摘要:

The use of cocaine in the United States has reached near epidemic proportions. A major factor responsible for the dramatic increase in cocaine use is the ability to freebase cocaine and extract essentially pure drug to be smoked as crack. As a result, a variety of respiratory problems temporally associated with crack inhalation have been reported. Cocaine may cause changes in the respiratory tract as a result of its pharmacologic effects exerted either locally or systemically, its method of administration (smoking, sniffing, injecting), or its alteration of central nervous system neuroregulation of pulmonary function. These changes include such diverse disorders as thermal airway injury, pulmonary edema and hemorrhage, hypersnsitivity reactions, and interstitial lung disease. However, a review of the pulmonary pathology and dysfunction associated with crack and/or cocaine use indicates that the reported changes are most likely multifactorial, even idiosyncratic, and fails to reveal common features diagnostic of cocaine use. It is likely that the spectrum of cocaine-induced pulmonary diseases will continue to enlarge.

ISSN:0195-7910    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We reviewed the Dallas County Medical Examiner's Office records of all individuals who had died in a local Christian Science Sanatorium during a 51/2-year period. Of 116 such patients, only 13 (11%) had pressure sores (decubitus ulcers). In 10 of these patients, the sores were described as small, superficial, and/or healing, while the other three patients had more serious ulcers. In contrast, for patients dying in nursing homes or hospitals, the incidence of pressure sores may be as high as 54–57%. It is our opinion that the difference in incidence is due to the personal and conscientious nursing care provided by Christian Science institutions.

ISSN:0195-7910    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Reviewed here are those circumstances surrounding 18 downhill skiing deaths in Alberta, Canada. Variables that elevate the risk of injury and death are highlighted. This study profiles the fatally injured skier. The individual most likely to die while downhill skiing is an experienced male skier, average age 31 years. He loses control while skiing too fast and strikes an object, resulting in fatal blunt trauma injuries. The ability to define characteristics of the individual at risk of a fatal ski injury is important to the design and implementation of injury prevention programs. Public education targeted to those at risk may reduce the incidence of death and injury in downhill skiing.

ISSN:0195-7910    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A review of circumstances surrounding 19 backcountry deaths in Alberta, Canada, between 1980 and 1991 suggests several factors that increase the risk of injury or death. This study provides a descriptive profile of a fatally injured backcountry skier and the circumstances surrounding his or her death. The individual most likely to suffer a fatal injury while participating in a back-country ski activity is a 36-year-old man. He is typically an experienced backcountry skier who chooses to ski in areas where the avalanche hazard is known to be moderate to extreme. Delineating the personal characteristics of those at risk for backcountry injury and identifying situations that put them at risk will enable better design of education programs. Targeting high-risk groups may also reduce the incidence of death from this activity.

ISSN:0195-7910    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Occasionally, encounters with a grizzly or a black bear have proved fatal. We describe the characteristics of fatal bear maulings and the circumstances that provoked them. The actions of wild bears are compared with those of bears that have become comfortable around people (wild/“habituated” bears). A description of eight deaths that occurred in the province of Alberta, Canada, between 1973 and 1988 will underscore the above.

ISSN:0195-7910    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

People use horses for work and recreational purposes on farms and ranches in Alberta, Canada. This retrospective descriptive review examines the records of all those people killed while around horses between 1975 and 1990. The intent is to ascertain features common to these injuries and to suggest prevention strategies. Records from the Office of the Chief Medical Examiner of Alberta revealed that 38 people were involved in horse-related fatalities between 1975 and 1990 and that 22 died of head injuries. All 38 deaths were classified as accidental. Some of these might have been prevented, or injuries might have been minimized by riders' wearing approved riding helmets. Public education encouraging the proper use of protective headgear is necessary if there is to be a reduction in the severity of these injuries.

ISSN:0195-7910    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A simple scheme is presented to enable coding of toxicologic data by medical examiners or coroners who can design or direct the structure of their computer databases. Based on the English language, BLURBs are created, which consist of a prefix describing the specimen, a root word indicating the substance analyzed, and a suffix indicating the test results. BLURBs are easily interpretable and can reduce computer disk space usage, facilitate useful queries, and promote uniformity of data.

ISSN:0195-7910    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

General information and principles regarding the automation of medical examiner and coroner offices are presented. Topics discussed include the importance of using available resource groups, questions that should be answered to determine the need for automation, the importance of specifically defining office needs and goals prior to automation, the value of capturing data in multiple ways, the importance of maintaining some hardcopy files, the value of ensuring capability to modify and enlarge the computer system, the need to tailor systems to the needs of specific offices, possibilities for generating money or acquiring equipment at little or no cost, the use of personal computers and commercially available software, the value of having all operations in-house, transition to new operating systems and environments, and the foreseeable use of emerging technologies.

ISSN:0195-7910    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The death of an individual on a military installation often raises the question of who has the authority to investigate that death and perform an autopsy. The answer to this question depends upon whether jurisdiction is exclusively federal or is shared by the state and federal governments. Jurisdiction can be determined by contacting the installation's Directorate of Engineering and Housing or the legal office. When there is exclusive federal jurisdiction, the installation commander or the Armed Forces Medical Examiner may authorize an autopsy on a military member. Under certain conditions, the installation commander may authorize an autopsy on a civilian, especially where a legitimate connection exists between that civilian and the federal government. When jurisdiction is concurrent (that is, shared by the state and federal governments), the civilian medical examiner may waive jurisdiction to the military, but only as to the death of a military member. The authority to investigate the death of a civilian (whether a military dependent or not), to include autopsy examination, is exclusively civilian when jurisdiction is concurrent. Overseas locations are controlled by special agreements that in general, give the U.S. government jurisdiction over military members, their dependents, and U.S. civilian components of the assigned force.

ISSN:0195-7910    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The use of U.S. vital statistics for surveillance of drug-related mortality may be limited by the way in which certifiers complete death certificates and by the constraints of theInternational classification of diseases, Ninth Revision(ICD-9). ICD-9 is the system used by the National Center for Health Statistics (NCHS) to compile national, cause-specific mortality data from information reported on death certificates. To investigate the extent of variability in certification practices among medical examiners (MEs), we conducted a mailout survey in which we asked a national sample of 49 MEs to review summaries of 28 death scenarios and, for each death, assign the cause and manner of death. Cocaine use was the unequivocal cause of death for 17 of the 28 deaths. We then asked a nosologist at NCHS to code the verbatim survey responses in accordance with the rules and rubrics of the ICD-9 system. Of the 20 MEs who responded, 14 provided complete cause and manner determinations. For the cocaine-caused deaths, the 14 respondents provided 238 cause-of-death statements; 220 (92.4%) explicitly mentioned cocaine. However, only 45 of the 238 responses (18.9%) led to a cocaine-specific ICD-9 code for the underlying cause of death. Our findings illustrate how death certification practices, coupled with the ambiguities of the ICD-9 system, may lead to substantial loss of detail about cocaine-caused deaths and misclassification of these deaths in official compilations of mortality statistics.

ISSN:0195-7910    

出版商:OVID    

年代:1993

数据来源: OVID