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At least 595 records · Page 33Linked to original sources
PubMed2005

Utilizing the urinary 5-HTOL/5-HIAA ratio to determine ethanol origin in civil aviation accident victims.

Specimens from fatal aviation accident victims are submitted to the FAA Civil Aerospace Medical Institute for toxicological analysis. During toxicological evaluations, ethanol analysis is performed on all cases. Care must be taken when interpreting a positive ethanol result due to the potential for postmortem ethanol formation. Several indicators of postmortem ethanol formation exist; however, none are completely reliable. The consumption of ethanol has been shown to alter the concentration of two major serotonin metabolites, 5-hydroxytryptophol (5-HTOL) and 5-hydroxyindole-3-acetic acid (5-HIAA). While the 5-HTOL/5-HIAA ratio is normally very low, previous studies using living subjects have demonstrated that the urinary 5-HTOL/5-HIAA ratio is significantly elevated for 11-19 h after acute ethanol ingestion. Recently, our laboratory developed and validated an analytical method for the simultaneous determination of both 5-HTOL and 5-HIAA in forensic urine samples using a simple liquid/liquid extraction and LC/MS/MS and LC/MS/MS/MS. In this previous work a 15 pmol/nmol serotonin metabolite ratio cutoff was established in postmortem urine, below which it could be conclusively determined that no recent antemortem ethanol consumption had occurred. In the current study this newly validated analytical method was applied to five ethanol-positive aviation fatalities where the origin of the ethanol present could not previously be conclusively determined. In four of the five cases examined the detected ethanol was demonstrated to be present due to postmortem microbial formation, and not consumption, even though some indication of ethanol consumption may have been present.

Accidents, Aviation↗
PubMed2004

The privatization of human services: myths, social capital and civil society.

It is fashionable to point to privatization and the involvement of for-profits as the parties responsible for many, if not most, of the ills that plague the social welfare system today. This article takes a contrary point of view. Three arguments are made. First, private sector human service delivery and the use of for-profits in the United States predate privatization as a defined public policy. Second, the privatization of the human services is a world wide phenomenon that transcends politics and ideology. Third, the privatization of human services helps to promote civil society and generate social capital.

Government Agencies↗
PubMed2005

[Analysis of risk factors of the occurrence of drug resistance in patients with tuberculosis from civil and penitentiary sectors in the Samara Region].

The true prevalence rates of multidrug-resistant tuberculosis (MDRT) are unknown for most regions of Russia. This study was conducted in the Samara Region that differs from other regions in the rapid spread of HIV infection. The purpose of this study was to determine the primary and acquired resistance of Mycobacterium tuberculosis (MBT) to first-line antituberculous drugs in patients from civil and penitentiary sectors and to reveal risk factors of drug resistance of MBT. Six hundred patients (309 civilians and 291 prisoners who had been bacteriologically diagnosed as having tuberculosis. The authors have established the following:--in new cases, primary drug resistance is as follows: to isoniazid [38.9% (95% CI, 31.3-36.9%)], to rifampicin [25.9% (95% CI, 19.4-33.4%)] and to MDRT [23.0% (95% CI, 16.7-30.3%)];--in prisoners, the primary resistance of MBT was statistically more significant than in civilians;--male sex, in adequate prior or current treatment for tuberculosis for more than 4 weeks, the presence of fibrocavernous tuberculosis and previous prison stay are essential risk factors of the development of resistance of MBT to both any first-line drug and MDRT;--HIV infection is unassociated with resistance.

Adult↗
PubMed2005

Civil money penalties: procedures for investigations, imposition of penalties, and hearings--extension of expiration date. Final rule.

An interim final rule establishing procedures for the imposition, by the Secretary of Health and Human Services, of civil money penalties on entities that violate standards adopted by the Secretary under the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was published on April 17, 2003. The interim final rule expires on September 16, 2005. This regulatory action extends the expiration date to March 16, 2006 to avoid the disruption of ongoing enforcement actions while HHS completes with rulemaking to develop a more comprehensive enforcement rule.

Facility Regulation and Control↗
PubMed2005

Avoiding involuntary sleep during civil air operations: validation of a wrist-worn alertness device.

BACKGROUND: Fatigue and sleepiness may rise to unacceptably high levels during civil air operations as a result of relatively long duty periods that may coincide with the circadian low of alertness, and disruption of the circadian rhythm due to time zone shift. Previous studies investigated various measures to detect the presence of sleep. Of these, wrist inactivity was able to identify sleep lasting longer than 5 min, and an alertness device based on wrist inactivity was subsequently developed. The aim of the present study was to assess the effectiveness and utility of the device. METHODS: The alertness device was worn by 21 Air New Zealand pilots during flights between Auckland and Perth. The presence of sleepiness and sleep was determined using brain electrical activity (electroencephalogram - EEG) and eye movements (via the electrooculogram - EOG). The EEG and EOG were recorded over the entire flight and were used to validate the effectiveness of the alertness device by determining whether sleep was detected correctly. Also, the pilots assessed the effectiveness and utility of the device subjectively. RESULTS: Of the 21 pilots, 10 showed sleepiness or sleep during the flights based on the EEG and EOG. The study demonstrated that the alertness device provides an effective method for preventing or inhibiting accidental sleep. Although some sleep episodes in excess of 5 min occurred due to brief movements resetting the alarm delay timer, the efficacy of the device can be increased by modifying the alarm software to ignore brief movements within a period of sleep. The majority of the aircrew found the device acceptable to use. CONCLUSIONS: The study has shown that the alertness device can awaken pilots effectively during flight. Its anticipated use is to prevent accidental sleep during flight, and as part of cockpit napping procedures to ensure that the non-napping pilot remains awake. However, use of such a device is not intended to replace the development of rosters that minimize fatigue or to extend current duty times.

Adult↗
PubMed1976

Observations on abdominal injuries in the Nigerian Civil War.

A retrospective study of 331 patients who sustained abdominal injuries during the Nigerian Civil War 1967-70 and were treated at Base Surgical Centres in the 3 Field Ambulance Nigerian Army is made. The most commonly injured organs are small intestine 148, caecum and colon 80, liver 69, spleen 26, stomach 28 and kidney 24. Case fatality rate is 33.8%. Factors influencing case mortality rate include type of organ injured, number of organs hit by penetrating missile, peri-operative complication. Other factors, not measurable in this study are mentioned. The few patients with injuries severally to the pancreas or the gall bladder who reached the operating table alive, all showed injuries to some other organs; these are among those with the highest mortality rates. Comparisons are made with similar studies from the Second World War 1942-45 and the Korean War 1952-53.

Abdominal Injuries↗
PubMed2005

Toxicological findings from 1587 civil aviation accident pilot fatalities, 1999-2003.

INTRODUCTION: The prevalence of drug and ethanol use in aviation is monitored by the Federal Aviation Administration (FAA). Under such monitoring, toxicological studies for the 1989-1993 and 1994-1998 periods indicated lower percentages of the presence of controlled substances (illegal drugs) than that of prescription and nonprescription (over-the-counter) drugs in aviation accident pilot fatalities. In continuation, a toxicological assessment was made for an additional period of 5 yr. METHODS: Biosamples from aviation accident pilot fatalities submitted to the FAA Civil Aerospace Medical Institute (CAMI) are analyzed, and those findings are stored in a database. This database was examined for the 1999-2003 period for the presence of controlled substances (Schedules I-V), prescription/nonprescription drugs, and ethanol in the fatalities. RESULTS: Out of 1629 fatal aviation accidents from which CAMI received biosamples, pilots were fatally injured in 1587 accidents. Drugs and/or ethanol were found in 830 (52%) of the 1587 fatalities. Controlled substances from Schedules I-II (SI-II) and Schedules III-V (SIII-V) were detected in 113 and 42 pilots, respectively. Prescription drugs were present in 315 pilots, nonprescription drugs in 259, and ethanol in 101. SI-II substances were detected in 5 of 122 first-class medical certificate-holding airline transport pilots. In addition to the controlled substances, many of the prescription/nonprescription drugs found in the fatalities have the potential for impairing performance. CONCLUSIONS: Findings from this study were consistent with those of two previous toxicological studies and support the FAA's programs aimed at reducing the usage of performance-impairing substances.

Accidents, Aviation↗
PubMed1992

[Diseases of civilization from the aspect of evolution of the human diet].

The authors discuss contemporary views regarding the causes of diseases of civilization which developed on an epidemic scale in industrial societies during the last 60-70 years. They are due to the immense changes of lifestyle adopted by these societies. On the whole this lifestyle is a marked deviation from optimal conditions for humans. The genetic equipment of man which determines the evolutional advantages and function of different metabolic processes which ensure the homeostasis of the healthy organism is conservative and is entirely adapted to the human genome which developed in the course of hundreds of thousands of years. The aim of preventive medicine is to analyze, point out and enforce diminution of the effect of risk factors, as an important way towards improvement of the general health status of the population.

Diet↗
PubMed2005

Before the welfare state: Bastian's Civil List pension.

Bastian, an eminent, if controversial, naturalist, pioneer neurologist, and for 30 years, professor at University College, London, ended with a certain income of only Ł75 in his last year. Sir James Crichton-Browne initiated the grant of a Civil List pension. Prime Minister H Asquith, after consulting the London Royal Society, advised King George V to disburse a pension of Ł150.

England↗
PubMed2005

[An alternative approach to the teaching of obesity as a civilization-related disease].

Universities are relying on student-activating methods in teaching. This work was concerned with an approach to teaching of obesity as a civilization-related disease to medical students. Brainstorming, snowball discussion, careful reading of medical texts, evidence-based medicine, and practicals on how to measure BMI and WHR were exploited. Analysis of medical histories to disclose risk factors of ischemic heart disease and polymetabolic syndrome X are proposed. Pharmacological and non-pharmacological therapies of obesity and its disorders are presented.

Adult↗
PubMed2006

Prevalence of HIV, hepatitis B and C amongst health workers of Civil Hospital Karachi.

OBJECTIVE: To determine the prevalence of HIV, Hepatitis B (HBV) and Hepatitis C (HCV) amongst the health workers of Civil Hospital Karachi (CHK). MATERIAL AND METHODS: Prospective study. A precoded Proforma was filled out which included questions regarding the knowledge, attitude and practices (KAP) of HIV, HBV and HCV. SETTING: Departments of a tertiary health care facility at CHK. Antibodies to HIV, HCV and Hepatitis B surface antigen (HBsAg) were done using enzymes linked immunosorbent assay [ELISA]. RESULTS: Uptake of screening was 98% to those offered. The prevalence was 5.6% for antibodies to HCV, 2.4% for HBsAg, while none of those studied had antibodies to HIV. CONCLUSION: Our results show the prevalence of antibodies to HCV in health workers are 20 folds higher than health workers in the developed countries. Similarly, the prevalence of HBV although not as high as HCV is significant. Seroprevalence of HIV does not exist in this group. We need to ensure better training; regulations regarding preventive and safety measures also need to be enforced (JPMA 52:92; 2002).

Journal Article↗
PubMed2006

The Danish Civil Registration System. A cohort of eight million persons.

BACKGROUND: The Danish Civil Registration System (CRS) was established in 1968, where all persons alive and living in Denmark were registered. Among many other variables, it includes individual information on personal identification number, gender, date of birth, place of birth, place of residence, citizenship, continuously updated information on vital status, and the identity of parents and spouses. METHODS: To evaluate the quality and completeness of the information recorded on persons in the CRS, we considered all persons registered on November 4, 2005, i.e. all persons who were alive and resident in Denmark at least one day from April 2, 1968 to November 4, 2005, or in Greenland from May 1, 1972 to November 4, 2005. RESULTS: A total of 8,176,097 persons were registered. On November 4, 2005, 5,427,687 (66.4%) were alive and resident in Denmark, 56,920 (0.7%) were alive and resident in Greenland, 2,141,373 (26.2%) were dead, 21,160 (0.3%) had disappeared, and 528,957 (6.5%) had emigrated. Among persons born in Denmark 1960 or later the CRS contains complete information on maternal identity. Among persons born in Denmark 1970 or later the CRS contains complete information on paternal identity. Among women born in Denmark April 1935 or later the CRS contains complete information on all their children. Among males born in Denmark April 1945 or later the CRS contains complete information on all their children. The CRS contains complete information on: a) immigrations and emigrations from 1971 onwards, b) permanent residence in a Danish municipality from 1971 onwards, c) permanent residence in a municipality in Greenland from May 1972 onwards, and d) full address in Denmark from 1977 onwards. CONCLUSION: Data from the CRS is an important research tool in epidemiological research, which enables Danish researchers to carry out representative population-based studies on e.g. the potential clustering of disease and death in families and the potential association between residence and disease and death.

Adolescent↗
PubMedDate not supplied

[Medical flight certification of civil pilots with cardiovascular pathologies].

Comprehensive examination of civil pilots including the clinical-physiological and mental tests was performed with the purpose to improve the system of expert evaluation of health and fight fitness of pilots with cardiovascular pathologies. Mental tests consisted of an MMPI modification, the standard multifactor personality test, portrait choice (adapted Szondi's eight inclinations test), and predictive drawing tests of the unconscious. Type of personality of the persons with cardiovascular pathologies were characterized in terms of individual traits, social behavior, thinking type, stress reaction, protective tactics, and form of deadaptation. Persons with a variety of premorbid cardiovascular pathologies (essential hypertension, atherosclerosis, and neurocirculatory dystonia) reveal specific traits that should be taken into consideration in the process of medical flight certification.

Aerospace Medicine↗
PubMed2006

"A century of civilization under the influence of eugenics": Dr. Enrique Diego Madrazo, socialism and scientific progress.

This article discusses the thought of one of the pioneers of eugenics in Spain, Dr. Enrique Diego Madrazo. In particular, it analyses his 1930 essay Un siglo de civilización bajo la influencia eugenésica [A Century of Civilization under the Influence of Eugenics], as the most explicit work on the eugenic utopia he advocated. This work, because of its breadth, was also one of the most extensive and detailed accounts of the steps to be taken towards the eugenic society that was produced. The present analysis of his work assesses the degree to which his thought, which has been described as "utopian socialist", in fact corresponded to that epithet, given the politically authoritarian nature and the gender bias of some aspects of his one-hundred year plan for the creation of a eugenic society. The article also places Madrazo's thought in the context of his time and other national currents of eugenic thought.

Eugenics↗
PubMed1991

[Epidemiology and civil trials].

The role epidemiology in courts has become increasingly important both in the United States and in Japan, especially in the field of product liability. In the United States, attributable risk percent (AR%) is used in civil trials as a measure to judge whether alleged factors caused health disturbances of plaintiffs. Most epidemiologists believe that an AR% of more than 50%, ie, relative risk more than 2, supports causality of alleged factors, because "preponderance of evidence" is regarded as a fundamental legal rule in the United States. In Japan, judges in courts require a more strict standard for proof of facts, which means that a much higher AR% may be needed to convince judges. The role of epidemiologists in courts may be to show a plausible range of AR%, based on design, execution, and analysis of quoted epidemiologic studies. Standards for accepting plaintiffs' allegation should be discussed in the legal framework of Japan.

Epidemiology↗
PubMed1991

Civil War surgery: Gettysburg, summer of 1863.

Gettysburg was the site of a bloody three-day battle starting July 1, 1863. Field hospitals became busy during the battle and were established in churches, schoolhouses, barns and private homes. The Union field hospitals treated 20,500 wounded Union and Confederate soldiers. Civil War surgeons had little equipment and knowledge, but we can appreciate their contributions to surgery and service to country.

General Surgery↗
PubMed1990

[Abnormalities of respiratory function in civil defence firefighter-submarine divers. Respective role of diving and occupational exposure related to occupational firefighter's functions].

Lung function was studied in 20 firemen-submarine divers (mean age 36 +/- 1.2 years) of the French civil defence undergoing the medical check-up compulsory for professional divers (lung function tests are not systematically performed in ordinary firemen). Compared with the CECA standards: (1) vital capacity (VC) was increased, residual volume (RV) was decreased and total lung capacity (TLC) was unchanged; (2) with the exception of peak respiratory flow, all expiratory flow values (FEV1, MEF50, MEF25) were decreased; (3) the permeability factor (KCO) was decreased. These functional abnormalities were moderately worse in subjects who smoked. Some abnormalities (increased VC, decreased RV) are typical of diving activities, but the deterioration of effort-dependent expiratory flow values and alveolar-capillary diffusion must be ascribed to specific nuisances (fumes, polluants, toxic substances) associated with fireman's activities. Monitoring lung function in all professional firemen therefore seems to be necessary, if not indispensable.

Adult↗