The renal vascular response to acutely elevated intrapelvic pressure: resistive index measurements in experimental urinary obstruction.

PURPOSE: To assess the accuracy of resistive index (RI) in the diagnosis of obstruction. MATERIALS AND METHODS: The time course of RI and its relationship to intrapelvic pressure were measured in 6 dogs following unilateral obstruction. RESULTS: Changes in RI 1) occurred as early as 1/2 hour after acute obstruction, 2) only reached diagnostic sensitivity after 3 to 4 hours, 3) accurately diagnosed obstruction whenever the RI ratio between the kidneys exceeded 1.15 and 4) were uninfluenced by alterations in intrapelvic pressure. CONCLUSIONS: Because RI more closely reflects changes in renal blood flow than pelvic pressure, it can accurately diagnose acute obstruction but only after several hours. Diagnostic accuracy in chronic obstruction may be influenced by these physiologic relationships.

An analysis of pediatric trauma deaths in Indiana.

From June 1986 to May 1988, there were 1,931 childhood deaths recorded in Indiana. Eight hundred six children (0 to 18 years old) died as a result of trauma (41.4% of all deaths). Seventy percent of all traumatic deaths occurred in boys. Blunt trauma accounted for 54% of deaths, asphyxia or drowning 26%, penetrating trauma 15%, electrocution 3%, and burns 1%. Sixty percent of deaths occurred in rural areas and 40% occurred in urban centers; however, state-wide demographics define the population as 70% urban. The percentage of deaths due to trauma within a given race was: hispanic 71%, caucasian 42%, black 35%, and others 50%. However, when deaths occurring in infants less than 30 days of age were eliminated, the percentages changed: hispanics 70%, caucasian 45%, black 45%, and others 50%. Traumatic deaths were 1.6 times as likely to occur during the months of June through October (n = 85 deaths/mo) as opposed to November through May (n = 53 deaths/mo) (P less than .05). Mortality from burns was limited to children less than 5 years of age and penetrating trauma mortality was twice as likely to occur in children over 15 years (10% v 20%). Fifty-two percent of all traumatic deaths in children occurred between 15 and 18 years of age. Major burns account for only 1% of traumatic deaths in this state. Asphyxia and drowning were more common in young children, and blunt traumatic deaths more common in older children. In 1988, the first state-wide accident awareness program was instituted.(ABSTRACT TRUNCATED AT 250 WORDS)