Occupational therapist-guided cognitive interventions in critically ill patients: a feasibility randomized controlled trial.

Purpose: Intensive care unit (ICU) delirium is a common complication of critical illness requiring a multimodal approach to management. We assessed the feasibility of a novel occupational therapist (OT)-guided cognitive intervention protocol, titrated according to sedation level, in critically ill patients.

Methods: Patients aged ≥ 18 yr admitted to a medical/surgical ICU were randomized to the standard delirium prevention protocol or to the OT-guided cognitive intervention protocol in addition to standard of care.

Effect of early cognitive interventions on delirium in critically ill patients: a systematic review.

Purpose: A systematic review of the literature was conducted to determine the effects of early cognitive interventions on delirium outcomes in critically ill patients.

Source: Search strategies were developed for MEDLINE, EMBASE, Joanna Briggs Institute, Cochrane, Scopus, and CINAHL databases. Eligible studies described the application of early cognitive interventions for delirium prevention or treatment within any intensive care setting.

A reflected energy prediction model for long-range hydroacoustic reflection in the oceans.

Acoustic energy from underwater earthquakes and explosions can propagate over long distances with very little attenuation in the deep ocean. When this sound encounters a seamount, island, or continental margin, it can scatter and again propagate over long distances. Hydrophones in the deep sound channel can detect these reflections tens of minutes or hours after arrivals from the direct source-to-receiver path.

Effectiveness of a prospective physician self-audit transfusion-monitoring system.

Background: The purpose of this study was to search for a more effective transfusion-monitoring system than the existing system of retrospective peer review.

Study Design And Methods: This research used a study-control, preintervention and postintervention design, to evaluate the effectiveness of a prospective physician self-audit transfusion-monitoring system that functioned without the direct involvement of transfusion service physicians. This research also evaluated the effectiveness of issuing to physicians a memo with transfusion guidelines.

Are retrospective peer-review transfusion monitoring systems effective in reducing red blood cell utilization?

Objective: This research used a study-control group design and examined data collected from five hospitals to evaluate the effectiveness of retrospective peer-review systems on reducing utilization of red blood cells (RBCs).

Design: The effects of retrospective peer-review systems were studied in three parts: (1) trends of RBC utilization were compared by the slopes of linear regression lines that assessed the effect of time on RBC utilization among four study hospitals and one control hospital, (2) diagnosis-specific RBC utilization was compared between the control hospital and one matched study hospital, and (3) the effect of the retrospective review system of one study hospital was assessed by linear regression using data accumulated 1 year before and 2 years after implementation of the program.

Results: Three study hospitals showed no significant changes in RBC utilization during the 10-month study period.

Infectious disease markers in various groups of donors.

A number of studies have commented on the inadvisability of transfusing unused blood given by autologous and directed donors to patients other than those for whom the blood was originally given (crossing over). It has been stated that these bloods are dangerous and should not be used for allogeneic transfusion. To test this hypothesis, data were taken from a pool of hospital donors.

The correlations of surrogate markers with anti-hepatitis C virus and other disease markers.

Testing of donors' sera for the level of alanine aminotransferase (ALT) and the presence of hepatitis B core antibody (anti-HBc) has been required since 1986 as "surrogate" tests for non-A, non-B post transfusion hepatitis (NANB-PTH). With the availability of a test for the antibody to hepatitis C virus (HCV), the need for these two tests and their impact on one hospital are reviewed. Precisely 12.

Nursing station order entry for hospital computers.

Tired of illegible labels, unlabeled specimens, and frantic phone calls asking what happened to specimens? This lab was and devised a system to allow test ordering and label printing from nurse stations.

Crossing over of autologous and directed donor blood.

There is a considerable interest in the possibility of crossing over autologous and directed donor blood to other patients. The practicality and safety of this approach depends on the possibility of disease transmission in these groups versus those of the usual homologous donors. A review of the current literature as to the incidence of infectious disease markers shows that the total number of donors studied is rather small, and the results are not too clear.

The extension of 4 degrees C storage time of frozen-thawed red cells.

Blood was drawn from volunteer donors and frozen using the high glycerin, mechanical freezing procedure accepted by the United States Navy. Subsequently, the units of blood were thawed and washed. Various anticoagulants were added, and the red cells were stored in a refrigerator at 4 degrees C for periods of up to 28 days.

Altered glycosylation of alpha-fetoprotein in hepadnavirus-induced hepatocellular carcinoma of the woodchuck.

Altered glycosylation of alpha-fetoprotein (AFP) has been proposed as a marker of hepatocellular carcinoma (HCC) in humans. The lectin-binding properties of woodchuck AFP were investigated to determine if woodchuck hepatitis virus (WHV)-induced HCCs are also accompanied by changes in AFP glycosylation. Ninety-eight to 100% of the AFP from normal, WHV-free woodchucks with physiologic AFP elevations and from WHV-carrier woodchucks with HCC bound to concanavalin A, indicating that virtually all of the AFP was glycosylated.

The prediction of autologous red cell survival.

Nine donors predicted from earlier studies to have increased autologous red cell survival and four predicted to have lesser survival were selected from a pool of previously studied donors. Blood was drawn from these donors, and stored in Neutracel (R-Cutter Lab) preservative for eight hours at room temperature. The platelet rich plasma was removed, the additive solution was introduced, and the red cells were stored for 42 days in an approved refrigerator.

The first recorded blood transfusions: 1656 to 1668.

The transfusion of blood was only one of many scientific competitions in which the citizens of France and England engaged in the 1600s. This particular competition laid the foundations for transfusion therapy that were built on 100 years later when more was known about blood. At the time of the studies discussed here, the most important goal seemed to be the establishment of the primacy of the discovery by one or the other nation.

The probability of finding suitable directed donors.

A series of tables based on mathematical calculations is given as guidelines for the number of directed donors needed by members of various ethnic/racial groups to provide a desired number of units of blood with a selected probability of achieving this result. From these tables, certain conclusions can be drawn. Unrelated donors who do not know their blood type are an inefficient source of directed donors.

Five-week red cell storage with preservation of 2,3 DPG.

The 2,3 diphosphoglycerate (2,3 DPG) content of red cells stored in current anticoagulant-preservative products decreases rapidly after the first few days of storage, and by 3 weeks the red cells are essentially depleted of 2,3 DPG. Because ascorbic acid and ascorbate-2-phosphate (A-2-P) are effective in maintaining erythrocyte 2,3 DPG during liquid preservation, ascorbate was stabilized through autoclaving and subsequent storage by adding it as the trisodium salt of A-2-P to a phosphate-adenine-saline solution at a pH of 8.5 to 9.

Toxicological quandary of the use of bis (2-diethylhexyl) phthalate (DEHP) as a plasticizer for blood bags.

Plastic bags are very useful containers for the storage of blood and blood products since they are relatively transparent, hard to break, can be sealed aseptically with a radio-frequency current, and can be centrifuged for the isolation of blood components. In order to make the plastic more flexible, various agents are added, of which the most common is di- (2-ethylhexyl) phthalate (DEHP). This plasticizer has been found to leach from the plastic into the blood components during the storage period.