Trends in reporting injury as a cause of death among people with epilepsy in the U.S., 1981–2010

PurposeTo examine trends in reporting injury as a cause of death among people with epilepsy in the U.S. during the past three decades.MethodWe analyzed the U.S. multiple causes of death data from death certificates in 1981–2010 to compare rate and odds ratios (OR) of reporting injury as cause of death among cases with vs. without mention of epilepsy across years.ResultsThe trends in reporting epilepsy with and without injury were similar in most age groups but were inconsistent in most external causes of injury. The OR of reporting injury was 1.02 (95% confidence intervals (CI) 0.97–1.07) in 1981–1985 and decreased to 0.52 (95% CI 0.48–0.55) in 2006–2010. The decline in OR was prominent among people aged 15–24 followed by people aged 25–44. For the five external causes of injury, the OR of suffocation and drowning were 6.32 (95% CI 5.91–6.75) and 5.64 (95% CI 5.16–6.16) in 1981–1985 and decreased to 3.03 (95% CI 2.74–3.35) and 2.56 (95% CI 2.18–3.00) in 2006–2010. The OR for poisoning and traffic crashes were 0.70 (95% CI 0.57–0.85) and 0.08 (95% CI 0.07–0.09) in 1981–1985 and 0.21 (95% CI 0.18–0.25) and 0.06 (95% CI 0.05–0.08) in 2006–2010.ConclusionThe risk of fatal injury among people with epilepsy decreased drastically during the past three decades in most age groups and for most external causes of injury except falls. People with epilepsy had lower risks of dying from injury due to poisoning or traffic crashes, had higher risks of dying from suffocation and drowning.     

Pregnant woman and road safety: a numerical approach. Application to a restrained third trimester pregnant woman in frontal impact

Objectives

The goal of our work is the development of a numerical model of pregnant woman in driving position. We present an application to the study of injury mechanisms during a frontal car crash for a seat belt restrained pregnant woman in driving position.

Materials and methods

We integrated a digital representation of a pregnant uterus, foetus and placenta in a previous existing numerical model of non pregnant Human body in driving position, the Humos model^®. The realization of a numerical simulation of a frontal car crash enabled us to analyze the part played by the safety belt in the organic traumatisms.

Results

Three phases were highlighted. The first phase consists of a translation forwards of the pregnant uterus during the impact. The second phase is a rotation forwards in the sagittal plan of the pregnant uterus with for axis of rotation the posterior wall of the pubis. The third phase is a vertical adjustment coupled to a translation of the uterus towards the back. This translation leads the uterus to impact the spine.

Conclusion

The development of a pregnant numerical model in the field of accidentology allows the analysis of organic traumatisms. That makes it possible to study the role played by the existing safety systems. This model might make it possible to develop safety systems specific to the pregnant woman.     

Hematological aftermath of the radiation accident in Istanbul

Purpose: The effects of radiation exposure are long-lasting. Long-term monitoring is imperative to diagnose late effects and improve our far-sightedness about possible events in the future. A radiation accident occurred in Istanbul in 1998 that resulted in mild to moderate acute radiation syndrome (ARS). In this study we aimed to investigate the changes in hematological parameters at the long-term follow-up of ARS patients.

Methods: Ten adults were hospitalized after exposure to a 60Co source. Seven were diagnosed as having ARS and had severe and symptomatic pancytopenia. All of the exposed people recovered following intensive treatment. Treatment was supportive with transfusion, granulocyte-colony stimulating factor, and anti- infective management covering antifungal agents. Patients were closely monitored. Nine years after the accident, the initial and follow-up complete blood count examinations and peripheral blood smears (PBS) were comparatively evaluated by an experienced hematologist. The hematological laboratory values of the patients on admission, after treatment, and nine years after the accident were documented and compared.

Results: Biodosimetric analysis revealed that whole-body doses ranged from 1–1.9 Gy. All subjects have shown complete recovery of the hematological laboratory values after treatment. All but one of the subjects showed complete blood cell recovery. The improvement of the blood cell count of the excepted patient stalled at a mildly reduced level and his bone marrow was still hypocellular nine years after the accident; however, no malignant changes were detected. Values at admission were significantly different compared with post treatment and present values of all patients. Post treatment and follow-up values were similar. One of the patients died of lung cancer. None of the patients developed hematological malignancy.

Conclusions: In this study, the recovery from ARS was complete after treatment. The small population, short follow-up period, and the relatively small doses resulted in no long-term adverse effects, as would be predicted.     

从《医疗事故处理条例》的不足看医患关系建设的完善

从现行《医疗事故处理条例》的不足入手,对进一步完善医疗事故处理的法律规范作一分析探讨,并提出有效解决医疗事故,建立和完善良好的医患关系,促进我国医疗事业的发展的建议。     

北京城区院前救治的道路交通损伤特点分析

目的:描述北京急救中心2004年1月1日至2010年12月31日救治城区道路交通损伤的现状,总结其社会学特点,并初步探讨其可能的改善方法.方法:所有数据来源于北京市统计局和北京急救中心病案室,在收集后者数据时检索并录入2004年1月1日至2010年12月31日共7年期间由北京急救中心参与救治的道路交通损伤病例,应用Excel 2007、SPSS 17.0进行方差分析及卡方检验.结果:共收集符合准入标准的完整病例19 550例,道路交通伤的年发病率约为120人/10万人,死亡率约为4.97人/10万人,其中男性(11 737,60.04％)明显多于女性(7 813,39.96％),平均年龄(38.76±16.84)岁.各年龄组交通伤均多发于每年的10月份,日间多于夜间,以中午前、后最多,但不同年龄患者交通损伤发生的每日时间分布特点不同.受伤者多为行人(7 588,38.81％)和骑自行车者(3 790,19.39％),发生部位多在头面(8 343,42.68％)和下肢(6 828,34.93％),损伤程度以中等损伤为主(11 718,59.94％),造成损伤的一方多为小型汽车(11 490,58.77％).结论:防治道路交通损伤,需要针对不同人群、不同时段和不同交通方式,采用不同的管理方法和规范化的院前救治.     

汕头市与潮州市摩托车驾驶员关于头盔知识、态度和行为的比较

目的调查了解摩托车驾驶员对头盔的知识、态度和行为的现状，为预防和控制摩托车伤害提供基础资料和科学依据。方法选取加油站、小学校门口以及超市停车场等摩托车集中地的摩托车驾驶员为调查对象，采用统一的问卷对驾驶员进行现场问卷调查。结果驾驶员对摩托车头盔的知识有较高的认知程度，佩戴头盔的目的主要为预防或减轻头部受伤，汕头驾驶员的认知程度（78．2％）高于潮州（70．6％）（P〈0．01）；载客时两地60％以上的驾驶员都要求乘客佩戴头盔；在汕头市有45．1％的驾驶员觉得交警平时查得严，高于潮州市的30．6％（P〈0．01）。结论摩托车驾驶员对头盔知识的认知程度较高，对佩戴方面也有较好的态度，但佩戴率低，应探讨其中存在差异的根本原因，实施针对性的综合防治措施。     

无锡市城乡居民2001~2005年伤害死亡状况

目的分析无锡市城乡居民伤害的死亡状况和潜在寿命损失,为采取干预措施提供基础依据。方法用描述性流行病学方法对2001~2005年伤害的死亡监测资料进行分析。结果5a伤害平均死亡率为63.43/10万,在死因顺位中排第4位;按潜在寿命损失年(PYLL)排位,伤害从第4位跃居为第2位,总PYLL为38140,PYLL‰为12.36人年。居民伤害死亡的前4位死因是交通运输事故(包括机动车辆交通事故和机动车以外运输事故),跌落、自杀、淹溺;1~14岁组儿童主要以淹溺为主,占该组死亡总数的52.75%;15~54岁组死因顺位均以交通运输事故、自杀为主,分别占该组死亡总数的59.07%、51.33%;5.5岁~以跌落、交通运输事故为主,分别占31.21%、25.96%。结论伤害是无锡市居民的主要死亡原因之一,是危害青壮年人群健康和生命的最主要危险因素,对劳动力的损失影响最明显。政府必须尽快把伤害纳入疾病预防控制规划,采取有效的措施进行干预。     

大学生意外伤害自救与互救能力的评估

目的 了解大学生意外伤害的自救与互救能力,为有针对性地提高大学生意外伤害的急救与互救能力提供依据.方法 采用分层整群抽样的方法对杭州市一所综合性大学的839名大学生进行了匿名式问卷调查.结果 除触电和煤气中毒外,大学生意外伤害自救与互救技能较低;不同性别的大学生骨折、手外伤、急性扭伤、游泳时腿部抽筋与游泳时呛水的自救与互救能力间差别均有显著性意义（P＜0.05）;除中暑、灼烫伤、游泳时腿部抽筋外,各年级大学生意外伤害的自救及互救能力间差别均有显著性意义（P＜0.05）;除灼烫伤、骨折外,各专业大学生意外伤害的自救及互救能力间差别均有显著性意义（P＜0.05）;除触电外,来自于城市、乡镇、农村的大学生意外伤害的自救及互救能力间差别均无显著性意义（P＞0.05）.结论 大学生的意外伤害自救与互救技能普遍欠缺,需要通过有针对性的急救能力培训来提高其急救能力.