Abstract:
OBJECTIVES:In 2014, 726 bicyclists were killed and an additional 50,000 were injured in crashes with motor vehicles. The number of cyclists in the United States is increasing, and as a result there has been a call for more bike lanes. We examined the difference in the severity of injury of bicyclists involved in motor vehicle crashes when riding in the traffic lane compared with riding in a bike lane or on a paved shoulder. We also controlled for other safety factors, including alcohol use, travel speed, posted speed, helmet usage, and lighting conditions to determine their impact on bicyclist safety. METHODS:Single-year National Automotive Sampling System-General Estimates System files were used to analyze data regarding the bike lanes, and multiyear data were used to analyze the additional factors. Univariate and multiple regression analyses controlling for confounders were performed on the data. RESULTS:When adjusting for speed limit, alcohol use by driver, weather conditions, time of day, and helmet use, the cyclist's position had no significant effect on the severity of injury (P = 0.57). The severity of injury was significantly greater when the driver or bicyclist had been drinking alcohol (P < 0.0001 and P < 0.003, respectively). Bicyclists were more severely injured when vehicles moved at greater speeds and the posted speed limit was higher (P < 0.0001 for both). Also, injury severity was found to be significantly higher when lighting conditions were "dark" (P < 0.0001). CONCLUSIONS:Our findings suggest that simply having a dedicated space for bicyclists, such as a bike lane or a paved shoulder, does not reduce the severity of injuries sustained when a crash with a motor vehicle takes place. Cyclist safety could be improved by implementing changes that affect vehicle speed, alcohol use by drivers, and lighting conditions. Moreover, emergency physicians should be aware that when they receive a report of a cyclist being struck by a car in a bike lane, they should prepare to treat injuries of severity similar to those received by a bicyclist hit by a vehicle in traffic.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Helak K,Jehle D,McNabb D,Battisti A,Sanford S,Lark MCdoi
10.14423/SMJ.0000000000000665subject
Has Abstractpub_date
2017-07-01 00:00:00pages
441-444issue
7eissn
0038-4348issn
1541-8243pii
SMJ50398journal_volume
110pub_type
杂志文章abstract::Takotsubo (stress induced) cardiomyopathy is also known as broken heart syndrome or transient left ventricular apical ballooning syndrome. The clinical presentation, which mimics acute myocardial infarction, is preceded by intense emotional or physical stress. Recurrence of apical ballooning syndrome seems to be rare....
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181e631ce
更新日期:2010-08-01 00:00:00
abstract::Asbestos is a versatile fibrous mineral that can cause lung disease and death. Asbestosis, benign pleural disease, lung cancer, and mesothelioma can all result from inhaling asbestos. The history of disease and exposure risks are discussed. The difficult assessment of risk and the long latency period for development o...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199206000-00009
更新日期:1992-06-01 00:00:00
abstract::As our population ages, the incidence and prevalence of Alzheimer disease (AD) will increase dramatically. A number of therapies have been investigated for the treatment and prevention of AD. Clinicians should be prepared to provide evidence-based answers to inquiries regarding AD treatment. There is insufficient evid...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000166671.86815.C1
更新日期:2005-06-01 00:00:00
abstract::This article reviews the epidemiology of weight gain and diabetes mellitus in general and in patients with severe mental illness in particular. Body mass index is defined, and possible predictors for weight gain in patients receiving antipsychotic medications are also enumerated. Information on risk of association wit...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.smj.0000167621.49292.11
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the prevalence of impairments relevant to upper extremity following breast cancer surgery and its impact on disability and health-related quality of life. METHODS:Sixty-seven female patients being treated with modified radical mastectomy or breast conserving surgery we...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181c38c41
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:Intraventricular hemorrhage (IVH) represents a clinicopathologic entity with a dismal prognosis. The associated mortality rate has been reported as high as 80%; the morbidity is also quite high. The use of various fibrinolytic agents (streptokinase, urokinase, and recombinant tissue-type plasminogen activator...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章
doi:10.1097/01.smj.0000170732.24324.ea
更新日期:2005-08-01 00:00:00
abstract::Massive ovarian edema is a rare tumor-like condition of the ovary characterized by marked enlargement of one or both ovaries due to marked accumulation of edema fluid in the ovarian stroma. This paper reviews the literature on massive ovarian edema and presents a case associated with androgenic manifestations. ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199511000-00015
更新日期:1995-11-01 00:00:00
abstract::This report describes a 42-year-old man with Brugada syndrome (BRS) mimicking acute coronary syndrome. Chest pain, near-syncope, and electrocardiographic changes were thought initially to be due to ischemia. Cardiac catheterization was performed. The coronary arteries and left ventricular function were normal. Careful...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000168135.26545.a6
更新日期:2005-08-01 00:00:00
abstract::In 1954 I described a case of chronic fluoride poisoning from artificially fluoridated water, in which the patient exhibited a multisymptomatic clinical picture without noticeable skeletal changes. Subsequently, others and I have confirmed this "nonskeletal phase" of the disease from fluoride in water and in air (in w...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00
abstract::Coronary heart disease remains the major cause of mortality and morbidity in the United States and other western countries despite major advances in its treatment. During the last decades, many markers of coronary artery disease have been found which help predict future risk of cardiovascular events. High-sensitivity ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e31816c0195
更新日期:2008-05-01 00:00:00
abstract::Among 600 impotent men who had endocrine evaluation for androgen deficiency, thyroid deficiency, and hyperprolactinemia, 192 (32%) were found to have an endocrine abnormality. Androgen deficiency was divided into primary testicular failure and "hypothalamic-pituitary dysfunction" by an androgen quotient derived using ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198904000-00010
更新日期:1989-04-01 00:00:00
abstract::Cronkhite-Canada syndrome is a rare, noninherited gastrointestinal polyposis syndrome associated with characteristic ectodermal abnormalities. This report describes a 60-year-old female who was diagnosed with Cronkhite-Canada syndrome with hypothyroidism after presenting with chronic diarrhea, alopecia, intermittent a...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000157528.71614.C4
更新日期:2005-05-01 00:00:00
abstract::In this study, the pelvic retroperitoneal anatomy was dissected during 140 consecutive exploratory laparotomies for benign gynecologic disease. In addition, 110 bilateral hypogastric artery ligations were done both to teach the technique and to attempt to determine whether such a procedure reduces blood loss in electi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198703000-00005
更新日期:1987-03-01 00:00:00
abstract::Fluoxetine is an antidepressant drug with a unique chemical configuration which enhances serotoninergic transmission by inhibiting serotonin uptake. The chronic presence of serotonin in the synaptic cleft reduces postsynaptic receptors, a postulated explanation for its antidepressant efficacy. Comparative studies show...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1989-08-01 00:00:00
abstract:OBJECTIVES:To explore factors that might contribute to misattribution of mental status changes to psychiatric illness when an elderly patient actually has a delirium (mental status changes due to a medical condition). METHODS:Records of 900 elderly patients referred to a Veterans Affairs psychiatric inpatient unit and...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181c99423
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Tobacco use causes significant morbidity and mortality. Resident physicians at the George Washington University Medical Center are trained to counsel patients to stop smoking. METHODS:I retrospectively reviewed charts of 300 patients treated by resident physicians in the Department of Medicine (200) and the...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199910000-00007
更新日期:1999-10-01 00:00:00
abstract::A total of 37 physicians and other health care professionals have been accepted into a monitoring and advocacy program for an average of 24 months. Thirty-five are working in their profession, one is in treatment, and one has repeatedly relapsed and is no longer practicing medicine (an overall improvement rate of 97%)...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199409000-00003
更新日期:1994-09-01 00:00:00
abstract::The use of psychotropic medication is often associated with weight gain. We provide documentation for this effect and review the mechanisms possibly responsible for it in the case of neuroleptic agents, lithium carbonate, monoamine oxidase inhibitors, and amitriptyline. We also enumerate the undesirable medical conseq...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198311000-00021
更新日期:1983-11-01 00:00:00
abstract::Transchondral talar dome fractures are a rare but not unknown cause of continued disability following a "sprained ankle." The diagnosis is made with standard ankle roentgenograms and an awareness of the lesion. Surgical treatment is recommended in acute and chronic cases, based on the amount of displacement of the fra...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198405000-00007
更新日期:1984-05-01 00:00:00
abstract::Psychiatric hospital services for adolescents have steadily increased in recent years and great interest has been generated in determining treatment outcome. In this study, 74 adolescent inpatients completed structured telephone interviews one year after discharge. The questions probed school, job, and family adjustme...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198009000-00013
更新日期:1980-09-01 00:00:00
abstract:OBJECTIVES:Immunochromatographic urine pneumococcal antigen testing (ICT) has become a common diagnostic tool for those presenting with possible invasive pneumococcal disease. The incidence and clinical impact of ICT false-positivity on hospitalized patients has not been assessed outside of specific patient subpopulati...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3182273b82
更新日期:2011-08-01 00:00:00
abstract::We report on two healthy white men who sustained high-voltage electrical burns and were transferred to our regional burn center for specialized care. Within 24 hours of admission, both patients developed clinical signs and laboratory evidence of diabetes insipidus. With appropriate treatment, no sequelae occurred and ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199403000-00025
更新日期:1994-03-01 00:00:00
abstract::Perinephric and prostatic abscesses may present with protean symptoms and often arise from ascending urinary tract infections. Both abscesses are often caused by uropathogens, and only on rare occasions is the etiology due to methacillin-resistant Staphylococcus aureus (MRSA). Perinephric and prostatic abscesses have ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31802fff6e
更新日期:2007-05-01 00:00:00
abstract::Using continuous wave Doppler ultrasound, we studied the umbilical and uterine flow velocity waveforms in 68 pregnant women who had chronic hypertension and/or preeclampsia. The systolic-diastolic (S/D) ratio was considered an expression of vascular resistance peripheral to the point of insonation. Abnormal umbilical ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199002000-00005
更新日期:1990-02-01 00:00:00
abstract::We examined present and anticipated future levels of career satisfaction among psychiatrists in the greater Houston area. We gathered data by means of an anonymous questionnaire. The strongest univariate correlations between background variables and current and anticipated future levels of career satisfaction were fou...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199505000-00003
更新日期:1995-05-01 00:00:00
abstract::We have described three patients with diabetes and renal insufficiency who had hyperkalemia during heparin therapy. These cases lend support to previous findings, and emphasize the clinical importance of this entity. We believe that heparin-induced hyperkalemia is a potentially life-threatening problem that is more co...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198711000-00029
更新日期:1987-11-01 00:00:00
abstract::Among natural disasters, lightning is a leading cause of morbidity and mortality throughout the world. A well-informed bystander and an astute physician can make the difference between an outcome of death or lifelong disability versus complete or near-complete recovery. What is done in the first few minutes after such...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199907000-00010
更新日期:1999-07-01 00:00:00
abstract::Most of the surgical procedures proposed for the treatment of fecal incontinence associated with prolapse are associated with considerable morbidity and mortality. We used a modified Thiersch procedure with a Silastic mesh implant (Dow-Corning 501-3) on a series of 12 patients over a period of 2 1/2 years. Nine patien...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198603000-00012
更新日期:1986-03-01 00:00:00
abstract::Hypochlorhydric states such as atrophic gastritis and partial gastrectomy have long been known to cause iron deficiency anemia. However, studies to date have failed to show a similar association with omeprazole, a proton pump inhibitor that also produces achlorhydria. These studies, however, have primarily involved no...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000110405.63179.69
更新日期:2004-09-01 00:00:00
abstract::We reviewed the records of 101 patients over the age of 60 who had exploration and cholecystectomy in 1982 at Norfolk General Hospital. There were 52 elective and 49 emergency cases. Women comprised 57.4% of the patients, and almost 50% of the patients were over the age of 70. Forty-nine percent of the cases were emer...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198704000-00016
更新日期:1987-04-01 00:00:00