Search PubMed⌕ Search

Biomedical subjects

P Cummings

Publications and source records attributed to P Cummings.

87 records · Page 5Linked to original sources
PubMed1994

Infant injury death in Washington State, 1981 through 1990.

OBJECTIVE: To measure annual rates of infant injury death in Washington State and identify potential risk factors for infant injury death. METHODS: A population-based case-control study using a linked file of birth and death certificates for the years 1981 through 1990. RESULTS: The leading causes of infant injury death, per 100,000 live births, were intentional injury (9.1); suffocation, choking, or hanging (6.9); motor vehicle crashes (4.4); and drowning (3.2). Unintentional injury death rates fell steeply during the 1970s but remained steady during the 1980s. Infanticide rates rose during the 1980s. Young maternal age (odds ratio, 9.0; 95% confidence interval, 4.5 to 17.9, for age < 20 years vs age > 30 years) and higher parity (odds ratio, 5.0; 95% confidence interval, 3.1 to 8.3, for parity of two or more vs parity of zero) were associated with infant injury death. There was a twofold increase in the risk of infant injury death if the mother smoked, was black, or lived in a rural area. Male sex of the infant, late prenatal care, and low income were associated only with intentional deaths, while higher parity was more strongly associated with unintentional injury deaths. CONCLUSIONS: During 1981 through 1990, infant mortality caused by injuries increased in Washington State. Young maternal age and higher parity were strongly associated with infant injury death.

Accidents↗
PubMed1994

Antibiotics to prevent infection in patients with dog bite wounds: a meta-analysis of randomized trials.

STUDY OBJECTIVES: To determine whether prophylactic antibiotics prevent infection in patients with dog bite wounds. DESIGN: Meta-analysis of published studies. METHODS: A literature search was performed to identify published, randomized trials of prophylactic antibiotics for dog bite wounds. The relative risk for infection in treated patients compared with controls was used as the measure of effect, and a summary relative risk was calculated. RESULTS: Eight randomized trials were identified. The estimated cumulative incidence of infection in controls was 16%. The relative risk for infection in patients given antibiotics compared with controls was 0.56 (95% confidence interval, 0.38 to 0.82). About 14 patients must be treated to prevent one infection. CONCLUSION: Prophylactic antibiotics reduce the incidence of infection in patients with dog bite wounds. The full costs and benefits of antibiotics in this situation are not known. It may be reasonable to limit prophylactic antibiotics to patients with wounds that are at high risk for infection.

Animals↗
PubMed1993

A demonstration program for homeless male alcohol and other drug abusers.

The National Institute on Alcohol Abuse and Alcoholism, in consultation with the National Institute on Drug Abuse, awarded nine demonstration grants in 1988 for community-based programs addressing issues of the homeless alcohol and other drug (AOD) abusers. Project Connect in Louisville, Kentucky, was one of the nine demonstration grants. The three-year project was designed to address a multitude of needs of the homeless male AOD abuser, including housing, medical, employment/economic, and social support, in addition to treatment for AOD abuse. The present article details the evolution and implementation of Project Connect and describes characteristics of the target population. In addition, the article presents issues and problems that surfaced during program implementation in order to assist other communities that are considering similar programs for their homeless populations.

Adult↗
PubMed1992

Improving the time to thrombolytic therapy for myocardial infarction by using a quality assurance audit.

STUDY OBJECTIVE: To evaluate a program designed to improve the speed of delivery of thrombolytic therapy for myocardial infarction in an emergency department. DESIGN: Time to administer thrombolytic therapy was evaluated retrospectively in 1988. Then after physician and nurse education, time to therapy was audited in 1989 and 1990, with feedback to physicians. SETTING: A community hospital ED. PARTICIPANTS: Eight board-certified emergency physicians were monitored in their treatment of 58 patients. INTERVENTIONS: After the 1988 audit, the results for each physician were made known. Physician and nurse education was undertaken, and it was agreed to continue the audit. Nurses were encouraged to order ECGs rapidly, physicians were encouraged to make the treatment decision before consulting private physicians, and a goal of therapy in less than one hour was established. Further feedback on times was given to the physicians in 1989. MEASUREMENTS AND MAIN RESULTS: Mean time from ED arrival to thrombolytic therapy was 63 minutes in 1988, 47 minutes in 1989, and 38 minutes in 1990. This fall in time was significant (P = .0002). The number of patients treated within one hour rose from 45% in 1988 to 67% in 1989 and to 96% in 1990. CONCLUSION: Auditing time to thrombolytic therapy, combined with physician and nurse education and increased experience, can significantly improve the time to administration of thrombolytic therapy.

Humans↗
PubMed1990

Cause of death in an emergency department.

A retrospective review was done of 601 consecutive emergency department deaths. Nontrauma causes accounted for 77% of the deaths and this group had an average age of 64 years and a male to female ratio of 1.9:1. Trauma caused 23% of the fatalities and this group had a younger average age of 29 years and a male to female ratio of 4.6:1. The most common causes of nontrauma death were sudden death of uncertain cause (34%), coronary artery disease (34%), cancer (5%), other heart disease (4%), chronic obstructive lung disease (3%), drug overdose (3%), and sudden infant death syndrome (2%). The most common causes of trauma death were motor vehicle accidents (61%) and gunshot wounds (16%). The overall autopsy rate was 40%. Death certificates were often in error.

Accidents↗
PubMed1989

The mouse carbonic anhydrase I gene contains two tissue-specific promoters.

We report the isolation and characterization of the mouse carbonic anhydrase I (CAI) gene. Direct RNA sequence analysis of the 5' nontranslated regions of CAI mRNA from mouse colon and mouse erythroleukemia cells demonstrated tissue specificity in the lengths and sequences of CAI transcripts. Analysis of several mouse CAI genomic clones showed that the transcripts arose from a single CAI gene with two tissue-specific promoters and eight exons. CAI transcripts in the colon were found to initiate just upstream of the erythroid exon 2 of the CAI gene region sequence. Erythroid transcripts originated from a novel promoter upstream of exon 1, which was located more than 10 but less than 250 kilobases upstream of exon 2. Erythroid exon 1 contained only a nontranslated sequence, which was spliced to exon 2 via a cryptic splice acceptor site located in the region that encoded the colon mRNA 5' nontranslated sequence. The remaining exon-intron junctions were conserved in comparison with those of the CAII and CAIII genes.

Animals↗
PubMed1984

Congenital pernicious anemia: report of seven patients, with studies of the extended family.

Seven children ages 1 1/2 to 12 years with congenital pernicious anemia were detected in an extended Mexican family. All affected children had megaloblastic anemia accompanied by low serum B12 and normal serum folate levels. Gastric fluid analysis in six patients revealed normal gastric acidity and absent intrinsic factor. Serum antibodies to intrinsic factor or parietal cells were also absent. Schilling tests performed in six of the seven patients yielded abnormal results. Of the three patients in whom gastric biopsy was done, two had normal histologic findings (including examination by electron microscopy) and one had mild atrophy. All patients responded rapidly to parenterally administered vitamin B12 therapy. In addition, 170 family members were screened for the defect with complete blood counts and serum B12 levels. Such screening detected pernicious anemia in two of the children, but no other abnormalities that could be attributed to pernicious anemia were found in other family members. Based on the family pedigree, autosomal recessive inheritance is likely. The variability of age of presentation in this family is noteworthy and suggests that expression may be modified by still undefined factors.

Anemia, Pernicious↗
PubMed1974

Schistosomiasis mansoni in Yemeni in California: duration of infection, presence of disease, therapeutic management.

Investigations of schistosomiasis mansoni in 218 Yemeni agricultural workers in the San Joaquin Valley of California revealed a prevalence of 56%. In those infected, quantitative egg counts performed by the Kato thick smear method revealed that 57% had light infections (1-100 eggs/g), 27% moderate infections (101-400 eggs/g), and 16% heavy infections (greater than 400 eggs/g; mean--918 eggs/g). The Yemeni had been migrating to the USA for the past 20 years, a period in which the prevalence of schistosomiasis had remained constant in the Yemen. The prevalence of schistosomiasis in those who had been away from Yemen for less than 5 years was 59% with a mean egg output of 236 eggs/g, but in those away for more than 5 years (up to 20 years) it was 32% with a mean egg output of 75% eggs/g. This is in spite of the fact that 75% of the latter had returned to Yemen for short visits. Statistical analysis by the Fisher's exact probability test revealed a significantly lower egg output in those away from Yemen more than 5 years. On the basis of these findings the mean life span of the Yemen strain of Schistosoma mansoni in man was estimated to be between 5 and 10 years. The presence of disease was assessed in this population by traditional medical means without prior knowledge of the status of the infection in the individuals examined. Under these circumstances, there were no differences in symptoms such as weakness, diarrhea and abdominal pain among the uninfected proportion of the population, total infected group and a small subgroup of those most heavily infected. None of the patients had hepatomegaly and only two had splenomegaly--one lightly and the other heavily infected. Because of the toxicity of antischistosomal drugs and the lack of treatment facilities only the 22 most heavily infected (greater than 200 eggs/g) of the 122 individuals with schistosomiasis mansoni were treated with niridazole. In addition the two individuals with splenomegaly were treated with antimony dimercaptosuccinate. Side effects, though common, were not severe. Although follow-up in this migrant population was poor the nine patients examined 3 to 7 months after treatment showed a mean decrease in egg output of 97%.

Adolescent↗