The first 2000 incidents reported to the Australian Incident Monitoring Study were analysed with respect to the role of the pulse oximeter. Of these 184 (9%) were first detected by a pulse oximeter and there were a further 177 (9%) in which desaturation was recorded. Of the 1256 incidents which occurred in association with general anaesthesia 48% were "human detected" and 52% "monitor detected".
View Article and Find Full Text PDFUnlabelled: BACKGROUND. New salvage chemotherapy is needed for metastatic breast cancer. Cisplatin and VP-16 have activity but considerable toxicity.
View Article and Find Full Text PDFA small wave propagation pump (WPP) was incorporated into oxygenators to create a disposable heart-lung machine. The WPP provides undirectional micropulsatile laminar flow of 8 L/min against 800 mmHg. The smaller WPP can generate 4 L/min against 400 mmHg (cardioplegia), or reversed, and can create up to 150 mmHg negative pressure for suction.
View Article and Find Full Text PDFAnn Thorac Surg
November 1992
Sixteen patients (2 women, 14 men) aged 29 to 72 years with continued cardiogenic shock during intraaortic balloon pumping (IABP) had additional treatment with percutaneous cardiopulmonary bypass (PBY). Cause of cardiogenic shock was myocardial infarction in 7 (3 survived), failed percutaneous transluminal coronary angioplasty requiring emergency coronary artery bypass grafting in 5, postoperative aortic valve replacement in 1, postoperative emergency coronary artery bypass grafting in 1, after cardiac transplantation in 1, and bridging to transplantation in 1. Mean blood pressure with PBY and IABP combined was 75 mm Hg versus 60 mm Hg with IABP off.
View Article and Find Full Text PDFWe have established the first prospective, collaborative study of spinal muscular atrophy, the second most common neuromuscular disease of childhood. One hundred and forty-one patients have been evaluated on at least four occasions over a 3-year period. The patients have been grouped by age of onset, as well as by function at the time of initial evaluation.
View Article and Find Full Text PDFThe effects of short-term, 7-day, treatment with synthetic 15-leucine human gastrin I, pentagastrin or sulfated cholecystokinin-8 on the activity of histamine (HA)-stimulated adenylate cyclase in membranes isolated from guinea pig gastric mucosa and H2-receptor-mediated contractions of isolated ilea were evaluated. Treatment with each of the peptides produced a decrease in the maximal rate of HA-stimulated adenylate cyclase. The decreases in the maximal rate occurred without any effect on the potency of HA or any effect on basal rates of activity.
View Article and Find Full Text PDFIn the early 1800s, an awareness of potential ventricular failure stimulated interest in artificial heart replacement. In 1937 the first total artificial heart (TAH) was implanted into the chest of a dog by Russian physicians. The primary driving force for mechanical cardiac assistance developed from the necessity for circulatory assistance in order to perform corrective cardiac surgery.
View Article and Find Full Text PDFA new theory of pumping fluids, including blood, has been developed using magnetostrictive technology. This new pump uses the magnetostrictive material known as Terfenol-DTM. A magnetic field is imposed on the Terfenol in periodic pulses causing it to expand and then relax to its original state.
View Article and Find Full Text PDFJ Clin Microbiol
November 1990
A series of 37 clinical isolates of coagulase-negative staphylococci previously identified as negative for slime production by the tube test were reexamined by the tissue culture plate test under aerobic and anaerobic conditions. None of the strains produced slime under anaerobic conditions; however, five strains (13%) produced slime under aerobic conditions.
View Article and Find Full Text PDFThe pathogenic Staphylococcus epidermidis strain RP62A (ATCC 35984) adheres to smooth surfaces by forming a tenacious bacterial film known as slime. The mechanism of slime production is not known; however, workers in the laboratory of G. Pier (Harvard Medical School, Boston, Mass.
View Article and Find Full Text PDFUnder fluoroscopy, the hemopump is passed through the aortic valve into the left ventricle through a Gortex (WF Gore, Denver, CO) chimney sewn to a surgically exposed femoral artery. The system aspirates the left ventricular blood and actively pumps it into the aorta. Five patients (four men, one woman), aged 47-71 years (mean, 62 years), were candidates for hemopump support because of refractory cardiogenic shock.
View Article and Find Full Text PDFCompetent use of interviewing skills is important for the care of all patients but is especially critical, and frequently deficient, in meeting the needs of patients experiencing emotional distress. This study presents an evaluation of a curriculum in communication and psychosocial skills taught to first-year medical residents. A randomized experimental design compared trained and untrained residents' (n = 48) performances with a simulated patient presenting with atypical chest pain and psychosocial distress.
View Article and Find Full Text PDFObjective: To evaluate the effectiveness of a process whereby a faculty-resident committee annually audits outpatient record keeping and preventive care practices and provides feedback to resident physicians.
Design: Pre- and postfeedback audits with interventions and observations repeated over six consecutive academic years.
Setting: The adult primary care practice of housestaff in a university-affiliated hospital.
Coagulase-negative staphylococci isolated from a patient with a pacemaker electrode infection were extensively evaluated by phenotypic and genotypic characterization. Findings from this evaluation were striking because different colony morphologic subtypes were recovered from blood and resected pacemaker electrodes. Staphylococci from each colony subtype (LBL, LBV, LBP, LBS) were identified as slime-producing strains of Staphylococcus epidermidis sensu stricto.
View Article and Find Full Text PDFWe have investigated the effect of sepsis induced by cecal ligation and puncture on the chronotropic actions of beta adrenoceptor agonists on isolated right atria. The present findings show that right atria obtained from rats in an early stage of sepsis were supersensitive to the chronotropic actions of the beta-agonists, isoproterenol (ISO), fenoterol (FEN) and prenalterol (PREN). The supersensitivity to the chronotropic actions of ISO and FEN was much greater than that which developed to PREN.
View Article and Find Full Text PDFThis paper provides a foundation for establishing curricula to train medical residents in ambulatory care. To do so, it first presents reasons that curricula are needed in this area. It then delineates attitudes and proficiencies (knowledge and skills) that such curricula should be designed to instill.
View Article and Find Full Text PDFA consultant-led day hospital in a district general hospital (DGH) was compared with general practitioner-controlled day hospitals in community hospitals (CHs). CHs were more generously provided for their populations, 3.87 compared with 1.
View Article and Find Full Text PDFPreclinical and clinical trial investigations are now underway for a variety of ventricular assist devices at centers around the country. The current progress of the HEMOPUMP is encouraging, and survival rates show the potential for a successful outcome. This article describes the HEMOPUMP system, and discusses patient description and clinical experience with the system.
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