About the San Antonio Trucking Accident
According to the San Antonio Express-News, the accident occurred around 11:30 am at the intersection of Loop 1604 and Northwest Military Highway.
The motorcyclist was traveling southbound on Military Highway when the 18-wheeler attempted to make a left hand turn from Military onto the westbound Loop 1604 access road.
The motorcyclist attempted to lay down his motorcycle, but hit his head on the road – the impact shattered his helmet. He was pronounced dead at the scene.
The truck driver stayed at the scene. Reports state that though the 18-wheeler had a green light, it did not have a protected arrow. Authorities are investigating the accident.
Trucking Accident Statistics
- According to the National Highway Traffic Safety Administration (NHTSA), 3,921 people were killed in trucking collisions in 2012.
- An additional 104,000 people were injured in accidents involving large trucks.
- Of those killed in trucking accidents in 2012:
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Intravenous Steroids For Tonsillectomies
Tonsillectomies are routine operations all over the world for both adults and children.
Intravenous steroid use after surgery can help reduce pain and nausea, but new research shows that a possible increased risk of bleeding may be a concern.
About The Research
The study was performed by Dr. Sayaka Suzuki and his team of the University of Tokyo in Japan.
Around 61,000 people from 718 hospitals were in a Japanese inpatient database that was used to collect data – approximately 4,767 patients received intravenous steroids while almost 56,600 received other medications.
1.6% of the patients in the steroid using group had another operation due to hemostasis, or bleeding. 0.9% of the non-steroid using patients had another operation due to hemostasis.
Patients who had intravenous steroids had a significantly higher risk of bleeding.
Children At Highest Risk
The data also showed a correlation between the rate of reoperation for hemostasis and age.
Children 15 and under had a much high rate of reoperation than the other age groups. Dr. Suzuki said, "tonsillitis in children usually has less severe adhesion to the surrounding tissue compared to that in adults. That is because children have less bleeding. Our study showed the negative impact of steroids on postoperative bleeding was detected only in children.”
Also, more reoperations occurred roughly seven days after the tonsillectomy.
Further research must be conducted to know the exact reason for the bleeding as well as the risks and benefits associated with using steroids in children for tonsillectomies.
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Researchers have found there is a statistical significance between NSAID use and VTE.
NSAID Use and the Risk of VTE
Medscape reports, nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk two-fold for venous thromboembolism, or VTE. The risk includes deep venous thrombosis as well as pulmonary embolisms.
According to Patompong Ungprasert, MD, from the Bassett Medical Center and Columbia University College of Physicians and Surgeons, New York City, and colleagues, "The results of our meta-analysis demonstrate a statistically significantly increased VTE risk among NSAID users. Physicians should be aware of this association and NSAIDs should be prescribed with caution, especially in patients at high baseline risk of VTE”.
The research performed was the first systematic review and meta-analysis of published observational studies that examined the correlation between NSAIDs and VTE.
Researchers were unable to use randomized clinical trials for analysis because the complication is too rare, thus requiring use of observational studies instead. The studies were conducted between 2007 and 2013 in the United Kingdom, France, the Netherlands, Denmark, and Sweden.
Break Down of NSAID Analysis
In their final analysis, researchers used 6 out of 597 potential published studies, which represented 21,401 VTE incidents. The findings reported odds ratios, relative risks, hazard ratios, or standardized incidence ratios for VTEs in comparisons between NSAID users and nonusers.
1 cohort (n= 19,293; 215 events) and 5 case-controls studies (cases, 21,186; controls, 110,824) were used in the studies. NSAID users were found to have a pooled risk ratio of 1.8-fold based on 95% confidence interval ranging from 1.28-2.52. The pooled risk ratio in patients who used selective cyclooxygenase 2 (COX-2) inhibitors was 1.99 based on 95% confidence interval ranging from 1.44-2.75. Therefore, the two measures were statistically significant.
Aspirin, a COX-1 inhibitor, is shown to be effective in VTE prevention leading researchers to believe the increased VTE risk may come from COX-2 inhibitors. Researchers stated, "Inhibition of the COX-2 enzyme has been shown to inhibit the synthesis of prostacyclins, potent platelet activation inhibitors, while stimulating the release of thromboxane, a potent platelet aggregation facilitator, from the activated platelets. The activation and aggregation of platelets might, in turn, induce a coagulation cascade and clotting, with the widespread use of these medicines, this increased risk may have important public health implications”. However, the method of risk for VTE is still uncertain.
Factors that can affect the validity of the studies include a publication bias, heterogeneity among the studies, and inability to show cause and effect.
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