California medicine
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California medicine · Oct 1964
TRAFFIC DEATHS. A PRELIMINARY STUDY OF URBAN AND RURAL FATALITIES IN CALIFORNIA.
An analysis by the California Department of Public Health of California Highway Patrol reports for 1961 showed that traffic accidents injured one and one-half times as many people per 1,000 population in rural California counties (under 50,000 people) as in urban counties (over 500,000 people), also persons injured in rural counties were almost four times as likely to die of their injuries as those injured in urban counties. A death certificate study was undertaken of 782 traffic deaths (excluding pedestrians) occurring in rural and urban California counties during 1961. Accidents occurring in rural counties tended to be single vehicle accidents which resulted in less severe injuries, while those in urban counties tended to be two vehicle and multiple vehicle accidents resulting in more serious injuries. ⋯ For injuries where theoretically few lives should be salvaged by prompt emergency care, the time between injury and death was about the same in urban as in rural counties. Where such care should delay or prevent death because the injury was possibly or probably salvageable, those injured in rural counties died more quickly. Thirty-two per cent of fatalities in rural counties happened to urban and out-of-state residents, while only 12 per cent of fatalities in urban counties were to rural or out-of-state residents, suggesting that traffic accidents to non-residents may place an excessive load upon medical care resources in rural areas.
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Historically, psychopharmaceutical agents have been used to produce a mystical state with the religious connotation of "a union with Divine Nature" or of "oneness with God." Such transcendental states are also known to occur in starvation, self-flagellation, Yoga and various psychoses. A common psychological origin is suggested for these states, in which there is a psychic regression to an early phase of development. ⋯ Mankind's quest for psychic development is difficult and precarious, alternately marked by progression and regression. Excesses in the use of drugs are indicated as regressive in nature.
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The effect of spinal anesthesia on fetal heart rate is due to maternal hypotension and subsequent fetal hypoxia. Maternal hypotension of 80 mm of mercury for five minutes almost always results in hypoxic fetal bradycardia. This bradycardia is gradual in onset, and may be preceded by a short period of fetal tachycardia. ⋯ Similar bradycardia has been observed in maternal syncope unassociated with anesthesia. Maternal hypotension should be prevented, and if it occurs should be corrected early. Administration of a vasopressor drug is the treatment of choice, with oxygen and fluids as indicated.
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California medicine · Mar 1963
Toxoplasmosis. The protean manifestations of the condition and their significance in pregnancy and in newborn infants.
Toxoplasmosis is a relatively common and generally mild parasitic infection which can, however, produce fatal and crippling complications under certain conditions - particularly when a human fetus or a newborn infant is infected. In this instance, the infection is the result of a spread of the acquired disease which may occur in the mother in the last six months of pregnancy. Although the infection of adults can be dangerous and fatalities have been reported, the danger to the nervous system, eyes and other structures of the newborn infant can be devastating-blindness, brain damage and mental deficiency, particularly as the result of an obstruction to the flow of circulating cerebrospinal fluid within the brain. ⋯ Early diagnosis is of paramount interest in view of the poor response which may be obtained in the treatment of subacute and chronic phases of the illness. Difficulties in diagnosis stem from the manifestations of toxoplasmosis which closely resemble the symptoms of other infectious diseases. The clinical laboratory diagnosis is made by the isolation of the organism or by the demonstration of immune protein in the patient's serum.