The impact of helmets on motorcycle head trauma at a tertiary hospital in Jamaica

<p>Abstract</p> <p>Background</p> <p>Although the Jamaica road traffic act mandates motorcycle riders to wear approved helmets, opponents suggest that the local road conditions obviate any benefits from helmet use that have been proven in Developed countries. They suggest that the narrow, winding, poorly surfaced, congested local highways do not allow motorcyclists to sustain high velocity travel. The accidents then tend to occur at lower speeds and are accompanied by less severe injuries. This study was carried out to determine the impact of helmet use on traumatic brain injuries from motorcycle collisions in patients admitted to a tertiary referral hospital in Jamaica.</p> <p>Methods</p> <p>A prospectively collected trauma registry maintained by the Department of Surgery at the University Hospital of the West Indies in Jamaica was accessed to identify all motorcycle collision victims from January 2000 to January 2007. The therapeutic outcomes of traumatic brain injuries were compared between helmeted and un-helmeted riders. The data was analyzed using SPSS Version 12.</p> <p>Results</p> <p>Of 293 motorcycle collision victims, 143 sustained brain injuries. There were 9 females (6.3%) with an average age of 23 +/- 7.3 years and 134 males (93.7%) at an average age of 33.4 +/- 11.2 years (mean +/- SD). Only 49 (34.3%) patients wore a helmet at the time of a collision. Helmet use at the time of a collision significantly reduced the severity of head injuries (28.6% vs 46.8%, P = 0.028) and the likelihood of sustaining intra-cranial lesions (26.5% vs 44.7%, P = 0.03) from head injuries.</p> <p>Conclusion</p> <p>Wearing a helmet at the time of a motorcycle collision reduces the severity of head injuries. However, the prevalence of helmet use at the time of a collision is unacceptably low.</p

Mortality, Recruitment and Change of Desert Tree Populations in a Hyper-Arid Environment

BACKGROUND: Long-term vegetation changes in hyper-arid areas have long been neglected. Mortality, recruitment and change in populations of the ecologically and culturally important and drought persistent Acacia tortilis and Balanites aegyptiaca are therefore estimated in the Eastern Desert of Egypt, and are related to the primary agents of change, water conditions and human intervention. METHODOLOGY: A change analysis using high-resolution Corona images (1965) in combination with field data (2003) is the basis for recruitment, mortality and change estimates. For assessing the influence of water conditions on patterns in recruitment and survival, different types of generalized linear models are tested. CONCLUSIONS: The overall trend in population size in that part of the Eastern Desert studied here is negative. At some sites this negative trend is alarming, because the reduction in mature trees is substantial (>50%) at the same time as recruitment is nearly absent. At a few sites there is a positive trend and better recruitment. Frequent observations of sprouting in saplings indicate that this is an important mechanism to increase their persistence. It is the establishment itself that seems to be the main challenge in the recruitment process. There are indications that hydrological variables and surface water in particular can explain some of the observed pattern in mortality, but our results indicate that direct human intervention, i.e., charcoal production, is the main cause of tree mortality in the Eastern Desert

Pompe disease diagnosis and management guideline

ACMG standards and guidelines are designed primarily as an educational resource for physicians and other health care providers to help them provide quality medical genetic services. Adherence to these standards and guidelines does not necessarily ensure a successful medical outcome. These standards and guidelines should not be considered inclusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed to obtaining the same results. in determining the propriety of any specific procedure or test, the geneticist should apply his or her own professional judgment to the specific clinical circumstances presented by the individual patient or specimen. It may be prudent, however, to document in the patient's record the rationale for any significant deviation from these standards and guidelines.Duke Univ, Med Ctr, Durham, NC 27706 USAOregon Hlth Sci Univ, Portland, OR 97201 USANYU, Sch Med, New York, NY USAUniv Florida, Coll Med, Powell Gene Therapy Ctr, Gainesville, FL 32611 USAIndiana Univ, Bloomington, in 47405 USAUniv Miami, Miller Sch Med, Coral Gables, FL 33124 USAHarvard Univ, Childrens Hosp, Sch Med, Cambridge, MA 02138 USAUniversidade Federal de São Paulo, São Paulo, BrazilColumbia Univ, New York, NY 10027 USANYU, Bellevue Hosp, Sch Med, New York, NY USAColumbia Univ, Med Ctr, New York, NY 10027 USAUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Controlled Comparison of BacT/Alert MB System, Manual Myco/F Lytic Procedure, and Isolator 10 System for Diagnosis of Mycobacterium tuberculosis Bacteremia▿

We compared the performance of the BacT/Alert MB system, that of the manual Bactec Myco/F Lytic procedure, and that of the Isolator 10 lysis-centrifugation system in the detection of Mycobacterium tuberculosis bacteremia. Mean times to detection were 16.4 days for BacT/Alert MB versus 20.0 days for Myco/F Lytic, 16.5 days for BacT/Alert MB versus 23.8 days for Isolator 10, and 21.1 days for Bactec Myco/F Lytic versus 22.7 days for Isolator 10. There were no significant differences in yields. The mean (range) magnitude of mycobacteremia was 30.0 (0.4, 90.0) CFU/ml and was correlated with the time to positivity in the BacT/Alert MB system (r = −0.4920). M. tuberculosis bacteremia was detected more rapidly in a continuously monitored liquid blood culture system, but the mean time to positivity exceeded 3 weeks

Late diagnosis and entry to care after diagnosis of human immunodeficiency virus infection: a country comparison.

Testing for HIV infection and entry to care are the first steps in the continuum of care that benefit individual health and may reduce onward transmission of HIV. We determined the percentage of people with HIV who were diagnosed late and the percentage linked into care overall and by demographic and risk characteristics by country.Data were analyzed from national HIV surveillance systems. Six countries, where available, provided data on two late diagnosis indicators (AIDS diagnosis within 3 months of HIV diagnosis, and AIDS diagnosis within 12 months before HIV diagnosis) and linkage to care (≥ 1 CD4 or viral load test result within 3 months of HIV diagnosis) for people diagnosed with HIV in 2009 or 2010 (most recent year data were available).The percentage of people presenting with late stage disease at HIV diagnosis varied by country, overall with a range from 28.7% (United States) to 8.8% (Canada), and by transmission categories. The percentage of people diagnosed with AIDS who had their initial HIV diagnosis within 12 months before AIDS diagnosis varied little among countries, except the percentages were somewhat lower in Spain and the United States. Overall, the majority of people diagnosed with HIV were linked to HIV care within 3 months of diagnosis (more than 70%), but varied by age and transmission category.Differences in patterns of late presentation at HIV diagnosis among countries may reflect differences in screening practices by providers, public health agencies, and people with HIV. The percentage of people who received assessments of immune status and viral load within 3 months of diagnosis was generally high

Development of a dual university system health research partnership as a foundation for the Sustainable Development Goals

Background: An innovative dual-system collaboration between the University of the West Indies and the State University of New York was created and implemented by a joint Health Research Faculty Task Force to establish a platform for education and research that would yield an integrated approach to the Sustainable Development Goals (SDGs). Methods: Following the establishment of a joint Center for Leadership and Sustainable Development, a needs assessment was conducted to identify research and education priorities that would benefit from a dual-system linkage structure. Partnerships were facilitated using HUBzero—an open-source software platform with project-specific faculty and staff assigned to each development group. Findings: Programmes in virology research; antimicrobial resistance and stewardship; liver, kidney, and metabolic diseases; and autoimmune diseases, together with the creation of a Clinical Research Center, were identified as highest priorities. Cannabinoid sciences and a joint effort in cancer research, natural products, and nanotechnology to identify indigenous compounds and develop nanomedicine were also key areas. A working group focused on a strategy for workforce planning through science, technology, engineering, and mathematics has also been implemented. Interpretation: This programme uses innovative technology platforms to promote shared project development and is a novel alternative to the traditional model that requires travel and prolonged visits at different training sites. A framework is now established to enable the Joint Health Research Faculty Task Force to begin implementation of high-impact health research initiatives as a foundation for multiple SDGs and to drive regional timelines and milestones. These education and research programmes will be funded through competitive research grants and used to complete data analytics for budget forecasting to achieve the SDGs. Funding: None

Number of people diagnosed with HIV infection and percentage who had a CD4 and/or viral load test within 3 months of HIV diagnosis, by country of residence.

a<p>Cases of HIV infection newly diagnosed HIV infection in Australia in 2010 including cases previously diagnosed overseas. All new diagnoses inAustralia in 2010, reported by 31 March 2012. All new diagnoses includes cases previously diagnosed overseas, some of whom have received treatment for HIV infection. The heterosexual contact category includes 53M, 80F, total 133 cases from high prevalence countries and 42M, 12F, total 54 cases whose exposure was attributed to heterosexual contact with a partner from a high prevalence country.</p>b<p>This dataset is not nationally representative; it includes data from 4 of the 13 provinces and territories and one of these jurisdictions was incomplete (nominal cases only). Across all 13 P/Ts, a total of 2,358 HIV cases were reported in 2010.</p>c<p>HIV surveillance includes the whole country except Sardegna region (coverage 97.8%). Data reported by 31 December 2010.</p>d<p>Data Source: New HIV Diagnoses Information System (SINIVIH in Spanish). In 2011, SINIVIH was implemented in 17 out of 19 Autonomous Region, and coverage was 71% of the total Spanish population. While information on first CD4 count after diagnosis is available in all Regions, information on DATE of CD4 count determination is currently available only in seven (Aragon, Asturias, Canary Islands, Castile-Leon, Madrid, Murcia and Navarre). This seven regions provided 1519 (52.2%) of the total 2907 new HIV diagnoses notified in 2010. Information on date of CD4 count was missing in 248 (16%) of the 1519 new HIV diagnoses. Information on viral load determination within 3 months after HIV diagnosis is not collected.</p>e<p>Includes cases of HIV infection diagnosed in 14 jurisdictions of the United States and reported by 31 December 2011. Estimated numbers resulted from statistical adjustment that accounted for missing risk-factor information, but not for reporting delays and incomplete reporting. Age group 10–19 includes 13–19 only.</p>f<p>MSM, men who have sex with men; IDU, injection drug use.</p

Percentage of people who had an HIV diagnosis within 12 months before AIDS diagnosis, among people diagnosed with AIDS in 2010, by country of residence–Italy, Spain, and United States.

a<p>National AIDS Register include the whole country. Data collected at 12/31/2011.</p>b<p>Spanish AIDS Register which covers the whole country. Information on date of of HIV dianosis is available in 900 (96.8%) of AIDS cases notified to the Register.</p>c<p>New diagnoses of AIDS, reported by 31 December 2011.Estimated numbers resulted from statistical adjustment that accounted for missing risk-factor information, but not for reporting delays and incomplete reporting.</p>d<p>MSM, men who have sex with men; IDU, injection drug use.</p