PubMed · 10238379
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H Hamilton. 1975. Crash!. https://pubmed.ncbi.nlm.nih.gov/10238379/
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BACKGROUND: We describe the surgical response of two affiliated hospitals during the day of, and week following, the September 11th, 2001 terrorist attack at the World Trade Center in New York City. The city of New York has 18 state designated regional trauma centers that receive major trauma victims. The southern half of Manhattan is served by a burn center, two regional trauma centers, and a community hospital that is an affiliate of one of the regional trauma centers. This report accounts for the surgical response by a regional trauma center (Hospital A, located 2.5 miles from the World Trade Center) and its affiliate hospital (Hospital B, located 5 city blocks from the World Trade Center) on September 11th when two commercial jets crashed into the Twin Towers at the World Trade Center mall. METHODS: Hospital A maintained a concurrent log of patients received during the first 5 hours, the first day, and the first week after the disaster which was kept by the Surgical Triage Officer. The trauma registry completed and verified this data by September 18th. Hospital B collected its data by hand counting and verification by chart review. Both hospitals, A and B, had established disaster plans that were implemented. RESULTS: Nine hundred eleven patients were received by two affiliated hospitals from the World Trade Center attack. Seven hundred seventy six patients (85%) were walking wounded, sustaining mild inhalation and eye irritant injuries. One hundred thirty five (15%) were admitted with 18 (13%) of these undergoing surgery. Twenty two of the 23 transfers were from the community hospital to specialized orthopedic or burn centers. Of the 109 patients admitted to Hospital A, 30 were to the surgical service. The mean ISS score of these patients was 12. There were 4 deaths (within minutes of arrival at the hospital) and 6 delayed deaths (day 1-14). Excluding walking wounded and DOAs, the critical mortality rate was 37.5% overall. CONCLUSION: The September 11th, 2001, terrorist attack in New York City, involving two commercial airliners crashing into the World Trade Center, led to 911 patients received at two affiliated hospitals in lower Manhattan. One hospital is a regional trauma center and one was an affiliate community hospital. Eighty five percent of the patients received were walking wounded. Of the rest, 13% underwent surgical procedures with an overall critical mortality rate of 37.5%.
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BACKGROUND AND OBJECTIVE: Ultrasound-detected carotid artery intima-media thickness (IMT) is regarded as a valid index of atherosclerosis. Cross-sectional studies have been helpful in establishing determinants of IMT, but the long-term relationship between cardiovascular risk factors and subclinical atherosclerosis in a low-risk population has not been thoroughly evaluated. METHODS: A cohort of 483 military aviators, officially considered as fit for flying and therefore normotensive, was included in the study. All subjects underwent baseline examination with measurement of cardiovascular risk factors (body mass index, blood pressure, physical working capacity, cigarette smoking, and levels of cholesterol, high-density lipoprotein cholesterol, triglycerides, and gamma-glutamyltransferase) and carotid ultrasonography at the end point after 10 years of follow-up. RESULTS: Age, cigarette smoking, and blood pressure were independent long-term predictors of IMT. After adjustment for age, cigarettes smoked daily at baseline, categorized in units of five cigarettes each (regression coefficient in mm, 0.057 [95% CI: 0.029 to 0.085]; p < 0.0001), and systolic blood pressure (regression coefficient in mm, 0.007 [95% CI: 0.003 to 0.010], p < 0.0001) were the only predictors of IMT. Physical working capacity was not associated with IMT. CONCLUSION: Even in normotensive individuals, systolic blood pressure is a strong predictor of early carotid atherosclerosis.