The death rate per 100,000 workers fell to just four in 1994, but there were 3.5 million disabling injuries. The cost associated with deaths and injuries was $120.7 billion that year.

Burns↗

PubMed1994

Minimizing unnecessary repetition.

Explore the source record for details and available documents.

Hospitals, Rural↗

PubMed1981

Newer techniques in the diagnosis and treatment of proximal bile duct carcinoma--an analysis of 41 consecutive patients.

The clinical course of 41 consecutive patients with primary bile duct carcinoma at or near the liver hilum was analysed to determine whether the outcome was improved by newer techniques of diagnosis and treatment. The age range was wide, with one third under 50 years. The only aetiological factor identified was long-standing ulcerative colitis (present in 9.8 per cent of patients). In one third of patients initial symptoms were misleading. The tumour had been missed in 11 (61 per cent) of 18 patients undergoing an exploratory laparotomy at other hospitals, despite operative cholangiography. None had pre-operative percutaneous cholangiography which was shown to be the best investigatory technique, giving the correct diagnosis in all cases in whom it was performed. Greyscale ultrasonography was useful and endoscopic retrograde cholangiography less so. Median survival in those treated by surgical T- or U-tube drainage (21 patients) or bypass (three) was nine months from diagnosis, as opposed to three months in the 36.5 per cent of patients in whom biliary drainage was not obtained. Radiotherapy, including insertion of a radioactive iridium wire through the tumour via a T- or U-tube, or percutaneously, was performed in nine patients and improved the duration of survival compared with tube drainage alone. The new percutaneous techniques offer a useful alternative to surgery for palliative drainage and radiotherapy.

Adult↗

PubMed1979

Non-invasive techniques in the diagnosis of jaundice--ultrasound and computer.

This study describes the use of ultrasound in 84 consecutive patients to distinguish between medical (intrahepatic) and surgical (extrahepatic) types of jaundice. Accuracy rates in the 84 patients investigated were compared with those found in 169 patients using the computer-aided diagnostic model for jaundice. In 50 patients in whom both techniques were carried out direct comparison was possible. Ultrasound failed to give adequate visualisation for technical reasons in two patients, but 75 of the remaining 82 (91.5%) were correctly separated into medical and surgical categories. A similar percentage (90%, 152 of 169 patients) were correctly classified by the computer-assisted model, and in the 50 patients assessed by both techniques correct diagnostic separation was achieved in 43 (86%) by ultrasound and in 42 (84%) by computer. However, in this latter group two of the errors with computer diagnosis were falsely positive for a surgical jaundice (extrahepatic obstruction), and a surgical exploration performed on the basis of this test could have been unnecessary. This was not found with ultrasound in these same patients, all the errors being false negative. A high degree of confidence can therefore be attached to the demonstration by ultrasound of a dilated biliary tree.

Cholestasis↗