Comparison of demographics and motivations of highly committed whole blood and platelet donors.

To compare donor demographics and motivations for donation, we surveyed 159 consecutive whole blood donors (WD) and 146 consecutive plateletpheresis donors. All donors had donation experiences of at least 2 gallons (i.e.

The clinical utility of computed tomographic scanning and neurologic examination in the management of patients with minor head injuries.

The evaluation and management of patients with minor head injury (MHI: history of loss of consciousness or posttraumatic amnesia and a GCS score greater than 12) remain controversial. Recommendations vary from routine admission without computed tomographic (CT) scanning to mandatory CT scanning and admission to CT scanning without admission for selected patients. Previous reports examining this issue have included patients with associated non-CNS injuries who confound the interpretation of the data and affect outcome.

A true aneurysm of a collateral branch of a proper digital artery.

An idiopathic true aneurysm of a collateral branch of the proper radial digital artery of the index finger was treated by ligation and resection. The proper digital artery remained in continuity without interruption, and the patient's symptoms were relieved.

Myocardial oxygen requirements during experimental cardiopulmonary resuscitation.

Objective: The aims were to determine myocardial oxygen requirements during cardiopulmonary resuscitation (CPR), and to test the hypothesis that endogenous catecholamines have a major effect on myocardial oxygen requirements in this setting.

Methods: Myocardial oxygen consumption (MVO2) was measured during 20 minutes of CPR in eight anaesthetised dogs. Coronary blood flow was maintained at prearrest levels using an external pump to provide a permissive level of oxygen delivery during ventricular fibrillation.

Altered myocardial force-frequency relation in human heart failure.

Background: In congestive heart failure (idiopathic dilated cardiomyopathy), exercise is accompanied by a smaller-than-normal decrease in end-diastolic left ventricular volume, depressed peak rates of left ventricular pressure rise and fall, and depressed heart-rate-dependent potentiation of contractility (bowditch treppe). We studied contractile function of isolated left ventricular myocardium from New York Heart Association class IV-failing and nonfailing hearts at physiological temperature and heart rates in order to identify and quantitate abnormalities in myocardial function that underlie abnormal ventricular function.

Methods And Results: The isometric tension-generating ability of isolated left ventricular strips from nonfailing and failing human hearts was investigated at 37 degrees C and contraction frequencies ranging from 12 to 240 per minute (min-1).

Percutaneous renal biopsy of the solitary kidney: a contraindication?

We recently were presented with a patient from the nephrology service, with the request to perform open renal biopsy because of a solitary functioning kidney. We performed the open biopsy and the patient subsequently had a wound infection, leading us to question the recommendation in the literature stating that a solitary kidney is an absolute contraindication for percutaneous renal biopsy. In a review of the literature from 1951 to 1990, a total of 19,459 percutaneous renal biopsies has been reported with an overall complication rate of 2.

Chronic or recurrent meningitis. Neurosurgical perspectives.

Chronic meningitis is not a commonly encountered clinical problem in the day-to-day patient care responsibilities of neurosurgeons. It is, however, important for the neurosurgeon to be familiar with the clinical problems, diagnostic challenges, and therapeutic options required to establish a definitive diagnosis. This article concentrates on specific entities causing chronic or recurrent meningitis that may require neurosurgical participation.

Elevated maternal serum alpha-fetoprotein levels and maternal risk factors. Their association with pregnancy complications.

Maternal serum alpha-fetoprotein (MS-AFP) screening programs identify a population of pregnant women with elevated MS-AFP values. When the levels are unassociated with a fetal anomaly, those women have a high incidence of pregnancy complications. Such patients were compared to a population with normal MS-AFP values to determine the incidence of historical risk factors and to ascertain if their presence affected the rate of pregnancy complications.

Multidisciplinary protocol for determining aminoglycoside dosage.

A protocol for determining optimal dosages of aminoglycosides early in therapy is described, and the effectiveness of the protocol is evaluated. The protocol was developed jointly by physicians and pharmacists at a 550-bed hospital to ensure that surgical patients prescribed aminoglycosides were quickly and consistently put on a safe and effective course of therapy. Physicians select an aminoglycoside and calculate a loading dose and initial maintenance dosage by using a nomogram printed on an antimicrobial order form.

Elevated maternal serum alpha-fetoprotein: association with placental sonolucencies, fetomaternal hemorrhage, vaginal bleeding, and pregnancy outcome in the absence of fetal anomalies.

Elevated maternal serum alpha-fetoprotein (MSAFP) levels have been associated with an increased incidence of both placental sonolucencies and pregnancy complications. We designed a prospective study to test the hypothesis that the presence of these sonolucencies or a positive maternal Kleihauer-Betke stain would be associated with an elevated risk of obstetric complications. We enrolled 95 women with singleton pregnancies, elevated MSAFP, and no evidence of fetal anomalies on second-trimester ultrasound evaluation.

Juvenile granulosa cell tumor of an intraabdominal testis.

Juvenile granulosa cell tumor of the testis is a distinct form of sex cord-stromal tumor of neonates and infants [1]. This tumor comprises a significant percentage of testicular tumors in baby boys. We present a patient who had preoperative imaging studies.

Embryonal heart rate as a predictor of pregnancy outcome: a prospective analysis.

To evaluate the association between embryonal heart rate and pregnancy outcome, we prospectively followed 50 very early pregnancies (4.5 to 7.3 weeks of gestation) through the first trimester.

Treatment of snakebite poisoning.

The epidemiology, mechanics, prevention, pharmacology, clinical manifestations, and treatment of snakebites are reviewed. Poisonous snakes bite approximately 8000 persons annually in the United States, causing approximately 12-15 deaths per year. Pit vipers (rattlesnakes, copperheads, cottonmouths, and massasaugas) are responsible for 99% of all snakebite poisonings; coral snakes and other foreign exotic species are responsible for the additional 1%.

Legionnaires' disease.

The Legionella bacillus is a relatively common pulmonary pathogen that has been responsible for a number of outbreaks of respiratory illness this century. Not until 1976, however, after exciting epidemiologic and microbiologic investigation, was the organism isolated and identified. Legionnaires' disease does not have a characteristic radiographic appearance, but certain features may alert the clinician to its presence.

Influence of infusion pumps on the pharmacologic response to nitroprusside.

Objective: To compare the relationship between variability in nitroprusside delivery from five infusion pumps and the resulting variability in mean arterial pressure (MAP).

Design: Randomized, crossover study design.

Setting: A pediatric ICU in a university hospital.

Cat-scratch disease: an unusual cause of combative behavior.

Acute encephalitis is an unusual manifestation of cat-scratch disease. The authors present the case of a 27-year-old man who exhibited the acute onset of encephalitis manifested by violent behavior and confusion. The diagnosis of drug abuse was presumed initially, but a careful examination revealed the true cause to be cat-scratch disease.