Dose-Dependent Pulmonary Injury Following Nitrogen Dioxide Inhalation From Kinepak Detonation.

Background: Nitrogen dioxide (NO) is a pulmonary irritant produced as a byproduct of bacterial anaerobic metabolism of organic materials, and is also produced as a byproduct of explosive detonations. Significant NO exposure results in free-radical-induced pulmonary injury that may be delayed up to 3-30 h after exposure and can progress to acute respiratory distress syndrome (ARDS) and death. Here we present a case series of 3 patients with dose-dependent pulmonary injury consistent with NO inhalation following exposure to fumes from detonation of an ammonium nitrate/nitromethane (ANNM) explosive device.

Unconscious race and social class bias among acute care surgical clinicians and clinical treatment decisions.

Importance: Significant health inequities persist among minority and socially disadvantaged patients. Better understanding of how unconscious biases affect clinical decision making may help to illuminate clinicians' roles in propagating disparities.

Objective: To determine whether clinicians' unconscious race and/or social class biases correlate with patient management decisions.

Unconscious race and class bias: its association with decision making by trauma and acute care surgeons.

Background: Recent studies have found that unconscious biases may influence physicians' clinical decision making. The objective of our study was to determine, using clinical vignettes, if unconscious race and class biases exist specifically among trauma/acute care surgeons and, if so, whether those biases impact surgeons' clinical decision making.

Methods: A prospective Web-based survey was administered to active members of the Eastern Association for the Surgery of Trauma.

Use of diagnostic laparoscopy in a patient with gastric pneumatosis and portal venous gas.

Gastric pneumatosis is a radiographic finding that represents a spectrum of conditions ranging from benign disease to abdominal sepsis and death. Along with portal venous gas, it is generally considered an ominous sign prompting emergent operative intervention. We report a rare case showing that diagnostic laparoscopy can be used to confirm or refute full thickness ischemic necrosis and that conservative management can be considered in some patients, recognizing the possibility of a benign process.

Maturational and aging effects on human brain apparent transverse relaxation.

The goal of this study was to address the need for comprehensive reference data regarding maturational and aging effects on regional transverse relaxation rates (R(2)) of the brain in normal humans. Regional R(2)s were measured in twenty-five brain structures from a sample of seventy-seven normal volunteers 9 to 85 years of age. The relationships between regional R(2) and age were determined using generalized additive models, without the constraint of a specified a priori model.