WMJ : official publication of the State Medical Society of Wisconsin
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Firearm injuries are a major contributor to injury mortality and morbidity in the United States and account for substantial loss of productive years of life. A public health approach to injury reduction, and particularly firearm injury prevention, has promise because it emphasizes prevention rather than reaction, it utilizes a scientific approach to policies and programs, it brings an integrative, multi-disciplinary approach to the effort, and it emphasizes the role of communities in solving health problems. The new Firearm Injury Center at the Medical College of Wisconsin exemplifies the public health approach to this vexing problem.
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Over the past few years, a substantial body of evidence has accumulated that indicates hyperhomocysteinemia as a significant risk factor for cardiovascular disease. Hyperhomocysteinemia arises from a lack of key enzymes or vitamins such as methylenetetrahydrofolate reductase, vitamin B6, and folate which are involved in homocysteine metabolism. Heavy coffee consumption is also known to elevate homocysteine levels. ⋯ Finally, when both amino acids are in adequate supply, homocysteine is cleaved by the enzyme homocysteine desulthydrase (cystathionase) to form a-ketobutyrate, ammonia, and H2S. Thus, homocysteine's physiological role is to assist in maintaining sulfur-amino acid homeostasis. Beyond these metabolic processes, homocysteine is beginning to be recognized as a significant risk factor for cardiovascular disease including atherosclerosis, coronary artery disease, cerebrovascular disease, and myocardial infarction.
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Extrinsic safety devices, such as trigger locks, have been central in the recent state discussions on how to reduce firearm injuries. The actual prevalence of handgun locking devices in the consumer market, however, is unknown. This study catalogued the extrinsic safety devices available from handgun dealers and discount retail chains in Milwaukee, WI. ⋯ Other types of devices included lock-boxes (n = 5), cable locks (n = 4), hammer locks (n = 1), barrel locks (n = 1), and a rubber slide strap (n = 1). Handgun owners in the Milwaukee metro area have a selection of extrinsic handgun safety devices available from handgun dealers and discount retailers. However, there does not appear to be a consistent availability on type of device.