The Evolution of Trauma in Los Angeles County Over More Than a Decade.

OBJECTIVE: Explore trends in trauma incidence and mortality rates in Los Angeles County. DESIGN: Data for patients treated at Los Angeles County trauma centers from 2000 to 2011 were analyzed for this study. Age-adjusted incidence and mortality rates were calculated by gender, race, injury type, injury severity, and mechanism of injury. Trends were assessed using linear regression to determine the annual percentage change (APC). RESULTS: There were 223 773 patients included. The trauma incidence rate increased by 14.6% driven by an increase in blunt injury of 5.4% annually (P < .05). Penetrating injury decreased at -6.9% APC (P < .01). Mortality rate decreased at -11.5% APC (P < .01), with reduction in both blunt (-6.8% APC [P < .01]) and penetrating injuries (-16.7% APC [P < .01]). The trends in mortality persisted with stratification by age, gender, race, and injury severity score. CONCLUSION: In this mature trauma system, the trauma incidence increased slightly from 2000 to 2011, while the mortality steadily declined. Public health officials in other areas could perform a similar self-evaluation to describe and monitor injury events and trends in their jurisdictions, a reassessment of priority and trauma system resource allocation, which will directly benefit the regional population.

Welcome release: perspective death in the early county lunatic asylums 1810-50.

Deaths in the asylum could be interpreted as a sign of failure, particularly if they were related to the poor condition of those admitted, the spread of disease among patients, or the direct consequences of severe mental disorders. County asylum superintendents lamented the bad physical state in which many were sent to the asylum and the consequences for death rates. Due to limited consideration of environmental and sanitary matters before the 1830s, there was great risk of contracting fatal diseases in the asylum. Combined with the deteriorated physical condition of many patients, and the growing overcrowding, this had a notable influence on mortality. For some individual patients, death came about as a direct consequence of a profound mental disorder. Without effective treatments to confront manifestations of disordered thinking, mental symptoms might precipitate physical deterioration to the point of death, while severe distress led some to kill themselves in the asylum.

[Overview on branch hospital of Central Medical Hospital and the county hospitals in Guangdong province during the Republic of China].

Central Medical Hospital were established in 1929. And then, based on the "Memorandum of Organization of Central Medical Hospital, Provincial and Municipal Branch", branch hospitals were set up in all provinces. Guangdong Branch and the county hospitals were established in 1931, and a variety of activities were carried out. However, because of the failure of striving for administrative power by Central Medical Hospital, the local Branch hospitals were defined as association. In addition, lack of powerful leaders and support of government led to the weakening of its function. They failed to develop traditional Chinese medicine further.

How interventional radiology changed the practice of a trauma surgeon.

Trauma Surgery, with the assistance of advanced technology especially in Imaging (formerly Radiology), enables it to have patient management approaching John Hunter's ideal of treatment by stratagem rather than the "force" of an open operation.

[Building of the surgical pavilion of the County Hospital in Bjelovar]. / Projekti i izgradnja kirurskoga paviljona bjelovarske bolnice.

Preparations for the construction of the surgical pavilion of the County hospital in Bjelovar began in 1913 initiated by doctor Antun Gottlieb. The entire project documentation was drawn by Ignjat Fischer (1870-1948), the architect who specialized in the construction of medical buildings in the first decades of the 20th century. Fischer designed the Bjelovar Pavillion as a two-storey building with an annexe in which double operating rooms were situated. In this paper Fischer's early functionalist approach to the designing of medical buildings is dealt with and the parallels between the Bjelovar Surgical Pavilion and other Fischer's medical buildings are drawn. The Bjelovar Pavilion has only been slightly reconstructed to date, and the arrangement of the majority of facilities--compared to the Fischer's project--has remained unchanged, which bears testimony to the high quality of Fischer's designing procedure.

Changes in county hospitals during Sheldon's tenure.

Dramatic changes took place in county hospitals during Dr. Sheldon's tenure, 1964 to 1985. The primary impact came from Medicaid and Medicare legislation in 1965. The secondary impact came as the result of the drug culture entering American cities.