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Results in treatment of polytraumatic patients after a car accident that occurred between 2002 and 2003 at the Dept. of surgery and transplantation of the Tübingen University Hospital, under consideration of airbag and seatbelt
No full textDiese Arbeit untersucht präklinische und klinische Aspekte bei Verkehrsunfallopfern. Im Rahmen des Qualitätsmanagements werden die Behandlungsergebnisse von in den Schockraum eingelieferten Patienten ermittelt und mit früheren Untersuchungen an der UKT und anderen Kliniken verglichen. Unter Berücksichtigung der zunehmenden Gurtnutzung, der serienmäßigen Pkw-Ausstat¬tung mit Airbag und ABS-Bremssystemen sowie Stabilisierungsprogrammen lassen sich Veränderungen von Verletzungsschwere, Verletzungsmustern und Outcome der verunfallten Fahrzeug¬insassen aufzeigen.
Diese Studie erfasst retrospektiv insgesamt 834 Patienten, welche in den Jahren 2002 und 2003 in den Schockraum der Chirurgischen UKT eingeliefert wurden. Davon wurden 65 Pkw-Unfälle, in 20 Fällen auch unter Einsichtnahme der polizeilichen Unfalldokumentation, genauer aus¬gewertet. In 13 Fällen wurden kasuistisch Unfallhergang, Verletzungsschutz durch Sicherheitsgurt und Airbag, präklinische Versorgung und klinische Behandlung dargestellt.
In den Monaten Mai bis Juli verunfallten im Jahresverlauf die meisten Menschen. Durchschnittlich wurden 35 Patienten pro Monat in den Schockraum eingeliefert (Max.: 56, Juli 2002 / Min.: 20, Januar 2003). An Freitagen und Samstagen sowie am späten Nachmittag (16-18 Uhr) fanden sich erhöhte Patientenzahlen. Mit 67% gegenüber 33% waren ca. zwei Drittel männliche Verletzte. Das Durch¬schnittsalter für 2002 betrug 39 (Max.: 91, Min.: 75 Jahre) auf. Zudem konzentrieren sich die Einlieferungen auf die Sommermonate und die Wochenenden, während in Tages-, Alters- und Geschlechtsverteilung keine deutlichen Veränderungen festzustellen sind. Pkw-Unfälle sind heute wie auch in früheren Untersuchungen die häufigste Unfallart.
Bei Pkw-Unfällen verunglücken etwa doppelt so viele Männer wie Frauen. Die 18-22 Jährigen waren mit 21% die größte Altersgruppe. Die durchschnittliche Anfahrtszeit des Notarztes (NA) betrug sieben Minuten (Max.: 27, Min.: 3). Mehr als die Hälfte der Patienten (61%) verunfallte als Fahrzeugführer, 25% als Beifahrer. Frontale Zusammenstöße waren die häufigsten Kollisionsart. 15% der Patienten standen zum Unfallzeitpunkt unter dem Einfluss von Alkohol, eine Beeinträchtigung der Fahrtüchtigkeit durch Drogen war in keinem der eingesehen Fälle dokumentiert. Den Beurteilungen des NA zufolge verblieben 54% der Patienten im Verlauf des Transportes in gleichem Vitalzustand, bei 46% wurde eine Verbesserung festgestellt. Der Vergleich der NA-Diagnosen am Unfallort mit den klinischen Befunden nach Abschluss der Diagnostik zeigt, dass Verletzungen aller Körperregionen vom NA eher überschätzt wurden. Bei Patienten nach Pkw-Unfall sind Kopf (75%) und Thorax (73%) am häufigsten betroffen. 25% der Patienten hatten abdominale Verletzungen, wobei Leberrupturen überwogen. Die Letalität bei Patienten nach Pkw-Unfall betrug 12%.
Die Gurtanlegequote der eingelieferten Patienten lag bei lediglich 42%, was deutlich unter dem Bundesdurchschnitt von über 90% ist. Anhand der am Unfallort durch den NA notierten Punktzahl nach Glasgow Coma Scale und auch eine Aufschlüsselung der Verletzungsmuster konnte ein effektiver Insassenschutz durch den angelegten Sicherheitsgurt belegt werden. In sechs Fällen lässt sich der Einsatz eines Airbag nachweisen. Dabei finden sich keine airbagspezifischen Verletzungsmuster wie Verbrennungen, Hörschäden oder Prellungen dokumentiert. Ein Verletzungsschutz durch Airbageinsatz konnte nicht nachgewiesen werden. Ein Grund dafür liegt in der durchweg erhöhten Unfallschwere bei Verkehrsunfällen mit Airbageinsatz, da die Sensoren des Pkw erst ab einer bestimmten kinetischen Energie und Dezeleration des Fahrzeugs eine Airbagauslösung bewirken.
In den obigen Untersuchungsergebnissen bleibt offen, ob der Airbag trotz der hier nicht nachgewiesenen Wirksamkeit als Verletzungsschutz im Einzelfall dem Verunfallten das Leben gerettet hat. Der angelegte Sicherheitsgurt stellte sich in allen Erhebungen als effektivster Verletzungsschutz beim Pkw-Unfall heraus. Daher ist eine weitere Zunahme der Gurtanlegequote anzustreben.This retrospective study analyses preclinical and clinical data of 834 trauma patients that occurred between 2002 and 2003 and were treated at the Dept. of surgery and transplantation of the Tübingen University Hospital. For our quality management we analyzed treatment results of these patients and compared these with earlier researches. Under consideration of the increasing usage of seatbelts, airbags, breaking systems and stabilizing systems, we found a change in the grades and types of injuries and outcome assessment in car accidents.
We used a database to examine the epidemiology, frequency, cause and therapy of these trauma cases. 65 cases of car accidents were evaluated more detailed under insight of police records.
The average number of admitted patients was 35 per month, maximum between May and July on Fridays and Saturdays late afternoon. Among these patients were 65% male and 33% female. Causes of injury were car accidents, 23% falls and 10% accidents with cycles as well as motorcycles. The lethality rate was 18%. More than 50% died in the first 48 hours after trauma. Comparisons with other descriptive researches (1979/80/81 and 1990/91) at Tübingen University Hospital accentuate a development towards older patients >75 years. In epidemiology and gender there were no remarkable changes verified. In all analysis car accidents were most common.
People between the age of 18 and 22 years represented the highest percentage in car accidents. More than half of the injured were drivers. Most frequent type of accidents was a frontal collision. 15% were under the influence of alcohol, no cases of drug usage were documented. The comparison of diagnoses by emergency physicians with finished clinical diagnosis showed that every kind of injury was overestimated. In total, head and thorax were mostly involved. 25% had abdominal traumas with mainly liverruptures. Lethality rate in car accidents was 12%.
Among the examined cases the rate of seatbelt usage was only 42%, which is far under the average rate of 90% in Germany. As well as the grades (with Glasgow Coma Scale) and the types of the injuries the positive effect of seatbelts were demonstrated. A safety benefit with an airbag could not be verified. We found no injuries that were caused by the airbag like burnings or bruising. A reason for these issues is the higher deceleration force in accidents with airbag application because the sensors only activate under impact of a higher level of kinetic energy.
Like in our study a high number of analyses describe a higher efficiency of seat belts than airbags. Still, we assume that airbags can improve the grade of injury and survival, even though it was not demonstrated in our study. Irrespective, a further increasing percentage of people using seatbelts has to be aspired
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Self-Perception of Medical Students' Knowledge and Interest in Disaster Medicine: Nine Years After the Approval of the Curriculum in German Universities
No full textFollowing the recommendations of the World Association for Disaster and Emergency Medicine (WADEM; Madison, Wisconsin USA) to develop standards for training the undergraduates in disaster-relevant fields (2004), a German curriculum was approved in 2006. This paper aims to describe the level of training and interest of medical students nine years later. Problem The aim of this study was to assess the self-perception of medical students' knowledge and interest in disaster medicine nine years after the implementation of a standardized disaster medicine curriculum in German medical schools
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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