Institution of same-day total joint replacement at an urban safety net hospital during the COVID-19 pandemic.

Background: Increasingly, total hip and total knee replacements are being performed at outpatient ambulatory surgery centers. The purpose of this study was to investigate the feasibility and safety of instituting a same-day surgery program for hip and knee replacement at an urban, safety net hospital.

Methods: Retrospective review of a prospectively collected registry for all patients scheduled for same-day total joint replacement at a safety net hospital was performed.

Impact of wildland firefighting on arterial stiffness and cardiorespiratory fitness.

The purpose of this study was to assess the effect of wildland firefighting on measures of cardiovascular health. The study was carried out in two parts. Part one assessed relationships between years of wildland firefighting and cardiovascular variables ( = 28).

Current and Future United States Light-Duty Vehicle Pathways: Cradle-to-Grave Lifecycle Greenhouse Gas Emissions and Economic Assessment.

This article presents a cradle-to-grave (C2G) assessment of greenhouse gas (GHG) emissions and costs for current (2015) and future (2025-2030) light-duty vehicles. The analysis addressed both fuel cycle and vehicle manufacturing cycle for the following vehicle types: gasoline and diesel internal combustion engine vehicles (ICEVs), flex fuel vehicles, compressed natural gas (CNG) vehicles, hybrid electric vehicles (HEVs), hydrogen fuel cell electric vehicles (FCEVs), battery electric vehicles (BEVs), and plug-in hybrid electric vehicles (PHEVs). Gasoline ICEVs using current technology have C2G emissions of ∼450 gCOe/mi (grams of carbon dioxide equivalents per mile), while C2G emissions from HEVs, PHEVs, H FCEVs, and BEVs range from 300-350 gCOe/mi.

Survival After Long-Term Residence in an Intensive Care Unit.

A higher mortality trend correlated with increased age and length of stay for medical and surgical patients in the intensive care unit.

Subdural hematoma after an epidural blood patch.

We report the case of a 37-year-old postpartum patient who developed a contained subacute spinal subdural hematoma causing mass effect on the cauda equina and severe spinal stenosis after undergoing an epidural blood patch for postdural puncture headache. Recovery occurred following administration of oral steroids.

The evolving role of preoperative testing in vascular surgery patients: can a little knowledge be dangerous?

It has been traditionally recommended that candidates for vascular surgery receive noninvasive stress perfusion testing risk stratification to help decide which patients may benefit from coronary artery revascularization. Recent clinical trials have contested the efficacy of revascularization in this population as well as the information yield of noninvasive testing. This article reviews a number of these studies that are likely to change our beliefs regarding testing and subsequent interventions as well as evolving role of medical therapy in patients undergoing vascular surgery.

Cerebral blood flow thresholds for tissue infarction in patients with acute ischemic stroke treated with intra-arterial revascularization therapy depend on timing of reperfusion.

Background And Purpose: MR perfusion CBF values can distinguish hypoperfused penumbral tissue likely to infarct from that which is likely to recover. Our aim was to determine if CBF thresholds for tissue infarction depend on the timing of recanalization in patients with acute stroke treated with IAT.

Materials And Methods: Twenty-six patients with acute proximal anterior circulation strokes underwent DWI and PWI before IAT.

Sickle cell disease and stroke.

Twenty-four percent of sickle cell disease (SCD) patients have a stroke by the age of 45 years. Blood transfusions decrease stroke risk in patients deemed high risk by transcranial Doppler. However, transcranial Doppler has poor specificity, and transfusions are limited by alloimmunization and iron overload.

Case volumes of intra-arterial and intravenous treatment of ischemic stroke in the USA.

Background And Purpose: Ischemic stroke is a major cause of disability and death in the USA. Intravenous tissue plasminogen activator (t-PA) remains underutilized. With the development of newer intra-arterial reperfusion therapies, there is increased opportunity to address the more devastating large-vessel occlusions.

MRI-based selection for intra-arterial stroke therapy: value of pretreatment diffusion-weighted imaging lesion volume in selecting patients with acute stroke who will benefit from early recanalization.

Background And Purpose: Recent studies demonstrate that an acute diffusion-weighted imaging lesion volume >70 cm(3) predicts poor outcome in patients with stroke. We sought to determine if this threshold could identify patients treated with intra-arterial therapy who would do poorly despite reperfusion. In patients with initial infarcts <70 cm(3), we sought to determine what effect recanalization and time to recanalization had on infarct growth and functional outcome.

Alpha2A-adrenoceptor stimulation improves prefrontal cortical regulation of behavior through inhibition of cAMP signaling in aging animals.

The working-memory functions of the prefrontal cortex (PFC) are improved by stimulation of postsynaptic, alpha2A-adrenoceptors, especially in aged animals with PFC cognitive deficits. Thus, the alpha2A-adrenoceptor agonist, guanfacine, greatly improves working-memory performance in monkeys and rats following systemic administration or intra-PFC infusion. Alpha2A-adrenoceptors are generally coupled to Gi, which can inhibit adenylyl cyclases and reduce the production of cAMP.

Effects of cholinergic stimulation of the caudate nucleus on active avoidance.

Experiments dealing with the effects of applications of cholinergic drugs into the caudate nucleus on learned behaviors have yielded contradictory results; both improvements and deficits have been found. In the present experiment choline was injected into the CN of rats previously trained in a two-way active avoidance task. The results show that an improvement in performance can be seen when a small dose of choline is used and suggest that the reported deficits in learned performance were due to an overactivation of acetylcholine receptors.