PubMed · 4133652
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1974-05-18. Editorial: Immediate care.. https://pubmed.ncbi.nlm.nih.gov/4133652/
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OBJECTIVE: To investigate the association between cholesterol lowering interventions and risk of death from suicide, accident, or trauma (non-illness mortality). DESIGN: Meta-analysis of the non-illness mortality outcomes of large, randomised clinical trials of cholesterol lowering treatments. STUDIES REVIEWED: 19 out of 21 eligible trials that had data available on non-illness mortality. INTERVENTIONS REVIEWED: Dietary modification, drug treatment, or partial ileal bypass surgery for 1-10 years. MAIN OUTCOME MEASURE: Deaths from suicides, accidents, and violence in treatment groups compared with control groups. RESULTS: Across all trials, the odds ratio of non-illness mortality in the treated groups, relative to control groups, was 1.18 (95% confidence interval 0.91 to 1.52; P=0.20). The odds ratios were 1.28 (0.94 to 1.74; P=0.12) for primary prevention trials and 1.00 (0.65 to 1.55; P=0.98) for secondary prevention trials. Randomised clinical trials using statins did not show a treatment related rise in non-illness mortality (0.84, 0.50 to 1.41; P=0.50), whereas a trend toward increased deaths from suicide and violence was observed in trials of dietary interventions and non-statin drugs (1.32, 0.98 to 1.77; P=0.06). No relation was found between the magnitude of cholesterol reduction and non-illness mortality (P=0.23). CONCLUSION: Currently available evidence does not indicate that non-illness mortality is increased significantly by cholesterol lowering treatments. A modest increase may occur with dietary interventions and non-statin drugs.
On 1st March 1994, a passenger train with a speed of 85 km/h ran into the rear end of a stopped passenger train north of Aarhus, Denmark. No fatalities occurred. Questionnaires were sent to passengers and crew and 113 of 128 (88%) answered. In the stopped train 32% (9/28) of the sitting passengers compared with 12% (9/76) in the moving train had symptons corresponding to a whiplash lesion. Only the chairs in the moving train had head rests which might explain the observed difference. In the rest section of the moving train with all seats facing the same direction 81% (13/16) of the sitting passengers had face injuries compared to 13% (8/60) in the rest of the train. The higher incidence in the rest section was caused by folding tables at the back of the seats. Serious thoraco-abdominal injuries were only seen in one patient despite the fact that 37 passengers were thrown againsts tables between the seats in the second class section of the moving train. The tables were fragile and usually gave way. In conclusion, carriage interior has a major influence on personal injuries at railway accidents.
A 29-year-old man was accidentally exposed to cold and his mild hypothermia uniquely resulted in the transient exaggeration of his normothermic electrocardiographic findings, which were consistent with early repolarization. A unifying concept of clinical entities with similar J wave and ST segment elevation (J-ST syndrome) is proposed.