When a private community neurology practice executes home sleep apnea testing: benefits identified and lessons learned in a retrospective observational study.

Objective: To investigate the feasibility and utility of a private community neurology practice-initiated home sleep apnea testing (HSAT) program.

Methods: A private community neurology practice conducted HSAT on patients clinically identified as high risk for obstructive sleep apnea (OSA). An academic board-certified sleep specialist performed all study interpretations.

Calbindin immunoreactivity in the geniculo-extrastriate system of the macaque: implications for heterogeneity in the koniocellular pathway and recovery from cortical damage.

Although most projection neurons in the primate dorsal lateral geniculate nucleus (dLGN) target striate cortex (V1), a small number project instead to extrastriate visual areas and have been suggested to play a role in the preserved vision ("blindsight") that survives damage to V1. Moreover, the distribution of dLGN cells projecting to extrastriate bears a striking similarity to that of neurons that stain for calbindin D-28K (Cal), a calcium-binding protein involved in regulating neuronal excitability and considered a marker for the koniocellular or "K" pathway of geniculocortical processing. In these studies, we used double-labeling techniques to examine whether Cal content characterizes all or a subset of neurons making up the geniculo-extrastriate pathway in normal macaque monkeys.

Sex difference in the phosphorylation of cAMP response element binding protein (CREB) in neonatal rat brain.

On the day of birth, a surge in testicular testosterone release in male rats is critical for sexual differentiation of the brain. Steroid hormones function by binding to intracellular steroid receptors and altering gene expression; however, little is known about the signal transduction pathways altered as a consequence of steroid hormone action in developing brain. We investigated whether the increase in testosterone at birth alters the phosphorylation of CREB, a major signal transduction protein.

Feasibility of an emergency department-based tuberculosis counseling and screening program.

Objective: To assess the feasibility and effectiveness of an ED-based tuberculosis (TB) screening program.

Methods: A TB screening program of adult ED patients was conducted at a university hospital ED with 46,000 annual visits that serves a poor urban community. Patients were screened on weekdays during business hours.

Loss of glove integrity during emergency department procedures.

Study Objective: We sought to assess the loss of integrity of the latex-glove barrier during use in the ED setting.

Methods: We conducted a prospective observational study in an urban ED and Level I trauma center. Procedures performed by ED health care workers (HCWs) were directly observed, timed, and categorized.

Feasibility of an emergency department-based, risk-targeted voluntary HIV screening program.

Study Objective: To assess the feasibility and effectiveness of an emergency department-based, risk-targeted voluntary HIV screening program.

Methods: We prospectively enrolled consenting adult i.v.

Esophageal detector device versus detection of end-tidal carbon dioxide level in emergency intubation.

Study Objectives: To confirm the ability of the esophageal detector device (EDD) to indicate positioning of endotracheal tubes (ETTs) in patients intubated under emergency conditions and to compare the performance of the EDD with that of end-tidal carbon dioxide (ETCO2).

Methods: This single-subject study comprising a prospective case series was conducted in the emergency department of an urban university hospital. All adult patients were intubated either in the ED or by paramedics in the field.

Trends in human immunodeficiency virus (HIV) infection among a patient population of an inner-city emergency department: implications for emergency department-based screening programs for HIV infection.

Personnel of inner-city emergency departments (EDs), which are frequently the only source of medical care for many patients, may be in a unique position to detect human immunodeficiency virus (HIV) infection earlier than personnel at other recommended screening sites. To assist development of ED-based screening strategies for HIV infection, we undertook a serosurvey of HIV infection in adult patients attending an ED during a 6-week period in 1992 using an identity-unlinked technique and compared our findings with data collected similarly in 1988. Of 1,606 patients, 183 (11.

Fever in geriatric emergency patients: clinical features associated with serious illness.

Study Objective: To determine the clinical significance of fever in geriatric emergency department patients.

Design: Case series with follow-up.

Setting: Urban, university-affiliated community hospital.

Substantial improvement in compliance with universal precautions in an emergency department following institution of policy.

Seven months following the introduction of an institutional policy mandating compliance with universal precautions (UPs), we observed 127 health care workers performing 1421 interventions on 155 critically ill and injured patients in an emergency department setting in July 1989. Results were compared with a similar study undertaken exactly 1 year previously when UPs were considered as guidelines only. Overall adherence to UPs improved from 44.

Investigation of an outbreak of listeriosis: new hypotheses for the etiology of epidemic Listeria monocytogenes infections.

From December 1986 to March 1987 an outbreak of Listeria monocytogenes infection occurred in the Philadelphia metropolitan area. A patient-control study showed patients were more likely than controls to have had an ill family member and to have used antidiarrheal medication during the month before their illness. Diet histories showed patients were significantly more likely to have eaten ice cream or salami than were controls, and to have shopped at one grocery store chain.