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1.
J Clin Pharm Ther ; 43(5): 682-694, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29729025

RESUMO

WHAT IS KNOWN AND OBJECTIVE: Drugs with anticholinergic properties increase the risk of falls, delirium, chronic cognitive impairment, and mortality and counteract procholinergic medications used in the treatment of dementia. Medication review and optimisation to reduce anticholinergic burden in patients at risk is recommended by specialist bodies. Little is known how effective this review is in patients who present acutely and how often drugs with anticholinergic properties are used temporarily during an admission. The aim of the study was to describe the changes in the anticholinergic cognitive burden (ACB) in patients admitted to hospital with a diagnosis of delirium, chronic cognitive impairment or falls and to look at the temporary use of anticholinergic medications during hospital stay. METHODS: This is a multi-centre observational study that was conducted in seven different hospitals in the UK, Finland, The Netherlands and Italy. RESULTS AND DISCUSSION: 21.1% of patients had their ACB score reduced by a mean of 1.7%, 19.7% had their ACB increased by a mean of 1.6%, 22.8% of DAP naïve patients were discharged on anticholinergic medications. There was no change in the ACB scores in 59.2% of patients. 54.1% of patients on procholinergics were taking anticholinergics. Out of the 98 medications on the ACB scale, only 56 were seen. Medications with a low individual burden were accounting for 64.9% of the total burden. Anticholinergic drugs were used temporarily during the admission in 21.9% of all patients. A higher number of DAPs used temporarily during admission was associated with a higher risk of ACB score increase on discharge (OR = 1.82, 95% CI for OR: 1.36-2.45, P < .001). WHAT IS NEW AND CONCLUSION: There was no reduction in anticholinergic cognitive burden during the acute admissions. This was the same for all diagnostic subgroups. The anticholinergic load was predominantly caused by medications with a low individual burden. More than 1 in 5 patients not taking anticholinergics on admission were discharged on them and similar numbers saw temporary use of these medications during their admission. More than half of patients on cholinesterase-inhibitors were taking anticholinergics at the same time on admission, potentially directly counteracting their effects.


Assuntos
Acidentes por Quedas/prevenção & controle , Antagonistas Colinérgicos/efeitos adversos , Cognição/efeitos dos fármacos , Disfunção Cognitiva/induzido quimicamente , Idoso , Demência/induzido quimicamente , Feminino , Finlândia , Hospitalização , Hospitais , Humanos , Itália , Tempo de Internação , Masculino , Países Baixos , Reino Unido
2.
Biomarkers ; 18(6): 525-31, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23879546

RESUMO

CONTEXT: Cardiorenal biomarkers (CBs) predict outcome in acute heart failure (AHF). OBJECTIVE: To evaluate CBs in early follow-up prognostication. METHODS: In 124 AHF patients, levels of CystatinC, NT-proBNP and TroponinI measured five weeks from admission (W5) and relative change from day 2 (D2) were assessed for 6-month prognosis (mortality/HF hospitalization). RESULTS: The combined end-point occurred in 33 patients (27%). D2-, W5-cystatin≥ median, and lack of ≥30%decrease in NT-proBNP were independent predictors of outcome. Additionally, a risk score established from W5 CBs identified patients with very high event rate. CONCLUSIONS: CBs at early follow-up of AHF may guide risk stratification.


Assuntos
Biomarcadores/sangue , Insuficiência Cardíaca/sangue , Coração/fisiopatologia , Hospitalização , Rim/fisiopatologia , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco
3.
Eur Spine J ; 10(2): 172-6, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11345640

RESUMO

Transforming growth factor beta (TGF-beta) is a potent inducer of angiogenesis and fibrogenesis. There is presently little information about the pathophysiological function of TGF-beta in herniated disc tissue. In order to analyze the cellular role and activation of TGF-beta after disc herniation we immunostained frozen material from 38 disc herniation operations and from eight macroscopically normal discs from organ donors. Polyclonal TGF-beta-I, TGF-beta-II and TGF-beta receptor type II antibodies were used with the avidin biotin complex (ABC-) immunoperoxidase method. All the herniated discs were TGF-beta immunopositive. Such immunoreactivity was mainly associated with disc cells. In a few samples, capillaries were also TGF-beta immunopositive. Immunopositivity was similarly observed in the control discs. To analyze possible differences between the two groups, we calculated the ratio of immunopositive disc cells. For all three antibodies, a statistically significantly (Mann-Whitney test, P = 0.0001) higher number of disc cells showed immunopositivity in the herniated discs. The increase in TGF-beta receptor immunopositivity suggested induction of TGF-beta receptors in herniated discs. Our results support an active regulatory role for TGF-beta in disc cell metabolism.


Assuntos
Deslocamento do Disco Intervertebral/metabolismo , Receptores de Fatores de Crescimento Transformadores beta/metabolismo , Adolescente , Adulto , Idoso , Capilares/metabolismo , Feminino , Humanos , Imuno-Histoquímica , Disco Intervertebral/irrigação sanguínea , Disco Intervertebral/metabolismo , Disco Intervertebral/patologia , Deslocamento do Disco Intervertebral/patologia , Masculino , Pessoa de Meia-Idade , Valores de Referência
4.
Eur Spine J ; 6(1): 63-9, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9093829

RESUMO

Angiogenesis is essential in tissue growth and regeneration. There are several factors that are able to stimulate vascular endothelial cell growth, including platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF). Disc herniation tissue (DHT) contains vascular ingrowth, which promotes granulation tissue formation. In this study we observed 50 disc herniations for PDGF and VEGF immunoreactivity. PDGF immunopositivity was detected in 38 samples (78%). In 28 samples (56%) there were PDGF immunopositive capillaries, PDGF immunopositive disc cells were detected in 19 samples (38%) and PDGF immunopositive fibroblasts in 6 DHT samples (12%). VEGF immunopositive capillaries were identified in 44 DHT samples (88%). For neither growth factor was immunopositivity dependent on preoperative radicular pain duration. In extrusions (n = 25) VEGF immunopositive capillaries were detected in 23 samples (92%) and PDGF immunopositivity in 21 samples (84%). PDGF immunopositivity was more commonly associated with capillaries than with nuclei of disc cells. In sequesters (n = 20) VEGF immunopositive capillaries were identified in all samples and PDGF immunopositivity in 16 (80%). As in extrusions, PDGF immunoreaction was more prevalent in capillaries than in disc cells. Patient age did not relate to VEGF expression. In all age groups it was higher than 80%. Thus capillaries in disc herniation tissue are evidently newly formed and our results demonstrate that PDGF and VEGF participate in the neovascularization process. The presence of PDGF in fibroblasts and in disc cells suggests that this growth factor regulates the function of these cells, possibly the proliferation of the cells and the production of extracellular matrix components.


Assuntos
Fatores de Crescimento Endotelial/metabolismo , Deslocamento do Disco Intervertebral/metabolismo , Disco Intervertebral/metabolismo , Linfocinas/metabolismo , Fator de Crescimento Derivado de Plaquetas/metabolismo , Adulto , Idoso , Envelhecimento/metabolismo , Capilares/metabolismo , Feminino , Humanos , Imuno-Histoquímica , Disco Intervertebral/irrigação sanguínea , Deslocamento do Disco Intervertebral/fisiopatologia , Deslocamento do Disco Intervertebral/cirurgia , Masculino , Pessoa de Meia-Idade , Neovascularização Fisiológica , Dor , Fatores de Tempo , Fator A de Crescimento do Endotélio Vascular , Fatores de Crescimento do Endotélio Vascular
5.
Spine (Phila Pa 1976) ; 22(23): 2711-5, 1997 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-9431603

RESUMO

STUDY DESIGN: Inflammatory cells were located by immunocytochemistry in areas of experimental intervertebral disc injury in pigs. OBJECTIVES: To study the occurrence of T lymphocytes and macrophages 1 week, 1 month, and 3 months after partial-thickness transverse scalpel injuries in pig lumbar discs. SUMMARY OF BACKGROUND DATA: Inflammatory cells and mediators recently have been observed in disc herniation tissue that was removed at disc prolapse surgery. The prevalence of inflammatory cell infiltrates in such clinical disc tissue material also has been studied. There are no studies, however, that have analyzed, using immunocytochemical methodology, the occurrence of, types of, and time dependence of inflammatory cells in an experimental disc injury model. The role of inflammation in intervertebral disc injury and repair has not been determined. METHODS: Transverse scalpel injuries 5-mm long and 4-mm deep were cut in the anterolateral anulus of L5-L6 and L4-L5 discs in 16 pigs. The cuts in the center of the anulus did not reach the nucleus pulposus and never produced a disc prolapse. In every pig, two non-adjacent lumbar discs (L1-L2 and L2-L3) were used as controls. Four discs per animal were studied in parallel by two different complementary immunohistochemical staining protocols. T lymphocytes and macrophages were located immunohistochemically using CD3 and CD68 antibodies, respectively. Discs were removed for analysis from four pigs at 1 week, from six pigs at 1 month, and from six pigs at 3 months. Inflammatory cells were categorized by two independent observers as being entirely absent (-), only few scattered cells (+), and at least one larger cellular infiltrate (+2). RESULTS: In none of the discs could extensive inflammatory cell infiltration be observed. T lymphocytes were present in significantly more sections cut from injured discs than in sections cut from control discs. The difference was highly significant particularly at 1 week and 1 month after disc removal. Only the 1-month-after-injury sections from injured discs exhibited significantly more macrophages than those from control discs. CONCLUSIONS: The results suggest the presence of only modest inflammatory cell infiltration in experimental intervertebral disc injury at all follow-up times. The inflammatory response in partial-thickness anterior experimental intervertebral disc injury, in the absence of disc prolapse, seems to be dominated by a T lymphocyte response. The macrophage response is apparently strongest at 1 month after such injury. These findings differ from what has been observed in herniated disc tissue.


Assuntos
Disco Intervertebral/patologia , Vértebras Lombares/lesões , Macrófagos/patologia , Doenças da Coluna Vertebral/patologia , Linfócitos T/patologia , Animais , Antígenos CD/análise , Antígenos de Diferenciação Mielomonocítica/análise , Complexo CD3/análise , Contagem de Células , Modelos Animais de Doenças , Imuno-Histoquímica , Disco Intervertebral/lesões , Suínos
6.
Spine (Phila Pa 1976) ; 20(3): 271-6, 1995 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-7537390

RESUMO

STUDY DESIGN: Basic fibroblast growth factor immunoreactivity was studied in disc herniation tissue. OBJECTIVES: The first objective was to analyze in which tissue components, if any, fibroblast growth factor is expressed in the disc herniation. The second objective was to compare such expression with that in fresh cadaver disc tissue. SUMMARY OF BACKGROUND DATA: Disc herniation tissue contains vascular ingrowth, which promotes the formation of granulation tissue. Fibroblast growth factor is a potent inducer of angiogenesis and also regulates extracellular proteolysis. METHODS: Twenty-seven disc herniation tissue and five macroscopically normal fresh cadaver discs were treated with an identical immunohistochemical protocol. Serial frozen sections were stained with a polyclonal basic fibroblast growth factor antibody and a polyclonal antibody to von Willebrand factor, which localizes endothelial cells. The immunostaining data were compared with relevant clinical data. RESULTS: Histologically, 74% of the samples contained anulus fibrosus and 59% nucleus pulposus. Basic fibroblast growth factor immunoreactivity was detected in 81% of the samples. There were immunopositive small blood vessels and scattered immunopositive disc cells (67%). Not all observed blood vessels were basic fibroblast growth factor immunopositive. In control discs, no immunoreactivity was observed. CONCLUSIONS: The observed presence of fibroblast growth factor in small blood vessels suggests an active angiogenesis as a result of disc injury. Cellular expression of fibroblast growth factor may be linked to proteolytic activity in disc extracellular matrix.


Assuntos
Endotélio Vascular/metabolismo , Fatores de Crescimento de Fibroblastos/metabolismo , Deslocamento do Disco Intervertebral/patologia , Disco Intervertebral/irrigação sanguínea , Adulto , Idoso , Endotélio Vascular/patologia , Feminino , Humanos , Imuno-Histoquímica , Disco Intervertebral/metabolismo , Disco Intervertebral/patologia , Deslocamento do Disco Intervertebral/metabolismo , Masculino , Pessoa de Meia-Idade , Neovascularização Patológica
7.
Spine (Phila Pa 1976) ; 19(24): 2744-51, 1994 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-7899973

RESUMO

STUDY DESIGN: The presence and abundance of inflammatory cells was studied immunocytochemically in lumbar disc herniations (DH) and macroscopically normal discs for comparison. OBJECTIVES: The objective of the study was to characterize inflammatory cells that appear in herniated disc tissue and to study the relative abundance of various types of inflammatory cells. SUMMARY OF BACKGROUND DATA: Only few macrophages were observed in control discs, whereas abundant macrophages were present in half of the DH. Other types of inflammatory cells were less often abundant in the present material. In about a third of the DH interleukin-1 beta-expressing cells were also observed. METHODS: Twenty-four DH and control tissue from five discs were studied immunocytochemically, using specific monoclonal antibodies to various types of inflammatory cells and interleukin-1 beta. The results were compared with corresponding clinical data. Macrophages were studied with an antibody to CD68 antigen and Ber-MAC3 antibody separately. RESULTS: The obtained results suggest a variable inflammatory cell response in DH, which seems to be often dominated by macrophages at the time of operation. Thus previous suggestions of sometimes very active inflammation in DH tissue are supported. CONCLUSIONS: Inflammation may be important in disc tissue pathophysiology, possibly also in discogenic pain mechanisms.


Assuntos
Inflamação/patologia , Deslocamento do Disco Intervertebral/patologia , Macrófagos/patologia , Adulto , Artrite/patologia , Linfócitos B/química , Linfócitos B/patologia , Feminino , Humanos , Imuno-Histoquímica , Interleucina-1/análise , Masculino , Pessoa de Meia-Idade , Neutrófilos/química , Neutrófilos/patologia , Membrana Sinovial/patologia , Linfócitos T/química , Linfócitos T/patologia
8.
Eur Spine J ; 3(6): 336-41, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-7866862

RESUMO

Twenty disc herniations (DH) were studied immunocytochemically for macrophages and blood vessels. Serial thin frozen sections were immunostained with an antibody specific for tissue macrophages (monoclonal antibody to CD68 antigen) and the endothelium of blood vessels (polyclonal antibody to von Willebrand factor). With this method, blood vessels, often abundant, were observed in as many as 16/20 (80%) of the DH studied, 12 disc extrusions and 8 sequestrated discs, whereas abundant macrophages were noted in 11/20 (55%) of the DH. Macrophages were present only in areas with blood vessels and had presumably infiltrated the tissue from them. As has been noted previously, some blood vessels are apparently newly formed as a result of tissue injury, whereas others were present in the disc prior to herniation. This is suggested by the lack of a clear correlation between the presence or absence of blood vessels and the preoperative duration of radicular pain. In areas of the DH where cartilage fragments occurred, both macrophages and blood vessels were particularly abundant.


Assuntos
Vasos Sanguíneos/patologia , Deslocamento do Disco Intervertebral/patologia , Disco Intervertebral/patologia , Vértebras Lombares/patologia , Macrófagos/patologia , Adulto , Feminino , Humanos , Técnicas Imunoenzimáticas , Masculino
9.
Acta Orthop Belg ; 57(1): 53-7, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-2038944

RESUMO

A consecutive clinical series of 33 patients with either an undisplaced (Garden I) or minimally displaced (Garden II) femoral neck fracture was randomly divided into two operative protocols. Half of the fractures were treated with three cannulated cancellous bone screws, while the other half were treated with a standard screw-angle plate device. After a mean follow-up of 2 years, 4 patients had died, while 20 of the remaining 29 hips showed excellent or good, 3 fair and 6 poor functional results. The three-screw fixation seemed to yield more technical complications as compared to the screw-angle plate fixation. However, the differences in functional end-results were of no clear statistical significance. We conclude that the screw-angle plate device gives acceptable results in this group of fractures. The use of cannulated hip screws may be more advantageous in the treatment of dislocated femoral neck fractures, where the torsional strength of fracture fixation and femoral head viability are more critical.


Assuntos
Placas Ósseas , Parafusos Ósseos , Fraturas do Colo Femoral/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Fraturas do Colo Femoral/diagnóstico por imagem , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Radiografia
10.
Acta Chir Scand ; 156(2): 131-6, 1990 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-2330792

RESUMO

Data from analysis of bicycle injuries in a defined, semirural Finnish population were compared with the national hospital discharge register and official police statistics and were related to national data on prevalence of bicycling. The results suggested an incidence of 7.3 injured persons/1000 population, which was 20-fold the figure derived from the police statistics. Inclusion of injuries treated at health centres doubled the number requiring medical attention. Bicycle injuries accounted for 52% of all traffic injuries. A motor vehicle was involved in 11% of bicycle injuries. In these accidents 18% of the victims were hospitalized, but only 6% in other bicycle accidents. Police and hospital records overestimated the proportion of motor vehicle crashes, involvement of elderly persons and incidence of head injuries and fractures. Non-motor vehicle bicycle accidents accounted for most of bicycle injuries, for 58% of in-patients and 93% of out-patients. Information from all levels of health care is required for injury control.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Ciclismo/lesões , Ferimentos e Lesões/epidemiologia , Acidentes de Trânsito/mortalidade , Adolescente , Adulto , Criança , Estudos Transversais , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Finlândia/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Ferimentos e Lesões/mortalidade
11.
J Thorac Cardiovasc Surg ; 98(3): 355-61, 1989 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-2770317

RESUMO

Several investigations have indicated that rupture of the thoracic aorta is one of the leading causes of immediate death in victims of road traffic accidents. In Finland in 1983, 92% of front-seat passengers were seat belt wearers on highways and 82% in build-up areas. The mechanisms of rupture of the aorta have been intensively investigated, but the relationship between seat belt wearing and injury mechanisms leading to aortic rupture is still largely unknown. This study comprises 4169 fatally injured victims investigated by the Boards of Traffic Accident Investigation of Insurance Companies during the period 1972 to 1985. Chest injuries were recorded as the main cause of death in 1121 (26.9%) victims, 207 (5.0%) of those victims having worn a seat belt. Aortic ruptures were found at autopsy in 98 victims and the exact information of the location of the aortic tears was available in 68. For a control group, we analyzed 72 randomly chosen unbelted victims who had a fatal aortic rupture in similar accidents. The location of the aortic rupture in unbelted victims was more often in the ascending aorta, especially in drivers, whereas in seat belt wearers the distal descending aorta was statistically more often ruptured, especially in right-front passengers (p less than 0.05). The steering wheel predominated statistically as the part of the car estimated to have caused the injury in unbelted victims (37/72), and some interior part of the car was the most common cause of fatal thoracic impacts in seat belt wearers (48/68) (p less than 0.001). The mechanism of rupture of the aorta in the classic site just distal to the subclavian artery seems to be rapid deceleration, although complex body movements are also responsible in side impact collisions. The main mechanism leading to rupture of the ascending aorta seems to be severe blow to the bony thorax. This also often causes associated thoracic injuries, such as heart rupture and sternal fracture. Injuries in the ascending aorta were mostly found in unbelted victims and were sustained in frontal impact collisions, the injury-causing part of the car being the steering wheel. Ruptures of the distal descending part of the aorta were frequently associated with fractures of the thoracic vertebra.


Assuntos
Acidentes de Trânsito/mortalidade , Ruptura Aórtica/mortalidade , Cintos de Segurança/efeitos adversos , Aorta Abdominal , Aorta Torácica , Ruptura Aórtica/etiologia , Feminino , Finlândia , Humanos , Masculino , Traumatismos Torácicos/etiologia , Traumatismos Torácicos/mortalidade
12.
J Trauma ; 27(4): 393-7, 1987 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-3573085

RESUMO

In Finland during the period 1972-1983, there were 3,564 severe traffic accidents involving one or more victims dying within 30 days of the accident. Forty-two of the victims had been wearing a seatbelt and had an abdominal trauma as the main cause of death or as first diagnosis of injury. Small intestine and colon injuries were more common in the severely injured victims than was the case with the fatally injured ones and in these accidents the injury mechanism was always deceleration or contusion, which was in most cases caused by the seatbelt. Liver injuries seem to be the major abdominal cause of fatality, and in the fatally injured group, half of the victims sustained the fatal abdominal injury through gross crushing impact. When the direction of the impact was analyzed, all the victims seated on the receiving side of the vehicle in lateral impact collisions sustained an abdominal injury with fatal outcome. It seems that the seatbelt is less effective in protecting wearers from severe or fatal abdominal injuries in lateral impact collisions.


Assuntos
Traumatismos Abdominais/etiologia , Acidentes de Trânsito , Cintos de Segurança , Traumatismos Abdominais/epidemiologia , Traumatismos Abdominais/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Desaceleração , Feminino , Finlândia , Humanos , Intestino Delgado/lesões , Fígado/lesões , Masculino , Cintos de Segurança/efeitos adversos , Baço/lesões , Traumatismos Torácicos/complicações
13.
Br J Oral Maxillofac Surg ; 24(4): 251-7, 1986 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-2942177

RESUMO

A survey of 84 victims of maxillofacial injuries sustained in road traffic accidents is presented. The material was based on the files of the Finnish National Board of Traffic Accident Investigation of the Insurance Companies, comprised the years 1972-1983 and covered the whole country. 86% of the victims were occupants of motor cars; only 24% had worn seat belts. Similarly only two of the eight motor-cyclists had worn a helmet. The majority of all victims also had other head injuries but only 24% had brain injuries; over 50% had a chest injury. In 20 cases the facial injury was thought to be the definitive fatal trauma. In the remaining cases the other injuries could have been responsible for the fatal outcome. However, aspiration of blood from the facial wounds, unconciousness and an injured thorax probably all contributed to death which in 87% was immediate. Thirty-six of the 64 victims who had not used a seat-belt or helmet could certainly, or probably, have been saved by either the belt or the helmet. The possibilities of preventing fatal maxillofacial injuries in road traffic are discussed.


Assuntos
Acidentes de Trânsito , Traumatismos Maxilofaciais/epidemiologia , Adolescente , Adulto , Idoso , Lesões Encefálicas/epidemiologia , Lesões Encefálicas/mortalidade , Criança , Feminino , Finlândia , Humanos , Masculino , Traumatismos Maxilofaciais/mortalidade , Pessoa de Meia-Idade , Fraturas Cranianas/epidemiologia , Fraturas Cranianas/mortalidade
14.
Injury ; 17(3): 154-8, 1986 May.
Artigo em Inglês | MEDLINE | ID: mdl-3818051

RESUMO

The present study analyses fatal road traffic accidents involving private cars and vans in Finland during the period 1972-1982, in which an injury to the cervical spine was the main cause of death. The material consists of 289 victims; this being 10.5 per cent of all the fatalities in this category of road traffic accidents. Front seat and rear seat passengers seem to have an equal risk of sustaining a fatal cervical spinal injury. However, front seat passengers have a significantly greater chance (P less than 0.001) of having fatal cervical spinal injuries than the drivers. Of the victims 21.1 per cent had worn safety belts but there was no statistical difference between those who did and those who did not wear safety belts. Increasing age seems to increase the risk of fatal cervical spinal injuries. Patients between 16 and 25 years of age had the lowest risk and patients over the age of 60 had the highest risk of sustaining a fatal cervical spinal injury (P less than 0.001). In 48.1 per cent of the cases, the victims were multiply injured and this is similar to other main causes of death in road traffic accidents. Wearers of safety belts had significantly (P less than 0.001) more multiple injuries. Of the patients who died of cervical injury, only 8.8 per cent survived transportation to hospital and 1.4 per cent survived longer than 24 hours. A direct blow was the most common mechanism of the cervical injury (47.1 per cent) and deceleration was found in 13.1 per cent of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Acidentes de Trânsito , Vértebras Cervicais/lesões , Fatores Etários , Feminino , Humanos , Masculino , Cintos de Segurança , Traumatismos da Coluna Vertebral/mortalidade , Traumatismos da Coluna Vertebral/prevenção & controle , Fatores de Tempo
15.
Ann Chir Gynaecol ; 73(1): 14-20, 1984.
Artigo em Inglês | MEDLINE | ID: mdl-6732152

RESUMO

The present investigation was based on the files of the Boards of Traffic Accident Investigation of insurance companies with regard to those fatal motor-car accidents in Finland during the period 1972-1979, where the driver or front seat passenger had died. The analysis concerned a total of 1197 fatalities. In collisions where the other vehicle had been clearly heavier (mass distribution smaller than 1/5) head injuries were significantly (p less than 0.001) more often found as the main cause of death (57.3%) than was the case when colliding vehicles had approximately the same weight (mass distribution 2/3-3/2), in which case head injuries were found in 37.8% of the cases to be the main cause of death. When the speed was over 80 kph , the number of head injuries as the main cause of death increased significantly (p less than 0.001) in collisions where the vehicles had approximately the same weight (mass distribution 2/3-3/2) and in single accidents of motor-cars. The wearing of seat belts had an effect on the distribution of causes of death in single accidents of motor-cars and in collisions where the vehicles had approximately the same weight but did not effect the distribution of causes of death in collisions where the other vehicle was clearly heavier. In single accidents of motor-cars where the victims had not used seat belts, there were more head injuries (54.2%) as the main cause of death than in victims who had used seat belts (head injuries in 36.8% as the main cause of death). In collisions where the vehicles had approximately the same weight, cervical spine injuries were more common causes of death in victims who had used seat belts than in those who had not (21.3%/13.7%). The mechanism of fatal cervical spine injuries in victims who had used seat belts was the rapid bending of the neck due to maximal deceleration in 38% of cases.


Assuntos
Acidentes de Trânsito , Automóveis , Traumatismos Craniocerebrais/mortalidade , Cintos de Segurança , Ferimentos e Lesões/mortalidade , Traumatismos Craniocerebrais/etiologia , Traumatismos Craniocerebrais/prevenção & controle , Finlândia , Humanos , Fenômenos Físicos , Física , Ferimentos e Lesões/etiologia , Ferimentos e Lesões/prevenção & controle
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