A Prospective Evaluation of the Accuracy of Weight Estimation Using the Broselow Tape in Overweight and Obese Pediatric Patients in the Emergency Department.

Objectives: The aims of the study were to examine the predictive accuracy of Broselow tape (BT) weight estimation and body mass index-based weight categorization in overweight and obese pediatric patients and to develop an adjustment factor that improves the BT weight estimate in overweight and obese pediatric patients.

Methods: A prospective observational study was conducted. We enrolled noncritical pediatric patients presenting to a tertiary care pediatric emergency department with nonurgent complaints.

Avoiding Negative Dysphagia Outcomes.

Dysphagia in adults affects their quality of life and can lead to life-threatening conditions. The authors draw on both 30 years of experience as clinicians and also on expert testimony in adult, dysphagia-malpractice cases to make five recommendations with the aim of preventing dysphagia-related deaths. They discuss the importance of informed consent documents and suggest the following nursing actions to reduce these often unnecessary tragedies: consider the importance of diet status; understand and follow speech-language-pathologists' recommendations; be familiar with the dysphagia assessment; be responsive to the need for an instrumental assessment; and ensure dysphagia communication is accurate and disseminated among healthcare professionals.

Lessons from nursing home dysphagia malpractice litigation.

The purpose of this article is to review the management of swallowing disorders in nursing home patients. The goal is to provide readers with five areas of contentious dysphagia management issues that have surfaced in several malpractice litigation cases. A detailed examination of what went wrong in the management of these patients' dysphagia from the perspective of the plaintiffs' dysphagia expert witness, as well as a discussion of what nursing home staff could have done to prevent these tragedies, is presented.

A redefining Wernicke's area: receptive language and discourse semantics.

This report calls for a more exacting definition of Wernicke's area in the discipline of communication sciences and disorders to reflect an accurate view of brain functioning with regard to decoding discourse semantics. Conventional definitions are provided to delineate the general usages of important terms used by many professional dictionaries and glossaries when defining Wernicke's area, receptive aphasia, understanding, and comprehension. Five levels of semantic decoding are described.

Eclectic perspectives on the psychology of aphasia.

This article explores the psychological changes that occur in patients who have suffered a stroke with resulting aphasia and examines the adjustments necessary to help the patient cope. The eclectic approach described in this paper examines the psychology of aphasia from three perspectives: effects of brain injury, psychological defenses and coping styles, and responses to loss. Depression, anxiety attacks, ego restriction, crying, euphoria, denial, anger, and a host of other psychological reactions can accompany stroke, sometimes causing health care personnel to feel overwhelmed by these psychological concomitants in their patients.

Endothelin-1--induced enhancement of coronary smooth muscle contraction via MAPK-dependent and MAPK-independent [Ca(2+)](i) sensitization pathways.

Endothelin-1 (ET-1) has been implicated in coronary vasospasm by enhancing coronary vasoconstriction to vasoactive eicosanoids, and a role for protein kinase C (PKC) activation has been suggested. However, the cellular mechanisms downstream from PKC activation are unclear. We investigated whether physiological concentrations of ET-1 enhance coronary smooth muscle contraction by activating a PKC-mediated signaling pathway involving tyrosine phosphorylation and activation of mitogen-activated protein kinase (MAPK).

Mechanism of the Solution-Phase Reaction of Alkyl Sulfides with Atomic Hydrogen. Reduction via a 9-S-3 Radical Intermediate.

The low selectivity of benzyl alkyl sulfide fragmentation subsequent to its reaction with atomic hydrogen is indicative of a reaction that proceeds via an early transition state. The competitive reduction of a series of substituted-benzyl alkyl sulfides was insensitive to the substituent on the aromatic ring (rho = -0.13, r = 0.

Formation of Three-Membered Rings by S(H)i Displacement. Reverse of Cyclopropyl Ring Opening(1).

The general methods, photoinitiated or peroxide-initiated free radical chain additions of halomethanes to olefins, yield 1,2-addition products at temperatures ranging from 20 to 100 degrees C. At lower temperatures, -42 to -104 degrees C, a competitive reaction, subsequent to the addition of CCl(2)X(*), yields alkylcyclopropanes. The reactions of 1-octene or 1-hexene and 1-methylcyclohexene with atomic hydrogen carried out in the presence of several transfer agents (CCl(4), CCl(3)Br, CCl(2)Br(2)) initiate a radical chain addition of CCl(2)X(*) and yield cyclized materials resulting from the S(H)i displacement of halogen by a carbon-centered radical.

On the Mechanism of the Reaction of alpha-Substituted Ketones with Allyltributylstannane.

The mechanisms for the reaction of allyltributylstannane with a number of fragmentation probes, alpha-substituted acetophenones, were studied. All reactions were shown to proceed through free radical chain sequences since they could be initiated by AIBN and inhibited by m-dinitrobenzene (DNB). alpha-Halo- and alpha-(benzoyloxy)acetophenones (I and II, PhCOCR(1)R(2)X; X = F, Cl, Br, OCOPh; R(1), R(2) = H, Me) yielded the allylation products, PhCOCR(1)R(2)CH(2)CH=CH(2)), through a chain sequence involving as the propagation step: an electron transfer from Bu(3)Sn(*) to I and II, fragmentation of the ketyl anion PhCOCR(1)R(2)X(*)(-), and addition of PhCOCR(1)R(2)(*) to allyltributylstannane.