Bilateral facial nerve paralysis after high voltage electrical injury.

A case of bilateral facial nerve paralysis of a patient who received a high voltage electrical burn is presented. This is an extremely unusual neurologic condition and has not been previously reported in association with electrical injuries. The patient regained nearly complete neurologic function several months after the incident.

Comparison of resuscitation with diaspirin crosslinked hemoglobin (DCLHb) vs fresh blood in a rat burn shock model.

Diaspirin crosslinked hemoglobin (DCLHb; Baxter Healthcare Corp, Deerfield, IL) is hemoglobin-based oxygen carrier which, in our laboratory, improved hemodynamic parameters in a rat burn shock model. Our objective was to compare the effects on hemodynamic parameters and metabolic acidosis of resuscitation with different doses of fresh blood (FB) vs DCLHb. Male Wistar rats (200 to 250 g), surgically prepared for an acute study, were randomly assigned to one of five treatment groups.

Efficacy of MGI 114 (6-hydroxymethylacylfulvene, HMAF) against the mdr1/gp170 metastatic MV522 lung carcinoma xenograft.

Illudins are a novel class of agents with a chemical structure entirely different from current chemotherapeutic agents. A new semisynthetic derivative, MGI 114 (NSC 683,863, 6-hydroxymethyl-acylfulvene, HMAF), is markedly effective in a variety of lung, breast and colon carcinoma xenograft models. This analogue, MGI 114, is currently in phase I human clinical trials, and is scheduled for two different phase II trials.

Pulmonary hypertension and trisomy 16.

An infant girl, born small for gestational age, with abnormal single creases on the fifth digits, subsequent severe developmental delay, hypertelorism, bilateral equinovalgus deformities, grade IV genitourinary reflux and mild right hydronephrosis, was found to have an inverted duplication of the short arm of chromosome 16 [46,XX; inv dup (16) (p 13.3-->p 11.2].

A practical approach to designing and performing a focused study.

Designing and performing focused studies is part of the regular work of infection surveillance, prevention, and control, and the methodology of a prevalence survey used in this practice forum will be familiar to many infection control professionals. A practical example of a focused study to evaluate cost savings from extending intravenous catheter site and administration set change frequency from 72 hours to 96 hours illustrates the steps required. Suggested references for additional information are included at the end of the article.

Who should manage CRRT in the ICU? The nursing viewpoint.

Continuous renal replacement therapy (CRRT) is performed in critical care units around the world with various levels of involvement from critical care and nephrology nurses. In this article, factors affecting the delivery of nursing care and the particular expertise nephrology and critical care nurses have in the area of CRRT are examined. Based on this discussion, three proposed models of nursing care for the patient receiving CRRT are discussed: the Nephrology Nursing Model, the Critical Care Model, and the Collaborative Model.

Patients' satisfaction when denied authorization for emergency department care by their managed care plan.

We conducted a survey of managed care plan (MCP) patients who presented to the emergency department (ED) but were denied insurance authorization during a 3-month period. Patients were identified by triage or registration records, contacted by telephone after their visit, and surveyed regarding their satisfaction with the ED and MCP, follow-up care, and future behavior. We surveyed 72 (73.

Domestic violence in the emergency department: how do women prefer to disclose and discuss the issues?

The purpose of this study was to survey women presenting to the emergency department (ED) and determine from them how best to identify and discuss issues of domestic violence (DV). An anonymous 10-question survey was given to ambulatory females presenting to the ED. It was conducted at two affiliated university hospital EDs, one an urban trauma center (ED 1) and the other an ED in an affluent suburban setting (ED 2).

Analysis of chronic obstructive pulmonary disease referrals for lung volume reduction surgery. The University of California San Diego Emphysema Treatment Group.

Background: Preliminary results of lung volume reduction surgery (LVRS) for patients with severe emphysema are promising, although many issues regarding the selection process for LVRS are still unaddressed. For example, it is unclear which patients should be referred for pulmonary rehabilitation, lung transplantation, or LVRS, and whether health-care providers are optimizing conservative treatment options before referral for surgical intervention. The purpose of this analysis is to describe preliminary results of the evaluation process for LVRS implemented as part of an integrated, programmatic approach to the evaluation, treatment, and rehabilitation of patients with advanced emphysema.

Shortened survival after relapse in T-cell acute lymphoblastic leukemia patients with p16/p15 deletions.

p16 Alterations were detected in > 60% of 103 primary T-ALL samples. In paired diagnosis-relapse patient samples, 80% of the relapse samples with p16 deletion were deleted at diagnosis. When p16 was homozygously deleted, p15 gene alterations were found in 72% of the diagnosis T-ALL patient samples, increasing significantly to 100% at relapse.

Current concepts in electrical defibrillation.

The electrical defibrillator has been proven to be a life-saving device in the treatment of cardiac arrest due to ventricular tachycardia or ventricular fibrillation. An understanding of the physiology and technology behind this device is useful for providers of emergency care. In this article, we review the current concepts in electrical defibrillation and briefly discuss the developmental history.

Acid-base transport in isolated rabbit duodenal villus and crypt cells.

Background: Duodenal mucosal bicarbonate secretion is an important first line of defense against gastric acid. Studies in the ileum indicate that the secretion originates from the crypt cells, whereas villus cells are mainly absorptive. Data on acid/base transporters along the crypt-villus axis in duodenal epithelia are not available.

Developmentally regulated transcripts and evidence of differential mRNA processing in Giardia lamblia.

Although encystation and excystation are crucial to transmission of Giardia lamblia, little is known about the regulation of these very distinct differentiation processes. Fingerprinting of giardial mRNA populations throughout the time course of differentiation demonstrated complex patterns in mRNA differential display. Certain transcripts appeared or increased, while others decreased or disappeared at specific times, in response to physiologic stimuli that mimic key stages in parasite descent through the host gastrointestinal tract.

A prospective evaluation of abdominal ultrasound in blunt trauma: is it useful?

Objective: The purpose of this study is to evaluate the utility and feasibility of abdominal ultrasound (US) in blunt trauma patients.

Design: This prospective study examined the operational issues and the diagnostic accuracy of US in selected blunt trauma patients triaged to a Level 1 trauma center.

Materials And Methods: All patients were evaluated by an attending trauma surgeon and our usual criteria for objective evaluation of the abdomen were applied.

Detection and treatment of dysfunctional hemodialysis access grafts: effect of a surveillance program on graft patency and the incidence of thrombosis.

Purpose: To determine the value of a hemodialysis graft surveillance program in reducing the incidence of graft thrombosis and prolonging graft patency by means of early detection and percutaneous transluminal angioplasty (PTA) of graft-related stenoses.

Materials And Methods: For 4-1/2 years, routine graft examination and measurement of several dialysis parameters were used to identify 106 cases of suspected graft dysfunction in 57 patients (56 men, one woman; aged 27-76 years). Graft-related stenoses detected with angiography were treated with PTA.

Radiologic, endoscopic, and surgical gastrostomy: an institutional evaluation and meta-analysis of the literature.

Purpose: To evaluate the effectiveness and safety of radiologic, percutaneous endoscopic (PEG), and surgical gastrostomy.

Materials And Methods: This project involved 5,752 patients (837 patients underwent radiologic gastrotomy; 4,194, PEG; and 721, surgical gastrostomy). Seventy-two (47 male, 25 female; age range, 12-94 years) underwent gastrostomy within 1 year in this series (radiologic gastrostomy, n = 33; PEG, n = 35; surgical gastrostomy, n = 4).

An unusual variant of popliteal artery entrapment.

A 43-year-old woman presented with incapacitating exertional pain in the right foot, ankle, and lower calf of 1 years' duration following a minor ankle sprain. Evaluation by several physicians had been inconclusive. Physical examination identified normal pedal pulses at rest but obliteration of pulses with active plantar flexion.

A theoretical model using mechanical principles to quantify the physical principles of balloon dilatation.

Rationale And Objectives: Balloon dilatation is a mechanical form of controlled injury used to alleviate vascular stenoses. Several factors influence successful angioplasty. Few mechanical models exist to illustrate the physical principles of balloon dilatation.