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Biomedical subjects

D Fife

Publications and source records attributed to D Fife.

At least 55 records · Page 3Linked to original sources
PubMed1985

Projected mortality from injuries.

Illustrative projections of mortality from injuries, all accidents and motor vehicle crashes were developed based on current mortality rates. If exposure to existing injury sources is unchanged and unless more effective injury prevention countermeasures are employed, 8 million injury deaths may be expected to occur among the resident population of the United States alive in 1980. These deaths include nearly 2 million motor vehicle fatalities and more than 5.6 million deaths from all accidents.

Accidents↗
PubMed1985

Northeastern Ohio Trauma Study III: incidence of fractures.

To determine the frequency with which fractures are encountered in emergency care and to estimate the incidence of fractures in a well-defined population, a population-based sample of emergency department (ED) visits was examined. Eleven percent of ED visits for trauma involved fractures. The incidence of fractures was 21 per 1,000 persons per year and had two peaks, the first at ages 10 to 14 and the second at ages greater than 60. Among young people, falls (often related to sports or recreation), striking objects, motor vehicle injuries, and assaults were the major causes of fractures. Among the elderly, falls caused 87% of all fractures.

Accidents↗
PubMed1985

Empirical development and evaluation of prehospital trauma triage instruments.

The field identification of the patients who should be taken to trauma centers is a major problem of trauma care. This study appears to be the first to use multivariate analysis to systematically design a field triage instrument and to evaluate its performance in terms of a meaningful and plausible criterion for which patients ought to be treated at trauma centers. Four new triage instruments were created and their performance compared to that of two existing measures, the Trauma Score and the CRAMS scale. The new measures appear to perform better than the best of existing instruments tested, although independent validation is necessary. The one purely physiologic instrument tested appeared to be inferior to instruments that included anatomic and historic as well as physiologic indices. Simple checklists performed approximately as well as weighted scales. No instrument was found to be high in both sensitivity and positive accuracy.

Adolescent↗
PubMed1985

Survival times and case fatality rates of brain-injured persons.

Survival time after injury (the time from injury to death) imposes an important constraint on the timing of the delivery of postinjury medical care. From a population-based study of brain-injured people, the survival times in 542 cases with fatal outcomes were studied. Prehospital deaths as well as hospital deaths were included. Survival times were considerably shorter for 95 people with untreatable injuries (Abbreviated Injury Scale level 6) than for the remaining 447 whose injuries were potentially treatable. For the former group, the median survival time was 10 minutes; for the latter, it was 2 hours. For those with potentially treatable injuries, the median time from injury to receiving medical assistance was approximately 30 minutes and 82% received medical assistance within 1 hour of injury. Short survival time was associated with prehospital death, young age, high Injury Severity Score, and having a nonbrain injury as the most severe injury. For patients who arrived alive at a hospital, intracranial surgery was associated with increased survival time.

Brain Injuries↗
PubMed1985

Slipped capital femoral epiphysis in growth hormone-deficient patients.

Slipped capital femoral epiphysis (SCFE), a potentially disabling hip disorder, occurs primarily during the pubertal growth spurt. It has been reported in association with pituitary gigantism, growth hormone deficiency, hypothyroidism, hypogonadism, and panhypopituitarism. We estimated the frequency of SCFE among children with growth hormone deficiency (treated or untreated) and compared it with the reported frequency of SCFE among Connecticut residents under 25 years of age. Based on this comparison, the risk of developing SCFE is significantly greater in growth hormone-deficient children than in the general population.

Adolescent↗
PubMed1985

Incidence, external causes, and outcomes of work-related brain injuries in males.

Little published information is available on the incidence of brain injury from work-related activities. A study of brain injury of residents of San Diego County, California, showed that the overall work-related injury rate for males was 19.8 per 100,000 workers (45.9 per 100 million hours). The incidence rates for male civilian and military personnel were 15.2 and 37.0 per 100,000 workers, respectively. In addition, the annual incidence of such injuries was 9.9 per 100 million work hours for males in the work force (18.5 per 100 million hours for military personnel and 7.6 per 100 million hours for civilians). Among military personnel, more than half of all work-related brain injuries were transportation related, primarily from off-road vehicles. Among civilians, more than half were due to falls. For both the military and civilian groups, work-related brain injury rates were markedly higher among young workers than among older ones.

Accidents, Occupational↗
PubMed1984

Effect of alcohol intoxication on the diagnosis and apparent severity of brain injury.

Because alcohol intoxication is common among brain-injured patients, we performed this study to determine the extent to which alcohol alters the initial assessment of brain injury severity in these patients by depressing the level of consciousness. The Glasgow coma scale was used to measure the level of consciousness of 257 brain-injured adults admitted to the University of Virginia Hospital, both on arrival in the emergency room and 6 to 10 hours later. Improvement in the level of consciousness between the first and second measurements was significantly related to the blood alcohol concentration on admission. Patients with the highest blood alcohol concentrations showed the greatest improvement. Most of this effect occurred in patients with a blood alcohol concentration of 0.20% or higher. Alcohol intoxication is a potential source of bias in the clinical classification of brain injuries according to severity.

Adolescent↗
PubMed1984

The role of motor vehicle crashes in causing certain injuries.

Hospital discharge data from Rhode Island were used to assess the role of motor vehicle crashes in causing several types of serious injuries. Motor vehicle crashes were the cause of injury for approximately two-thirds of patients hospitalized with injuries to the chest organs, liver, and spleen, and approximately one-third of those with traumatic pneumothorax or hemothorax, and injuries to the head, kidney, intestine, distal femur, pelvis, and patella.

Accidents, Traffic↗
PubMed1984

Northeastern Ohio Trauma Study: II. Injury rates by age, sex, and cause.

Using a 1977 sample of emergency department visits in five northeastern Ohio counties, population-based injury rates are tabulated by age, sex, and cause. Case fatality ratios are estimated by comparing these injury rates with population-based mortality rates for 1976-1978. For all age and sex groups, injuries are a major cause of emergency department visits. Falls, striking, cuts, and motor vehicle crashes are the leading causes of injury. Case fatality ratios for motor vehicle crash injuries are considerably higher than those for non-transport injuries. Injury rates and case fatality ratios for males exceed those for females except among the elderly. With increasing age, injury rates decline but the fraction of injuries leading to hospital admission or to fatality rises sharply.

Accidents, Home↗
PubMed1984

The contribution of brain injury to the overall injury severity of brain-injured patients.

Several recent population-based studies of the incidence of head injury have identified cases by screening hospitalized patients. This method assumes a close relationship between severity of head injury and overall injury severity, since it is the latter that determines hospital admission. Thus, a patient whose overall injury severity is high will be admitted to the hospital regardless of the degree of his head injury. Similarly, since a patient's outcome status after treatment depends on his response to all his injuries, studies of the prognosis of various types of head injury also assume a close relationship between head injury severity and overall injury severity. The present study examines the relationship between brain injury severity and overall injury severity in a series of hospitalized head-injured patients with evidence of actual or probable brain trauma. Among these patients, brain injury severity was closely related to overall injury severity. Head injury severity and head and neck injury severity were also closely related to overall injury severity. For all other body regions, injury severity was not closely related to overall injury severity in this group of patients.

Adolescent↗
PubMed1983

Evaluation of clinical data in childhood asthma. Application of a computer file system.

A computer file system was used in our pediatric allergy clinic to assess the value of chest roentgenograms and hemoglobin determinations used in the examination of patients and to correlate exposure to pets and forced hot air with the severity of asthma. Among 889 children with asthma, 20.7% had abnormal chest roentgenographic findings, excluding hyperinflation and peribronchial thickening, and 0.7% had abnormal hemoglobin values. Environmental exposure to pets or forced hot air was not associated with increased severity of asthma, as assessed by five measures of outcome: number of medications administered, requirement for corticosteroids, frequency of clinic visits, frequency of emergency room visits, and frequency of hospitalizations.

Adolescent↗
PubMed1983

Two fatal bicyclist injuries from extended rear view mirrors.

Rear view mirrors mounted on the sides of vans and small trucks may extend beyond the sides of the vehicles and pose a hazard to other road users. Case reports of two bicyclists fatally injured by extended rear view mirrors of small trucks are presented.

Accidents, Traffic↗
PubMed1983

Prevalence of salt-losing among congenital adrenal hyperplasia patients.

Among clinic patients with congenital adrenal hyperplasia (CAH) the observed frequency of salt-losing has increased significantly over the past 30 years. Comparing estimates from various clinics, older estimates of the frequency of salt-losing are lower than estimates cited in more recent literature. Within the patient population of a single long-established clinic, an increase in the frequency of salt-losing can also be observed. It is likely that the increase in the frequency of salt-losing CAH reflects improved case finding and survival of salt-losing patients. Based on reports of recent populations of CAH patients, the frequency of salt-losing among CAH patients is approximately 66%.

Adolescent↗
PubMed1983

Northeastern Ohio trauma study: I. Magnitude of the problem.

This study measured the incidence of cause-specific trauma in the Cleveland and Lorain-Elyria Standard Metropolitan Statistical Areas (SMSAs), population 2.2 million, as reported to hospital emergency departments (ED). Cases were selected according to a stratified probability sampling plan (N = 9268). The participating hospitals accounted for 97.6 per cent of 903,346 ED visits in 1977; 52 per cent of these visits were for trauma (ICDA-8 E800-E999). The trauma incidence rate was 197 per 1,000 population. The six leading causes of injury were: falls, 24.4 per cent; cut/piercing injury, 14.2 per cent; striking or struck by object, 13.8 per cent; motor vehicle collisions (MVC), 11.6 per cent; overexertion/strain, 8.2 per cent; and assault, 4.3 per cent. Only falls, MVCs, and assaults were leading causes of both injury and death. The injury incidence rates for vehicular crashes and assault were 1.4 and 3.8 times higher, respectively, than the official incidence rates for these SMSAs. These differences point to a significant underreporting of data needed for public health decision making. Because data were not collected on cases treated outside the participating hospitals, the incidence rates reported here represent a conservative estimate of the magnitude of the problem.

Accidents↗
PubMed1983

Fatal injuries to bicyclists: the experience of Dade County, Florida.

Among 173 fatally injured bicyclists, the head or neck was the region most seriously injured in 86%. The frequency of injury to the head and neck region and the frequency of nonsurvivable (AIS 6) injury were highest among the cases aged 16 years or less. Vertebral fractures occurred most often in the highest cervical vertebra (C1) and progressively less often in lower vertebrae. The relationship between vertebral position and fracture likelihood is approximately log linear. Bicyclists with a relatively long time from injury to death tended to be older persons with survivable injuries. They often died from complications (pneumonia, pulmonary embolus) rather than directly from their injuries.

Accidents, Traffic↗
PubMed1981

Relative mortality of unbelted infant passengers and belted non-infant passengers in air accidents with survivors.

Aircraft accidents with survivors were examined to determine the relative risk of mortality for unrestrained infant passengers vs seat-belted adult passengers. The crude relative risk was estimated to be 7.1, based on US data, and 7.4, based on worldwide data. More refined estimates allow for possible effect of seat location and for differences in lethality between crashes. Using such estimates, unbelted infant passengers have relative risk of 5.9 based on US data and 9.6 based on worldwide data. The injury experience of restrained vs unrestrained automobile passengers suggests that observed excess risk to infant air passengers may be related to the absence of a mechanical restraint system. Recommendations for a mechanical restraint system are made and the cost and benefits of implementing these recommendations in the US are discussed.

Accidents, Aviation↗
PubMed1980

Urine C-peptide, beta-cell function, and insulin requirement.

Urinary C-peptide excretion was investigated as a method for monitoring beta-cell function in diabetic patients and for studying the contribution of endogenous insulin production to diabetic control. Control subjects had variations in serum and urine C-peptide immunoreactivity that correlated with basal and meal-related insulin secretion. In a group of well-controlled juvenile diabetic patients, those receiving high doses of insulin had low or negligible C-peptide excretion, whereas most patients with low exogenous insulin requirements had near-normal urinary C-peptide excretion. Patients treated for diabetic ketoacidosis had recovery of beta-cell function as measured by C-peptide immunoreactivity in serial urine specimens. Thus, measurement of urinary C-peptide excretion is a simple technique that may be useful in assessing endogenous insulin production in juvenile diabetic patients.

Adolescent↗