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Biomedical subjects

D Beard

Publications and source records attributed to D Beard.

At least 37 records · Page 2Linked to original sources
PubMed1999

Injury analyses of fatal motorcycle collisions in south-east Scotland.

The timing of death and pathological findings in fatal motorcycle accidents in south-east Scotland between 1987 and 1997 were investigated. Of the 59 motorcyclists who died, 38 were dead when found at the accident scene, six others were alive when found but died at the scene, two died in an ambulance in transit to hospital and 13 died after reaching hospital. Scoring of the injuries according to the Abbreviated Injury Scale revealed Injury Severity Scores (ISS) ranging from 25 to 75. Overall, injuries to the head, neck and chest were responsible for the most severe injuries. Twenty-five motorcyclists had injuries acknowledged to be unsurvivable (ISS = 75), most of which involved the thoracic aorta, brainstem and cervical spinal cord. The greatest potential to reduce the death rate amongst motorcyclists lies with accident prevention/injury reduction measures, rather than through improved treatment of injuries. Efforts to try to alter driving behaviour and to improve the design of vehicles and helmets need to continue.

Abbreviated Injury Scale↗
PubMed1999

Fatal falls down stairs.

Fatal falls down stairs in south-east Scotland were studied using prospectively collected data between 1992 and 1997. 51 individuals, comprising 27 men and 24 women with mean age 68.9 years, died following falls down stairs, 30 (59%) of which were unwitnessed. 43 (84%) individuals died following falls within their own homes. Overall, 27 (53%) fatal falls resulted in death at the scene of the accident. Analysis of injuries according to the Abbreviated Injury Scale yielded injury severity scores (ISS) of between 5 and 75, but only four individuals had injuries recognised to be unsurvivable (ISS = 75). Injury to the brain and/or spinal cord was responsible for the vast majority of most severe injuries. The results demonstrate that stairs represent a significant hazard for the elderly. Most of the deaths in the pre-hospital setting appeared to be more the result of the fact that the victim was alone and unable to summon assistance, rather than as a result of unsurvivable injuries. Consideration needs to be given to both how the safety of stairs can be improved and whether a particular elderly person can safely cope with stairs.

Accidental Falls↗
PubMed1999

The association between seniority of Accident and Emergency doctor and outcome following trauma.

The actual survival of patients treated following trauma in four Scottish Teaching hospitals during five years was compared with predicted survival according to TRISS analysis. The data were analysed according to the seniority of the Accident and Emergency (A&E) doctor treating each patient. The group of patients treated by a consultant had a significantly better outcome (p < 0.05) than the group of patients treated by junior doctors. Analysis of outcome according to the grade of junior A&E doctor suggested a step-wise improvement in outcome with seniority, thus supporting the concept that an improved outcome is associated with experience and seniority. These results support calls for A&E consultants to be increasingly involved in the management of patients with major trauma. Such increased involvement would require an increase in the number of A&E consultants.

Chi-Square Distribution↗
PubMed1999

Trends in ipecac use: a survey of poison center staff.

The steady decline in syrup of ipecac used by poisoned victims from a peak of 15% in 1985 to 2.3% in 1995 is of concern. A survey compared syrup of ipecac use by CSPI, ABAT, and ABMT/ACMT members as the first response decontamination. The survey asked CSPI, ABAT, and ABMT/ACMT members their professional opinion on the use of syrup of ipecac in a potentially toxic ingestion. The scenario was "Your 2-y-old child/grandchild accidentally ingested a potentially lethal dose of poison (i.e. colchicine) 5 min ago and you have syrup of ipecac at home. Would you consider using it?" Of the 171 CSPI's who responded, 34.5% favored the use of syrup of ipecac while 63% were against and 2.3% needed more information. Of the 26 ABAT's who responded, 50% favored it's use, 42.3% would not and 7.6% needed more information. From the 55 ABMT/ACMT members who responded, 81.8% would use ipecac while 18.1% would not. ABMT/ACMT members favored the use of syrup of ipecac in this scenario (P < 0.005), while the CSPI's did not (P < 0.005), and the ABAT's did not have statistical difference. With CSPI's providing the treatment recommendations from poison centers, it is important that ABMT/ACMT members influence the recommended treatment protocols.

Child, Preschool↗
PubMed1998

Quantifying injury and predicting outcome after trauma.

The Abbreviated Injury Scale (AIS), Injury Severity Scale and TRISS methodology comprise a mathematically sound system for the analysis of injuries and injured patients. This system is of value for research and audit and has potential applications in forensic medicine, such as its use as a tool to assist the classification and analysis of injuries sustained by those injured in mass disasters.

Abbreviated Injury Scale↗
PubMed1997

Acute caffeine ingestion fatalities: management issues.

Caffeine is used and abused on a daily basis in different beverages, OTC products, and as a prescribed medication. The strength varies widely from negligible in decaffeinated drinks to medicinal grade of 200 mg/tablet. A total of 7,655 exposures were recorded in 1995 by the AAPCC Toxic Exposure Surveillance System with no fatality. However, within a 4-mo period, the Panhandle Poison Center recorded 2 deaths due to caffeine overdose. The abrupt onset of intractable seizures needs to be anticipated in order to appropriately manage the victims and to prevent the adverse outcome.

Acute Disease↗
PubMed1996

Rate, causes and prevention of deaths from injuries in south-east Scotland.

Data on all deaths after injuries in Lothian and Borders regions of south-east Scotland were collected prospectively over 2 years. Post-mortems were performed after all deaths and Injury Severity Scores (ISS) calculated. There were 331 deaths at a rate of 20 per 100,000 per year; of those who died 49 per cent were younger than 40 years and most were male; 37 per cent of deaths were caused by road traffic accidents, 16 per cent by falls and 15 per cent by hangings. Two hundred and forty-eight patients (75 per cent) were either dead when found or died instantly with unsurvivable injuries (ISS = 75). A further five patients died in the first hour after injury and before reaching hospital. Nineteen (7 per cent) died between 1 and 4 h after injury, 59 (17 per cent) died more than 4 h after. These results demonstrate the rate, causes and timing of deaths following injuries in one UK region. The pattern of these deaths differs markedly from that previously described in the US. There is no evidence to support the concept of a trimodal distribution of trauma deaths. The greatest potential to reduce the number of trauma deaths lies with prevention.

Accident Prevention↗
PubMed1996

Greater initial adaptations to submaximal muscle lengthening than maximal shortening.

The purpose of this study was to compare the short-term strength and neural adaptations to eccentric and concentric training at equal force levels. Forty-two sedentary women (age = 21.5 yr) were ranked based on the initial quadriceps strength score, and trios of subjects were randomly assigned to either an eccentric (n = 14), a concentric (n = 14), or a nonexercising control group (n = 14). Training involved a total of 824 eccentric or concentric quadriceps actions at 1.05 rad.s-1 administered in four sets of 6-10 repetitions, four times per week for 6 wk. Before and after training, all subjects were tested for unilateral maximal isometric and eccentric and concentric actions at 1.05 rad.s-1 and for a 40-repetition eccentric and concentric fatigue series of the left and right quadriceps. Surface electromyographic activity of the vastus lateralis and medialis was monitored during testing. Concentric training increased concentric (36%, P < 0.05), isometric (18%, P < 0.05), and eccentric strength (13%), and eccentric training increased eccentric (42%, P < 0.05), isometric (30%, P < 0.05), and concentric (13%) strength. Eccentric training improved eccentric and isometric strength more (P < 0.05) than did concentric training. The electromyographic adaptations were greater with eccentric training. Cross-education was 6%, and neither training mode modified fatigability. The data suggest that training of the quadriceps muscle with submaximal eccentric actions brings about greater strength adaptations faster than does training with maximal-level concentric actions in women. This greater adaptation is likely to be mediated by both mechanical and neural factors.

Adaptation, Physiological↗
PubMed1995

A transcriptional enhancer of the glutamine synthetase gene that is selective for retinal Müller glial cells.

This article demonstrates that the chicken glutamine synthetase (GS) promoter contains cis-acting elements that direct transcription to retinal Müller glial cells. The transient assay system developed to identify these elements involved electroporation of intact retinal tissue with GS-beta-galactosidase fusion genes followed by preparation of primary cultures and histochemical assay of cells expressing beta-galactosidase. Plasmids containing beta-galactosidase under transcriptional control by two different viral promoters are expressed primarily in neuronal cells after transfection of intact embryonic d 12 retina. In sharp contrast, expression is primarily in Müller glia after transfection with a GS-beta-galactosidase fusion gene. Although GS is glucocorticoid inducible, steroid hormone is not required to achieve Müller cell-selective expression of the GS-beta-galactosidase fusion gene. Deletion studies indicate that multiple cis-acting elements located between nucleotides-436 and -61 relative to the GS transcription start site contribute to produce Müller cell selectivity. Moreover, these upstream elements enhance expression of a heterologous promoter in Müller cells not neurons. These results indicate that an enhancer located between 61 and 436 nucleotides upstream of the transcription start site contributes to Müller cell-selective expression of the GS gene in the retina.

Animals↗
PubMed1994

Relational database design: evaluation of the recognition, isolation and treatment of hospitalized patients with tuberculosis.

Hospitals have been charged with the the evaluation of their abilities to identify, diagnose, isolate and treat individuals with active tuberculosis. This evaluation can be facilitated by a properly designed relational database. Using Entity Relationship diagrams, a relational data model, and the process of normalization, a database was designed that will contain the information gathered in prospective surveillance of tuberculosis in a community hospital. Although the authors' intent is to implement the design using a personal computer and a commercially available relational database management tool (Microsoft Access), the design is independent of the management tool and can be applied to other systems.

Database Management Systems↗
PubMed1994

Enhanced elimination of biotinylated antibodies by avidin-based hemoperfusion in rats.

We designed a hemoperfusion system using immobilized avidin for selective removal of biotinylated therapeutic antibodies from rats. Two prototype therapeutic antibodies, ovine antidigoxin Fab fragment and murine monoclonal 8A1 against Escherichia coli J5 lipopolysaccharide endotoxin, were biotinylated using biotin-long-chain-N-hydroxysuccinimide ester. Biotinylated antibodies were administered i.v. to anesthetized rats which were instrumented for measurement of cardiovascular parameters and connected to avidin-hemoperfusion devices. By using several different protocols of antibody administration and hemoperfusion, we found that the half-lives and areas under the time vs. concentration curves of biotinylated antibodies were reduced significantly after passage over immobilized avidin. Avidin hemoperfusion was not associated with adverse changes in blood pressure, heart rate or excess hemolysis. These data suggest that avidin hemoperfusion affords a means for selective removal of biotinylated ligands from serum, and that other therapeutic and potentially toxic compounds could be removed in this manner.

Animals↗
PubMed1992

Military surgery.

Explore the source record for details and available documents.

Australia↗
PubMed1990

Designing a radiology workstation: a focus on navigation during the interpretation task.

The potential cost and logistic improvements of picture archive and communication system (PACS) over film-based medical image management awaits the development of viable radiology workstations (RWS) targeted for the primary interpretation task. While the quality of electronically displayed images has been highly investigated, only recently have design and experimental work been devoted to the other critical aspect of workstation design, mainly its computer human interaction, and, in particular, its navigation. By RWS navigation we include its underlying mental model or metaphor, and the commands and hand motions used to access patient folders and to display images. For the last 5 years, the University of North Carolina (UNC) Medical Image Display Research Group has analyzed the primary interpretation task and designed, developed, and evaluated the FilmPlane series of RWS prototypes. This work has helped us understand both RWS requirements and viable design approaches. In this paper, we present our workstation design strategy and our observations and understanding of the issues and problems with RWS navigation. To illustrate the discussion, we describe FilmPlane2, the UNC radiology workstation. We also briefly detail three rapid-evaluation techniques (including two observer experiments) for quickly gaining feedback on a design. These observations and evaluation techniques may aid other RWS designers in producing superior tools for the clinicians.

Data Display↗