sodium-ethylxanthate and Craniocerebral-Trauma

This Report puts forward a plan for the management of physical disability. It recognises that the subject is administratively complex and that many different organisations, including Social Services, are involved. The Report concentrates upon the role of the NHS in general, and upon the position of physicians in particular. The Report starts by reviewing some of the evidence that services for the physically disabled are in many respects deficient. The evidence includes accounts given by disabled people themselves, the fact that many patients are 'follow-up' by inexperienced junior hospital staff, and the lack of agreed standards of provision in many areas (see Section 3) such as pressure sores, incontinence, wheelchairs, and the care of head injured patients. Disabled people between the ages of 15 and 65 are identified as requiring particular attention (Paediatric and Geriatric Services probably cater reasonably well for the young and the old). The 'size' of the problem of physical disability is examined. For instance, the average Health District (of 250,000 persons) will contain 25,000 physically disabled people, of whom 6,250 will be severely, or very severely disabled; and 1,800 will have a wheelchair; 40 per cent of disabled people are under the age of 65. The Working Party on Rehabilitation Medicine of the Royal College of Physicians (1978) was of the opinion that rehabilitation is an integral part of total patient care, and is therefore the concern of all clinicians. The implication of this view is that Medical Disability Services should be developed without a major specialty of Rehabilitation or its equivalent, such as exists in most western countries. The Report explores the practical implications of this principle in the light of evidence discussed above.

Topics: Adolescent; Adult; Aged; Automobile Driving; Child; Communication Aids for Disabled; Craniocerebral Trauma; Delivery of Health Care; Disabled Persons; England; Female; Hearing Disorders; Humans; Male; Middle Aged; Orthotic Devices; Pressure Ulcer; Prostheses and Implants; Quality of Health Care; Regional Medical Programs; Rehabilitation; Research; Sex; Urinary Incontinence; Vision Disorders; Wales; Wheelchairs

Topics: Altitude Sickness; Brain; Cerebrovascular Disorders; Cold Temperature; Craniocerebral Trauma; Endarterectomy; Food; Giant Cell Arteritis; Headache; Humans; Hypertension; Hypertension, Renal; Lupus Erythematosus, Systemic; Migraine Disorders; Physical Exertion; Sex; Vascular Diseases; Vascular Headaches

To investigate mortality rate in a population of adults admitted to hospital with mild head injury (MHI) 15 years later.. A prospective case control, record linkage study.. 2428 adults with MHI and an equal number of community controls (CC) were case-matched for age, gender and social deprivation. A further control group admitted with a non-head injury was in addition matched for duration of hospital admission. Controls with a history of head injury prior to study entry were excluded.. Death or survival 15 years poststudy entry.. Mortality per 1000 per year after MHI (24.49; 95% CI 23.21 to 25.79) was higher than in CC (13.34; 95% CI 12.29 to 14.44; p<0.0001) or 'other injury' controls (OIC) (19.63; 95% CI 18.43 to 20.87; p<0.0001). Age at injury was important: younger adults (15-54 years) with MHI had a 4.2-fold greater risk of death than CC; in adults aged over 54, the risk was 1.4 times higher. Gender and social deprivation showed a similar association with death in the MHI and control groups. Repeated head injury was a risk factor for death in the MHI group. The frequency of hospital admission with systemic disease preinjury and postinjury was higher in both injury groups than in CC and higher in MHI than OIC. Prospective data in the MHI group suggest an association between preinjury lifestyle and mortality. Causes of death after MHI were similar to those of the control groups.. Adults hospitalised with MHI had greater risk of death in the following 15 years than matched controls. The extent to which lifestyle and potential chronic changes in neuropathology explain these findings is unclear. Lifestyle factors do contribute to risk of death after MHI and this finding has implications for lifestyle management interventions.

Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Case-Control Studies; Cause of Death; Craniocerebral Trauma; Female; Hospitalization; Humans; Kaplan-Meier Estimate; Life Style; Male; Middle Aged; Prospective Studies; Risk Factors; Sex; Socioeconomic Factors; Young Adult

A retrospective study of children with head injuries and head lacerations in an active emergency department (Vancouver General Hospital) revealed differences in incidence with age and sex, as well as relationships between the frequency of visits and the season, the day of the week and the time of day. Radiographs were taken of a large number of the patients with head injuries and a significant proportion of these children were admitted to hospital.A prospective study is proposed which would examine the natural history of accidental head injuries in children.

Topics: Adolescent; Aging; British Columbia; Child; Child, Hospitalized; Child, Preschool; Craniocerebral Trauma; Female; Humans; Infant; Infant, Newborn; Male; Retrospective Studies; Seasons; Sex; Statistics as Topic

Topics: Autonomic Nervous System Diseases; Craniocerebral Trauma; Electroencephalography; Epilepsy; Headache; Humans; Hyperventilation; Light; Mental Disorders; Seizures; Sex; Sleep; Substance-Related Disorders; Syncope

Topics: Ankylosis; Cervical Vertebrae; Craniocerebral Trauma; England; Family Practice; Humans; Mining; Neck; Occupational Medicine; Prevalence; Radiography; Sex; Spondylosis; Statistics as Topic

Topics: Air Pollution; Asphyxia; Bronchitis; Cerebrovascular Disorders; Cough; Craniocerebral Trauma; Electrocardiography; Heart Failure; Humans; Myocardial Infarction; Neoplasm Metastasis; Neoplasms; Occupations; Peptic Ulcer; Pneumonia; Pneumothorax; Polycythemia; Pulmonary Emphysema; Pulmonary Heart Disease; Radiography, Thoracic; Respiratory Function Tests; Sex; Smoking; Suicide

Topics: Athetosis; Black People; Brain Diseases; Cerebral Palsy; Cerebrovascular Disorders; Child; Classification; Craniocerebral Trauma; Hemiplegia; Meningitis; Movement Disorders; Muscle Spasticity; Paralysis; Paraplegia; Sex; Statistics as Topic; Tremor