Intracardiac air- the "hospital killer' identified?

Venous access is an essential part of caring for the sick neonate. The primary problem with catheters, whether peripherally or centrally placed, is the difficulty in maintaining them, the development of phlebitis and systemic infection, and fluid extravasation. A lesser known complication is the development of venous air embolism (VAE), as described in the 4 cases presented. We agree with others that VAE in newborn infants may occur more frequently than expected and emphasise the fact that it is preventable and that careful attention must be given to the techniques of preparing venous infusions. As health professionals (medical and nursing) we should take a harder line and regard these events as medically negligent until proven otherwise. We should take full responsibility for equipment, the connections, the infusate and the monitoring thereof. Unfortunately, the prognosis for this condition remains poor and it is unclear whether an increased awareness of this condition would influence outcome.  Manufacturers of intravenous fluids should produce products devoid of air in order to reduce the risk of venous air embolism

PECULIARITIES OF SINGLE TRACK FORMATION FROM TI6AL4V ALLOY AT DIFFERENT LASER POWER DENSITIES BY SELECTIVE LASER MELTING#

Published ArticleThis paper describes the geometrical characteristics of single tracks manufactured by selective laser melting (SLM) at different laser powers (20-170 W) and scanning speeds (0.1-2.0 m/s). Simulation of temperature distribution during processing is carried out. A conclusion about the optimal process parameters and peculiarities of selective laser melting of Ti6Al4V alloy at low and high laser powers and scanning speeds is reached. The analysis of temperature fields creates opportunities to build parts with the desired properties by using SLM

Transthyretin levels in the vitreous correlate with change in visual acuity after vitrectomy

Background/aim: Little is known about biochemical markers related to change in visual acuity after vitrectomy. The potential use of transthyretin (TTR), a carrier of the retinol/retinol-binding protein, as a biochemical marker protein, was investigated. Methods: TTR was measured using immunonephelometry in a group of patients (n = 77) in longstanding (> 1 week) retinal detachment (n = 29), fresh (< 1 week) retinal detachment (n = 17), macular holes (n = 20) or diabetic retinopathy (n = 11). Vitreous samples were taken at the start of every vitrectomy procedure. For reference values, cadaver specimens (n = 73) were used. Results: Reference values for vitreous TTR (median 18 mg/l; IQR 4 to 24 mg/l) comprised 2.2% of reference values for vitreous protein levels (median 538 mg/l; IQR 269 to 987 mg/l). Vitreous TTR values of patients were comparable in all disorders. Vitreous TTR values were higher in phakic (median 22.5 mg/l; IQR 10 to 27 mg/l) than in pseudophakic patients (median 12 mg/l; IQR 8 to 19 mg/l; p = 0.06). Postoperative change in visual acuity correlated well with vitreous TTR values found peroperatively (r(s) = 0.408; p = 0.012). Both change in visual acuity and lens status were the only variables which proved to explain the variance of TTR (multiple correlation coefficient: 0.494; phakic status: t = 2.767; p = 0.0084; and change in visual acuity t = 2.924: p = 0.0056). Conclusion: Vitreous fluid concentrations of TTR can be regarded as a biochemical marker for retinal function

Selective cerebral hypothermia for post-hypoxic neuroprotection in neonates using a solid ice cap

No Abstract. South African Medical Journal Vol. 96(9) (Part 2) 2006: 976-98

High mannose-specific lectin Msl mediates key interactions of the vaginal Lactobacillus plantarum isolate CMPG5300

To characterize the interaction potential of the human vaginal isolate Lactobacillus plantarum CMPG5300, its genome was mined for genes encoding lectin-like proteins. cmpg5300.05_29 was identified as the gene encoding a putative mannose-binding lectin. Phenotypic analysis of a gene knock-out mutant of cmpg5300.05_29 showed that expression of this gene is important for auto-aggregation, adhesion to the vaginal epithelial cells, biofilm formation and binding to mannosylated glycans. Purification of the predicted lectin domain of Cmpg5300.05_29 and characterization of its sugar binding capacity confirmed the specificity of the lectin for high-mannose glycans. Therefore, we renamed Cmpg5300.05_29 as a mannose-specific lectin (Msl). The purified lectin domain of Msl could efficiently bind to HIV-1 glycoprotein gp120 and Candida albicans, and showed an inhibitory activity against biofilm formation of uropathogenic Escherichia coli, Staphylococcus aureus and Salmonella Typhimurium. Thus, using a combination of molecular lectin characterization and functional assays, we could show that lectin-sugar interactions play a key role in host and pathogen interactions of a prototype isolate of the vaginal Lactobacillus microbiota

EVALUATION OF THE COMPRESSIVE MECHANICAL PROPERTIES OF CELLULAR DMLS STRUCTURES FOR BIOMEDICAL APPLICATIONS

Published Conference ProceedingsThe type of material used in biomedical applications depends on specific implant applications; different types of implant need different mechanical properties. Since the architectures of bone tissues in the human body are not completely dense and solid, it is desirable to produce biomimic structures as a replacement for damaged bone tissues. Learning from nature, it can be understood that cellular structures would be more preferable for biomedical implants than dense solid structures. Verification of mechanical properties of DMLS PA 2200 cellular structures should be conducted since scaffolds from this material have been proven for biomedical applications. Ti6Al4V alloy is well known to have a superior track record as leading material for bone replacement since it is a light-weight and biocompatible material, but the density of human cortical bone is less than half that of solid Ti6Al4V implants. The mismatch of the elastic modulus between such implants and bone tissue is one of the major causes of stress shielding, bone resorption and implant loosening. Finite element analysis showed big differences in strains of jaw bone and an implanted solid Ti6Al4V part. The elastic modulus of lattice structures was used to simulate a complex mandible to obtain foreknowledge of manufacturing advanced light-weight implants with suitable biomechanical properties. Compressive properties of proposed cellular structures were determined to demonstrate the viability of attaining different effective elastic moduli for Ti6Al4V implants

Time-dependent stimulation by aldosterone of blocker-sensitive ENaCs in A6 epithelia

To study and define the early time-dependent response (< or = 6 h) of blocker-sensitive epithelial Na+ channels (ENaCs) to stimulation of Na+ transport by aldosterone, we used a new modified method of blocker-induced noise analysis to determine the changes of single-channel current (iNa) channel open probability (Po), and channel density (NT) under transient conditions of transport as measured by macroscopic short-circuit currents (Isc). In three groups of experiments in which spontaneous baseline rates of transport averaged 1.06, 5.40, and 15.14 microA/cm2, stimulation of transport occurred due to increase of blocker-sensitive channels. NT varied linearly over a 70-fold range of transport (0.5-35 microA/cm2). Relatively small and slow time-dependent but aldosterone-independent decreases of Po occurred during control (10-20% over 2 h) and aldosterone experimental periods (10-30% over 6 h). When the Po of control and aldosterone-treated tissues was examined over the 70-fold extended range of Na+ transport, Po was observed to vary inversely with Isc, falling from approximately 0.5 to approximately 0.15 at the highest rates of Na+ transport or approximately 25% per 3-fold increase of transport. Because decreases of Po from any source cannot explain stimulation of transport by aldosterone, it is concluded that the early time-dependent stimulation of Na+ transport in A6 epithelia is due exclusively to increase of apical membrane NT

The interRAI Acute Care instrument incorporated in an eHealth system for standardized and web-based geriatric assessment: strengths, weaknesses, opportunities and threats in the acute hospital setting

BACKGROUND: The interRAI Acute Care instrument is a multidimensional geriatric assessment system intended to determine a hospitalized older persons’ medical, psychosocial and functional capacity and needs. Its objective is to develop an overall plan for treatment and long-term follow-up based on a common set of standardized items that can be used in various care settings. A Belgian web-based software system (BelRAI-software) was developed to enable clinicians to interpret the output and to communicate the patients’ data across wards and care organizations. The purpose of the study is to evaluate the (dis)advantages of the implementation of the interRAI Acute Care instrument as a comprehensive geriatric assessment instrument in an acute hospital context. METHODS: In a cross-sectional multicenter study on four geriatric wards in three acute hospitals, trained clinical staff (nurses, occupational therapists, social workers, and geriatricians) assessed 410 inpatients in routine clinical practice. The BelRAI-system was evaluated by focus groups, observations, and questionnaires. The Strengths, Weaknesses, Opportunities and Threats were mapped (SWOT-analysis) and validated by the participants. RESULTS: The primary strengths of the BelRAI-system were a structured overview of the patients’ condition early after admission and the promotion of multidisciplinary assessment. Our study was a first attempt to transfer standardized data between home care organizations, nursing homes and hospitals and a way to centralize medical, allied health professionals and nursing data. With the BelRAI-software, privacy of data is guaranteed. Weaknesses are the time-consuming character of the process and the overlap with other assessment instruments or (electronic) registration forms. There is room for improving the user-friendliness and the efficiency of the software, which needs hospital-specific adaptations. Opportunities are a timely and systematic problem detection and continuity of care. An actual shortage of funding of personnel to coordinate the assessment process is the most important threat. CONCLUSION: The BelRAI-software allows standardized transmural information transfer and the centralization of medical, allied health professionals and nursing data. It is strictly secured and follows strict privacy regulations, allowing hospitals to optimize (transmural) communication and interaction. However, weaknesses and threats exist and must be tackled in order to promote large scale implementation

Domain excitations in spin-Peierls systems

We study a model of a Spin-Peierls material consisting of a set of antiferromagnetic Heisenberg chains coupled with phonons and interacting among them via an inter-chain elastic coupling. The excitation spectrum is analyzed by bosonization techniques and the self-harmonic approximation. The elementary excitation is the creation of a localized domain structure where the dimerized order is the opposite to the one of the surroundings. It is a triplet excitation whose formation energy is smaller than the magnon gap. Magnetic internal excitations of the domain are possible and give the further excitations of the system. We discuss these results in the context of recent experimental measurements on the inorganic Spin-Peierls compound CuGeO$_3$Comment: 5 pages, 2 figures, corrected version to appear in Phys. Rev.