Pulmonary Microembolism in the Canine Model: Report of a Pilot Study

Use of in-line final filters to prevent the infusion of foreign particulates has lowered the rates of postinfusion phlebitis in several controlled studies. The systemic effect of particulate infusion, however, has not been thoroughly studied. In this study, 12 mongrel dogs recovering from a right pneumonectomy were studied following infusion of various-sized particulates. Ten of the dogs were infused with either 10 or 40 million, 9 or 25 μm, latex particles. The remaining two dogs were control animals. Hemodynamic parameters were monitored in each animal. At death or 72 hours following particle injection, the left lung was examined grossly and histologically. Changes in hemodynamic parameters were not seen. Three of the dogs became clinically ill 48 hours following microsphere injection. All dogs injected with particles had multiple discrete punctate areas of hemorrhagic pulmonary infarction. The control dogs showed no sign of clinical illness or pulmonary injury. More sophisticated animal and human studies are required to fully determine the physiologic effect of injected particles

Malnutrition and Length of Stay - A Relationship?

The admission nutrition status of 135 consecutive general medical patients admitted to a single nursing unit was evaluated using a simple questionnaire and available laboratory studies. A statistical analysis of the data obtained indicates that prolonged length of stay may be related to admission nutritional status

Belmont Criminal Law Journal Symposium 2017: Judicial Panel

Transcript of the Judicial Panel given during the 2017 Symposium featuring Chief Justice Jeffrey S. Bivins, Judge Joseph A. Woodruff, Judge Timothy L. Easter, and Judge Angelita B. Dalton

Using neighborhood-level census data to predict diabetes progression in patients with laboratory-defined prediabetes

Context Research on predictors of clinical outcomes usually focuses on the impact of individual patient factors, despite known relationships between neighborhood environment and health. Objective To determine whether US census information on where a patient resides is associated with diabetes development among patients with prediabetes. Design Retrospective cohort study of all 157,752 patients aged 18 years or older from Kaiser Permanente Northern California with laboratory-defined prediabetes (fasting plasma glucose, 100 mg/dL-125 mg/dL, and/or glycated hemoglobin, 5.7%-6.4%). We assessed whether census data on education, income, and percentage of households receiving benefits through the US Department of Agriculture’s Supplemental Nutrition Assistance Program (SNAP) was associated with diabetes development using logistic regression controlling for age, sex, race/ethnicity, blood glucose levels, and body mass index. Main Outcome Measure: Progression to diabetes within 36 months. Results Patients were more likely to progress to diabetes if they lived in an area where less than 16% of adults had obtained a bachelor’s degree or higher (odds ratio [OR] =1.22, 95% confidence interval [CI] = 1.09-1.36), where median annual income was below $79,999 (OR = 1.16 95% CI = 1.03-1.31), or where SNAP benefits were received by 10% or more of households (OR = 1.24, 95% CI = 1.1-1.4). Conclusion Area-level socioeconomic and food assistance data predict the development of diabetes, even after adjusting for traditional individual demographic and clinical factors. Clinical interventions should take these factors into account, and health care systems should consider addressing social needs and community resources as a path to improving health outcomes

Area Monitoring Dosimeter Program for the Pacific Northwest National Laboratory: Results for CY 2006

Pacific Northwest National Laboratory (PNNL) established an area monitoring dosimeter program in accordance with Article 514 of the Department of Energy (DOE) Radiological Control Manual (RCM) in January 1993. This program is to minimize the number of areas requiring issuance of personnel dosimeters and to demonstrate that doses outside Radiological Buffer Areas are negligible. In accordance with 10 CFR Part 835.402 (a)(1)-(4) and Article 511.1 of the PNNL Radiological Control Program Description, personnel dosimetry shall be provided to 1) radiological workers who are likely to receive at least 100 mrem annually, and 2) declared pregnant workers, minors, and members of the public who are likely to receive at least 50 mrem annually. Program results for calendar years 1993-2005 confirm that personnel dosimetry is not needed for individuals located in areas monitored by the program

Area monitoring dosimeter program for the Pacific Northwest National Laboratory: Results for CY 1996

In January 1993, Pacific Northwest National Laboratory (PNNL) established an area monitoring dosimeter program in accordance with Article 514 of the Department of Energy (DOE) Radiological Control Manual (RCM). The purpose of the program was to minimize the number of areas requiring issuance of personnel dosimeters and to demonstrate that doses outside Radiological buffer Areas are negligible. In accordance with 10 CFR Part 835.402 (a) (1)-(3) and Article 511.1 of the RCM, personnel dosimetry shall be provided to (1) radiological workers who are likely to receive at least 100 mrem annually and (2) declared pregnant workers, minors, and members of the public who are likely to receive at least 50 mrem annually. Program results for calendar years 1993, 1994, and 1995 confirmed that personnel dosimetry was not needed for individuals located in areas monitored by the program. A total of 108 area TLDs were placed in PNNL facilities during CY 1996. The TLDs were exchanged and analyzed quarterly. All routine area monitoring TLD results were less than 50 mrem annually after correcting for worker occupancy. The results support the conclusion that personnel dosimeters are not necessary for staff, declared pregnant workers, minors, or members of the public in these monitored areas

Shining new light on mammalian diving physiology using wearable near-infrared spectroscopy

Investigation of marine mammal dive-by-dive blood distribution and oxygenation has been limited by a lack of non-invasive technology for use in freely diving animals. Here, we developed a non-invasive near-infrared spectroscopy (NIRS) device to measure relative changes in blood volume and haemoglobin oxygenation continuously in the blubber and brain of voluntarily diving harbour seals. Our results show that seals routinely exhibit preparatory peripheral vasoconstriction accompanied by increased cerebral blood volume approximately 15 s before submersion. These anticipatory adjustments confirm that blood redistribution in seals is under some degree of cognitive control that precedes the mammalian dive response. Seals also routinely increase cerebral oxygenation at a consistent time during each dive, despite a lack of access to ambient air. We suggest that this frequent and reproducible reoxygenation pattern, without access to ambient air, is underpinned by previously unrecognised changes in cerebral drainage. The ability to track blood volume and oxygenation in different tissues using NIRS will facilitate a more accurate understanding of physiological plasticity in diving animals in an increasingly disturbed and exploited environment

A Prospective Randomized Comparison of a Single Antibiotic (Moxalactam) Versus Combination Therapy (Gentamicin and Clindamycin) in Penetrating Abdominal Trauma

From July 1 to December 31, 1983, 50 consecutive patients undergoing abdominal exploration for penetrating abdominal trauma from stab and gunshot wounds were prospectively randomized to receive postinjury, preoperative antibiotic coverage with moxalactam (2 g intravenously every 12 hours) or a combination of gentamicin (3 to 5 mg/kg/day in three equal doses administered every eight hours) and clindamycin (600 mg intravenously every six hours). No intraabdominal abscesses or wound infections developed, and no direct evidence of toxicity of the antibiotic regimens developed in either group. In the study group, moxalactam therapy was an effective alternative to the combination antibiotic regimen. The subsequently documented incidence of moxalactam-induced bleeding episodes precludes its use as a primary preventive antibiotic; however, other less toxic cephalosporins may demonstrate similar effectiveness