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Biomedical subjects

D Anglin

Publications and source records attributed to D Anglin.

36 records · Page 2Linked to original sources
PubMed1996

Managing law enforcement (K-9) dog bites in the emergency department.

OBJECTIVE: To review the types of injuries due to law enforcement (K-9) dog bites and address related management issues. METHODS: A case series of law enforcement dog bite victims is reported and related literature reviewed. RESULTS: Law enforcement dogs are taught a bite-and-hold technique for subduing individuals suspected of felony crimes. This bite-and-hold technique's greater applied force results in a unique spectrum of injuries, including deep puncture wounds, severe crush injuries, large tissue avulsions and lacerations, wounds necessitating surgical débridement, bony injuries ranging from cortical violations to displaced fractures, neurovascular damage, and other wounds at high risk for infection. The four reported cases highlight the types of injuries and complications associated with law enforcement dog bites. CONCLUSION: Attention to potential deep injuries of nerves, vessels, and the musculoskeletal system is essential with law enforcement dog bites. Injuries associated both with pursuit and arrest and with the bites themselves must be identified and assessed. Guidelines for the ED treatment of patients with law enforcement dog bite injuries are proposed.

Adolescent↗
PubMed1996

HIV risk behaviors among women in methadone maintenance treatment.

This article reports on the HIV risk behaviors of a sample of 158 women heroin addicts admitted into the Los Angeles Enhanced Methadone Maintenance Project. Risk behaviors for HIV were associated with age, lack of education, ethnicity, relationship with a drug user, HIV status, and higher scores on measures of illegal activity, suicidality, depression, polydrug use, and alcohol use. Significant reductions in number of male sex partners and needle-sharing partners were reported at follow-up, although frequency of condom use was unchanged. Methadone maintenance programs need to screen women for risk factors and assist them in developing new behavioral skills in order to implement a harm reduction approach to treatment.

Adult↗
PubMed1995

The epidemic of gang-related homicides in Los Angeles County from 1979 through 1994.

OBJECTIVE: To determine trends in gang homicides and the population at greatest risk for homicide by reviewing all gang-related homicides in Los Angeles County, California, from January 1979 to December 1994. DESIGN: Homicide files of the Los Angeles Police Department and the Los Angeles County Sheriff's Department from 1979 to 1994 involving violent street gang activity were reviewed. Gang files were reviewed for demographic data, weapons used, homicides by drive-by shootings, and times and geographic areas of occurrence. SETTING: Los Angeles County from January 1, 1979, to December 31, 1994. MAIN OUTCOME MEASURES: Age, race, and sex of gang-related homicide victims; frequency of weapon use; and the change in gang-related homicide rates during the study period. RESULTS: A total of 7288 gang-related homicides occurred in Los Angeles County from 1979 through 1994; 5541 of these homicides occurred in Los Angeles Police Department and Los Angeles County Sheriff's Department jurisdictions. During the study period, the proportion of all homicides that were gang related increased from 18.1% to 43.0% (P < .001). Of the 5541 gang-related homicide victims, 4580 (85.6%) were aged 15 to 34 years, 93.3% were African American or Hispanic, 5157 (93.2%) were male, 3559 (64.2%) were gang members, and 1408 (25.4%) occurred during drive-by shootings. Firearms were used in an increasing proportion of homicides, from 71.4% in 1979 to 94.5% in 1994. Homicides by semiautomatic handguns dramatically increased during the study period. Gang-related homicide rates for African-American males aged 15 to 19 years increased from 60.50 per 100,000 population per year in 1979 to 1981 to 192.41 per 100,000 population per year in 1989 to 1991. CONCLUSIONS: Gang-related homicides in Los Angeles County have reached epidemic proportions and are a major public health problem. To prevent gang violence, the root causes of violent street gang formation must be alleviated, the cycle of violent street gang involvement must be broken, and access to firearms must be limited.

Adolescent↗
PubMed1995

Lisfranc fracture-dislocation: a frequently missed diagnosis in the emergency department.

Lisfranc fracture-dislocations are rare, and their correct diagnosis is important. Misdiagnosis is common and can lead to grave, chronic disability. We present two cases of Lisfranc fracture-dislocation to highlight the mechanisms of injury, clinical presentation, diagnosis, and treatment. Accurate diagnosis by emergency physicians with early orthopedic referral and evaluation are essential because surgery is often necessary for optimal results.

Adult↗
PubMed1995

Drive-by shootings.

Gang violence has reached epidemic proportions in Los Angeles and is occurring with increasing frequency in many other US cities. Gang members and innocent bystanders often suffer severe and sometimes fatal injuries in drive-by shootings. We present the case of one such innocent victim and discuss the personal and societal ramifications of drive-by shootings.

Adolescent↗
PubMed1995

The perspectives of violent street gang injuries.

Street gang violence has become a major public health problem in the United States, especially in the inner city. To prevent gang violence, one must understand the many facets of violent street gang activity and the psychological effects of gang violence on individuals as well as on the community. Further, one must have an understanding of the root causes of violent street gang formation, the relationship of firearms to gang violence, and the medical cost of these types of injuries. Prevention should begin with alleviating the root causes of violent street gang formation and include breaking the bonds of violent street gang membership. Adults acknowledge a societal obligation to protect and guide children and adolescents as an investment in the future. Because both children and adolescents lack judgment and experience, they cannot be expected to avoid injury and violence on their own. Although the financial cost of preventing gang violence would not be insignificant, the savings in terms of lives and medical expenditure would be immense. Unless steps are taken to end the physical and psychological trauma, regions of the United States, such as Los Angeles County, will not be safe from the effects of gang violence.

Humans↗
PubMed1994

Adolescents and children injured or killed in drive-by shootings in Los Angeles.

BACKGROUND: Drive-by shootings by violent street gangs contribute to early morbidity and mortality among adolescents and children in Los Angeles. This study attempted to determine the frequency of this problem and the population at greatest risk. We also studied the most frequently injured areas of the body, the seasons in which the most shootings occurred, the most common sites for drive-by shootings, and the types of firearms used. METHODS: We retrospectively reviewed the files of the Gang Information Section of the Los Angeles Police Department to identify all drive-by shootings in Los Angeles in 1991 in which a child or adolescent under the age of 18 was shot at, injured, or killed. RESULTS: A total of 677 adolescents and children were shot at, among whom 429 (63 percent) had gunshot wounds and 36 (5.3 percent) died from their injuries. Three hundred three of those with gunshot wounds (71 percent) were gang members. Arms and legs were the areas of the body most commonly injured. Handguns were the most frequently used type of firearm. All the homicide victims were African American or Hispanic, and 97 percent were boys. African American and Hispanic children and adolescents, especially male gang members, had a significantly higher risk than their Asian and white counterparts of injury and death from drive-by shootings in Los Angeles (P < 0.001). CONCLUSIONS: Drive-by shootings involving adolescents and children are frequent in Los Angeles. Although Los Angeles may be an atypical case, understanding why violent street gangs form, preventing causes of violence, and limiting access to firearms are essential steps in preventing this serious problem.

Adolescent↗
PubMed1994

Residents' perspectives on violence and personal safety in the emergency department.

STUDY OBJECTIVE: To assess emergency medicine residents' perspectives on violence and personal safety in the emergency department. DESIGN AND PARTICIPANTS: Survey of all 461 current emergency medicine residents and 1992 graduates in the 13 emergency medicine residency programs in California. RESULTS: Eighty-five percent of residents responded to the survey questionnaire. Sixty-two percent of respondents worry about their own safety while working in the ED. The majority of these respondents (72%), however, most fear a needlestick injury from an HIV-positive patient. Fifty percent of the respondents believe that their hospital/residency programs do not provide adequate security in the ED. Respondents overwhelmingly favor some form of gun control legislation. CONCLUSION: Violence and personal safety in the ED are major concerns of emergency medicine residents.

Attitude of Health Personnel↗
PubMed1994

An unusual cause of hand trauma in the emergency department.

Leprosy was once a severely mutilating and incapacitating disease with little hope for the afflicted. Today, patients with leprosy do not suffer from the obvious deformities seen in earlier days, so recognition of this disease has become more difficult. We report the case of a man with no previous disabilities who presented to the emergency department with acute unintentional hand trauma secondary to peripheral neuropathy caused by leprosy.

Acute Disease↗
PubMed1993

A 24-year follow-up of California narcotics addicts.

OBJECTIVE: This study examined longitudinal patterns of narcotics use, other substance use, criminal involvement, morbidity, and mortality among narcotics addicts. DESIGN: A 24-year follow-up study. Data were obtained from admission records and two face-to-face interviews conducted in 1974-1975 and 1985-1986. PARTICIPANTS: Five hundred eighty-one narcotics addicts admitted to the California Civil Addict Program during the years 1962 through 1964. RESULTS: Most of this sample initiated narcotics use before age 20 years and had a mean age at program admission of 25.4 years. In 1974-1975, 13.8% of the sample died and 28.6% tested negative for opiates. Corresponding rates in 1985-1986 were 27.7% and 25.0%, respectively. Substance use and criminal involvement remained high among this sample into their late 40s. In any given year during the 10 years prior to the 1985-1986 interview, less than 10% of the sample participated in community-based treatment programs such as methadone maintenance. Disability, long periods of heavy alcohol use, heavy criminal involvement, and tobacco use were among the strongest correlates of mortality. CONCLUSIONS: The results suggest that the eventual cessation of narcotics use is a very slow process, unlikely to occur for some addicts, especially if they have not ceased use by their late 30s.

Adult↗
PubMed1993

Unrecognized cocaine use among schizophrenic patients.

OBJECTIVE: Unrecognized stimulant use could lead to the misdiagnosis of schizophrenia or the misunderstanding of its course and prognosis. This study was conducted to determine the prevalence of unrecognized stimulant use among patients with a clinical diagnosis of schizophrenia. METHOD: The subjects were 108 schizophrenic patients admitted consecutively to a Veterans Affairs psychiatric hospital. Admitting psychiatrists supplemented routine clinical evaluations with a semistructured interview regarding recent and lifetime use of alcohol, cocaine, amphetamine, marijuana, and opiates. A urine specimen was assayed for the four illicit drugs. RESULTS: Of the 103 patients who provided a urine specimen, 37 (36%) used cocaine during the 6 months before admission, including 31 who used the drug in the week before admission. Because of the poor reliability of negative self-reports of recent cocaine use, clinicians failed to recognize cocaine use in one-third of the patients with a urine toxicology positive for cocaine metabolites. Two other groups of patients were identified; schizophrenic patients without substance abuse (including alcohol) and schizophrenic patients with substance abuse other than stimulants. Both substance-abusing groups were younger than the nonabusing group, but the three groups had similarly high rates of recent psychotic symptoms, homelessness, and unemployment. CONCLUSIONS: Among schizophrenic patients who require hospitalization, clinicians should not rely solely on self-reported stimulant use. Recognition of stimulant use could be improved through routine urine toxicologies for all psychotic patients. The authors suggest that recognition of stimulant use among schizophrenic patients may identify a population with a better prognosis for schizophrenia and different treatment needs.

Adult↗
PubMed1992

Minimizing gang violence in the emergency department.

Street gang members are frequently injured, and the violence of their subculture may follow them from the streets into the emergency department. We present four cases in which in-hospital gang violence occurred or was prevented. To decrease the risk of injury from gang-related violence within the hospital, we offer guidelines for patient care and health care provider safety. Emphasis is on education, awareness, and early hospital security involvement.

Adolescent↗
PubMed1983

Severe lithium intoxication treated by forced diuresis.

In a woman who had been in coma for 4 days because of severe lithium intoxication forced diuresis led to full recovery. Forced diuresis is simpler than hemodialysis and may be as effective in some patients with severe lithium intoxication.

Acute Disease↗