Intra-abdominal Hypertension and Abdominal Compartment Syndrome

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are increasingly recognized in critically ill patients; no non operative treatments exist, and mortality remains high. The purpose of this thesis was to prospectively characterize the incidence of IAH in a mixed medical-surgical intensive care unit, and to test the potential therapeutic benefit of carbon monoxide (CO) and hydrogen sulphide (H2S) using an animal model of ACS. IAH was diagnosed in 30% of patients on admission; further 15% developed IAH during ICU stay. Incidence of ACS was 3%, with obesity, sepsis, mechanical ventilation and 24-hour fluid balance as independent predictors, also predicting ICU mortality. In a rat model of ACS, CO and H2S were found to improve ACS-induced microcirculatory dysfunction, inflammation, cell death and overall organ dysfunction. IAH incidence in the critically ill is high, with its correction possibly reducing mortality. CO and H2S show promise in animal model of ACS, as potential therapeutics

The biochemical, physiological, and metabolic effects of Apollo nominal mission and contingency diets on human subjects while on a simulated Apollo mission Final report, Feb. - Jun. 1966

Biochemical, physiological, and metabolic effects of simulated Apollo mission with space diet on human

Efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of acute pain after orthopedic trauma: A practice management guideline from the Eastern Association for the Surgery of Trauma and the Orthopedic Trauma Association

OBJECTIVES: Fracture is a common injury after a traumatic event. The efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) to treat acute pain related to fractures is not well established. METHODS: Clinically relevant questions were determined regarding NSAID use in the setting of trauma-induced fractures with clearly defined patient populations, interventions, comparisons and appropriately selected outcomes (PICO). These questions centered around efficacy (pain control, reduction in opioid use) and safety (non-union, kidney injury). A systematic review including literature search and meta-analysis was performed, and the quality of evidence was graded per the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The working group reached consensus on the final evidence-based recommendations. RESULTS: A total of 19 studies were identified for analysis. Not all outcomes identified as critically important were reported in all studies, and the outcome of pain control was too heterogenous to perform a meta-analysis. Nine studies reported on non-union (three randomized control trials), six of which reported no association with NSAIDs. The overall incidence of non-union in patients receiving NSAIDs compared with patients not receiving NSAIDs was 2.99% and 2.19% (p=0.04), respectively. Of studies reporting on pain control and reduction of opioids, the use of NSAIDs reduced pain and the need for opioids after traumatic fracture. One study reported on the outcome of acute kidney injury and found no association with NSAID use. CONCLUSIONS: In patients with traumatic fractures, NSAIDs appear to reduce post-trauma pain, reduce the need for opioids and have a small effect on non-union. We conditionally recommend the use of NSAIDs in patients suffering from traumatic fractures as the benefit appears to outweigh the small potential risks

Motion of the State of Ohio to Dismiss

Alan Davis, Special Administrator of the Estate of Samuel Sheppard, through counsel, has requested the Cuyahoga County Court of Common Pleas, by way of petition, to make a determination that he is a wrongfully incarcerated individual pursuant to R. C. §2305.02 and §2743.48. The State of Ohio asserts that, pursuant to Ohio Civil Rule 12 (B) (6) the court should dismiss the action. The State of Ohio is entitled to dismissal by operation of the doctrine of laches and the applicable statutes of limitation. Additionally, a claim of wrongful incarceration is a personal claim which an estate has no standing to pursue. Finally, any claim which may have been lawfully asserted by Samuel Sheppard has abated with his death, the passage of time, and his failure to pursue the claim at or near the time of his acquittal. This motion was denied on 01/13/97. See Court Docket

Motion to Strike, or in the Alternative, Motion to Dismiss of the State of Ohio

The State of Ohio asserted that the petition should be stricken or dismissed because it was filed under the original criminal case when it should have been filed as a civil action

Answer of the State of Ohio

Includes affirmative defenses of failure to state a claim, statute of limitations, lack of jurisdiction, lack of standing, laches and abatement upon death

Objections to Transfer of Case, Motion to Reassign the Docket of Kathleen Sutula According to Random Draw (with supporting materials)

The State of Ohio’s objection to the transfer of the case to Judge Suster’s Docket. At this point the court has already decided transfer the civil case from Judge Kathleen Sutula’s Docket to Judge Suster’s. The State objects to that transfer, arguing that the case assignment should be subject to random draw because the criminal case and civil case are not related. The court denied this motion on 2/5/1997; see docke

Motion of the State of Ohio for Judgment on the Pleadings, Hearing Requested

The State of Ohio asserted that the claims brought forth by the Estate of Sam Sheppard fail as matter of law and requests a full hearing on the issues it presents. The motion makes three legal arguments: (1) the court lacks jurisdiction over the Estate of Sam Sheppard\u27s claims because the claim was unreasonably delayed, (2) the statute of limitations bars any claim that Sam Sheppard might have, and (3) the Estate of Sam Sheppard does not have standing to bring a wrongful imprisonment claim because the injured party is deceased. This motion was denied; see docke

Motion of the State of Ohio for Judgment on the Pleadings

The State of Ohio asserts that the claims brought forth by the Estate of Sam Sheppard fail as matter of law. The motion makes three legal arguments: (1) the court lacks jurisdiction over the Estate of Sam Sheppard\u27s claims because the claim was unreasonably delayed, (2) the statute of limitations bars any claim that Sam Sheppard might have, and (3) the Estate of Sam Sheppard does not have standing to bring a wrongful imprisonment claim because the injured party is deceased

Objections to Transfer of Case, Motion to Reassign the Docket of Kathleen Sutula According to Random Draw (with supporting materials)

The State of Ohio’s objection to the transfer of the case to Judge Suster’s Docket. At this point the court has already decided transfer the civil case from Judge Kathleen Sutula’s Docket to Judge Suster’s. The State objects to that transfer, arguing that the case assignment should be subject to random draw because the criminal case and civil case are not related. The court denied this motion on 2/5/1997; see docke