Traditional bone setter's gangrene (TBSG) is the term we use to describe the sequelae sometimes seen after treatment with native fracture splints. Twenty five consecutive complications were recorded in 25 patients aged between 5-50 years with a median age of 10 years. The major complication of the native fracture splint treatment was distal limb gangrene necessitating proximal amputations in 15 cases. (+info)
Pedestrian fatalities--Cobb, DeKalb, Fulton, and Gwinnett counties, Georgia, 1994-1998.
(18/2587)
In 1997, a total of 5307 pedestrian fatalities occurred in the United States, accounting for 13% of motor-vehicle-related deaths. The Atlanta metropolitan statistical area (MSA) is reported to be the third most dangerous large metropolitan area for walking, behind Fort Lauderdale and Miami, Florida. This report summarizes an investigation of pedestrian fatalities in four central metropolitan Atlanta counties; the findings indicate that the annual pedestrian fatality rate for these counties combined has been consistently higher than the national rate, and from 1994 to 1998 the four-county area pedestrian fatality rate increased 13%. (+info)
Relative excess risk: an alternative measure of comparative risk.
(19/2587)
The proverbial relative risk may not always be the most suitable measure to compare the risk of two exposures, since it inherently includes a background effect. An alternative comparative measure, the relative excess risk, is introduced. It applies to situations in which an "unexposed" reference group is included in addition to the two exposures under evaluation. This comparative measure is based solely on the component of risk due to the exposures, since it removes the background risk. Estimators of the relative excess risk are presented, along with formulas for the confidence intervals under cohort and case-control designs, using both crude and adjusted rate ratios. This new measure is illustrated with data from epidemiologic studies of the risks of oral contraceptives and antidiabetic drugs. (+info)
Differential pupillary constriction and awareness in the absence of striate cortex.
(20/2587)
The fact that the pupil constricts differentially to visual stimuli in the absence of changes in light energy makes it a valuable tool for studying normal function as well as residual capacity in hemianopic subjects. When pupillometrically effective stimuli such as equiluminant gratings or coloured patches with an abrupt onset and offset are presented to the 'blind' hemifield, a hemianopic subject with damage largely restricted to striate cortex (V1) sometimes reports being 'aware' of the transient onset/offset, although without 'seeing' as such. The question addressed here is whether the pupil still responds in the condition of blindsight in its strict sense--i.e. discriminative capacity in the absence of acknowledged awareness--when stimuli are deliberately designed to eliminate awareness. This was accomplished by making stimulus onset and offset slow and gradual. The results with a well-studied hemianope, G.Y., demonstrate that there is still a pupillary constriction to isoluminant achromatic gratings and red-coloured stimuli, although reduced in size, in the absence of acknowledged awareness. (+info)
Relationship of psychopathology to the human serotonin1B genotype and receptor binding kinetics in postmortem brain tissue.
(21/2587)
Knockout of the 5-HT1B gene in mice results in increased aggression, as well as alcohol and cocaine consumption. Given the clinical association of aggression, suicide, alcoholism, and substance abuse, we studied relationship of psychopathology to the human 5-HT1B receptor gene (N = 178) and postmortem human 5-HT1B receptor binding (N = 96) in the brain. The sample comprised: 71 suicide victims, 107 nonsuicides, 45 with a history of major depression and 79 without, 64 with a history of a alcoholism or substance abuse and 60 without, as well as 36 with a history of pathological aggression and 42 without. Single-strand conformational polymorphism (SSCP) analysis and DNA sequencing techniques were used to screen the coding region of the human 5-HT1B receptor gene in genomic DNA isolated from postmortem human brain tissue. Two common polymorphisms were identified in the 5-HT1B receptor gene, involving a silent C to T substitution at nucleotide 129 and a silent G to C substitution at nucleotide 861 of the coding region. These polymorphisms were found with the same frequency in the suicide and the nonsuicide groups and in those with and without a history of major depression, alcoholism, or pathological aggression. The binding indices (Bmax and KD of the 5-HT1B receptor in prefrontal cortex also did not differ in suicides and controls, major depression, alcoholism, and cases with a history of pathological aggression. The C129 or G861 allele had 20% fewer 5-HT1B receptor compared to the 129T or 861C allele. We did not identify a relationship between suicide, major depression, alcoholism, or pathological aggression with 5-HT1B receptor binding indices or genotype. (+info)
Post-traumatic stress reactions following motor vehicle accidents.
(22/2587)
Despite improvements in road conditions, vehicle safety and driver education, over 3 million persons are injured in motor vehicle accidents each year. Many of these persons develop post-traumatic stress symptoms that can become chronic. Patients with post-traumatic stress disorder experience disabling memories and anxiety related to the traumatic event. Early identification of these patients is critical to allow for intervention and prevent greater impairment and restriction. The family physician is in an ideal position to identify, treat or refer patients with traumatic responses to traffic accidents. The physician's awareness of patient characteristics and pre-accident functioning allows him or her to critically evaluate symptoms that may begin to interfere with the resumption of daily activities. (+info)
Vehicle accidents related to sleep: a review.
(23/2587)
Falling asleep while driving accounts for a considerable proportion of vehicle accidents under monotonous driving conditions. Many of these accidents are related to work--for example, drivers of lorries, goods vehicles, and company cars. Time of day (circadian) effects are profound, with sleepiness being particularly evident during night shift work, and driving home afterwards. Circadian factors are as important in determining driver sleepiness as is the duration of the drive, but only duration of the drive is built into legislation protecting professional drivers. Older drivers are also vulnerable to sleepiness in the mid-afternoon. Possible pathological causes of driver sleepiness are discussed, but there is little evidence that this factor contributes greatly to the accident statistics. Sleep does not occur spontaneously without warning. Drivers falling asleep are unlikely to recollect having done so, but will be aware of the precursory state of increasing sleepiness; probably reaching a state of fighting off sleep before an accident. Self awareness of sleepiness is a better method for alerting the driver than automatic sleepiness detectors in the vehicle. None of these have been proved to be reliable and most have shortcomings. Putative counter measures to sleepiness, adopted during continued driving (cold air, use of car radio) are only effective for a short time. The only safe counter measure to driver sleepiness, particularly when the driver reaches the stage of fighting sleep, is to stop driving, and--for example, take a 30 minute break encompassing a short (< 15 minute) nap or coffee (about 150 mg caffeine), which are very effective particularly if taken together. Exercise is of little use. CONCLUSIONS: More education of employers and employees is needed about planning journeys, the dangers of driving while sleepy, and driving at vulnerable times of the day. (+info)
Minimum-age drinking laws and youth suicide, 1970-1990.
(24/2587)
OBJECTIVES: This study examined the association between the minimum legal drinking age (MLDA) and suicides among youths aged 18 to 20 years. METHODS: The study used pooled cross-sectional time-series data on youth suicide and the MLDA for the 48 contiguous states in the United States from 1970 to 1990. Poisson regression was used to estimate the association between MLDA and youth suicide. RESULTS: A significant association exists between MLDA and youth suicide. Between 1970 and 1990, the suicide rate of 18- to 20-year-old youths living in states with an 18-year MLDA was 8% higher than the suicide rate among 18- to 20-year-old youths in states with a 21-year MLDA (P < .01). CONCLUSIONS: MLDA is associated not only with the motor-vehicle death rate among youths but also with the rate of youth suicide. We estimate that lowering the drinking age from 21 to 18 years in all states could increase the number of suicides in the 18- to 20-year-old population by approximately 125 each year. (+info)