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Biomedical subjects

K T Hegmann

Publications and source records attributed to K T Hegmann.

5 recordsLinked to original sources
PubMed2006

Cellulitis incidence in a defined population.

A population-based insurance claims database was used to examine cellulitis incidence, anatomical sites of infection, complicating diagnoses, source of health service, and recurrence rates. Insurance claim files were searched for cellulitis ICD-9-CM codes 681.0-682.9. Complications of cellulitis including erysipelas, lymphadenitis, lymphangitis, and necrotizing fasciitis were also identified by ICD-9-CM codes. We found a cellulitis incidence rate of 24.6/1000 person-years, with a higher incidence among males and individuals aged 45-64 years. The most common site of infection was the lower extremity (39.9%). The majority of patients were seen in an outpatient setting (73.8%), and most (82.0%) had only one episode of cellulitis during the 5-year period studied. There was a very low incidence of cellulitis complications, including necrotizing fasciitis. Cellulitis is fairly common, usually treated in outpatient settings, and is infrequently complicated by erysipelas, lymphadenitis, lymphangitis, or necrotizing fasciitis.

Adolescent↗
PubMed2000

Hazardous materials readiness of United States level 1 trauma centers.

Injuries caused by hazardous materials (hazmat) accidents are common in the United States, and emergency departments should be capable of decontaminating these patients. There are, however, no national studies that assess emergency department preparedness. The purpose of this survey was to assess the hazmat readiness of US Level 1 trauma centers (TCs). All 1996 Hospital Blue Book TCs (256) were queried by anonymous survey; 61% (156) responded to the survey. The TCs treated 43,046 +/- 28,455 patients (median, 40,500; range, 600 to 220,000); 15 +/- 29 (median, 6; range, 0 to 200) were hazmat-contaminated. Only 6% acknowledged having all necessary equipment required for safe decontamination. Many (83%) had hazmat response plans, but few (30%) of these plans were complete. Approximately 36% of the staff had received training. Thirteen staff required medical attention themselves after rendering care to a contaminated patient. Only 58% of the TCs performed a single drill. The preparedness of US Level 1 TCs to safely decontaminate hazmat patients seems to be inadequate.

Data Collection↗
PubMed1999

Effectiveness of Waddell's nonorganic signs in predicting a delayed return to regular work in patients experiencing acute occupational low back pain.

STUDY DESIGN: Consecutive case series. OBJECTIVE: To determine whether the presence of Waddell's nonorganic signs in occupational, acute low back pain patients predicts a longer time before return to unrestricted regular work. SUMMARY OF BACKGROUND DATA: Waddell's nonorganic signs identify patients with chronic low back pain with a poor prognosis; however, they have not been used as an outcome predictor in patients with occupational, acute low back pain. METHODS: Standardized histories and physical examinations, including Waddell's signs were recorded at the first clinic visit (n = 143) by a single physician who was not blinded to the study's goals or methods. Those with chronic low back pain or complicating medical conditions (n = 88) were excluded. Data from patients exhibiting the nonorganic signs were compared with those from patients without the signs for time to return to regular work without restrictions and medical resource use. RESULTS: Fifty-five patients with acute work-related low back pain were included. One or more of the nonorganic signs were seen in 14 patients (25.5%) at the first appointment. The most common signs were simulated axial loading (78.6%) and simulated rotation (71.4%). Those with any nonorganic sign required a median 58.5 days to return to regular work compared with 15.0 days for those without (P < 0.0001). Patients exhibiting any nonorganic sign compared with those without used more physical therapy (50.0% vs. 12.2%; P < 0.01) and lumbar computed axial tomography (21.4% vs. 0.0%; P = 0.01). CONCLUSIONS: Patients with acute, occupational low back pain exhibiting Waddell's nonorganic signs had a four times lengthier time for return to unrestricted, regular work and a greater use of physical therapy and lumbar computed tomographic scans.

Acute Disease↗
PubMed1993

The effect of age at smoking initiation on lung cancer risk.

It has been assumed that a younger age at initiation of cigarette smoking is associated with an increased risk of lung cancer, but previous studies have not adjusted for two strong risk factors, the amount smoked and duration smoked. We used data from a population-based case-control study with 282 histologically confirmed lung cancer cases matched to 3,282 random controls to determine whether age at initiation of smoking plays an independent role in the occurrence of lung cancer. After controlling for age, sex, and amount of tobacco exposure, men who began to smoke before age 20 had a substantially higher risk of developing lung cancer [odds ratio (OR) = 12.7; 95% confidence interval (CI) = 6.39-25.2] compared with men who began smoking at age 20 or older (OR = 6.03; 95% CI = 2.82-12.9). For women, the heavy increase in risk continued until age 25 (OR = 9.97; 95% CI = 4.68-21.2) compared with women who began smoking at age 26 or older (OR = 2.58; 95% CI = 0.53-12.4). There was no predisposition toward a specific histologic type of lung cancer. In this study, up to 52.4% of lung cancer cases in men and up to 73.0% of lung cancer cases in women could be attributed to this effect of early age of first smoking.

Adenocarcinoma↗