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Biomedical subjects

F McCabe

Publications and source records attributed to F McCabe.

7 recordsLinked to original sources

Emergency department-based study of risk factors for acute injury from domestic violence against women.

STUDY OBJECTIVES: To evaluate the associations between selected socioeconomic risk factors and acute injury from domestic violence against women. METHODS: We conducted a preliminary matched case-control study to measure the association of selected predictor variables with acute injury from domestic, violence against women. Patients identified as cases were Hispanic or white female emergency department patients, 16 to 65 years of age, with acute injury sustained from physical assault by an intimate male partner. Cases were selected for inclusion in the study if they reported or admitted acute physical assault by their male partners. Controls were selected from non-case female ED patients so as to represent the base population of the cases and enhance comparability. Two controls were matched to each case. The socioeconomic predictor variables examined were the education level, employment status, history of alcohol abuse, and history of drug abuse of the male partner and the education level and cohabitation status of the female partner. RESULTS: Forty-six cases were identified and included in the study. The age range was 16 to 51 years (mean, 33 years). There were 26 (57%) Hispanic and 20 (43%) white cases. The strongest predictor for acute injury from domestic violence in these patients was a history of alcohol abuse by the male partner, as reported by the female partner (odds ratio, 12.9). The remaining predictor variables were weakly associated or not associated with domestic violence. One half of the cases stated that their male partners were intoxicated with alcohol at the time of assault. CONCLUSION: Of the socioeconomic variables examined in this preliminary study, a history of alcohol abuse by the male partner, as reported by the female partner, was the strongest predictor for acute injury from domestic violence. A large-scale, multicenter, ED-based study is needed to clarify the relation between alcohol abuse, other socioeconomic factors, and acute physical assaults against women by their intimate male partners.

Academic Medical Centers↗

Delayed recognition and infection control for tuberculosis patients in the emergency department.

STUDY OBJECTIVE: The recent increase in tuberculosis (TB) cases may have an important effect on emergency department infection-control measures. We describe infection-control interventions for TB patients admitted through the ED and hypothesize that ED suspicion of TB is associated with more rapid isolation and treatment. DESIGN: Retrospective chart review. SETTING: The ED of a 400-bed urban, university-affiliated county hospital. PARTICIPANTS: Fifty-five patients with TB culture-positive and acid-fast bacillus stain-positive respiratory specimens who were evaluated in the ED during 1991 and 1992. RESULTS: We identified cases from the mycobacteriology log. Demographic and historical data and time elapsed before initiation of infection-control measures and TB therapy were recorded. We assessed the relationships of individual clinical findings and the ED presumptive diagnosis of TB (predictor variables) to time elapsed before isolation and therapy (outcome variables) with the log-rank test. The median time (interquartile range) from ED registration to isolation was 8 hours (range, 3 to 13 hours). An ED presumptive diagnosis of TB was made in 71% of cases and was significantly associated with shorter time elapsed before isolation (5 hours [range, 2 to 10 hours] versus 21 hours [range, 11 to 111 hours]; P < .001) and less time elapsed before therapy (12 hours [range, 9 to 22 hours] versus 128 hours [68 to 374 hours]; P < .001). We found TB exposure, radiographic changes typical of TB, absence of HIV risk factors, presence of cough, and sputum production to be associated with more rapid isolation. CONCLUSION: Among patients with active pulmonary TB in the ED, TB is often unsuspected and isolation measures are often not used. ED suspicion of TB is associated with more rapid isolation and treatment.

Adolescent↗

Noninvasive assessment of ulnar bending stiffness in women.

The load-carrying capacity of cortical bone is closely related to its geometry and to its fundamental material properties, including mineral content (BMC). Together these determine the bending stiffness EI, where I is the cross-sectional moment of inertia and E is Young's modulus of elasticity. To assess the relationship of BMC and bone width (BW) to EI in healthy women, we used mechanical response tissue analysis (MRTA), a noninvasive method that involves analysis of tissue responses to ulnar vibration. A total of 48 healthy women were enrolled into an older (64 +/- 1y, n = 25) and a younger (25 +/- 0.6y, n = 23) group. BMC and BW of the dominant ulna were measured by single-photon absorptiometry (SPA). EI was determined by MRTA. BMC (0.75 +/- 0.02 versus 0.63 +/- 0.02 g/cm), BMC/BW (0.75 +/- 0.02 versus 0.63 +/- 0.02 g/cm2), and EI (27.7 +/- 1.3 versus 21.3 +/- 1.1 N.m2) were significantly greater (p less than 0.005) in the young subjects. BW did not change with age (1.00 +/- 0.01 versus 1.01 +/- 0.01 cm). In young women, simple correlations of BMC and BW with EI were both significant. By multiple regression analysis only BW independently predicted EI (EI = -0.35 + 39.1 x BMC, R2 = 0.52). In older women BMC and BW correlated with EI, but in multiple regression only BMC was significant (EI = -34.5 + 62.1 x BW; R2 = 0.45). When this analysis of older women included only those whose BMC values were within 2 SD of the young mean, BMC remained the only significant predictor of EI.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

Survey of health visiting in antenatal care.

The range of the health visitor's work is expanding. To find out what antenatal work health visitors actually carry out and what their attitudes towards such work are we surveyed general practitioners, midwives, and health visitors in three district health authorities. The results indicate that health visitors are qualified and willing to work with women in the antenatal period.

Communication Barriers↗

Community-acquired bacteremia in the elderly: analysis of one hundred consecutive episodes.

A retrospective analysis was made of the records of 100 consecutive geriatric patients with community-acquired bacteremia, admitted to a suburban hospital. The most frequently identified tissue sources for these bacteremias were the urinary tract (34 percent), biliary tract (20 percent), and lungs (13 percent). In 11 percent of the patients, the tissue focus was not established. E. coli, Klebsiella species and Streptococcus pneumoniae were the most common organisms isolated, and they contributed to 73 percent of the bacteremias. Of the 100 patients, 26 succumbed to the infection. Clinical manifestations unique to the geriatric patient are described.

Aged↗