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Hall JR. The lowdown on high-rise fires. NFPA JOURNAL : THE OFFICIAL MAGAZINE OF THE NATIONAL FIRE PROTECTION ASSOCIATION 1997; 91:84-90. [PMID: 10174386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Hall JR. Impact of traumatic subarachnoid hemorrhage on outcome in nonpenetrating head injury. Part II: relationship to clinical course and outcome variables during acute hospitalization. THE JOURNAL OF TRAUMA 1997; 42:1196-7. [PMID: 9210568 DOI: 10.1097/00005373-199706000-00039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Hall JR, Crawford P, Lewis JV. Nonoperative management of a blunt pancreatic injury. TENNESSEE MEDICINE : JOURNAL OF THE TENNESSEE MEDICAL ASSOCIATION 1996; 89:413-4. [PMID: 8942280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Hession PR, Rawlinson J, Hall JR, Keating JP, Guyer PB. The clinical and radiological features of cholecystocolic fistulae. Br J Radiol 1996; 69:804-9. [PMID: 8983583 DOI: 10.1259/0007-1285-69-825-804] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The clinical and radiological features of seven patients presenting with cholecystocolic fistulae are reviewed. The majority of the patients were elderly (age range 43-85 years, mean 70.7 years) and there was a female preponderance (6:1). The condition usually has a benign clinical course. Diarrhoea was the most common presenting symptom and the typical clinical features of gallbladder disease were absent. Cholangitis occurred in only one patient. The time between onset of symptoms and diagnosis varied from 1 week to 2 years (mean 22 weeks). In only one patient was the diagnosis of biliary-intestinal fistula suspected on the basis of the plain abdominal radiograph (Case 5). A diagnosis of cholecystocolic fistula was established by barium enema (5 cases), endoscopic retrograde cholangiopancreatography (ERCP) (1 case) and diagnostic laparotomy (1 case). The only cause identified in this series was acute or chronic cholecystitis.
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Hall JR. The latest toll from the private use of fireworks. NFPA JOURNAL : THE OFFICIAL MAGAZINE OF THE NATIONAL FIRE PROTECTION ASSOCIATION 1996; 90:79-82. [PMID: 10158565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Hall JR, Reyes HM, Meller JL, Loeff DS, Dembek R. The outcome for children with blunt trauma is best at a pediatric trauma center. J Pediatr Surg 1996; 31:72-6; discussion 76-7. [PMID: 8632290 DOI: 10.1016/s0022-3468(96)90322-x] [Citation(s) in RCA: 135] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE The mortality rate for pediatric trauma patients cared for in adult trauma centers has been shown, by means of TRISS methodology, not to differ significantly from that of the Major Trauma Outcome Study (MTOS). The question remains, however, whether the outcome of injured children is better in a designated pediatric trauma center (DPTC). The authors' hypothesis is that outcome is better at a DPTC. METHODS The records of 1,797 children (0 to 15 years of age) admitted to a DPTC between 1987 and 1993 were reviewed. TRISS methodology was used to calculate probability of survival for outcome comparison with the MTOS. The data also was compared with outcome in relation to the admitting Glasgow Coma Score (GCS) reported in the National Pediatric Trauma Registry (NPTR). RESULTS The outcome of all children at this DPTC had a Z score of +1.4199 (P > .1). The Z score of children admitted because of penetrating trauma (PT, n = 460) did not differ significantly from that of the MTOS. However, the children admitted because of blunt trauma (BT, n = 1,337) had a Z score of +3.3501 (M score = .90), which is significantly better than that of the MTOS (P < .001). The BT population with an ISS of > or = 9 (n = 149) had a Z score of +2.8686 (P < .005) (M = .95). By GCS comparison, the BT group had a outcome similar to that reported in the NPTR. Head injury was the cause of death for 26 (84%) of the 31 PT deaths and 20 (83%) of the 24 BT deaths (three of the remaining four had associated severe head injury). Only 1 of 24 (4%) BT liver injuries and 5 (21%) of 24 BT splenic injuries required surgical intervention. This low incidence of liver and splenic surgical invention is similar to that reported by other DPTCs, but for children treated at adult centers the rates are 37% to 58% and 43% to 53% for liver & splenic surgical intervention, respectively. CONCLUSION Children with BT have a significantly better outcome at a DPTC; the outcome for children with PT does not differ. Successful nonoperative treatment of blunt abdominal injuries is more likely to occur at a DPTC than at adult trauma centers "with pediatric committment." Thus, children with blunt injuries should be taken to a DPTC, when available.
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Lopes AD, Hall JR, Monaghan JM. Drainage following radical hysterectomy and pelvic lymphadenectomy: dogma or need? Obstet Gynecol 1995; 86:960-3. [PMID: 7501348 DOI: 10.1016/0029-7844(95)00311-e] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To compare the incidence of lymphocyst formation and postoperative morbidity in patients drained or not drained following radical hysterectomy and pelvic lymph node dissection for cervical or endometrial malignancy. METHODS A prospective study was undertaken of consecutive patients undergoing radical hysterectomy and pelvic lymphadenectomy at the Regional Department of Gynaecological Oncology, Gateshead, United Kingdom, between February 1992 and September 1994. A Piver type II procedure was performed with nonclosure of the vaginal cuff and pelvic peritoneum. Patients were randomized at the end of surgery to have either two suction drains inserted along the pelvic sidewalls or to have no drains inserted. The detection of lymphocysts was made by clinical examination and abdominal ultrasound scan performed 8 weeks postoperatively. RESULTS Eight patients were excluded from the study when drains were deemed necessary to assess postoperative blood loss. Fifty-one were randomized to drains, and 49 to no drains. The detection of lymphocysts by ultrasound and clinical examination in the drained group (15.6 and 5.9%, respectively) was not significantly different from the group not drained (17.4 and 6.1%, respectively). There was no difference in postoperative morbidity in the two groups. CONCLUSION There appears to be no advantage to the routine use of pelvic suction drainage following radical hysterectomy and pelvic lymphadenectomy.
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Barrette J, Bellwied R, Braun-Munzinger P, Cleland WE, Cormier T, Dadusc G, David G, Dee J, Dietzsch O, Fatyga M, Greene SV, Germani JV, Hall JR, Hemmick TK, Herrmann N, Hogue RW, Hong B, Jayananda K, Kraus D, Kumar BS, Lacasse R, Lissauer D, Llope WJ, Ludlam TW, Majka R, Mark SK, Mitchell JT, Muthuswamy M, O'Brien E, Pruneau C, Rotondo FS, Simon-Gillo J, Sonnadara U, Stachel J, Takai H, Takagui EM, Throwe TG, Waters L, Winter C, Wolfe D, Woody CL, Xu N, Zhang Y, Zhang Z, Zou C. Search for pion-neutron bound states in 14.6A GeV Si + nucleus collisions. PHYSICAL REVIEW. C, NUCLEAR PHYSICS 1995; 52:2679-2683. [PMID: 9970798 DOI: 10.1103/physrevc.52.2679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Roberts DN, Juman S, Hall JR, Jonathan DA. Parotid duct stenosis: interventional radiology to the rescue. Ann R Coll Surg Engl 1995; 77:444-6. [PMID: 8540664 PMCID: PMC2502464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Recurrent parotid sialadenitis due to isolated parotid duct stenosis is an uncommon condition and poses a difficult management problem. Conventional surgical practice carries with it a potentially high morbidity for what is a benign condition. We present three cases where parotid duct stenosis has been treated by balloon dilatation and propose that this is a safe, quick and repeatable method for dealing with this problem.
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Barrette J, Bellwied R, Braun-Munzinger P, Cleland WE, Cormier T, David G, Dee J, Diebold GE, Dietzsch O, Germani JV, Gilbert S, Greene SV, Hall JR, Hemmick TK, Herrmann N, Hong B, Jayananda K, Kraus D, Kumar BS, Lacasse R, Lissauer D, Llope WJ, Ludlam T, Majka R, Mark SK, Mitchell JT, Muthuswamy M, O'Brien E, Pruneau C, Rosati M, Rotondo FS, Sonnadara U, Stachel J, Takai H, Takagui EM, Wang G, Woody CL, Xu N, Zhang Y, Zhang Z, Zou C. Tranverse energy and charged particle multiplicity in p-nucleus collisions at 14.6 GeV/c. PHYSICAL REVIEW. C, NUCLEAR PHYSICS 1995; 52:2028-2036. [PMID: 9970719 DOI: 10.1103/physrevc.52.2028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Hall JR, Reyes HM, Meller JL, Loeff DS, Dembek RG. The new epidemic in children: penetrating injuries. THE JOURNAL OF TRAUMA 1995; 39:487-91. [PMID: 7473913 DOI: 10.1097/00005373-199509000-00015] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE It is our hypothesis that there has been a dramatic increase in penetrating injuries in children. The purpose of this study is to verify this "new" epidemic in children and to note some of its characteristics. METHODS We performed a 7-year retrospective review of the trauma registry at our urban pediatric (< 16 years of age) trauma center (UPTC). RESULTS The percentage of admissions due to penetrating injuries at our UPTC has gradually risen over the past 7 years primarily due to gunshot wounds. In 1992 and 1993, compared to 1987 and 1988, the incidence of penetrating injuries has increased from 20 to 36% in all children and from 45 to 66% in the 12-to-15-year-old age group. CONCLUSION Injuries due to penetrating trauma have, indeed, increased to epidemic proportions.
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Barrette J, Bellwied R, Braun-Munzinger P, Cleland WE, David G, Dee J, Dietzsch O, Duek E, Fatyga M, Fox D, Greene SV, Hall JR, Hemmick TK, Herrmann N, Hong B, Jayananda K, Kraus D, Kumar BS, Lacasse R, Lissauer D, Llope WJ, Ludlam T, Mark SK, McCorkle S, Mitchell JT, Muthuswamy M, O'Brien E, Pruneau C, Rotondo FS, Simon-Gillo J, Sonnadara U, Stachel J, Takagui EM, Takai H, Throwe TG, Waters L, Winter C, Wolf K, Wolfe D, Woody CL, Xu N, Zhang Y, Zhang Z, Zou C. Production of neutron-rich isotopes from the fragmentation of 28Si projectiles at plab=14.6 GeV/c per nucleon. PHYSICAL REVIEW. C, NUCLEAR PHYSICS 1995; 52:956-963. [PMID: 9970585 DOI: 10.1103/physrevc.52.956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Barrette J, Bellwied R, Bennett S, Braun-Munzinger P, Cleland WE, Clemen M, Cole JD, Cormier TM, David G, Dee J, Dietzsch O, Drigert MW, Hall JR, Hemmick TK, Herrmann N, Hong B, Kwon Y, Lacasse R, Lukaszew A, Li Q, Ludlam TW, Mark SK, McCorkle S, Matheus R, Murgatroyd JT, O'Brien E, Panitkin S, Piazza T, Pruneau C, Rao MN, Rosati M, daSilva NC, Sedykh S, Sonnadara U, Stachel J, Starinsky N, Takagui EM, Voloshin S, Wang G, Wessels JP, Woody CL, Xu N, Zhang Y, Zou C. Charged-particle pseudorapidity distributions in Au+Al, Cu, Au, and U collisions at 10.8A GeV/c. PHYSICAL REVIEW. C, NUCLEAR PHYSICS 1995; 51:3309-3319. [PMID: 9970434 DOI: 10.1103/physrevc.51.3309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Barrette J, Bellwied R, Braun-Munzinger P, Cleland WE, David G, Dee J, Dietzsch O, Duek E, Fatyga M, Fox D, Greene SV, Hall JR, Hemmick TK, Herrmann N, Hong B, Jayananda K, Kraus D, Kumar BS, Lacasse R, Lissauer D, Llope WJ, Ludlam T, Mark SK, McCorkle S, Mitchell JT, Muthuswamy M, O'Brien E, Pruneau C, Rotondo FS, Simon-Gillo J, Sonnadara U, Stachel J, Takagui EM, Takai H, Throwe TG, Waters L, Winter C, Wolf K, Wolfe D, Woody CL, Xu N, Zhang Y, Zhang Z, Zou C. Electromagnetic dissociation of relativistic 28Si. PHYSICAL REVIEW. C, NUCLEAR PHYSICS 1995; 51:865-878. [PMID: 9970131 DOI: 10.1103/physrevc.51.865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Hornung M, Bull KR, Cresser M, Ullyett J, Hall JR, Langan S, Loveland PJ, Wilson MJ. The sensitivity of surface waters of Great Britain to acidification predicted from catchment characteristics. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 1995; 87:207-214. [PMID: 15091595 DOI: 10.1016/0269-7491(94)p2608-c] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/1993] [Accepted: 01/04/1994] [Indexed: 05/24/2023]
Abstract
Using a combination of soil, land use and geological information, a map of Great Britain has been derived which indicates the sensitivity of surface waters to acidification. For the geological information, a slightly modified version of an available map was used which indicated the sensitivity of groundwaters to acidification. For soils, 1-km databases of soil information for England and Wales and for Scotland were employed to map the soil sensitivity as determined by buffering capacity. The derived soils map was modified to take account of agricultural liming in arable and managed grassland areas using the ITE Land Classification. The final map of surface water sensitivity was obtained by using a geographic information system overlay procedure which enabled each combination of soil and geology sensitivity to be uniquely defined. The final sensitivity classification was based upon expert knowledge and the experience of a similar sensitivity mapping exercise for Wales.
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Barrette J, Bellwied R, Braun-Munzinger P, Cleland WE, Cormier TM, David G, Dee J, Diebold GE, Dietzsch O, Germani JV, Gilbert S, Greene SV, Hall JR, Hemmick TK, Herrmann N, Hong B, Jayananda K, Kraus D, Kumar BS, Lacasse R, Lissauer D, Llope WJ, Ludlam TW, McCorkle S, Majka R, Mark SK, Mitchell JT, Muthuswamy M, O'Brien E, Pruneau C, Rao MN, Rotondo F, daSilva NC, Sonnadara U, Stachel J, Takai H, Takagui EM, Throwe TG, Winter C, Wang G, Wolfe D, Woody CL, Xu N, Zhang Y, Zhang Z, Zou C. Centrality dependence of longitudinal and transverse baryon distributions in ultrarelativistic nuclear collisions. PHYSICAL REVIEW. C, NUCLEAR PHYSICS 1994; 50:3047-3059. [PMID: 9970007 DOI: 10.1103/physrevc.50.3047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Barrette J, Bellwied R, Bennett S, Braun-Munzinger P, Cleland WE, Clemen M, Cole J, Cormier TM, David G, Dee J, Dietzsch O, Drigert M, Gilbert S, Hall JR, Hemmick TK, Herrmann N, Hong B, Jiang CL, Kwon Y, Lacasse R, Lukaszew A, Li Q, Ludlam TW, McCorkle S, Mark SK, Matheus R, O'Brien E, Panitkin S, Piazza T, Pruneau C, Rao MN, Rosati M, daSilva NC, Sedykh S, Sonnadara U, Stachel J, Takai H, Takagui EM, Voloshin S, Wang G, Wessels JP, Woody CL, Xu N, Zhang Y, Zhang Z, Zou C. Observation of anisotropic event shapes and transverse flow in ultrarelativistic Au+Au collisions. PHYSICAL REVIEW LETTERS 1994; 73:2532-2535. [PMID: 10057084 DOI: 10.1103/physrevlett.73.2532] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Hall JR. The U.S. experience with smoke detectors: who has them? How well do they work? When don't they work? NFPA JOURNAL : THE OFFICIAL MAGAZINE OF THE NATIONAL FIRE PROTECTION ASSOCIATION 1994; 88:36-9, 41-6. [PMID: 10137381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
From 1975 to 1984, the United States experienced remarkable growth in the use of home smoke detectors, making the home smoke detector the fire safety success story of the decade. As of 1993, only 1 home in 12 remained unprotected.
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Chakraverty S, Hughes T, Keir MJ, Hall JR, Rawlinson J. Preparation of the colon for double-contrast barium enema: comparison of Picolax, Picolax with cleansing enema and Citramag (2 sachets)--a randomized prospective trial. Clin Radiol 1994; 49:566-9. [PMID: 7955872 DOI: 10.1016/s0009-9260(05)82939-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A randomized prospective trial was undertaken on 196 consecutive patients referred for double-contrast barium enema examination to assess the relative efficacy of three colon cleansing regimes: Citramag (2 sachets), Picolax and Picolax with a preliminary cleansing enema. Each of the regimes was preceded by a 5 day low residue diet. The radiographs from the examinations were assessed on a double-blind basis. The quality of bowel preparation was significantly poorer (P < 0.001) in the group receiving the preliminary cleansing enema, notably with respect to mucosal coating, compared with the other two groups. The quality of the preparation was slightly better in the group receiving Picolax alone than in the Citramag group (P < 0.01), the difference being most apparent in the proximal colon. The laxatives were equally well tolerated. The study has formed the basis of a departmental audit. As a result, the bowel preparation has been standardized to a 5 day period of dietary restriction followed by 2 Picolax sachets. This measure has improved efficiency within the department with no sacrifice in quality.
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Barrette J, Bellwied R, Braun-Munzinger P, Cleland WE, Cormier TM, David G, Dee J, Diebold GE, Dietzsch O, Germani JV, Gilbert S, Greene SV, Hall JR, Hemmick TK, Herrmann N, Hong B, Jayananda K, Kraus D, Kumar BS, Lacasse R, Lissauer D, Llope WJ, Ludlam TW, McCorkle S, Majka R, Mark SK, Mitchell JT, Muthuswamy M, O'Brien E, Pruneau C, Rotondo FS, Sandweiss J, daSilva NC, Sonnadara U, Stachel J, Takai H, Takagui EM, Throwe TG, Wolfe D, Woody CL, Xu N, Zhang Y, Zhang Z, Zou C. Production of light nuclei in relativistic heavy-ion collisions. PHYSICAL REVIEW. C, NUCLEAR PHYSICS 1994; 50:1077-1084. [PMID: 9969750 DOI: 10.1103/physrevc.50.1077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Bain SC, Prins JB, Hearne CM, Rodrigues NR, Rowe BR, Pritchard LE, Ritchie RJ, Hall JR, Undlien DE, Ronningen KS. Insulin gene region-encoded susceptibility to type 1 diabetes is not restricted to HLA-DR4-positive individuals. Nat Genet 1994; 2:212-5. [PMID: 1345171 DOI: 10.1038/ng1192-212] [Citation(s) in RCA: 92] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Type 1 or insulin-dependent diabetes mellitus (IDDM) is an autoimmune disease of the insulin-producing pancreatic beta-cells which is determined by both genetic and environmental factors. The major histocompatibility complex and the insulin gene region (INS) on human chromosomes 6p and 11p, respectively, contain susceptibility genes. Using a mostly French data set, evidence for linkage of INS to IDDM was recently obtained but only in male meioses (suggesting involvement of maternal imprinting) and only in HLA-DR4-positive diabetics. In contrast, we find evidence for linkage in both male and female meioses and that the effect of the susceptibility gene(s) in the INS region is not dependent on the presence of HLA-DR4.
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Abstract
This study was conducted to determine the extent of blood contamination of anesthesia equipment and monitoring equipment in clinical use in operating rooms. The study employed a catalytic-test method, which is used in forensic medicine, to detect blood contamination of anesthesia equipment and monitoring equipment. Nineteen definable surfaces were sampled in 22 operating rooms. Thirty-three percent of surfaces were contaminated with blood. Contaminated equipment included surfaces that are in continuous contact with patients, e.g., blood pressure cuffs and pulse oximeter probes. Visual inspection was not a reliable means of detecting blood contamination. Whether this blood contamination represents an infection risk was not determined. Nevertheless, improved cleaning and disinfection procedures are probably needed. Equipment design needs to focus on reducing the potential for blood contamination and enhancing capability for cleaning and disinfection.
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Hall JR. U.S. high-rise fires: the big picture. NFPA JOURNAL : THE OFFICIAL MAGAZINE OF THE NATIONAL FIRE PROTECTION ASSOCIATION 1994; 88:47-53. [PMID: 10132425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
In the past, efforts to track fire experience in high-rise buildings have been less than systematic. Now, for the first time, we can provide an overall perspective on the problem.
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Barrette J, Bellwied R, Braun-Munzinger P, Cleland WE, David G, Dee J, Dietzsch O, Greene SV, Hall JR, Hemmick TK, Herrmann N, Hong B, Jayananda K, Kraus D, Kumar BS, Lacasse R, Lissauer D, Llope WJ, Ludlam T, Majka R, Mark SK, McCorkle S, Mitchell JT, Muthuswamy M, O'Brien E, Pruneau C, Rotondo FS, Sonnadara U, Stachel J, Takagui EM, Takai H, Throwe TG, Voloshin S, Waters L, Winter C, Wolfe D, Woody CL, Xu N, Zhang Y, Zhang Z, Zou C. Two charged particle and transverse energy correlations in Si+Pb collisions at 14.6A GeV/c. PHYSICAL REVIEW. C, NUCLEAR PHYSICS 1994; 49:1669-1683. [PMID: 9969389 DOI: 10.1103/physrevc.49.1669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Reichard KW, Hall JR, Meller JL, Spigos D, Reyes HM. Arteriography in the evaluation of penetrating pediatric extremity injuries. J Pediatr Surg 1994; 29:19-22. [PMID: 8120754 DOI: 10.1016/0022-3468(94)90515-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The routine use of arteriography for evaluating penetrating extremity injuries is undergoing reevaluation in the adult literature. Its role in children is less clear. Eighty-seven children treated for penetrating extremity trauma over a 5-year period were studied retrospectively to define the usefulness of arteriography. The ages ranged from 2 to 16 years. Twenty-four arteriograms were performed. Twelve were for patients who exhibited physical signs of vascular injury (diminished pulse, distal ischemia, expanding hematoma, or bruits/thrills over the wound). The other 12 were performed on asymptomatic children with wounds in proximity to major vessels. Two other patients with ongoing hemorrhage were taken directly to the operating room. Of the 12 arteriograms performed for abnormal physical signs, eight (67%) showed vascular injuries. None of the studies performed for proximity alone had abnormal results (P < .01). Ten of 10 patients with vascular injuries had abnormal physical findings, whereas only four of 77 patients without vascular injuries had abnormal findings (sensitivity 100%, specificity 95%). Eighty-five percent of patients have had follow-up in the pediatric surgery clinic, and no missed injuries or complications have been discovered. Timely diagnosis and repair is the cornerstone for successful management of vascular injuries. While the arteriogram is an important adjunct in patients who have abnormal physical findings, proximity to major vessels alone fails to identify patients at risk for significant injuries. Angiography may not be warranted in patients whose physical examination results are normal. Noninvasive modalities such as B-mode ultrasound and Doppler may have future application in the evaluation of these cases.
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