Monthly Archives: May 2016

The risk of head injuries

The risk of death after head injury remained significantly increased for as long as 13 years, irrespective of the severity of the injury, results of a case-control study showed.

Overall, patients with a history of head injury had more than a twofold greater risk of death than did two control groups of individuals without head injury.

Among young adults, the risk disparity ballooned to more than a fivefold difference, Scottish investigators reported online in the Journal of Neurology, Neurosurgery and Psychiatry.

“More than 40% of young people and adults admitted to hospital in Glasgow after a head injury were dead 13 years later,” Dr. Thomas M. McMillan, of the University of Glasgow, and coauthors wrote in the discussion of their findings. “This stark finding is not explained by age, gender, or deprivation characteristics.”

“As might be expected following an injury, the highest rate of death occurred in the first year after head injury,” they continued. “However, risk of death remained high for at least a further 12 years when, for example, death was 2.8 times more likely after head injury than for community controls.”

Previous studies of mortality after head injury have focused primarily on early death, either during hospitalization or in the first year after the injury. Whether the excess mortality risk persists over time has remained unclear, the authors noted.

Few studies have compared mortality after head injury with expected mortality in the community. To provide that missing context, McMillan and coauthors conducted a case-control study involving 757 patients who incurred head injuries of varying severity from February 1995 to February 1996 and were admitted to a Glasgow-area hospital.

For comparison, the investigators assembled two control groups, both matched with the cases for age, sex, and socioeconomic status and one matched for duration of hospitalization after injury not involving the head.

One control group was comprised of persons hospitalized for other injured and other comparison group included healthy non-hospitalized adults.

The cases comprised 602 men and 155 women who had a mean age of 43, and almost 70 percent were in the lowest socioeconomic quintile.

At the end of follow-up, 305 of the head-injured patients had died, compared with 215 of the hospitalized control group, and 135 of healthy, non-hospitalized adults.

Mortality after one year remained significantly higher in the head-injury group—34 percent versus 24 percent among the hospitalized comparison group and 16 percent for the healthy non-hospitalized adults.

Overall, the head-injury group had a death rate of 30.99/1,000/ year versus 13.72/1,000/year in the community controls and 21.85/1,000/year in the hospitalized-other injury control group.

The disparity was greater among younger adults (15 to 54), who had a rate of 17.36/1,000/year versus 2.21/1,000/year in the community controls. Older adults in the head injury group had a death rate of 61.47/1,000/year compared with 39.45/1,000/year in the community controls.

“Demographic factors do not explain the risk of death late after head injury, and there is a need to further consider factors that might lead to health vulnerability after head injury and in this way explain the range of causes of death,” the authors wrote in conclusion. “The elevated risk of mortality after mild head injury and in younger adults makes further study in this area a priority.”

Whats the danger of jewelry

A 1-year-old boy living in New York City had a rapid increase in blood lead levels, and the likely source of the exposure was traced to a Cambodian amulet made from knotted string and metallic beads, according to researchers from the NYC Department of Health and Mental Hygiene and the CDC.

Testing revealed that the beads contained 45 percent lead, the researchers reported in Jan. 28 issue of Morbidity and Mortality Weekly Report.

The boy had worn the amulet — “something to protect him,” his father said — since he was 3 months old, and had been seen putting it in his mouth.

“Healthcare providers and public health workers should consider traditional customs when seeking sources of lead exposure in Southeast Asian populations,” the authors wrote.

Healthcare professionals should ask parents — particularly from Southeast Asian families — about the use of amulets, they added, noting that educational efforts about the risk of lead poisoning from jewelry are needed for immigrant families.

An accompanying editorial note pointed out that the CDC recommends blood lead testing for internationally adopted and refugee children and that the New York City health department recommends testing all children with recent travel to foreign countries.

Although the most common source of lead exposure in young children is paint, other sources have been increasingly identified.

That is particularly true in immigrant communities because of the use of lead-containing products from their country of origin, such as spices, food, candy, cosmetics, health remedies, ceramics or pottery, and jewelry.

For the case of the 1-year-old boy, routine lead testing showed an elevated blood lead level of 10 micrograms/dL.

According to the National Institutes of Health lead concentrations in blood should be less than 10 micrograms/dL in children and less than 20 micrograms/dL in adults.

Because he lived in a household with a cousin who had had lead poisoning, he had also been tested at 6 months. His blood lead level was just 1 microgram/dL then.

A risk assessor from the Environmental Protection Agency visited the home to look for potential sources of the lead exposure. The boy’s father denied using any imported products, and the assessor failed to find any potential sources of exposure.

Three months later, the boy’s blood level doubled to 20 micrograms/dL.

The boy’s father again denied that the child wore jewelry or charms, but eventually admitted that the child had worn an amulet acquired at a Cambodian market since he was 3 months old.

A second home inspection identified one area of paint with an elevated lead level, as well as imported spices and rice. Testing revealed that the food products did not have elevated lead content.

Within eight days of the amulet being removed from the home, the boy’s blood lead level decreased to 14 micrograms/dL.

About five weeks later — after the lead paint was reported to be removed — the boy’s blood lead level was 10 micrograms/dL, and five months after the amulet was removed, the level was down to 5 micrograms/dL.

What do you know about kidney stones

Kidney stones are small chunks of solid material that can form in your kidneys, a pair of organs that filter your blood.

The “stones,” which are usually yellow and brown, vary in size and shape.

For instance, some may be jagged and as small as a grain of sand, while others may be lumpy and the size of golf balls.

A stone may stay in the kidney or travel down the urinary tract — the body’s waste and excess-water drainage system — and get stuck, causing severe pain in the belly or side of the back.

Other symptoms may include nausea, chills, and blood in the urine.

Prevalence and Demographics of Kidney Stones

Kidney stones are one of the most common disorders of the urinary tract, resulting in more than a million visits to health care providers and 300,000 emergency room visits each year in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

About one in 11 people in the United States, or 8.8 percent of the population, have had a kidney stone, according to a 2012 report in the journal European Urology.

Kidney stones affect both men and women, though struvite stones are more common in women and uric acid stones are more common in men.

Overall, however, the prevalence of kidney stones is higher in men than women.

Kidney stones are also more common in obese people than non-obese people, and less common in non-Hispanic African and Mexican-Americans than in non-Hispanic Caucasians, according to the European Urology study.

What Are the Kidneys?

Part of the urinary system, your two kidneys are fist-sized, bean-shaped organs, located just below the rib cage, one on each side of the spine.

They have a number of important functions, mainly filtering the blood to remove waste and excess water, resulting in the formation of urine, which is stored in the bladder and emptied from the body through the urethra.

The kidneys also:

  • Balance the body’s levels of electrolytes, including sodium, potassium, and phosphate, to maintain the body’s balance of acids and bases
  • Produce hormones involved in regulating blood pressure, producing red blood cells, and maintaining bone strength
  • Prevent the buildup of waste and fluid in the body

 

Development of Kidney Stones

Kidney stones develop when the concentration of normal kidney substances (especially calcium, oxalate, and phosphorus) increases substantially.

This process — sometimes known as nephrolithiasis — can be due to various factors, including low fluid intake, diet, or medications such as diuretics and calcium-based antacids.

A number of issues can increase a person’s risk of developing kidney stones, including:

  • A family history of kidney stones
  • Medical conditions that affect the levels of urinary substances
  • Urinary tract blockage
  • Digestive problems
  • Recurrent urinary tract infections