Lipid Emulsion Therapy as Treatment for Local Anesthetic Systemic Toxicity

Local anesthetic systemic toxicity, due to misapplication of local anesthetic in an otherwise routine procedure, can result in deleterious effects. Although improved regional anesthesia techniques, effective test-dosing, and availability of less toxic local anesthetics have resulted in a decline in local anesthetic toxicity rates, adverse events do occur. A comprehensive review of literature was conducted and current research findings and documented case studies were systematically reviewed. The “lipid sink” phenomenon is the most widely accepted theoretical framework surrounding intravenous lipid emulsion treatment for local anesthetic induced cardiovascular collapse (Rothschild, Bern, Oswald, & Weinberg, 2010). Current evidence suggests that immediate infusion of lipid emulsion should be considered when clinical signs of local anesthetic toxicity manifest. By relaying information surrounding practice guidelines on local anesthetic systemic toxicity, anesthesia practitioners will have an improved understanding of local anesthetic systemic toxicity clinical diagnosis and lipid emulsion infusion as a treatment modality

Study of blood flow sensing with microwave radiometry

A study and experimental investigation has been performed to determine the feasibility of measuring regional blood flow and volume in man by means of microwave radiometry. An indication was expected of regional blood flow from measurement of surface and subsurface temperatures with a sensitive radiometer. Following theoretical modeling of biological tissue, to determine the optimum operating frequency for adequate sensing depth, a sensitive microwave radiometer was designed for operation at 793 MHz. A temperature sensitivity of of 0.06 K rms was realized in this equipment. Measurements performed on phantom tissue models, consisting of beef fat and lean beefsteak showed that the radiometer was capable of sensing temperatures from a depth between 3.8 and 5.1 cm. Radiometric and thermodynamic temperature measurements were also performed on the hind thighs of large dogs. These showed that the radiometer could sense subsurface temperatures from a depth of, at least, 1.3 cm. Delays caused by externally-generated RF interference, coupled with the lack of reliable blood flow measurement equipment, prevented correlation of radiometer readings with reginal blood flow. For the same reasons, it was not possible to extend the radiometric observations to human subjects

Shakespeare\u27s Honest and Vertuous Ensigns: Transgressing the Military/Domestic Divide in the Henriad and Othello

This thesis explores how the military service of the ensign disrupts and ultimately obliterates domestic life in Shakespeare’s Henriad and Othello. The rank of the ensign held expectations of honesty and honor, yet Shakespeare portrays his only two ensign characters, Ancient Pistol and Iago, as ironically failing to adhere to these standards. The received view of Pistol that results from his portrayal in 2 Henry IV as a stock braggadocio is challenged by a sympathetic reading of his character, especially in Henry V. Although Pistol occasionally behaves with honor in Henry V, his military service results in the ruin of his domestic life. Shakespeare juxtaposes Pistol to King Henry V, who leaves war with a new wife; his promises of honor and glory in his supposedly inspiring St. Crispin’s day speech clearly do not apply to Pistol, whose wife dies while he is away at war. Iago degrades concepts of domesticity, such as family and marriage, to try to advance his military career. One method he employs is to convert Desdemona’s handkerchief, a token of domesticity, into a symbol of her supposed infidelity, creating a false ensign. He sacrifices the ensign’s honesty and honor, and even his wife’s life, in ruthless pursuit of promotion. His rhetoric plays on Othello’s fears of replacement, which may occur in both military and domestic contexts. Together, these ensign characters reveal Shakespeare’s interest in and distrust of the military’s destructive effects on domesticity. INDEX WORDS: Ensign, Rank, Ancient Pistol, Iago, Honest, Honorable, Military, Domestic, Shakespeare, Henriad, 2 Henry IV, Henry V, Othell

Nutritional support for head-injured patients

Copyright John Wiley & Sons. This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2004, Issue 3. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.’ Perel, P. , Yanagawa, T. , Bunn, F. , Roberts, I. , Wentz, R. and Pierro, A. Nutritional support for head-injured patients. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD001530. DOI: 10.1002/14651858.CD001530.pub2Background: Head injury increases the body's metabolic responses, and therefore nutritional demands. Provision of an adequate supply of nutrients is associated with improved outcome. The best route for administering nutrition (parenterally (TPN) or enterally (EN)), and the best timing of administration (for example, early versus late) of nutrients needs to be established. Objectives: To quantify the effect on mortality and morbidity of alternative strategies of providing nutritional support following head injury. Search strategy: Trials were identified by computerised searches of the Cochrane Injuries Group specialised register, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, National Research Register, Web of Science and other electronic trials registers. Reference lists of trials and review articles were checked. The searches were last updated in July 2006. Selection criteria: Randomised controlled trials of timing or route of nutritional support following acute traumatic brain injury. Data collection and analysis: Two authors independently abstracted data and assessed trial quality. Information was collected on death, disability, and incidence of infection. If trial quality was unclear, or if there were missing outcome data, trialists were contacted in an attempt to get further information. Main results: A total of 11 trials were included. Seven trials addressed the timing of support (early versus delayed), data on mortality were obtained for all seven trials (284 participants). The relative risk (RR) for death with early nutritional support was 0.67 (95% CI 0.41 to 1.07). Data on disability were available for three trials. The RR for death or disability at the end of follow-up was 0.75 (95% CI 0.50 to 1.11). Seven trials compared parenteral versus enteral nutrition. Because early support often involves parenteral nutrition, three of the trials are also included in the previous analyses. Five trials (207 participants) reported mortality. The RR for mortality at the end of follow-up period was 0.66 (0.41 to 1.07). Two trials provided data on death and disability. The RR was 0.69 (95% Cl 0.40 to 1.19). One trial compared gastric versus jejunal enteral nutrition, there were no deaths and the RR was not estimable. Authors' conclusions: This review suggests that early feeding may be associated with a trend towards better outcomes in terms of survival and disability. Further trials are required. These trials should report not only nutritional outcomes but also the effect on death and disability.Peer reviewe

RF model of the distribution system as a communication channel, phase 2. Volume 4: Sofware source program and illustrations ASCII database listings

Listings of source programs and some illustrative examples of various ASCII data base files are presented. The listings are grouped into the following categories: main programs, subroutine programs, illustrative ASCII data base files. Within each category files are listed alphabetically

RF model of the distribution system as a communication channel, phase 2. Volume 3: Appendices

Program documentation concerning the design, implementation, and verification of a computerized model for predicting the steady-state sinusoidal response of radial configured distribution feeders is presented in these appendices

Anestro e cio silencioso em porcas desmamadas.

bitstream/item/59091/1/CUsersPiazzonDocuments104.pd

Aumento do peso e redução da idade a puberdade de leitoas através dos cruzamentos.

bitstream/item/58795/1/CUsersPiazzonDocuments151.pd

Fêmeas cruzadas ou F1 recomendadas para a produção de suínos para o abate.

bitstream/item/58663/1/CUsersPiazzonDocuments184.pd

Experiência a campo com inseminação artificial de suínos.

bitstream/item/59338/1/CUsersPiazzonDocuments16.pd