods. All patients ( diagnosed with a fracture of the sternum by means of a CT scan were analysed with respect to accident circumstances, fracture morphology and topography, associated injuries, and outcome. Results. Isolated sternal fractures occurred in 9%. In all other admissions, concomitant injuries were diagnosed: mainly rip fractures (64%, injury to the head (48%, the thoracic spine (38%, lumbar spine (27%, and cervical spine (22%. Predominant fracture location was the manubrium sterni. In these locations, the observed mean ISS was the highest. They were strongly associated with thoracic spine and other chest injuries. Furthermore, the incidence of head injuries was significantly higher. ICU admission was significantly higher in patients with manubrium sterni fractures. Conclusion. Sternal fractures are frequently associated with other injuries. It appears that the fracture location can provide important information regarding concomitant injuries. In particular, in fractures of manubrium sterni, the need for further detailed clinical and radiologic workup is necessary to detect the frequently associated injuries and reduce the increased mortality.

  20. Workers' Health Surveillance in the Meat Processing Industry : Work and Health Indicators Associated with Work Ability

    van Holland, Berry J.; Soer, Remko; de Boer, Michiel R.; Reneman, Michiel F.; Brouwer, Sandra

    2015-01-01

    Background Workers' health surveillance (WHS) programs commonly measure a large number of indicators addressing health habits and health risks. Recently, work ability and functional capacity have been included as important risk measures in WHS. In order to address work ability appropriately, knowled

  1. Utility of the brain injury screening index in identifying female prisoners with a traumatic brain injury and associated cognitive impairment.

    O'Sullivan, Michelle

    2015-01-01

    An estimated 60.25% of offenders have a history of traumatic brain injury (TBI). There is currently no established valid or reliable screening tool for identifying female prisoners with a TBI and associated cognitive impairment available in the UK. Using a cross-sectional design, this study aimed to investigate the retest reliability and construct validity of the Brain Injury Screening Index (BISI). Convergent validity was explored using self-report measures of mood and neurodisability, as we...

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

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

    2013-10-01

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

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

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

    2011-01-01

    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…

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

    Berg, Kasper Drimer; Vainer, Ben; Thomsen, Frederik Birkebæk;

    2014-01-01

    BACKGROUND: Compelling biomarkers identifying prostate cancer patients with a high risk of progression during active surveillance (AS) are needed. OBJECTIVE: To examine the association between ERG expression at diagnosis and the risk of progression during AS. DESIGN, SETTING, AND PARTICIPANTS......: This study included 265 patients followed on AS with prostate-specific antigen (PSA) measurements, clinical examinations, and 10-12 core rebiopsies from 2002 to 2012 in a prospectively maintained database. ERG immunohistochemical staining was performed on diagnostic paraffin-embedded formalin-fixed sections...

  5. 2007-2008年北京市0~6岁儿童伤害社区监测结果分析%Community based injury surveillance among children of 0~6 years old in Beijing

    闫淑娟; 陈欣欣; 万欢

    2011-01-01

    [Objective] To understand the pattern of child injury through community based surveillance and to provide evidence for targeted interventions. [Methods] Children of 0~6 years old in 2 urban and 3 rural communities in Beijing, were included in the injury surveillance system by stratified cluster sampling. Injury data were collected at community primary health care centers and community kindergartens located in these communities. [ Results] From 2007 to 2008, an average of 8,085 children per year were covered by the surveillance. Injury incidence rates were reduced from 2. 09% to 1. 75%. The main causes of injury were falls (49. 52%), blunt object injury(12. 30%), animal injury(10. 36%), burn/ scald(10. 03%), and traffic injury(8. 09%). The main causes in urban area were falls and blunt object injuries whereas in rural area were falls, animal injuries, and traffic injuries. The majority of injuries happened at home(32. 04%),kindergar-ten(22.98%), courtyard/stair/corridor( 14. 24%), road(13. 59%) and public places(11. 33%). Head(50. 81%), upper limbs(28. 80%) and lower limbs(14. 24%) were injured more frequently than other parts of the body. The majority of the injuries are unintentional, minor injuries. [Conclusions] Community based injury surveillance provides a viable source of data collection for child injury prevention. In urban area, interventions should focus on falls and blunt object injuries, whereas dog bites and injuries resulting from children getting their feet caught in bicycle wheels are the focuses in rural area.%[目的]通过社区监测了解儿童伤害特点,制定有针对性的干预措施. [方法]采用分层整群抽样方法抽取北京市城市2个街道和农村3个乡镇,通过社区卫生服务中心和幼儿园监测0~6岁儿童伤害发生情况. [结果] 2007-2008年平均每年监测0~6岁儿童8 085人,2年中,0~6岁儿童伤害发生率从2.09%下降至1.75%.儿童主要伤害原因为跌伤(49.51%)、钝器伤(12.30%)

  6. Breaking Out of Surveillance Silos: Integrative Geospatial Data Collection for Child Injury Risk and Active School Transport.

    Schuch, Laura; Curtis, Jacqueline W; Curtis, Andrew; Hudson, Courtney; Wuensch, Heather; Sampsell, Malinda; Wiles, Erika; Infantino, Mary; Davis, Andrew J

    2016-02-01

    The preponderance of active school transport (AST) and child injury research has occurred independently, yet they are inherently related. This is particularly true in urban areas where the environmental context of AST may pose risks to safety. However, it can be difficult to make these connections due to the often segregated nature in which these veins of research operate. Spatial video presents a geospatial approach for simultaneous data collection related to both issues. This article reports on a multi-sector pilot project among researchers, a children's hospital, and a police department, using spatial video to map child AST behaviors; a geographic information system (GIS) is used to analyze these data in the environmental context of child pedestrian injury and community violence.

  7. [Metformin-associated lactic acidosis and acute kidney injury].

    Greco, Paolo; Regolisti, Giuseppe; Antoniotti, Riccardo; Maccari, Caterina; Parenti, Elisabetta; Corrado, Silvia; Fiaccadori, Enrico

    2016-01-01

    Metformin is recommended as the treatment of choice in patients with type 2 diabetes mellitus because of its efficacy, general tolerability and low cost. Recent guidelines have extended the use of metformin to patients with Chronic Kidney Disease (CKD) up to stage III. However, in the recent literature, cases of MALA (metformin-associated lactic acidosis) are increasingly reported. MALA is the most dangerous side effect of the drug, with an incidence rate of 2-9 cases per 100000 person-years of exposure. We report on two patients with accidental metformin overdose, severe lactic acidosis and acute kidney injury. In both cases, the usual dose of metformin was inappropriate with respect to the level of kidney dysfunction (CKD stage III). As both patients met the criteria for renal replacement therapy in metformin poisoning, they were treated effectively with sustained low-efficiency dialysis until normalization of serum lactate and bicarbonate values. Clinical status and kidney function improved and both patients could be discharged from the hospital.

  8. Molecular signatures of trauma-hemorrhagic shock-induced lung injury: hemorrhage- and injury-associated genes.

    Feinman, Rena; Deitch, Edwin A; Aris, Virginie; Chu, Hung B; Abungu, Billy; Caputo, Francis J; Galante, Anthony; Xu, DaZhong; Lu, Qi; Colorado, Iriana; Streck, Deanna; Dermody, James; Soteropoulos, Patricia

    2007-09-01

    The etiology of trauma-hemorrhagic shock (T/HS)-induced acute lung injury has been difficult to elucidate because of, at least in part, the inability of in vivo studies to separate the noninjurious pulmonary effects of trauma-hemorrhage from the tissue-injurious ones. To circumvent this in vivo limitation, we used a model of T/HS in which T/HS lung injury was abrogated by dividing the mesenteric lymph duct. In this way, it was possible to separate the pulmonary injurious response from the noninjurious systemic response to T/HS by comparing the pulmonary molecular responses of rats subjected to T/HS, which did and did not develop lung injury, with those of nonshocked rats. Using high-density oligonucleotide arrays and treatment group comparisons of whole lung tissue collected at 3 h after the end of the shock or sham-shock period, 139 of 8,799 assessed genes were identified by significant analysis of microarrays. Hemorrhage without the secondary effects of lung injury modulated the expression of 21 genes such as interleukin 1beta, metallothionein-2, and myeloctomatosis oncogene (c-myc). In response to injury, 42 genes were identified to be differentially expressed. Upregulated genes included the L1 retroposon and guanine deaminase, whereas downregulated genes included catalase and superoxide dismutase 1. Real-time polymerase chain reaction confirmed the differential expression for selected genes. PathwayAssist analysis identified interleukin 1beta as a central regulator of two subpathways of stress response-related genes (c-myc and superoxide dismutase 1/catalase) as well as several unrelated genes such as lipoprotein lipase. Our model system provided a unique opportunity to distinguish the molecular changes associated with T/HS-induced acute lung injury from the systemic molecular response to T/HS.

  9. A Scoping Review of the Associations of Golf with Eye Injuries in Adults and Children

    Evan Jenkins

    2016-01-01

    Full Text Available Introduction. Sport presents a risk of ocular trauma and accounts for a significant number of eye injuries that require hospital admission. The sport of golf presents a risk to eyesight from fast moving objects such as golf clubs and balls. This study aims to investigate the associations of golf with eye injuries and the reasons that these injuries occur. Material/Methods. A literature search was conducted using the databases MEDLINE, Web of Science, SPORTDiscus, and PsycINFO. Grey literature was searched using the WHO international clinical trials registry platform, Google Scholar, and ProQuest. Data was extracted using a standardised form and summarised into a report. Results and Discussion. Twenty-three studies were found relating to eye injuries in golf. Injuries appear to be rare, but more frequent in men and children. Injuries resulted in high rates of enucleation and visual impairment. Children sustained more injury from golf clubs whereas adults sustained more injuries from golf balls. Conclusion. Efforts are needed to encourage golf participants to understand the risks of ocular and indeed other head injuries. Initiatives to provide appropriate supervision and education on this topic are merited. Further research is needed to investigate the circumstances of eye injury in golf and assess the effects of interventions aimed at reducing risk of injury.

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

    Lobb, Ano

    2009-04-14

    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.

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

    Ano Lobb

    2009-01-01

    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.

  12. Association between early airway damage-associated molecular patterns and subsequent bacterial infection in patients with inhalational and burn injury.

    Maile, Robert; Jones, Samuel; Pan, Yinghao; Zhou, Haibo; Jaspers, Ilona; Peden, David B; Cairns, Bruce A; Noah, Terry L

    2015-05-01

    Bacterial infection is a major cause of morbidity affecting outcome following burn and inhalation injury. While experimental burn and inhalation injury animal models have suggested that mediators of cell damage and inflammation increase the risk of infection, few studies have been done on humans. This is a prospective, observational study of patients admitted to the North Carolina Jaycee Burn Center at the University of North Carolina who were intubated and on mechanical ventilation for treatment of burn and inhalational injury. Subjects were enrolled over a 2-yr period and followed till discharge or death. Serial bronchial washings from clinically indicated bronchoscopies were collected and analyzed for markers of tissue injury and inflammation. These include damage-associated molecular patterns (DAMPs) such as hyaluronic acid (HA), double-stranded DNA (dsDNA), heat-shock protein 70 (HSP-70), and high-mobility group protein B-1 (HMGB-1). The study population was comprised of 72 patients who had bacterial cultures obtained for clinical indications. Elevated HA, dsDNA, and IL-10 levels in bronchial washings obtained early (the first 72 h after injury) were significantly associated with positive bacterial respiratory cultures obtained during the first 14 days postinjury. Independent of initial inhalation injury severity and extent of surface burn, elevated levels of HA dsDNA and IL-10 in the central airways obtained early after injury are associated with subsequent positive bacterial respiratory cultures in patients intubated after acute burn/inhalation injury.

  13. Bone contusion progression from traumatic knee injury: association of rate of contusion resolution with injury severity

    Pedersen, Douglas R; El-Khoury, Georges Y; Thedens, Dan R; Saad-Eldine, Mothana; Phisitkul, Phinit; Amendola, Annunziato

    2017-01-01

    Background Bone contusions are frequently encountered in magnetic resonance imaging (MRI) evaluation of knee anterior cruciate ligament (ACL) injuries. Their role as indicators of injury severity remains unclear, primarily due to indeterminate levels of joint injury forces and to a lack of preinjury imaging. Purpose The purpose of this study was to 1) quantify bone contusion pathogenesis following traumatic joint injuries using fixed imaging follow-ups, and 2) assess the feasibility of using longitudinal bone contusion volumes as an indicator of knee injury severity. Study design Prospective sequential MRI follow-ups of a goat cohort exposed to controlled stifle trauma in vivo were compared to parallel clinical MRI follow-ups of a human ACL tear patient series. Methods Reproducible cartilage impact damage of various energy magnitudes was applied in a survival goat model, coupled with partial resection of anterior portions of medial menisci. Both emulate injury patterns to the knee osteochondral structures commonly encountered in human ACL injury imaging as well as instability from resultant ligament laxity. Longitudinal clinical MRI sequences portrayed stifle bone contusion evolution through 6 months after the inciting event. Results In the first 2 weeks, biological response variability dominated the whole-joint response with no apparent correlation to trauma severity. Control goats subjected to partial meniscectomy alone exhibited minimal bone response. Thereafter, 0.6 J impact bone contusions portrayed a faster rate of resolution than those induced by 1.2 J cartilage impacts. Conclusion Bone contusion sizes combined with time of persistence are likely better measures of joint injury severity than isolated bone contusion volume.

  14. Return to Play After Forearm and Hand Injuries in the National Basketball Association

    Morse, Kyle W.; Hearns, Krystle A.; Carlson, Michelle Gerwin

    2017-01-01

    Background: Hand injuries can result in significant time away from competition for professional basketball players. Time to return to play after hand injuries in elite athletes has not been well described. Purpose: To report the return to play from metacarpal fractures, phalangeal fractures, and thumb ligament tears in National Basketball Association (NBA) players over a 5-year period. Study Design: Descriptive epidemiology study. Methods: The NBA transaction report was analyzed from January 2009 to May 2014. Players were identified if they were added to the inactive list (IL), missed games due to their injury, or underwent surgery as a result of hand injury. Number of games missed due to injury, days spent on the IL, and age at injury were calculated by injury type and location. Results: One hundred thirty-seven injuries were identified: 39 injuries to the hand and 98 injuries to the finger. Three major injury patterns were identified and analyzed: metacarpal fractures (n = 26), phalangeal fractures (n = 33), and thumb ligament tears (n = 9). The type of injury sustained affected return to play (P < .05). All thumb ligament tears required surgery and had the longest return to play of 67.5 ± 17.7 days (P < .05). The return to play for surgically treated metacarpal fractures (56.7 ± 26.3 days) was significantly greater than nonsurgically treated metacarpal fractures (26.3 ± 12.1 days; P < .01). Return to play for surgically repaired phalangeal fractures (46.2 ± 10.8 days) trended greater but was not significantly different than phalangeal fractures treated nonsurgically (33.3 ± 28.5 days; P = .21). Conclusion: Hand injuries in professional basketball players can lead to prolonged periods of time away from competition, especially after surgery. This study provides guidelines on expected return to play in the NBA after these common hand injuries. PMID:28251168

  15. Review of liver injury associated with dietary supplements.

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

    2011-05-01

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

  16. Breviscapine reduces neuronal injury caused by traumatic brain injury insult: partly associated with suppression of interleukin-6 expression

    Ling Jiang

    2017-01-01

    Full Text Available Breviscapine, extracted from the herb Erigeron breviscapus, is widely used for the treatment of cardiovascular diseases, cerebral infarct, and stroke, but its mechanism of action remains unclear. This study established a rat model of traumatic brain injury induced by controlled cortical impact, and injected 75 μg breviscapine via the right lateral ventricle. We found that breviscapine significantly improved neurobehavioral dysfunction at 6 and 9 days after injection. Meanwhile, interleukin-6 expression was markedly down-regulated following breviscapine treatment. Our results suggest that breviscapine is effective in promoting neurological behavior after traumatic brain injury and the underlying molecular mechanism may be associated with the suppression of interleukin-6.

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

    Bock, J.; Christoffersen, J.K.; Hedegaard, M.;

    2008-01-01

    We investigated the files of the Danish Patient Insurance Association for newborns suffering from hypoxic brain injuries. From 1992 to 2004, a total of 127 approved claims concerning peripartum hypoxic injury were registered. Thirty-eight newborns died and the majority of the 89 surviving childre...

  18. Risk Factors Associated with Self-Injurious Behaviors in Children and Adolescents with Autism Spectrum Disorders

    Duerden, Emma G.; Oatley, Hannah K.; Mak-Fan, Kathleen M.; McGrath, Patricia A.; Taylor, Margot J.; Szatmari, Peter; Roberts, S. Wendy

    2012-01-01

    While self-injurious behaviors (SIB) can cause significant morbidity for children with autism spectrum disorders (ASD), little is known about its associated risk factors. We assessed 7 factors that may influence self-injury in a large cohort of children with ASD: (a) atypical sensory processing; (b) impaired cognitive ability; (c) abnormal…

  19. Notes from the Field: Injuries Associated with Bison Encounters - Yellowstone National Park, 2015.

    Cherry, Cara; Leong, Kirsten; Wallen, Rick; Buttke, Danielle

    2016-03-25

    Since 1980, bison have injured more pedestrian visitors to Yellowstone National Park (Yellowstone) than any other animal (1). After the occurrence of 33 bison-related injuries during 1983-1985 (range = 10-13/year), the park implemented successful outreach campaigns (1) to reduce the average number of injuries to 0.8/year (range = 0-2/year) during 2010-2014 (unpublished data, National Park Service, September 2015). During May-July 2015, five injuries associated with bison encounters occurred (Table). Case reports were reviewed to evaluate circumstances surrounding these injuries to inform prevention.

  20. Health care-associated infections surveillance in an intensive care unit of a university hospital in China, 2010-2014: Findings of International Nosocomial Infection Control Consortium.

    Peng, Hui; Tao, Xiu-Bin; Li, Yan; Hu, Qiang; Qian, Li-Hua; Wu, Qun; Ruan, Jing-Jing; Cai, Dong-Zhen

    2015-12-01

    Using a standardized methodology by the National Nosocomial Infection Surveillance System, a continuous health care-associated infections (HAIs) surveillance was conducted in our mixed intensive care unit at a Chinese teaching hospital. During the study period (2010-2014), 4,013 patients were hospitalized for 32,924 bed days and acquired 427 HAIs (482 HAI events), with an overall rate of 10.64% and 14.640 HAIs per 1,000 bed days. Ventilator-associated pneumonia was the most common device-associated health care-acquired infection, with an incidence rate of 19.561 per 1,000 mechanical ventilator days.

  1. Health environmental risks surveillance systems: toxicological surveillance

    Ana Ferrer Dufol

    2004-12-01

    Full Text Available A study of the Clinical Toxicological Section, about the Epidemiological Surveillance in Emergency Services, in relation to chemical products intoxications during the 1999-2003 period, is presented. This work is a result of an agreement between the Spanish Toxicological Association (AETOX and the Spanish Ministry of Health and Consumption, and was presented in the National Congress of Environment (CONAMA within the “Health Environmental Risks Surveillance Systems” working group.

  2. Health environmental risks surveillance systems: toxicological surveillance

    Ana Ferrer Dufol; Santiago Nogué Xarau; Francisco Vargas Marcos; Olivia Castillo Soria; Pilar Gascó Alberich; Ana de la Torre Reoyo; Eduardo de la Peña de Torres

    2004-01-01

    A study of the Clinical Toxicological Section, about the Epidemiological Surveillance in Emergency Services, in relation to chemical products intoxications during the 1999-2003 period, is presented. This work is a result of an agreement between the Spanish Toxicological Association (AETOX) and the Spanish Ministry of Health and Consumption, and was presented in the National Congress of Environment (CONAMA) within the “Health Environmental Risks Surveillance Systems” working group.

  3. Muscle function is associated with future patient-reported outcomes in young adults with ACL injury

    Flosadottir, Vala; Roos, Ewa M; Ageberg, Eva

    2016-01-01

    BACKGROUND/AIM: Consequences of an anterior cruciate ligament (ACL) injury include worse patient-reported outcomes (PROs) and a decrease in activity level. Muscle function can be improved by targeted exercise. Our aims were to investigate cross-sectional and longitudinal associations among lower...... extremity muscle function and PROs after ACL injury. METHODS: Fifty-four participants (15 women, mean 30 years) with ACL injury or reconstruction, from the Knee Anterior Cruciate Ligament, Nonsurgical versus Surgical Treatment (KANON) trial (ISRCTN84752559), were assessed with hop performance, muscle power...... and postural orientation 3 years (SD 0.85) after ACL injury. PROs at 3 and 5 years after injury included Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales Function in sport and recreation (KOOS Sport/rec) and Knee-related Quality of life (KOOS QoL), KOOS item Q3 (KOOS Q3), Tegner Activity Scale...

  4. Using Poison Center Data for Postdisaster Surveillance

    Wolkin, Amy; Schnall, Amy H.; Law, Royal; Schier, Joshua

    2015-01-01

    The role of public health surveillance in disaster response continues to expand as timely, accurate information is needed to mitigate the impact of disasters. Health surveillance after a disaster involves the rapid assessment of the distribution and determinants of disaster-related deaths, illnesses, and injuries in the affected population. Public health disaster surveillance is one mechanism that can provide information to identify health problems faced by the affected population, establish priorities for decision makers, and target interventions to meet specific needs. Public health surveillance traditionally relies on a wide variety of data sources and methods. Poison center (PC) data can serve as data sources of chemical exposures and poisonings during a disaster. In the US, a system of 57 regional PCs serves the entire population. Poison centers respond to poison-related questions from the public, health care professionals, and public health agencies. The Centers for Disease Control and Prevention (CDC) uses PC data during disasters for surveillance of disaster-related toxic exposures and associated illnesses to enhance situational awareness during disaster response and recovery. Poison center data can also be leveraged during a disaster by local and state public health to supplement existing surveillance systems. Augmenting traditional surveillance data (ie, emergency room visits and death records) with other data sources, such as PCs, allows for better characterization of disaster-related morbidity and mortality. Poison center data can be used during a disaster to detect outbreaks, monitor trends, track particular exposures, and characterize the epidemiology of the event. This timely and accurate information can be used to inform public health decision making during a disaster and mitigate future disaster-related morbidity and mortality. PMID:25205009

  5. The evaluation of a surveillance system for violent and non-intentional injury mortality in Colombian cities.

    Gutierrez-Martinez, Maria Isabel; Del Villin, Rafael Espinosa; Fandiño, Andrés; Oliver, Ronald L

    2007-06-01

    Since 2002, the Institute for Peace Promotion and Injury/Violence Prevention (CISALVA) at the Universidad del Valle, Cali, Colombia and the Colombia Program at Georgetown University have developed and implemented 21 epidemiologically based municipal crime observatories in intermediate-sized municipalities in Colombia. These crime observatories serve as monitoring centres that provide low cost, geo-referenced methods of data collection and analysis, which allow cities to develop more responsive policies and prevention programmes and enhance governance. This article focuses on the methodology employed and lessons learned that may be applicable to similar settings. Worth noting within the results was a significant decrease in homicides after the first year of the programme. Whether or not such results could be attributed to the method or to the nature of the interventions and policy initiatives stemming from it remains open to conjecture.

  6. Holding fat stereotypes is associated with lower body dissatisfaction in normal weight Caucasian women who engage in body surveillance.

    Kim, Jean; Jarry, Josée L

    2014-09-01

    This study examined the moderating effect of body surveillance on the relationship between fat stereotype endorsement and body dissatisfaction in normal weight women. Participants (N=225) completed online measures of fat stereotyping, body surveillance, body dissatisfaction, and internalized thin ideals. After accounting for thin ideals, body surveillance moderated the relationship between fat stereotypes and body dissatisfaction. Contrary to hypotheses, higher fat stereotype endorsement predicted lower body dissatisfaction in women with higher body surveillance. Conversely, higher fat stereotype endorsement predicted greater body dissatisfaction in women with lower body surveillance. Thus, endorsing fat stereotypes appears protective against body dissatisfaction in normal weight women who extensively engage in body surveillance. For women who hold fat stereotypes and report high body surveillance, we propose that downward appearance comparison may create a contrast between themselves and the people with overweight whom they denigrate, thus improving body dissatisfaction.

  7. Severe cerebral vasospasm after traumatic brain injury.

    Fehnel, Corey R; Wendell, Linda C; Potter, N Stevenson; Klinge, Petra; Thompson, Bradford B

    2014-07-01

    Severe traumatic brain injury is associated with both acute and delayed neuro- logical injury. Cerebral vasospasm is commonly associated with delayed neurological decline in aneurysmal subarachnoid hemorrhage patients. However, the role played by vasospasm in traumatic brain injury is less clear. Vasospasm occurs earlier, for a shorter duration, and often without significant neurological consequence among traumatic brain injury patients. Detection and management strategies for vasospasm in aneurysmal subarachnoid hemorrhage are not easily transferrable to traumatic brain injury patients. We present a patient with a severe traumatic brain injury who had dramatic improvement following emergent decompressive hemicraniectomy. Two weeks after initial presentation he suffered a precipitous decline despite intensive surveillance. This case illustrates the distinct challenges of diagnosing cerebral vasospasm in the setting of severe traumatic brain injury.

  8. Exploring associations between self-regulatory mechanisms and neuropsychological functioning and driver behaviour after brain injury.

    Rike, Per-Ola; Johansen, Hans J; Ulleberg, Pål; Lundqvist, Anna; Schanke, Anne-Kristine

    2016-04-11

    The objective of this prospective one-year follow-up study was to explore the associations between self-regulatory mechanisms and neuropsychological tests as well as baseline and follow-up ratings of driver behaviour. The participants were a cohort of subjects with stroke and traumatic brain injury (TBI) who were found fit to drive after a multi-disciplinary driver assessment (baseline). Baseline measures included neuropsychological tests and ratings of self-regulatory mechanisms, i.e., executive functions (Behavior Rating Inventory of Executive Function-Adult Version; BRIEF-A) and impulsive personality traits (UPPS Impulsive Behavior Scale). The participants rated pre-injury driving behaviour on the Driver Behaviour Qestionnaire (DBQ) retrospectively at baseline and after one year of post-injury driving (follow-up). Better performance on neuropsychological tests was significantly associated with more post-injury DBQ Violations. The BRIEF-A main indexes were significantly associated with baseline and follow-up ratings of DBQ Mistakes and follow-up DBQ Inattention. UPPS (lack of) Perseverance was significantly associated with baseline DBQ Inattention, whereas UPPS Urgency was significantly associated with baseline DBQ Inexperience and post-injury DBQ Mistakes. There were no significant changes in DBQ ratings from baseline (pre-injury) to follow-up (post-injury). It was concluded that neuropsychological functioning and self-regulatory mechanisms are related to driver behaviour. Some aspects of driver behaviour do not necessarily change after brain injury, reflecting the influence of premorbid driving behaviour or impaired awareness of deficits on post-injury driving behaviour. Further evidence is required to predict the role of self-regulatory mechanisms on driver behaviour and crashes or near misses.

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

    2013-09-06

    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.

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

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

    2014-10-09

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

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

    Rankin Elizabeth

    2008-04-01

    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.

  12. Differences in Attentional Focus Associated With Recovery From Sports Injury: Does Injury Induce an Internal Focus?

    Gray, Rob

    2015-12-01

    Although it is commonly believed that focusing too much attention on the injured body area impairs recovery in sports, this has not been directly assessed. The present study investigated attentional focus following sports injury. Experienced baseball position players recovering from knee surgery (Expt 1) and baseball pitchers recovering from elbow surgery (Expt 2) performed simulated batting and pitching respectively. They also performed three different secondary tasks: leg angle judgments, arm angle judgments, and judgments about the ball leaving their bat/hand. Injured athletes were compared with expert and novice control groups. Performance on the secondary tasks indicated that the injured batters had an internal focus of attention localized on the area of the injury resulting in significantly poorer batting performance as compared with the expert controls. Injured pitchers had a diffuse, internal attentional focus similar to that of novices resulting in poorer pitching performance as compared with the expert controls.

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

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

  14. Musculoskeletal Injury in Professional Dancers: Prevalence and Associated Factors: An International Cross-Sectional Study

    Jacobs, Craig L; Cassidy, J. David; Côté, Pierre;

    2016-01-01

    OBJECTIVE: The purpose of the study was to determine the prevalence and factors associated with injury in professional ballet and modern dancers, and assess if dancers are reporting their injuries and explore reasons for not reporting injuries. DESIGN: Cross-sectional study. SETTING: Participants...... specific characteristics included number of years in present dance company, number of years dancing professionally, number of years dancing total, and rank in the company. MAIN OUTCOME MEASURES: Self-reported injury and Self-Estimated Functional Inability because of Pain. RESULTS: A total of 260 dancers...... participated in the study with an overall response rate of 81%. The point prevalence of self-reported injury in professional ballet and modern dancers was 54.8% (95% CI, 47.7-62.1) and 46.3% (95% CI, 35.5-57.1), respectively. Number of years dancing professionally (OR = 4.4, 95% CI, 1.6-12.3) and rank (OR = 2...

  15. The Epidemiology of Emergency Department-Treated Burn Injuries Associated with Portable Heaters in the United States, 2003-2013.

    Brooks, Raina D; McGwin, Gerald

    The purpose of this study is to examine the epidemiology of portable space heater-related burn injuries among an emergency department nationally representative population of the United States. The data analyzed in this study were collected from the Consumer Products Safety Commission's 2003-2013 National Electronic Injury Surveillance System. There were approximately 53,636 space heater-related thermal burn injuries attributed to portable space heaters from 2003 to 2013. The rate of injuries was relatively constant during the 10-year span. The number of burn injuries was highest during winter months. Young children, older adults, males, and Blacks had the highest rates of injury. The body part most commonly injured was the hand, which accounted for 33.3% of all burn injuries. It is important to understand the characteristics of persons who have an increased risk of portable space heater burn and trip/fall injuries, so that preventative methods and awareness strategies can be used to help reduce the number of annual portable space heater injuries.

  16. Passive Surveillance of Ixodes scapularis (Say), Their Biting Activity, and Associated Pathogens in Massachusetts

    Xu, Guang; Mather, Thomas N.; Hollingsworth, Craig S.

    2016-01-01

    Abstract A passive surveillance of tick-borne pathogens was conducted over a 7-year period (2006–2012), in which a total of 3551 ticks were submitted to the University of Massachusetts for PCR testing. The vast majority of these ticks were Ixodes scapularis from Massachusetts (N = 2088) and hence were the focus of further analysis. Two TaqMan duplex qPCR assays were developed to test I. scapularis ticks for the presence of three human pathogens: Borrelia burgdorferi, Anaplasma phagocytophilum, and Babesia microti. I. scapularis submissions were concentrated from Cape Cod, the eastern half of the state outside of the Boston metropolitan area, parts of Franklin and Hampshire counties along the Quabbin Reservoir watershed, and southwestern Berkshire county. Differences in seasonal activity pattern were observed for different developmental stages of I. scapularis. The largest proportion of tick bite victims were age 9 years and under. Nymphal ticks were found more often on lower extremities of their hosts, while more adult ticks were found on the head. Overall infection rate of B. burgdorferi, A. phagocytophilum, and B. microti in human-biting ticks was 29.6%, 4.6%, and 1.8%, respectively. B. burgdorferi-infected ticks were widely distributed, but A. phagocytophilum- and B. microti-infected I. scapularis were found mainly in the eastern half of the state. We found that 1.8%, 1.0%, and 0.4% of ticks were coinfected by B. burgdorferi and A. phagocytophilum, B. burgdorferi and B. microti, and A. phagocytophilum and B. microti, respectively, and 0.3% of ticks had triple coinfection. PMID:27248292

  17. Treatment of Hip Dislocations and Associated Injuries: Current State of Care.

    Beebe, Michael J; Bauer, Jennifer M; Mir, Hassan R

    2016-07-01

    Hip dislocations, most often caused by motor vehicle accidents or similar high-energy trauma, traverse a large subset of distinct injury patterns. Understanding these patterns and their associated injuries allows surgeons to provide optimal care for these patients both in the early and late postinjury periods. Nonoperative care requires surgeons to understand the indications. Surgical care requires the surgeon to understand the benefits and limitations of several surgical approaches. This article presents the current understanding of hip dislocation treatment, focusing on anatomy, injury classifications, nonoperative and operative management, and postinjury care.

  18. Introduction to surveillance studies

    Petersen, JK

    2012-01-01

    Introduction & OverviewIntroduction Brief History of Surveillance Technologies & TechniquesOptical SurveillanceAerial Surveillance Audio Surveillance Radio-Wave SurveillanceGlobal Positioning Systems Sensors Computers & the Internet Data Cards Biochemical Surveillance Animal Surveillance Biometrics Genetics Practical ConsiderationsPrevalence of Surveillance Effectiveness of Surveillance Freedom & Privacy IssuesConstitutional Freedoms Privacy Safeguards & Intrusions ResourcesReferences Glossary Index

  19. OCCULT MANUBRIOSTERNAL JOINT INJURY ASSOCIATED WITH FRACTURE OF THE THORACIC SPINE

    2015-01-01

    The authors report the occurrence of an occult manubriosternal joint injury in the initial evaluation on a patient with a thoracic spine fracture (T9). This T9 fracture was diagnosed in a 37-year-old man and was associated with a partial neurological deficit. At the initial evaluation, the radiographs produced did not show the manubriosternal joint injury. During rehabilitation, after surgical stabilization of the thoracic spine fracture, the patient suddenly felt an intense pain accompanied ...

  20. Burn-injury affects gut-associated lymphoid tissues derived CD4+ T cells☆

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

    2013-01-01

    After scald burn-injury, the intestinal immune system responds to maintain immune balance. In this regard CD4+T cells in Gut-Associated Lymphoid Tissues (GALT), like mesenteric lymph nodes (MLN) and Peyer's patches (PP) respond to avoid immune suppression following major injury such as burn. Therefore, we hypothesized that the gut CD4+T cells become dysfunctional and turn the immune homeostasis towards depression of CD4+ T cell-mediated adaptive immune responses. In the current study we show ...

  1. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries. 1

    Diangelis, A J; Andreasen, J O; Ebeleseder, K A;

    2014-01-01

    Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning and follow up are important for improving a favorable outcome. Guidelines...... should assist dentists and patients in decision making and for providing the best care effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers...

  2. Deployment Surveillance Summary, U.S. Army Operation Iraqi Freedom/Operation New Dawn/Operation Enduring Freedom, 2011. Injury Prevention Report

    2012-12-10

    system /sensory Muskuloskeletal Genitourinary Digestives Ill-defined Disease Mental Health Battle injury Non-Battle injury Percent Injury Prevention Report...35 40 45 Unknown Other Neoplasms Endocrine Nervous system /sensory Infectious and parasitic Skin Respiratory Genitourinary Circulatory Muskuloskeletal...Respiratory Neoplasms Circulatory Nervous system /sensory Battle injury Muskuloskeletal Genitourinary Digestive Ill-defined conditions Mental

  3. Management of severe pelvic fracture associated with injuries of adjacent viscera

    高劲谋; 田显扬; 胡平; 李昌华; 王建柏; 曾剑波

    2005-01-01

    Objective: To investigate the approach of emergency management for severe pelvic fracture associated with injuries of adjacent viscera and evaluate the therapeutic effect. Methods: The data of 79 patients with severe pelvic fracture associated with injuries of adjacent viscera were retrospectively studied, and the study covered a period of 14 years. Results: To cease massive bleeding due to pelvic fracture, ligation of internal iliac arteries was performed on 33 cases, and angioembolization on 8. Of 42 patients with cystic or/and urethral injury, 35 underwent cystostomy and delayed reconstruction, and 7 received a primary realignment. All of 17 patients with injury of retroperitoneal rectum underwent diverting colostomy of the proximal end of sigmoid with presacral drainage, but 4 received primary repair without colostomy. In 22 patients with intraperitoneal colorectal injury, 19 were managed with primary repair or anastomosis while 3 received a colostomy. The overall mortality rate was 8.86% (7/79); the main causes were hemorrhagic shock and associated injury. The complications included urethro-rectal fistula in 4 cases, thrombosis of right common iliac artery in 1, ARDS following chest trauma in 1, and paraplegia in 1. Except the patient with paraplegia, all of them were cured. Conclusions: Prompt diagnosis and proper treatment are the key to success. Devascularization of internal iliac arteries with external fixation cage of the pelvis, cystostomy and proximal sigmoidostomy are effective procedures in emergency treatment of the critical patients.

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

    Komatsu, Yoji; Matsumura, Akira; Meguro, Kotoo; Shibata, Tomoyuki; Shibuya, Fumiho; Nakata, Yoshitaka (Tsukuba Medical Center Hospital, Ibaraki (Japan)); Nose, Tadao

    1993-09-01

    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).

  5. Novel biomarkers for cardiac surgery-associated acute kidney injury: a skeptical assessment of their role.

    Sidebotham, David

    2012-12-01

    Cardiac surgery-associated acute kidney injury (AKI) is common and is associated with a high mortality rate. Traditional biomarkers of AKI (creatinine and urea) increase slowly in response to renal injury, are insensitive to mild degrees of AKI, and are influenced by nonrenal factors. There is considerable interest in novel biomarkers of AKI such as neutrophil gelatinase-associated lipocalin that increase rapidly after renal injury, detect mild degrees of AKI, and are less subject to nonrenal factors. It has been postulated that the early diagnosis of cardiac surgery-associated AKI using novel biomarkers will result in improved outcomes. However, there is little evidence that interventions started early in the course of evolving AKI enhance renal recovery. Until effective therapies are developed that significantly improve the outcome from AKI, there is little benefit from early diagnosis using novel biomarkers.

  6. Surveillance Programme for Healthcare Associated Infections in the State of São Paulo, Brazil. Implementation and the first three years' results.

    Padoveze, M C; Assis, D B; Freire, M P; Madalosso, G; Ferreira, S A; Valente, M G; Fortaleza, C M C B

    2010-12-01

    Governmental programmes should be developed to collect and analyse data on healthcare associated infections (HAIs). This study describes the healthcare setting and both the implementation and preliminary results of the Programme for Surveillance of Healthcare Associated Infections in the State of São Paulo (PSHAISP), Brazil, from 2004 to 2006. Characterisation of the healthcare settings was carried out using a national database. The PSHAISP was implemented using components for acute care hospitals (ACH) or long term care facilities (LTCF). The components for surveillance in ACHs were surgical unit, intensive care unit and high risk nursery. The infections included in the surveillance were surgical site infection in clean surgery, pneumonia, urinary tract infection and device-associated bloodstream infections. Regarding the LTCF component, pneumonia, scabies and gastroenteritis in all inpatients were reported. In the first year of the programme there were 457 participating healthcare settings, representing 51.1% of the hospitals registered in the national database. Data obtained in this study are the initial results and have already been used for education in both surveillance and the prevention of HAI. The results of the PSHAISP show that it is feasible to collect data from a large number of hospitals. This will assist the State of São Paulo in assessing the impact of interventions and in resource allocation.

  7. No association between q-angle and foot posture with running-related injuries

    Ramskov, Daniel; Jensen, M L; Obling, K;

    2013-01-01

    There is a paucity of knowledge on the association between different foot posture quantified by Foot Posture Index (FPI) and Quadriceps angle (Q-angle) with development of running-related injuries. Earlier studies investigating these associations did not include an objective measure of the amount...

  8. The NLstart2run study : Training-related factors associated with running-related injuries in novice runners

    Kluitenberg, Bas; van der Worp, Henk; Huisstede, Bionka M A; Hartgens, Fred; Diercks, Ron; Verhagen, Evert; van Middelkoop, Marienke

    2016-01-01

    Objectives: The incidence of running-related injuries is high. Some risk factors for injury were identified in novice runners, however, not much is known about the effect of training factors on injury risk. Therefore, the purpose of this study was to examine the associations between training factors

  9. Analysis on prevalence trends of injury surveillance in Ding' an County of Hainan Province, 2006-2010%2006-2010年海南省定安县伤害监测分析

    王兴任; 王红美; 莫周武; 陈浩南; 骆箐华; 苏英迪

    2012-01-01

    [目的]了解2006-2010年海南省定安县伤害变化趋势,为制定伤害预防控制策略提供依据.[方法]应用伤害监测资料,对伤害结果进行描述性统计分析.[结果]2006-2010年发生伤害例数合计17 638例.男性11 812例,女性5826例,男女性别比为2.03∶1.2008-2010年伤害病例前3位为跌倒/坠落、动物伤和钝器伤,伤害病例文化程度以初中为主,主要为家务、农牧渔水利业和在校学生三类人群.2010年学龄前儿童伤害比例达12.25%,为历年最高.2006-2010年伤害发生地点主要在家中和公路/街道;伤害性质主要是非故意伤害,由暴力、攻击引起的故意伤害比重呈逐年下降趋势,分别为16.47%、11.33%、5.80%、4.03%和3.78%.[结论]2007-2010年伤害报告人数较稳定,伤害前3位原因跌倒/坠落、动物伤和钝器伤.对不同人群采取针对性措施加以预防.%Objective To analyze injury surveillance bends in Ding'an County of Hainan Province in 2006 -2010. Methods Injured patients in 2006 - 2010 were surveyed with descriptive analysis by using injury surveillance system. Results The number of injury cases was 17 638 in 2006 -2010, male 11 812 and female S826, sex ratio was 2.03:1. The top three major causes of injury were fall/falling, injuries caused by animals and blunt injury. The education levels of most cases were junior high school. Most of cases were people who did housework, farm work, animal husbandry, fisher industry or students. The injury rate of preschool children was the highest in 2010. Injuries were often occurred at home and road/street ( % )Most of injury cases were unintentional injury. The rates of intentional injury caused by violence and attack was decreasing in 2006 - 2010 (16.47% , 11. 33% , 5. 80% , 4.03% , and 3. 78% , respectively). Conclnsion The case numbers of injury reported were stabled in 2007 - 2010. The main three causes of injury were fall/ falling, injuries caused by animals and blunt

  10. Refractory epilepsy is highly associated with severe dentoalveolar and maxillofacial injuries.

    Costa, Andre Luiz F; Yasuda, Clarissa Lin; França, Marcondes C; Morita, Marcia Elisabete; Cendes, Fernando

    2011-03-01

    Dental intrusion and avulsion, crown fracture and mandibular fractures are important dentofacial complications in patients with epilepsy-related traumas. The objective of the present study was to describe the occurrence of orofacial injuries in patients with epilepsy. One hundred and nine consecutive patients (60 women; mean age 38.81 ± 14 years), treated for refractory epilepsy (45 with extratemporal epilepsy and 64 with temporal epilepsy) at the outpatient clinic of our University Hospital, were included in the present study. Orofacial injury occurring as a direct result of a seizure was determined by clinical examination and interview. In addition, seizure frequency, use of medication, and the occurrence and type of injury to other parts of the body, were documented. We employed regression analyses to investigate the association between teeth fractures and frequency of seizures. The majority of injuries were crown fractures (42 subjects), followed by mandibular fractures (eight subjects) and tooth avulsion (eight subjects). Sixteen patients had more than two fractured teeth. Patients with mandibular trauma also suffered concomitant injuries (teeth fracture, avulsion and dislocation). The number of fractured teeth was associated with seizure frequency (r(2) = 0.59, p dentoalveolar and maxillofacial injuries in patients with poorly controlled epileptic seizures.

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

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

    2013-01-01

    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.

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

    Anna Mrzljak

    2013-01-01

    Full Text Available 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.

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

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

    2013-01-01

    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

  14. From Cues to Nudge: A Knowledge-Based Framework for Surveillance of Healthcare-Associated Infections.

    Shaban-Nejad, Arash; Mamiya, Hiroshi; Riazanov, Alexandre; Forster, Alan J; Baker, Christopher J O; Tamblyn, Robyn; Buckeridge, David L

    2016-01-01

    We propose an integrated semantic web framework consisting of formal ontologies, web services, a reasoner and a rule engine that together recommend appropriate level of patient-care based on the defined semantic rules and guidelines. The classification of healthcare-associated infections within the HAIKU (Hospital Acquired Infections - Knowledge in Use) framework enables hospitals to consistently follow the standards along with their routine clinical practice and diagnosis coding to improve quality of care and patient safety. The HAI ontology (HAIO) groups over thousands of codes into a consistent hierarchy of concepts, along with relationships and axioms to capture knowledge on hospital-associated infections and complications with focus on the big four types, surgical site infections (SSIs), catheter-associated urinary tract infection (CAUTI); hospital-acquired pneumonia, and blood stream infection. By employing statistical inferencing in our study we use a set of heuristics to define the rule axioms to improve the SSI case detection. We also demonstrate how the occurrence of an SSI is identified using semantic e-triggers. The e-triggers will be used to improve our risk assessment of post-operative surgical site infections (SSIs) for patients undergoing certain type of surgeries (e.g., coronary artery bypass graft surgery (CABG)).

  15. No association between q-angle and foot posture with running-related injuries

    Jørgensen, Daniel Ramskov; Jensen, Majbritt Lykke; Obling, Kirstine Høj;

    2013-01-01

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

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

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

    2014-06-01

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

  17. The Extent of Consumer Product Involvement in Paediatric Injuries

    Jesani Catchpoole

    2016-07-01

    Full Text Available A challenge in utilising health sector injury data for Product Safety purposes is that clinically coded data have limited ability to inform regulators about product involvement in injury events, given data entry is bound by a predefined set of codes. Text narratives collected in emergency departments can potentially address this limitation by providing relevant product information with additional accompanying context. This study aims to identify and quantify consumer product involvement in paediatric injuries recorded in emergency department-based injury surveillance data. A total of 7743 paediatric injuries were randomly selected from Queensland Injury Surveillance Unit database and associated text narratives were manually reviewed to determine product involvement in the injury event. A Product Involvement Factor classification system was used to categorise these injury cases. Overall, 44% of all reviewed cases were associated with consumer products, with proximity factor (25% being identified as the most common involvement of a product in an injury event. Only 6% were established as being directly due to the product. The study highlights the importance of utilising injury data to inform product safety initiatives where text narratives can be used to identify the type and involvement of products in injury cases.

  18. The Extent of Consumer Product Involvement in Paediatric Injuries.

    Catchpoole, Jesani; Walker, Sue; Vallmuur, Kirsten

    2016-07-07

    A challenge in utilising health sector injury data for Product Safety purposes is that clinically coded data have limited ability to inform regulators about product involvement in injury events, given data entry is bound by a predefined set of codes. Text narratives collected in emergency departments can potentially address this limitation by providing relevant product information with additional accompanying context. This study aims to identify and quantify consumer product involvement in paediatric injuries recorded in emergency department-based injury surveillance data. A total of 7743 paediatric injuries were randomly selected from Queensland Injury Surveillance Unit database and associated text narratives were manually reviewed to determine product involvement in the injury event. A Product Involvement Factor classification system was used to categorise these injury cases. Overall, 44% of all reviewed cases were associated with consumer products, with proximity factor (25%) being identified as the most common involvement of a product in an injury event. Only 6% were established as being directly due to the product. The study highlights the importance of utilising injury data to inform product safety initiatives where text narratives can be used to identify the type and involvement of products in injury cases.

  19. Association between body mass index and recovery from whiplash injuries: a cohort study.

    Yang, Xiaoqing; Côté, Pierre; Cassidy, J David; Carroll, Linda

    2007-05-01

    It is hypothesized that excess weight is a risk factor for delayed recovery from neck pain, such as from whiplash injuries. However, the association between obesity and recovery from whiplash injury has not been studied. The authors examined the association between body mass index and time to recovery from whiplash injuries in a population-based cohort study of traffic injuries in Saskatchewan, Canada. The cohort included 4,395 individuals who made an insurance claim to Saskatchewan Government Insurance and were treated for whiplash injury between July 1, 1994, and December 31, 1995. Of those, 87.7% had recovered by November 1, 1997. No association was found between baseline body mass index and time to recovery. Compared with individuals with normal weight, those who were underweight (hazard rate ratio = 0.88, 95% confidence interval: 0.73, 1.06), overweight (hazard rate ratio = 1.01, 95% confidence interval: 0.94, 1.09), and obese (hazard rate ratio = 0.99, 95% confidence interval: 0.90, 1.08) had similar rates of recovery, even after adjustment for other factors. The results do not support the hypothesis that individuals who are overweight or obese have a worse prognosis for whiplash.

  20. Nonfatal occupational injuries associated with slips and falls in the United States.

    Yoon, Hoon-Yong; Lockhart, Thurmon E

    2006-01-01

    The purpose of this study was to examine nonfatal occupational injury data associated with slip and fall accidents by extracting the latest information from the database of the Bureau of Labor Statistics (BLS). Systematic information on the cost and causes of industrial slip and fall accidents are not readily available from statistical and survey data sources, as such, detailed information regarding the slip-/fall-related injuries in US industries categorized by various factors are presented in this study. Nonfatal injuries resulting in days lost from work due to fall and slip were categorized by the number and incidence rate by various characteristics such as major US industry, nature of injury, source of injury, types of fall, occupation, part of body injured, age of the injured, gender of the injured and number of lost workdays utilizing the BLS database. Additionally, cost per claim associated with industrial slip and fall accidents are reviewed using the National Safety Council database. This information may be used to focus our attention toward most relevant intervention strategies associated with workplace slip and fall accidents.

  1. Intra-articular pathology associated with isolated posterior cruciate ligament injury on MRI

    Ringler, Michael D.; Collins, Mark S.; Howe, B.M. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Shotts, Ezekiel E. [NEA Baptist Clinic, Jonesboro, AR (United States)

    2016-12-15

    Unlike with anterior cruciate ligament injury, little is known about the prevalence of intra-articular pathology associated with isolated posterior cruciate ligament (PCL) injury in the knee. The objectives of this study were to characterize and identify the frequency of meniscal tears and osteochondral injuries in these patients, and to see if management might be affected. Altogether, 48 knee MRI exams with isolated PCL tears were evaluated for the presence of: grade and location of PCL tear, meniscal tear, articular chondral lesion, bone bruise, and fracture. Comparisons between PCL tear grade and location, as well as mechanism of injury when known, with the presence of various intra-articular pathologies, were made using the chi-square or Fisher's exact test as appropriate. In all, 69 % of isolated PCL tears occur in the midsubstance, 27 % proximally. Meniscal tears were seen in 25 % of knees, involving all segments of both menisci, except for the anterior horn medial meniscus. Altogether, 23 % had focal cartilage lesions, usually affecting the central third medial femoral condyle and medial trochlea, while 12.5 % of knees had fractures, and 48 % demonstrated bone bruises, usually involving the central to anterior tibiofemoral joint. The presence of a fracture (p = 0.0123) and proximal location of PCL tear (p = 0.0016) were both associated with the hyperextension mechanism of injury. There were no statistically significant associations between PCL tear grade and presence of intra-articular abnormality. Potentially treatable meniscal tears and osteochondral injuries are relatively prevalent, and demonstrable on MRI in patients with isolated acute PCL injury of the knee. (orig.)

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

    Riad I. Hammoud

    2014-10-01

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

  3. Ventilator-associated pneumonia after combined burn and trauma is caused by associated injuries and not the burn wound.

    Eckert, Matthew J; Wade, Terence E; Davis, Kimberly A; Luchette, Fred A; Esposito, Thomas J; Poulakidas, Stathis J; Santaniello, John M; Gamelli, Richard L

    2006-01-01

    An increased risk of ventilator-associated pneumonia (VAP) has previously been demonstrated in trauma patients urgently intubated in the prehospital (ie, field) and emergency department (ED) settings. This study investigated the impact of urgent intubation on subsequent VAP in patients who sustained both a burn injury and a traumatic injury. We undertook a retrospective review of both trauma registry data and medical records for all patients with combined thermal and traumatic injuries admitted to a single verified burn center and level I trauma center. Patients undergoing field or ED intubation during the 5-year period ending December 2002 were identified and studied. Data abstracted included admission demographics and vital signs, presence of inhalation injury, location at the time of intubation, presence of associated injury, percentage TBSA burn, hospital and intensive care unit length of stay, and hospital day of VAP diagnosis. Seventy-eight of the 3388 patients (2.3%) admitted during the study period sustained a combination of burn wounds and trauma and underwent urgent field or ED intubation. The majority of patients were men (71%), with a mean age of 46 +/- 24 years. There was one failed oral intubation, which required cricothyroidotomy. The location of the patient at the time of intubation was ED, 66%; burn center ED, 17%; and field, 17%. Eighty percent of all patients were diagnosed with an inhalation injury. VAP was diagnosed in 39 patients (50%), with a mean time to diagnosis of 10 +/- 9 days. TBSA burn, smoke inhalation, and time (in days) to diagnosis of VAP were not independent risk factors for the occurrence of pneumonia in any of the 3 groups. However, those intubated at the initial ED were more likely to develop VAP (P = .028) compared to those intubated in the field or in the burn center. The incidence of associated injuries was significantly greater (P burn patients also sustain blunt trauma. VAP occurs in 50% of the patients requiring urgent

  4. 2006-2009年四川省监测哨点伤害流行特征变化趋势%Epidemiological trend of injury in surveillance area in Sichuan province,2006-2009

    易光辉; 邓颖; 高亚礼

    2011-01-01

    Objective To analyze the epidemiological characteristics and trend of injury in urban and rural areas under surveillance in Sichuan. Methods The survey was conducted among the patients diagnosed as injury in the first medical care seeking in sentinel hospitals from 1 January 2006 to 31 December 2009 to understand the distribution and pattern of injury incidence. Results Injury occurred in all age groups and both in males and in females. The mostly affected people were young males aged 25 - 44 years old. The time of incidence peak of injury in urban area differed with that in rural area. In Qingyang district of Chengdu , the case numbers and proportions of traffic accident, blunt injury and selfharm/suicide declined by years, but the case number and proportion of animal bite increased by years, The proportion of self-harm/suicide of women in Miyi county dcclined by years too. Conclusion The epidemiological characteristics and trend of injury differed between urban area and rural area in surveillance area in Sichuan, which is with significance to guide the development of prevention and control measures.%目的 通过对四川省城市与农村伤害监测哨点监测资料进行比较分析,了解当地伤害发生的特征和变化规律.方法 将2006年1月1日至2009年12月31日到监测医院就诊且被诊断为伤害的首诊患者作为监测对象进行调查,分析伤害发生的分布和规律.结果 不同性别人群各年龄段都有伤害发生,最危险的人群为25~44岁的男性,城市与农村伤害发生的高峰时段不同.青羊区车祸、钝器伤、自残/自杀发生的例数、构成比逐年减少,但动物伤的例数和构成比逐年增加,米易县女性自残/自杀构成比也逐年减少.结论 四川省伤害监测点2006-2009年城市与农村伤害流行特征的变化趋势不同,这些变化对制定防制方案有指导性意义.

  5. Association of Electroencephalography (EEG) Power Spectra with Corneal Nerve Fiber Injury in Retinoblastoma Patients.

    Liu, Jianliang; Sun, Juanjuan; Diao, Yumei; Deng, Aijun

    2016-09-04

    BACKGROUND In our clinical experience we discovered that EEG band power may be correlated with corneal nerve injury in retinoblastoma patients. This study aimed to investigate biomarkers obtained from electroencephalography (EEG) recordings to reflect corneal nerve injury in retinoblastoma patients. MATERIAL AND METHODS Our study included 20 retinoblastoma patients treated at the Department of Ophthalmology, Affiliated Hospital of Weifang Medical University between 2010 and 2014. Twenty normal individuals were included in the control group. EEG activity was recorded continuously with 32 electrodes using standard EEG electrode placement for detecting EEG power. A cornea confocal microscope was used to examine corneal nerve injury in retinoblastoma patients and normal individuals. Spearman rank correlation analysis was used to analyze the correlation between corneal nerve injury and EEG power changes. The sensitivity and specificity of changed EEG power in diagnosis of corneal nerve injury were also analyzed. RESULTS The predominantly slow EEG oscillations changed gradually into faster waves in retinoblastoma patients. The EEG pattern in retinoblastoma patients was characterized by a distinct increase of delta (PEEG spectra power and negatively correlated with theta EEG spectra power. The diagnostic sensitivity and specificity by compounding in the series were 60% and 67%, respectively. CONCLUSIONS Changes in delta and theta of EEG appear to be associated with occurrence of corneal nerve injury. Useful information can be provided for evaluating corneal nerve damage in retinoblastoma patients through analyzing EEG power bands.

  6. Glucocorticoids aggravate retrograde memory deficiency associated with traumatic brain injury in rats.

    Chen, Xin; Zhang, Ke-Li; Yang, Shu-Yuan; Dong, Jing-Fei; Zhang, Jian-Ning

    2009-02-11

    Administration of glucocorticoid to patients with head injury has previously been demonstrated to impair memory. We hypothesize that glucocorticoids promote post-traumatic hippocampal apoptosis, resulting in retrograde memory deficiency associated with traumatic brain injury (TBI). In the present study, we tested this hypothesis by measuring spatial memory deficiency in rats subjected to fluid percussion injury (FPI) and receiving dexamethasone (DXM at 0.5-10 mg/kg) or methylprednisolone (MP at 5-30 mg/kg); we also examined neuronal apoptosis in hippocampus. Adult male Wistar rats were trained for the acquisition of spatial memory, then subjected to FPI and tested for spatial reference memory on post-injury days 7 and 14 using the Morris Water Maze. Brain tissue from injured rats was examined 24 h to 2 weeks after injury. The percent time in the goal quadrant, which measures spatial reference memory, was significantly lower in injured rats receiving either high-dose DXM or MP than in control groups. TUNEL-positive cells in hippocampus were first detected 24 h post-injury, plateauing at 48h. The number of TUNEL-positive cells was significantly higher in injured rats treated with either DXM or MP. The data suggest that glucocorticoid therapy for TBI may increase neuronal apoptosis in hippocampus and, as a result, aggravate retrograde memory deficits induced by TBI.

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

    Michael T. Lebec

    2014-01-01

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

  8. Pathophysiology Associated with Traumatic Brain Injury: Current Treatments and Potential Novel Therapeutics.

    Pearn, Matthew L; Niesman, Ingrid R; Egawa, Junji; Sawada, Atsushi; Almenar-Queralt, Angels; Shah, Sameer B; Duckworth, Josh L; Head, Brian P

    2016-07-06

    Traumatic brain injury (TBI) is one of the leading causes of death of young people in the developed world. In the United States alone, 1.7 million traumatic events occur annually accounting for 50,000 deaths. The etiology of TBI includes traffic accidents, falls, gunshot wounds, sports, and combat-related events. TBI severity ranges from mild to severe. TBI can induce subtle changes in molecular signaling, alterations in cellular structure and function, and/or primary tissue injury, such as contusion, hemorrhage, and diffuse axonal injury. TBI results in blood-brain barrier (BBB) damage and leakage, which allows for increased extravasation of immune cells (i.e., increased neuroinflammation). BBB dysfunction and impaired homeostasis contribute to secondary injury that occurs from hours to days to months after the initial trauma. This delayed nature of the secondary injury suggests a potential therapeutic window. The focus of this article is on the (1) pathophysiology of TBI and (2) potential therapies that include biologics (stem cells, gene therapy, peptides), pharmacological (anti-inflammatory, antiepileptic, progrowth), and noninvasive (exercise, transcranial magnetic stimulation). In final, the review briefly discusses membrane/lipid rafts (MLR) and the MLR-associated protein caveolin (Cav). Interventions that increase Cav-1, MLR formation, and MLR recruitment of growth-promoting signaling components may augment the efficacy of pharmacologic agents or already existing endogenous neurotransmitters and neurotrophins that converge upon progrowth signaling cascades resulting in improved neuronal function after injury.

  9. Neonatal injury at cephalic vaginal delivery: a retrospective analysis of extent of association with shoulder dystocia.

    Cantekin Iskender

    Full Text Available PURPOSE: To describe the risk factors and labor characteristics of Clavicular fracture (CF and brachial plexus injury (BPI; and compare antenatal and labor characteristics and prognosis of obstetrical BPI associated with shoulder dystocia with obstetrical BPI not associated with shoulder dystocia. METHODS: This retrospective study consisted of women who gave birth to an infant with a fractured clavicle or BPI between January 2009 and June 2013. Antenatal and neonatal data were compared between groups. The control group (1300 was composed of the four singleton vaginal deliveries that immediately followed each birth injury. A multivariable logistic regression model, with backward elimination, was constructed in order to find independent risk factors associated with BPI and CF. A subgroup analysis involved comparison of features of BPI cases with or without associated shoulder dystocia. RESULTS: During the study period, the total number of vaginal deliveries was 44092. The rates of CF, BPI and shoulder dystocia during the study period were 0,6%, 0,16% and 0,29%, respectively. In the logistic regression model, shoulder dystocia, GDM, multiparity, gestational age >42 weeks, protracted labor, short second stage of labor and fetal birth weight greater than 4250 grams increased the risk of CF independently. Shoulder dystocia and protracted labor were independently associated with BPI when controlled for other factors. Among neonates with BPI whose injury was not associated with shoulder dystocia, five (12.2% sustained permanent injury, whereas one neonate (4.5% with BPI following shoulder dystocia sustained permanent injury (p = 0.34. CONCLUSION: BPI not associated with shoulder dystocia might have a higher rate of concomitant CF and permanent sequelae.

  10. Factors associated with deep tissue injury in male wheelchair basketball players of a Japanese national team

    Hirotaka Mutsuzaki

    2014-04-01

    Full Text Available Maintenance of the sporting activity of elite athletes in adapted sports can be difficult if a secondary disorder, such as a pressure ulcer, occurs. Pressure ulcers result from deep tissue injuries by external pressure. The purpose of this study was to use ultrasonography to investigate deep tissue injuries in male wheelchair basketball players of a Japanese national team, and to determine factors associated with the injuries (e.g., body mass index, class of wheelchair basketball, underlying disease, length of athletic career, and whether use of wheelchair is primarily for playing basketball. Twenty male Japanese wheelchair basketball players on the national team for the 2012 London Paralympic Games (12 representative players and eight candidate representative players participated in this study. The sacral region and bilateral ischial regions in each athlete were examined by ultrasonography to detect low-echoic lesions indicative of deep tissue injuries. Nine (45% players had low-echoic lesions, which were detected in 10 of 60 areas. Eight lesions were detected in the sacral region and two lesions were detected in the ischial region. More players with spinal cord injury had low-echoic lesions [9 (69.2% of 13 players], compared to players with skeletal system disease [0 (0% of 7 players, p = 0.002]. Players who used a wheelchair in daily life were more likely to have low-echoic lesions [8 (66.74% of 12 players], compared to players who primarily used a wheelchair for playing basketball [1 (12.5% of 8 players, p = 0.010]. Deep tissue injuries were detected in 45% of male Japanese wheelchair basketball players on the national team. Players with spinal cord injury and players who used a wheelchair in daily life were more likely to have deep tissue injuries, particularly in the sacral region. The lesions were small, but a periodic medical check should be performed to maintain athletes' sporting life.

  11. SODIUM BICARBONATE INFUSION: TO PREVENT CARDIAC SURGERY - ASSOCIATED ACUTE KIDNEY INJURY

    Ramesh

    2015-02-01

    Full Text Available OBJECTIVES: The incidence of cardiac surgery – associated acute kidney injury is 50% of patients and is associated with increased mortality and morbidity. This study aimed to determine if perioperative urinary and plasma alkalization with sodium bicarbonate infusion re duces the incidence of cardiac surgery – associated acute kidney injury. SETTING AND DESIGN: This study is double blind randomized control trial conducted at U N Mehta Institute of Cardiology and Research Center , India. METHOD S AND RESULT: A total of 140 pat ients scheduled to undergo elective cardiac surgery , who were at increased risk of development of cardiac surgery – associated acute kidney injury using recognized risk factors. Patients were randomly allocated to receive either sodium bicarbonate (n = 70 o r sodium chloride (n = 70 infusion , commencing at the start of anesthesia , in a dose of 4 mmol/kg over 24 hour. The primary outcome measure was the number of patients with development of CSA - AKI , defined as an increase in creatinine greater than 25% from baseline to peak value within the first three postoperative days. Significant differences among the groups in both plasma and urinary pH were achieved 6 hours after commencement of the infusion , and these changes persisted for more than 24 hours. A total o f 7 out of 70(10% patients in the sodium bicarbonate group and 16 out of 70(22.85% patients in the sodium chloride group developed acute kidney injury within the first three postoperative days with p value of 0.06 which is statistically not significant . There were also no significant differences in ventilation hours , ICU or hospital length of stay , or mortality. CONCLUSIONS: Perioperative alkalization of blood and urine using an infusion of sodium bicarbonate did not result in a decrease in the incidence of acute kidney injury in patients undergoing cardiac surgery. KEYWORDS: Acute kidney injury; Cardiac surgery; Cardiopulmonary bypass; Creatinine

  12. Trigeminal nerve injury associated with injection of local anesthetics

    Hillerup, Søren; Jensen, Rigmor H.; Ersbøll, Bjarne Kjær

    2011-01-01

    , prilocaine 3 percent, and articaine 4 percent sold in cartridges. Results. The study results showed a highly significant overrepresentation of NSDs associated with articaine 4 percent, in particular with mandibular blocks. Conclusions. The distribution of NSDs was disproportionate to the market share......Background. The authors used comprehensive national registry and clinical data to conduct a study of adverse drug reactions (ADRs), in particular neurosensory disturbance (NSD), associated with local anesthetics used in dentistry. Methods. The study included data sets of annual sales of local...... anesthetics (from 1995 through 2007), 292 reports to the Danish Medicines Agency, Copenhagen, Denmark, of adverse reactions to local anesthetic drugs, and a clinical sample of 115 patients with NSD associated with local anesthetics. The authors assessed lidocaine 2 percent, mepivacaine 2 percent and 3 percent...

  13. Trend of traumatic crown injuries and associated factors in preschool children

    Bernardo Antonio AGOSTINI

    Full Text Available Abstract The aim of this study was to assess trends in traumatic crown injuries (TCIs, their prevalence, and association with socioeconomic and clinical factors in preschool children over a 5-year period. A series of cross-sectional surveys was conducted in Santa Maria, Brazil, on children attending a National Day of Children’s Vaccination. The same protocol was used in all surveys conducted in 2008, 2010, and 2013. Clinical examinations were performed to evaluate types of traumatic crown injuries using the O’brien index. A semi-structured questionnaire was answered by the parents. It provided information about several socioeconomic factors as well as the parents’ perception of their child’s oral health. The chi-square for trends test was used to verify changes in TCI prevalence throughout the years. The association between socioeconomic and clinical factors with TCI was assessed by the Poisson regression analysis. A total of 1,640 children were examined. The prevalence of TCIs decreased significantly from 2008 to 2013 (10.12%; p < 0.001. Central incisors were the most vulnerable to injury, independent of the year. Moreover, older children and those with inadequate lip coverage were more likely to present with some traumatic dental injury (p < 0.001. prevalence of traumatic crown injuries decreased following the years, however TCI remain an important subject to consider when planning oral health policies.

  14. Galactorrhea and hyperprolactinemia associated with chest wall injury.

    Morley, J E; Dawson, M; Hodgkinson, H; Kalk, W J

    1977-11-01

    A 48 year old premenopausal woman presented with galactorrhea and amenorrhea associated with chest wall burns. Basal serum prolactin levels were raised, and were further elevated by the administration of L-dopa, chlorpromazine and TRH. Intercostal nerve block and bromocryptine treatment reduced prolactin levels to normal, but did not noticably reduce milk secretion.

  15. Spasm of the near reflex associated with head injury.

    Knapp, Christopher; Sachdev, Arun; Gottlob, Irene

    2002-03-01

    Spasm of the near reflex is characterized by intermittent miosis, convergence spasm and pseudomyopia with blurred vision at distance. Usually, it is a functional disorder in young patients with underlying emotional problems. Only rarely is it caused by organic disorder. We report a patient who developed convergent spasm associated with miosis after head trauma at the age of 84 years.

  16. What Do We Know About the Association Between Firearm Legislation and Firearm-Related Injuries?

    Santaella-Tenorio, Julian; Cerdá, Magdalena; Villaveces, Andrés; Galea, Sandro

    2016-01-01

    Firearms account for a substantial proportion of external causes of death, injury, and disability across the world. Legislation to regulate firearms has often been passed with the intent of reducing problems related to their use. However, lack of clarity around which interventions are effective remains a major challenge for policy development. Aiming to meet this challenge, we systematically reviewed studies exploring the associations between firearm-related laws and firearm homicides, suicides, and unintentional injuries/deaths. We restricted our search to studies published from 1950 to 2014. Evidence from 130 studies in 10 countries suggests that in certain nations the simultaneous implementation of laws targeting multiple firearms restrictions is associated with reductions in firearm deaths. Laws restricting the purchase of (e.g., background checks) and access to (e.g., safer storage) firearms are also associated with lower rates of intimate partner homicides and firearm unintentional deaths in children, respectively. Limitations of studies include challenges inherent to their ecological design, their execution, and the lack of robustness of findings to model specifications. High quality research on the association between the implementation or repeal of firearm legislation (rather than the evaluation of existing laws) and firearm injuries would lead to a better understanding of what interventions are likely to work given local contexts. This information is key to move this field forward and for the development of effective policies that may counteract the burden that firearm injuries pose on populations.

  17. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries

    Malmgren, Barbro; Andreasen, Jens O; Flores, Marie Therese;

    2012-01-01

    Traumatic injuries to the primary dentition present special problems and the management is often different as compared with the permanent dentition. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group...

  18. Guideline on anterior cruciate ligament injury A multidisciplinary review by the Dutch Orthopaedic Association

    Meuffels, D.E.; Poldervaart, M.T.; Diercks, R.L.; Fievez, A.W.F.M.; Patt, T.W.; van der Hart, C.P.; Hammacher, E.R.; van der Meer, F.; Goedhart, E.A.; Lenssen, A.F.; Muller-Ploeger, S.B.; Pols, M.A.; Saris, D.B.F.

    2012-01-01

    The Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulated by a steer

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

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

    2005-01-01

    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…

  20. Muscle function is associated with future patient-reported outcomes in young adults with ACL injury

    Flosadottir, Vala; Roos, Ewa M; Ageberg, Eva

    2016-01-01

    BACKGROUND/AIM: Consequences of an anterior cruciate ligament (ACL) injury include worse patient-reported outcomes (PROs) and a decrease in activity level. Muscle function can be improved by targeted exercise. Our aims were to investigate cross-sectional and longitudinal associations among lower ...

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

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

    2012-01-01

    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…

  2. Longitudinal association between lifestyle and coronary heart disease risk factors among individuals with spinal cord injury

    de Groot, S.; Post, M. W.; Snoek, G. J.; Schuitemaker, M.; van der Woude, L. H.

    2013-01-01

    Objective: To investigate: (1) the course of coronary heart disease risk factors (lipid profiles and body mass index (BMI)) in the first five years after discharge from inpatient spinal cord injury (SCI) rehabilitation and (2) the association between lifestyle (physical activity, self-care related t

  3. EXPERIENCE IN TREATING SECONDARY SYSTEMIC MYCOTIC INFECTION AFTER SEVERE BURNS ASSOCIATED WITH ELECTRIC INJURY

    谢卫兴; 李秀芝

    1995-01-01

    One patient with wound surface sepsis caused by secondary pyocyanic infection after extensive burns associated with visceral injuries (peptic ulcer hemorrhage, renal insufficiency and hepatic dysfunction) and generalized candidiasis albicans was cured after anti-infection treatment with proper antibiotics, removal of the infected focus, and effective anti-fungal drugs.

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

    Rajendra Prasad

    2009-01-01

    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.

  5. Association between the levels of urine kidney injury molecule-1 and the progression of acute kidney injury in the elderly

    Wang, Chunlin; Che, Xiajing; Shao, Xinghua; Xu, Yao; Ni, Zhaohui; Mou, Shan

    2017-01-01

    Background The factors influencing the prognosis of acute kidney injury (AKI) were analyzed in a group of elderly AKI patients to determine the markers of early prognosis. Methods A total of 258 patients were screened, and 201 patients were enrolled in the study. Eventually, 184 AKI patients were included in the study, including 79 elderly AKI patients (≥60 years old). During one year of follow-up, renal function changes were observed, and the risk factors that influenced the prognosis of AKI were analyzed. Results When AKI occurred, the urine kidney injury molecule-1 (uKIM-1) level was significantly higher in the progressive deterioration of renal function group than in the renal function stable group. The ROC curve analysis revealed that the area under the curve for poor progressive deterioration of renal function as predicted by the uKIM-1 level was 0.681. At a cutoff point of 2.46 ng/mg, the sensitivity was 71.9% and the specificity was 70.0%. In elderly AKI patients, uKIM-1 levels exceeding 2.46 ng/mg were positively associated with poor kidney prognosis. Conclusions Elderly AKI patients are at risk of developing progressive deterioration of renal function. In elderly AKI patients, the high uKIM-1 level may predict the prognosis of kidney function and may be used as an early screening indicator of poor kidney prognosis. PMID:28187124

  6. Mandibular alveolar neurovascular bundle injury associated with impacted third molar surgery.

    Ruga, Emanuele; Gallesio, Cesare; Boffano, Paolo

    2010-07-01

    Inferior alveolar neurovascular bundle (IANB) injury is one of the most common complications of third molar removal and involves important medicolegal issues. An accurate preoperative radiographic assessment of surgical difficulty is necessary to correctly plan the removal of impacted third molars and to estimate the risk of IANB injury. Therefore, the preoperative knowledge of the exact location of the third molar roots in relation to the mandibular canal is mandatory. A direct contact between the tooth and neurovascular bundle is suggested by a radiotransparent band across the roots of the impacted third molar on panoramic radiograph. We present the management of a patient with IANB damage associated with third molar surgery.

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

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

    2012-08-01

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

  8. The association of needlestick injury with depressive symptoms among first-year medical residents in Japan.

    Wada, Koji; Sakata, Yumi; Fujino, Yoshihisa; Yoshikawa, Toru; Tanaka, Katsutoshi; Miyajima, Eriko; Watanabe, Mitsuyasu; Aizawa, Yoshiharu

    2007-12-01

    Depressive symptoms among medical residents are common. The objective of this study was to determine the association of depressive symptoms with needlestick injury among first-year medical residents (so-called "intern"). We conducted a prospective cohort study among 107 medical residents in 14 training hospitals. The baseline survey was conducted in August 2005 and the follow-up survey was conducted in March 2006. Depressive symptoms were based on the Center for Epidemiological Study of Depression. Factors associated with depressive symptoms were examined using logistic regression analysis. For medical residents without depressive symptoms at the baseline survey, needlestick injury events were associated with depressive symptoms at the follow-up survey (corrected odds ratio [cOR]=2.98; 95% confidence interval [CI], 1.16-3.70). Because it was not possible to determine when the medical residents developed depressive symptoms, it is not possible to definitely determine causality between needlestick injury and depressive symptoms, although these findings are suggestive. Therefore, it would seem prudent to suggest the provision of mental health services to medical residents sustaining a needlestick injury since this may be helpful in identifying and treating depression.

  9. Risk Factors Associated with Injury and Mortality from Paediatric Low Speed Vehicle Incidents: A Systematic Review

    Anne Paul Anthikkat

    2013-01-01

    Full Text Available Objective. This study reviews modifiable risk factors associated with fatal and nonfatal injury from low-speed vehicle runover (LSVRO incidents involving children aged 0–15 years. Data Sources. Electronic searches for child pedestrian and driveway injuries from the peer-reviewed literature and transport-related websites from 1955 to 2012. Study Selection. 41 studies met the study inclusion criteria. Data Extraction. A systematic narrative summary was conducted that included study design, methodology, risk factors, and other study variables. Results. The most commonly reported risk factors for LSVRO incidents included age under 5 years, male gender, and reversing vehicles. The majority of reported incidents involved residential driveways, but several studies identified other traffic and nontraffic locations. Low socioeconomic status and rental accommodation were also associated with LSVRO injury. Vehicles were most commonly driven by a family member, predominantly a parent. Conclusion. There are a number of modifiable vehicular, environmental, and behavioural factors associated with LSVRO injuries in young children that have been identified in the literature to date. Strategies relating to vehicle design (devices for increased rearward visibility and crash avoidance systems, housing design (physical separation of driveway and play areas, and behaviour (driver behaviour, supervision of young children are discussed.

  10. Dephosphorylation of cardiomyocyte Cx43 is associated with myocardial ischemia and reperfusion injury

    Zhijuan Cao; Xuan Xu; Linli Que; Qi Chen; Yuehua Li

    2009-01-01

    Objective:Myocardial ischemia/reperfusion(I/R) injury is the leading cause of death in the world. However, the details of the mechanism of its pathophysioiogy are still unknown. The present study was designed to investigate the role of connexin 43(Cx63) in acute models of myocardial I/R injury. Methods: Male C57BL/6 mice were subjected to myocardial ischemia(45 rain) followed by reperfusion(4 hrs) in vivo. The whole operation was monitored using a two-lead ECG. Hearts were harvested and the level of protein was assessed by western blot analysis. Haematoxylin and Eosin(HE) staining was used to detect the extent of neutrophil infiltration. The expression level of IL-6 was detected by ELISA. Results: A murine myocardial I/R injury model was constructed successfully. Phosphorylated Cx43 decreased 83.45% while non-phosphorylated Cx43 increased 1.62- fold in the myocardium after I/R injury. Neutrophil infiltration and the expression of the inflammatory cytokine IL-6 increased in the myocardium following I/R. Conclusion: During myocardial I/R injury, cardiomyocyte Cx43 is dephosphorylated, and this may be associated with an inflammatory response.

  11. Withdrawal-associated injury site pain (WISP): a descriptive case series of an opioid cessation phenomenon

    Rieb, Launette Marie; Norman, Wendy V.; Martin, Ruth Elwood; Berkowitz, Jonathan; Wood, Evan; McNeil, Ryan; Milloy, M.-J.

    2016-01-01

    Abstract Withdrawal pain can be a barrier to opioid cessation. Yet, little is known about old injury site pain in this context. We conducted an exploratory mixed-methods descriptive case series using a web-based survey and in-person interviews with adults recruited from pain and addiction treatment and research settings. We included individuals who self-reported a past significant injury that was healed and pain-free before the initiation of opioids, which then became temporarily painful upon opioid cessation—a phenomenon we have named withdrawal-associated injury site pain (WISP). Screening identified WISP in 47 people, of whom 34 (72%) completed the descriptive survey, including 21 who completed qualitative interviews. Recalled pain severity scores for WISP were typically high (median: 8/10; interquartile range [IQR]: 2), emotionally and physically aversive, and took approximately 2 weeks to resolve (median: 14; IQR: 24 days). Withdrawal-associated injury site pain intensity was typically slightly less than participants' original injury pain (median: 10/10; IQR: 3), and more painful than other generalized withdrawal symptoms which also lasted approximately 2 weeks (median: 13; IQR: 25 days). Fifteen surveyed participants (44%) reported returning to opioid use because of WISP in the past. Participants developed theories about the etiology of WISP, including that the pain is the brain's way of communicating a desire for opioids. This research represents the first known documentation that previously healed, and pain-free injury sites can temporarily become painful again during opioid withdrawal, an experience which may be a barrier to opioid cessation, and a contributor to opioid reinitiation. PMID:27598412

  12. 2006-2009年河北省城乡居民伤害监测%Surveillance of Injury Among Residents in Hebei Province, 2006-2009

    栗华; 张中朝; 朱俊卿; 张敬一; 刘春霞; 齐静兵

    2011-01-01

    目的 了解河北省城乡居民伤害状况和危害程度,为制定有效的干预措施提供科学依据.方法 资料来源于秦皇岛市、藁城市各3家不同级别伤害监测哨点医院急诊室.对2006-01-01/2009-12-31首次就诊于哨点医院的伤害患者资料进行分析.结果 2006-01-01/2009-12-31共收集81154例伤害病例,男女性别比为2.17:1;前6位伤害病例的原因依次是机动车车祸(28.14%)、钝器伤(23.26%)、跌倒/坠落(22.25%)、刀/锐器伤(9.14%)、中毒(7.54%)和非机动车车祸(5.65%);中毒是农村老年女性的第1位伤害原因(36.84%),钝器伤是15~19岁年龄组最主要的伤害原因;溺水、窒息/悬吊、火器伤、烧烫伤和中毒造成的严重程度较重;伤害部位以头部为主;伤害发生时间有一定规律性;自残/自杀造成的伤害病例81.49%需观察或住院或转院.结论 河北省2006-2009年居民伤害以机动车车祸、钝器伤、跌倒/坠落、刀/锐器伤和中毒为主,青壮年是高发人群,应加强伤害的预防控制工作.%Objective To understand the prevalence and degree of injury among residents in urban and rural area in Hebei and provide scientific eyidence to conduct effective interventions. Methods The surveiUance was conducted among the injury patients seeking medical care for the first time in 6 hospitals in Qinhuangdao and Gaocheng from January 1,2006 to December 31 ,2009. Results Totally 81 154 injury cases were surveyed. The male to female ratio of the cases was 2. 17 : 1. The first six injuries were the traffic injury by motor vehicles (28. 14% ) , blunt injury (23. 26% ) , falling injury ( 22. 25% ) , sharp instrument injury (9. 14% ) , poisoning (7. 54% ) and the traffic injury by non - motor vehicles (5. 65) . The poisoning was the first injury cause of elderly females in rural area (36. 84% ). Blunt injury was the most important injury in age group of 15 - 19 years old. Drowning, asphyxia or hanging, gun shot, fire

  13. Association between heat stress and occupational injury among Thai workers: findings of the Thai Cohort Study.

    Tawatsupa, Benjawan; Yiengprugsawan, Vasoontara; Kjellstrom, Tord; Berecki-Gisolf, Janneke; Seubsman, Sam-Ang; Sleigh, Adrian

    2013-01-01

    Global warming will increase heat stress at home and at work. Few studies have addressed the health consequences in tropical low and middle income settings such as Thailand. We report on the association between heat stress and workplace injury among workers enrolled in the large national Thai Cohort Study in 2005 (N=58,495). We used logistic regression to relate heat stress and occupational injury separately for males and females, adjusting for covariate effects of age, income, education, alcohol, smoking, Body Mass Index, job location, job type, sleeping hours, existing illness, and having to work very fast. Nearly 20% of workers experienced occupational heat stress which strongly and significantly associated with occupational injury (adjusted OR 2.12, 95%CI 1.87-2.42 for males and 1.89, 95%CI 1.64-2.18 for females). This study provides evidence connecting heat stress and occupational injury in tropical Thailand and also identifies several factors that increase heat exposure. The findings will be useful for policy makers to consider work-related heat stress problems in tropical Thailand and to develop an occupational health and safety program which is urgently needed given the looming threat of global warming.

  14. Rehydration with soft drink-like beverages exacerbates dehydration and worsens dehydration-associated renal injury.

    García-Arroyo, Fernando E; Cristóbal, Magdalena; Arellano-Buendía, Abraham S; Osorio, Horacio; Tapia, Edilia; Soto, Virgilia; Madero, Magdalena; Lanaspa, Miguel A; Roncal-Jiménez, Carlos; Bankir, Lise; Johnson, Richard J; Sánchez-Lozada, Laura-Gabriela

    2016-07-01

    Recurrent dehydration, such as commonly occurs with manual labor in tropical environments, has been recently shown to result in chronic kidney injury, likely through the effects of hyperosmolarity to activate both vasopressin and aldose reductase-fructokinase pathways. The observation that the latter pathway can be directly engaged by simple sugars (glucose and fructose) leads to the hypothesis that soft drinks (which contain these sugars) might worsen rather than benefit dehydration associated kidney disease. Recurrent dehydration was induced in rats by exposure to heat (36°C) for 1 h/24 h followed by access for 2 h to plain water (W), a 11% fructose-glucose solution (FG, same composition as typical soft drinks), or water sweetened with noncaloric stevia (ST). After 4 wk plasma and urine samples were collected, and kidneys were examined for oxidative stress, inflammation, and injury. Recurrent heat-induced dehydration with ad libitum water repletion resulted in plasma and urinary hyperosmolarity with stimulation of the vasopressin (copeptin) levels and resulted in mild tubular injury and renal oxidative stress. Rehydration with 11% FG solution, despite larger total fluid intake, resulted in greater dehydration (higher osmolarity and copeptin levels) and worse renal injury, with activation of aldose reductase and fructokinase, whereas rehydration with stevia water had opposite effects. In animals that are dehydrated, rehydration acutely with soft drinks worsens dehydration and exacerbates dehydration associated renal damage. These studies emphasize the danger of drinking soft drink-like beverages as an attempt to rehydrate following dehydration.

  15. Association Between Lateral Posterior Tibial Slope, Body Mass Index, and ACL Injury Risk

    Bojicic, Katherine M.; Beaulieu, Mélanie L.; Imaizumi Krieger, Daniel Y.; Ashton-Miller, James A.; Wojtys, Edward M.

    2017-01-01

    Background: While body mass index (BMI), a modifiable parameter, and knee morphology, a nonmodifiable parameter, have been identified as risk factors for anterior cruciate ligament (ACL) rupture, the interaction between them remains unknown. An understanding of this interaction is important because greater compressive axial force (perhaps due to greater BMI) applied to a knee that is already at an increased risk because of its geometry, such as a steep lateral posterior tibial slope, could further increase the probability of ACL injury. Purpose: To quantify the relationship between BMI and select knee morphological parameters as potential risk factors for ACL injury. Study Design: Case-control study; Level of evidence, 3. Methods: Sagittal knee magnetic resonance imaging (MRI) files from 76 ACL-injured and 42 uninjured subjects were gathered from the University of Michigan Health System’s archive. The posterior tibial slope (PTS), middle cartilage slope (MCS), posterior meniscus height (PMH), and posterior meniscus bone angle (MBA) in the lateral compartment were measured using MRI. BMI was calculated from demographic data. The association between the knee structural factors, BMI, and ACL injury risk was explored using univariate and multivariate logistic regression. Results: PTS (P = .043) and MCS (P = .037) significantly predicted ACL injury risk. As PTS and MCS increased by 1°, odds of sustaining an ACL injury increased by 12% and 13%, respectively. The multivariate logistic regression analysis, which included PTS, BMI centered around the mean (cBMI), and their interaction, showed that this interaction predicted the odds of ACL rupture (P = .050; odds ratio, 1.03). For every 1-unit increase in BMI from the average that is combined with a 1° increase in PTS, the odds of an ACL tear increased by 15%. Conclusion: An increase in BMI was associated with increased risk of ACL tear in the presence of increased lateral posterior tibial slope. Larger values of PTS or

  16. Correlation between expectations of recovery and injury severity perception in whiplash-associated disorders

    Robert FERRARI; Deon LOUW

    2011-01-01

    Objective:To assess the correlation between expectations of recovery and whiplash patients' perceptions of injury sevedty using a simplified instrument.Expectations of recovery have been shown to predict rate of recovery from whiplash injury in population-based studies.The perception of having more severe pathology or more ominous diagnostic labels has also been associated with a worse prognosis.Methods:Consecutive patients with whiplashassociated disorder grade 1 or 2,presenting in the acute stage to a primary care centre,were asked "do you think that your injury will…" with response options "get better soon; get better slowly; never get better; don't know." Injury severity perception (ISP) was measured with a numerical rating scale which ranged from 0-10,on which subjects were asked to rate how severe (in terms of damage) they thought their injury was.The anchors were labeled "no damage" (0) and "severe,and maybe permanent damage" (10).The primary outcome measure was the correlation between the subject's ISP score and expectation of recovery.Results:A total of 94 subjects (34 males,60 females,and mean age (40.6+10.0) years,range 19-60 years) were included.The initial responses to expectation of recovery were:get better soon (29/94); get better slowly (22/94); never get better (11/94); don't know (32/94).The mean ISP score was 4.9+1.7(range 2-9 out of 10).There was a high correlation between expectations and ISP scores (Spearman's rank correlation coefficient 0.68).Those who expected to recover soon and those who expected to get better slowly had the lowest ISP scores.Conclusions:The more slowly whiplash patients expect to recover,or the less sure they are of recovery,the more severe their initial perceptions of injury.

  17. Pregnancy nutrition surveillance system.

    2003-01-01

    The Pregnancy Nutrition Surveillance System is a useful tool in monitoring Healthy People 2010 objectives and is intended to provide a framework for analyzing data on the nutritional status and behavioral risk factors of pregnant women and the association to birth outcome. The data are useful to health professionals in providing prenatal care and developing programs to reduce pregnancy-related health risks.

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

    Weiss, Harold B.; Kaplan, Sigal; Prato, Carlo Giacomo

    2014-01-01

    fit than a binary and a generalized ordered logit. Results show that the young drivers’ behavior, the presence of passengers and the involvement of vulnerable road users were the most relevant factors associated with higher injury severity in both single-vehicle and two-vehicle crashes. Seatbelt non......-use, inexperience and alcohol use were the deadliest behavioral factors in single-vehicle crashes, while fatigue, reckless driving and seatbelt non-use were the deadliest factors in two-vehicle crashes. The presence of passengers in the young drivers’ vehicle, and in particular a combination of males and females......Young people are a risk to themselves and other road users, as motor vehicle crashes are the leading cause of their death. A thorough understanding of the most important factors associated with injury severity in crashes involving young drivers is important for designing well-targeted restrictive...

  19. Surveillance of Autism.

    Boyle, Coleen A.; Bertrand, Jacquelyn; Yeargin-Allsopp, Marshalyn

    1999-01-01

    This article describes the autism surveillance activities of the Center for Disease Control and Prevention. It considers why surveillance to track prevalence of autistic disorders is needed, how such surveillance is conducted, and the special challenges of autism surveillance. (DB)

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

    Vilma Pinheiro Gawryszewski

    2006-01-01

    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

  1. Analysis of patients with spinal cord trauma associated with traumatic brain injury

    João Simão de Melo Neto

    2014-12-01

    Full Text Available Objective: Characterize victims of spinal cord injury (SCI associated with traumatic brain injury (TBI and risk factors. Methods: Study conducted with 52 victims of SCI associated with TBI. The variables studied were: sex; age; marital status; occupation; educational level; religion; etiology and the lesion area; neurological condition by the ASIA scale; associated injuries and potential risk factors. Results: The male (85%, aged between 21-30 years (25%, civil status stable union (56%, low level of education (69% and the Roman Catholic religion (77% presented the greater number of victims. Motor vehicle accidents (58% were the main etiology. The cervical segment had higher injury risk (RR=3.48, p<0.0001. The neurological status ASIA-E (52%, the syndromic neck pain (35% and the rate of mild TBI (65% were the most frequent. Complications occurred in 13 patients with increased frequency of pneumonia (62%. The length of hospital stay was significantly higher (20±28 days and 17% of patients died. Men (RR=2.14, p=0.028 and individuals exposed to motor vehicle accidents (RR=1.91, p=0.022 showed a higher risk of these lesions concurrently. Moreover, these patients had 2.48 (p<0.01 higher risk of death than victims of SCI alone. Conclusion: The SCI associated with TBI was more frequent in men, young adults, and individuals exposed to motor vehicle accidents. The cervical spine is more likely to be affected. Furthermore, the length of hospitalization is significantly higher and the subjects analyzed have higher risk of death.

  2. Role of Sertraline in insomnia associated with post traumatic brain injury (TBI depression

    Ansari Ahmed

    2016-09-01

    Full Text Available Traumatic brain injury (TBI is a major cause of disability (1, 2. Sleep disturbances, such as insomnia, are very common following traumatic brain injury and have been reported in frequencies from 40% (3 to as high as 84% (4. Sleep disruption can be related to the TBI itself but may also be secondary to neuropsychiatric (e.g., depression or neuromuscular (e.g., pain conditions associated with TBI or to the pharmacological management of the injury and its consequences. Post-TBI insomnia has been associated with numerous negative outcomes including daytime fatigue, tiredness, difficulty functioning: impaired performance at work, memory problems, mood problems, greater functional disability, reduced participation in activities of daily living, less social and recreational activity, less employment potential, increased caregiver burden, greater sexual dysfunction, and also lower ratings of health, poor subjective wellbeing. These negative consequences can hamper the person’s reintegration into the community, adjustment after injury, and overall QOL. (5 The connection between depression and insomnia has not been investigated within the post TBI population to a great extent. For the general population, clinically significant insomnia is often associated with the presence of an emotional disorder (6. Fichtenberg et al. (2002 (7, in his study established that the strongest relationship with the diagnosis of insomnia belonged to depression. Given the high prevalence of depression during the first 2 years following TBI (8, a link between depression and insomnia among TBI patients makes innate sense. The present study aims at assessing role of sertralline in post TBI insomnia associated with depression.

  3. Evaluation of an Acute RNAi-Mediated Therapeutic for Visual Dysfunction Associated with Traumatic Brain Injury

    2013-10-01

    brain injury (TBI) is the leading cause of death in children and young adults globally. Malignant cerebral edema plays a major role in the...pathophysiology which evolves after severe TBI. Added to this is the significant morbidity and mortality from cerebral edema associated with acute stroke...hypoxic ischemic coma, neurological cancers and brain infection. Therapeutic strategies to prevent cerebral edema are limited and if brain swelling

  4. Necrotrophic fungi associated with epidermal microcracking caused by chilling injury in pickling cucumber fruit

    2008-01-01

    The objective of this work was to visualize the association between microcracking and other epidermal chilling injury symptoms, and to identify rots in cucumber fruit (Cucumis sativus L.) by scanning electron microscopy (SEM). Depressed epidermal areas and surface cracking due to damages of subepidermal cells characterized the onset of pitting in cucumber fruit. The germination of conidia of Alternaria alternata, with some of them evident on the fractures in the cultivar Trópico, occurred aft...

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

    2009-01-01

    Abstract Background Benzodiazepines are frequently prescribed to elderly patients' despite concerns about adverse effects leading to injurious falls. Previous studies have not investigated the extent to which patients with pre-existing risk factors for falls are prescribed benzodiazepines. The objective of this study is to assess if some of the risk factors for falls are associated with new benzodiazepine prescriptions in elderly persons. Methods Using provincial administrative databases, eld...

  6. Attaching Hollywood to a Surveillant Assemblage: Normalizing Discourses of Video Surveillance

    Randy K Lippert

    2015-10-01

    Full Text Available This article examines video surveillance images in Hollywood film. It moves beyond previous accounts of video surveillance in relation to film by theoretically situating the use of these surveillance images in a broader “surveillant assemblage”. To this end, scenes from a sample of thirty-five (35 films of several genres are examined to discern dominant discourses and how they lend themselves to normalization of video surveillance. Four discourses are discovered and elaborated by providing examples from Hollywood films. While the films provide video surveillance with a positive associative association it is not without nuance and limitations. Thus, it is found that some forms of resistance to video surveillance are shown while its deterrent effect is not. It is ultimately argued that Hollywood film is becoming attached to a video surveillant assemblage discursively through these normalizing discourses as well as structurally to the extent actual video surveillance technology to produce the images is used.

  7. A Comparison of Administrative Data Versus Surveillance Data for Hospital-Associated Methicillin-Resistant Staphylococcus aureus Infections in Canadian Hospitals.

    Ramirez Mendoza, Jessica Y; Daneman, Nick; Elias, Mary N; Amuah, Joseph E; Bush, Kathryn; Couris, Chantal M; Leeb, Kira

    2016-12-20

    BACKGROUND In Canadian hospitals, clinical information is coded according to national coding standards and is routinely collected as administrative data. Administrative data may complement active surveillance programs by providing in-hospital MRSA infection data in a standardized and efficient manner, but only if infections are accurately captured. OBJECTIVE To assess the accuracy of administrative data regarding in-hospital bloodstream infections (BSIs) and all-body-site infections due to MRSA. METHODS A retrospective study of all (adult and pediatric) in-hospital MRSA infections was conducted by comparing administrative data against surveillance data from 217 acute Canadian hospitals (124 in Ontario, 93 in Alberta) over a 12-month period. Hospital-associated MRSA BSI cases in Ontario, and for all-body-site MRSA infections in Alberta were identified. Pearson correlation coefficients were used to compare the number of hospital-level MRSA cases within administrative versus surveillance datasets. The correlation of all-body-site MRSA infections versus MRSA BSIs was also assessed using the Ontario administrative data. RESULTS Strong correlations between hospital-level MRSA cases in administrative and surveillance datasets were identified for Ontario (r=0.79; 95% CI, 0.72-0.85) and Alberta (r=0.92; 95% CI, 0.88-0.94). A strong correlation between all-body-site and bloodstream-only MRSA infection rates was identified across Ontario hospitals (r=0.95; Phospital MRSA infections. With standard definitions, administrative data can provide estimates of in-hospital infections for monitoring and/or comparisons across hospitals. Infect Control Hosp Epidemiol 2016;1-8.

  8. Avulsion fracture of the posterior cruciate ligament in an uncommon location associated with distal injury to the patellar ligament

    Rodrigo Pires e Albuquerque

    2015-12-01

    Full Text Available ABSTRACT Avulsion fractures of the posterior cruciate ligament in unusual locations are rare injuries. We report the first case in the literature of an avulsion fracture of the posterior cruciate ligament associated with distal injury to the patellar ligament. The aim of this study was to present a novel case, the therapy used and the clinical follow-up.

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

    Heilbron, N.; Prinstein, M.J.

    2010-01-01

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

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

    Heilbron, Nicole; Prinstein, Mitchell J.

    2010-01-01

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

  11. Surveillance Angels

    Rothkrantz, L.J.M.

    2014-01-01

    The use of sensor networks has been proposed for military surveillance and environmental monitoring applications. Those systems are composed of a heterogeneous set of sensors to observe the environment. In centralised systems the observed data will be conveyed to the control room to process the data

  12. Epidemiology of Chain Saw Related Injuries, United States: 2009 through 2013

    Bart Hammig

    2015-01-01

    Full Text Available Problem. Chain saws are a commonly used tool with the potential to inflict severe injuries. Methods. Descriptive epidemiological estimates for emergency department (ED visits for injuries associated with the use of a chain saw were calculated using data from the National Electronic Injury Surveillance System for the years 2009–2013. Results. A total of 115,895 ED visits for injuries related to the use of a chain saw occurred during the study period. Most injury visits occurred among males (95% and persons aged 30–59 years and during the months of September through November. The main body sites injured were the hand/fingers and knee. The majority of injuries were lacerations (80%. Conclusions. Chain saw injuries present with characteristic patterns which can aid in prevention of injuries related to the use of these tools. Examination of the epidemiology of chain saw injuries will help to ascertain targeted needs for prevention and control efforts.

  13. Pediatric volleyball-related injuries treated in US emergency departments, 1990-2009.

    Pollard, Katherine A; Shields, Brenda J; Smith, Gary A

    2011-09-01

    This study describes the epidemiology of pediatric volleyball-related injuries treated in US hospital emergency departments. Data for children younger than 18 years obtained from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission from 1990 through 2009 were analyzed. An estimated 692 024 volleyball-related injuries to children younger than 18 years occurred during the study period. The annual number of injuries declined significantly by 23% during the study period; however, the annual injury rate remained unchanged, and the number of volleyball-related concussions/closed head injuries increased significantly. Upper (48%) and lower (39%) extremity injuries occurred most frequently, as did strains/sprains (54%). Contact with the net/pole was associated with concussions/closed head injury our findings indicate opportunities for making volleyball an even safer sport for children. Protective padding, complying with US volleyball standards, should cover all volleyball poles and protruding hardware to prevent impact-related injuries.

  14. Kidney injury molecule-1 expression is closely associated with renal allograft damage.

    Song, Lianlian; Xue, Lijuan; Yu, Jinyu; Zhao, Jun; Zhang, Wenlan; Fu, Yaowen

    2013-08-01

    The aim of our study was to investigate the expression of kidney injury molecule-1 (KIM-1) in renal allograft biopsy samples and assess the clinical significance of its use as a biomarker for tissue damage. A total of 69 renal allograft biopsy samples from 17 patients with normal serum creatinine and 52 cases of increased serum creatinine were collected. They were divided into different groups according to the Banff 2007 diagnostic criteria. KIM-1 expression was detected by immunohistochemical methods and the association of KIM-1 and blood biochemical indexes was analyzed. KIM-1 expression increased as Banff 2007 classification grade increased and was positively correlated with tubular inflammation severity in the acute T-cell rejection group. Moreover, KIM-1 expression was strongly positive in the chronic active antibody-mediated rejection group. Interestingly, KIM-1 was weakly positive in the normal group without obvious acute rejection and injury of immunosuppressant toxicity. In this group, 27.3% (3/11) of the cases with normal serum creatinine level showed weakly positive KIM-1 expression in their renal tissues. KIM-1 expression level is positively correlated with renal allograft damage and tubular cell injury. KIM-1 is expressed in tubular epithelial cells before blood biochemical indexes become elevated and morphological changes occur. KIM-1 expression is an early, sensitive, and specific biomarker to determine renal tubular epithelial cell injury in renal allograft tissue.

  15. 2006~2007年米易县不同性别伤害监测病例资料分析%Epidemiologicai Analysis of the Sex Differences of Injury Surveillance Cases in Miyi County from 2006 to 2007

    蒲玉红; 黄君安; 刘杰; 庄福明

    2009-01-01

    [Objective]To understand the sex differences of the occurrence time, cause,intention and clinical information. of injury surveillance cases, so as to provide the basis of pertinent injury intervention. [Methods]The data from sentinel hospital surveillance for 14 993 eases reported by 3 sentinel hospitals during 2006 to 2007 were used in this study. [Results] 14 993 injury cases were reported during 2006 to 2007, the proportion of male was 69.29 % (10 388 cases) ,and female was 30, 71% (4 605 cases). There was no difference of injury occurrence time between male and female(P >0.05) but there were significant differences of the place and the activity when injury occurred(P <0. 01) ; the proportion of poisoning and animal injury of female was 9.47% and 8. 17% ,and that of male was 3.56% and 5.62% ;the proportion of female suicide was 5.80% ,and male was 1.31% ;the proportion of mild,moderate and severe injury of female was 68.34%, 28.38% and 3. 28% ,that of male was 66.66% ,30.78% and 2.56% (P <0. 01) ;the proportion of hospital treatment of female was 66.34 %, and male was 70.42 % (P<0.01). [Conclusion]Different people had different characteristic of injury, should be targeted for intervention.%[目的]了解不同性别伤害病例在伤害发生时间、发生原因、发生意图以及伤害临床信息等方面的差异,为开展针对性的伤害干预提供依据.[方法]对米易县2006~2007年监测哨点医院报告首诊的14 993例伤害病例资料进行分析.[结果]2006~2007年合计报告伤害病例14 993例.其中,男性10 388例,占69.29%;女性4 605例,占30.71%.不同性别病例伤害发生时间分布元差异(P>0.05);不同性别伤害发生地点与发生时的活动不同(P<0.01).中毒、动物伤所占比例.女性分别为9.47%、8.17%,男性分别为3.56%、5.62%;自残/自杀所占比例,女性为5.80%,男性为1.31%.中度、重度伤害所占比例,女性分别为28.38%、3.28%,男性分别为30.78%、2.56%(P<0.01).

  16. Annual report for Hanford Site: Epidemiologic surveillance - 1994

    NONE

    1998-01-01

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

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

    NONE

    1998-12-31

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

  18. Epidemiologic surveillance. Annual report for EG&G Rocky Flats

    NONE

    1994-12-31

    Epidemiologic surveillance at U.S. Department of Energy (DOE) facilities consists of regular and systematic collection, analysis, and interpretation of data on absences resulting from illness and injury in the work force. Its purpose is to provide an early warning system for health problems occurring among employees at participating sites. Data are collected by coordinators at each site and submitted to the Epidemiologic Surveillance Data Center, located at the Oak Ridge Institute for Science and Education, where quality control procedures and analyses are carried out. Rates of absences and rates of diagnoses associated with absences are analyzed by occupation and other relevant variables. They may be compared with the disease experience of different groups within the DOE work force and with populations that do not work for DOE to identify disease patterns or clusters that may be associated with work activities. This report presents the 1994 morbidity data for the Rocky Flats plant.

  19. 浙江省0~14岁儿童伤害急诊监测结果分析%Analysis of data from emergency-room-based injury surveillance of children aged 0~14 in Zhejiang Province

    钟节鸣; 丛黎明; 俞敏; 李丽萍

    2008-01-01

    and pattern of children injury of Zhejiang Province,and provides scientific evidence for the prevention and control strategy of children injury. Method Children diagnosed as injury at emergency department in sentry hospitals (Tnere are 5 monitoring sites for injury surveillance in Zhejiang in 2005: Jinhua, Shengsi, Tongxiang, Yinzhou dislrict of Ningbo, Hailing; each monitoring site has 3 sentry hospitals: one county level hospital, one town center hospital and one town level hospital) from January to December,2005 were investigated by trained doctors or nurses in emerncy department. The investigation included basic information, when injury happened, where injury happened and type of injury. Children were investigated when they were conscious, and their parents or accompanies could answer if they were not able to. The contents of investigation were kept private. The distribution of variables which included sex, age, when injury happened, where injury happened, why injury happened and severity level were described mainly with proportion and means, and chisquare test was used to analyze the proportion difference. Remits A total of 1 794 injury cases were recorded in 2005 among which 67.56% were male and 32.44% were female. The majority were native people and the average age was 7.33±3.84 years old. The injury occurred mostly at home and was of high frequent occurrence from April to November. The most common causes of injury were tumble (47.94%).traffic accident (17.17%) and blunt injury(10.26%). The injury happened mostly during spare time(67.66%), and then school aetivities(11.25%)ant]sports activities(9.96%). Totally 90.33% of the injured children went home after been treated, 1.40% stayed for obsrvafion, 7.04% were in hospital, 0.56% were transferred to other hospitals, 0.22% died and 0.45% unknown. The slight superficial injury and moderate injury were the most common injuries. The most common three types of injury were haemaloma and stasis injury(31

  20. Environmental exposure to arsenic and chromium in children is associated with kidney injury molecule-1.

    Cárdenas-González, M; Osorio-Yáñez, C; Gaspar-Ramírez, O; Pavković, M; Ochoa-Martínez, A; López-Ventura, D; Medeiros, M; Barbier, O C; Pérez-Maldonado, I N; Sabbisetti, V S; Bonventre, J V; Vaidya, V S

    2016-10-01

    Environmental hazards from natural or anthropological sources are widespread, especially in the north-central region of Mexico. Children represent a susceptible population due to their unique routes of exposure and special vulnerabilities. In this study we evaluated the association of exposure to environmental kidney toxicants with kidney injury biomarkers in children living in San Luis Potosi (SLP), Mexico. A cross-sectional study was conducted with 83 children (5-12 years of age) residents of Villa de Reyes, SLP. Exposure to arsenic, cadmium, chromium, fluoride and lead was assessed in urine, blood and drinking water samples. Almost all tap and well water samples had levels of arsenic (81.5%) and fluoride (100%) above the permissible levels recommended by the World Health Organization. Mean urine arsenic (45.6ppb) and chromium (61.7ppb) were higher than the biological exposure index, a reference value in occupational settings. Using multivariate adjusted models, we found a dose-dependent association between kidney injury molecule-1 (KIM-1) across chromium exposure tertiles [(T1: reference, T2: 467pg/mL; T3: 615pg/mL) (p-trend=0.001)]. Chromium upper tertile was also associated with higher urinary miR-200c (500 copies/μl) and miR-423 (189 copies/μL). Arsenic upper tertile was also associated with higher urinary KIM-1 (372pg/mL). Other kidney injury/functional biomarkers such as serum creatinine, glomerular filtration rate, albuminuria, neutrophil gelatinase-associated lipocalin and miR-21 did not show any association with arsenic, chromium or any of the other toxicants evaluated. We conclude that KIM-1 might serve as a sensitive biomarker to screen children for kidney damage induced by environmental toxic agents.

  1. Cardiac surgery-associated acute kidney injury in a developing country: Prevalence, risk factors and outcome

    2015-01-01

    Little is known about cardiac surgery-associated acute kidney injury (CS-AKI) in children in developing regions of the world. The study aimed to determine the prevalence of CSAKI, associated factors and its impact on mortality and utilization of hospital services. The hospital records of children aged 0-17 years who underwent CS at an Indian hospital were reviewed. CS-AKI was defined as a rise in serum creatinine of ≥0.3 mg/dL in any 48 h and or by urine output

  2. 湖北省2006-2007年监测点居民伤害死因分析%Analysis on the Causes of Injury Death of Surveillance Residents in Hubei Province from 2006 to 2007

    孔德广; 张庆军; 申幸福; 崔晓晨; 郭毅

    2011-01-01

    Objective: To analyze the causes of injury death and study the potential life lost of surveillance residents in Hubei province, and to provide basis for prevention &- control and data for policy-making. Methods: The mortality and potential years of life lost (PYLL) were calculated by collecting injury death data from the death registry system in Hubei province from 2006 to 2007. Results: The cases which died of injury were account for 5 994, the gross mortality was 61. 45 per 100 000 from 2006 to 2007(standardized mortality was 58. 26 per 100 000), of which 3 725 were male and 2 269 were female, the gross mortality of male was 74. 53 per 100 000 and female's was 47. 71 per 100 000 (standardized mortalities were 68. 78 per 100 000 and 46.14 per 100 000). The mortality of male was higher than that of female. The first five causes of injury death were as follows: suicide, traffic accident, falls, drowning and crush injury. The top five causes of PYLL were as follows: traffic accident, suicide, drowning, falls and crush injured. Conclusion; The main causes of injury death of surveillance residents were traffic accident, suicide, drowning, falls and crush injury in Hubei province. Traffic accident and suicide were mainly leading to premature death and life losses.%目的:了解湖北省监测点居民伤害死因及潜在寿命损失状况,为预防控制提供科学依据。方法:采用死亡率与潜在减寿年数(PYLL)等指标对湖北省2006-2007年监测点居民伤害死亡资料进行分析。结果:监测点居民伤害死亡5994例,粗死亡率为61.45/10万(标化死亡率为58.26/10万),其中男性3 725例、女性2 269例,粗死亡率分别为74.53/10万、47.71/10万(标化死亡率分别为68.78/10万、46.14/10万),男性高于女性。伤害死因前5位依次是自杀、交通事故、意外跌落、溺水和砸伤压伤;以PYLL计,前5位依次为交通事故、自杀、溺水、意外跌落和砸伤压伤。各年龄段伤

  3. Reduced thalamic volume in preterm infants is associated with abnormal white matter metabolism independent of injury

    Wisnowski, Jessica L. [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); University of Pittsburgh, Department of Pediatric Radiology, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); University of Southern California, Brain and Creativity Institute, Los Angeles, CA (United States); Ceschin, Rafael C. [University of Pittsburgh, Department of Pediatric Radiology, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); University of Pittsburgh, Department of Biomedical Informatics, Pittsburgh, PA (United States); Choi, So Young [University of Southern California, Brain and Creativity Institute, Los Angeles, CA (United States); Schmithorst, Vincent J. [University of Pittsburgh, Department of Pediatric Radiology, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); Painter, Michael J. [University of Pittsburgh, Department of Pediatrics, Division of Neurology, Childrens Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); Nelson, Marvin D. [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); Blueml, Stefan [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); Rudi Schulte Research Institute, Santa Barbara, CA (United States); Panigrahy, Ashok [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); University of Pittsburgh, Department of Pediatric Radiology, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States)

    2015-05-01

    Altered thalamocortical development is hypothesized to be a key substrate underlying neurodevelopmental disabilities in preterm infants. However, the pathogenesis of this abnormality is not well-understood. We combined magnetic resonance spectroscopy of the parietal white matter and morphometric analyses of the thalamus to investigate the association between white matter metabolism and thalamic volume and tested the hypothesis that thalamic volume would be associated with diminished N-acetyl-aspartate (NAA), a measure of neuronal/axonal maturation, independent of white matter injury. Data from 106 preterm infants (mean gestational age at birth: 31.0 weeks ± 4.3; range 23-36 weeks) who underwent MR examinations under clinical indications were included in this study. Linear regression analyses demonstrated a significant association between parietal white matter NAA concentration and thalamic volume. This effect was above and beyond the effect of white matter injury and age at MRI and remained significant even when preterm infants with punctate white matter lesions (pWMLs) were excluded from the analysis. Furthermore, choline, and among the preterm infants without pWMLs, lactate concentrations were also associated with thalamic volume. Of note, the associations between NAA and choline concentration and thalamic volume remained significant even when the sample was restricted to neonates who were term-equivalent age or older. These observations provide convergent evidence of a neuroimaging phenotype characterized by widespread abnormal thalamocortical development and suggest that the pathogenesis may involve impaired axonal maturation. (orig.)

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

    Katherine Chaplin

    2011-05-01

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

  5. Factors Associated With Length of Stay and Hospital Charges among Pediatric Burn Injury in Kermanshah, West of Iran

    Satar Rezaei

    2015-01-01

    This study highlights that the independent predictors affecting hospital costs and LOS associated with pediatric burn injury in Kermanshah. Also, our study indicates the BBS was the main factors affecting hospital costs and LOS for the study population. 

  6. Association of aggression and non-suicidal self injury: a school-based sample of adolescents.

    Jie Tang

    Full Text Available PURPOSE: Non-suicidal self-injury (NSSI in adolescent has drawn increasing attention because it is associated with subsequent depression, drug abuse, anxiety disorders, and suicide. In the present study, we aimed to estimate the prevalence of non-suicidal self-injury (NSSI in a school-based sample of Chinese adolescents and to explore the association between aggression and NSSI. METHODS: This study was part of a nationwide study on aggression among adolescents in urban areas of China. A sample of 2907 school students including 1436 boys and 1471 girls were randomly selected in Guangdong Province, with their age ranging from 10 to 18 years old. NSSI, aggression, emotional management and other factors were measured by self-administrated questionnaire. Multinomial logistic regression was used to estimate the association between aggression and NSSI, after adjustment for participants' emotional management, and other potential confounding variables. RESULTS: The one year self-reported prevalence of NSSI was 33.6%. Of them, 21.7% engaged in 'minor NSSI', 11.9% in 'moderate/severe NSSI'. 96.9% of self-injuries engaged in one to five different types of NSSI in the past year. Hostility, verbal and indirect aggression was significantly associated with self-reported NSSI after adjusting for other potential factors both in 'minor NSSI' and 'moderate/severe NSSI'. Hostility, verbal and indirect aggression was significantly associated with greater risk of 'minor NSSI' and 'moderate/severe NSSI' in those who had poor emotional management ability. CONCLUSION: These findings highlight a high prevalence of NSSI and indicate the importance of hostility, verbal and indirect aggression as potentially risk factor for NSSI among Chinese adolescents.

  7. Sport-related structural brain injury associated with arachnoid cysts: a systematic review and quantitative analysis.

    Zuckerman, Scott L; Prather, Colin T; Yengo-Kahn, Aaron M; Solomon, Gary S; Sills, Allen K; Bonfield, Christopher M

    2016-04-01

    OBJECTIVE Arachnoid cysts (ACs) are congenital lesions bordered by an arachnoid membrane. Researchers have postulated that individuals with an AC demonstrate a higher rate of structural brain injury after trauma. Given the potential neurological consequences of a structural brain injury requiring neurosurgical intervention, the authors sought to perform a systematic review of sport-related structural-brain injury associated with ACs with a corresponding quantitative analysis. METHODS Titles and abstracts were searched systematically across the following databases: PubMed, Embase, CINAHL, and PsycINFO. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Peer-reviewed case reports, case series, or observational studies that reported a structural brain injury due to a sport or recreational activity (hereafter referred to as sport-related) with an associated AC were included. Patients were excluded if they did not have an AC, suffered a concussion without structural brain injury, or sustained the injury during a non-sport-related activity (e.g., fall, motor vehicle collision). Descriptive statistical analysis and time to presentation data were summarized. Univariate logistic regression models to assess predictors of neurological deficit, open craniotomy, and cystoperitoneal shunt were completed. RESULTS After an initial search of 994 original articles, 52 studies were found that reported 65 cases of sport-related structural brain injury associated with an AC. The median age at presentation was 16 years (range 4-75 years). Headache was the most common presenting symptom (98%), followed by nausea and vomiting in 49%. Thirteen patients (21%) presented with a neurological deficit, most commonly hemiparesis. Open craniotomy was the most common form of treatment (49%). Bur holes and cyst fenestration were performed in 29 (45%) and 31 (48%) patients, respectively. Seven patients (11%) received

  8. OCCULT MANUBRIOSTERNAL JOINT INJURY ASSOCIATED WITH FRACTURE OF THE THORACIC SPINE.

    da Silva Herrero, Carlos Fernando Pereira; Porto, Maximiliano Aguiar; Nogueira-Barbosa, Marcello Henrique; Defino, Helton Luiz Aparecido

    2011-01-01

    The authors report the occurrence of an occult manubriosternal joint injury in the initial evaluation on a patient with a thoracic spine fracture (T9). This T9 fracture was diagnosed in a 37-year-old man and was associated with a partial neurological deficit. At the initial evaluation, the radiographs produced did not show the manubriosternal joint injury. During rehabilitation, after surgical stabilization of the thoracic spine fracture, the patient suddenly felt an intense pain accompanied by deformation at the sternal level. From imaging examinations, manubriosternal luxation was diagnosed. Because of recurrence of the luxation and the incapacitating pain, open reduction and fixation of the manubriosternal joint had to be performed. At the 12-month follow-up, the patient presented complete recovery of the neurological lesion, consolidation of the arthrodesis on the T7-T11 vertebral segment and maintenance of the reduction of the manubriosternal joint, which was asymptomatic during daily activities.

  9. The association of functional oral intake and pneumonia in patients with severe traumatic brain injury

    Hansen, T.S.; Larsen, K.; Engberg, Anders

    2008-01-01

    associated with a higher occurrence of pneumonia. CONCLUSIONS: Among patients with severe TBI, 27% had pneumonia at transfer from the intensive care unit. Pneumonia developed in only 12% of the participants during rehabilitation. Patients with a low level of consciousness and patients with a tracheotomy tube...... MEASURE: Pneumonia. RESULTS: Twenty-seven percent of the patients admitted to the brain injury unit were in treatment for pneumonia; pneumonia developed in 12% of the patients during rehabilitation; the condition occurred within 19 days of admission in all but 1 patient. Of these patients, 81% received...... rehabilitation department in a university hospital in Denmark. PARTICIPANTS: Patients (N=173) aged 16 to 65 years with severe TBI who were admitted during a 5-year period. Patients are transferred to the brain injury unit as soon as they ventilate spontaneously. INTERVENTIONS: Not applicable. MAIN OUTCOME...

  10. Protective effect of ginkgo proanthocyanidins against cerebral ischemia/reperfusion injury associated with its antioxidant effects

    Cao, Wang-li; Huang, Hai-bo; Fang, Ling; Hu, Jiang-ning; Jin, Zhu-ming; Wang, Ru-wei

    2016-01-01

    Proanthocyanidins have been shown to effectively protect ischemic neurons, but its mechanism remains poorly understood. Ginkgo proanthocyanidins (20, 40, 80 mg/kg) were intraperitoneally administered 1, 24, 48 and 72 hours before reperfusion. Results showed that ginkgo proanthocyanidins could effectively mitigate neurological disorders, shorten infarct volume, increase superoxide dismutase activity, and decrease malondialdehyde and nitric oxide contents. Simultaneously, the study on grape seed proanthocyanidins (40 mg/kg) confirmed that different sources of proanthocyanidins have a similar effect. The neurological outcomes of ginkgo proanthocyanidins were similar to that of nimodipine in the treatment of cerebral ischemia/reperfusion injury. Our results suggest that ginkgo proanthocyanidins can effectively lessen cerebral ischemia/reperfusion injury and protect ischemic brain tissue and these effects are associated with antioxidant properties. PMID:28123420

  11. Air surveillance

    Patton, G.W.

    1995-06-01

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

  12. Association of initial CT findings with quality-of-life outcomes for traumatic brain injury in children

    Swanson, Jonathan O. [Seattle Children' s Hospital and University of Washington, Department of Radiology, Seattle, WA (United States); Vavilala, Monica S.; Wang, Jin; Rivara, Frederick P. [Harborview Medical Center, University of Washington, Department of Pediatrics, Seattle, WA (United States); Pruthi, Sumit [Monroe Carell Jr. Children' s Hospital at Vanderbilt University, Department of Radiology, Nashville, TN (United States); Fink, James [University of Washington, Department of Radiology, Seattle, WA (United States); Jaffe, Kenneth M. [University of Washington, Department of Rehabilitation Medicine, Seattle, WA (United States); Durbin, Dennis [University of Pennsylvania, Department of Pediatrics, Center for Injury Research and Prevention, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Koepsell, Thomas [University of Washington, Department of Epidemiology, Seattle, WA (United States); Temkin, Nancy [University of Washington, Biostatistics, Seattle, WA (United States)

    2012-08-15

    Traumatic brain injury (TBI) is a leading cause of acquired disability in children and adolescents. To demonstrate the association between specific findings on initial noncontrast head CT and long-term outcomes in children who have suffered TBI. This was an IRB-approved prospective study of children ages 2-17 years treated in emergency departments for TBI and who underwent a head CT as part of the initial work-up (n = 347). The change in quality of life at 12 months after injury was measured by the PedsQL scale. Children with TBI who had intracranial injuries identified on the initial head CT had a significantly lower quality-of-life scores compared to children with TBI whose initial head CTs were normal. In multivariate analysis, children whose initial head CT scans demonstrated intraventricular hemorrhage, parenchymal injury, midline shift {>=}5 mm, hemorrhagic shear injury, abnormal cisterns or subdural hematomas {>=}3 mm had lower quality of life scores 1 year after injury than children whose initial CTs did not have these same injuries. Associations exist between findings from the initial noncontrast head CT and quality of life score 12 months after injury in children with TBI. (orig.)

  13. Association of Cerebral Amyloidosis, Blood Pressure, and Neuronal Injury with Late-life Onset Depression

    Min Soo Byun

    2016-10-01

    Full Text Available Previous literature suggests that Alzheimer’s disease (AD process may contribute to late-life onset depression (LLOD. Therefore, we investigated the association of LLOD with cerebral amyloidosis and neuronal injury, the two key brain changes in AD, along with vascular risks. Twenty nine non-demented individuals who first experienced major depressive disorder (MDD after age of 60 years were included as LLOD subjects, and 27 non-demented elderly individuals without lifetime experience of MDD were included as normal controls (NC. Comorbid mild cognitive impairment (MCI was diagnosed in 48% of LLOD subjects and in 0% of NC. LLOD, irrespective of comorbid MCI diagnosis, was associated with prominent prefrontal cortical atrophy. Compared to NC, LLOD subjects with comorbid MCI (LLODMCI showed increased cerebral 11C-Pittsburg compound B (PiB retention and plasma beta-amyloid 1-40 and 1-42 peptides, as measures of cerebral amyloidosis; and, such relationship was not observed in overall LLOD or LLOD without MCI (LLODwoMCI. LLOD subjects, particularly the LLODwoMCI, had higher systolic blood pressure (SBP than NC. When analyzed in the same multiple logistic regression model that included prefrontal gray matter (GM density, cerebral amyloidosis and SBP as independent variables, only prefrontal GM density showed a significant independent association with LLOD regardless of MCI comorbidity status. Our findings suggest AD process might be related to LLOD via prefrontal neuronal injury in the MCI stage, whereas vascular processes—SBP elevation, in particular—are associated with LLOD via prefrontal neuronal injury even in cognitively intact or less impaired individuals.

  14. Association of Cerebral Amyloidosis, Blood Pressure, and Neuronal Injury with Late-Life Onset Depression

    Byun, Min Soo; Choe, Young Min; Sohn, Bo Kyung; Yi, Dahyun; Han, Ji Young; Park, Jinsick; Choi, Hyo Jung; Baek, Hyewon; Lee, Jun Ho; Kim, Hyun Jung; Kim, Yu Kyeong; Yoon, Eun Jin; Sohn, Chul-Ho; Woo, Jong Inn; Lee, Dong Young

    2016-01-01

    Previous literature suggests that Alzheimer's disease (AD) process may contribute to late-life onset depression (LLOD). Therefore, we investigated the association of LLOD with cerebral amyloidosis and neuronal injury, the two key brain changes in AD, along with vascular risks. Twenty nine non-demented individuals who first experienced major depressive disorder (MDD) after age of 60 years were included as LLOD subjects, and 27 non-demented elderly individuals without lifetime experience of MDD were included as normal controls (NC). Comorbid mild cognitive impairment (MCI) was diagnosed in 48% of LLOD subjects and in 0% of NC. LLOD, irrespective of comorbid MCI diagnosis, was associated with prominent prefrontal cortical atrophy. Compared to NC, LLOD subjects with comorbid MCI (LLODMCI) showed increased cerebral 11C-Pittsburg compound B (PiB) retention and plasma beta-amyloid 1–40 and 1–42 peptides, as measures of cerebral amyloidosis; and, such relationship was not observed in overall LLOD or LLOD without MCI (LLODwoMCI). LLOD subjects, particularly the LLODwoMCI, had higher systolic blood pressure (SBP) than NC. When analyzed in the same multiple logistic regression model that included prefrontal gray matter (GM) density, cerebral amyloidosis, and SBP as independent variables, only prefrontal GM density showed a significant independent association with LLOD regardless of MCI comorbidity status. Our findings suggest AD process might be related to LLOD via prefrontal neuronal injury in the MCI stage, whereas vascular processes—SBP elevation, in particular—are associated with LLOD via prefrontal neuronal injury even in cognitively intact or less impaired individuals. PMID:27790137

  15. Association between cervical spine and skull-base fractures and blunt cerebrovascular injury

    Buch, Karen; Nguyen, Thanh; Norbash, Alex; Mian, Asim [Boston University School of Medicine, Department of Radiology, Boston Medical Center, Boston, MA (United States); Mahoney, Eric; Burke, Peter [Boston University School of Medicine, Department of Surgery, Boston Medical Center, Boston, MA (United States); Libby, Brandon; Calner, Paul [Boston University School of Medicine, Department of Emergency Medicine, Boston Medical Center, Boston, MA (United States)

    2016-02-15

    Blunt cerebrovascular injuries (BCVI) are associated with high morbidity and mortality and can lead to neurological deficits. The established criteria for patients undergoing CT angiography (CTA) for BCVI are broad, and can expose patients to radiation unnecessarily. This study aimed to examine the prevalence of BCVI in patients on CTA and determine presentations associated with the highest rates of BCVI. With IRB approval, patients were selected for CTA screening for BCVI according to a predefined set of criteria at our hospital between 2007 and 2010. Patients were identified from our institution's trauma database. CTAs were retrospectively reviewed for BCVI including vasospasm and dissection. Electronic medical records were reviewed for clinical presentation and hospital course. Of 432 patients, vasospasm (n = 10) and/or dissection (n = 36) were found in 46 patients (10.6 %). BCVI was associated with cervical spine and/or skull-base fracture in 40/46 patients (87 %, P < 0.0001). Significant correlations were seen between dissection and fracture in 31/36 patients (86.2 %, p < 0.0001) and between BCVI and both neurological deficits and fractures (27/44, P < 0.0001). BCVI was significantly associated with cervical and/or skullbase fractures and neurological deficits with coexistent fractures. Patients with these injuries should be prioritized for rapid CTA evaluation for BCVI. (orig.)

  16. Annual report for Brookhaven National Laboratory 1994 epidemiologic surveillance

    NONE

    1997-01-01

    Epidemiologic surveillance at DOE facilities consists of regular and systematic collection, analysis, and interpretation of data on absences due to illness and injury in the work force. Its purpose is to provide an early warning system for health problems occurring among employees at participating sites. Data are collected by coordinators at each site and submitted to the Epidemiologic Surveillance Data Center, located at the Oak Ridge Institute for Science and Education, where quality control procedures and analyses are carried out. Rates of absences and rates of diagnoses associated with absences are analyzed by occupation and other relevant variables. They may be compared with the disease experience of different groups within the DOE work force and with populations that do not work for DOE to identify disease patterns or clusters that may be associated with work activities. In this annual report, the 1994 morbidity data for BNL are summarized. These analyses focus on absences of 5 or more consecutive workdays occurring among workers aged 16-80 years. They are arranged in five sets of tables that present: (1) the distribution of the labor force by occupational category and salary status; (2) the absences per person, diagnoses per absence, and diagnosis rates for the whole work force; (3) diagnosis rates by type of disease or injury; (4) diagnosis rates by occupational category; and (5) relative risks for specific types of disease or injury by occupational category.

  17. Innovative Solutions Shockproof Protection In Occupations Associated With An Increased Risk Of Injury

    Denisov, O. V.; Buligin, Y. I.; Ponomarev, A. E.; Ponomareva, I. A.; Lebedeva, V. V.

    2017-01-01

    An important direction in the development of the shockproof devices for occupations associated with an increased risk of injury is reducing their overall size with the preservation the ability of energy absorption. The fixture protection of large joints, with the brace in the coils of an elastic-plastic material with shape memory effect, can effectively protect people from injury and can be used in the domain of occupational safety to reduce injuries by shocks or jolts. In innovative anti-shock device as elastic-plastic material applied equiatomic Titanium-Nickel alloy which has acceptable temperature phase transitions that is necessary to restore shape. As an experienced model first approximation was adopted shockproof device, having in its composition a bandage in coils of elastic-plastic material with shape memory effect and with electric contacts at the ends. This solution allows the punches to plastically deform with the absorption of the impact energy, and then recover the original shape, including at the expense of electric heating.

  18. Effects of hypercapnia and hypercapnic acidosis on attenuation of ventilator-associated lung injury.

    Ismaiel, N M; Henzler, D

    2011-07-01

    Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are associated with impaired gas exchange, severe inflammation and alveolar damage including cell death. Patients with ALI or ARDS typically experience respiratory failure and thus require mechanical ventilation for support, which itself can aggravate lung injury. Recent developments in this field have revealed several therapeutic strategies that improve gas exchange, increase survival and minimize the deleterious effects of mechanical ventilation. Among those strategies is the reduction in tidal volume and allowing hypercapnia to develop during ventilation, or actively inducing hypercapnia. Here, we provide an overview of hypercapnia and the hypercapnic acidosis that typically follows, as well as the therapeutic effects of hypercapnia and acidosis in clinical studies and experimental models of ALI. Specifically, we review the effects of hypercapnia and acidosis on the attenuation of pulmonary inflammation, reduction of apoptosis in alveolar epithelial cells, improvement in sepsis-induced ALI and the therapeutic effects on other organ systems, as well as the potentially harmful effects of these strategies. The clinical implications of hypercapnia and hypercapnic acidosis are still not entirely clear. However, future research should focus on the intracellular signaling pathways that mediate ALI development, potentially focusing on the role of reactive biological species in ALI pathogenesis. Future research can also elucidate how such pathways may be targeted by hypercapnia and hypercapnic acidosis to attenuate lung injury.

  19. Traumatic Testicular Dislocation Associated with Lateral Compression Pelvic Ring Injury and T-Shaped Acetabulum Fracture

    Daniel Howard Wiznia

    2016-01-01

    Full Text Available We report a case of a unilateral testicular dislocation to the superficial inguinal region associated with a lateral compression type pelvic ring injury (OTA classification 61-C3.3a2, b2, c3 and left T-shaped acetabulum fracture (OTA classification 62-B2 in a 44-year-old male who was in a motorcycle accident. The testicular dislocation was noted during the emergency department primary survey, and its location and viability were verified with ultrasound. The testicle was isolated during surgical stabilization of the left acetabulum through a Pfannenstiel incision and modified-Stoppa approach and returned through the inguinal canal to the scrotum. In follow-up, the patient did not suffer urologic or sexual dysfunction. All motorcycle collision patients presenting with pelvic ring injuries or acetabulum fractures should be worked up for possible testicular dislocation with a scrotal exam. Advanced imaging and a urologic consult may be necessary to detect and treat these injuries.

  20. Functional independence and health-related functional status following spinal cord injury : a prospective study of the association with physical capacity

    Haisma, Janneke A.; Post, Marcel W.; van der Woude, Lucas H.; Stam, Henk J.; Bergen, Michael P.; Sluis, Tebbe A.; van den Berg-Emons, Hendrika J.; Bussmann, Johannes B.

    2008-01-01

    Objective: To determine changes in functional independence following spinal cord injury and to evaluate the association between functional independence and physical capacity. Design: Multi-centre prospective cohort study. Subjects: Patients with spinal cord injury admitted for initial rehabilitation

  1. LONGITUDINAL ASSOCIATION BETWEEN RESPIRATORY MUSCLE STRENGTH AND COUGH CAPACITY IN PERSONS WITH SPINAL CORD INJURY : AN EXPLORATIVE ANALYSIS OF DATA FROM A RANDOMIZED CONTROLLED TRIAL

    Postma, Karin; Vlemmix, Lonneke Y.; Haisma, Janneke A.; de Groot, Sonja; Sluis, Tebbe A. R.; Stam, Henk J.; Bussmann, Johannes B. J.

    2015-01-01

    Objective: To assess the longitudinal association between respiratory muscle strength and cough capacity in persons with recent spinal cord injury. Design: Longitudinal analyses. Subjects: Forty persons with recent spinal cord injury and impaired pulmonary function. Methods: Measurements were perfor

  2. Factors Associated with Needlestick Injuries in Health Care Occupations: A Systematic Review

    Motaarefi, Hossein; Mohammadi, Eesa; Hasanpour-Dehkordi, Ali

    2016-01-01

    Introduction Needlestick and sharps injuries (NSIs), are among the main job-related injuries that health care workers experience. In fact, contraction of hepatitis B or hepatitis C from work-related NSIs is one of the most common occupational hazards among health care workers. Aim The aim of this study was to determine the factors associated with NSIs in health care occupation. Materials and Methods In this study, a systematic and purposive review with emphasis on the research question was run to retrieve, evaluate and consolidate the required information. The following four key words were used to search for the relevant articles published from January 1998 to May 2015: NSI health care workers, risk factor and factors associated, in Science direct, EBSCO Host, PubMed, ProQuest, SID and Cochrane Library. Several steps of evaluation were taken to select and analyse the full texts of relevant articles. According to the inclusion criteria, we finally selected 11 articles from the 18642 retrieved articles. Results The data of the analysed articles indicated that the highest incidence of NSIs was seen in nurses and that the associated factors were age, level of education, number of shifts per month and history of related training. The highest rate of NSIs was related to instrument preparation followed by injection and recapping of used needles. Findings show that health care workers suffer a high rate of needlestick injuries. Conclusion It was seen that device, location, or action cannot be separately considered as responsible for all types of the NSIs. Rather, each of them has a contribution to the NSIs. Nevertheless, factors with higher frequency should be given a higher priority. PMID:27656466

  3. Spatiotemporal phosphoprotein distribution and associated cytokine response of a traumatic injury.

    Han, Alice A; Currie, Holly N; Loos, Matthew S; Vrana, Julie A; Fabyanic, Emily B; Prediger, Maren S; Boyd, Jonathan W

    2016-03-01

    Molecular mechanisms of wound healing have been extensively characterized, providing a better understanding of the processes involved in wound repair and offering advances in treatment methods. Both spatial and temporal investigations of injury biomarkers have helped to pinpoint significant time points and locations during the recovery process, which may be vital in managing the injury and making the appropriate diagnosis. This study addresses spatial and temporal differences of phosphoproteins found in skeletal muscle tissue following a traumatic femur fracture, which were further compared to co-localized cytokine responses. In particular, several proteins (Akt, ERK, c-Jun, CREB, JNK, MEK1, and p38) and post-translational phosphorylations (p-Akt, p-c-Jun, p-CREB, p-ERK1/2, p-MEK1, p-p38, p-GSK3α/β, p-HSP27, p-p70S6K, and p-STAT3) associated with inflammation, new tissue formation, and remodeling were found to exhibit significant spatial and temporal differences in response to the traumatic injury. Quadratic discriminant analysis of all measured responses, including cytokine concentrations from previously published findings, was used to classify temporal and spatial observations at high predictive rates, further confirming that distinct spatiotemporal distributions for total protein, phosphorylation signaling, and cytokine (IL-1α, IL-1ß, IL2, IL6, TNF-α, and MIP-1α) responses exist. Finally, phosphoprotein measurements were found to be significantly correlated to cytokine concentrations, suggesting coordinated intracellular and extracellular activity during crucial periods of repair. This study represents a first attempt to monitor and assess integrated changes in extracellular and intracellular signaling in response to a traumatic injury in muscle tissues, which may provide a framework for future research to improve both our understanding of wounds and their treatment options.

  4. Role of Kupffer cells in acute hemorrhagic necrotizing pancreatitis-associated lung injury of rats

    Hong-Bin Liu; Nai-Qiang Cui; Dong-Hua Li; Chang Chen

    2006-01-01

    AIM: To investigate the role of Kupffer cells (KCs) in acute hemorrhagic necrotizing pancreatitis-associated lung injury (AHNP-LI).METHODS: Forty-two rats were allocated to four groups [sham operation, AHNP model, gadolinium chloride (GdCl3) pretreatment, GdCl3 control]. In GdCl3pretreatment group, GdCl3 was administered by caudal vein injection 24 h before the AHNP model induction.Blood from the iliac artery, alveolar macrophages and tissues from the pancreas and lung, were collected in six animals per group 3 and 6 h after acute pancreatitis induction. TNF-α, IL-1 of serum, myeloperoxidase (MPO)of lung tissue, NF-κB activation of alveolar macrophages were detected. Serum AST and ALT in sham operation group and GdCl3 control group were tested. In addition,histopathological changes of the pancreas and lung were observed under light microscope.RESULTS: MPO of lung tissue and TNF-α, IL-1 levels of serum were all reduced significantly in GdCl3pretreatment group compared to those in AHNP group(P<0.01). NF-κB activation of alveolar macrophages was also attenuated significantly in GdCl3 pretreatment group compared to that in AHNP group (P<0.01). The pathological injury of the lung was ameliorated obviously in GdCl3 pretreatment group compared to that in AHNP group. Nevertheless, the serum amylase level did not reduce and injury of the pancreas was not prevented in GdCl3 pretreatment group.CONCLUSION: Pulmonary injury induced by AHNP is mediated by KC activation and AHNP-LI can be significantly ameliorated by pretreatment with GdCl3 and KCs play a vital role in AHNP-LI.

  5. The association of functional oral intake and pneumonia in patients with severe Traumatic Brain Injury

    Schow, Trine; Larsen, Klaus; Engberg, Aase Worså

    2008-01-01

    Abstract Objective(s): This study investigates the incidence and onset time of pneumonia for patients with severe Traumatic Brain Injury (TBI) in the early phase of rehabilitation, and identifies parameters associated with the risk of pneumonia. Design: Observational retrospective cohort study......: None Main Outcome Measure(s): Pneumonia. Results: Twenty-seven percent (27%) of the patients admitted to the BIU were in treatment for pneumonia and 12% developed pneumonia during rehabilitation, all but one within 19 days of admission. Of these patients, 81% received nothing by mouth. Three factors...... identified patients at highest risk of pneumonia: Glasgow Coma score (GCS) pneumonia...

  6. Traumatic Testicular Dislocation Associated with Lateral Compression Pelvic Ring Injury and T-Shaped Acetabulum Fracture

    Daniel Howard Wiznia; Mike Wang; Chang Yeon-Kim; Paul Tomaszewski; Michael P. Leslie

    2016-01-01

    We report a case of a unilateral testicular dislocation to the superficial inguinal region associated with a lateral compression type pelvic ring injury (OTA classification 61-C3.3a2, b2, c3) and left T-shaped acetabulum fracture (OTA classification 62-B2) in a 44-year-old male who was in a motorcycle accident. The testicular dislocation was noted during the emergency department primary survey, and its location and viability were verified with ultrasound. The testicle was isolated during surg...

  7. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries

    Andersson, Lars; Andreasen, Jens O; Day, Peter

    2012-01-01

    and group discussions. Experienced researchers and clinicians from various specialties were included in the task group. The guidelines represent the current best evidence and practice based on literature research and professionals' opinion. In cases where the data did not appear conclusive, recommendations......Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature...

  8. PLASMA NEUTROPHIL GELATINASE ASSOCIATED LIPOCALIN AS AN EARLY BIOMARKER OF ACUTE KIDNEY INJURY IN SNAKE BITE

    Thamarai

    2014-12-01

    Full Text Available INTRODUCTION: Acute kidney injury due to snake bite represents a frequent and devastating problem. Currently, Acute Kidney Injury is diagnosed by biochemical monitoring of increase in serum creatinine. Increase in serum creatinine represents a late indication of a functional change in glomerular function rate. Studies have shown that Neutrophil Gelatinase Associated Lipocalin has been found to be very useful for the detection of acute kidney injury within few hours of nephrotoxic insult. Limited information, however, is available regarding the study of plasma Neutrophil Gelatinase-Associated Lipocalin in snake bite. AIM: The purpose of the study was to estimate the diagnostic accuracy of plasma Neutrophil Gelatinase-Associated Lipocalin as an early biomarker of Acute Kidney Injury in patients with snake bite and to correlate with serum creatinine. If early detection of Acute Kidney Injury occurs, it can be followed by effective treatment modalities to abort the development or limit the severity of AKI. Therefore this study was designed to explore the importance of pNGAL in cases of snake bite induced AKI. MATERIALS AND METHODS: A prospective observational study was designed to study the patients admitted for the treatment of snakebite within 6 hours in a tertiary care hospital. Patients admitted for snake bite were followed by estimation of pNGAL on day 1 and serum creatinine from the period of admission for up to 5 days. A total of 130 snake bite patients were enrolled and 100 were included in the final study. Snake bite patients were classified into two groups based on the occurrence and absence of AKI. Plasma NGAL and serum creatinine was estimated by solid phase Enzyme Linked Immunosorbent Assay method and Jaffe`s method respectively. Data were entered into the excel sheet and analyzed statistically using statistical package for the social sciences (SPSS version 17. RESULTS:Among 100 snake bite patients 64 individuals had elevated p

  9. Plantar talar head contusions and osteochondral fractures: associated findings on ankle MRI and proposed mechanism of injury

    Gorbachova, Tetyana; Wang, Peter S.; Hu, Bing [Einstein Medical Center Philadelphia, Department of Radiology, Philadelphia, PA (United States); Horrow, Jay C. [Drexel University, Department of Anesthesiology and Perioperative Medicine, Philadelphia, PA (United States)

    2016-06-15

    To evaluate the significance of plantar talar head injury (PTHI) in predicting osseous and soft tissue injuries on ankle MRI. The IRB approved this HIPAA-compliant retrospective study. The study group consisted of 41 ankle MRIs with PTHI that occurred at our institution over a 5 1/2 year period. Eighty MRIs with bone injuries in other locations matched for age, time interval since injury, and gender formed a control group. Injuries to the following structures were recorded: medial malleolus, lateral malleolus/distal fibula, posterior malleolus, talus, calcaneus, navicular, cuboid, lateral, medial and syndesmotic ligaments, spring ligament complex, and extensor digitorum brevis (EDB) muscle. Twenty separate logistic regressions determined which injuries PTHI predicted, using the Holm procedure to control for family-wise alpha at 0.05. PTHI strongly predicted the occurrence of injuries involving the anterior process of the calcaneus [24 % of cases, odds ratio (OR) 12.66], plantar components of the spring ligament (27 %, OR 9.43), calcaneal origin of the EDB and attachment of the dorsolateral calcaneocuboid ligament (22 %, OR 7.22), cuboid (51 %, OR 6.58), EDB (27 %, OR 5.49), anteromedial talus (66 %, OR 4.78), and posteromedial talus (49 %, OR 4.48). PTHI strongly predicted lack of occurrence of syndesmotic ligament injury (OR 19.6). The PTHI group had a high incidence of lateral ligamentous injury (78 %), but not significantly different from the control group (53 %). PTHI is strongly associated with injury involving the transverse tarsal joint complex. We hypothesize it results from talo-cuboid and/or talo-calcaneal impaction from a supination injury of the foot and ankle. (orig.)

  10. Border Malaria Associated with Multidrug Resistance on Thailand-Myanmar and Thailand-Cambodia Borders: Transmission Dynamic, Vulnerability, and Surveillance

    Adisak Bhumiratana

    2013-01-01

    Full Text Available This systematic review elaborates the concepts and impacts of border malaria, particularly on the emergence and spread of Plasmodium falciparum and Plasmodium vivax multidrug resistance (MDR malaria on Thailand-Myanmar and Thailand-Cambodia borders. Border malaria encompasses any complex epidemiological settings of forest-related and forest fringe-related malaria, both regularly occurring in certain transmission areas and manifesting a trend of increased incidence in transmission prone areas along these borders, as the result of interconnections of human settlements and movement activities, cross-border population migrations, ecological changes, vector population dynamics, and multidrug resistance. For regional and global perspectives, this review analyzes and synthesizes the rationales pertaining to transmission dynamics and the vulnerabilities of border malaria that constrain surveillance and control of the world’s most MDR falciparum and vivax malaria on these chaotic borders.

  11. The presence of primary circulating prostate cells is associated with upgrading and upstaging in patients eligible for active surveillance

    Murray, Nigel P; Reyes, Eduardo; Fuentealba, Cynthia; Aedo, Socrates; Jacob, Omar

    2017-01-01

    Active surveillance (AS) is a considered treatment option for men with low or very low-risk prostate cancer. However, on repeat biopsy some 25% were upgraded and recommended for active treatment. We compare the presence or absence of primary circulating prostate cells (CPCs) with the clinical pathological findings after radical prostatectomy in men fulfilling the criteria for active surveillance and the risk of reclassification for active observation (AO). Methods and patients A single centre observational study was done involving 102 men who fulfilled the Epstein criteria for AS and underwent radical prostatectomy as mono-therapy for prostate cancer. The patients were classified according to the presence or absence of CPCs detected immediately before the prostate biopsy. Mononuclear cells were obtained by differential gel centrifugation of 8 mL of venous blood and CPCs identified using immunocytochemistry with anti-PSA and anti-P504S. A positive CPC test was defined as at least 1 PSA (+), P504S (+) cell detected/blood sample. The surgical specimen was analysed for Gleason score and pathological stage. Results A total of 25 out of 102 (24.5%) men were upgraded based on the pathological findings of the surgical specimen. Among which 45 (44%) men were positive for CPCs. They were younger, 63.9 versus 68.1 years (p = 0.0148), had a lower frequency of pT2 or lower disease (64.4% versus 91.2% p <0.001), higher median Gleason scores (6 versus 5 p < 0.001) in both the biopsy and surgical specimens, and a higher frequency of upgrading 44% versus 9% (p < 0.001) Conclusions In men fulfilling the criteria for AS, the presence of primary CPCs suggests a high risk for disease upgrade and therefore these men may not be ideal for observational therapy. Further studies with a larger population are warranted. PMID:28144285

  12. Uncovering precision phenotype-biomarker associations in traumatic brain injury using topological data analysis

    Nielson, Jessica L.; Cooper, Shelly R.; Sorani, Marco D.; Inoue, Tomoo; Yuh, Esther L.; Mukherjee, Pratik; Petrossian, Tanya C.; Lum, Pek Y.; Lingsma, Hester F.; Gordon, Wayne A.; Okonkwo, David O.; Manley, Geoffrey T.

    2017-01-01

    Background Traumatic brain injury (TBI) is a complex disorder that is traditionally stratified based on clinical signs and symptoms. Recent imaging and molecular biomarker innovations provide unprecedented opportunities for improved TBI precision medicine, incorporating patho-anatomical and molecular mechanisms. Complete integration of these diverse data for TBI diagnosis and patient stratification remains an unmet challenge. Methods and findings The Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Pilot multicenter study enrolled 586 acute TBI patients and collected diverse common data elements (TBI-CDEs) across the study population, including imaging, genetics, and clinical outcomes. We then applied topology-based data-driven discovery to identify natural subgroups of patients, based on the TBI-CDEs collected. Our hypothesis was two-fold: 1) A machine learning tool known as topological data analysis (TDA) would reveal data-driven patterns in patient outcomes to identify candidate biomarkers of recovery, and 2) TDA-identified biomarkers would significantly predict patient outcome recovery after TBI using more traditional methods of univariate statistical tests. TDA algorithms organized and mapped the data of TBI patients in multidimensional space, identifying a subset of mild TBI patients with a specific multivariate phenotype associated with unfavorable outcome at 3 and 6 months after injury. Further analyses revealed that this patient subset had high rates of post-traumatic stress disorder (PTSD), and enrichment in several distinct genetic polymorphisms associated with cellular responses to stress and DNA damage (PARP1), and in striatal dopamine processing (ANKK1, COMT, DRD2). Conclusions TDA identified a unique diagnostic subgroup of patients with unfavorable outcome after mild TBI that were significantly predicted by the presence of specific genetic polymorphisms. Machine learning methods such as TDA may provide a robust

  13. Surveillance Systems from Public Health Institutions and Scientific Societies for Antimicrobial Resistance and Healthcare-Associated Infections in Europe (SUSPIRE): protocol for a systematic review

    Núñez-Núñez, María; Navarro, María Dolores; Gkolia, Panagiota; Babu Rajendran, Nithya; del Toro, María Dolores; Voss, Andreas; Sharland, Mike; Sifakis, Frangiscos; Tacconelli, Evelina; Rodríguez-Baño, Jesús

    2017-01-01

    Introduction The worldwide spread of antimicrobial resistance is now recognised as a global public health threat. Owing to the geographical heterogeneity, complexity and continuously evolving dynamics of resistant organisms and genes, surveillance is a key tool for understanding, measuring and informing actions in the fight against this problem. To date there is no harmonisation of key indicators or of methodologies used to obtain them. Methods and analysis The main objective of this project is to systematically review and analyse the current publicly available surveillance activities on antimicrobial resistance and healthcare-associated infections in Europe. Eligible activities are those endorsed by regional, national or transnational health organisations and scientific societies providing data on a periodic basis. Grey and peer-reviewed literature will be searched with no language restrictions. Three independent reviewers will perform a two-step selection process using a previously piloted, tailored electronic data extraction form. Descriptive summaries and tables of all relevant findings will be performed and reported according to PRISMA guidelines. Ethics and dissemination We did not seek ethical approval for this study because the data to be collected are not linked to individuals. Data will be presented at international conferences and published in peer-reviewed journals. Trial registration number CRD42016033867. PMID:28348192

  14. Normalization of coagulopathy is associated with improved outcome after isolated traumatic brain injury.

    Epstein, Daniel S; Mitra, Biswadev; Cameron, Peter A; Fitzgerald, Mark; Rosenfeld, Jeffrey V

    2016-07-01

    Acute traumatic coagulopathy (ATC) has been reported in the setting of isolated traumatic brain injury (iTBI) and is associated with poor outcomes. We aimed to evaluate the effectiveness of procoagulant agents administered to patients with ATC and iTBI during resuscitation, hypothesizing that timely normalization of coagulopathy may be associated with a decrease in mortality. A retrospective review of the Alfred Hospital trauma registry, Australia, was conducted and patients with iTBI (head Abbreviated Injury Score [AIS] ⩾3 and all other body AIS normalized ratio ⩾1.3) were selected for analysis. Data on procoagulant agents used (fresh frozen plasma, platelets, cryoprecipitate, prothrombin complex concentrates, tranexamic acid, vitamin K) were extracted. Among patients who had achieved normalization of INR or survived beyond 24hours and were not taking oral anticoagulants, the association of normalization of INR and death at hospital discharge was analyzed using multivariable logistic regression analysis. There were 157 patients with ATC of whom 68 (43.3%) received procoagulant products within 24hours of presentation. The median time to delivery of first products was 182.5 (interquartile range [IQR] 115-375) minutes, and following administration of coagulants, time to normalization of INR was 605 (IQR 274-1146) minutes. Normalization of INR was independently associated with significantly lower mortality (adjusted odds ratio 0.10; 95% confidence interval 0.03-0.38). Normalization of INR was associated with improved mortality in patients with ATC in the setting of iTBI. As there was a substantial time lag between delivery of products and eventual normalization of coagulation, specific management of coagulopathy should be implemented as early as possible.

  15. Associated Injuries in Patients with Maxillofacial Trauma at the Hospital São Vicente de Paulo, Passo Fundo, Brazil

    João Matheus Scherbaum Eidt

    2013-10-01

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

  16. Deficits in Visual System Functional Connectivity after Blast-Related Mild TBI are Associated with Injury Severity and Executive Dysfunction

    2016-08-24

    Deficits in Visual System Functional Connectivity after Blast-Related Mild TBI are Associated with Injury Severity and Executive Dysfunction Casey S...5Department of Ophthalmology & Visual Science, University of Iowa, Iowa City, Iowa 6Iowa City Veterans Affairs Health Care System, Iowa City, Iowa...Keywords blast TBI, executive function, functional connectivity, rest fMRI, TBI severity, traumatic brain injury, Visual Correspondence Casey S. Gilmore, PhD

  17. Social anxiety following traumatic brain injury: an exploration of associated factors.

    Curvis, William; Simpson, Jane; Hampson, Natalie

    2016-05-17

    Social anxiety (SA) following traumatic brain injury (TBI) has the potential to affect an individual's general psychological well-being and social functioning, however little research has explored factors associated with its development. The present study used hierarchical multiple regression to investigate the demographic, clinical and psychological factors associated with SA following TBI. A sample of 85 people who experienced TBI were recruited through social media websites and brain injury services across the North-West of England. The overall combined biopsychosocial model was significant, explaining 52-54.3% of the variance in SA (across five imputations of missing data). The addition of psychological variables (self-esteem, locus of control, self-efficacy) made a significant contribution to the overall model, accounting for an additional 12.2-13% of variance in SA above that explained by demographic and clinical variables. Perceived stigma was the only significant independent predictor of SA (B = .274, p = .005). The findings suggest that psychological variables are important in the development of SA following TBI and must be considered alongside clinical factors. Furthermore, the significant role of stigma highlights the need for intervention at both an individualised and societal level.

  18. Identification of types of landings after blocking in volleyball associated with risk of ACL injury.

    Zahradnik, David; Jandacka, Daniel; Farana, Roman; Uchytil, Jaroslav; Hamill, Joseph

    2017-03-01

    Landing with a low knee flexion angle after volleyball block jumps may be associated with an increased risk of anterior cruciate ligament (ACL) injury. The aim of the present study was to identify the types of volleyball landings after blocks where the knee flexion angle is found to be under a critical knee flexion angle value of 30° at the instant of the first peak of the ground reaction force (GRF). Synchronized kinematic and kinetic data were collected for each trial. T-tests were used to determine if each knee flexion angle at the instant of the peak GRF was significantly different from the critical value of 30°. A repeated measures ANOVA was used to compare knee flexion angle, time to first peak and the magnitude of the first peak of the resultant GRF and knee stiffness. Significantly lower knee flexion angles were found in the "go" landing (p = .01, ES = 0.6) and the "reverse" landing (p = .02, ES = 0.6) only. The results for knee flexion angle and GRF parameters indicated a significant difference between a "reverse" and "go" and other types of landings, except the "side stick" landing for GRF. The "reverse" and "go" landings may present a risk for ACL injury due to the single-leg landing of these activities that have an associated mediolateral movement.

  19. Proteasome inhibitor ameliorates severe acute pancreatitis and associated lung injury of rats

    Xi Chen; Shun-Le Li; Tao Wu; Ji-Dong Liu

    2008-01-01

    AIM:To observe the effect of proteasome inhibitor MG-132 on severe acute pancreatitis (SAP) and associated lung injury of rats.METHODS:Male adult SD rats were randomly divided into SAP group,sham-operation group,and MG-132 treatment group.A model of SAP was established by injection of 5% sodium taurocholate into the biliarypancreatic duct of rats.The MG-132 group was pretreated with 10 mg/kg MG-132 intraperitoneally (ip) 30 rnin before the induction of pancreatitis.The changes in serum amylase,myeloperoxidase (MPO) activity of pancreatic and pulmonary tissue were measured.The TNF-α level in pancreatic cytosolic fractions was assayed with an enzyme-linked immunosorbent assay (ELISA) kit.Meanwhile,the pathological changes in both pancreatic and pulmonary tissues were also observed.RESULTS:MG-132 significantly decreased serum amylase,pancreatic weight/body ratio,pancreatic TNF-α level,pancreatic and pulmonary MPO activity (P < 0.05).Histopathological examinations revealed that pancreatic and pulmonary samples from rats pretreated with MG-132 demonstrated milder edema,cellular damage,and inflammatory activity (P < 0.05).CONCLUSION:The proteasome inhibitor MG-132shows a protective effect on severe acute pancreatitis and associated lung injury of rats.

  20. Western Trauma Association Critical Decisions in Trauma: Diagnosis and management of esophageal injuries.

    Biffl, Walter L; Moore, Ernest E; Feliciano, David V; Albrecht, Roxie A; Croce, Martin; Karmy-Jones, Riyad; Namias, Nicholas; Rowell, Susan; Schreiber, Martin; Shatz, David V; Brasel, Karen

    2015-12-01

    This is a recommended management algorithm from the Western Trauma Association addressing the diagnostic evaluation and management of esophageal injuries in adult patients. Because there is a paucity of published prospective randomized clinical trials that have generated Class I data, the recommendations herein are based primarily on published observational studies and expert opinion of Western Trauma Association members. The algorithms and accompanying comments represent a safe and sensible approach that can be followed at most trauma centers. We recognize that there will be patient, personnel, institutional, and situational factors that may warrant or require deviation from the recommended algorithm. We encourage institutions to use this guideline to formulate their own local protocols.The algorithm contains letters at decision points; the corresponding paragraphs in the text elaborate on the thought process and cite pertinent literature. The annotated algorithm is intended to (a) serve as a quick bedside reference for clinicians; (b) foster more detailed patient care protocols that will allow for prospective data collection and analysis to identify best practices; and (c) generate research projects to answer specific questions concerning decision making in the management of adults with esophageal injuries.

  1. 2010年广东省深圳市光明新区医院急诊伤害监测资料分析%Sentinel surveillance of injury in a district hospital in Shenzhen city, Guangdong province, 2010

    陈小良; 邰昌松; 詹劲基; 苏展; 李伟梅

    2012-01-01

    Objective To understand the epidemiological characteristics of injuries in emergency department in the hospital in Guangming new district and provide evidence for injury prevention and control. Methods Descriptive epidemiological analysis was conducted on the surveillance data of injury in the hospital in 2010. Results A total of 22 784 injury cases were reported in 2010. The injuries were mainly caused by blunt force (40. 24% ), falling down (16. 46% ), animal bite (13. 28% ), knife/sharp instrument wound (11.43% ) and motor vehicle accident (10. 51% ). The injuries mainly occurred in industrial/construction sites (40. 80% ) and on street/road( 22. 65% ). Most cases were unintentional injuries (83. 97% ) and mild in severity (76. 30% ). The majority of serious injuries were caused by motor vehicle accident (55. 26% ). Most injuries occurred during 08:00 -22:00 in a day (85. 51% ). No obvious peak was found in overall time distribution of injury cases, but the differences on the time distribution in different populations were significant (x2 = 998, P = 0. 00). The injuries in pre school aged children mainly occurred during 17: 00 - 20:00 (37. 43% ), the injuries in students mainly occurred during 16:00 - 19:00 (36.91 % ) and self wounding/suicide mainly occurred during 00:00-01:00 (12. 85% ) ,20:00 - 21:00 (8.38%) and 21:00 - 22:00 (8.38%). Conclusion Targeted intervention should be focused on occupational injury, animal bite and traffic accident injury prevention and control in different population, places and times.%目的 了解广东省深圳市光明新区医院急诊伤害分布情况,为伤害事件预防与控制提供依据.方法 采用统一的调查表对在深圳市光明新区伤害监测哨点医院急诊科就诊的首诊伤害病例进行登记,运用描述流行病学方法进行分析.结果 2010年全年累计伤害病例22 784例,伤害发生的主要原因为钝器伤(40.24%)、跌倒/坠落(16.46%)、动物伤(13.28%)、刀/锐器伤(11

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

    Haris Habib

    2011-02-01

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

  3. Anterolateral ligament abnormalities in patients with acute anterior cruciate ligament rupture are associated with lateral meniscal and osseous injuries

    Dyck, Pieter van; Smet, Eline de; Gielen, Jan L.; Parizel, Paul M. [Antwerp University Hospital and University of Antwerp, Department of Radiology, Antwerp (Belgium); Clockaerts, Stefan [University College Hospitals, Department of Orthopaedics, London (United Kingdom); Vanhoenacker, Filip M. [Antwerp University Hospital and University of Antwerp, Department of Radiology, Antwerp (Belgium); Ghent University Hospital and University of Ghent, Department of Radiology, Ghent (Belgium); AZ St-Maarten, Department of Radiology, Antwerp (Belgium); Lambrecht, Valerie [Ghent University Hospital and University of Ghent, Department of Radiology, Ghent (Belgium); Wouters, Kristien [Antwerp University Hospital and University of Antwerp, Department of Biostatistics, Antwerp (Belgium)

    2016-10-15

    To determine the frequency of anterolateral ligament (ALL) injury in patients with acute anterior cruciate ligament (ACL) rupture and to analyse its associated injury patterns. Ninety patients with acute ACL rupture for which MRI was obtained within 8 weeks after the initial trauma were retrospectively identified. Two radiologists assessed the status of the ALL on MRI by consensus. The presence or absence of an ALL abnormality was compared with the existence of medial and lateral meniscal tears diagnosed during arthroscopy. Associated collateral ligament and osseous injuries were documented with MRI. Forty-one of 90 knees (46 %) demonstrated ALL abnormalities on MRI. Of 49 knees with intact ALL, 15 (31 %) had a torn lateral meniscus as compared to 25 torn lateral menisci in 41 knees (61 %) with abnormal ALL (p = 0.008). Collateral ligament (p ≤ 0.05) and osseous injuries (p = 0.0037) were more frequent and severe in ALL-injured as compared with ALL-intact knees. ALL injuries are fairly common in patients with acute ACL rupture and are statistically significantly associated with lateral meniscal, collateral ligament and osseous injuries. (orig.)

  4. Mild traumatic brain injury is associated with reduced cortical thickness in those at risk for Alzheimer's disease.

    Hayes, Jasmeet P; Logue, Mark W; Sadeh, Naomi; Spielberg, Jeffrey M; Verfaellie, Mieke; Hayes, Scott M; Reagan, Andrew; Salat, David H; Wolf, Erika J; McGlinchey, Regina E; Milberg, William P; Stone, Annjanette; Schichman, Steven A; Miller, Mark W

    2017-01-11

    Moderate-to-severe traumatic brain injury is one of the strongest environmental risk factors for the development of neurodegenerative diseases such as late-onset Alzheimer's disease, although it is unclear whether mild traumatic brain injury, or concussion, also confers risk. This study examined mild traumatic brain injury and genetic risk as predictors of reduced cortical thickness in brain regions previously associated with early Alzheimer's disease, and their relationship with episodic memory. Participants were 160 Iraq and Afghanistan War veterans between the ages of 19 and 58, many of whom carried mild traumatic brain injury and post-traumatic stress disorder diagnoses. Whole-genome polygenic risk scores for the development of Alzheimer's disease were calculated using summary statistics from the largest Alzheimer's disease genome-wide association study to date. Results showed that mild traumatic brain injury moderated the relationship between genetic risk for Alzheimer's disease and cortical thickness, such that individuals with mild traumatic brain injury and high genetic risk showed reduced cortical thickness in Alzheimer's disease-vulnerable regions. Among males with mild traumatic brain injury, high genetic risk for Alzheimer's disease was associated with cortical thinning as a function of time since injury. A moderated mediation analysis showed that mild traumatic brain injury and high genetic risk indirectly influenced episodic memory performance through cortical thickness, suggesting that cortical thinning in Alzheimer's disease-vulnerable brain regions is a mechanism for reduced memory performance. Finally, analyses that examined the apolipoprotein E4 allele, post-traumatic stress disorder, and genetic risk for schizophrenia and depression confirmed the specificity of the Alzheimer's disease polygenic risk finding. These results provide evidence that mild traumatic brain injury is associated with greater neurodegeneration and reduced memory performance

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

    Strader, Cliff [US Dept. of Energy, Washington, DC (United States); Richter, Bonnie [US Dept. of Energy, Washington, DC (United States)

    2013-01-23

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

  6. Risk factors for device-associated infection related to organisational characteristics of intensive care units: findings from the Korean Nosocomial Infections Surveillance System.

    Kwak, Y G; Lee, S-O; Kim, H Y; Kim, Y K; Park, E S; Jin, H Y; Choi, H J; Jeong, S Y; Kim, E S; Ki, H K; Kim, S R; Lee, J Y; Hong, H K; Kim, S; Lee, Y S; Oh, H-B; Kim, J M

    2010-07-01

    Device-associated infections (DAIs) have been the major causes of morbidity and mortality of patients in intensive care units (ICUs). This study evaluated the risk factors for DAIs in ICUs. Ninety-six medical or surgical ICUs of 56 hospitals participated in the Korean Nosocomial Infections Surveillance System between July 2007 and June 2008. The occurrence of catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CABSI), and ventilator-associated pneumonia (VAP) were monitored and DAI rates were calculated. Data associated with ICU characteristics were collected and Poisson regression was used for statistical analysis. Rates of CAUTI, CABSI, and VAP were 3.87 per 1000 urinary catheter days, 2.23 per 1000 central line days, and 1.89 per 1000 mechanical ventilator days, respectively. Rates of CAUTI were higher in ICUs in Seoul (P=0.032) and ICUs of major teaching hospitals (P=0.010). The ICUs of university-affiliated hospitals showed lower CAUTI rates (P=0.013). CABSI rates were higher in Seoul (P=0.001) and in medical ICUs (P=0.026). VAP rates were lower in ICUs of hospitals with more than 900 beds compared with hospitals with 400-699 beds (P=0.026). VAP rates were higher in surgical ICUs (Pinfection control professional (P=0.003). The organisational and institutional characteristics of ICUs may influence DAI rates and there is a need for improvement in the incidence of VAP, CAUTI or CABSI.

  7. Poor sleep quality and nightmares are associated with non-suicidal self-injury in adolescents.

    Liu, Xianchen; Chen, Hua; Bo, Qi-Gui; Fan, Fang; Jia, Cun-Xian

    2017-03-01

    Non-suicidal self-injury (NSSI) is prevalent and is associated with increased risk of suicidal behavior in adolescents. This study examined which sleep variables are associated with NSSI, independently from demographics and mental health problems in Chinese adolescents. Participants consisted of 2090 students sampled from three high schools in Shandong, China and had a mean age of 15.49 years. Participants completed a sleep and health questionnaire to report their demographic and family information, sleep duration and sleep problems, impulsiveness, hopelessness, internalizing and externalizing problems, and NSSI. A series of regression analyses were conducted to examine the associations between sleep variables and NSSI. Of the sample, 12.6 % reported having ever engaged in NSSI and 8.8 % engaged during the last year. Univariate logistic analyses demonstrated that multiple sleep variables including short sleep duration, insomnia symptoms, poor sleep quality, sleep insufficiency, unrefreshed sleep, sleep dissatisfaction, daytime sleepiness, fatigue, snoring, and nightmares were associated with increased risk of NSSI. After adjusting for demographic and mental health variables, NSSI was significantly associated with sleeping adolescents.

  8. Association of oliguria with the development of acute kidney injury in the critically ill.

    Vaara, Suvi T; Parviainen, Ilkka; Pettilä, Ville; Nisula, Sara; Inkinen, Outi; Uusaro, Ari

    2016-01-01

    Urine output (UO) criterion may increase the sensitivity of the definition of acute kidney injury (AKI). We determined whether the empirically derived definition for oliguria(<0.5 ml/kg/h) is independently associated with adverse outcome. Data analysis included hourly recorded UO from the prospective, multicenter FINNAKI study conducted in 16 Finnish intensive care units. Confounder-adjusted association of oliguria of different severity and duration primarily with the development of AKI defined by creatinine criterion (Cr-AKI) or renal replacement therapy(RRT) was assessed. Secondarily, we determined the association of oliguria with 90-day mortality. Of the 1966 patients analyzed for the development of AKI, 454 (23.1%) reached this endpoint. Within this AKI cohort, 312 (68.7%)developed Cr-AKI, 21 (4.6%) commenced RRT without Cr-AKI, and 121 (26.7%) commenced RRT with Cr-AKI. Episodes of severe oliguria (<0.1 ml/kg/h) for more than 3 h were independently associated with the development of Cr-AKI or RRT. The shortest periods of consecutive oliguria independently associated with an increased risk for 90-day mortality were 6–12 h of oliguria from 0.3 to <0.5 ml/kg/h, over 6 h of oliguria from 0.1 to <0.3 ml/kg/h, and severe oliguria lasting over 3 h.Thus, our findings underlie the importance of hourly UO measurements.

  9. [Health risks associated with the migration of Atlantic salmon (Salmo salar L.): an epidemiological surveillance programme in Northern Spain].

    Ortega, C; Fernandez, A B; Muzquiz, J L; Ania, S; Gimeno, O

    2005-12-01

    The authors present the results of an epidemiological surveillance programme involving Atlantic salmon (Salmo salar) populations in north-eastern Spain. The study investigates the risk factors critical in disease transmission, which include the presence of potentially pathogenic micro-organisms, the innate cell-mediated immune response of the salmon, and the potential interactions between the two. Also taken into account are the biological and migratory cycles of these salmon populations. The results showed that Aeromonas salmonicida and Saprolegnia parasitica were the micro-organisms that played the most important role in the transmission of the disease by virtue of their pathological characteristics, their occurrence in large numbers, and their capacity to transmit disease. With regard to the cell-mediated immune response, the authors observed a wide variability between individuals in some cell groups, as well as certain seasonal and age differences. These may be factors that predispose the animals to infection or to becoming asymptomatic carriers, with the attendant risk of transmitting infection in the course of migration. This could be especially relevant in the case of salmon infected with A. salmonicida and S. parasitica, since it has been observed that such salmon have a decreased number of leucocytes compared to non-infected salmon.

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

    Sylvestre Marie-Pierre

    2009-01-01

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

  11. Association of systemic hypertension with renal injury in dogs with induced renal failure.

    Finco, Delmar R

    2004-01-01

    Systemic hypertension is hypothesized to cause renal injury to dogs. This study was performed on dogs with surgically induced renal failure to determine whether hypertension was associated with altered renal function or morphology. Mean arterial pressure (MAP), heart rate (HR), systolic arterial pressure (SAP), and diastolic arterial pressure (DAP) were measured before and after surgery. Glomerular filtration rate (GFR) and urine protein:creatinine ratios (UPC) were measured at 1, 12, 24, 36, and 56-69 weeks after surgery, and renal histology was evaluated terminally. The mean of weekly MAP, SAP, and DAP measurements for each dog over the 1st 26 weeks was used to rank dogs on the basis of MAP, SAP, or DAP values. A statistically significant association was found between systemic arterial pressure ranking and ranked measures of adverse renal responses. When dogs were divided into higher pressure and lower pressure groups on the basis of SAP, group 1 (higher pressure, n = 9) compared with group 2 (lower pressure, n = 10) had significantly lower GFR values at 36 and 56-69 weeks; higher UPC values at 12 and 56-69 weeks; and higher kidney lesion scores for mesangial matrix, tubule damage, and fibrosis. When dogs were divided on MAP and DAP values, group 1 compared with group 2 had significantly lower GFR values at 12, 24, 36, and 56-69 weeks; higher UPC values at 12 and 56-69 weeks; and higher kidney lesion scores for mesangial matrix, tubule damage, fibrosis, and cell infiltrate. These results demonstrate an association between increased systemic arterial pressure and renal injury. Results from this study might apply to dogs with some types of naturally occurring renal failure.

  12. Inhibition of IκB Kinase Attenuates the Organ Injury and Dysfunction Associated with Hemorrhagic Shock.

    Sordi, Regina; Chiazza, Fausto; Johnson, Florence L; Patel, Nimesh S A; Brohi, Karim; Collino, Massimo; Thiemermann, Christoph

    2015-06-18

    Nuclear factor-kappa B (NF-κB) activation is widely implicated in multiple organ failure (MOF); however, a direct inhibitor of IκB kinase (IKK), which plays a pivotal role in the activation of NF-κB, has not been investigated in shock. Thus, the aim of the present work was to investigate the effects of an IKK inhibitor on the MOF associated with hemorrhagic shock (HS). Therefore, rats were subjected to HS and were resuscitated with the shed blood. Rats were treated with the inhibitor of IKK or vehicle at resuscitation. Four hours later, blood and organs were assessed for organ injury and signaling events involved in the activation of NF-κB. Additionally, survival following serum deprivation was assessed in HK-2 cells treated with the inhibitor of IKK. HS resulted in renal dysfunction, lung, liver and muscular injury, and increases in serum inflammatory cytokines. Kidney and liver tissue from HS rats revealed increases in phosphorylation of IKKαβ and IκBα, nuclear translocation of NF-κB and expression of inducible isoform of nitric oxide synthase (iNOS). IKK16 treatment upon resuscitation attenuated NF-κB activation and activated the Akt survival pathway, leading to a significant attenuation of all of the above parameters. Furthermore, IKK16 exhibited cytoprotective effects in human kidney cells. In conclusion, the inhibitor of IKK complex attenuated the MOF associated with HS. This effect may be due to the inhibition of the NF-κB pathway and activation of the survival kinase Akt. Thus, the inhibition of the IKK complex might be an effective strategy for the prevention of MOF associated with HS.

  13. Protective effects of carbenoxolone are associated with attenuation of oxidative stress in ischemic brain injury

    Lang Zhang; Yu-Min Li; Yu-Hong Jing; Shao-Yu Wang; Yan-Feng Song; Jie Yin

    2013-01-01

    Accumulating evidence has suggested that the gap junction plays an important role in the determination of cerebral ischemia,but the underlying mechanisms remain to be elucidated.In this study,we assessed the effect of a gap-junction blocker,carbenoxolone (CBX),on ischemia/reperfusion-induced brain injury and the possible mechanisms.By using the transient cerebral ischemia model induced by occlusion of the middle cerebral artery for 30 min followed by reperfusion for 24 h,we found that pre-administration of CBX (25 mg/kg,intracerebroventricular injection,30 min before cerebral ischemic surgery) diminished the infarction size in rats.And this was associated with a decrease of reactive oxygen species generation and inhibition of the activation of astrocytes and microglia.In PC12 cells,H202 treatment induced more coupling and apoptosis,while CBX partly inhibited the opening of gap junctions and improved the cell viability.These results suggest that cerebral ischemia enhances the opening of gap junctions.Blocking the gap junction with CBX may attenuate the brain injury after cerebral ischemia/reperfusion by partially contributing to amelioration of the oxidative stress and apoptosis.

  14. Cinnabar-Induced Subchronic Renal Injury Is Associated with Increased Apoptosis in Rats

    Ying Wang

    2015-01-01

    Full Text Available The aim of this study was to explore the role of apoptosis in cinnabar-induced renal injury in rats. To test this role, rats were dosed orally with cinnabar (1 g/kg/day for 8 weeks or 12 weeks, and the control rats were treated with 5% carboxymethylcellulose solution. Levels of urinary mercury (UHg, renal mercury (RHg, serum creatinine (SCr, and urine kidney injury molecule 1 (KIM-1 were assessed, and renal pathology was analyzed. Apoptotic cells were identified and the apoptotic index was calculated. A rat antibody array was used to analyze expression of cytokines associated with apoptosis. Results from these analyses showed that UHg, RHg, and urine KIM-1, but not SCr, levels were significantly increased in cinnabar-treated rats. Renal pathological changes in cinnabar-treated rats included vacuolization of tubular cells, formation of protein casts, infiltration of inflammatory cells, and increase in the number of apoptotic tubular cells. In comparison to the control group, expression of FasL, Fas, TNF-α, TRAIL, activin A, and adiponectin was upregulated in the cinnabar-treated group. Collectively, our results suggest that prolonged use of cinnabar results in kidney damage due to accumulation of mercury and that the underlying mechanism involves apoptosis of tubular cells via a death receptor-mediated pathway.

  15. The postreperfusion syndrome is associated with acute kidney injury following donation after brain death liver transplantation.

    Kalisvaart, Marit; de Haan, Jubi E; Hesselink, Dennis A; Polak, Wojciech G; Hansen, Bettina E; IJzermans, Jan N M; Gommers, Diederik; Metselaar, Herold J; de Jonge, Jeroen

    2016-11-19

    Acute kidney injury (AKI) is frequently observed after donation after brain death (DBD) liver transplantation (LT) and associated with impaired recipient survival and chronic kidney disease. Hepatic ischemia/reperfusion injury (IRI) is suggested to be an important factor in this process. The postreperfusion syndrome (PRS) is the first manifestation of severe hepatic IRI directly after reperfusion. We performed a retrospective study on the relation between hepatic IRI and PRS and their impact on AKI in 155 DBD LT recipients. Severity of hepatic IRI was measured by peak postoperative AST levels and PRS was defined as >30% decrease in MAP ≥1 min within 5 min after reperfusion. AKI was observed in 39% of the recipients. AKI was significantly more observed in recipients with PRS (53% vs. 32%; P = 0.013). Median peak AST level was higher in recipients with PRS (1388 vs. 771 U/l; P PRS as an independent factor for postoperative AKI (OR 2.28; 95% CI 1.06-4.99; P = 0.035). In conclusion, PRS reflects severe hepatic IRI and predicts AKI after DBD LT. PRS immediately after reperfusion is an early warning sign and creates opportunities to preserve postoperative renal function.

  16. Sympathoadrenal Activation is Associated with Acute Traumatic Coagulopathy and Endotheliopathy in Isolated Brain Injury

    Di Battista, Alex P.; Rizoli, Sandro B.; Lejnieks, Brandon; Min, Arimie; Shiu, Maria Y.; Peng, Henry T.; Baker, Andrew J.; Hutchison, Michael G.; Churchill, Nathan; Inaba, Kenji; Nascimento, Bartolomeu B.; de Oliveira Manoel, Airton Leonardo; Beckett, Andrew; Rhind, Shawn G.

    2016-01-01

    ABSTRACT Background: Acute coagulopathy after traumatic brain injury (TBI) involves a complex multifactorial hemostatic response that is poorly characterized. Objectives: To examine early posttraumatic alterations in coagulofibrinolytic, endothelial, and inflammatory blood biomarkers in relation to sympathetic nervous system (SNS) activation and 6-month patient outcomes, using multivariate partial least-squares (PLS) analysis. Patients and Methods: A multicenter observational study of 159 adult isolated TBI patients admitted to the emergency department at an urban level I trauma center, was performed. Plasma concentrations of 6 coagulofibrinolytic, 10 vascular endothelial, 19 inflammatory, and 2 catecholamine biomarkers were measured by immunoassay on admission and 24 h postinjury. Neurological outcome at 6 months was assessed using the Extended Glasgow Outcome Scale. PLS-discriminant analysis was used to identify salient biomarker contributions to unfavorable outcome, whereas PLS regression analysis was used to evaluate the covariance between SNS correlates (catecholamines) and biomarkers of coagulopathy, endotheliopathy, and inflammation. Results: Biomarker profiles in patients with an unfavorable outcome displayed procoagulation, hyperfibrinolysis, glycocalyx and endothelial damage, vasculature activation, and inflammation. A strong covariant relationship was evident between catecholamines and biomarkers of coagulopathy, endotheliopathy, and inflammation at both admission and 24 h postinjury. Conclusions: Biomarkers of coagulopathy and endotheliopathy are associated with poor outcome after TBI. Catecholamine levels were highly correlated with endotheliopathy and coagulopathy markers within the first 24 h after injury. Further research is warranted to characterize the pathogenic role of SNS-mediated hemostatic alterations in isolated TBI. PMID:27206278

  17. Ozone-induced injury and oxidative stress in bronchiolar epithelium are associated with altered pulmonary mechanics.

    Sunil, Vasanthi R; Vayas, Kinal N; Massa, Christopher B; Gow, Andrew J; Laskin, Jeffrey D; Laskin, Debra L

    2013-06-01

    In these studies, we analyzed the effects of ozone on bronchiolar epithelium. Exposure of rats to ozone (2 ppm, 3 h) resulted in rapid (within 3 h) and persistent (up to 72 h) histological changes in the bronchiolar epithelium, including hypercellularity, loss of cilia, and necrotizing bronchiolitis. Perivascular edema and vascular congestion were also evident, along with a decrease in Clara cell secretory protein in bronchoalveolar lavage, which was maximal 24 h post-exposure. Ozone also induced the appearance of 8-hydroxy-2'-deoxyguanosine, Ym1, and heme oxygenase-1 in the bronchiolar epithelium. This was associated with increased expression of cleaved caspase-9 and beclin-1, indicating initiation of apoptosis and autophagy. A rapid and persistent increase in galectin-3, a regulator of epithelial cell apoptosis, was also observed. Following ozone exposure (3-24 h), increased expression of cyclooxygenase-2, inducible nitric oxide synthase, and arginase-1 was noted in bronchiolar epithelium. Ozone-induced injury and oxidative stress in bronchiolar epithelium were linked to methacholine-induced alterations in pulmonary mechanics. Thus, significant increases in lung resistance and elastance, along with decreases in lung compliance and end tidal volume, were observed at higher doses of methacholine. This indicates that ozone causes an increase in effective stiffness of the lung as a consequence of changes in the conducting airways. Collectively, these studies demonstrate that bronchiolar epithelium is highly susceptible to injury and oxidative stress induced by acute exposure to ozone; moreover, this is accompanied by altered lung functioning.

  18. SUR1-Associated Mechanisms Are Not Involved in Ischemic Optic Neuropathy 1 Day Post-Injury.

    Nicholson, James D; Guo, Yan; Bernstein, Steven L

    2016-01-01

    Ischemia-reperfusion injury after central nervous system (CNS) injury presents a major health care challenge with few promising treatments. Recently, it has become possible to reduce edema after CNS injury by antagonizing a sulfonylurea receptor 1 (SUR1) regulated ion channel expressed after injury. SUR1 upregulation after injury is a necessary precondition for the formation of this channel, and has been implicated in white matter injury after clinical spinal cord trauma. Glibenclamide, an SUR1 antagonist, appears to have neuroprotective effect against cerebral stroke in an open-label small clinical trial and great effectiveness in reducing damage after varied experimental CNS injury models. Despite its importance in CNS injuries, SUR1 upregulation appears to play no part in rodent anterior ischemic optic neuropathy (rAION) injury as tested by real-time PCR and immunohistochemical staining of rAION-injured rat optic nerve (ON). Furthermore, the SUR1 antagonist glibenclamide administered immediately after rAION injury provided no protection to proximal ON microvasculature 1 day post-injury but may reduce optic nerve head edema in a manner unrelated to ON SUR1 expression. Our results suggest that there may be fundamental differences between rAION optic nerve ischemia and other CNS white matter injuries where SUR1 appears to play a role.

  19. Illness perceptions and mood states are associated with injury-related outcomes in athletes

    van Wilgen, C. Paul; Kaptein, Ad A.; Brink, Michel S.

    2010-01-01

    Background. Athletes have to cope adequately with the consequences of their injury in order to return into sports as soon as possible. Besides the physical characteristics of the injury, illness perceptions and emotional responses impact the behavioural responses to the injury. Purpose. To apply Lev

  20. 2006-2013年全国伤害监测系统中自残/自杀病例特征分析%Analysis on the characteristics of self-inflicted injury/suicide based on the Chinese National Injury Surveillance System from 2006 to 2013

    高欣; 段蕾蕾; 杨超; 叶鹏鹏; 纪翠蓉; 汪媛; 邓晓; 金叶; 耳玉亮

    2015-01-01

    目的 了解全国伤害监测系统(NISS)自残/自杀门/急诊病例的分布特征,为制定相关政策提供依据.方法 利用2006-2013年NISS监测数据,分析自残/自杀病例占伤害病例构成趋势、人口社会学特征、自残/自杀事件基本情况及临床信息构成情况.结果 监测期间因自残/自杀就诊人数占所有伤害就诊人数的比例呈下降趋势.2013年因自残/自杀就诊女性病例占58.6%,文化程度为初中者占42.1%;76.2%的自残/自杀发生在家中;因自残/自杀就诊者中56.1%采用中毒的方式自伤,其次为锐器;60.8%的自残/自杀就诊者治疗后观察/住院/转院.结论 自残/自杀行为干预应加强农药/毒麻药品的管制,利用自杀未遂者在院期间开展再次自杀的预防工作.%Objective To understand the characteristics of self-inflicted injury/suicide cases that were seen from the clinic or the emergency rooms,to provide basis for suicide prevention strategies development.Methods Data from the National Injury Surveillance System,from 2006 to 2013 were used to analyze the trend of self-inflicted injury/suicide proportion in injuries as well as the socio-demographic characteristics of the cases with related basic and clinic information related to self-inflicted injury/suicide.Results The proportion of self-inflicted injury/suicide cases decreased during the past 8 years.58.6% of the self-inflicted injury/suicide cases were females in 2013 and 42.1% received junior secondary school education.Self-inflicted injury/suicide were mostly taken place at home (76.2%).Poisoning (56.1%) and sharp injury were the major ways causing self-inflicted injury or suicide.Conclusion Interventions on self-inflicted injury/suicide should be strengthened including control programs on pesticide/psychotropic drugs.Prevention on future attempts and suicide should include the full use during the in-hospital time of those suicide attempters.

  1. Non-suicidal self-injury in high school students: Associations with identity processes and statuses.

    Luyckx, Koen; Gandhi, Amarendra; Bijttebier, Patricia; Claes, Laurence

    2015-06-01

    Non-suicidal self-injury (NSSI) refers to the direct, deliberate destruction of one's body tissue without suicidal intent. Research has highlighted the importance of identity synthesis versus confusion for NSSI. However, the association with identity processes and statuses remains unknown. A total of 568 adolescents reported on NSSI, identity, anxiety, and depression. Although identity processes of identification with commitment (negatively) and ruminative exploration (positively) were related to NSSI variables, these relationships were no longer significant when controlling for anxiety and depression. When examining identity statuses (using cluster analysis), individuals who had engaged in NSSI in the past (but not currently) were more likely to be in the moratorium cluster and less likely to be in the achievement cluster. Individuals who were currently engaging in NSSI were more likely to be in the troubled diffusion cluster. Clinicians should be attentive to the complex interplay between identity and NSSI when treating adolescents.

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

    Rasmussen, Kurt; Hansen, Claus D; Nielsen, Kent Jacob

    2011-01-01

    BACKGROUND: The objective was to examine the incidence of work accidents that required medical attention among Danish adolescents and to identify possible work environment factors associated with such accidents. METHODS: We collected information in two questionnaire rounds (2004 and 2007) from...... a birth cohort comprising all adolescents born in 1989 (n = 3,687) living in Ringkjobing County, Denmark. The questionnaire contained items on self-reported number of accidents and number of working hours in both rounds and on work environment factors in the second round. RESULTS: Approximately 5......% of the adolescents who held a job, experienced a work injury at the age of 17. This equals an incidence of 65 accidents per million working hours. Most adolescents had decent working conditions, although nearly half reported that their work was heavy, monotonous or psychologically demanding. Heavy work, high...

  3. Who is Surveilling Whom?

    Mortensen, Mette

    2014-01-01

    This article concerns the particular form of counter-surveillance termed “sousveillance”, which aims to turn surveillance at the institutions responsible for surveillance. Drawing on the theoretical perspectives “mediatization” and “aerial surveillance,” the article studies WikiLeaks’ publication...

  4. Surveillance issues in inflammatory bowel disease: ulcerative colitis.

    Provenzale, D; Onken, J

    2001-02-01

    This review article on the surveillance of patients with ulcerative colitis provides an overview of the criteria for evaluating screening and surveillance programs and applies the criteria to the available evidence to determine the effectiveness of the surveillance of patients with ulcerative colitis. We examine the clinical outcomes associated with surveillance, the additional clinical time required to confirm the diagnosis of dysplasia and cancer, compliance with surveillance and follow-up, and the effectiveness of the individual components of a surveillance program, including colonoscopy and pathologist's interpretation. The disability associated with colectomy is considered, as are the cost and acceptability of surveillance programs. Patients with long-standing ulcerative colitis are at risk for developing colorectal cancer. Recommended surveillance colonoscopy should be supported. New endoscopic and histopathologic techniques to improve the identification of high-risk patients may enhance the effectiveness and cost-effectiveness of surveillance practices.

  5. Treatment With Tetrahydrobiopterin Overcomes Brain Death–Associated Injury in a Murine Model of Pancreas Transplantation

    Oberhuber, R.; Ritschl, P.; Fabritius, C.; Nguyen, A.‐V.; Hermann, M.; Obrist, P.; Werner, E. R.; Maglione, M.; Flörchinger, B.; Ebner, S.; Resch, T.; Pratschke, J.

    2015-01-01

    Brain death (BD) has been associated with an immunological priming of donor organs and is thought to exacerbate ischemia reperfusion injury (IRI). Recently, we showed that the essential nitric oxide synthase co‐factor tetrahydrobiopterin (BH4) abrogates IRI following experimental pancreas transplantation. We therefore studied the effects of BD in a murine model of syngeneic pancreas transplantation and tested the therapeutic potential of BH4 treatment. Compared with sham‐operated controls, donor BD resulted in intragraft inflammation reflected by induced IL‐1ß, IL‐6, VCAM‐1, and P‐selectin mRNA expression levels and impaired microcirculation after reperfusion (p < 0.05), whereas pretreatment of the BD donor with BH4 significantly improved microcirculation after reperfusion (p < 0.05). Moreover, BD had a devastating impact on cell viability, whereas BH4‐treated grafts showed a significantly higher percentage of viable cells (p < 0.001). Early parenchymal damage in pancreatic grafts was significantly more pronounced in organs from BD donors than from sham or non‐BD donors (p < 0.05), but BH4 pretreatment significantly ameliorated necrotic lesions in BD organs (p < 0.05). Pretreatment of the BD donor with BH4 resulted in significant recipient survival (p < 0.05). Our data provide novel insights into the impact of BD on pancreatic isografts, further demonstrating the potential of donor pretreatment strategies including BH4 for preventing BD‐associated injury after transplantation. PMID:26104062

  6. Raised plasma Robo4 and cardiac surgery-associated acute kidney injury.

    Anne Burke-Gaffney

    Full Text Available OBJECTIVE: Endothelial dysfunction associated with systemic inflammation can contribute to organ injury/failure following cardiac surgery requiring cardiopulmonary bypass (CPB. Roundabout protein 4 (Robo4, an endothelial-expressed transmembrane receptor and regulator of cell activation, is an important inhibitor of endothelial hyper-permeability. We investigated the hypothesis that plasma levels of Robo4 are indicative of organ injury, in particular acute kidney injury (AKI, after cardiac surgery. METHODS: Patients (n = 32 undergoing elective cardiac surgery with CPB were enrolled, prospectively. Plasma Robo4 concentrations were measured pre-, 2 and 24 h post-operatively, using a commercially available ELISA. Plasma and endothelial markers of inflammation [interleukin (IL -6, -8, -10: von Willibrand factor (vWF and angiopoeitin-2 (Ang-2] and the AKI marker, neutrophil gelatinase-associated lipocalin (NGAL, were also measured by ELISA. RESULTS: Plasma Robo4 increased significantly (p<0.001 from pre-operative levels of 2515 ± 904 pg/ml to 4473 ± 1915 pg/ml, 2 h after surgery; and returned to basal levels (2682 ± 979 pg/ml by 24 h. Plasma cytokines, vWF and NGAL also increased 2 h post-operatively and remained elevated at 24 h. Ang-2 increased 24 h post-operatively, only. There was a positive, significant correlation (r = 0.385, p = 0.0298 between Robo-4 and IL-10, but not other cytokines, 2 h post-operatively. Whilst raised Robo4 did not correlate with indices of lung dysfunction or other biomarkers of endothelial activation; there was a positive, significant correlation between raised (2 h plasma NGAL and Robo4 (r = 0.4322, p = 0.0135. When patients were classed as AKI or non-AKI either using NGAL cut-off of 150 ng/ml, or the AKI Network (AKIN clinical classification; plasma Robo4 was significantly higher (p = 0.0073 and 0.003, respectively in AKI vs. non-AKI patients (NGAL cut-off: 5350 ± 2191 ng/ml, n = 16 vs. 3595 ± 1068 pg/ml, n = 16

  7. The surveillant assemblage.

    Haggerty, K D; Ericson, R V

    2000-12-01

    George Orwell's 'Big Brother' and Michel Foucault's 'panopticon' have dominated discussion of contemporary developments in surveillance. While such metaphors draw our attention to important attributes of surveillance, they also miss some recent dynamics in its operation. The work of Gilles Deleuze and Felix Guattari is used to analyse the convergence of once discrete surveillance systems. The resultant 'surveillant assemblage' operates by abstracting human bodies from their territorial settings, and separating them into a series of discrete flows. These flows are then reassembled in different locations as discrete and virtual 'data doubles'. The surveillant assemblage transforms the purposes of surveillance and the hierarchies of surveillance, as well as the institution of privacy.

  8. The Association Between Knee Confidence and Muscle Power, Hop Performance, and Postural Orientation in People With Anterior Cruciate Ligament Injury.

    Ageberg, Eva; Roos, Ewa M

    2016-06-01

    Study Design Cross-sectional. Background The association between muscle function and lack of knee confidence in people with anterior cruciate ligament (ACL) injury has not been well investigated. Such knowledge would help in the design of training programs for this population. Objective To investigate associations between self-reported knee confidence and muscle function in patients with ACL injury. Methods Cross-sectional data from 54 patients (mean age, 30 years; range, 20-39 years; 28% women) with ACL injury, treated with training and reconstructive surgery (n = 36) or training only (n = 18), were assessed 3 ± 1 years after injury. Univariate and multivariable ordinal regression analyses were conducted to test the association between the patient's knee confidence (question 3 from the Knee injury and Osteoarthritis Outcome Score as the dependent variable) and performance on tests of muscle power, hop performance, and postural orientation (test for substitution patterns score) as independent variables (absolute value on the injured leg, and limb symmetry index [LSI; injured leg/uninjured leg × 100] or absolute difference between the injured and uninjured legs). Results Sixteen patients reported no trouble with lack of knee confidence, 24 mild trouble, 10 moderate trouble, and 4 severe or extreme trouble. Univariate analyses revealed significant associations between worse knee confidence and lower (worse) LSIs for knee extension power, vertical jump, and side hop, and worse test for substitution patterns scores. In the multivariable analysis, worse vertical jump LSI (P = .043) and worse side hop LSI (P = .012) significantly accounted for 25% of the variation in perceived knee confidence. Conclusion Between-leg differences during demanding tasks are associated with knee confidence in individuals with ACL injury. J Orthop Sports Phys Ther 2016;46(6):477-482. Epub 26 Apr 2016. doi:10.2519/jospt.2016.6374.

  9. Systematic review and comparison of pharmacologic therapies for neuropathic pain associated with spinal cord injury

    Snedecor SJ

    2013-07-01

    Full Text Available Sonya J Snedecor,1 Lavanya Sudharshan,1 Joseph C Cappelleri,2 Alesia Sadosky,3 Pooja Desai,4 Yash J Jalundhwala,5 Marc Botteman1 1Pharmerit International, Bethesda, MD, USA; 2Global Research and Development, Pfizer, Groton, CT, USA; 3Biostatistics, Pfizer, New York, NY, USA; 4College of Pharmacy, University of Texas at Austin, Austin, TX, USA; 5Pharmacy Administration, University of Illinois at Chicago, Chicago, IL, USA Background: Management of neuropathic pain (NeP associated with spinal cord injury (SCI is difficult. This report presents a systematic literature review and comparison of the efficacy and safety of pharmacologic therapies for treating SCI-associated NeP. Methods: Medline, Embase, Cochrane, and Database of Abstracts of Reviews of Effects were searched through December 2011 for randomized, blinded, and controlled clinical trials of SCI-associated NeP meeting predefined inclusion criteria. Efficacy outcomes of interest were pain reduction on the 11-point numeric rating scale (NRS or 100 mm visual analog scale and proportion of patients achieving ≥30% or ≥50% pain reduction. Discontinuations and adverse events (AEs were also assessed, for which Bayesian meta-analytic indirect comparisons were performed. Results: Of the nine studies included in the analysis, samples were <100 patients, except for one pregabalin study (n = 136. Standard errors for the NRS outcome were often not reported, precluding quantitative comparisons across treatments. Estimated 11-point NRS pain reduction relative to placebo was –1.72 for pregabalin, –1.65 for amitriptyline, –1.0 for duloxetine, –1 (median for levetiracetam, –0.27 for gabapentin, 1 (median for lamotrigine, and 2 for dronabinol. Risk ratios relative to placebo for 30% improvement were 0.71 for levetiracetam and 2.56 for pregabalin, and 0.94 and 2.91, respectively, for 50% improvement. Meta-analytic comparisons showed significantly more AEs with pregabalin and tramadol compared with

  10. Surveillance for gastrointestinal malignancies

    Ashish K Tiwari; Heather S Laird-Fick; Ramesh K Wali; Hemant K Roy

    2012-01-01

    Gastrointestinal (GI) malignancies are notorious for frequently progressing to advanced stages even in the absence of serious symptoms,thus leading to delayed diagnoses and dismal prognoses.Secondary prevention of GI malignancies through early detection and treatment of cancer-precursor/premalignant lesions,therefore,is recognized as an effective cancer prevention strategy.In order to efficiently detect these lesions,systemic application of screening tests (surveillance) is needed.However,most of the currently used non-invasive screening tests for GI malignancies (for example,serum markers such as alpha-fetoprotein for hepatocellular carcinoma,and fecal occult blood test,for colon cancer) are only modestly effective necessitating the use of highly invasive endoscopy-based procedures,such as esophagogastroduodenoscopy and colonoscopy for screening purposes.Even for hepatocellular carcinoma where non-invasive imaging (ultrasonography) has become a standard screening tool,the need for repeated liver biopsies of suspicious liver nodules for histopathological confirmation can't be avoided.The invasive nature and high-cost associated with these screening tools hinders implementation of GI cancer screening programs.Moreover,only a small fraction of general population is truly predisposed to developing GI malignancies,and indeed needs surveillance.To spare the average-risk individuals from superfluous invasive procedures and achieve an economically viable model of cancer prevention,it's important to identify cohorts in general population that are at substantially high risk of developing GI malignancies (riskstratification),and select suitable screening tests for surveillance in these cohorts.We herein provide a brief overview of such high-risk cohorts for different GI malignancies,and the screening strategies that have commonly been employed for surveillance purpose in them.

  11. Cardiac surgery-associated acute kidney injury in a developing country: Prevalence, risk factors and outcome.

    Ekure, Ekanem Nsikak; Esezobor, Christopher Imokhuede; Sridhar, Anuradha; Vasudevan, Jyothi; Subramanyan, Rajhavan; Cherian, Kotturathu Mammen

    2015-01-01

    Little is known about cardiac surgery-associated acute kidney injury (CS-AKI) in children in developing regions of the world. The study aimed to determine the prevalence of CSAKI, associated factors and its impact on mortality and utilization of hospital services. The hospital records of children aged 0-17 years who underwent CS at an Indian hospital were reviewed. CS-AKI was defined as a rise in serum creatinine of ≥0.3 mg/dL in any 48 h and or by urine output CS. The study included 323 children with a median age of one year (0.04-17), of whom 22 (6.8%) were neonates and 18.3% had a single ventricle. About 60% of the children had Risk Adjusted Congenital Heart Surgery-I category 1 or 2 interventions. CS-AKI occurred in 39 children (12.1%). Factors associated with CS-AKI were sepsis and intraand post-operative hypotension. In-hospital mortality was six-fold higher in children who developed CS-AKI. CS-AKI was associated with two to three days more of mechanical ventilation and Intensive care unit stay. CS-AKI occurs in children in developing countries, but at a lower frequency mainly due to the predominance of post-neonatal children undergoing less-complex CSs. CS-AKI was associated with higher in-hospital mortality and increased utilization of hospital services. Factors associated with CS-AKI included intraand post-operative hypotension and sepsis.

  12. Paragliding injuries.

    Krüger-Franke, M; Siebert, C H; Pförringer, W

    1991-01-01

    Regulations controlling the sport of paragliding were issued in April 1987 by the German Department of Transportation. The growing popularity of this sport has led to a steady increase in the number of associated injuries. This study presents the incidence, localization and degree of injuries associated with paragliding documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218 paragliders were documented in the period 1987-1989: 181 occurred during landing, 28 during st...

  13. Neuropsychiatric disturbances associated with traumatic brain injury: a practical approach to evaluation and management.

    Rao, Vani; Koliatsos, Vassilis; Ahmed, Faizi; Lyketsos, Constantine; Kortte, Kathleen

    2015-02-01

    Traumatic brain injury (TBI) causes a wide variety of neuropsychiatric disturbances associated with great functional impairments and low quality of life. These disturbances include disorders of mood, behavior, and cognition, and changes in personality. The diagnosis of specific neuropsychiatric disturbances can be difficult because there is significant symptom overlap. Systematic clinical evaluations are necessary to make the diagnosis and formulate a treatment plan that often requires a multipronged approach. Management of TBI-associated neuropsychiatric disorders should always include nonpharmacological interventions, including education, family involvement, supportive and behavioral psychotherapies, and cognitive rehabilitation. Pharmacological treatments include antidepressants, anticonvulsants, antipsychotics, dopaminergic agents, and cholinesterase inhibitors. However, evidence-based treatments are extremely limited, and management relies on clinical empiricism and resemblance of TBI neuropsychiatric symptom profiles with those of idiopathic psychiatric disorders. Although the understanding of TBI-associated neuropsychiatric disorders has improved in the last decade, further research is needed including prospective, longitudinal studies to explore biomarkers that will assist with management and prognosis as well as randomized-controlled studies to validate pharmacological and nonpharmacological treatments. The current review summarizes the available literature in support of a structured, systematic evaluation approach and treatment options as well as recommendations for further research directions.

  14. Treatment with analgesics after mouse sciatic nerve injury does not alter expression of wound healing-associated genes

    Matt C Danzi

    2016-01-01

    Full Text Available Animal models of sciatic nerve injury are commonly used to study neuropathic pain as well as axon regeneration. Administration of post-surgical analgesics is an important consideration for animal welfare, but the actions of the analgesic must not interfere with the scientific goals of the experiment. In this study, we show that treatment with either buprenorphine or acetaminophen following a bilateral sciatic nerve crush surgery does not alter the expression in dorsal root ganglion (DRG sensory neurons of a panel of genes associated with wound healing. These findings indicate that the post-operative use of buprenorphine or acetaminophen at doses commonly suggested by Institutional Animal Care and Use Committees does not change the intrinsic gene expression response of DRG neurons to a sciatic nerve crush injury, for many wound healing-associated genes. Therefore, administration of post-operative analgesics may not confound the results of transcriptomic studies employing this injury model.

  15. Treatment with analgesics after mouse sciatic nerve injury does not alter expression of wound healing-associated genes

    Matt C Danzi; Dario Motti; Donna L Avison; John L Bixby; Vance P Lemmon

    2016-01-01

    Animal models of sciatic nerve injury are commonly used to study neuropathic pain as well as axon regen-eration. Administration of post-surgical analgesics is an important consideration for animal welfare, but the actions of the analgesic must not interfere with the scientiifc goals of the experiment. In this study, we show that treatment with either buprenorphine or acetaminophen following a bilateral sciatic nerve crush surgery does not alter the expression in dorsal root ganglion (DRG) sensory neurons of a panel of genes associated with wound healing. These ifndings indicate that the post-operative use of buprenorphine or acetaminophen at doses commonly suggested by Institutional Animal Care and Use Committees does not change the intrinsic gene expression response of DRG neurons to a sciatic nerve crush injury, for many wound healing-associated genes. Therefore, administration of post-operative analgesics may not confound the results of transcriptomic studies employing this injury model.

  16. Quality of life perception of basketball master athletes: association with physical activity level and sports injuries.

    Moreira, Natália Boneti; Mazzardo, Oldemar; Vagetti, Gislaine Cristina; De Oliveira, Valdomiro; De Campos, Wagner

    2016-01-01

    This study aimed to verify the prevalence and characteristics of sports injuries (SI) and determine the association between the physical activity level (PA) and SI with perception of health-related quality of life (HRQoL) in Brazilian basketball master athletes. A cross-sectional study was conducted with 410 male master athletes, between 35 and 85 years of age (mean 52.26, SD ±11.83). The HRQoL was assessed using the Medical Outcomes Study - Short Form-36. The PA was evaluated using the International Physical Activity Questionnaire. Information regarding SI was collected using the Reported Morbidity Survey. Poisson regression, as estimated by the prevalence ratio (PR), was used as a measure of the association of PA and SI with HRQoL. The majority of athletes showed a high SI prevalence (58.3%) and reported one injury (67.8%) that occurred during training (61.1%) and primarily affected a lower limb (74.6%). The adjusted regression models showed a positive association of PA with the Functional Capacity (PR = 1.46, 95% confidence interval [CI] = 1.12-1.90) and Physical Component (PR = 1.32, 95% CI = 1.03-1.70) of HRQoL. Furthermore, the SI were negatively associated with HRQoL in Functional Capacity (PR = 1.85, 95% CI = 1.51-2.27), Physical Aspects (PR = 3.99, 95% CI = 3.08-5.18), Pain (PR = 1.65, 95% CI = 1.26-2.16), Social Functioning (PR = 1.79, 95% CI = 1.41-2.27), Emotional Aspects (PR = 4.40, 95% CI = 3.35-5.78), Mental Health domains (PR = 1.37, 95% CI = 1.06-1.68), Physical Component (PR = 2.35, 95% CI = 1.90-2.90) and Mental Component (PR = 2.65, 95% CI = 2.14-3.29). These results highlighted that master athletes showed a high SI prevalence, primarily in the lower limbs. PA positively correlates with the physical HRQoL domain, whereas SI may decrease the HRQoL levels of both physical and mental domains.

  17. Wortmannin, PI3K/Akt signaling pathway inhibitor, attenuates thyroid injury associated with severe acute pancreatitis in rats.

    Abliz, Ablikim; Deng, Wenhong; Sun, Rongze; Guo, Wenyi; Zhao, Liang; Wang, Weixing

    2015-01-01

    Increasing evidences suggest that PI3K/AKT pathway plays an important role in the pathogenesis of inflammatory diseases such as acute pancreatitis. However, the exact effect of PI3K/AKT on thyroid injury associated with acute pancreatitis has not been investigated. This study aimed to investigate the protective effects of wortmannin, PI3K/AKT inhibitor, on thyroid injury in a rat model of severe acute pancreatitis (SAP). Sixty male SD rats were randomly divided into four groups: sham operating group (SO), SAP group, wortmannin treatment (WOR) group and drug control (WOR-CON) group. Serum amylase (AMY), lipase (LIP) and thyroid hormone levels were evaluated. The morphological change of thyroid tissue was analyzed under the light and transmission electron microscopy. AKT, P38MAPK and NF-κB expression in the thyroid tissue was evaluated by immunohistochemical staining. Oxidative stress and inflammatory cytokines were detected. Results showed that wortmannin attenuated the following: (1) serum AMY, LIP and thyroid hormone (2) pancreatic and thyroid pathological injuries (3) thyroid MDA, (4) thyroid ultrastructural change, (5) serum TNF-α, IL-6 and IL-1β (6) AKT, MAPKP38 and NF-κB expression in thyroid tissues. These results suggested that wortmannin attenuates thyroid injury in SAP rats, presumably because of its role on prevent ROS generation and inhibits the activation of P38MAPK, NF-κB pathway. Our findings provide new therapeutic targets for thyroid injury associated with SAP.

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

    Garcia-Fernandez Nuria

    2009-09-01

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

  19. Human Serum Metabolites Associate With Severity and Patient Outcomes in Traumatic Brain Injury

    Matej Orešič

    2016-10-01

    Full Text Available Traumatic brain injury (TBI is a major cause of death and disability worldwide, especially in children and young adults. TBI is an example of a medical condition where there are still major lacks in diagnostics and outcome prediction. Here we apply comprehensive metabolic profiling of serum samples from TBI patients and controls in two independent cohorts. The discovery study included 144 TBI patients, with the samples taken at the time of hospitalization. The patients were diagnosed as severe (sTBI; n = 22, moderate (moTBI; n = 14 or mild TBI (mTBI; n = 108 according to Glasgow Coma Scale. The control group (n = 28 comprised of acute orthopedic non-brain injuries. The validation study included sTBI (n = 23, moTBI (n = 7, mTBI (n = 37 patients and controls (n = 27. We show that two medium-chain fatty acids (decanoic and octanoic acids and sugar derivatives including 2,3-bisphosphoglyceric acid are strongly associated with severity of TBI, and most of them are also detected at high concentrations in brain microdialysates of TBI patients. Based on metabolite concentrations from TBI patients at the time of hospitalization, an algorithm was developed that accurately predicted the patient outcomes (AUC = 0.84 in validation cohort. Addition of the metabolites to the established clinical model (CRASH, comprising clinical and computed tomography data, significantly improved prediction of patient outcomes. The identified ‘TBI metabotype’ in serum, that may be indicative of disrupted blood-brain barrier, of protective physiological response and altered metabolism due to head trauma, offers a new avenue for the development of diagnostic and prognostic markers of broad spectrum of TBIs.

  20. Threshold age and burn size associated with poor outcomes in the elderly after burn injury.

    Jeschke, Marc G; Pinto, Ruxandra; Costford, Sheila R; Amini-Nik, Saeid

    2016-03-01

    Elderly burn care represents a vast challenge. The elderly are one of the most susceptible populations to burn injuries, but also one of the fastest growing demographics, indicating a substantial increase in patient numbers in the near future. Despite the need and importance of elderly burn care, survival of elderly burn patients is poor. Additionally, little is known about the responses of elderly patients after burn. One central question that has not been answered is what age defines an elderly patient. The current study was conducted to determine whether there is a cut-off age for elderly burn patients that is correlated with an increased risk for mortality and to determine the burn size in modern burn care that is associated with increased mortality. To answer these questions, we applied appropriate statistical analyses to the Ross Tilley Burn Centre and the Inflammatory and Host Response to Injury databases. We could not find a clear cut-off age that differentiates or predicts between survival and death. Risk of death increased linearly with increasing age. Additionally, we found that the LD50 decreases from 45% total body surface area (TBSA) to 25% TBSA from the age of 55 years to the age of 70 years, indicating that even small burns lead to poor outcome in the elderly. We therefore concluded that age is not an ideal to predictor of burn outcome, but we strongly suggest that burn care providers be aware that if an elderly patient sustains even a 25% TBSA burn, the risk of mortality is 50% despite the implementation of modern protocolized burn care.

  1. Establishment of the critical period of severe acute pancreatitis-associated lung injury

    Yi-Peng Chen; Jian-Wen Ning; Feng Ji

    2009-01-01

    BACKGROUND: Since respiratory dysfunction is the main cause of death in patients with severe acute pancreatitis (SAP), elucidating the critical period of acute pancreatitis-associated lung injury (APALI) is of important clinical value. This study aimed to define the risk period of APALI by a series of studies including a dynamic analysis of total water content, ultrastructure and number of type Ⅱ alveolar epithelial cells, and reactive oxygen metabolites (ROMs) of lung tissue in a mouse model of SAP, and a clinical analysis of APALI patients. METHODS: ICR mice were selected to establish a SAP model. They were given 7 intraperitoneal injections of cerulein (50 μg/kg body weight) at hourly intervals, followed by an intraperitoneal injection of lipopolysaccharide (15 mg/kg body weight). The total water content, ultrastructure, and number of type Ⅱ alveolar epithelial cells, and ROMs of lung tissue were assessed before (0 hour) and after the establishment of SAP model (6 hours, 12 hours, 1 day, 4 days, and 7 days). In addition, we analyzed the data from 215 patients with APALI (PaO2 RESULTS: The total water content and ultrastructure of type Ⅱ alveolar epithelial cells (mitochondria and lamellar bodies) of the lung in the SAP mice were significantly altered at 12 hours after the establishment of SAP model, and reached a maximum at 1 to 4 days. The number of type Ⅱ alveolar epithelial cells and ROMs increased maximally at 1 day after the establishment of the model. Furthermore, clinical results showed that lung injury occurred at a mean of 3.1435±1.0199 days in patients with SAP. These clinical data were almost consistent with the results of the SAP model. CONCLUSION: The risk period for APALI is between the first and fourth day during the course of SAP.

  2. An assessment of the association between soil pH and ovine Johne's disease using Australian abattoir surveillance data.

    Cowled, Brendan D; Stevenson, Mark A; Madin, Ben

    2016-04-01

    There has long been discussion in the literature about the role of soil on ovine Johnes disease (OJD). This is especially true of soil pH, however there is very little research to support an association between pH and OJD prevalence. The primary objective of this study was to examine the hypothesis that there is an association between soil pH and OJD. Several additional hypotheses were also assessed. Sheep properties that were surveyed by the Australian National Sheep Health Monitoring Project where classified as OJD reactor positive or otherwise. A variety of explanatory variables such as soil (especially soil pH), environmental and management factors were examined. Spatial regression models were assessed using information theory to examine support for various hypotheses and to examine associations; especially that soil pH is associated with OJD. A total of 1213 properties from 10,578 were classified as OJD positive (11.5%, 95% CI: 10.9-12.1). Within the limitations of the study, only modest support was found for an association between soil pH and the presence or absence of OJD. Instead, OJD prevalence was affected by several factors concurrently, a so called multi-factorial model (hypothesis). In this supported multifactorial hypothesis soil pH was marginally associated with OJD (p=0.04) and had a relatively weak effect (OR 0.91, 95% CI 0.82 to 1.00). OJD was strongly associated with a number of biosecurity and environmental factors such as the time since infection arrived in a region, absence of biosecurity programs (such as regional biosecurity programs or state based programs) and, to a lesser extent, solar irradiation. Soil pH may play a relatively small role in explaining OJD prevalence when evaluated as part of a multifactorial model. Biosecurity and other environmental factors appear to be more strongly associated with the presence of OJD in Australia.

  3. Factors Associated with Self-Injurious Behaviors in Children with Autism Spectrum Disorder: Findings from Two Large National Samples

    Soke, G. N.; Rosenberg, S. A.; Hamman, R. F.; Fingerlin, T.; Rosenberg, C. R.; Carpenter, L.; Lee, L. C.; Giarelli, E.; Wiggins, L. D.; Durkin, M. S.; Reynolds, A.; DiGuiseppi, C.

    2017-01-01

    In this study, we explored potential associations among self-injurious behaviors (SIB) and a diverse group of protective and risk factors in children with autism spectrum disorder from two databases: Autism and Developmental Disabilities Monitoring (ADDM) Network and the Autism Speaks-Autism Treatment Network (AS-ATN). The presence of SIB was…

  4. A Meta-analysis of the Association of Estimated GFR, Albuminuria, Age, Race, and Sex With Acute Kidney Injury

    Grams, Morgan E.; Sang, Yingying; Ballew, Shoshana H.; Gansevoort, Ron T.; Kimm, Heejin; Kovesdy, Csaba P.; Naimark, David; Oien, Cecilia; Smith, David H.; Coresh, Josef; Sarnak, Mark J.; Stengel, Benedicte; Tonelli, Marcello; de Zeeuw, Dick; Bakker, Stephan J. L.; van der Harst, Pim; Heerspink, Hiddo J.; Hillege, Hans L.

    2015-01-01

    Background: Acute kidney injury (AKI) is a serious global public health problem. We aimed to quantify the risk of AKI associated with estimated glomerular filtration rate (eGFR), albuminuria (albumin-creatinine ratio [ACR]), age, sex, and race (African American and white). Study Design: Collaborativ

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

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

    2011-01-01

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

  6. Prevalence of hypertension and associated risk factors in people with long-term spinal cord injury living in the Netherlands

    Adriaansen, Jacinthe J E; Douma-Haan, Yvonne; van Asbeck, Floris W A; van Koppenhagen, Casper F; de Groot, Sonja; Smit, Christof A; Visser-Meily, Johanna M A; Post, Marcel W M

    2016-01-01

    PURPOSE: To describe the prevalence of hypertension and associated risk factors in people with long-term spinal cord injury (SCI) and to compare the prevalence of high blood pressure and/or the use of antihypertensive drugs with the prevalence in the Dutch general population. METHOD: Multicentre cro

  7. Insulin-Associated Neuroinflammatory Pathways as Therapeutic Targets for Traumatic Brain Injury

    Cerecedo-López, Christian D.; Kim-Lee, Jennifer H.; Hernandez, Diana; Acosta, Sandra A.; Borlongan, Cesar V.

    2014-01-01

    Traumatic brain injury (TBI) is characterized by an abrupt blow or exchange of force against the head and can be categorized as mild, moderate, and severe. The secondary cell death after TBI displays ischemic-like patterns including neuroinflammation. The scavenger receptor cluster of differentiation (CD) 36 is a lipid-associated protein capable of transducing intracellular signals to promote inflammatory mechanisms within different cell types. Expression and activation of CD36 is closely related to dyslipidemia secondary to diabetes. Diabetes mellitus (DM) has been documented as a co-morbidity factor in TBI, in that patients with a history of diabetes present with more severe brain damage and slower recovery from TBI than non-diabetic patients. Indeed, a strict regulation of blood serum glucose by the use of insulin promotes a better outcome for TBI patients. Based on these recent findings, we now advance the hypothesis that CD36 via DM insulin-associated pathways is closely involved in TBI chronic pathology. PMID:24332562

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

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

    2012-07-01

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

  9. Association of pain and CNS structural changes after spinal cord injury

    Jutzeler, Catherine R.; Huber, Eveline; Callaghan, Martina F.; Luechinger, Roger; Curt, Armin; Kramer, John L. K.; Freund, Patrick

    2016-01-01

    Traumatic spinal cord injury (SCI) has been shown to trigger structural atrophic changes within the spinal cord and brain. However, the relationship between structural changes and magnitude of neuropathic pain (NP) remains incompletely understood. Voxel-wise analysis of anatomical magnetic resonance imaging data provided information on cross-sectional cervical cord area and volumetric brain changes in 30 individuals with chronic traumatic SCI and 31 healthy controls. Participants were clinically assessed including neurological examination and pain questionnaire. Compared to controls, individuals with SCI exhibited decreased cord area, reduced grey matter (GM) volumes in anterior cingulate cortex (ACC), left insula, left secondary somatosensory cortex, bilateral thalamus, and decreased white matter volumes in pyramids and left internal capsule. The presence of NP was related with smaller cord area, increased GM in left ACC and right M1, and decreased GM in right primary somatosensory cortex and thalamus. Greater GM volume in M1 was associated with amount of NP. Below-level NP-associated structural changes in the spinal cord and brain can be discerned from trauma-induced consequences of SCI. The directionality of these relationships reveals specific changes across the neuroaxis (i.e., atrophic changes versus increases in volume) and may provide substrates of underlying neural mechanisms in the development of NP. PMID:26732942

  10. The association between meteorological factors and road traffic injuries: a case analysis from Shantou city, China

    Gao, Jinghong; Chen, Xiaojun; Woodward, Alistair; Liu, Xiaobo; Wu, Haixia; Lu, Yaogui; Li, Liping; Liu, Qiyong

    2016-11-01

    Few studies examined the associations of meteorological factors with road traffic injuries (RTIs). The purpose of the present study was to quantify the contributions of meteorological factors to RTI cases treated at a tertiary level hospital in Shantou city, China. A time-series diagram was employed to illustrate the time trends and seasonal variation of RTIs, and correlation analysis and multiple linear regression analysis were conducted to investigate the relationships between meteorological parameters and RTIs. RTIs followed a seasonal pattern as more cases occurred during summer and winter months. RTIs are positively correlated with temperature and sunshine duration, while negatively associated with wind speed. Temperature, sunshine hour and wind speed were included in the final linear model with regression coefficients of 0.65 (t = 2.36, P = 0.019), 2.23 (t = 2.72, P = 0.007) and -27.66 (t = -5.67, P traffic management system in the future.

  11. "Floating shoulder" injuries.

    Heng, Kenneth

    2016-12-01

    "Floating shoulder" is a rare injury complex resulting from high-energy blunt force trauma to the shoulder, resulting in scapulothoracic dissociation. It is commonly associated with catastrophic neurovascular injury. Two cases of motorcyclists with floating shoulder injuries are described.

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

    Dillon, J P

    2012-02-03

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

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

    Galvan Manuel D

    2008-06-01

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

  14. College Sports-Related Injuries - United States, 2009-10 Through 2013-14 Academic Years.

    Kerr, Zachary Y; Marshall, Stephen W; Dompier, Thomas P; Corlette, Jill; Klossner, David A; Gilchrist, Julie

    2015-12-11

    Sports-related injuries can have a substantial impact on the long-term health of student-athletes. The National Collegiate Athletic Association (NCAA) monitors injuries among college student-athletes at member schools. In academic year 2013-14, a total of 1,113 member schools fielded 19,334 teams with 478,869 participating student-athletes in NCAA championship sports (i.e., sports with NCAA championship competition) (1). External researchers and CDC used information reported to the NCAA Injury Surveillance Program (NCAA-ISP) by a sample of championship sports programs to summarize the estimated national cumulative and annual average numbers of injuries during the 5 academic years from 2009-10 through 2013-14. Analyses were restricted to injuries reported among student-athletes in 25 NCAA championship sports. During this period, 1,053,370 injuries were estimated to have occurred during an estimated 176.7 million athlete-exposures to potential injury (i.e., one athlete's participation in one competition or one practice). Injury incidence varied widely by sport. Among all sports, men's football accounted for the largest average annual estimated number of injuries (47,199) and the highest competition injury rate (39.9 per 1,000 athlete-exposures). Men's wrestling experienced the highest overall injury rate (13.1 per 1,000) and practice injury rate (10.2 per 1,000). Among women's sports, gymnastics had the highest overall injury rate (10.4 per 1,000) and practice injury rate (10.0 per 1,000), although soccer had the highest competition injury rate (17.2 per 1,000). More injuries were estimated to have occurred from practice than from competition for all sports, with the exception of men's ice hockey and baseball. However, injuries incurred during competition were somewhat more severe (e.g., requiring ≥7 days to return to full participation) than those acquired during practice. Multiple strategies are employed by NCAA and others to reduce the number of injuries in

  15. Association of Chronic Obstructive Pulmonary Disease With Increased Confusion or Memory Loss and Functional Limitations Among Adults in 21 States, 2011 Behavioral Risk Factor Surveillance System

    Kurt J. Greenlund, PhD

    2016-01-01

    Full Text Available Introduction Chronic obstructive pulmonary disease (COPD is associated with cognitive impairment, but consequences of this association on a person’s functional limitations are unclear. We examined the association between COPD and increased confusion and memory loss (ICML and functional limitations among adults with COPD. Methods We studied adults aged 45 years or older in 21 states who participated in the 2011 Behavioral Risk Factor Surveillance System (n = 102,739. Presence of COPD was based on self-reported physician diagnosis. ICML was based on self-report that confusion or memory loss occurred more often or worsened during the prior year. ICML-associated difficulties were defined as giving up household chores and former activities, decreased ability to work or engage in social activities, or needing help from family or friends during the prior year due to ICML. General limitations were defined as needing special equipment as a result of a health condition, having had activity limitations for 2 weeks or more in the prior month, or being unable to work. Multivariable models were adjusted for demographics, health behaviors or conditions, and frequent mental distress. Results COPD was reported by 9.3% of adults. ICML was greater among those with COPD than among those without COPD (25.8% vs 11%; adjusted prevalence ratio [aPR], 1.48; 95% confidence interval [CI], 1.32%–1.66%. People with COPD, either with or without ICML, were more likely than those without COPD to report general functional limitations. Among people reporting ICML, those with COPD were more likely to report interference with work or social activities than those without COPD (aPR, 1.17; 95% CI, 1.01%–1.36%. Conclusion Functional limitations were greater among those with COPD than among those without, and ICML may further affect these limitations. Results from our study can inform future studies of self- management and functional limitations for people with COPD.

  16. The association between body-built and injury occurrence in pre-professional ballet dancers – Separated analysis for the injured body-locations

    Petra Zaletel

    2017-02-01

    Full Text Available Objectives: This study has aimed at identifying prevalence of injury-occurrence in 24 pre-professional-ballet-dancers (females, 16–18 years of age, and identifying the associations between the body-built and prevalence of injuries. Material and Methods: The sample of variables included: body mass, body height, and 3 somatotype characteristics (mesomorph, ectomorph and endomorph and data on injuries over the preceding year. Results: Dancers were mostly ectomorphic-mesomorph (endomorphy: 2.6±0.54, mesomorphy: 3.99±0.77, ectomorphy: 3.23±0.54. The most commonly injured locations were the foot (17% of all injuries and ankle (17%. Majority of the injuries occurred while practising but 37% of hip-injuries occurred while performing. Ankle-injuries resulted in longest absence from ballet. Endomorphy was related to ankle-injury (odds ratio (OR = 1.9, 95% confidence interval (CI: 1.4–2.3, ectomorphy to foot injury (OR = 1.7, 95% CI: 1.1–2.9, and body-mass to injury to the toes (OR = 1.7, 95% CI: 1.4–3.1. Conclusions: The results of this study allow for recognizing those dancers who are particularly vulnerable to injuries of certain body location. A more profound analysis of the possible mechanisms that lead to hip-injury during performance is needed. Int J Occup Med Environ Health 2017;30(1:151–159

  17. The Association Between Knee Confidence and Muscle Power, Hop Performance, and Postural Orientation in People With Anterior Cruciate Ligament Injury

    Ageberg, Eva; Roos, Ewa M

    2016-01-01

    Study Design Cross-sectional. Background The association between muscle function and lack of knee confidence in people with anterior cruciate ligament (ACL) injury has not been well investigated. Such knowledge would help in the design of training programs for this population. Objective To invest......Study Design Cross-sectional. Background The association between muscle function and lack of knee confidence in people with anterior cruciate ligament (ACL) injury has not been well investigated. Such knowledge would help in the design of training programs for this population. Objective...... To investigate associations between self-reported knee confidence and muscle function in patients with ACL injury. Methods Cross-sectional data from 54 patients (mean age, 30 years; range, 20-39 years; 28% women) with ACL injury, treated with training and reconstructive surgery (n = 36) or training only (n = 18...... power, hop performance, and postural orientation (test for substitution patterns score) as independent variables (absolute value on the injured leg, and limb symmetry index [LSI; injured leg/uninjured leg × 100] or absolute difference between the injured and uninjured legs). Results Sixteen patients...

  18. Indomethacin injury to the rat small intestine is dependent upon biliary secretion and is associated with overgrowth of enterococci.

    Mayo, Sara A; Song, Ye K; Cruz, Melissa R; Phan, Tri M; Singh, Kavindra V; Garsin, Danielle A; Murray, Barbara E; Dial, Elizabeth J; Lichtenberger, Lenard M

    2016-03-01

    NSAIDuse is limited due to the drugs' toxicity to the gastrointestinal mucosa, an action incompletely understood. Lower gut injury induced byNSAIDs is dependent on bile secretion and is reported to increase the growth of a number of bacterial species, including an enterococcal species,Enterococcus faecalis This study examined the relationships between indomethacin (INDO)-induced intestinal injury/bleeding, small bowel overgrowth (SBO) and dissemination of enterococci, and the contribution of bile secretion to these pathological responses. Rats received either a sham operation (SO) or bile duct ligation (BDL) prior to administration of two daily subcutaneous doses of saline orINDO, and 24 h later, biopsies of ileum and liver were collected for plating on selective bacterial media. Fecal hemoglobin (Hb) and blood hematocrit (Hct) were measured to assess intestinal bleeding. Of the four treatment groups, onlySO/INDOrats experienced a significant 10- to 30-fold increase in fecal Hb and reduction in Hct, indicating thatBDLattenuatedINDO-induced intestinal injury/bleeding. Ileal enterococcal colony-forming units were significantly increased (500- to 1000-fold) inSO/INDOrats. Of all groups, only theSO/INDOrats demonstrated gut injury, and this was associated with enterococcal overgrowth of the gut and dissemination to the liver. We also demonstrated thatINDO-induced intestinal injury andE. faecalisovergrowth was independent of the route of administration of the drug, as similar findings were observed in rats orally dosed with theNSAID Bile secretion plays an important role inINDO-induced gut injury and appears to support enterococcal overgrowth of the intestine.NSAID-induced enterococcalSBOmay be involved either as a compensatory response to gut injury or with the pathogenic process itself and the subsequent development of sepsis.

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

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

    2008-10-01

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

  20. Injury in rugby league.

    Hoskins, W; Pollard, H; Hough, K; Tully, C

    2006-05-01

    It was the purpose of this review to document the range, incidence, location and mechanism of injury occurring in the sport of rugby league. Rugby league is a collision sport played in Europe and the Pacific regions including Australia. The sport is well established and has competitions ranging from junior to elite professional. Due to the contact nature of the game, injury is relatively common. The most common injuries are musculotendinous in nature and afflict the lower limb more frequently than elsewhere. Despite the high incidence of minor (sprains/strains) to moderate musculoskeletal injury (fracture, ligament and joint injury) and minor head injuries such as lacerations, nasal fractures and concussions, rare more serious spinal cord and other injuries causing death have also been recorded. The literature on rugby league injury is small but growing and suffers from a lack of consistent definition of what an injury is, thereby causing variability in the nature and incidence/prevalence of injury. Information is lacking on the injury profiles of different age groups. Importantly, there has been little attempt to establish a coordinated injury surveillance program in rugby league in the junior or professional levels. The implementation of such programs would require a universal definition of injury and a focus on important events and competitions. The implementation could provide important information in the identification and prevention of risk factors for injury.

  1. Increasing incidence of hospital-acquired and healthcare-associated bacteremia in northeast Thailand: a multicenter surveillance study.

    Maliwan Hongsuwan

    Full Text Available BACKGROUND: Little is known about the epidemiology of nosocomial bloodstream infections in public hospitals in developing countries. We evaluated trends in incidence of hospital-acquired bacteremia (HAB and healthcare-associated bacteremia (HCAB and associated mortality in a developing country using routinely available databases. METHODS: Information from the microbiology and hospital databases of 10 provincial hospitals in northeast Thailand was linked with the national death registry for 2004-2010. Bacteremia was considered hospital-acquired if detected after the first two days of hospital admission, and healthcare-associated if detected within two days of hospital admission with a prior inpatient episode in the preceding 30 days. RESULTS: A total of 3,424 patients out of 1,069,443 at risk developed HAB and 2,184 out of 119,286 at risk had HCAB. Of these 1,559 (45.5% and 913 (41.8% died within 30 days, respectively. Between 2004 and 2010, the incidence rate of HAB increased from 0.6 to 0.8 per 1,000 patient-days at risk (p<0.001, and the cumulative incidence of HCAB increased from 1.2 to 2.0 per 100 readmissions (p<0.001. The most common causes of HAB were Acinetobacter spp. (16.2%, Klebsiella pneumoniae (13.9%, and Staphylococcus aureus (13.9%, while those of HCAB were Escherichia coli (26.3%, S. aureus (14.0%, and K. pneumoniae (9.7%. There was an overall increase over time in the proportions of ESBL-producing E. coli causing HAB and HCAB. CONCLUSIONS: This study demonstrates a high and increasing incidence of HAB and HCAB in provincial hospitals in northeast Thailand, increasing proportions of ESBL-producing isolates, and very high associated mortality.

  2. Factors associated with injuries in adolescents, from the National Adolescent School-based Health Survey (PeNSE 2012

    Deborah Carvalho Malta

    2014-01-01

    Full Text Available OBJECTIVE: To estimate the prevalence of injuries among teenagers and to examine the associated risk factors, such as sociodemographic characteristics, risk behaviors, family ties and other factors. METHOD: The prevalence of the outcome (injury was estimated with a 95%confidence interval. In order to verify factors associated with the injury, a bivariate analysis was made with estimated odds ratio (OR and its respective confidence intervals. Then, a multivariate analysis was carried out, only with variables whose descriptive level was equal to or lower than 5% (p < 0.05 remaining in the model. RESULTS: The study of injury in adolescents, based on the data from the National Adolescent School-based Health Survey (PeNSE, pointed out that 10.3% of the teenagers suffered severe injuries in the past 12 months, such as cuts or perforations, broken bones or dislocated joints. The following variables remained independently associated with "suffering severe injuries": being a male teenager; black, mulatto or indigenous race/color and working. Factors related to family ties are significant when the relations are fragile amongst members: adolescents that are injured the most are the ones who suffer most aggressions at home, who skip classes without notifying their parents, those who do not live with their parents and have low family control. The most relevant aspects of mental health are insomnia and loneliness. The factors associated to the exposure to situations of violence that remained in the model were: insecurity in school and in the route home-school; getting a ride with someone inebriated; drinking and driving motorized vehicles; not wearing the seatbelt; not wearing a helmet and being bullied. Among the factors of individual behavior, the following can be emphasized: use of alcohol, cigarettes, trying illicit drugs and early sexual intercourse. CONCLUSION: The analysis of the determinants for suffering injuries in childhood and adolescence shows

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

    2005-01-01

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

  4. PET Imaging of Mild Traumatic Brain Injury and Whiplash Associated Disorder

    Vállez García, David

    2015-01-01

    Traumatic brain injury is the leading cause of brain injury in our society with 235 per 100,000 inhabitants per year in the European Union and about 500 per 100,000 inhabitants per year in the United States. About 80% of all these events are accounted for as mild cases. At the same time, whiplash-as

  5. Injury of the knee ligaments associated with ipsilateral femoral shaft fractures

    Marco Tulio Lopes Caldas

    2013-09-01

    Full Text Available OBJECTIVE: With the objective of identifying the incidence of ipsilateral knee ligament injury, thirty-six patients with femoral shaft fractures were evaluated. METHODS: During the osteosynthesis procedure to repair the femur while under anesthesia, all patients underwent a physical examination and X-ray examination. RESULTS: The most common mechanism of injury observed was motorcycle accidents. Of the thirty-six patients that were studied, eleven patients (30.5% had a knee ligament injury. Of the eleven patients, 64% had a cruciate ligament injury. The ligament injury was not treated at the time of the osteosynthesis procedure. CONCLUSION: We highlight the difficulty of diagnosis at the time of admission and the need for systematic physical examination before and after surgical treatment of femoral fracture.

  6. Epidemiology, microbiology and mortality associated with community-acquired bacteremia in northeast Thailand: a multicenter surveillance study.

    Manas Kanoksil

    Full Text Available BACKGROUND: National statistics in developing countries are likely to underestimate deaths due to bacterial infections. Here, we calculated mortality associated with community-acquired bacteremia (CAB in a developing country using routinely available databases. METHODS/PRINCIPAL FINDINGS: Information was obtained from the microbiology and hospital database of 10 provincial hospitals in northeast Thailand, and compared with the national death registry from the Ministry of Interior, Thailand for the period between 2004 and 2010. CAB was defined in patients who had pathogenic organisms isolated from blood taken within 2 days of hospital admission without a prior inpatient episode in the preceding 30 days. A total of 15,251 CAB patients identified, of which 5,722 (37.5% died within 30 days of admission. The incidence rate of CAB between 2004 and 2010 increased from 16.7 to 38.1 per 100,000 people per year, and the mortality rate associated with CAB increased from 6.9 to 13.7 per 100,000 people per year. In 2010, the mortality rate associated with CAB was lower than that from respiratory tract infection, but higher than HIV disease or tuberculosis. The most common causes of CAB were Escherichia coli (23.1%, Burkholderia pseudomallei (19.3%, and Staphylococcus aureus (8.2%. There was an increase in the proportion of Extended-Spectrum Beta-Lactamases (ESBL producing E. coli and Klebsiella pneumoniae over time. CONCLUSIONS: This study has demonstrated that national statistics on causes of death in developing countries could be improved by integrating information from readily available databases. CAB is neglected as an important cause of death, and specific prevention and intervention is urgently required to reduce its incidence and mortality.

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

    Liu Yong

    2013-01-01

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

  8. Association between Bone Mineral Density and Clinical Parameters in Traumatic Brain Injury Patients

    Murat Ersöz,

    2016-04-01

    Full Text Available Objective: Determine the association between the bone mineral density and traumatic brain injury (TBI. Materials and Methods: Twenty-two patients with TBI included to the study. Dual energy X-ray absorptiometry measurements which determines the femur neck and L1-4 vertebrate T scores in patients was performed via Lunar Prodigy DPX system. Clinical parameters such as types of involvements (plegia, upper-lower extremity spasticity values, presence of heterotypic ossification, ambulation levels were determined and their relations with femur neck and L1-4 vertebrate T scores were examined with Mann-Whitney U Test. Results: In the comparison of sub groups of type of plegia (tetraplegic/hemi-paraplegic, lower extremity spasticity values [Ascworth score 0/1-2-3-4, presence of heterotopic ossification no statistically significant (p>0.05 difference was found in the femur neck and L1-4 vertebrate T scores. On the other hand, in the subgroups determined according to ambulatory levels of the patients (confined to bed-wheelchair/ ambulated (orthesis-hand support-independent] significant difference was observed in the femur neck T scores (p=0.044. Femur neck T scores were significantly high in ambulated patients (p=0.044. Conclusion: In TBI cases ambulation level is a factor which significantly affect bone mineral density. It is necessary to ambulate patients with potential as soon as possible and to plan alternative approaches in patient could not be ambulated.

  9. Inter-α inhibitor protein and its associated glycosaminoglycans protect against histone-induced injury

    Chaaban, Hala; Keshari, Ravi S.; Silasi-Mansat, Robert; Popescu, Narcis I.; Mehta-D’Souza, Padmaja; Lim, Yow-Pin

    2015-01-01

    Extracellular histones are mediators of tissue injury and organ dysfunction; therefore they constitute potential therapeutic targets in sepsis, inflammation, and thrombosis. Histone cytotoxicity in vitro decreases in the presence of plasma. Here, we demonstrate that plasma inter-α inhibitor protein (IAIP) neutralizes the cytotoxic effects of histones and decreases histone-induced platelet aggregation. These effects are mediated through the negatively charged glycosaminoglycans (GAGs) chondroitin sulfate and high-molecular-weight hyaluronan (HMW-HA) associated with IAIP. Cell surface anionic glycosaminoglycans heparan sulfate and HA protect the cells against histone-mediated damage in vitro. Surface plasmon resonance showed that both IAIP and HMW-HA directly bind to recombinant histone H4. In vivo neutralization of histones with IAIP and HMW-HA prevented histone-induced thrombocytopenia, bleeding, and lung microvascular thrombosis, decreased neutrophil activation, and averted histone-induced production of inflammatory cytokines and chemokines. IAIP and HMW-HA colocalized with histones in necrotic tissues and areas that displayed neutrophil extracellular traps. Increasing amounts of IAIP-histone complexes detected in the plasma of septic baboons correlated with increase in histones and/or nucleosomes and consumption of plasma IAIP. Our data suggest that IAIP, chondroitin sulfate, and HMW-HA are potential therapeutic agents to protect against histone-induced cytotoxicity, coagulopathy, systemic inflammation, and organ damage during inflammatory conditions such as sepsis and trauma. PMID:25631771

  10. Dialysis for acute kidney injury associated with influenza a (H1N1 infection

    Augusto Vallejos

    2013-01-01

    Full Text Available In June 2009, the World Health Organization declared a novel influenza A, S-OIV (H1N1, pandemic. We observed 44 consecutive patients during the "first wave" of the pandemic. 70.5% of them showed co-morbidities (hypertension, obesity, chronic respiratory diseases, chronic renal disease, diabetes, pregnancy. Serious cases were admitted to the intensive care unit (ICU, particularly those with severe acute respiratory failure. Some of them developed acute kidney injury (AKI and required renal replacement therapy (RRT. The average time between admission to the ICU and initiation of RRT was 3.16 ± 2.6 days. At initiation of RRT, most patients required mechanical ventilation. No relationship was found with creatinine-kinase levels. Seventy-five percent of the cases were observed during a 3-week period and mortality, related to respiratory failure, doubling of alanine amino transferase and use of inotropics was 81.8%. In conclusion, the H1N1-infected patients who developed RRT-requiring AKI, in the context of multi-organ failure, showed a high mortality rate. Thus, it is mandatory that elaborate strategies aimed at anticipating potential renal complications associated to future pandemics are implemented.

  11. Maternal, fetal and renal outcomes of pregnancy-associated acute kidney injury requiring dialysis.

    Krishna, A; Singh, R; Prasad, N; Gupta, A; Bhadauria, D; Kaul, A; Sharma, R K; Kapoor, D

    2015-01-01

    Pregnancy-associated acute kidney injury (PAKI) is encountered frequently in developing countries. We evaluated the maternal, fetal and renal outcomes in women with PAKI who needed at least one session of dialysis. Of the total of 98 cases (mean age 28.85 ± 5.13 years; mean parity 2.65 ± 1.28) of PAKI, the most common cause of PAKI was postabortal sepsis. Eighteen patients died; those with oligoanuria, sepsis and central nervous system (CNS) involvement were at greater risk of mortality. The relative risk (RR) of neonatal mortality was lower after with full-term delivery (RR: 0.17, 95% confidence interval (CI): 0.03-0.96, P = 0.02) compared to preterm delivery. Of the 80 surviving patients, 60 (75%) patients achieved complete recovery of renal function at the end of 3 months; and of the remaining 14 had presumed (n = 4) or, biopsy-proven (n = 10) acute patchy cortical necrosis. The RR of non-recovery of renal function was high (RR: 24.7, 95% CI: 3.4- 179.5) in patients who did not recover at 6 weeks. Of the 14 patients with cortical necrosis, 3 (21.42%) became independent of dialysis at 6 months. PAKI patients should be watched for dialysis independency for 6 months.

  12. Dialysis for acute kidney injury associated with influenza a (H1N1) infection.

    Vallejos, Augusto; Arias, Marcelo; Cusumano, Ana; Coste, Eduardo; Simon, Miguel; Martinez, Ricardo; Mendez, Sandra; Raño, Miguel; Sintado, Luis; Lococo, Bruno; Blanco, Carlos; Cestari, Jorge

    2013-05-01

    In June 2009, the World Health Organization declared a novel influenza A, S-OIV (H1N1), pandemic. We observed 44 consecutive patients during the "first wave" of the pandemic. 70.5% of them showed co-morbidities (hypertension, obesity, chronic respiratory diseases, chronic renal disease, diabetes, pregnancy). Serious cases were admitted to the intensive care unit (ICU), particularly those with severe acute respiratory failure. Some of them developed acute kidney injury (AKI) and required renal replacement therapy (RRT). The average time between admission to the ICU and initiation of RRT was 3.16 ± 2.6 days. At initiation of RRT, most patients required mechanical ventilation. No relationship was found with creatinine-kinase levels. Seventy-five percent of the cases were observed during a 3-week period and mortality, related to respiratory failure, doubling of alanine amino transferase and use of inotropics was 81.8%. In conclusion, the H1N1-infected patients who developed RRT-requiring AKI, in the context of multi-organ failure, showed a high mortality rate. Thus, it is mandatory that elaborate strategies aimed at anticipating potential renal complications associated to future pandemics are implemented.

  13. Glycine blunts transplantative liver ischemia-reperfusion injury by downregulating interleukin 1 receptor associated kinase-4

    Zuo-jin LIU; Lu-nan YAN; Shen-wei LI; Hai-bo YOU; Jian-ping GONG

    2006-01-01

    Aim: To determine whether glycine could downregulate interleukin 1 receptor associated kinase-4 (IRAK-4) expression to interfere with lipopolysaccharides (LPS) signal transduction and blunt transplantative liver ischemia-reperfusion injury (I/RI). Methods: SD rats were randomly divided into two groups: donor animals of the glycine group (n=40) were given glycine (1.5 mL; 300 mmol/L, iv) 1 h before harvest, and the control group were treated with 1.5 mL physiological saline (n= 40). Orthotropic liver transplantation was then performed according to the Kamada technique. Ten animals in each group were followed up for 7 d after surgery to assess survival. The remaining animals in each group were divided into 3 subgroups (n=10) at 1h, 2 h and 6 h after portal vein reperfusion. Levels of LPS, serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and total bilirubin in portal circulation, as well as IRAK-4 and TNF-α expression, NF-кB transcriptional activity and morphological study of liver tissues were analyzed. Results: Reperfusion resulted in a significant elevation of LPS concentrations in each group persisting to the end of our study. However, glycine, which led to improved survival rate and liver function, significantly alleviated liver parenchyma cell damage by downregulating IRAK-4, TNF-α expression and NF-кB transcriptional activity compared with the control group. Conclusion: Glycine can attenuate hepatic I/RI by downregulating IRAK-4 to interfere with LPS signal transduction.

  14. Factors associated with self-esteem following acquired brain injury in adults: A systematic review.

    Curvis, William; Simpson, Jane; Hampson, Natalie

    2016-03-03

    Self-esteem is potentially a key factor in psychological and psychosocial well-being following acquired brain injury (ABI). The current review aimed to identify, synthesise and appraise all existing quantitative empirical studies on predictors or correlates of self-esteem following ABI in adulthood. In total, 27 papers met the inclusion criteria. A range of clinical factors were related to self-esteem after ABI, including the degree of physical and functional impairment. It is unclear if cognitive impairment is related to high or low self-esteem. Additionally, psychological variables such as coping styles, adjustment and perception of problems or rehabilitation are related to self-esteem following ABI. Depression is strongly associated with low self-esteem, alongside anxiety, psychological distress and quality of life. Limitations of the available research and recommendations for clinical practice and further research are discussed. In particular, there is a need to engage with contemporary theoretical understandings of self-esteem, integrated with and supported by developments in how self-esteem is conceptualised and measured over time in an ABI population. The findings of the review suggest that self-esteem is an important factor to consider following ABI, particularly in the context of developing individualised, formulation-driven rehabilitation interventions that take into account biological, social and psychological factors.

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

    Lee Ya-Jane

    2012-12-01

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

  16. Reverse-migrated neutrophils regulated by JAM-C are involved in acute pancreatitis-associated lung injury.

    Wu, Deqing; Zeng, Yue; Fan, Yuting; Wu, Jianghong; Mulatibieke, Tunike; Ni, Jianbo; Yu, Ge; Wan, Rong; Wang, Xingpeng; Hu, Guoyong

    2016-02-04

    Junctional adhesion molecule-C (JAM-C) plays a key role in the promotion of the reverse transendothelial migration (rTEM) of neutrophils, which contributes to the dissemination of systemic inflammation and to secondary organ damage. During acute pancreatitis (AP), systemic inflammatory responses lead to distant organ damage and typically result in acute lung injury (ALI). Here, we investigated the role of rTEM neutrophils in AP-associated ALI and the molecular mechanisms by which JAM-C regulates neutrophil rTEM in this disorder. In this study, rTEM neutrophils were identified in the peripheral blood both in murine model of AP and human patients with AP, which elevated with increased severity of lung injury. Pancreatic JAM-C was downregulated during murine experimental pancreatitis, whose expression levels were inversely correlated with both increased neutrophil rTEM and severity of lung injury. Knockout of JAM-C resulted in more severe lung injury and systemic inflammation. Significantly greater numbers of rTEM neutrophils were present both in the circulation and pulmonary vascular washout in JAM-C knockout mice with AP. This study demonstrates that during AP, neutrophils that are recruited to the pancreas may migrate back into the circulation and then contribute to ALI. JAM-C downregulation may contribute to AP-associated ALI via promoting neutrophil rTEM.

  17. 中毒伤害住院病例748例流行特征分析%Epidemiology analysis of 748 poisoning cases in hospital injury surveillance system

    刘海燕; 张吉玉; 郭晓雷; 徐爱强; 付振涛; 高丛丛

    2014-01-01

    目的:了解山东省部分地区中毒病例流行特征,为以后的干预工作提供依据。方法收集2012年山东省部分住院伤害监测点中毒伤害病例的一般信息、中毒事件基本情况、临床信息等,利用SPSS18.0软件进行统计分析。结果共收集中毒病例748例,占全部住院伤害监测病例的4.90%。中毒类型最多的为农药中毒,占66.58%,其次分别为一氧化碳中毒(16.44%)、药物中毒(10.70%)、腐蚀伤(3.21%)、酒精中毒(1.34%)、其他中毒(1.74%)。男女性别比为0.63∶1;其中,腐蚀伤、酒精中毒、其他中毒男性明显多于女性。患者以青壮年从事农牧渔水利业人员为主。伤害意图分布中,农药中毒和药物中毒以自残/自杀为主,其他类型中毒以非故意(意外事故)为主。住宅是中毒发生的主要地点。中毒时的活动以特指的活动和生命必需活动为主。病例的结局主要是治疗后回家。结论农药中毒、一氧化碳中毒和药物中毒是我省部分地区中毒伤害的主要原因,是将来干预的重点领域;女性更容易受到化学制品或其他物质的危害,是将来干预的重点人群。%Objective To understand the epidemiological characteristics of poisoning cases of Shandong province and provide the basis for intervention. Methods Data from the hospital injury surveillance system in 2012 was analyzed by SPSS18.0. Results There were 748 poisoning cases reported by the hospital injury surveillance system in 2012. The most poi-soning type was pesticide poisoning, accounting for 66.58%, followed by carbon monoxide poisoning(16.44%), drug poisoning (10.70%), corrosive injury(3.21%), alcoholic poisoning (1.34%), other type of poisoning (1.74%). The male to female ratio was 0.63∶1. Corrosive injury, alcoholic poisoning,poisoning by other of men were more than women. Young adult patients en-gaged in animal husbandry and fishery water

  18. Associations between iliotibial band injury status and running biomechanics in women.

    Foch, Eric; Reinbolt, Jeffrey A; Zhang, Songning; Fitzhugh, Eugene C; Milner, Clare E

    2015-02-01

    Iliotibial band syndrome (ITBS) is a common overuse knee injury that is twice as likely to afflict women compared to men. Lower extremity and trunk biomechanics during running, as well as hip abductor strength and iliotibial band flexibility, are factors believed to be associated with ITBS. The purpose of this cross-sectional study was to determine if differences in lower extremity and trunk biomechanics during running exist among runners with current ITBS, previous ITBS, and controls. Additionally, we sought to determine if isometric hip abductor strength and iliotibial band flexibility were different among groups. Twenty-seven female runners participated in the study. Participants were divided into three equal groups: current ITBS, previous ITBS, and controls. Overground running trials, isometric hip abductor strength, and iliotibial band flexibility were recorded for all participants. Discrete joint and segment biomechanics, as well as hip strength and flexibility measures were analyzed using a one-way analysis of variance. Runners with current ITBS exhibited 1.8 (1.5)° greater trunk ipsilateral flexion and 7 (6)° less iliotibial band flexibility compared to runners with previous ITBS and controls. Runners with previous ITBS exhibited 2.2 (2.9) ° less hip adduction compared to runners with current ITBS and controls. Hip abductor strength 3.3 (2.6) %BM×h was less in runners with previous ITBS but not current ITBS compared to controls. Runners with current ITBS may lean their trunk more towards the stance limb which may be associated with decreased iliotibial band flexibility.

  19. Low-frequency connectivity is associated with mild traumatic brain injury

    B.T. Dunkley

    2015-01-01

    Full Text Available Mild traumatic brain injury (mTBI occurs from a closed-head impact. Often referred to as concussion, about 20% of cases complain of secondary psychological sequelae, such as disorders of attention and memory. Known as post-concussive symptoms (PCS, these problems can severely disrupt the patient's quality of life. Changes in local spectral power, particularly low-frequency amplitude increases and/or peak alpha slowing have been reported in mTBI, but large-scale connectivity metrics based on inter-regional amplitude correlations relevant for integration and segregation in functional brain networks, and their association with disorders in cognition and behaviour, remain relatively unexplored. Here, we used non-invasive neuroimaging with magnetoencephalography to examine functional connectivity in a resting-state protocol in a group with mTBI (n = 20, and a control group (n = 21. We observed a trend for atypical slow-wave power changes in subcortical, temporal and parietal regions in mTBI, as well as significant long-range increases in amplitude envelope correlations among deep-source, temporal, and frontal regions in the delta, theta, and alpha bands. Subsequently, we conducted an exploratory analysis of patterns of connectivity most associated with variability in secondary symptoms of mTBI, including inattention, anxiety, and depression. Differential patterns of altered resting state neurophysiological network connectivity were found across frequency bands. This indicated that multiple network and frequency specific alterations in large scale brain connectivity may contribute to overlapping cognitive sequelae in mTBI. In conclusion, we show that local spectral power content can be supplemented with measures of correlations in amplitude to define general networks that are atypical in mTBI, and suggest that certain cognitive difficulties are mediated by disturbances in a variety of alterations in network interactions which are differentially

  20. Is there an association between traumatic dental injury and social capital, binge drinking and socioeconomic indicators among schoolchildren?

    Haroldo Neves de Paiva

    Full Text Available Traumatic dental injury is defined as trauma caused by forces on a tooth with variable extent and severity. The aim of the present study was to investigate the prevalence of traumatic dental injury and its association with overjet, lip protection, sex, socioeconomic status, social capital and binge drinking among 12-year-old students.A cross-sectional study was conducted with a sample of 633 12-year-old students. Data were collected through a clinical exam and self-administered questionnaires. Socioeconomic status was determined based on mother's schooling and household income. The Social Capital Questionnaire for Adolescent Students and Alcohol Use Disorders Identification Test (AUDIT-C were used to measure social capital and binge drinking, respectively.The prevalence of traumatic dental injury was 29.9% (176/588. Traumatic dental injury was more prevalent among male adolescents (p = 0.010, those with overjet greater than 5 mm (p < 0.001 and those with inadequate lip protection (p < 0.001. In the multiple logistic regression analysis, overjet [OR = 3.80 (95% CI: 2.235-6.466, p < 0.0001], inadequate lip protection [OR = 5.585 (95% CI: 3.654-8.535, p < 0.0001] and binge drinking [OR = 1.93 (95% CI: 1.21-3.06, p = 0.005] remained significantly associated with traumatic dental injury.The present findings suggest that a high level of total social capital and trust are not associated with TDI in adolescents, unlike binge drinking. The effects of social and behavioral factors on TDI are not well elucidated. Therefore, further research involving other populations and a longitudinal design is recommended.

  1. SOA-surveillance Nederland

    Rijlaarsdam J; Bosman A; Laar MJW van de; CIE

    2000-01-01

    In May 1999 a working group was started to evaluate the current surveillance systems for sexually transmitted diseases (STD) and to make suggestions for a renewed effective and efficient STD surveillance system in the Netherlands. The surveillance system has to provide insight into the prevalence an

  2. The Association between Sleep and Injury among School-Aged Children in Iran

    Forugh Rafii

    2013-01-01

    Full Text Available Background. A good night’s sleep plays a key role in diseases resistance, injury prevention, and mood stability. The objective of this study was to examine relationship between sleep problems and accidental injury occurrences in school-aged children. Method. A retrospective study was conducted for comparing two groups of children. Children who have experienced injuries for at least two times during an academic year are the participants in the injury group (IG and those who have not experienced any kind of injuries are placed in the noninjury group (NIG. Data was collected through parent-reported sleep patterns and problems using Children’s Sleep Habits Questionnaire (CSHQ. Findings. The findings showed that global sleep problems were more in the IG than in the NIG. Multivariate logistic regression analysis showed that the daytime sleepiness and sleep duration are the two major reasons for accidental injury. In addition, significant difference was seen between the sleep patterns of the two groups. Sleep duration was also shorter in the IG, and this group had a greater percentage (63% versus 41.1% of “short sleepers” (<9 h. Conclusion. There is a significant relationship between injury occurrence and sleep problems and sleep duration in Iranian school-aged children.

  3. Utility of a surveillance system to detect associations between work and cancer among women in Canada, 1965-1991.

    Aronson, K J; Howe, G R

    1994-11-01

    Data on the occupation and industry in which 242,196 females worked in Canada between 1965 and 1971 are available from a national survey of employers by Statistics Canada. As an example of the future utility of this cohort, computerized record linkage was conducted with the Canadian National Mortality Data Base through 1979. This article presents selected results. Associations are measured by standardized relative risks. Those meeting specific criteria (two or more observed deaths, relative risk > 2.0, and 95% confidence interval excluding 1.00) include (a) buccal cavity and pharyngeal cancer among mechanics and repairers, tobacco preparers and product makers, and telephone systems industry workers; (b) lung cancer among service station attendants, motor vehicle mechanics, and petroleum refinery workers; and (c) breast cancer among workers manufacturing electrical industrial equipment and printing and publishing industry workers. The mortality experience of the cohort through 1991 is currently being determined by another record linkage, thus providing up to 25 years of follow-up and over 8,500 cancer deaths anticipated among females.

  4. Systems toxicology of chemically induced liver and kidney injuries: histopathology-associated gene co-expression modules.

    Te, Jerez A; AbdulHameed, Mohamed Diwan M; Wallqvist, Anders

    2016-09-01

    Organ injuries caused by environmental chemical exposures or use of pharmaceutical drugs pose a serious health risk that may be difficult to assess because of a lack of non-invasive diagnostic tests. Mapping chemical injuries to organ-specific histopathology outcomes via biomarkers will provide a foundation for designing precise and robust diagnostic tests. We identified co-expressed genes (modules) specific to injury endpoints using the Open Toxicogenomics Project-Genomics Assisted Toxicity Evaluation System (TG-GATEs) - a toxicogenomics database containing organ-specific gene expression data matched to dose- and time-dependent chemical exposures and adverse histopathology assessments in Sprague-Dawley rats. We proposed a protocol for selecting gene modules associated with chemical-induced injuries that classify 11 liver and eight kidney histopathology endpoints based on dose-dependent activation of the identified modules. We showed that the activation of the modules for a particular chemical exposure condition, i.e., chemical-time-dose combination, correlated with the severity of histopathological damage in a dose-dependent manner. Furthermore, the modules could distinguish different types of injuries caused by chemical exposures as well as determine whether the injury module activation was specific to the tissue of origin (liver and kidney). The generated modules provide a link between toxic chemical exposures, different molecular initiating events among underlying molecular pathways and resultant organ damage. Published 2016. This article is a U.S. Government work and is in the public domain in the USA. Journal of Applied Toxicology published by John Wiley & Sons, Ltd.

  5. Factors Associated with Injuries among Commercial Motorcyclists: Evidence from a Matched Case Control Study in Kampala City, Uganda.

    Nazarius M Tumwesigye

    Full Text Available Road traffic injuries are the eighth leading cause of death globally and the most affected are young people aged 15-29. By 2030 road traffic deaths will become the fifth leading cause of death unless urgent action is taken. Motorcyclists are among the most vulnerable road users and in Uganda they contribute 41% of all road traffic injuries. This paper establishes factors associated with the injuries of commercial motorcycle riders also known as boda-boda riders in Kampala, Uganda's capital city.The study was matched case-control with a case being a boda-boda rider that was seen at one of the 5 major city hospitals with a road traffic injury while a control was a boda-boda rider that was at the parking stage where the case operated from before the injury. The sample size was 289 riders per arm and data collection took 7 months. A structured questionnaire was used to collect data on background and exposing factors. Being matched case-control data conditional logistic regression was used in the analysis.Factors independently associated with injury among motorcyclists were younger age group, being a current alcohol drinker (OR = 2.30, 95%CI: 1.19-4.45, lower engine capacity (<100 cc (OR = 5.03, 95%CI: 2.91-8.70, riding experience of less than 3 years, not changing a motorcycle in past 1 year (OR = 2.04, 95%CI: 1.19-3.52, riding for a longer time in a day (OR = 6.05, 95%CI: 2.58-14.18 and sharing a motorcycle (OR = 8.25, 95%CI:2.62-25.9. Other factors associated with injury were low level of knowledge of traffic rules, being stopped by police for checks on condition of motorcycle/license/insurance, working till late.More road safety sensitization is required among riders to raise awareness against sharing motorcycles, working for a longer time and alcohol consumption. Police enforcement of drink-driving laws should include riders of commercial motorcycles. Investigate the validity of motorcycle riding licenses and test the riding competency of all

  6. Demographic and Substance Use Factors Associated with Non-Violent Alcohol-Related Injuries among Patrons of Australian Night-Time Entertainment Districts

    Coomber, Kerri; Mayshak, Richelle; Hyder, Shannon; Droste, Nicolas; Curtis, Ashlee; Pennay, Amy; Gilmore, William; Lam, Tina; Chikritzhs, Tanya; Miller, Peter G.

    2017-01-01

    This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016) were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC), pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries. PMID:28085105

  7. Sensors for Desert Surveillance

    B. S. Chauhan

    2005-10-01

    Full Text Available Various types of sensors-visible, passive night vision, infrared, synthetic aperture radar, etc can be used for desert surveillance. The surveillance capability of these sensors depends to a large extent, on various atmospheric effects, viz., absorption, scattering, aerosol, turbulence, and optical mirage. In this paper, effects of various atmospheric phenomena on the transmission of signals, merits and demerits of different means of surveillance under desert environmental conditions are discussed. Advanced surveillance techniques, ie, multisensor fusion, multi and hyperspectral imaging, having special significance for desert surveillance, have also been discussed.

  8. 78 FR 28546 - Secondary Service Connection for Diagnosable Illnesses Associated With Traumatic Brain Injury

    2013-05-15

    ... Traumatic Brain Injury Correction In proposed rule document 2012-29709 beginning on page 73366 in the issue...: Structural imaging of the brain. LOC--Loss of consciousness. AOC--Alteration of consciousness/mental...

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

    Norton, Eimear

    2012-02-01

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

  10. Early pulmonary immune hyporesponsiveness is associated with mortality after burn and smoke inhalation injury.

    Davis, Christopher S; Albright, Joslyn M; Carter, Stewart R; Ramirez, Luis; Kim, Hajwa; Gamelli, Richard L; Kovacs, Elizabeth J

    2012-01-01

    This prospective study aims to address mortality in the context of the early pulmonary immune response to burn and inhalation injury. The authors collected bronchoalveolar lavage fluid from 60 burn patients within 14 hours of their injury when smoke inhalation was suspected. Clinical and laboratory parameters and immune mediator profiles were compared with patient outcomes. Patients who succumbed to their injuries were older (P = .005), had a larger % TBSA burn (P burn on mortality, nonsurvivors also had reduced levels of IL-2, IL-4, granulocyte colony-stimulating factor, interferon-γ, macrophage inflammatory protein-1β, and tumor necrosis factor-α (P response to burn and smoke inhalation may be attenuated in patients who succumb to their injuries.

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

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

    1974-01-01

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

  12. Improved hospital-level risk adjustment for surveillance of healthcare-associated bloodstream infections: a retrospective cohort study

    Jones MA

    2009-09-01

    Full Text Available Abstract Background To allow direct comparison of bloodstream infection (BSI rates between hospitals for performance measurement, observed rates need to be risk adjusted according to the types of patients cared for by the hospital. However, attribute data on all individual patients are often unavailable and hospital-level risk adjustment needs to be done using indirect indicator variables of patient case mix, such as hospital level. We aimed to identify medical services associated with high or low BSI rates, and to evaluate the services provided by the hospital as indicators that can be used for more objective hospital-level risk adjustment. Methods From February 2001-December 2007, 1719 monthly BSI counts were available from 18 hospitals in Queensland, Australia. BSI outcomes were stratified into four groups: overall BSI (OBSI, Staphylococcus aureus BSI (STAPH, intravascular device-related S. aureus BSI (IVD-STAPH and methicillin-resistant S. aureus BSI (MRSA. Twelve services were considered as candidate risk-adjustment variables. For OBSI, STAPH and IVD-STAPH, we developed generalized estimating equation Poisson regression models that accounted for autocorrelation in longitudinal counts. Due to a lack of autocorrelation, a standard logistic regression model was specified for MRSA. Results Four risk services were identified for OBSI: AIDS (IRR 2.14, 95% CI 1.20 to 3.82, infectious diseases (IRR 2.72, 95% CI 1.97 to 3.76, oncology (IRR 1.60, 95% CI 1.29 to 1.98 and bone marrow transplants (IRR 1.52, 95% CI 1.14 to 2.03. Four protective services were also found. A similar but smaller group of risk and protective services were found for the other outcomes. Acceptable agreement between observed and fitted values was found for the OBSI and STAPH models but not for the IVD-STAPH and MRSA models. However, the IVD-STAPH and MRSA models successfully discriminated between hospitals with higher and lower BSI rates. Conclusion The high model goodness

  13. Paragliding injuries.

    Krüger-Franke, M; Siebert, C H; Pförringer, W

    1991-06-01

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

  14. Clinical factors associated with intracranial complications after pediatric traumatic head injury: an observational study of children submitted to a neurosurgical referral unit

    Åstrand, Ramona Alice; Undén, Johan; Hesselgard, Karin;

    2010-01-01

    Clinically validated guidelines for the management of head injury in children do not exist, and the treatment is often based upon adult management routines. In order to examine the safety of this procedure, an analysis of clinical factors associated with complications after pediatric head injury ...

  15. Relationship between serum indicators, endothelial injury markers and renal damage in patients with ANCA-associated systemic vasculitis

    Wei-Jia Liu; Jun-Bo Huang

    2016-01-01

    Objective:To study the relationship between serum indicators, endothelial injury markers and renal damage in patients with ANCA-associated systemic vasculitis.Methods:Patients with ANCA-associated systemic vasculitis were selected for study, 30 cases of patients not complicated with renal damage were screened as AAV group and 30 cases of patients complicated with renal damage were screened as renal damage group, and then serum autoantibody contents and endothelial injury marker contents were detected.Results:Serum PR3-ANCA and MPO-ANCA contents of renal damage group were not statistically different from those of AAV group while anti-LAMP-2 antibody and AECA contents were significantly higher than those of AAV group; serum CECs, vWF, ES and VCAM-1 contents of renal damage group were significantly higher than those of AAV group while TM and eNOS contents were lower than those of AAV group; the higher the CKD stage in renal damage group, the more significant the albuminuria, the higher the serum CECs, vWF, ES and VCAM-1 contents and the lower the TM and eNOS contents.Conclusion:Abnormal contents of serum autoantibody anti-LAMP-2 antibody, AECA and endothelial injury markers in patients with ANCA-associated systemic vasculitis are closely related to renal damage and can be used for disease evaluation.

  16. 2006-2008年全国伤害监测中毒病例分布特征分析%Analysis of poisoning cases from Chinese National Injury Surveillance System, 2006-2008

    蒋炜; 吴春眉; 邓晓; 段蕾蕾

    2010-01-01

    Objective To study the preventive strategies through analyzing the poisoning cases from the National Injury Surveillance System (NISS), from 2006 to 2008. Methods Data of poisoning cases was descriptively analyzed from Chinese NISS, from 2006 to 2008. Results The proportion of poisoning cases to all injuries cases from NISS were 2.57%, 2.48% and 2.52% from 2006 to 2008, which ranked sixth in all the injuries causes. Most people being poisoned had junior middle school education and most of them were agriculture/animal husbandry/fishery/water producers or commercial/service personnel. Most of the poisoning incidents were happened at home, always occurred in leisure time - around 8 PM, every day. The common types of poisoning were alcohol,clinical drugs, pesticide and carbon monoxide. Unintentional injuries were the main causes. Self-harm/suicidal cases in the rural areas were more than in the urban areas, with women more than men. The main type of self-harm/suicide related poisoning cases were through drugs or pesticide. ≥65, 15-29and 30-44 year-olds were most commonly seen. Conclusion Alcoholism was the primary type of poisoning injuries which is the highest in young adults ( 15-29 years and 30-44 years). It's important to promote civilized drinking habits and limit access to alcohol for youth. Self-harm/suicide had close relationship with clinical drugs and pesticide. The key points to prevent pesticide and clinical drugs poisoning were safe storage of pesticides, universal security of pesticide, and the supervision on drug producing and marketing. Children and the elderly were the high risk people for carbon monoxide poisoning. Monitoring and intervention must be strengthened.%目的 分析2006-2008年全国伤害监测中毒病例分布特征.方法 针对中毒病例一般信息、中毒事件特征等进行统计分析.结果 2006-2008年全国伤害监测中毒病例分别占总伤害病例的2.57%、2.48%和2.52%,在所有伤害原因中居第六位;初中

  17. Injury data needs and opportunities in Europe.

    Kisser, Rupert; Latarjet, Jaques; Bauer, Robert; Rogmans, Wim

    2009-06-01

    Targeted injury prevention needs information, and the basis is data. The EU Council Recommendation on injury prevention of 2007 recommends that Member States make better use of the existing data, and that they implement additional injury surveillance, when appropriate, in order to obtain comparable information. In almost all Member States, some data on injuries are available: on deaths, hospital discharges, external causes of injuries, traffic accidents and workplace accidents. It is examined how far these data meet the information needs of key stakeholders in injury prevention. General information about the health burden of injury, based on mortality and hospital discharges, is available and sufficient for identifying injury as a priority for health policy. Health indicators like lost life years, rates of hospitalisation, estimated rates of disabilities or health care costs could be derived, but are not widely available yet. Information about external circumstances (causes) of injuries is indispensible for targeted prevention, but only 12 countries have a harmonised surveillance system on external causes in place (European Injury Database IDB 2009). It is recommended that the harmonised collection of data on fatalities, hospital discharges and external causes of injuries should become compulsory within the new European health information system. The provision of harmonised injury indicators should be promoted. The surveillance system on external causes (IDB) should be implemented in countries without such system. National injury data administrators ('clearing houses') should be established for the provision of comprehensive injury reports and for serving the needs of key stakeholders in injury prevention.

  18. Appearance-related residual injury, posttraumatic stress, and body image: Associations within a sample of female victims of intimate partner violence.

    Weaver, Terri L; Resnick, Heidi S; Kokoska, Mimi S; Etzel, Julie C

    2007-12-01

    One third of women who experience intimate partner violence (IPV) receive some form of injury. After acute injuries have healed, a victim's physical appearance may be altered with residual changes including marks or scars. This study included 56 female victims of IPV (31 with appearance-related residual injury and a comparison group of 25 with no appearance-related residual injury) and examined the associations between violence-related experiences, body image distress, and symptoms of posttraumatic stress disorder (PTSD). Appearance-related residual injury status moderated the relationship between body image distress and symptoms of PTSD. In addition, within the appearance-related residual injury group, body image distress emerged a unique predictor of PTSD explaining incremental variance beyond that explained by severity of psychological maltreatment.

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

    Iwamoto, Junichi; Saito, Yoshifumi; Honda, Akira; Matsuzaki, Yasushi

    2013-03-21

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

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

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

    2010-10-01

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

  1. Dysregulation of protein degradation pathways may mediate the liver injury and phospholipidosis associated with a cationic amphiphilic antibiotic drug

    Mosedale, Merrie [Hamner-University of North Carolina Institute for Drug Safety Sciences, The Hamner Institutes for Health Sciences, Research Triangle Park, NC 27709 (United States); Wu, Hong [Drug Safety Research and Development, Pfizer Global Research and Development, Groton, CT06340 (United States); Kurtz, C. Lisa [Hamner-University of North Carolina Institute for Drug Safety Sciences, The Hamner Institutes for Health Sciences, Research Triangle Park, NC 27709 (United States); Schmidt, Stephen P. [Drug Safety Research and Development, Pfizer Global Research and Development, Groton, CT06340 (United States); Adkins, Karissa, E-mail: Karissa.Adkins@pfizer.com [Drug Safety Research and Development, Pfizer Global Research and Development, Groton, CT06340 (United States); Harrill, Alison H. [Hamner-University of North Carolina Institute for Drug Safety Sciences, The Hamner Institutes for Health Sciences, Research Triangle Park, NC 27709 (United States); University of Arkansas for Medical Sciences, Little Rock, AR72205 (United States)

    2014-10-01

    A large number of antibiotics are known to cause drug-induced liver injury in the clinic; however, interpreting clinical risk is not straightforward owing to a lack of predictivity of the toxicity by standard preclinical species and a poor understanding of the mechanisms of toxicity. An example is PF-04287881, a novel ketolide antibiotic that caused elevations in liver function tests in Phase I clinical studies. In this study, a mouse diversity panel (MDP), comprised of 34 genetically diverse, inbred mouse strains, was utilized to model the toxicity observed with PF-04287881 treatment and investigate potential mechanisms that may mediate the liver response. Significant elevations in serum alanine aminotransferase (ALT) levels in PF-04287881-treated animals relative to vehicle-treated controls were observed in the majority (88%) of strains tested following a seven day exposure. The average fold elevation in ALT varied by genetic background and correlated with microscopic findings of hepatocellular hypertrophy, hepatocellular single cell necrosis, and Kupffer cell vacuolation (confirmed as phospholipidosis) in the liver. Global liver mRNA expression was evaluated in a subset of four strains to identify transcript and pathway differences that distinguish susceptible mice from resistant mice in the context of PF-04287881 treatment. The protein ubiquitination pathway was highly enriched among genes associated with PF-04287881-induced hepatocellular necrosis. Expression changes associated with PF-04287881-induced phospholipidosis included genes involved in drug transport, phospholipid metabolism, and lysosomal function. The findings suggest that perturbations in genes involved in protein degradation leading to accumulation of oxidized proteins may mediate the liver injury induced by this drug. - Highlights: • Identified susceptible and resistant mouse strains to liver injury induced by a CAD • Liver injury characterized by single cell necrosis, and phospholipidosis

  2. Association between victimization by bullying and direct self injurious behavior among adolescence in Europe: a ten-country study.

    Brunstein Klomek, Anat; Snir, Avigal; Apter, Alan; Carli, Vladimir; Wasserman, Camilla; Hadlaczky, Gergö; Hoven, Christina W; Sarchiapone, Marco; Balazs, Judit; Bobes, Julio; Brunner, Romuald; Corcoran, Paul; Cosman, Doina; Haring, Christian; Kahn, Jean-Pierre; Kaess, Michael; Postuvan, Vita; Sisask, Merike; Tubiana, Alexandra; Varnik, Airi; Žiberna, Janina; Wasserman, Danuta

    2016-11-01

    Previous studies have examined the association between victimization by bullying and both suicide ideation and suicide attempts. The current study examined the association between victimization by bullying and direct-self-injurious behavior (D-SIB) among a large representative sample of male and female adolescents in Europe. This study is part of the Saving and Empowering Young Lives in Europe (SEYLE) study and includes 168 schools, with 11,110 students (mean age = 14.9, SD = 0.89). Students were administered a self-report survey within the classroom, in which they were asked about three types of victimization by bullying (physical, verbal and relational) as well as direct self-injurious behavior (D-SIB). Additional risk factors (symptoms of depression and anxiety, suicide ideation, suicide attempts, loneliness, alcohol consumption, drug consumption), and protective factors (parent support, peer support, pro-social behavior) were included. The three types of victimization examined were associated with D-SIB. Examination of gender as moderator of the association between victimization (relational, verbal, and physical) and D-SIB yielded no significant results. As for the risk factors, depression, but not anxiety, partially mediated the effect of relational victimization and verbal victimization on D-SIB. As for the protective factors, students with parent and peer support and those with pro-social behaviors were at significantly lower risk of engaging in D-SIB after being victimized compared to students without support/pro-social behaviors. This large-scale study has clearly demonstrated the cross-sectional association between specific types of victimization with self-injurious behavior among adolescents and what may be part of the risk and protective factors in this complex association.

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

    El-Galaly, Tarec Christoffer; Mylam, Karen Juul; Brown, Peter;

    2012-01-01

    Background. The value of performing post-therapy routine surveillance imaging in patients with Hodgkin lymphoma is controversial. This study evaluates the utility of positron emission tomography / computed tomography using 2-[18F]fluoro-2-deoxyglucose (PET/CT) for this purpose and in situations...... with suspected lymphoma relapse. Design and Methods. We conducted a multicenter retrospective study. Patients with newly diagnosed Hodgkin lymphoma achieving at least a partial remission on first-line therapy were eligible if they received PET/CT surveillance during follow-up. Two types of surveillance PET....../CTs were analyzed; routine PET/CT when patients showed no signs of relapse at referral to PET/CT, and clinically indicated PET/CT when recurrence was suspected. Results. A total of 211 routine and 88 clinically indicated PET/CTs were performed in 161 patients. In ten of 22 patients with Hodgkin lymphoma...

  4. Association of HIF- expression and cell apoptosis after traumatic brain injury in the rat

    2001-01-01

    Objective: To explore the expression of hypoxia inducible factor-1α (HIF-1~) and the correlation between HIF-1α and apoptosis after traumatic brain injury.Methods: Using experimental traumatic brain injury in the rats, the expression of HIF-1α was studied by immunohisto-chemistry in cerebral tissue, apoptotic cell death was evaluated with TUNEL (transferase-mediated XdUTP nick end labeling ), and double-labeled immunohistochemistry and TUNEL methods were used to investigate the relationship between HIF-1α and apoptosis.Results: There was remarkable difference in the expression of HIF-1α between the experimental groups and the control groups (P < 0.01), in the experimental groups,the expression of HIF-1α at 48 hours was highest; the evidence of apoptotic cell death after experimental traumatic brain injury was found by TUNEL; the apoptotic percentage increased or decreased according to the changes of the positive expression of HIF-1α (r = 0.99).Conclusions: The results suggest that secondary brain ischemia plays a crucial role in apoptotic cell death after traumatic brain injury; HIF-1α can prompt apoptotic cell death after experimental traumatic brain injury.e expres

  5. Motor vehicle crashes: the association of alcohol consumption with the type and severity of injuries and outcomes.

    Plurad, David; Demetriades, Demetrios; Gruzinski, Ginger; Preston, Christy; Chan, Linda; Gaspard, Donald; Margulies, Daniel; Cryer, Gill

    2010-01-01

    The effect of alcohol ingestion on short-term outcomes for trauma patients is indeterminate. Experimental and clinical reports often conflict. The objective of this study was to investigate the prevalence of positive alcohol screens, the effect of alcohol ingestion on injury patterns, severity, and outcomes in patients who were involved in motor vehicle crashes (MVC). MVC patients aged > 10 years treated in any of the 13 trauma centers in Los Angeles County during the calendar year 2003 were studied. All patients underwent routine alcohol screening on admission. The alcohol negative group ("no ETOH") had a blood alcohol level (BAL) of 0.005 g/dL to or = 0.08 g/dL, respectively. Logistic regression was performed to compare injury severity, complications, survival, and length of hospital stay among the three groups. Of the 3025 patients studied, 2013 (67%) were in the no ETOH group, 216 (7%) were in the low ETOH group, and 796 (26%) were in the high ETOH group. Levels were not associated with injury severity, Emergency Department hypotension, or Intensive Care Unit length of stay. Patients with an injury severity score > 15 and a high BAL had a higher incidence of severe head trauma (head abbreviated injury score > 3) and increased incidence of sepsis. However, in this group of severely injured, the high ETOH group had a significantly better survival rate than patients in the no ETOH group (adjusted odds ratio 0.41, 95% confidence interval 0.16-0.94, p = 0.05). Severely injured MVC victims with a high BAL have a higher incidence of severe head trauma and septic complications than no ETOH patients. However, the high ETOH group had superior adjusted survival rates.

  6. The moderating effects of sex and age on the association between traumatic brain injury and harmful psychological correlates among adolescents.

    Gabriela Ilie

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

  7. Association between mandatory seatbelt laws and road traffic injuries in Iran.

    Soori, H; Nasermoadeli, A; Ainy, E; Hassani, S A; Mehmandar, M R

    2011-11-01

    This study investigated the efficacy of mandatory seatbelt legislation on traffic injuries and intensity of road traffic injuries (RTIs). We carried out a before- after interventional study. Data regarding road traffic accidents and injuries one year before and one and two years after the implementation of mandatory seatbelt legislation were obtained from the traffic police database. Traffic accident mortality was 13.0% of all RTIs during the year prior to implementation. This decreased to 9.7% and 11.4% during the first and second years after implementation, respectively (p < 0.001). The mortality rate was not consistent for seatbelt use since there was a slight increase in the mortality rate in second year after implementation of mandatory seatbelt use although this level was lower than the pre- implementation rate. Our findings suggest mandatory seatbelt use reduces the intensity of RTIs and reduces the crude number of RTIs.

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

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

    2012-09-01

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

  9. In vivo DTI longitudinal measurements of acute sciatic nerve traction injury and the association with pathological and functional changes

    Li, Xinchun [Department of Radiology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou 510120 (China); Chen, Jingcong [Department of Radiology, The Center People Hospital of Huizhou, Huizhou 516001 (China); Hong, Goubin [Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000 (China); Sun, Congpeng; Wu, Xiaomen [Department of Radiology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou 510120 (China); Peng, Matthew Jianqiao, E-mail: PengJQshl@163.com [Department of Joint Surgery, The First Affiliated Hospital of Guangzhou Medical University, Orthopedic Implantation Key Lab of Guangdong Province, 151 Yanjiangxi Road, Guangzhou 510120 (China); Zeng, Guangqiao, E-mail: zgqiao@vip.163.com [State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou 510120 (China)

    2013-11-01

    Objective: To explore the feasibility of longitudinally measuring acute traction injury to the sciatic nerve using 1.5 T clinical MRI scanner of diffusion tensor imaging (DTI) and to analyze the associations of the measurements [regarding fractional anisotropy (FA), apparent diffusion coefficient (ADC), eigenvalue (λ{sub ||} and λ{sub ⊥})] with limb function and pathology. Materials and methods: Acute traction injuries to the sciatic nerve were created in the right hind limbs of 32 New Zealand white rabbits, the left hind limbs were chosen as sham operation nerves. MRI scans were performed at intervals from pre-operation through 8 weeks post-operation follow up. Scanning sequences included T2WI, STIR, and single shot spin echo DTI with single shot EPI acquisition (SE-DTI-SSEPI). Parameters of FA, ADC, axial diffusivity (λ{sub ||}) and radial diffusivity (λ{sub ⊥}) were then calculated from the DTI. The limb functions and pathologic changes were evaluated and compared. Results: Diffusion Tensor Tractography (DTT) only revealed the proximal portion of the injured nerves 1–3 days after traction injury but did not reveal the nerve of the distal and traction portions at all. Nerve fibers of the distal and traction portions were not revealed by DTT until after the 1st week. They were elongated gradually and recovered almost to the normal at 8th week. The value of FA and λ{sub ⊥}of the injured nerves, which varied in different portions, were significantly different between the traction injury nerves and the sham operation nerves, whereas the value of ADC and λ{sub ||} were not significantly different. The curve lines of FA value-time for the proximal, traction and distal portions of the injured nerve correlated well to the functional and pathological changes of the limb affected, while the DTI parameters did not change that much in the sham-operated nerves. Conclusions: DTI obtained on a 1.5 T clinical MRI scanner can demonstrate early abnormal changes

  10. [On the problem of traumatic shock associated with a combined injury (based on the materials of one forensic medical expertise)].

    Volkov, V P

    2012-01-01

    The author presents the results of the critical analysis of the materials of forensic medical expertise of a case of the serious harm to health that has led to involunry manslaughter. According to the expert opinion, the death resulted from the traumatic shock associated with the combined head and the chest injury. Such conclusion levels out the difference between the two accused persons and their "contribution" to the extent and severity of the inflicted damage to the victim's body; thereby, it equalizes the degree of their guilt and criminal responsibility. The present study showed that such interpretation of tanatogenesis associated with the combined injury is erroneous. The death of the injured person resulted from cerebral coma that developed following a severe craniocerebral injury as a constituent component of the combined trauma. It is emphasized that the thorough investigation of tanatogenesis based on the reliable elucidation of the immediate cause of death makes it possible to avoid poorly substantiated expert conclusions and their potential dire legal consequences.

  11. Association of Symptoms Following Mild Traumatic Brain Injury With Posttraumatic Stress Disorder vs Postconcussion Syndrome

    Lagarde, E.; Salmi, L. R.; Holm, L. W.

    2014-01-01

    IMPORTANCE A proportion of patients experience long-lasting symptoms following mild traumatic brain injury (MTBI). The postconcussion syndrome (PCS), included in the DSM-IV, has been proposed to describe this condition. Because these symptoms are subjective and common to other conditions, there i......IMPORTANCE A proportion of patients experience long-lasting symptoms following mild traumatic brain injury (MTBI). The postconcussion syndrome (PCS), included in the DSM-IV, has been proposed to describe this condition. Because these symptoms are subjective and common to other conditions...

  12. Toy-related injuries among children treated in US Emergency Departments, 1990-2011.

    Abraham, Vihas M; Gaw, Christopher E; Chounthirath, Thiphalak; Smith, Gary A

    2015-02-01

    This study investigates the epidemiology of injuries associated with toys among US children by analyzing data from the National Electronic Injury Surveillance System. During 1990-2011, an estimated 3278073 (95% confidence interval = 2762281-3793865) children toy-related injuries, averaging 149003 cases annually. The annual injury rate per 10000 children increased significantly by 39.9% from 18.88 in 1990 to 26.42 in 2011. The number and rate of injuries peaked at age 2 years; 63.4% of patients were male; and 80.3% of injuries occurred at home. Ride-on toys accounted for 34.9% of injuries and 42.5% of hospital admissions. This study is the first to comprehensively investigate toy-related injuries among children using a nationally representative data set. The increasing number and rate of toy-related injuries to children, especially those associated with ride-on toys, underscore the need for increased efforts to prevent these injuries.

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

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

    2009-02-15

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

  14. HMGB1 induces apoptosis and EMT in association with increased autophagy following H/R injury in cardiomyocytes.

    Ouyang, Fan; Huang, He; Zhang, Mingyu; Chen, Mingxian; Huang, Haobo; Huang, Fang; Zhou, Shenghua

    2016-03-01

    Hypoxia/reoxygenation (H/R) is a critical factor in the pathogenesis of tissue injury following myocardial infarction (MI) which can lead to tissue damage and pathological remodeling. Therefore, it is necessary to try and prevent myocardial H/R injury in order to optimize the treatment of MI. This study aimed to explore the functions and molecular mechanisms of action of high mobility group box 1 (HMGB1) and its role in H/R injury to H9c2 cells. The mRNA expression of levels genes were detected by RT-qPCR. The protein levels were examined by western blot analysis. The Beclin 1 expression level was further determined by immunocytochemistry (ICC). In addition, an HMGB1 overexpression vector and a shRNA lentiviral vector were constructed in order to induce the overexpression and silencing of HMGB1, respectively. The apoptotic rate of the H9c2 cells was determined by flow cytometry. The expression of miR-210 was markedly increased following the exposure of the cells to H/R, thus indicating that the cell model of H/R injury was successfully established. In addition, an in vivo model of MI was also created using rats. The mRNA and protein level of HMGB1 was found to be upregulated in the myocardial tissue of the rats with MI and in the H9c2 cells subjected to H/R injury. HMGB1 promoted apoptosis by increasing the expression of cleaved caspase-3 and the apoptotic rate of the cells, while decreasing the expression of Bcl-2 during H/R in the H9c2 cells. HMGB1 promoted epithelial-to-mesenchymal transition (EMT) by reducing the protein level of the epithelial marker, E-cadherin, while increasing the expression of the mesenchymal markers, vimentin and fibroblast-specific protein (FSP), during H/R in the H9c2 cells. HMGB1 induced the apoptosis of the H9c2 cells and EMT following H/R in association with the induction of autophagy. HMGB1 induced autophagy by upregulating the expression of discoidin domain receptor 1 (DDR1) and downregulating the phosphorylation levels of

  15. Whole-Genome Sequence of Multidrug-Resistant Pseudomonas aeruginosa Strain BAMCPA07-48, Isolated from a Combat Injury Wound.

    Sanjar, Fatemeh; Karna, S L Rajasekhar; Chen, Tsute; Chen, Ping; Abercrombie, Johnathan J; Leung, Kai P

    2016-07-07

    We report here the complete genome sequence of Pseudomonas aeruginosa strain BAMCPA07-48, isolated from a combat injury wound. The closed genome sequence of this isolate is a valuable resource for pathogenome characterization of P. aeruginosa associated with wounds, which will aid in the development of a higher-resolution phylogenomic framework for molecular-guided pathogen-surveillance.

  16. Correlation of serum neutrophil gelatinase-associated lipocalin with acute kidney injury in hypertensive disorders of pregnancy.

    Patel, Ml; Sachan, Rekha; Gangwar, Radheyshyam; Sachan, Pushpalata; Natu, Sm

    2013-01-01

    Hypertensive disorders of pregnancy (HDP) remain one of the largest single causes of maternal and fetal morbidity and mortality, accounting for 16.1% of maternal deaths in developed countries. The aim of the study was to evaluate acute kidney injury (AKI) in hypertensive disorders of pregnancy and to examine the correlation of serum neutrophil gelatinase-associated lipocalin (NGAL) with acute kidney injury. This prospective case control study was carried out over a period of 1 year. After written, informed consent and ethical clearance, 149 cases of hypertensive disorders of pregnancy were screened, and seven were lost to follow-up. Acute kidney injury was detected in 88 cases and acute renal failure in 30 cases of HDP. Thirty-one healthy pregnant nonhypertensive women were enrolled as controls. Quantitative measurement of serum NGAL levels was done by enzyme linked immunosorbent assay technique using a sandwich enzyme-linked immunosorbent assay kit. As per the Kidney Diseases Improving Global Outcomes International guidelines acute kidney injury network (AKIN), 50 cases (42.37%) of AKI stage I, 38 (32.2%) cases of AKI stage II, and 30 (25.42%) cases of renal failure were detected. Serum NGAL had a positive association with increasing proteinuria. It also had a positive correlation with systolic blood pressure (r∼0.36), diastolic blood pressure (r∼0.37), and serum creatinine (r∼0.4). NGAL was found to be significantly correlated with creatinine in the cases with the value of the correlation coefficient being 0.4. This direct correlation might be a consequence of endothelial dysfunction on which hypertension and proteinuria probably depends.

  17. Elective cesarean section to prevent anal incontinence and brachial plexus injuries associated with macrosomia--a decision analysis.

    Culligan, Patrick J; Myers, John A; Goldberg, Roger P; Blackwell, Linda; Gohmann, Stephan F; Abell, Troy D

    2005-01-01

    Our aim was to determine the cost-effectiveness of a policy of elective C-section for macrosomic infants to prevent maternal anal incontinence, urinary incontinence, and newborn brachial plexus injuries. We used a decision analytic model to compare the standard of care with a policy whereby all primigravid patients in the United States would undergo an ultrasound at 39 weeks gestation, followed by an elective C-section for any fetus estimated at > or =4500 g. The following clinical consequences were considered crucial to the analysis: brachial plexus injury to the newborn; maternal anal and urinary incontinence; emergency hysterectomy; hemorrhage requiring blood transfusion; and maternal mortality. Our outcome measures included (1) number of brachial plexus injuries or cases of incontinence averted, (2) incremental monetary cost per 100,000 deliveries, (3) expected quality of life of the mother and her child, and (4) "quality-adjusted life years" (QALY) associated with the two policies. For every 100,000 deliveries, the policy of elective C-section resulted in 16.6 fewer permanent brachial plexus injuries, 185.7 fewer cases of anal incontinence, and cost savings of $3,211,000. Therefore, this policy would prevent one case of anal incontinence for every 539 elective C-sections performed. The expected quality of life associated with the elective C-section policy was also greater (quality of life score 0.923 vs 0.917 on a scale from 0.0 to 1.0 and 53.6 QALY vs 53.2). A policy whereby primigravid patients in the United States have a 39 week ultrasound-estimated fetal weight followed by C-section for any fetuses > or =4500 g appears cost effective. However, the monetary costs in our analysis were sensitive to the probability estimates of urinary incontinence following C-section and vaginal delivery and the cost estimates for urinary incontinence, vaginal delivery, and C-section.

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

    Qian Yimei

    2009-01-01

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

  19. Triathlon related musculoskeletal injuries: the status of injury prevention knowledge.

    Gosling, Cameron McR; Gabbe, Belinda J; Forbes, Andrew B

    2008-07-01

    Triathlon is a popular participation sport that combines swimming, cycling and running into a single event. A number of studies have investigated the incidence of injury, profile of injuries sustained and factors contributing to triathlon injury. This paper summarises the published literature in the context of the evidence base for the prevention of triathlon related injuries. Relevant articles on triathlon injuries were sourced from peer-reviewed English language journals and assessed using the Translating Research into Injury Prevention Practice (TRIPP) framework. This review highlights the significant knowledge gap that exists in the published literature describing the incidence of injury, the profile of injuries sustained and evidence for the prevention of injury in triathlon. Despite the number of studies undertaken to address TRIPP Stages 1 and 2 (injury surveillance, aetiology and mechanism of injury), most triathlon studies have been limited by retrospective designs with substantial, and unvalidated, recall periods, inconsistency in the definitions used for a reportable injury and exposure to injury, or a failure to capture exposure data at all. Overall, the paucity of quality, prospective studies investigating the incidence of injury in triathlon and factors contributing to their occurrence has led to an inability to adequately inform the development of injury prevention strategies (TRIPP Stages 3-6) for this sport, a situation that must be rectified if gains are to be made in reducing the burden of triathlon related injury.

  20. Autonomous surveillance for biosecurity.

    Jurdak, Raja; Elfes, Alberto; Kusy, Branislav; Tews, Ashley; Hu, Wen; Hernandez, Emili; Kottege, Navinda; Sikka, Pavan

    2015-04-01

    The global movement of people and goods has increased the risk of biosecurity threats and their potential to incur large economic, social, and environmental costs. Conventional manual biosecurity surveillance methods are limited by their scalability in space and time. This article focuses on autonomous surveillance systems, comprising sensor networks, robots, and intelligent algorithms, and their applicability to biosecurity threats. We discuss the spatial and temporal attributes of autonomous surveillance technologies and map them to three broad categories of biosecurity threat: (i) vector-borne diseases; (ii) plant pests; and (iii) aquatic pests. Our discussion reveals a broad range of opportunities to serve biosecurity needs through autonomous surveillance.

  1. Handbook of surveillance technologies

    Petersen, JK

    2012-01-01

    From officially sanctioned, high-tech operations to budget spy cameras and cell phone video, this updated and expanded edition of a bestselling handbook reflects the rapid and significant growth of the surveillance industry. The Handbook of Surveillance Technologies, Third Edition is the only comprehensive work to chronicle the background and current applications of the full-range of surveillance technologies--offering the latest in surveillance and privacy issues.Cutting-Edge--updates its bestselling predecessor with discussions on social media, GPS circuits in cell phones and PDAs, new GIS s

  2. COMT Val 158 Met polymorphism is associated with nonverbal cognition following mild traumatic brain injury

    E.A. Winkler (Ethan A.); J.K. Yue (John); T.W. McAllister (Thomas W.); N.R. Temkin (Nancy); S.S. Oh (Sam S.); E.G. Burchard (Esteban); D. Hu (Donglei); A.R. Ferguson (Adam); H.F. Lingsma (Hester); J.F. Burke (John F.); M.D. Sorani (Marco); J. Rosand (Jonathan); E.L. Yuh (Esther); J. Barber (Jason); P.E. Tarapore (Phiroz E.); R.C. Gardner (Raquel C.); S. Sharma (Sourabh); G.G. Satris (Gabriela G.); C. Eng (Celeste); A.M. Puccio (Ava); K.K.W. Wang (Kevin K. W.); P. Mukherjee (Pratik); A.B. Valadka (Alex); D. Okonkwo (David); R. Diaz-Arrastia (Ramon); G. Manley (Geoffrey)

    2016-01-01

    textabstractMild traumatic brain injury (mTBI) results in variable clinical outcomes, which may be influenced by genetic variation. A single-nucleotide polymorphism in catechol-o-methyltransferase (COMT), an enzyme which degrades catecholamine neurotransmitters, may influence cognitive deficits foll

  3. Prevention of Infections Associated With Combat-Related Eye, Maxillofacial, and Neck Injuries

    2011-08-01

    immobilization , and primary clo- sure with drainage are important to prevent infection. 38 However, there is no consensus regarding the optimal management...esophageal suture line for further protection. If an extensive esophageal injury is present, a lateral cervical esophagostomy should be created and

  4. Urinary neutrophil gelatinase-associated lipocalin and acute kidney injury after cardiac surgery

    Wagener, G.; Gubitosa, G.; Wang, S.;

    2008-01-01

    for cardiopulmonary bypass time and aortic cross-clamp time to predict AKI were 0.592 (95% CI, 0.518 to 0.666) and 0.593 (95% CI, 0.523 to 0.665), respectively. LIMITATIONS: Limited sensitivity of changes in serum creatinine levels for kidney injury. CONCLUSIONS: Urinary NGAL has limited diagnostic accuracy...

  5. 78 FR 76196 - Secondary Service Connection for Diagnosable Illnesses Associated With Traumatic Brain Injury

    2013-12-17

    ... or severe TBI; (4) Depression if manifest within 3 years of moderate or severe TBI, or within 12... connection'' refers to the situation in which a service-connected disease or injury causes or aggravates a... service and also has been diagnosed with a distinct mental or physical condition, such as depression...

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

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

    2009-01-01

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

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

    Andishe Ranjbari

    2012-01-01

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

  8. Imipramine treatment improves cognitive outcome associated with enhanced hippocampal neurogenesis after traumatic brain injury in mice.

    Han, Xiaodi; Tong, Jing; Zhang, Jun; Farahvar, Arash; Wang, Ernest; Yang, Jiankai; Samadani, Uzma; Smith, Douglas H; Huang, Jason H

    2011-06-01

    Previous animal and human studies have demonstrated that chronic treatment with several different antidepressants can stimulate neurogenesis, neural remodeling, and synaptic plasticity in the normal hippocampus. Imipramine is a commonly used tricyclic antidepressant (TCA). We employed a controlled cortical impact (CCI) mouse model of traumatic brain injury (TBI) to assess the effect of imipramine on neurogenesis and cognitive and motor function recovery after TBI. Mice were given daily imipramine injections for either 2 or 4 weeks after injury. Bromodeoxyuridine (BrdU) was administered 3-7 days post-brain injury to label the cells that proliferated as a result of the injury. We assessed the effects of imipramine on post-traumatic motor function using a beam-walk test and an assessment of cognitive function: the novel object recognition test (NOR). Histological analyses were performed at 2 and 4 weeks after CCI. Brain-injured mice treated with imipramine showed significantly improved cognitive function compared to a saline-treated group (pimipramine-treated and saline-treated mice. Histological examination revealed increased preservation of proliferation of Ki-67- and BrdU-positive cells in the hippocampal dentate gyrus (DG) at 2 and 4 weeks after TBI. Immunofluorescence double-labeling with BrdU and neuron-specific markers at 4 weeks after injury showed that most progenitors became neurons in the DG and astrocytes in the hilus. Notably, treatment with imipramine increased preservation of the total number of newly-generated neurons. Our findings provide direct evidence that imipramine treatment contributes to cognitive improvement after TBI, perhaps by enhanced hippocampal neurogenesis.

  9. Biomechanical factors associated with shoe/pedal interfaces. Implications for injury.

    Gregor, R J; Wheeler, J B

    1994-02-01

    The principal demand on the body during cycling is on the lower extremities as they are responsible for producing a majority of the energy imparted to the bike. As a result the legs, due to high reactive forces between the foot and pedal, experience high loads on the joints. These loads may adversely affect joint tissues and contribute to overuse injuries, e.g. knee pain. The mechanical link between the leg and the bike is the shoe/pedal interface. This transmission site, by design, can either create smooth transfer of energy or abnormally high repetitive loads which are potentially injurious to the body. Incidence of lower extremity injury in cycling is high, and historically biomechanical analyses of this activity have focused their attention on either the rider or the bike, but not the link between the two. Recently, pedal designs have changed in response to complaints of sore knees with the development of pedals allowing varying degrees of float. This form of transmission is intended to enhance power transfer from rider to bike as well as minimise trauma to the legs by permitting the foot to rotate during the pedalling cycle in a toe-in/heel-out or heel-in/toe-out movement pattern. Recent evidence suggests this type of pedal design does reduce trauma and maintains power output. This article reviews common lower extremity overuse injuries and biomechanical factors during the pedalling cycle with the primary focus on the shoe/pedal interface. We will summarise information available on lower extremity kinematics and kinetics as well as recent data specifically related to shoe/pedal interface kinetics, evaluation of different pedal types-specifically comparison between clipless 'fixed' and clipless 'float' systems-and discuss their resultant effect on lower extremity dynamics and their implications for injury.

  10. Correlation of serum neutrophil gelatinase-associated lipocalin with acute kidney injury in hypertensive disorders of pregnancy

    Patel ML

    2013-10-01

    Full Text Available ML Patel,1 Rekha Sachan,2 Radheyshyam Gangwar,3 Pushpalata Sachan,4 SM Natu51Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India; 2Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India; 3Department of Critical Care, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India; 4Department of Physiology, King George's Medical University, Lucknow, Uttar Pradesh, India; 5Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, IndiaAbstract: Hypertensive disorders of pregnancy (HDP remain one of the largest single causes of maternal and fetal morbidity and mortality, accounting for 16.1% of maternal deaths in developed countries. The aim of the study was to evaluate acute kidney injury (AKI in hypertensive disorders of pregnancy and to examine the correlation of serum neutrophil gelatinase-associated lipocalin (NGAL with acute kidney injury. This prospective case control study was carried out over a period of 1 year. After written, informed consent and ethical clearance, 149 cases of hypertensive disorders of pregnancy were screened, and seven were lost to follow-up. Acute kidney injury was detected in 88 cases and acute renal failure in 30 cases of HDP. Thirty-one healthy pregnant nonhypertensive women were enrolled as controls. Quantitative measurement of serum NGAL levels was done by enzyme linked immunosorbent assay technique using a sandwich enzyme-linked immunosorbent assay kit. As per the Kidney Diseases Improving Global Outcomes International guidelines acute kidney injury network (AKIN, 50 cases (42.37% of AKI stage I, 38 (32.2% cases of AKI stage II, and 30 (25.42% cases of renal failure were detected. Serum NGAL had a positive association with increasing proteinuria. It also had a positive correlation with systolic blood pressure (r~0.36, diastolic blood pressure (r~0.37, and serum creatinine (r~0

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

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

    2010-02-01

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

  12. Targeting Neutrophils to Prevent Malaria-Associated Acute Lung Injury/Acute Respiratory Distress Syndrome in Mice

    Soeiro-Pereira, Paulo V.; Gomes, Eliane; Neto, Antonio Condino; D' Império Lima, Maria R.; Alvarez, José M.; Portugal, Silvia; Epiphanio, Sabrina

    2016-01-01

    Malaria remains one of the greatest burdens to global health, causing nearly 500,000 deaths in 2014. When manifesting in the lungs, severe malaria causes acute lung injury/acute respiratory distress syndrome (ALI/ARDS). We have previously shown that a proportion of DBA/2 mice infected with Plasmodium berghei ANKA (PbA) develop ALI/ARDS and that these mice recapitulate various aspects of the human syndrome, such as pulmonary edema, hemorrhaging, pleural effusion and hypoxemia. Herein, we investigated the role of neutrophils in the pathogenesis of malaria-associated ALI/ARDS. Mice developing ALI/ARDS showed greater neutrophil accumulation in the lungs compared with mice that did not develop pulmonary complications. In addition, mice with ALI/ARDS produced more neutrophil-attracting chemokines, myeloperoxidase and reactive oxygen species. We also observed that the parasites Plasmodium falciparum and PbA induced the formation of neutrophil extracellular traps (NETs) ex vivo, which were associated with inflammation and tissue injury. The depletion of neutrophils, treatment with AMD3100 (a CXCR4 antagonist), Pulmozyme (human recombinant DNase) or Sivelestat (inhibitor of neutrophil elastase) decreased the development of malaria-associated ALI/ARDS and significantly increased mouse survival. This study implicates neutrophils and NETs in the genesis of experimentally induced malaria-associated ALI/ARDS and proposes a new therapeutic approach to improve the prognosis of severe malaria. PMID:27926944

  13. Closed-suction drain placement at laparotomy in isolated solid organ injury is not associated with decreased risk of deep surgical site infection.

    Mohseni, Shahin; Talving, Peep; Kobayashi, Leslie; Kim, Dennis; Inaba, Kenji; Lam, Lydia; Chan, Linda S; Coimbra, Raul; Demetriades, Demetrios

    2012-10-01

    The purpose of this study was to investigate the role of intra-abdominal closed-suction drainage after emergent trauma laparotomy for isolated solid organ injuries (iSOI) and to determine its association with deep surgical site infections (DSSI). All patients subjected to trauma laparotomy between January 2006 and December 2008 for an iSOI at two Level I urban trauma centers were identified. Patients with isolated hepatic, splenic, or renal injuries were included. Study variables extracted included demographics, clinical characteristics, intra-abdominal injuries, drain placement, DSSI, septic events, intensive care unit and hospital length of stay, and in-hospital mortality. Diagnosis of DSSI was based on abdominal computed tomography scan demonstrating an intra-abdominal collection combined with fever and elevated white blood cell count. For the analysis, patients were stratified based on injury severity. To identify an independent association between closed-suction drain placement and DSSI, stepwise logistic regression analysis was performed. Overall, 142 patients met the inclusion criteria with 80 per cent (n=114) having severe iSOI. In 47 per cent (n=53) of the patients with a severe injury, an intra-abdominal drain was placed. A drain was placed more often in patients with a blunt trauma with more severe injury defined by Injury Severity Score and abdominal Abbreviated Injury Scale Score and those who underwent splenectomy (Pdrain placement (odds ratio, 2.8; 95% confidence interval, 1.0 to 8.2; P=0.046). Subgroup analysis demonstrated those who sustained severe hepatic injury receiving a drain had a significantly increase risk of DSSI (P=0.02). There was no statistical difference in the rate of DSSI based on the presence or absence of an intra-abdominal drain after severe splenic injury (17 vs 18%, P=0.88). The use of intra-abdominal closed-suction drains after iSOI is not associated with decreased risk of DSSI.

  14. Environmental surveillance master sampling schedule

    Bisping, L.E.

    1995-02-01

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

  15. 1995 Annual epidemiologic surveillance report for Brookhaven National Laboratory

    NONE

    1995-12-31

    The US Department of Energy`s (DOE) conduct of epidemiologic surveillance provides an early warning system for health problems among workers. This program monitors illnesses and health conditions that result in an absence of five or more consecutive workdays, occupational injuries and illnesses, and disabilities and deaths among current workers. This report summarizes epidemiologic surveillance data collected from Brookhaven National Laboratory (BNL) from January 1, 1995 through December 31, 1995. The data were collected by a coordinator at BNL and submitted to the Epidemiologic Surveillance Data Center, located at Oak Ridge Institute for Science and Education, where quality control procedures and data analyses were carried out.

  16. 77 FR 4048 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Initial Review

    2012-01-26

    ... Dengue Epidemiology, Outcomes, and Prevention in Sentinel Surveillance and Research Sites in Puerto Rico... to ``Evaluation of Dengue Epidemiology, Outcomes and Prevention in Sentinel Surveillance and Research... HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention...

  17. Whiplash injuries.

    Malanga, Gerard; Peter, Jason

    2005-10-01

    Whiplash injuries are very common and usually are associated with rear-end collisions. However, a whiplash injury can be caused by any event that results in hyperextension and flexion of the cervical spine. These injuries are of serious concern to all consumers due to escalating cost of diagnosis, treatment, insurance, and litigation. Most acute whiplash injury cases respond well to conservative treatments, which result in resolution of symptoms usually within weeks to a few months after the injury occurred. Chronic whiplash injuries often are harder to diagnose and treat and often result in poor outcomes. Current research shows that various structures in the cervical spine receive nociceptive innervation and potentially may be the cause of chronic pain symptoms. One potential pain generator showing promise is the facet or zygapophyseal joints. Various researchers have proven that these joints are injured during whiplash injuries and that diagnosis and temporary pain relief can be obtained with facet joint injections. The initial evaluation of any patient should follow an organized and stepwise approach, and more serious causes of neck pain must first be ruled out through the history, physical examination, and diagnostic testing. Treatment regimens should be evidence-based, focusing on treatments that have proven to be effective in treating acute and chronic whiplash injuries.

  18. A study on maxillofacial impact injury associated with brain injury%颌面部撞击伤伴发颅脑损伤的实验研究

    张明; 何黎升; 薄斌; 周树夏

    2001-01-01

    目的研究颌面部撞击伤合并颅脑损伤的损伤特点。方法采用水平气动式撞击机分别以(4.77±0.53)m/s、(9.16±0.65)m/s和(13.95±0.67)m/s对兔左侧面中部进行撞击(n=6)。观察致伤后动物生命体征的变化,并对颌面部软组织、脑组织进行损伤的大体和光、电镜观察,测定致伤后6小时血清中脂质过氧化物(LPO)、脑组织中LPO、超氧化物歧化酶(SOD)、一氧化氮(NO)和水的含量变化,与正常组对照。结果形态学改变低速和中速致伤组主要以局部损伤为主,高速致伤组则同时合并颅脑损伤。兔致伤后6小时,血清中LPO,脑组织中LPO、NO值和水的含量显著升高,而脑组织中SOD含量显著降低(P<0.01)。结论颌面部撞击伤后,增强的自由基反应参与损伤过程,局部组织内NO的生成与组织损伤的破坏程度一致,说明大量生成的NO可能是参与组织细胞损伤的重要物质。%Objective To study the characteristics of maxillofacial injury associated with brain injury.Methods Eighteen rabbits were subjected to left middle face impact with different impact velocities, which were(4.77±0.53)m/s,(9.16±0.65)m/s,(13.95±0.67)m/s. Life system change during the impact period was monitored. The pathological characteristics of correlative tissues at the time of 6 hours after impact were examined in detail. The content of LPO in blood and LPO,SOD,NO in brain were measured at the same time, compared with control.Results  The content of LPO in blood,LPO,NO in brain and cerebral water content significantly increased,but the content of SOD in brain reduced with the increase of impact velocity (P<0.01).Conclusion Free radicals and NO are involved in the progress of tissue injury followed by maxillofacial impact injury. Production of a large quantity of NO may be an important factor to cause progressive damage of tissues.

  19. Surveillance and persuasion

    Nagenborg, Michael

    2014-01-01

    This paper is as much about surveillance as about persuasive technologies (PTs). With regard to PTs it raises the question about the ethical limits of persuasion. It will be argued that even some forms of self-imposed persuasive soft surveillance technologies may be considered unethical. Therefore,

  20. Soil and vegetation surveillance

    Antonio, E.J.

    1995-06-01

    Soil sampling and analysis evaluates long-term contamination trends and monitors environmental radionuclide inventories. This section of the 1994 Hanford Site Environmental Report summarizes the soil and vegetation surveillance programs which were conducted during 1994. Vegetation surveillance is conducted offsite to monitor atmospheric deposition of radioactive materials in areas not under cultivation and onsite at locations adjacent to potential sources of radioactivity.