Inner urban and national suicide rates, a simple comparative study

The authors have calculated the suicide rate per million for individual causes of death in the Inner North London Coroner's jurisdiction and also a composite rate for all methods of self-destruction. These have been compared with the rates for England and Wales in the years 1979-1985 inclusive. Also calculated has been a total 'non-accidental' death rate comprising all deaths by self-destructive behaviour. For certain causes the two rates are similar but for the remainder there are wide differences. The effect of the law relating to suicide verdicts has been described and its effects discussed.     

Differences in investigations of sudden unexpected deaths in young people in a nationwide setting

Background  

Inherited disease may be causative in many young sudden unexpected death cases. Autopsy is essential in the counselling of the bereaved, as the family of the victim may be at risk too. In a nationwide setting operating under the same set of laws, we hypothesized that regional differences exist in the investigation of young persons dying suddenly and unexpectedly.     

Increasing hospital admissions for patellar instability: a national database study from 2004 to 2017

ABSTRACT

Objectives

Epidemiology of patellar instability is not fully characterized, as some studies have produced conflicting information or been drawn from limited populations. In this study, we used the Pediatric Health Information System (PHIS) database to examine trends in admissions for patellar instability throughout the United States. We hypothesized that there would be an increasing rate of patellar instability admissions in recent years. Secondarily, we examined how demographic factors and insurance status relate to admissions for patellar instability.     

Clinical services in interventional radiology: results from the national Medicare database and a Society of Interventional Radiology membership survey

PURPOSE: To evaluate trends in evaluation and management (E & M) services performed by interventional radiologists. MATERIALS AND METHODS: Recent national Medicare physician utilization data (1997-2000) were analyzed for trends in E & M services provided by interventional radiologists. The results were evaluated in conjunction with a recent Society of Interventional Radiology (SIR) membership survey in which 165 interventional radiology (IR) practices answered questions about clinical service issues. RESULTS: Despite the perception of frequent clinical services by interventional radiologists, paid Medicare claims for E & M services have increased only minimally, from 9,472 to 9,662 (+2.0%), and have lagged behind non-E & M procedural services, which have increased from 2,283,111 to 2,527,323 (+10.7%). The relative value unit (RVU) impact of E & M encounters has increased from 14,422 to 14,893 (+3.2%) while the RVU impact of procedural services has increased from 2,262,991 to 3,723,486 (+64.5%). E & M services account for only 0.39% of all Medicare claims, 0.49% of service RVUs, and 0.68% of all reimbursable time spent by interventionalists. However, when surveyed, interventional radiologists perceived that E & M services are much more frequent: 92% provide clinical services and indicate that 6.6% +/- 5.4 of physician time is spent providing E & M services. CONCLUSION: Despite perceptions by interventional radiologists that E & M services are common, Medicare claims for such services are infrequent and growth lags behind that of IR services overall. These discrepancies may be explained in part by practice and billing infrastructures that do not effectively translate actual clinical services into successful claims.     

DNA reviews: the national DNA database of the United Kingdom

The national DNA database in United Kingdom has now been operational for over 10 years. This review looks at the history and development of this investigative resource. From the development of commercial DNA profiling kits to the current statistics for matches obtained in relation to criminal investigation in the United Kingdom, before moving onto discussing potential future direction that national DNA databases might take, including international collaboration on a European and global scale.     

Epidemiology of hospitalizations and deaths from heat illness in soldiers

PURPOSE: Serious heat illness has received considerable recent attention due to catastrophic heat waves in the United States and Europe, the deaths of high-profile athletes, and military deployments. METHODS: This study documents heat illness hospitalizations and deaths for the U.S. Army from 1980 through 2002. Hospitalization data were obtained from the Total Army Injury Health Outcomes Database (TAIHOD) coded according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). North Atlantic Treaty Organization Standardization Agreement codes were searched for heat injuries in an effort to detect cases that were not found during the ICD-9-CM search. RESULTS: Five-thousand two-hundred forty-six soldiers were hospitalized, and 37 died due to heat illness. Our results indicate: 1) approximately 60% reduction in hospitalization rates (fewer heat exhaustion cases) over the 22-yr period; 2) fivefold increase in heat stroke hospitalization rates (1.8 per 100,000 in 1980 to 14.5 per 100,000 in 2001); 3) heat stroke cases were associated with dehydration (17%), rhabdomyolysis (25%), and acute renal failure (13%); 4) lower hospitalizations rates among African and Hispanic Americans compared with Caucasians (incidence density ratio, 0.76 [95% confidence interval, 0.71-0.82]; 5) greater rates of hospitalizations and heat strokes among recruits from northern than southern states (incidence density ratio, 1.69 [95% confidence interval, 1.42-1.90]; and 6) greater rates of hospitalizations and heat strokes among women than men (incidence density ratio, 1.18 [95% confidence interval, 1.09-1.27]). CONCLUSIONS: Exertional heat illness continues to be a military problem during training and operations. Whereas the hospitalization rate of heat illness is declining, heat stroke has markedly increased.     

全国恶性肿瘤介入治疗数据库及登记系统设计初探

目的本课题是十一五国家科技支撑计划课题常见恶性肿瘤介入治疗方法规范化的比较研究和中远期疗效评估的一个子课题,根据计划书需要采用国际标准化的登记方法,建立全国恶性肿瘤介入治疗登记系统,整合多中心的病历资料,构建肿瘤介入治疗数据库。方法采用软件下载、自主管理、自动整合的技术方案,实现全国恶性肿瘤介入治疗数据库及登记系统的建立。结果建立完成全国肿瘤介入治疗数据库及登记系统,实现肿瘤介入治疗的信息化管理,可以进行数据的简单或复合查询,在院内调试及初运行良好。结论全国恶性肿瘤介入治疗数据库及登记系统的建立,不仅可以明确肿瘤介入治疗的全国普及率,不同肿瘤介入治疗的疗效,最新介入手段应用情况,便于不同医院之间的技术交流,提高介入医师诊治水平,而且能了解介入人才的分布结构,介入器材的消耗品种及数量,优化资金,节约医疗成本。     

Incidence and body location of reported acute sport injuries in seven sports using a national insurance database

Sports with high numbers of athletes and acute injuries are an important target for preventive actions at a national level. Both for the health of the athlete and to reduce costs associated with injury. The aim of this study was to identify injuries where injury prevention should focus, in order to have major impact on decreasing acute injury rates at a national level. All athletes in the seven investigated sport federations (automobile sports, basketball, floorball, football (soccer), handball, ice hockey, and motor sports) were insured by the same insurance company. Using this insurance database, the incidence and proportion of acute injuries, and injuries leading to permanent medical impairment (PMI), at each body location, was calculated. Comparisons were made between sports, sex, and age. In total, there were 84 754 registered injuries during the study period (year 2006‐2013). Athletes in team sports, except in male ice hockey, had the highest risk to sustain an injury and PMI in the lower limb. Females had higher risk of injury and PMI in the lower limb compared to males, in all sports except in ice hockey. This study recommends that injury prevention at national level should particularly focus on lower limb injuries. In ice hockey and motor sports, head/neck and upper limb injuries also need attention.     

Automated determination of bubble grades from Doppler ultrasound recordings

INTRODUCTION: One of the difficulties in the development of automated algorithms for the detection of bubbles in Doppler ultrasound recordings is that expert labels are only available on an aggregate basis, i.e., the expert provides a single label for a recording which may contain many bubbles. It is thus very difficult to determine whether an algorithm is correctly identifying the actual bubbles or simply identifying the correct number of events, but mislabeling some events that are not due to bubbles. METHODS: The analysis presented here shows that the classification probabilities for the detection of bubble events and other artifacts can be determined if a large number of recordings are available. DISCUSSION: Using a half-integer scoring system from 0-4 gives a bias of approximately 1-2% and a standard deviation that varies with the number of event sequences available, dropping from approximately 7.5% for 100 60-s recordings to 3% for 1000 60-s recordings. These values are larger if an integer scoring system is used, but using a scale finer than half-integers confers no extra benefit due to the fact that the expert labels the whole recording rather than individual bubbles. CONCLUSIONS: It is thus possible to estimate the classification probabilities with a reasonably high degree of accuracy, but difficult to show that one bubble detection algorithm is superior to another to any degree of statistical significance. Expert labels can be used to validate, but not to compare the performance of bubble detection algorithms.     

The current status of embolization in renal cell carcinoma--a survey of local and national practice.

The current role of renal embolization in carcinoma of the kidney is uncertain. In order to assess surgeons' opinion of its usefulness a questionnaire was circulated to all general urologists practising in Britain and Ireland. Also, a series of cases in which the technique was employed (n = 35) was reviewed and compared with a similar group who were not embolized (n = 40). There was a 71% response to the survey. The principal findings were that all but five urologists believe that embolization should not be used routinely in the management of renal cell carcinoma. Thirty-five per cent stated that they felt it has a role in management of symptoms in metastatic or inoperable tumours. The review of both series of patients in our unit shows that embolization (using 95% ethanol infused via a balloon occlusion catheter) did not reduce peroperative blood loss and did significantly increase hospital stay. There were no deaths in this series, and morbidity was confined to 'post-embolization syndrome' in 16 cases. We believe that in those cases where embolization is indicated, alcohol infusion via a balloon occlusion catheter is a safe and efficient method.     

Restraint asphyxia in in-custody deaths Medical examiner's role in prevention of deaths

In the United States, the office of the Medical Examiner-Coroner is responsible for investigating all sudden and unexpected deaths and deaths by violence. Its jurisdiction includes deaths during the arrest procedures and deaths in police custody. Police officers are sometimes required to subdue and restrain an individual who is violent, often irrational and resisting arrest. This procedure may cause harm to the subject and to the arresting officers. This article deals with our experiences in Los Angeles and reviews the policies and procedures for investigating and determining the cause and manner of death in such cases. We have taken a "quality improvement approach" to the study of these deaths due to restraint asphyxia and related officer involved deaths, Since 1999, through interagency coordination with law enforcement agencies similar to the hospital healthcare quality improvement meeting program, detailed information related to the sequence of events in these cases and ideas for improvements to prevent such deaths are discussed.     

Child deaths from family violence in Dakahlia and Damiatta Governorates,Egypt

This retrospective study evaluated 41 cases of child deaths child deaths of both sexes from family violence and autopsied at Mansoura Morgue of Forensic Medicine Institute from 1996 to 2005. According to their ages, children were divided into four groups as follow: <3 years; 3–6 years; 6–9 years and 9–12 years. Some socio-demographic parameters concerning the perpetrators were investigated such as level of education of fathers, parent marital status and residence. Also, the cause of violence and the manner of deaths were recorded. Results revealed that the highest incidence of children deaths was between 3 and 6 years (39.0%) and the lowest incidence was between 9 and 12 years (4.9%). The majority of perpetrators were males (75.62%); they comprised children fathers in 60.98%, while female perpetrators represented 24.39%; they comprised the children mothers in 7.32%. Fathers who lived in rural areas represented 75.6% and 24.4% in urban areas. Regarding the level of education of fathers of decedent children, 36.6% were illiterate, 17.1% were highly educated and 46.3% were less than high school education. The marital status of those parents were as follows: separated couples (51.2%), still married couples (22.0%); fathers with multiple wives (26.8%). Blunt trauma in abusive manner was the most common form (63.4%). It was concluded that some socio-demographic parameters are considered risk factors related to intrafamilial violence and it should be considered by Family Planning Programs to estimate the magnitude of this problem in our community on a large scale, offering psychological assessment and assurance for risky perpetrators aiming to prevent such fatal child abuse crimes.