Modified percutaneous tracheostomy in patients with COVID-19.

Background: Patients hospitalized with COVID-19 are at risk of developing hypoxic respiratory failure and often require prolonged mechanical ventilation. Indication and timing to perform tracheostomy is controversial in patients with COVID-19.

Methods: This was a single-institution retrospective review of tracheostomies performed on patients admitted for COVID-19 between April 8, 2020 and August 1, 2020 using a modified percutaneous tracheostomy technique to minimize hypoxia and aerosolization.

From World War II to COVID-19: A Historical Perspective on the American Medical Supply Chain.

COVID-19 is the latest episode of shortages of critical medical supplies. Historically and to the present day, medical supplies have been sourced from single regions in the world, thus rendering the supply chain vulnerable to a myriad of harmful circumstances. We argue that shortages in medications related and unrelated to COVID have illustrated the need for the United States to diversify its medical supply sources before future pandemics, political crises, or natural disasters occur.

100% Nitrous Oxide in the Oxygen Line: How Could This Happen in a Modern Anesthesia Machine?

The inadvertent crossover between O2 and N2O pipelines has become extremely rare in practice. We describe a case where it was possible to ventilate with 100% N2O instead of the intended 100% O2 on a modern anesthesia delivery system (Dräger Apollo; Drägerwerk AG & Co KgaA, Lübeck, Germany). This was the result of the incorrect assembly of diameter index safety system (DISS) components during preventative maintenance that defeated the DISS failsafe system.

A toolbox of IgG subclass-switched recombinant monoclonal antibodies for enhanced multiplex immunolabeling of brain.

Generating recombinant monoclonal antibodies (R-mAbs) from mAb-producing hybridomas offers numerous advantages that increase the effectiveness, reproducibility, and transparent reporting of research. We report here the generation of a novel resource in the form of a library of recombinant R-mAbs validated for neuroscience research. We cloned immunoglobulin G (IgG) variable domains from cryopreserved hybridoma cells and input them into an integrated pipeline for expression and validation of functional R-mAbs.

Epidemiology and Risk Factors for Outpatient-Acquired Catheter-Related Bloodstream Infections in Children Receiving Home Parenteral Nutrition.

Background: Few studies have examined the epidemiology and risk factors for the development of outpatient-acquired catheter-related bloodstream infections (CRBSIs) in children receiving home parenteral nutrition. This study aimed to (1) characterize the incidence, clinical presentation, and epidemiology of CRBSIs and (2) identify risk factors for CRBSIs in children receiving home parenteral nutrition.

Methods: A longitudinal database approved by our Institutional Review Board was created to prospectively track CRBSIs in the UCLA pediatric population from January to December 2012.

Nutrition Deficiencies in Children With Intestinal Failure Receiving Chronic Parenteral Nutrition.

Background: Home parenteral nutrition (PN) is a lifesaving therapy for children with intestinal failure (IF). Our aims were to describe the prevalence of micronutrient deficiencies (vitamin D, zinc, copper, iron, selenium) in a diverse population of children with IF receiving PN and to identify and characterize risk factors associated with micronutrient deficiencies, including hematologic abnormalities.

Methods: Data were collected on 60 eligible patients through retrospective chart review between May 2012 and February 2015.

Vitamin D deficiency in children with intestinal failure receiving home parenteral nutrition.

Background: Vitamin D plays important roles in both skeletal and nonskeletal health. Limited data suggest that patients with intestinal failure (IF) receiving home parenteral nutrition (PN) are at risk for vitamin D deficiency due to inadequate oral intake, poor absorption, and chronic illness. The purpose of this study was to document vitamin D status in pediatric patients with IF receiving home PN.

High resolution measurement of light in terrestrial ecosystems using photodegrading dyes.

Incoming solar radiation is the main determinant of terrestrial ecosystem processes, such as primary production, litter decomposition, or soil mineralization rates. Light in terrestrial ecosystems is spatially and temporally heterogeneous due to the interaction among sunlight angle, cloud cover and tree-canopy structure. To integrate this variability and to know light distribution over time and space, a high number of measurements are needed, but tools to do this are usually expensive and limited.

Pharmaceuticals suppress algal growth and microbial respiration and alter bacterial communities in stream biofilms.

Pharmaceutical and personal care products are ubiquitous in surface waters but their effects on aquatic biofilms and associated ecosystem properties are not well understood. We measured in situ responses of stream biofilms to six common pharmaceutical compounds (caffeine, cimetidine, ciprofloxacin, diphenhydramine, metformin, ranitidine, and a mixture of each) by deploying pharmaceutical-diffusing substrates in streams in Indiana, Maryland, and New York. Results were consistent across seasons and geographic locations.

The consequence of species loss on ecosystem nitrogen cycling depends on community compensation.

Repercussions of species loss on ecosystem processes depend on the effects of the lost species as well as the compensatory responses of the remaining species in the community. We experimentally removed two co-dominant plant species and added a 15N tracer in alpine tundra to compare how species' functional differences influence community structure and N cycling. For both of the species, production compensated for the biomass removed by the second year.

Anticoagulation with low-molecular-weight heparin in patients with heart diseases.

Low-molecular-weight heparins (LMWH) were investigated in different cardiac diseases requiring anticoagulation. In case of short term usage advantages over intravenous unfractionated heparin (UFH) are of relevance, such as simple subcutaneous application, possibility for outpatient treatment and predictable effect on anticoagulation enabling abstention of laboratory monitoring in most cases. Thromboprophylaxis in acute medically ill patients and therapy of non-ST-elevation acute coronary syndromes (NSTE-ACS) are important indications, in which significant advantages for special LMWH as compared to Placebo or UFH were shown.

Anticoagulation with the low-molecular-weight heparin dalteparin (Fragmin) in atrial fibrillation and TEE-guided cardioversion.

Background: Cardioversion (CV) in atrial fibrillation can cause arterial embolism. Effective anticoagulation clearly reduces the risk. In practice, in every third case anticoagulation is not in line with the recommendations.

[Diagnosis and treatment of streptococcal myositis].

History And Clinical Findings: Case 1: Following an influenza a 40-year-old patient was treated by intramuscular injections for backache. 24 hours later he was admitted to a hospital with massive pain in both lower extremities and a markedly reduced general condition. Case 2: Two days after a knee joint arthroscopy a 57-year-old man developed strong pain in the extremity treated by application of diclofenac.

The farnesyl protein transferase inhibitor BZA-5B blocks farnesylation of nuclear lamins and p21ras but does not affect their function or localization.

BZA-5B is a peptidomimetic inhibitor of protein farnesylation in mammalian cells. We have examined the specificity of this compound toward inhibition of farnesylation of p21ras and the nuclear lamin proteins, prelamin A and lamin B. We have also used the Raney nickel cleavage technique in conjunction with radio-gas liquid chromatography to assess the ability of this compound to block total protein farnesylation.

The effects of intravenous mexiletine on spectra of the signal-averaged ECG.

This study examined the effects of intravenous mexiletine on the time-domain and spectrotemporal signal-averaged ECG (SAECG). SAECGs were recorded in 60 postmyocardial infarction (MI) patients with more than 100 premature ventricular beats per hour, before and after a constant infusion of mexiletine, 7 mg/kg, given over 1 hour. Spectrotemporal analysis was done on a fixed analyzed signal duration of QRS complex and ST segment of X, Y, and Z leads using a temporal window of rectangular type, measuring the signal content between 10-120 Hz.

Signal-averaged ECG in prediction of the short-term suppression of ventricular premature beats by Mexiletine.

We analyzed whether baseline parameters of time-domain and spectrotemporal analysis of a signal-averaged ECG or their changes during Mexiletine therapy can predict the antiarrhythmic efficacy of the drug. On 60 post-MI patients with > 100 ventricular premature beats per hour, signal-averaged ECGs were recorded before and after a constant infusion of Mexiletine (7 mg/kg) for 1 h and again after 4 days of oral Mexiletine therapy (Mexiletine SR, 360 mg twice daily). Spectrotemporal analysis was performed on a fixed analyzed signal duration of QRS-complex and ST-segment of X-, Y-, Z-leads using the temporal window of the rectangular type, measuring signals between 10-20 Hz.

[Effect of low-dosage intravenous nitrate therapy on the anticoagulant effect of heparin].

Background And Aim: Controversial studies concerning the fact that simultaneous i.v. administration of heparin and glyceroltrinitrate (GTN) might reduce the anticoagulatory effect of heparin have been published.

[Ultrasonographic findings in varicose phlebitis of the great saphenous vein. Evidence of thrombus growth and detachment with asymptomatic lung embolism].

In five women (mean age 58 [31-74] years) with clinically diagnosed varicose phlebitis of the long saphenous vein appositional thrombus growth was demonstrated by serial ultrasonography (B-mode compression and colour-coded duplex sonography). In one patient the appositional thrombus was found to be free-floating as far as the common femoral vein, but this was not seen by phlebography. During therapeutic heparinization there was ultrasonographic evidence of softening and partial liquefaction of thrombus material in a cranial direction.