Search PubMed⌕ Search

Biomedical subjects

R K Requa

Publications and source records attributed to R K Requa.

At least 19 recordsLinked to original sources
PubMed1993

Influence of time until emesis on the efficacy of decontamination using acetaminophen as a marker in a pediatric population.

STUDY OBJECTIVE: To determine the extent of drug removal by emesis at different times after the ingestion of a toxic substance. DESIGN: Multicenter retrospective chart review. METHODS: Using the American Association of Poison Control Centers' aggregate data base, children who had ingested acetaminophen and who were referred to a health care facility by one of 11 poison centers during a two-year period were identified. Charts of these patients were reviewed to determine the quantity ingested per kilogram of body weight, method of decontamination used, the timing of decontamination, and the serum acetaminophen concentration obtained four hours after ingestion. RESULT: Charts of 455 patients met all requirements for inclusion. When emesis occurred within one-half hour after ingestion, mean serum acetaminophen concentration drawn four hours after ingestion was approximately half that in a control group that received no decontamination. Emesis had less impact when it was delayed further and had no demonstrable impact when it occurred more than 90 minutes after ingestion. CONCLUSION: Many factors must be considered when deciding if and by what method a given patient should receive decontamination. When delayed gastric emptying is not expected, emesis can at best decrease a toxic burden by half if it occurs early. Medical care givers must continue to scrutinize management practice to ensure that syrup of ipecac is given only in situations in which it is likely to make a difference in outcome and in which it is the most effective agent to achieve this goal.

Acetaminophen↗
PubMed1990

A review of the use of prophylactic knee braces in football.

A review of nine studies of prophylactic knee braces worn by players in American tackle football lends some support for the use of double-hinged braces at the high-school level. Evidence for their use at the college level seems less persuasive. Caution should be exercised in interpreting these studies owing to the probable presence of bias and confounding variables and to difficulty in generalizing results beyond the study populations. The two studies that assigned braces randomly found lower injury rates for knees and knee ligaments among high-school and high-school size players. Conversely, a large, multiteam collegiate study found a significantly higher rate of knee injuries among brace users, a difference that remained when controlled for position, skill, and previous injury.

Adolescent↗
PubMed1990

Clinical significance and evaluation of prophylactic knee brace studies in football.

A review of nine studies of prophylactic knee braces in American tackle football found some support for the use of double-hinge braces in high school but little support for their use at the collegiate level. Problems with bias and confounding make it necessary that caution be exercised in the interpretation of the results of these studies, however,. To which groups these results might apply must also be considered. The two studies that assigned braces randomly found lower injury rates among high school and high-school-sized players for knee injuries and knee ligament injuries. Conversely a large, multiteam collegiate study found a significantly higher rate of knee injuries among brace users, a difference that remained when controlled for position, skill, and previous injury.

Bias↗
PubMed1989

The epidemiology of foot and ankle injuries in sports.

A 6 1/2-year review of 16,754 injuries seen in a multispecialty sports medicine clinic found that 25 per cent of the 12,681 injuries in the top 19 sports occurred at the ankle and foot. The percentages of foot and ankle injuries varied substantially from sport to sport, as did the proportion of sprains versus overuse injuries at each location. An appreciation of the patterns and numbers of injuries presenting can be helpful in patient management and can aid the planning of both clinical investigations and educational programs.

Ankle Injuries↗
PubMed1988

Prophylactic knee bracing.

Six studies to determine the effectiveness of prophylactic knee braces in preventing medial collateral ligament (MCL) injury in football are compared. Criteria useful in evaluating studies are discussed, such as the probability of confounding factors, bias in selecting cases and controls, and variations in defining injury and exposure. Cost, as well as some ethical issues associated with mandated use are discussed. While four of these studies found a reduction in MCL injuries associated with using a brace, two of them reported increases. No consensus arises from these studies, conflicting results as well as methodological problems in some make it impossible to state with assurance the role of prophylactic knee bracing in football at this time.

Athletic Injuries↗
PubMed1988

The epidemiology of foot and ankle injuries in sports.

A 6 1/2-year review of 16,754 injuries seen in a multispecialty sports medicine clinic found that 25 per cent of the 12,681 injuries in the top 19 sports occurred at the ankle and foot. The percentages of foot and ankle injuries varied substantially from sport to sport, as did the proportion of sprains versus overuse injuries at each location. An appreciation of the patterns and numbers of injuries presenting to a sports medicine facility can be helpful in patient management and can aid the planning of both clinical investigations and educational programs.

Ankle Injuries↗
PubMed1985

Noninvasive vascular studies in management of rattlesnake envenomations to extremities.

Twenty-five consecutive patients suffering rattlesnake envenomation to an extremity underwent noninvasive vascular arterial studies using contralateral extremities as controls. All but one received antivenin, and none underwent early surgical decompression. Pulse volume amplitudes in the envenomated extremities, reflecting pulsatile arterial blood flow, were increased in 24 of 25 patients (P less than .02) in spite of edema and discoloration. Ischemia requiring surgical procedures developed in three of seven patients with decreased skin temperatures, as compared to none of 18 with increased or mixed skin temperatures on the envenomated extremity (P less than .02). One of 24 survivors suffered a functional deficit. Most victims of rattlesnake bites have increased arterial pulsatile blood flow in an envenomated extremity and do well with medical therapy. Noninvasive arterial studies help select those who are more likely to require special surgical intervention.

Adolescent↗
PubMed1985

Daily vs alternate day prednisone therapy for stage II sarcoidosis.

Forty-four patients with newly discovered biopsy-proven pulmonary sarcoidosis in roentgenographic stage II (adenopathy and interstitial abnormalities) who also had abnormal pulmonary function (TLC and/or DCO less than 80 percent predicted) were assigned in alternate sequence to either a daily or alternate day prednisone treatment protocol. Both groups showed statistically significant improvement in pulmonary function (TLC, FVC, FEV1, DCO) at three or six months, but there were no significant differences between the two groups. Radiographic adenopathy and interstitial scores (interpreted by blinded readers in random sequence according to a quantitative scale) also showed significant improvement in both groups at three or six months, and again no significant difference was noted between the two groups. Thus, both daily and alternate day prednisone regimens were effective therapy for stage II sarcoidosis. Alternate day therapy may be the treatment of choice for those patients at high risk for significant adverse steroid effects.

Adult↗
PubMed1978

Girls' sports injuries in high school athletics.

Because of appreciable increases in the number of participants, injuries resulting from girls' interscholastic athletic activities have become a concern for school administrators and medical care providers. Four girls' high school athletic programs were prospectively studied for two years. Specially trained athletic trainers placed at each school examined each injured athlete and collected epidemiologic data. The 870 participant-seasons in nine sports resulted in 192 injuries. Three times more injuries occurred in practices than in competitive events. Although more than one third required a physician's services, the majority (59%) had returned to full athletic activity within a week of injury. Strains and sprains accounted for nearly two thirds of the injuries. Generally, the type and frequency of injuries were comparable with those seen in noncontact boys' interscholastic sports.

Adolescent↗
PubMed1978

Injuries in high school sports.

A two-year study was made of injuries received in high school sports. Athletic trainers were placed in four high schools to conduct the investigation. Injuries occurred in women's sports at a rate of 22 per 100 participants; men's injuries occurred at a rate of 39 per 100 participants. Football and wrestling accounted for the highest injury rates; tennis and swimming accounted for the lowest rates for both sexes.

Athletic Injuries↗
PubMed1977

Parameters of injury reporting in skiing.

An injury survey of 505 skiers from the 1971-72 and 5,459 skiers from thh 1972-73 season collected 601 time loss injries for a rate of 9.31000 skier days. Forty percent of these injuries were reported to a ski patrol and almost 60 to physicians. Fractures and lacerations were reported to the patrol more frequently than other injury types, bruises and strains less commonly. Injuries not reported to patrols and physicians were primarily bruises, sprains and strains. Although fractures were almost invariably reported to physicians, one in four was not seen by the ski patrol. Patrol-only or physician only reported injuries thus do not represent the full spectrum of time loss skiing injuries.

Adolescent↗
PubMedDate not supplied

Disability days in major league baseball.

We have examined the injury experience in Major League Baseball as reflected by the disabled list, based on data presented by American Specialty Companies in their publications, to examine any changes in injury rates over the past 11 years. It is reasonable to expect that improvements in training and conditioning, diagnostic methods, and surgical treatment over the last 11 years would have reduced injuries and resulted in fewer players on the disabled list. Yet, such does not appear to be the case. There is no evidence that the number of injuries in Major League Baseball has declined over the last decade; on the contrary, it appears that both the number of players and player days on the disabled list have increased. Team membership, injury location, and position do not appear to be related to the increase. Nor does it appear that the increase in injuries is a result of more sensitive diagnostic tests allowing the diagnoses of previously unrecognized injuries. Whatever the reason, it is significant that publicly available data, when viewed over an 11-year period, reveal a gradual and consistent increase in reported injuries--suggesting a problem that deserves attention.

Absenteeism↗
PubMedDate not supplied

Injury patterns in children and adolescent skiers.

Over 3,500 students from five major high schools in the Seattle metropolitan area were studied as to skiing injuries. Each had skiied an average of 13.3 days. The average age of t'he group was 13.5 years, the ages ranging from 3 to 19 years. The students 10 years and under had the lowest incidence of injuries, those aged 11 to 14 years had the highest over-all injury rates, and the group 15 years of age and over laid midway between these two groups in injury rate. There was no evidence in the study that the open physis led to a higher incidence of epiphyseal injuries. The knee was more commonly involved than the ankle, and sprains, contusions, and fractures followed in that order as far as injury rates were concerned. The female was more prone to injury than the male. Skiiers with greater ability had fewer injuries than those with less skill in this particular sport.

Adolescent↗