Geospatial and co-occurrence analysis of antibiotics, hormones, and UV filters in the Chesapeake Bay (USA) to confirm inputs from wastewater treatment plants, septic systems, and animal feeding operations.

Previous studies have reported select contaminants of emerging concern (CECs) in limited areas of the Chesapeake Bay (USA), but no comprehensive efforts have been conducted. In this work, 43 antibiotics, 9 hormones, 11 UV filters, and sucralose, were measured in matched water, sediment, and oyster samples from 58 sites. The highest sucralose concentration was 3051 ng L in a subwatershed with 4.

Non-targeted analysis (NTA) and suspect screening analysis (SSA): a review of examining the chemical exposome.

Non-targeted analysis (NTA) and suspect screening analysis (SSA) are powerful techniques that rely on high-resolution mass spectrometry (HRMS) and computational tools to detect and identify unknown or suspected chemicals in the exposome. Fully understanding the chemical exposome requires characterization of both environmental media and human specimens. As such, we conducted a review to examine the use of different NTA and SSA methods in various exposure media and human samples, including the results and chemicals detected.

Forensic Mental Health Nurses' Perceptions of Clinical Supervision: A Qualitative Descriptive Study.

Mental health nursing in the forensic services is perceived as stressful as there is often a tension between therapeutic and custodial processes. Clinical supervision has been discussed as a support strategy for nurses. The aim of this paper is to explore forensic mental health nurses understanding of clinical supervision and their perception of its utility within their practice.

Cardiac arrest in intensive care unit: Case report and future recommendations.

Initiation of hemofiltration in a patient in septic shock can cause hemodynamic compromise potentially leading to cardiac arrest. We propose that the standard '4Hs and 4Ts' approach to the differential diagnosis of a cardiac arrest should be supplemented in critically ill patients with anaphylaxis and human and technical errors involving drug administration (the 5(th) H and T). To illustrate the point, we report a case where norepinephrine infused through a central venous catheter (CVC) was being removed by the central venovenous hemofiltration (CVVH) catheter causing the hemodynamic instability.

Hyperglycemia during hypothermic cardiopulmonary bypass does not alter postbypass vascular endothelial responses in dogs.

Background: Hyperglycemia during hypothermic cardiopulmonary bypass (CPB) may alter intrinsic vasomotion by reducing endothelial-dependent vasorelaxation. Using a canine model of hypothermic CPB, this study tested whether hyperglycemia altered the vasodilator response to acetylcholine (ACh) and the vasoconstrictor response to phenylephrine (Phe).

Methods: In 20 anesthetized dogs, the left femoral arteries were excised and placed in gassed (95% O2-5% CO2) cold Krebs's solution.

Volume expansion increases right ventricular infarct size in dogs by reducing collateral perfusion.

Study Objective: Plasma volume expansion is frequently recommended to correct the low output state resulting from right ventricular (RV) infarction. However, any subsequent increase in pericardial and RV filling pressures from volume expansion could impair RV collateral blood flow. We examined whether volume expansion in dogs before right coronary ligation reduced collateral perfusion and worsened the extent of RV necrosis.

Cerebral metabolic consequences of hypotensive challenges in hemodiluted pigs with and without cardiopulmonary bypass.

We tested the hypothesis that progressive aortic hypotension with bicarotid occlusion produces greater reductions in cerebral blood flow (CBF) and more flow-metabolism mismatching with hemodilution during cardiopulmonary bypass (CPB) than with hemodilution alone. In Yorkshire pigs randomized to hemodilution with CPB (n = 10) or hemodilution without CPB (control; n = 9), the effects of bicarotid ligation and graded hypotension on CBF (microspheres), the electroencephalogram (EEG), and cortical energy metabolites were examined. After bicarotid ligation, systemic flow was reduced for 15-min intervals of 80, 60, and 40 mm Hg aortic pressure, followed by a cortical brain biopsy.

Systemic gaseous microemboli during left atrial catheterization: a common occurrence?

Objective: Gaseous microemboli during cardiac surgery have been implicated as a potential cause of postoperative neurologic injury. Any monitoring technique that exposes the systemic circulation to atmospheric pressure could introduce gaseous microemboli, causing cerebral microembolization. The incidence of carotid artery gaseous microemboli was studied during left atrial catheter insertion.

Increasing organ blood flow during cardiopulmonary bypass in pigs: comparison of dopamine and perfusion pressure.

Objective: To determine whether low-dose dopamine infusion (5 micrograms/kg/min) during cardiopulmonary bypass selectively increases perfusion to the kidney, splanchnic organs, and brain at low (45 mm Hg) as well as high (90 mm Hg) perfusion pressures.

Design: Randomized crossover trial.

Setting: Animal research laboratory in a university medical center.

Hyperglycemia during hypothermic canine cardiopulmonary bypass increases cerebral lactate.

Background: Hyperglycemia frequently occurs during cardiopulmonary bypass (CPB), although its direct effects on cerebral perfusion and metabolism are not known. Using a canine model of hypothermic CPB, we tested whether hyperglycemia alters cerebral blood flow and metabolism and cerebral energy charge.

Methods: Twenty anesthetized dogs were randomized into hyperglycemic (n = 10) and normoglycemic (n = 10) groups.

Cardiopulmonary bypass impairs vascular endothelial relaxation: effects of gaseous microemboli in dogs.

Gaseous microemboli during hypothermic cardiopulmonary bypass (CPB) may injure the vascular endothelium and interfere with intrinsic vasomotion. We tested whether gaseous microemboli reduced the vasodilator response to acetylcholine (ACh, 10(-9)-10(-6) M) and potentiated the vasoconstrictor response to norepinephrine (NE, 3 x 10(-8)-10(-4) M). Arteries from 18 dogs were excised before and after 120 min 28 degrees C CPB using membrane (n = 9) and bubble (n = 9) oxygenators to produce microemboli, which were quantitated by Doppler.

Clinical audit in intensive care--the Meath Intensive Care Audit.

Audit is now recognised as being an essential component of clinical practice. We report on the first year of the Meath Intensive Care Audit (MICA). This audit was instituted to investigate the activity of the unit, to assess the feasibility of continuous audit in our ICU and to provide data for future development of ICU facilities.