20 research outputs found

    Plato on Well-Being

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    Plato's dialogues use several terms for the concept of well-being, which concept plays a central ethical role as the ultimate goal for action and a central political role as the proper aim for states. But the dialogues also reveal sharp debate about what human well-being is. I argue that they endorse a Socratic conception of well-being as virtuous activity, by considering and rejecting several alternatives, including an ordinary conception that lists a variety of goods, a Protagorean conception that identifies one's well-being with what appears one to be one's well-being, and hedonistic conceptions

    Lung Protective Ventilation (ARDSNet) versus APRV: Ventilatory Management in a Combined Model of Acute Lung and Brain Injury

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    BACKGROUND: Concomitant lung/brain traumatic injury, results in significant morbidity and mortality. Lung protective ventilation (ARDSNet) has become the standard for managing acute respiratory distress syndrome (ARDS); however, the resulting permissive hypercapnea may compound traumatic brain injury (TBI). Airway pressure release ventilation (APRV) offers an alternative strategy for management of this patient population. APRV was hypothesized to retard the progression of acute lung/brain injury to a greater degree than ARDSNet in a swine model. METHODS: Yorkshire swine were randomized to ARDSNet, APRV, or sham. Ventilatory settings and pulmonary parameters, vitals, blood gases, quantitative histopathology, and cerebral microdialysis were compared between groups using chi-square, Fisher’s exact, Student’s t-test, Wilcoxon rank-sum, and mixed effects repeated measures modeling. RESULTS: 22 swine (17 male, 5 female), weighing 25±6.0kg, were randomized to APRV (n=9), ARDSNet (n=12), or sham (n=1). PaO(2)/FiO(2) (P/F) ratio dropped significantly while intracranial pressure increased significantly for all three groups immediately following lung and brain injury. Over time, peak inspiratory pressure, mean airway pressure, and P/F ratio significantly increased, while total respiratory rate significantly decreased within the APRV group compared to the ARDSNet group. Histopathology did not show significant differences between groups in overall brain or lung tissue injury; however, cerebral microdialysis trends suggested increased ischemia within the APRV group compared to ARDSNet over time. CONCLUSION: Previous studies have not evaluated the effects of APRV in this population. While our macroscopic parameters and histopathology did not observe a significant difference between groups, microdialysis data suggest a trend toward increased cerebral ischemia associated with APRV over time. Additional and future studies should focus on extending the time interval for observation to further delineate differences between groups. LEVEL OF EVIDENCE: II STUDY TYPE: Therapeuti

    Extreme Longevity Is Associated with Increased Serum Thyrotropin

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    Context: The distribution of serum TSH shifts progressively to higher concentrations with age

    Tall Stature

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