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The Relationship of Substance Abuse to Orofacial Injuries in an Inner City Population
Black, Edward E.,Kathryn Atchison,Vivek Shetty,Leathers, Richard D.,Shan Bagby,Sandra Delrahim Korean Academy of Oral Biology and the UCLA Dental 1998 International Journal of Oral Biology Vol.23 No.1
The prevalence of drug and alcohol abuse was investigated prospectively in a population of 207 patients with orofacial injuries seeking treatment at the King/Drew Medical Center, Los Angeles. Demographic details were collected, the use of alcohol and street drugs obtained, and a clinical determination made on whether the injuries were related to alcohol or drug intoxication. The prevalence of covert alcoholism was determined by administering the CAGE questionnaire. The majority of victims were young (33.3±9.05 yrs), male (88%), African-American (73%) or Hispanic (25%), unemployed (71%) and had < 12 years of education (73%). About 83% of the African-American patients reported regular use of alcohol and 48% reported regular use of street drugs. Among Hispanic patients, 80% reported use of alcohol and 18% used drugs regularly. Of the 119 patients screened by the CAGE test, 60% of the African-American patients and 46% of the Hispanic patients answered affirmatively for one or more items, which indicates potential for alcoholism. A significantly greater proportion of patients who screened positive had a history of previous head trauma (80% vs. 50%, p=0.01) and a history of orofacial trauma (77% vs. 52%, p=0.03) or both, indicating a high rate of recidivism. We conclude that alcohol and drug abuse is strongly associated with the occurrence of orofacial injury in inner-city populations. The CAGE test appears to be a simple and effective screening mechanism for clinicians to yield valuable information that can affect the treatment provided. Beyond socioeconomic factors, substance abuse in and of itself appears to be an important risk factor of repeat injury.
Elliott Brown, Karin A.,Shetty, Vivek,Atchison, Kathryn,Leathers, Richard,Black, Edward,Delrahim, Sandra Korean Academy of Oral Biology and the UCLA Dental 1998 International Journal of Oral Biology Vol.23 No.1
This study examined the relationship between perceived social support and reports of well-being and risky health behaviors among minority males treated at an urban orofacial trauma center. One hundred nineteen African American and 49 Hispanic males, who received orofacial surgery due to a fractured jaw, participated in a structured interview over a six month period. Selected scales from the MOS Short-Form(SF-20) survey were used to obtain self-reports of general health, emotional well-being and the perceived availability of general social support. Patients were also asked about alcohol and street drug use to assess risky health behavior and its relationship to social support. An overwhelming majority of the patients perceived social support to be available to them. However, significantly more Hispanic patients reported "having enough friends and social life" compared to African-American patients. For both groups, perceived availability of social support was found to be positively related to patients reports of general health and emotional well-being. Eighty percent of the patients reported alcohol use as a habit. Alcohol use did not influence perceptions of available social support. More African-American patients (46%) reported habitual street drug use than Hispanics (16%). Habitual street drug use poses a significant risk for poor social support and emotional distress. Social support did not buffer the relationship between street drug use and mental health risk. Perceptions of social support remained consistent when examined across three and six months post-surgery. The positive perceptions of available support reported by the majority of inner-city ethnic-minority males in this study suggests that the potential positive influence of social relationships on their recovery and well-being should not be underestimated. Instead, information on supportive relationships should be elicited and availed of as an adjunct to surgical care.
Yung O . Shin,Elaine M . Elder,R . Wayne Atchison 대한바이러스학회 1981 Journal of Bacteriology and Virology Vol.11 No.1
Enzyme immunoassay (EIA) techniques were modified for the direct detection of influenza soluble antigens in patient specimens. Twenty-four available clinical specimens, previously tested by irnmunofluorescence(IIF) on cell culture isolates and by egg isolation (EGG) techniques, were retrospectively tested by 2 different methods of EIA, I.e., direct sorption type, EIA (DS), and double antibody, EIA (DA), EIA (DS) showed. 83.3% (20/24) agreement with IIF and 58.3% (14/24) agreement with EGG. EIA (DS) detected more positive specimens (50% 12/24) than EIA (DA) (36,8%, 8/24). EIA (DS) data showed the highest-agreement (91.7%, 22/24) with data obtained from both IIF and EGG; 2 specimens gave different results from those seen by IIF and EGG. With the advantages of its sensitivity, rapidity and sirnplicity, EIA test for the detection of influenza soluble antigen would be an important supplement to other standard techniques used in influenzal diagnosis.
Orofacial Injury Profiles and Patterns of Care in an Inner-City Hospital
Leathers, Richard D.,Vivek Shetty,Black, Edward E.,Kathryn Atchison Korean Academy of Oral Biology and the UCLA Dental 1998 International Journal of Oral Biology Vol.23 No.1
To understand the types of orofacial injuries and determine patterns of surgical care in patients presenting to an inner-city hospital, 203 adult patients seeking treatment at the King/Drew Medical Center in Los Angeles were studied prospectively. Sociodemographic details including race, age, gender and education were collected and the etiology of the injury noted. The nature and severity of injury was categorized using a modified AO classification scheme and related to the type of surgical care provided (maxillomandibular fixation or rigid internal fixation). The majority of the victims were minorities, male (88%), uninsured (86%), and under or unemployed (83%). Interpersonal violence (88%) was the most common etiology of the orofacial injury. The body and angle of the mandible were most commonly involved and approximately 25% of the patients had associated midfacial fractures. While most fractures (83%) with low severity were treated by maxillomandibular fixation, a substantial number (17%) were treated by rigid internal fixation. In contrast, over 65% mandible fractures deemed to be severe were treated exclusively by maxillomandibular fixation. The patterns of injury observed at this inner-city hospital and their antecedents ate distinctly different. The majority of the injuries result from intentional violence and the victims are primarily socially and economically disadvantaged groups without financial resources to pay for treatment. Although women are less involved, they are disproportionally the victims of domestic violence. The large inconsistencies in the treatment methods and the preventable aspect of these injuries emphasizes the need for systematic audit and for developing prevention programs targeting high-risk groups.