Les avantages de bien faire le boulot avec des sp�cialistes supervis�s Plut�t que faire la job � moiti� et en vitesse avec les meilleurs (pas n�cessairement bien supervis�)
http://www.sane-sart.com/ SANE Programs Growing Exponentially; Trauma Common Among Sexual Assault Victims and Fewer Know their Assailants Laura Gore - (202) 728-0610 ext. 3006 Washington, DC � A new study examines Sexual Assault Nurse Examiner (SANE) programs, which uses a team approach to treating and gathering forensic evidence from victims of sexual assault, in the April issue of Annals of Emergency Medicine. Another study reports that trauma is common among sexual assault victims and that fewer victims know their assailants. A case report describes the complications of a man who ingested an popular over-the-counter, body-building hormone, praised in popular fitness magazines. Embargoed copies of the articles are available from the Washington office of the American College of Emergency Physicians. SANE Program A survey of 92 programs SANE programs in the United States (61 responding) found many similarities among programs related to staffing, training, prevention of sexually transmitted diseases (STDs) and pregnancy, and documentation techniques. The study also found inconsistencies in the use of STD cultures, HIV testing, and drug-alcohol screening, suggesting a best-practices protocol could be designed. Since only a few programs could provide survivor followup and legal outcome information, it was not possible to evaluate the program's effectiveness. National victimization studies estimate 683,000 rapes occur each year, with 16% to 32% of rapes reported and 30% of those actually prosecuted. (Sexual Assault Nurse Examiner Programs in the United States) "There has been an exponential growth of SANE programs in the country, and forensic nurse examiners increasingly have become important in treating sexual assault victims," said Caroline Wilson, MD, of the Summa Health System Department of Emergency Medicine in Akron, Ohio. "Forensic nursing programs were designed to remove sexual assault evidence collection from emergency department staff, to create a compassionate examination process, and to obtain complete, consistent data." The study found that most programs use registered nurses and nurse practitioners, primarily those with specific and practical training for forensic examinations. According to the study, program director-coordinators predominately were registered nurses. More than half of responding programs performed initial sexual assault examinations in hospital emergency departments, and most of them (86%) used pre-prepared commercial sexual assault kits. HIV testing was not offered in more than half of responding programs. "Sexual assault and its traumatic, infectious, psychologic, and legal consequences are a continuing challenge in emergency medicine," said Dr. Wilson. "Excellent care for survivors requires coordination of clinical medicine with forensic science, law enforcement, and victim advocacy. Further research is needed, and collection of outcome measures will help define the impact of the programs." Analysis of Sexual Assault A study of more than 1,000 sexual assault victims found trauma to be common, and fewer victims to know their assailants. According to the study, 40% of assaults occurred in either the victim's or the assailant's home, and force was used in 80% of reported assaults. In more than one-fourth of cases (27%), a weapon was used, and in more than one-third of cases (39%), the assailant was a stranger (Analysis of 1,076 Cases of Sexual Assault) "Several demographic features of sexual assault victims and sexual assaults have changed in the past 20 years," said Debra Houry, MD, of Denver Health Center. "Although sexual assault victims are still much more likely to be female than male, the percentage of sexual assaults perpetrated by strangers has declined." Sexual assault victims are more likely to be female (96%) than male (4%). General body trauma was seen in more than two-thirds of cases, and genital trauma occurred in about half of cases. According to the study, evidence of semen is commonly found by a crime laboratory, even when it is not noted in the emergency department and when there is no trauma noted on examination. Sperm were noted in the emergency department in only 13% (93 of 716 ) of victims. "The value of an examination immediately after an incident is also limited by the fact that contusions may not become visible for at least 48 hours," said Dr. Houry. "Because many sexual assault victims may not have physical trauma or genital trauma on examination, this does not mean an assault did not occur." The Federal Bureau of Investigations in 1994 estimated that 1 of 3 women and 1 of 7 men in the United States will be raped at some point in their lifetime. Reports of incidence and prevalence of sexual assault are increasing, in part because of increased reporting of such crime. Athletic Drug Related to Sexual Dysfunction A case report describes a 30-year old man with the rare condition of priapism, a painful involuntary penile erection, unrelated to sexual desire or stimulation, which needs urgent attention to minimize the risk of future impotence. According to the report, the man had ingested an over-the-counter male hormone androstenedione, praised in popular fitness magazines as having both muscle-enhancing qualities and as an alternative to Viagra. Unlike testosterone, which cannot be legally purchased, androstenedione can be readily purchased in tablet form at local fitness and nutrition stores. (Priapism After Androstenedione Intake for Athletic Performance Enhancement) "The role of this hormone has not be studied in human beings," said Pranav N. Kachhi, MD, of the University of Southern California School of Medicine in Los Angeles. "It's important for the public and physicians to be aware of possible complications of over-the counter body-building supplements." Rewarming of Hypothermia Victims A study of methods for rewarming hypothermia victims in a pre-hospital setting found that using a heating blanket (set to 42�C or 107.6�F) more than doubled the rewarming rate compared with the use of insulation with reflective metal foil, a commonly used field rewarming method. Resistive heating eliminated heat loss and even transferred some heat across the skin surface. Study authors said that faster rewarming of hypothermia patients is important, because it is likely to reduce hypothermia-related complications. (Resistive Heating is More Effective Than Metallic-Foil Insulation in an Experimental Model of Accidental Hypothermia: A Randomized Controlled Trial) Annals of Emergency Medicine is the peer-reviewed journal of the American College of Emergency Physicians, a national medical society representing almost 21,000 physicians who specialize in emergency medicine. ACEP is committed to improving the quality of emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia, and a Government Services Chapter representing emergency physicians employed by military branches and other government agencies. http://www.acep.org/3,1318,0.html � 1996-2003. American College of Emergency Physicians. Contact [EMAIL PROTECTED] for more information. This page last updated on July 11, 2002 at 5:08:06 pm. __________________________________ Do you Yahoo!? Yahoo! SiteBuilder - Free, easy-to-use web site design software http://sitebuilder.yahoo.com --- URG-L Pour modifier votre adresse de courriel sur URG-L, envoyez un avis a [EMAIL PROTECTED] en indiquant votre nouvelle adresse ainsi que l'ancienne et le nom de la liste.
