[New non-volumetric method for estimating peroperative blood loss].

Science.gov (United States)

Tachoires, D; Mourot, F; Gillardeau, G

1979-01-01

The authors have developed a new method for the estimation of peroperative blood loss by measurement of the haematocrit of a fluid obtained by diluting the blood from swabs in a known volume of isotonic saline solution. This value, referred to a monogram, may be used to assess the volume of blood impregnating the compresses, in relation to the pre-operative or present haematocrit of the patient, by direct reading. The precision of the method is discussed. The results obtained justified its routine application in surgery in children, patients with cardiac failure and in all cases requiring precise compensation of per-operative blood loss.

The comparison of placental removal methods on operative blood loss

International Nuclear Information System (INIS)

Waqar, F.; Fawad, A.

2008-01-01

On an average 1 litre of blood is lost during Caesarean Section. Many variable techniques have been tried to reduce this blood loss. Many study trials have shown the spontaneous delivery of placenta method to be superior over manual method because of reduced intra operative blood loss and reduced incidence of post operative endometritis. The main objective of our study was to compare the risk of blood loss associated with spontaneous and manual removal of the placenta during caesarean section. This study was conducted at Department of Obstetrics and Gynaecology, Islamic International Medical Complex, Islamabad from September 2004 to September 2005. All Women undergoing elective or emergency caesarean section were included in the study. Exclusion criteria were pregnancy below 37 weeks, severe maternal anaemia, and prolonged rupture of the membranes with fever, placenta praevia, placenta accreta and clotting disorders. Patients were allocated to the two groups randomly. Group A comprised of women in whom the obstetrician waited a maximum of 5 minutes till the placenta delivered spontaneously. In group B the obstetrician manually cleaved out the placenta as soon as the infant was delivered. The primary outcome measures noted were difference in haemoglobin of >2 gm/dl (preoperatively and postoperatively), time interval between delivery of baby and placenta, significant blood loss (>1000 cc), additional use of oxytocics, total operating time and blood transfusions. Data was analysed by SPSS. Statistical tests used for specific comparison were chi square-test and Student's t-test. One hundred and forty-five patients were allocated to two groups randomly. Seventy-eight patients were allocated to group A and 67 patients allocated to group B. Mean maternal age, birth weight, and total operating time were the same in two groups, but blood loss as measured by a difference in haemoglobin of greater then 2 grams/dl was statistically significant. Significant blood loss (>1000 cc

Role of Tranexamic Acid in Reducing Blood Loss in Vaginal Delivery.

Science.gov (United States)

Roy, Priyankur; Sujatha, M S; Bhandiwad, Ambarisha; Biswas, Bivas

2016-10-01

Anti-fibrinolytic agents are used to reduce obstetric blood loss as the fibrinolytic system is known to get activated after placental delivery. To evaluate the efficacy of parenteral tranexamic acid in reducing blood loss during normal labour and to compare it with the amount of blood loss in patients who received placebo in the third stage of labour. Patients with spontaneous labour or planned for induction of labour and fulfilling the inclusion criteria were recruited for the study. In each patient, the pre-delivery pulse rate, blood pressure, Hb gm% and PCV% were noted. Labour was monitored carefully using a partogram. The study group received Inj. Oxytocin and Inj. Tranexamic acid. The control group received Inj. Oxytocin and Placebo injection. Immediately after delivery of the baby, when all the liquor was drained, the patient was placed over a blood drape-a disposable conical, graduated plastic collection bag. The amount of blood collected in the blood drape was measured. Then the patient was given pre-weighed pads, which were weighed 2 h post-partum. The blood loss was measured by measuring the blood collected in the drape and by weighing the swabs before and after delivery. The total number of patients studied was 100-equally distributed in both the groups. The age group of the patients and BMI were comparable. There was a significant increase in the pulse rate and decrease in blood pressure in the control group as compared with the study group. The post-delivery haemoglobin and haematocrit were significantly reduced in the control group as compared to the study group. The mean blood loss at the end of 2 h was 105 ml in the study group and 252 ml in the control group. There was a significant increase in the usage of uterotonics and also in the need for blood transfusion in the control group; 12 % of the patients in the control group had to stay for more than 3 days compared to 2 % in the study group. Tranexamic acid injection, an antifibrinolytic

Perioperative blood loss and diclofenac in major arthroplastic surgery

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Ljiljana Gvozdenović

2011-04-01

Full Text Available Introduction: Contemporary literature indicates precaution over the perioperative use of non-steroidal anti-inflammatory drugs, since they can potentially increase perioperative blood loss related to their mechanism of action. The aim of this study was to assess the influence of non-steroidal anti-inflammatory drugs on perioperative blood loss undergoing hip arthroplasty and its correlation with general and regional anesthesia.Methods: This prospective study included 120 patients who had undergone elective unilateral total hip arthroplasty. Patients were allocated into four groups. Groups 1 and 2 were pretreated with diclofenac and operated in general and regional anesthesia. Group 3 and 4 weren’t pretreated with any non-steroidal anti-inflammatory drug and were, as well, operated in general and regional anesthesia. Diclofenac was administered orally two times a day 75 mg (total 150 mg and also as intramuscular injection (75 mg preoperatively and 12 hours later on a day of surgery.Results: The perioperative blood loss in the rst 24 hours showed an increase of 29.4% in the diclofenac group operated in general anesthesia and increase of 26.8% in patients operated in regional anesthesia (P < 0.05 compared to control group. Statistical data evaluation of patients operated in general anesthesia compared to regional anesthesia, the overall blood loss in the rst 24 h after surgery, showed an increase of 6.4% in the diclofenac group and increase of 3.6% in placebo group. This was not statistically significant.Conclusion: Pretreatment with non-steroidal anti-inflammatory drugs (diclofenac before elective unilateral total hip arthroplasty increases the perioperative blood loss signficantly. Early discontinuation of non-selective non-steroidal anti-inflammatory drugs is advised.

Postpartum Vaginal Blood Loss following Two Different Methods of Cervical Ripening

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Okon Asuquo Okon

2017-01-01

Full Text Available Eighty women undergoing induction of labor at the University of Calabar Teaching Hospital were recruited and randomly allocated into two treatment groups (40 each, to receive either serial 50 µg doses of misoprostol or intracervical Foley catheter. Vaginal blood loss was collected and measured using an under buttocks plastic collection bag and by perineal pad weighing up to 6 hours postpartum. There were no significant differences between the two groups with respect to sociodemographic and obstetric characteristics. Comparison of blood loss in vaginal deliveries between the two groups revealed that subjects in the misoprostol group had significantly higher blood loss than subjects in the Foley catheter group (488 ± 222 versus 326 ± 106, p<0.05. In both groups, there was strong and statistically significant positive correlation between postpartum blood loss and induction delivery interval (r=0.75, p<0.0001; r=0.77, p<0.0001. There were no significant differences in maternal outcomes. In view of this, further study is required to ascertain if lower doses of misoprostol for induction of labor may result in lesser blood loss. This trial is registered with ISRCTN14479515.

PREVENTION OF BLOOD LOSS IN THIRD STAGE OF LABOUR BY PLACENTAL BLOOD DRAINAGE- A CLINICAL STUDY

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B. K. Dutta

2017-12-01

Full Text Available BACKGROUND Placental cord drainage is a simple, safe and non-invasive method which reduces the duration and blood loss in the third stage of labour thereby preventing PPH. This method is of great use in day to day obstetric practices not requiring any extra effort, cost or equipment, so this type of practice is more relevant in rural areas. The objectives of the study were1. To evaluate the effectiveness of placental blood drainage via umbilical cord in reducing duration and blood loss in third stage of labour. 2. Reducing the incidence of postpartum haemorrhage. 3. Decreasing the complications in third stage of labour and reduce maternal mortality. MATERIALS AND METHODS This study was carried out in 100 full term pregnant women admitted in the labour room in Gauhati medical college and hospital in the department of obstetrics and gynaecology since 1st August 2007 to 30th August 2008. Cases were divided into two. Study group and control group. RESULTS In control group the average duration of third stage was 7.41 minutes and in study group 5.57 minutes and p value was <0.001 which is very highly significant. The blood loss in third stage of labour was more in case of control group, the mean blood loss in control was 169.48 ml and study group was 110.38 ml after delivery of placenta. The post-partum haemorrhage was present in 2% of cases in control group while in study group it was present in 0% case. CONCLUSION Placental blood drainage is one of the additional components in active management of third stage of labour, which is safe, simple and non-invasive method. It reduces the duration of third stage of labour, amount of blood loss and decreases the duration of placental separation time.

A systematic review of the relationship between blood loss and clinical signs.

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Rodolfo Carvalho Pacagnella

Full Text Available INTRODUCTION: This systematic review examines the relationship between blood loss and clinical signs and explores its use to trigger clinical interventions in the management of obstetric haemorrhage. METHODS: A systematic review of the literature was carried out using a comprehensive search strategy to identify studies presenting data on the relationship of clinical signs & symptoms and blood loss. Methodological quality was assessed using the STROBE checklist and the general guidelines of MOOSE. RESULTS: 30 studies were included and five were performed in women with pregnancy-related haemorrhage (other studies were carried in non-obstetric populations. Heart rate (HR, systolic blood pressure (SBP and shock index were the parameters most frequently studied. An association between blood loss and HR changes was observed in 22 out of 24 studies, and between blood loss and SBP was observed in 17 out of 23 studies. An association was found in all papers reporting on the relationship of shock index and blood loss. Seven studies have used Receiver Operating Characteristic Curves to determine the accuracy of clinical signs in predicting blood loss. In those studies the AUC ranged from 0.56 to 0.74 for HR, from 0.56 to 0.79 for SBP and from 0.77 to 0.84 for shock index. In some studies, HR, SBP and shock index were associated with increased mortality. CONCLUSION: We found a substantial variability in the relationship between blood loss and clinical signs, making it difficult to establish specific cut-off points for clinical signs that could be used as triggers for clinical interventions. However, the shock index can be an accurate indicator of compensatory changes in the cardiovascular system due to blood loss. Considering that most of the evidence included in this systematic review is derived from studies in non-obstetric populations, further research on the use of the shock index in obstetric populations is needed.

Real Time Intraoperative Monitoring of Blood Loss with a Novel Tablet Application

Science.gov (United States)

Sharareh, Behnam; Woolwine, Spencer; Satish, Siddarth; Abraham, Peter; Schwarzkopf, Ran

2015-01-01

Introduction : Real-time monitoring of blood loss is critical in fluid management. Visual estimation remains the standard of care in estimating blood loss, yet is demonstrably inaccurate. Photometric analysis, which is the referenced “gold-standard” for measuring blood loss, is both time-consuming and costly. The purpose of this study was to evaluate the efficacy of a novel tablet-monitoring device for measurement of Hb loss during orthopaedic procedures. Methods : This is a prospective study of 50 patients in a consecutive series of joint arthroplasty cases. The novel System with Feature Extraction Technology was used to measure the amount of Hb contained within surgical sponges intra-operatively. The system’s measures were then compared with those obtained via gravimetric method and photometric analysis. Accuracy was evaluated using linear regression and Bland-Altman analysis. Results : Our results showed a significant positive correlation between Triton tablet system and photometric analysis with respect to intra-operative hemoglobin and blood loss at 0.92 and 0.91, respectively. Discussion : This novel system can accurately determine Hb loss contained within surgical sponges. We believe that this user-friendly software can be used for measurement of total intraoperative blood loss and thus aid in a more accurate fluid management protocols during orthopaedic surgical procedures. PMID:26401167

Thinning Hair and Hair Loss: Could it be Female Pattern Hair Loss?

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... mcat1=de12", ]; for (var c = 0; c Thinning hair and hair loss: Could it be female pattern hair loss? Female pattern hair loss: Without treatment, female ... can I tell if I have female pattern hair loss? It’s best to make an appointment to ...

Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients

DEFF Research Database (Denmark)

Husted, Henrik; Blønd, Lars; Sonne-Holm, Stig

2003-01-01

INTRODUCTION: We performed a prospective, randomized, double-blind study on 40 patients scheduled for primary total hip arthroplasty due to arthrosis or osteonecrosis to determine the effect of tranexamic acid on per- and postoperative blood losses and on the number of blood transfusions needed...... blood losses at removal of the drain 24 hours after the operation and the number of blood transfusions. RESULTS: Patients receiving tranexamic acid had a mean peroperative blood loss of 480 mL versus 622 mL in patients receiving placebo (p = 0.3), a postoperative blood loss of 334 mL versus 609 mL (p...... = 0.001), a total blood loss of 814 mL versus 1231 mL (p = 0.001) and a total need for 4 blood transfusions versus 25 (p = 0.04). No patient in either group had symptoms of deep venous thrombosis, pulmonary embolism or prolonged wound drainage. INTERPRETATION: Transemic acid is effective in reducing...

Visual estimation versus gravimetric measurement of postpartum blood loss: a prospective cohort study.

Science.gov (United States)

Al Kadri, Hanan M F; Al Anazi, Bedayah K; Tamim, Hani M

2011-06-01

One of the major problems in international literature is how to measure postpartum blood loss with accuracy. We aimed in this research to assess the accuracy of visual estimation of postpartum blood loss (by each of two main health-care providers) compared with the gravimetric calculation method. We carried out a prospective cohort study at King Abdulaziz Medical City, Riyadh, Saudi Arabia between 1 November 2009 and 31 December 2009. All women who were admitted to labor and delivery suite and delivered vaginally were included in the study. Postpartum blood loss was visually estimated by the attending physician and obstetrics nurse and then objectively calculated by a gravimetric machine. Comparison between the three methods of blood loss calculation was carried out. A total of 150 patients were included in this study. There was a significant difference between the gravimetric calculated blood loss and both health-care providers' estimation with a tendency to underestimate the loss by about 30%. The background and seniority of the assessing health-care provider did not affect the accuracy of the estimation. The corrected incidence of postpartum hemorrhage in Saudi Arabia was found to be 1.47%. Health-care providers tend to underestimate the volume of postpartum blood loss by about 30%. Training and continuous auditing of the diagnosis of postpartum hemorrhage is needed to avoid missing cases and thus preventing associated morbidity and mortality.

Luteinizing hormone (LH) blood test

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ICSH - blood test; Luteinizing hormone - blood test; Interstitial cell stimulating hormone - blood test ... to temporarily stop medicines that may affect the test results. Be sure to tell your provider about ...

DOES INTRAVENOUS TRANEXAMIC ACID REDUCE BLOOD LOSS DURING SURGICALLY ASSISTED RAPID PALATAL EXPANSION?

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Emine AKBAŞ

2017-10-01

Full Text Available Purpose: The purpose of this study was to evaluate the efficacy of tranexamic acid (TXA in reducing blood loss during surgically assisted rapid palatal expansion (SARPE procedure. Subjects and Methods: A total of 34 patients (12 male, 22 female who had been treated surgically under general anesthesia with SARPE including pterygoid disjunction for transverse maxillary deficiency (TMD were included in this study. The study group (n=17 received intravenous (IV TXA 10 mg/kg as a preoperative bolus; the control group (n=17 received normal saline solution. Preoperative and postoperative haemoglobin and haematocrit values, intraoperative blood loss, and any blood product transfusion were recorded. Results: Blood loss during SARPE was statistically significantly less in the study group than the control group (p=0.0001. Conclusion: Preoperative IV administration of TXA can effectively control blood loss during when SARPE with pterygoid disjunction is performed.

The use of torniquet to reduce blood loss at myomectomy.

Science.gov (United States)

Ikechebelu, J I; Ezeama, C O; Obiechina, N J A

2010-06-01

Fibroids remain the commonest pelvic tumour seen in women with myomectomy being the major form of treatment in our environment. Techniques to minimize blood loss will reduce patient morbidity and the need for blood transfusions. One such technique is the use of a tourniquet during myomectomy operation. This study examines the effectiveness and safety this tourniquet technique. A comparative analysis of the blood loss, transfusion rate and the morbidities associated with the use and non-use of a tourniquet during myomectomy operation at Nnamdi Azikiwe University Teaching Hospital, Nnewi Nigeria was undertaken. The Foley's urethral catheter was adapted as a uterine tourniquet and applied as low as possible at the base of the uterus before enucleating the fibroid masses. The patients who had their myomectomy performed with application of a tourniquet [tourniquet group] and those without [no-tourniquet group] were evenly matched for age, parity and presenting symptoms. The overall mean age of patients was 35.7 +/- 6.1 years and parity was 0.40 +/- 1.25. The main presenting symptoms of the patients were lower abdominal mass 65.6%, menorrhagia 38.7%, infertility 33.3%, abdominal pain 19.4% and dysmenorrhoea 14.0%. There was a statistically significant difference [P < 0.001] in mean blood loss for the no-tourniquet group [756.4 +/- 285.7] and the tourniquet group [515.7 +/- 292.8] as well as the mean blood transfusion rate in no-tourniquet group [1.0 units +/- 1.14] and the tourniquet group [0.24 units +/- 0.51]. However there was no significant difference between the two groups with respect to complication profile. The Foley's catheter form of tourniquet is cheap, safe, effectively reduces blood loss during myomectomy and significantly reduces transfusion rate while not adding to the complications due to the operation.

Occupational Noise Exposure, Bilateral High-Frequency Hearing Loss, and Blood Pressure.

Science.gov (United States)

Gan, Wen Qi; Mannino, David M

2017-11-13

The aim of this study was to investigate the relationships between occupational noise exposure and blood pressure using self-reported occupational exposure and bilateral high-frequency hearing loss. This study included 4548 participants aged 20 to 69 years from the National Health and Nutrition Examination Survey 1999 to 2004. On the basis of self-reported exposure status, participants were divided into the current, former, or never exposed groups. Bilateral high-frequency hearing loss was defined as the average high-frequency hearing threshold at least 25 dB in both ears. The currently exposed participants had slightly increased diastolic blood pressure compared with those never exposed. Among previously exposed participants, those with bilateral high-frequency hearing loss had increased systolic blood pressure, heart rate, and the prevalence of hypertension compared with those with normal high-frequency hearing. Although there were some significant results, the evidence was not consistent to support the associations between occupational noise exposure and blood pressure.

BUN - blood test

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... page: //medlineplus.gov/ency/article/003474.htm BUN - blood test To use the sharing features on this page, ... for the Test Many medicines can interfere with blood test results. Your health care provider will tell you ...

An Evaluation of Intra‑ and Post‑operative Blood Loss in Total Hip ...

African Journals Online (AJOL)

2017-05-18

May 18, 2017 ... Results: The mean intra‑ and post‑operative blood losses were 1222.7 ... To evaluate blood loss after total hip replacement. 2. To evaluate the .... 12.3. 4.2. 0.1. Median. 400.0. 150.0. 20.0. 3.0. Mode. 400.0. 100.0. 0.0. 3.0. SD.

Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients

DEFF Research Database (Denmark)

Husted, Henrik; Blønd, Lars; Sonne-Holm, Stig

2003-01-01

INTRODUCTION: We performed a prospective, randomized, double-blind study on 40 patients scheduled for primary total hip arthroplasty due to arthrosis or osteonecrosis to determine the effect of tranexamic acid on per- and postoperative blood losses and on the number of blood transfusions needed....... PATIENTS AND METHODS: 40 patients were randomized to tranexamic acid (10 mg/kg given as a bolus intravenous injection, followed by a continuous infusion of 1 mg/kg/hour for 10 hours) or placebo (20 mL saline given intravenously) 15 minutes before the incision. We recorded the peroperative and postoperative...... blood losses at removal of the drain 24 hours after the operation and the number of blood transfusions. RESULTS: Patients receiving tranexamic acid had a mean peroperative blood loss of 480 mL versus 622 mL in patients receiving placebo (p = 0.3), a postoperative blood loss of 334 mL versus 609 mL (p...

Tranexamic acid reduces blood loss in patients with extracapsular fractures of the hip

DEFF Research Database (Denmark)

Tengberg, P T; Foss, N B; Palm, H

2016-01-01

AIMS: We chose unstable extra-capsular hip fractures as our study group because these types of fractures suffer the largest blood loss. We hypothesised that tranexamic acid (TXA) would reduce total blood loss (TBL) in extra-capsular fractures of the hip. PATIENTS AND METHODS: A single...

Manage your blood sugar (image)

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Checking your blood sugar levels often and writing down the results will tell you how well you are managing your diabetes so you ... possible. The best times to check your blood sugar are before meals and at bedtime. Your blood ...

Estradiol blood test

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... page: //medlineplus.gov/ency/article/003711.htm Estradiol blood test To use the sharing features on this page, ... of estrogens. How the Test is Performed A blood sample is needed . How to Prepare for the Test Your health care provider may tell you to ...

Blood Loss in Surgery for Aggressive Vertebral Haemangioma with and without Embolisation

OpenAIRE

Robinson, Yohan; Sheta, Reda; Salci, Konstantin; Willander, Johan

2015-01-01

Despite their benign nature some symptomatic aggressive vertebral haemangiomas (AVH) require surgery to decompress spinal cord and/or stabilise pathological fractures. Preoperative embolisation may reduce the considerable blood loss during surgical decompression. This systematic review investigated whether preoperative embolisation reduced surgical blood loss during treatment of symptomatic AVH. PubMed Medline, Web of Science, and Ovid Medline were searched for case reports and clinical studi...

Blood loss associated with Ring uncemented total knee replacement: comparison between continuous and intermittent suction drainage.

Science.gov (United States)

Wittmann, F W; Ring, P A

1984-01-01

In a retrospective comparison of blood loss following uncemented total knee replacement, in which either continuous or intermittent suction drainage was used, measured blood loss was significantly greater with continuous drainage. However, a method of calculating actual blood loss demonstrated no significant difference. With intermittent drainage, more blood remains undetected around the knee joint; this technique should therefore be abandoned in favour of continuous suction drainage. PMID:6747978

Comparision of blood loss between computer assisted and conventional total knee arthroplasty

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Paras Kumar Mohanlal

2013-01-01

Conclusion: These results suggest that there is no significant difference in blood loss in CAS TKA and conventional TKA. This study also highlights the heterogeneity of methods used in studies related to CAS TKA. We believe that there is a need for a large multicenter prospective randomized controlled trial to be performed before a consensus can be reached on the influence of CAS techniques on blood loss during primary TKA.

Coagulation competence and fluid recruitment after moderate blood loss in young men

DEFF Research Database (Denmark)

Zaar, Morten; Mørkeberg, Jakob; Pott, Frank C

2014-01-01

The coagulation system is activated by a reduction of the central blood volume during orthostatic stress and lower body negative pressure suggesting that also a blood loss enhances coagulation. During bleeding, however, the central blood volume is supported by fluid recruitment to the circulation...

Factors contributing to postpartum blood-loss in low-risk mothers through expectant management in Japanese birth centres.

Science.gov (United States)

Eto, Hiromi; Hasegawa, Ayako; Kataoka, Yaeko; Porter, Sarah E

2017-08-01

To describe aspects of expectant midwifery care for low-risk women conducted in midwifery-managed birth centres during the first two critical hours after delivery and to compare differences between midwifery care, client factors and postpartum blood loss volume. As a secondary analysis from a larger study, this descriptive retrospective study examined data from birth records of 4051 women who birthed from 2001 to 2006 at nine (21%) of the 43 midwifery centres in Tokyo. Nonparametric and parametric analyses identified factors related to increased blood loss. Interviews to establish sequence of midwifery care were conducted. The midwifery centres provided care based on expectant management principles from birth to after expulsion of the placenta. Approximately 63.3% of women were within the normal limits of blood loss volume under 500g. A minority of women (12.9%) experienced blood loss between 500 and 800g and 4% had blood loss exceeding 1000g. Blood loss volume tended to increase with infant birth weight and duration of delivery. The total blood loss volume was significantly higher for primiparas than for multiparas during the critical two hours after delivery and for immediately after delivery, yet blood loss volume was significantly higher for multiparas than for primiparas during the first hour after delivery. Preventive uterine massage and umbilical cord clamping after placenta expulsion resulted in statistically significant less blood loss. Identified were two patterns of midwifery care based on expectant management principles from birth to after expulsion of the placenta. The practice of expectant management was not a significant factor for increased postpartum blood loss. These results detail specific midwifery practices and highlight the clinical significance of expectant management with low risk pregnant women experiencing a normal delivery. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Radiochromium (chromium-51) evaluation of gastrointestinal blood loss associated with placebo, aspirin, and nabumetone

International Nuclear Information System (INIS)

Lussier, A.; LeBel, E.

1987-01-01

Gastrointestinal blood loss is one of the most serious clinical events induced by drugs. To date, almost no nonsteroidal anti-inflammatory drug has been shown to be devoid of that side effect in a strictly controlled study. The objective of this study was to assess quantitatively, by use of radioactive chromium (chromium-51)-labeled red blood cells, gastrointestinal blood loss associated with nabumetone (1000 mg daily), aspirin (3.6 g daily), and placebo. A total of 37 normal subjects, divided among the three treatment groups and a fourth group that received no treatment, were assessed clinically and quantitatively for gastrointestinal blood loss over a period of 28 days of active treatment. The results with chromium-51, analyzed on a logarithmic scale, revealed no statistically significant differences between the nabumetone, placebo, and control groups. Gastrointestinal blood loss in the aspirin group, however, was elevated when compared with all other groups at a high level of statistical significance (p less than 0.001). It is concluded that, under conditions in which aspirin causes substantial gastrointestinal microbleeding, nabumetone is not significantly different from placebo

An evaluation of intra-operative and post-operative blood loss in ...

African Journals Online (AJOL)

Background: Total knee replacement is a rewarding and reliable procedure, producing a lasting relief to severe knee pains. However, significant blood loss usually in the post-operative period may be a challenge, necessitating prompt restoration of circulating blood volume to minimize morbidity and mortality. The aim of this ...

Quantifying Blood Loss and Transfusion Risk After Primary vs Conversion Total Hip Arthroplasty.

Science.gov (United States)

Newman, Jared M; Webb, Matthew R; Klika, Alison K; Murray, Trevor G; Barsoum, Wael K; Higuera, Carlos A

2017-06-01

Primary total hip arthroplasty (THA) and conversion THA may result in substantial blood loss, sometimes necessitating transfusion. Despite the complexities of the latter, both are grouped in the same category for quality assessment and reimbursement. This study's purpose was to compare both blood loss and transfusion risk in primary and conversion THA and identify their associated predictors. A total of 1616 patients who underwent primary and conversion THA at a single hospital from 2009-2013 were reviewed (primary THA = 1575; conversion THA = 41). Demographics, comorbidities, and perioperative data were collected from electronic records. Blood loss was calculated using a validated method. Transfusion triggers were based on standardized criteria. Separate multivariable regression models for blood loss and transfusion were performed. Conversion THA patients were younger (P = .002), had lower age-adjusted Charlson scores (P = .006), longer surgeries (P quantified in the present study and showed consistent results between the 2 metrics. The differences between these procedures should be addressed during quality assurance because conversion THA is associated with higher resource utilization, which is important in the allocation of resources and tiered reimbursement strategies. Copyright © 2017 Elsevier Inc. All rights reserved.

To tell or not to tell the diagnosis of schizophrenia.

OpenAIRE

Donnelly, P

1989-01-01

Some patients with schizophrenia are not told their diagnosis. The moral, clinical and practical issues involved in telling or not telling the patient are discussed. In some cases a relative is told the diagnosis but not the patient. The implications for the family and clinical outcome are outlined. A case history illustrating some of these issues is presented.

FACTORS AFFECTING BLOOD LOSS DURING OpEN REDUCTION ...

African Journals Online (AJOL)

The use of diathermy and positioning of the patient in a way that encourages free venous drainage at the operative site (1) is a practical and inexpensive way of minimising blood loss during surgery. The operative site should be a little above the level of the heart (1). Good anaesthetic technique reduces episodes of.

Medications for High Blood Pressure

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... Consumers Home For Consumers Consumer Updates Medications for High Blood Pressure Share Tweet Linkedin Pin it More sharing options ... age and you cannot tell if you have high blood pressure by the way you feel, so have your ...

ROLE OF 400 MCG INTRAOPERATIVE SUBLINGUAL MISOPROSTOL FOR REDUCTION OF CAESAREAN BLOOD LOSS

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Lalmohan Nayak

2017-02-01

Full Text Available BACKGROUND Lower segment caesarean section is a common surgical procedure. Postpartum haemorrhage incidence after LSCS is 4%. Misoprostol is a prostaglandin E1 analogue with good uterotonic properties, easy availability, low cost, thermostability, long shelf life, easy administration and few adverse effects at therapeutic dose. It is readily absorbed by oral, sublingual, buccal, vaginal or rectal route. Sublingual route attains quickest concentration. Dose of 400 mcg was chosen in this study to minimise adverse effects with optimal therapeutic benefit. The aim of the study is to determine the efficacy of sublingual misoprostol in reducing caesarean blood loss. MATERIALS AND METHODS It is a prospective experimental study done in VSSIMSAR, Burla. Women undergoing LSCS were randomly assigned to study and control groups of equal strength of 100 each. In all cases, preoperative Hb%, haematocrit, pulse, BP was noted. Study group were given 400 mcg misoprostol at the time of cord clamping. In control group, nothing was given. In all patients, active management of third stage of labour was done by using oxytocin 10 IU (IV along with uterine massage. Blood loss soaked by tetra was calculated using formula, blood loss = wet weight-dry weight/1.05 (1.05 is constant. Amount of blood loss, postoperative Hb%, haematocrit, pulse rate, BP was noted in both groups and compared. BP and pulse were noted after 1 hour and Hb%, haematocrit were noted after 24 hours. RESULTS Study group showed significant decrease in total blood loss (around 117.9 mL as compared to control group. There was significant decrease in the postoperative fall in Hb in the study group as compared to control, the mean difference being 0.631 gm%. Study group also showed decrease in postoperative fall in haematocrit as compared to control, the mean difference being 0.055. CONCLUSION Misoprostol significantly reduced caesarean blood loss and doesn’t affect foetal outcome without significant

Evaluation of the use of shock index in identifying acute blood loss in healthy blood donor dogs.

Science.gov (United States)

McGowan, Erin E; Marryott, Kimberly; Drobatz, Kenneth J; Reineke, Erica L

2017-09-01

To determine if shock index (SI) would increase following blood donation and if it would be a more sensitive assessment of acute blood loss as compared with heart rate (HR), blood pressure, and plasma lactate. Prospective study. University teaching hospital. Twenty client-owned clinically normal dogs. Peripheral venous blood measurements and blood donation. Data were collected at 3 time points: prior to donation (T pre ), immediately after donation (T 0 ), and 10 minutes following completion of donation (T 10 ). HR and systolic blood pressure (SBP) were recorded and used to calculate SI at time points T pre , T 0 , and T 10 . Packed cell volume (PCV), total plasma protein (TPP), and plasma lactate were evaluated from a peripheral venous blood sample at T pre and T 10. The mean SI was significantly increased at both time points following blood donation as compared to baseline (SI pre = 0.88 ± 0.19 vs SI 0 = 1.17 ± 0.21 vs SI 10 = 1.12 ± 0.25 (P = 0.0002 and 0.0003, respectively). Following blood donation, the mean SBP was significantly lower (SBP pre = 149 ± 24 mm Hg, SBP 0 = 118 ± 20 mm Hg; P = 0.0001, SBP 10 = 133 ± 21 mm Hg; P = 0.011). The mean HR was not significantly different at T 0 but was significantly increased at T 10 (HR pre = 128 ± 21/min, HR 0 = 136 ± 25/min, P = 0.193; HR 10 = 146 ± 29/min, P = 0.003). There was no significant difference in mean PCV (PCV pre = 50 ± 4%, PCV 10 = 48 ± 4%, P = 0.08). The mean TPP and plasma lactate were significantly different following donation but still within the reference interval (TPP pre = 6.8 ± 0.4 g/dL, TPP 10 = 6.4 ± 0.4 g/dL, P = 0.0014; Lac pre = 1.7 ± 0.7mmol/L, Lac 10 = 1.9 ± 0.8 mmol/L, P = 0.04). A receiver operating characteristic (ROC) analysis comparing area under the curve (AUC) for SI, HR, and SBP at T 0 and T 10 compared to T pre found that SI (AUC at T 0 : 0.858, CI: 0.730, 0.984 AUC at T 10 : 0.769 CI: 0.617, 0.921) was a better indicator of blood loss

Can Tranexamic Acid Reduce Blood Loss during Major Cardiac Surgery? A Pilot Study.

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Compton, Frances; Wahed, Amer; Gregoric, Igor; Kar, Biswajit; Dasgupta, Amitava; Tint, Hlaing

2017-09-01

We examined the effectiveness of tranexamic acid in preventing intraoperative blood loss during major cardiac surgery. Out of initial 81 patients undergoing major cardiac surgery (both coronary artery bypass and valve repair procedures) at our teaching hospital, sixty-seven patients were selected for this study. We compared estimated blood loss, decrease in percent hemoglobin and hematocrit following surgery between two groups of patients (none of them received any blood product during surgery), one group receiving no tranexamic acid (n=17) and another group receiving tranexamic acid (n=25). In the second study, we combined these patients with patients receiving modest amounts of blood products (1-2 unit) and compared these parameters between two groups of patients (25 patients received no tranexamic acid, 42 patients received tranexamic acid). In patients who received no blood product during surgery, those who received no tranexamic acid showed statistically significant (independent t-test two tailed at p tranexamic acid (mean: 987.2 mL, SD: 459.9, n=25). We observed similar results when the patients receiving no blood products and patients receiving modest amount of blood products were combined based on the use of tranexamic acid or not. No statistically significant difference was observed in percent reduced hemoglobin or hematocrit following surgery in any group of patients. We conclude that intraoperative antifibrinolytic therapy with tranexamic acid does not reduce intraoperative blood loss during major cardiac surgery which contradicts popular belief. © 2017 by the Association of Clinical Scientists, Inc.

Prothrombin complex concentrate in the reduction of blood loss during orthotopic liver transplantation: PROTON-trial

NARCIS (Netherlands)

F. Arshad (Freeha); B. Ickx (Brigitte); R.T. van Beem (Rachel); W.G. Polak (Wojciech); F. Grüne (Frank); F. Nevens (Frederik); M. Ilmakunnas (Minna); A.M. Koivusalo (Anna-Maria); H. Isoniemi (Helena); P.F.W. Strengers; H.J.M. Groen (Henk); H.G.D. Hendriks (Herman); T. Lisman (Ton); J. Pirenne (Jacques); R.J. Porte (Robert)

2013-01-01

textabstractBackground: In patients with cirrhosis, the synthesis of coagulation factors can fall short, reflected by a prolonged prothrombin time. Although anticoagulants factors are decreased as well, blood loss during orthotopic liver transplantation can still be excessive. Blood loss during

Prothrombin complex concentrate in the reduction of blood loss during orthotopic liver transplantation : PROTON-trial

NARCIS (Netherlands)

Arshad, Freeha; Ickx, Brigitte; van Beem, Rachel T.; Polak, Wojciech; Grune, Frank; Nevens, Frederik; Ilmakunnas, Minna; Koivusalo, Anna-Maria; Isoniemi, Helena; Strengers, Paul F. W.; Groen, Henk; Hendriks, Herman G. D.; Lisman, Ton; Pirenne, Jacques; Porte, Robert J.

2013-01-01

Background: In patients with cirrhosis, the synthesis of coagulation factors can fall short, reflected by a prolonged prothrombin time. Although anticoagulants factors are decreased as well, blood loss during orthotopic liver transplantation can still be excessive. Blood loss during orthotopic liver

Tranexamic acid reduces blood loss and need of blood transfusion in total knee arthroplasty: A prospective, randomized, double-blind study in Indian population

Directory of Open Access Journals (Sweden)

Abhishek Shinde

2015-01-01

Full Text Available Introduction: For quite a few years, tranexamic acid (TEA has been used during total knee arthroplasty (TKA to reduce blood loss. However, no consensus exits regarding its timing and doses. Materials and Methods: We conducted a prospective, randomized double-blinded study of 56 patients in the Indian population undergoing TKA from 2011 to 2012. A dose of 10 mg/kg body weight of TEA (three doses was given in one group and normal saline was administered in the other. Results: The mean blood loss in the TEA unilateral group was 295 mL ± 218 mL and in the placebo group was 482 mL ± 186 mL (P < 0.005. In the bilateral TEA group, the mean blood loss was 596 mL ± 235 mL and in the placebo group was 1349 mL ± 41 mL (P < 0.005. Conclusion: The number of patients requiring blood transfusion reduced substantially. There was no increase in the risk of deep vein thrombosis (DVT and pulmonary embolism. TEA reduces intraoperative and postoperative blood loss and thus reduces the need of allogenic blood transfusion.

Hydroxyethyl Starch Reduces Coagulation Competence and Increases Blood Loss During Major Surgery

DEFF Research Database (Denmark)

Rasmussen, Kirsten C; Johansson, Pär I; Højskov, Michael

2014-01-01

OBJECTIVE: This study evaluated whether administration of hydroxyethyl starch (HES) 130/0.4 affects coagulation competence and influences the perioperative blood loss. BACKGROUND: Artificial colloids substitute blood volume during surgery; with the administration of HES 130/0.4 (Voluven, Fresenius...

Calibrated delivery drape versus indirect gravimetric technique for the measurement of blood loss after delivery: a randomized trial.

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Ambardekar, Shubha; Shochet, Tara; Bracken, Hillary; Coyaji, Kurus; Winikoff, Beverly

2014-08-15

Trials of interventions for PPH prevention and treatment rely on different measurement methods for the quantification of blood loss and identification of PPH. This study's objective was to compare measures of blood loss obtained from two different measurement protocols frequently used in studies. Nine hundred women presenting for vaginal delivery were randomized to a direct method (a calibrated delivery drape) or an indirect method (a shallow bedpan placed below the buttocks and weighing the collected blood and blood-soaked gauze/pads). Blood loss was measured from immediately after delivery for at least one hour or until active bleeding stopped. Significantly greater mean blood loss was recorded by the direct than by the indirect measurement technique (253.9 mL and 195.3 mL, respectively; difference = 58.6 mL (95% CI: 31-86); p 500 mL (8.7% vs. 4.7%, p = 0.02). The study suggests a real and significant difference in blood loss measurement between these methods. Research using blood loss measurement as an endpoint needs to be interpreted taking measurement technique into consideration. This study has been registered at clinicaltrials.gov as NCT01885845.

Antioxidants Attenuate Oxidative Stress-Induced Hidden Blood Loss in Rats

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Hong Qian

2017-12-01

Full Text Available Objective: Hidden blood loss (HBL, commonly seen after total knee or hip arthroplasty, causes postoperative anemia even after reinfusion or blood transfusion based on the visible blood loss volume. Recent studies demonstrated that oxidative stress might be involved in HBL. However, whether the antioxidants proanthocyanidin (PA or hydrogen water (HW can ameliorate HBL remains poorly understood. The aim of this study was to evaluate the effects of PA and HW on HBL. Materials and Methods: A rat HBL model was established through administration of linoleic acid with or without treatment with PA or HW. The levels of hemoglobin (Hb, red blood cell (RBC count, superoxide dismutase (SOD activity, glutathione peroxidase (GSH-PX activity, malondialdehyde (MDA, and ferryl Hb were measured. Results: RBC and Hb values as well as the activity of SOD and GSH-PX were reduced after administration of linoleic acid, which was ameliorated by treatment with PA or HW. In addition, the quantity of MDA was significantly decreased with the administration of PA or HW. Conclusion: PA and HW could ameliorate HBL in a rat model by reducing oxidative stress, suggesting that they might be used as a novel therapeutic approach in the prophylaxis or treatment of HBL in clinics.

The effect of aspirin on blood loss and transfusion requirements in patients with femoral neck fractures.

LENUS (Irish Health Repository)

Manning, Brian J

2012-02-03

Although it is widely accepted that aspirin will increase the risk of intra- and post-operative bleeding, clinical studies have not consistently supported this assumption. We aimed to assess the effect of pre-operative aspirin on blood loss and transfusion requirements in patients undergoing emergency fixation of femoral neck fractures. A prospective case-control study was undertaken in patients presenting with femoral neck fractures. Parameters recorded included intra-operative blood loss, post-operative blood loss, transfusion requirements and peri-operative reduction in haemoglobin concentration. Of 89 patients presenting with femoral neck fractures 32 were on long-term aspirin therapy. Pre-operative aspirin ingestion did not significantly affect peri-operative blood loss, or change in haemoglobin concentration or haematocrit. However those patients taking aspirin pre-operatively had a significantly lower haemoglobin concentration and haematocrit and were more likely to be anaemic at presentation than those who were not receiving aspirin. Patients taking aspirin were also more likely to receive blood transfusion post-operatively.

[Evaluation of hearing loss parameters in workers and its relationship with fasting blood glucose levels].

Science.gov (United States)

Vicente-Herrero, M Teofila; Lladosa Marco, Silvia; Ramírez-Iñiguez de La Torre, M Victoria; Terradillos-García, M Jesús; López-González, Ángel Arturo

2014-05-01

Hearing loss due to noise is considered within the prevention plans of the most common occupational diseases. In addition to evaluation of working conditions, other personal factors increasing the risk of hypoacusis, such as diabetes, should be taken into account. To explore hearing loss in the workplace and its relationship to impaired fasting baseline blood glucose levels. An observational, cross-sectional study enrolling 1636 workers from service companies was conducted. Full audiometric evaluation was performed at different frequencies: high frequency (HF), early loss index (ELI), speech average loss (SAL), and monaural and binaural loss. Results were categorized by baseline blood glucose levels: G1 (125mg/dl). Based on both HF and ELI, 11% of workers had clear indication of deafness. Women with G3 levels showed significant differences in the results of HF and ELI indexes as compared to the G1 group (P=.038 and .046, respectively). A positive association was found between hearing loss and G3 blood glucose levels in HF (OR: .338; p=.002), ELI (OR: .407; p=.007), and the monaural test in the left ear (OR: 4.77×10-5; p=.006). Despite the methodological limitations of this study, there is evidence for an increased risk of high frequency hearing loss in workers with high baseline blood glucose levels. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

Polysaccharides from astragali radix restore chemical-induced blood vessel loss in zebrafish

Science.gov (United States)

2012-01-01

Background Astragali Radix has been used widely for the treatment of cardiovascular and cerebrovascular diseases, and to enhance endurance and stamina in traditional Chinese medicine (TCM) for over 2000 years. The polysaccharide constituents of Astragali Radix (ARP) are considered as one of the major constituents contributing to the multiple pharmacological effects of this medicinal plant. The purpose of the study is to evaluate the vascular regenerative activities of ARPs in a chemically-induced blood vessel loss model in zebrafish. Methods Blood vessel loss was induced in both Tg(fli-1a:EGFP)y1 and Tg(fli-1a:nEGFP)y7 embryos by administration of 300 nM VEGFR tyrosine kinase inhibitor II (VRI) for 3 h at 24 hpf (hour post-fertilization). Then, the blood vessel damaged zebrafish were treated with ARPs for 21 h and 45 h after VRI withdrawal. Morphological changes in intersegmental vessels (ISVs) of zebrafish larvae were observed under the fluorescence microscope and measured quantitatively. The rescue effect of ARPs in the zebrafish models was validated by measuring the relative mRNA expressions of Kdrl, Kdr and Flt-1 using real-time PCR. Results Two polysaccharide fractions, P4 (50000 D 0.1 μm), isolated from Astragali Radix by ultrafiltration, produced a significant and dose-dependent recovery in VRI-induced blood vessel loss in zebrafish. Furthermore, the down-regulation of Flk-1 and Flt-1 mRNA expression induced by VRI was reversed by treatment with P4. Conclusion The present study demonstrates that P4 isolated from Astragali Radix reduces VRI-induced blood vessel loss in zebrafish. These findings support the hypothesis that polysaccharides are one of the active constituents in Astragali Radix, contributing to its beneficial effect on treatment of diseases associated with a deficiency in angiogenesis. PMID:22357377

Comparison of blood loss between using non central part cutting knee prosthesis and distal central part cutting.

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Malairungsakul, Anan

2014-12-01

Patients who undergo knee replacement surgery may need to receive a blood transfusion due to blood loss during the operation. Therefore it was important to improve the design of knee implant operative procedures in an attempt to reduce the rate of blood loss. The present study aimed to compare the blood loss between two types of knee replacement surgery. This is a retrospective study in which 78 patients received cemented knee replacements in Phayao Hospital between October 2010 and March 2012. There were two types of surgical procedure: 1) using an implant position covering the end of the femoral bone without cutting into the central part of the distal femoral, 2) using an implant position covering the end of the femoral bone cutting the central part of the distal femoral. Blood loss, blood transfusion, hemoglobin and hematocrit were recorded preoperatively, immediately postsurgery and 48 hours after surgery. Findings revealed that the knee replacement surgery using the implant position covering the end of the femoral bone without cutting the central part of the distal femoral significantly lowered the rate of blood loss when compared to using the implant position covering the end of the femoral bone with central cutting of the distal femor. The average blood loss during the operation without cutting at the central part of distal femoral was 49.50 ± 11.11 mL; whereas the operation cutting the central part of the distal femoral was 58.50 ± 11.69 mL. As regards blood loss, the knee replacement surgery using the implant position covering the end ofthefemoral bone without cutting the central part of distal femor was better than using the implant position covering the end of the femoral bone cutting at the central part of the distal femor.

Tranexamic acid reduces blood loss during and after cesarean section: A double blinded, randomized, controlled trial

Directory of Open Access Journals (Sweden)

Amr H. Yehia

2014-03-01

Conclusions: Tranexamic acid can be used safely to reduce blood loss during cesarean section. Reduced blood loss after tranexamic acid was associated with improvement of post-operative hemoglobin, hematocrit and with reduction of post-partum need for iron replacement.

Ghost-Story Telling: Keeping It Appropriate.

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Weintraub, Jeff

1996-01-01

Guidelines for telling ghost stories at camp involve considering children's fears at different ages, telling age appropriate stories, determining appropriate times for telling ghost stories, and minimizing fear when a child becomes frightened by a ghost story. Includes tips on the selection, preparation, and presentation of ghost stories. (LP)

Donation frequency, iron loss, and risk of cancer among blood donors

DEFF Research Database (Denmark)

Edgren, Gustaf; Reilly, Marie; Hjalgrim, Henrik

2008-01-01

BACKGROUND: Long-term deleterious effects of repeated blood donations may be masked by the donors' healthy lifestyle. To investigate possible effects of blood donation and iron loss through blood donation on cancer incidence while minimizing "healthy donor effects," we made dose......-response comparisons within a cohort of Swedish and Danish blood donors. METHODS: We used a nested case-control study design, in which case patients were defined as all donors who were diagnosed with a malignancy between their first recorded blood donation and study termination (n = 10866). Control subjects (n...... plasma donors (> 25 vs 0 donations, OR = 2.14, 95% CI = 1.22 to 3.74). CONCLUSIONS: Repeated blood donation was not associated with increased or decreased risk of cancer overall. The lack of consistency across latency periods casts doubt on an apparent association between reduced cancer risk and iron...

Epsilon Aminocaproic Acid to Reduce Blood Loss and Transfusion After Total Hip and Total Knee Arthroplasty.

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Hobbs, Juliann C; Welsby, Ian J; Green, Cynthia L; Dhakal, Ishwori B; Wellman, Samuel S

2018-01-01

Total hip and knee arthroplasty (THA and TKA) are associated with significant blood loss and some patients require postoperative blood transfusion. While tranexamic acid has been studied extensively among this population, we tested the hypothesis that epsilon aminocaproic acid (EACA) can reduce blood loss and transfusion after joint arthroplasty. In April 2014, our Veterans Affairs Medical Center introduced a protocol to administer EACA during THA and TKA. No antifibrinolytics were used previously. We retrospectively compared blood loss and incidence of transfusion among patients who underwent primary arthroplasty in the year before standardized administration of EACA with patients having the same procedures the following year. Blood loss was measured as delta hemoglobin (preoperative hemoglobin - hemoglobin on postoperative day 1). All patients undergoing primary THA or TKA were included. Patients having revision surgery were excluded. We identified 185 primary arthroplasty patients from the year before and 184 from the year after introducing the EACA protocol. There were no changes in surgical technique or attending surgeons during this period. Delta hemoglobin was significantly lower in the EACA group (2.7 ± 0.8 mg/dL) compared to the control group (3.4 ± 1.1 mg/dL) (P blood transfusion was also significantly lower in the EACA group (2.7%) compared to the control group (25.4%) (P transfusion following introduction of the EACA protocol in patients undergoing primary arthroplasty. EACA offers a lower cost alternative to TXA for reducing blood loss and transfusion in this population. Published by Elsevier Inc.

Minimizing blood loss in liver transplantation : Progress through research and evolution of techniques

NARCIS (Netherlands)

de Boer, MT; Molenaar, IQ; Hendriks, HGD; Slooff, MJH; Porte, RJ

2005-01-01

Blood loss during liver transplantation has long been recognized as an important cause of morbidity and, especially in the early days, also mortality. It is well known that blood transfusions are associated with an increased risk of postoperative complications, such as infections, pulmonary

Plasmalemma Vesicle-Associated Protein Has a Key Role in Blood-Retinal Barrier Loss

NARCIS (Netherlands)

Wisniewska-Kruk, Joanna; van der Wijk, Anne-Eva; van Veen, Henk A.; Gorgels, Theo G. M. F.; Vogels, Ilse M. C.; Versteeg, Danielle; van Noorden, Cornelis J. F.; Schlingemann, Reinier O.; Klaassen, Ingeborg

2016-01-01

Loss of blood-retinal barrier (BRB) properties induced by vascular endothelial growth factor (VEGF) and other factors is an important cause of diabetic macular edema. Previously, we found that the presence of plasmalemma vesicle-associated protein (PLVAP) in retinal capillaries associates with loss

Chemotherapy and Hair Loss: What to Expect during Treatment

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Chemotherapy and hair loss: What to expect during treatment Your doctor can tell you whether your particular chemotherapy treatment is likely to cause hair loss. This allows you to plan ahead for head ...

Effectiveness of tranexamic acid in reducing blood loss during cytoreductive surgery for advanced ovarian cancer.

Science.gov (United States)

Kietpeerakool, Chumnan; Supoken, Amornrat; Laopaiboon, Malinee; Lumbiganon, Pisake

2016-01-23

Ovarian cancer is the third most common gynaecological cancer worldwide, with an age-standardised incidence rate of 6.1 per 10,000 women. Standard therapy for advanced epithelial ovarian cancer (EOC) includes a combination of cytoreductive surgery and platinum-based chemotherapy. Cytoreductive surgery aims to remove as much of the visible tumour as possible. As extensive intraperitoneal metastases are typical of advanced EOC, cytoreductive surgery is usually an extensive procedure with the risk of excessive bleeding. Tranexamic acid given perioperatively is effective in reducing blood loss and allogeneic blood transfusion requirements in a variety of surgical settings. Therefore, tranexamic acid seems to be a promising agent for minimising blood loss and the need for blood transfusion among women with advanced EOC undergoing cytoreductive surgery. To assess the effects of tranexamic acid for reducing blood loss associated with cytoreductive surgery in women with advanced EOC (stage III to IV). We searched the Cochrane Gynaecological, Neuro-oncology and Orphan Cancers Trial Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 5, 2015), MEDLINE, EMBASE and conference proceedings to May 2015. We also checked registers of clinical trials, citation lists of included studies, key textbooks and previous systematic reviews for potentially relevant studies. We included randomised controlled trials (RCTs) comparing tranexamic acid given during surgery versus placebo or no treatment, in adult women diagnosed with advanced EOC. Two review authors (CK, AS) independently selected potentially relevant trials, extracted data, assessed risk of bias, compared results and resolved disagreements by discussion. We found only one study that met our inclusion criteria. This was a randomised double blind, placebo-controlled multicentre study conducted to evaluate the effectiveness of a single dose of intravenous tranexamic acid (15 mg/kg body weight) versus

Being asked to tell an unpleasant truth about another person activates anterior insula and medial prefrontal cortex.

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Littlefield, Melissa M; Dietz, Martin J; Fitzgerald, Des; Knudsen, Kasper J; Tonks, James

2015-01-01

"Truth" has been used as a baseline condition in several functional magnetic resonance imaging (fMRI) studies of deception. However, like deception, telling the truth is an inherently social construct, which requires consideration of another person's mental state, a phenomenon known as Theory of Mind. Using a novel ecological paradigm, we examined blood oxygenation level dependent (BOLD) responses during social and simple truth telling. Participants (n = 27) were randomly divided into two competing teams. Post-competition, each participant was scanned while evaluating performances from in-group and out-group members. Participants were asked to be honest and were told that their evaluations would be made public. We found increased BOLD responses in the medial prefrontal cortex, bilateral anterior insula and precuneus when participants were asked to tell social truths compared to simple truths about another person. At the behavioral level, participants were slower at responding to social compared to simple questions about another person. These findings suggest that telling the truth is a nuanced cognitive operation that is dependent on the degree of mentalizing. Importantly, we show that the cortical regions engaged by truth telling show a distinct pattern when the task requires social reasoning.

No Effect of a Bipolar Sealer on Total Blood Loss or Blood Transfusion in Nonseptic Revision Knee Arthroplasty-A Prospective Study With Matched Retrospective Controls.

Science.gov (United States)

Nielsen, Christian Skovgaard; Gromov, Kirill; Jans, Øivind; Troelsen, Anders; Husted, Henrik

2017-01-01

Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The aim of this study was therefore to evaluate the effect of a bipolar sealer on blood loss and transfusion in revision TKA. In this single-center prospective cohort study with retrospective controls, 51 patients were enrolled in a fast-track setup for revision TKA without the use of a tourniquet. Twenty-five prospectively enrolled patients received treatment with both a bipolar sealer and electrocautery, whereas 26 patients had received treatment with a conventional electrocautery only in the retrospective group. No significant differences were found neither for calculated blood loss, with 1397 (standard deviation, ± 452) mL in the bipolar sealer group vs 1452 (SD, ± 530) mL in the control group (P = .66), nor for blood transfusion rates of 53% and 46% (P = .89), respectively. Four controls were readmitted within 90 days follow-up. The use of a bipolar sealer in a TKA revision setting without the use of a tourniquet did not reduce blood loss or blood transfusion rates. Copyright © 2016 Elsevier Inc. All rights reserved.

[Intra-Articular Application of Tranexamic Acid Significantly Reduces Blood Loss and Transfusion Requirement in Primary Total Knee Arthroplasty].

Science.gov (United States)

Lošťák, J; Gallo, J; Špička, J; Langová, K

2016-01-01

PURPOSE OF THE STUDY The aim of this prospective study was to investigate the effect of topical application of tranexamic acid (TXA, Exacyl) on the amount of post-operative blood loss, and blood transfusion requirement in patients undergoing primary total knee arthroplasty (TKA). Attention was paid to early complications potentially associated with TXA administration, such as haematoma, wound exudate, or knee swelling. In addition, the economic benefit of TXA treatment was also taken into account. MATERIAL AND METHODS The study included 238 patients (85 men and 153 women) who underwent primary total knee arthroplasty (TKA) at our department between January 2013 and November 2015. A group of 119 patients (41 men and 78 women) received intraarticular TXA injections according to the treatment protocol (TXA group). A control group matched in basic characteristics to the TXA group also consisted of 119 patients. The average age in the TXA group was 69.8 years, and the most frequent indication for TKA surgery was primary knee osteoarthritis (81.5%). In each patient, post-operative volume of blood lost from drains and total blood loss including hidden blood loss were recorded, as well as post-operative haemoglobin and haematocrit levels. On discharge of each patient from hospital, the size and site of a haematoma; wound exudate, if present after post-operative day 4; joint swelling; range of motion and early revision surgery, if performed, were evaluated. Requirements of analgesic drugs after surgery were also recorded. RESULTS In the TXA group, blood losses from drains were significantly lower than in the control group (456.7 ± 270.8 vs 640.5 ±448.2; p = 0.004). The median value for blood losses from drains was lower by 22% and the average value for total blood loss, including hidden losses, was also lower than in the control group (762.4 ± 345.2 ml vs 995.5 ± 457.3 ml). The difference in the total amount of blood loss between the two groups was significant (p = 0

Low-Dose Epinephrine Plus Tranexamic Acid Reduces Early Postoperative Blood Loss and Inflammatory Response: A Randomized Controlled Trial.

Science.gov (United States)

Zeng, Wei-Nan; Liu, Jun-Li; Wang, Fu-You; Chen, Cheng; Zhou, Qiang; Yang, Liu

2018-02-21

The reductions of perioperative blood loss and inflammatory response are important in total knee arthroplasty. Tranexamic acid reduced blood loss and the inflammatory response in several studies. However, the effect of epinephrine administration plus tranexamic acid has not been intensively investigated, to our knowledge. In this study, we evaluated whether the combined administration of low-dose epinephrine plus tranexamic acid reduced perioperative blood loss or inflammatory response further compared with tranexamic acid alone. This randomized placebo-controlled trial consisted of 179 consecutive patients who underwent primary total knee arthroplasty. Patients were randomized into 3 interventions: Group IV received intravenous low-dose epinephrine plus tranexamic acid, Group TP received topical diluted epinephrine plus tranexamic acid, and Group CT received tranexamic acid alone. The primary outcome was perioperative blood loss on postoperative day 1. Secondary outcomes included perioperative blood loss on postoperative day 3, coagulation and fibrinolysis parameters (measured by thromboelastography), inflammatory cytokine levels, transfusion values (rate and volume), thromboembolic complications, length of hospital stay, wound score, range of motion, and Hospital for Special Surgery (HSS) score. The mean calculated total blood loss (and standard deviation) in Group IV was 348.1 ± 158.2 mL on postoperative day 1 and 458.0 ± 183.4 mL on postoperative day 3, which were significantly reduced (p 0.05). The combined administration of low-dose epinephrine and tranexamic acid demonstrated an increased effect in reducing perioperative blood loss and the inflammatory response compared with tranexamic acid alone, with no apparent increased incidence of thromboembolic and other complications. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Is intraarticular administration of tranexamic acid better than its intravenous administration in reducing blood loss after total knee arthroplasty?

Directory of Open Access Journals (Sweden)

Ameet Pispati

2013-01-01

Full Text Available Context: It has been well-established now that intravenous (IV tranexamic acid (TXA is a potent agent to control postoperative blood loss following total knee arthroplasty (TKA. Recently, intraarticular administration of this agent has also shown good efficacy for the same. Aims: Comparison of postoperative blood loss between IV and topical administration of TXA in TKAs. Materials and Design: Eighty-six TKAs on knees were included in this study. Randomization was done so that 40 TKA received 1 g of IV TXA, while 46 had intraarticular administration of 1 g TXA. Subjets and Methods: We compared the postoperative blood loss by calculating the difference in pre- and postop hemoglobin and need for blood transfusion. Functional assessment was done on basis of Western Ontario McMaster Osteo-Arthritis Index (WOMAC scores and complications like postoperative infection, oozing from the wound site and thromboembolic manifestations. Results: Blood loss was significantly less in the intraarticular administration group as compared to the IV injection group. Total blood loss, blood transfusion group, and drain output was also less but the difference was not significant. The functional assessment (WOMAC scores were equivocal and so were the complications including thromboembolic manifestations (two cases each of deep vein thrombosis (DVT and no cases of pulmonary embolism (PE. Conclusion: Intraarticular administration of TXA to prevent postoperative blood loss in TKA is a safe and effective alternative/adjunct to its IV administration.

Significant reduction in blood loss in patients undergoing minimal extracorporeal circulation

NARCIS (Netherlands)

Gerritsen, W. B.; van Boven, W. J.; Smelt, M.; Morshuis, W. J.; van Dongen, H. P.; Haas, F. J.; Aarts, L. P.

2006-01-01

Several recent studies have shown differences in blood loss and allogeneic transfusion requirements between on-pump and off-pump coronary artery bypass grafting (CABG). Recently a new concept, the mini-extracorporeal circulation, was introduced to minimize the side effects of extracorporeal

Reducing blood loss during laparoscopic myomectomy by temporary uterine artery clamping using bulldog clamp

Directory of Open Access Journals (Sweden)

Kai-Jo Chiang

2014-01-01

Full Text Available Uterine myoma is the most common benign gynecologic tumor worldwide. Mini-invasive surgery has become popular for myomectomy, with advantages over laparotomy. However, reducing blood loss during laparoscopic myomectomy is a major concern for the surgeon because of the limitation in making a quick control bleeding during the operation. Several methods have proved to decrease blood flow, but are not always effective or available. We present a case of uterine myoma with the uterine arteries clamped by bulldog clamps during laparoscopic myomectomy. The myoma was removed successfully with minimal blood loss (<50 ml during the operation. This is an effective, safe, and reliable method for reducing bleeding during laparoscopic myomectomy that does not require ligation of the uterine artery.

Effect of tranexamic acid on intraoperative blood loss and transfusion requirements in patients undergoing excision of intracranial meningioma.

Science.gov (United States)

Hooda, Bhavna; Chouhan, Rajendra Singh; Rath, Girija Prasad; Bithal, Parmod Kumar; Suri, Ashish; Lamsal, Ritesh

2017-07-01

Surgical excision of meningioma is often complicated by significant blood loss requiring blood transfusion with its attendant risks. Although tranexamic acid is used to reduce perioperative blood loss, its blood conservation effect is uncertain in neurosurgery. Sixty adults undergoing elective craniotomy for meningioma excision were randomized to receive either tranexamic acid or placebo, initiated prior to skin incision. Patients in the tranexamic acid group received intravenous bolus of 20mg/kg over 20min followed by an infusion of 1mg/kg/h till the conclusion of surgery. Intraoperative blood loss, transfusion requirements and estimation of surgical hemostasis using a 5-grade scale were noted. Postoperatively, the extent of tumor excision on CT scan and complications were observed. Demographics, tumor characteristics, amount of fluid infusion, and duration of surgery and anesthesia were comparable between the two groups. The amount of blood loss was significantly less in tranexamic acid group compared to placebo (830mlvs 1124ml; p=0.03). The transfusion requirement was less in tranexamic acid group (p>0.05). The patients in tranexamic acid group fared better on a 5-grade surgical hemostasis scale with more patients showing good hemostasis (p=0.007). There were no significant differences between the groups with regards to extent of tumor removal, perioperative complications, hospital stay or neurologic outcome. To conclude, administration of tranexamic acid significantly reduced blood loss in patients undergoing excision of meningioma. Fewer patients in the tranexamic acid group received blood transfusions. Surgical field hemostasis was better achieved in patients who received tranexamic acid. Copyright © 2017 Elsevier Ltd. All rights reserved.

Leukocytic Response and Peripheral Venous Blood Lymphocyte Apoptosis as a Marker of Tissue Ischemia in Acute Massive Blood Loss

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N. V. Borovkova

2013-01-01

Full Text Available Objective: to estimate the level of peripheral venous blood lymphocyte apoptosis and intraoperative hypoxia in victims with acute massive blood loss. Subjects and methods. Twenty-two patients with open and close chest and abdominal traumas complicated by acute massive blood loss were examined. All the patients were emergently operated on to stop bleeding. Tissue metabolism was evaluated from gases, acid-base parameters, and plasma lactate, glucose, potassium, and sodium levels. Apoptosis of mononuclear cells was studied and dead leukocytes were counted using flow cytometry. Results. Preoperatively, the victims were found to have venous hypoxemia, hyperlactatemia, hyperglycemia, moderate leukocytosis, and higher dead leukocyte counts. There were also raised counts of lymphocytes coming into the process of apoptosis. A significant relationship was found between monocyte counts and hypoxia values. At the end of surgery, oxygen balance values became stable and exerted an effect on the count of leukocytes, the relative level of granulocytes, the relative and absolute counts of dead and damaged leukocytes, and the concentration of lymphocytes in the victims’ venous blood during the early stages of apoptosis, as evidenced by nonlinear regression models. Conclusion. The indicators of immunocompetent cell apoptosis and the count of venous blood dead leukocytes along with lactate levels and venous hypoxemia parameters reflect the degree of tissue hypoxia and may be used as specific markers.

ATLS Hypovolemic Shock Classification by Prediction of Blood Loss in Rats Using Regression Models.

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Choi, Soo Beom; Choi, Joon Yul; Park, Jee Soo; Kim, Deok Won

2016-07-01

In our previous study, our input data set consisted of 78 rats, the blood loss in percent as a dependent variable, and 11 independent variables (heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse pressure, respiration rate, temperature, perfusion index, lactate concentration, shock index, and new index (lactate concentration/perfusion)). The machine learning methods for multicategory classification were applied to a rat model in acute hemorrhage to predict the four Advanced Trauma Life Support (ATLS) hypovolemic shock classes for triage in our previous study. However, multicategory classification is much more difficult and complicated than binary classification. We introduce a simple approach for classifying ATLS hypovolaemic shock class by predicting blood loss in percent using support vector regression and multivariate linear regression (MLR). We also compared the performance of the classification models using absolute and relative vital signs. The accuracies of support vector regression and MLR models with relative values by predicting blood loss in percent were 88.5% and 84.6%, respectively. These were better than the best accuracy of 80.8% of the direct multicategory classification using the support vector machine one-versus-one model in our previous study for the same validation data set. Moreover, the simple MLR models with both absolute and relative values could provide possibility of the future clinical decision support system for ATLS classification. The perfusion index and new index were more appropriate with relative changes than absolute values.

Bipolar sealer device reduces blood loss and transfusion requirements in posterior spinal fusion for adolescent idiopathic scoliosis.

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Gordon, Zachary L; Son-Hing, Jochen P; Poe-Kochert, Connie; Thompson, George H

2013-01-01

Reducing perioperative blood loss and transfusion requirements is important in the operative treatment of idiopathic scoliosis. This can be achieved with special frames, cell saver systems, pharmacologic aspects, and other techniques. Recently there has been interest in bipolar sealer devices as an adjunct to traditional monopolar electrocautery. However, there is limited information on this device in pediatric spinal deformity surgery. We reviewed our experience with this device in a setting of a standard institutional operative carepath. Perioperative blood loss and transfusion requirements of 50 consecutive patients with adolescent idiopathic scoliosis undergoing a posterior spinal fusion and segmental spinal instrumentation and who had a bipolar sealer device used during their surgery was compared with a control group of the 50 preceding consecutive patients who did not. Anesthesia, surgical technique, use of intraoperative epsilon aminocaproic acid (Amicar), postoperative protocol, and indications for transfusions (hemoglobin≤7.0 g/dL) were identical in both groups. The preoperative demographics for the patients in both groups were statistically the same. The bipolar sealer group demonstrated a significant reduction in intraoperative estimated blood loss, total perioperative blood loss, volume of blood products transfused, and overall transfusion rate when compared with the control group. When subgroups consisting of only hybrid or all-pedicle screw constructs were considered individually, these findings remained consistent. There were no complications associated with the use of this device. Using the bipolar sealer device is a significant adjunct in decreasing perioperative blood loss and transfusion requirements in patients undergoing surgery for adolescent idiopathic scoliosis. Level III-retrospective comparative study.

Role of tranexamic acid in reducing blood loss during and after caesarean section

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Simran Kaur Bhatia

2015-01-01

Full Text Available Introduction: Association between caesarean section and intra operative and post operative bleeding is known. Post-partum hemorrhage is still a leading cause for maternal morbidity and mortality. This study will evaluate the efficacy and safety of tranexamic acid in reducing the blood loss after placental delivery following lower segment caesarean section (LSCS and note any adverse effects. Materials and Methods: A total of 100 women, who underwent elective or emergency primary caesarean section at term between 37 and 41 weeks have been studied prospectively. They were divided into two groups. In the study group of 50, tranexamic acid 1 gm IV was given 20 minutes before making incision for caesarean section and the control group of 50 did not receive tranexamic acid. Statistical Analysis: For quantitative outcomes, the t-test was used to test for difference in the two groups. For categorical outcomes, chi square and odds ratio with 95% confidence interval were used as applicable. Results: The patient characteristics, namely age, height, weight, gestational age and gravidity in two groups were similar which was statistically insignificant. Hemoglobin decreased slightly after birth in both groups but no statistical difference between two groups was noticed. There was no episode of thrombosis in the study. Tranexamic acid significantly reduced the quantity of the blood loss from time of placental delivery to 2 hours postpartum (P < 0.001 and from end of LSCS to 2 hours postpartum (P < 0.001. However, there was no statistical difference in quantity of blood loss from time of placental delivery to end of LSCS in both groups (P < 0.001. Conclusion: A safe dose of tranexamic acid has an effective role in reducing blood loss during LSCS without causing adverse reaction. Thus, drug can be used effectively in reducing maternal morbidity and mortality during LSCS.

Continuous Postoperative Pericardial Flushing: A Pilot Study on Safety, Feasibility, and Effect on Blood Loss

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Manshanden, Johan S. J.; Gielen, Chantal L. I.; de Borgie, Corianne A. J. M.; Klautz, Robert J. M.; de Mol, Bas A. J. M.; Koolbergen, David R.

2015-01-01

Background: Prolonged or excessive blood loss is a common complication after cardiac surgery. Blood remnants and clots, remaining in the pericardial space in spite of chest tube drainage, induce high fibrinolytic activity that may contribute to bleeding complications. Continuous postoperative

Effects of preoperative aspirin and clopidogrel therapy on perioperative blood loss and blood transfusion requirements in patients undergoing off-pump coronary artery bypass graft surgery.

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Shim, Jae Kwang; Choi, Yong Seon; Oh, Young Jun; Bang, Sou Ouk; Yoo, Kyung Jong; Kwak, Young Lan

2007-07-01

Preoperative exposure to clopidogrel and aspirin significantly increases postoperative bleeding in patients undergoing on-pump coronary artery bypass graft surgery. Off-pump coronary bypass grafting has been proposed as an alternative technique to attenuate postoperative bleeding associated with clopidogrel. This study aimed to determine the effects of aspirin and clopidogrel therapy on perioperative blood loss and blood transfusion requirements in off-pump coronary artery bypass grafting. One hundred six patients scheduled for off-pump coronary artery bypass grafting were divided into three groups: aspirin and clopidogrel discontinued more than 6 days before surgery (group 1, n = 35), aspirin and clopidogrel continued until 3 to 5 days before surgery (group 2, n = 51), and both medications continued within 2 days of surgery (group 3, n = 20). Thromboelastographic tracings were analyzed before induction of anesthesia. Routine coagulation profiles were measured before and after surgery. A cell salvage device was used during surgery and salvaged blood was reinfused. Chest tube drainage and blood transfusion requirement were recorded postoperatively. Patient characteristics, operative data, and thromboelastographic tracings were similar among the groups. There were significant decreases in hematocrit level and platelet count and prolongation in prothrombin time postoperatively in all groups without any intergroup differences. The amounts of perioperative blood loss and blood transfusion required were all similar among the groups. Preoperative clopidogrel and aspirin exposure even within 2 days of surgery does not increase perioperative blood loss and blood transfusion requirements in patients undergoing elective off-pump coronary artery bypass grafting.

Reduction of aspirin-induced fecal blood loss with low-dose misoprostol tablets in man

International Nuclear Information System (INIS)

Cohen, M.M.; Clark, L.; Armstrong, L.; D'Souza, J.

1985-01-01

Misoprostol (SC-29333), a synthetic prostaglandin E1 methyl ester analog, was given simultaneously with acetylsalicylic acid in a double-blind, placebo-controlled randomized prospective study of 32 healthy human male subjects. Fecal blood loss was measured for eight days using the 51 Cr-labeled red blood cell technique. Aspirin (650 mg qid) and misoprostol (25 micrograms qid) or placebo were given during days 3, 4, and 5. There was a significant (P less than 0.05) increase in median blood loss (modified Friedman test) from 0.81 to 6.05 ml/day in the aspirin with placebo group (N = 16). Median blood loss was increased (from 0.75 to 3.75 ml/day) in the aspirin with misoprostol group (N = 16), but this was significantly less (Mann-Whitney U test, P less than 0.01) than the placebo group. Mean serum salicylate concentrations in the placebo and misoprostol groups were similar (7.8 and 6.8 micrograms/ml, respectively). There were no significant changes in laboratory values in any of the subjects studied, nor were any major side-effects encountered. This study demonstrates that oral misoprostol reduces aspirin-induced gastrointestinal bleeding even when administered simultaneously and at a dose level below its threshold for significant acid inhibition. This indicates a potential role for misoprostol in the prevention of gastric mucosal damage in selected patients

"Hidden" Preoperative Blood Loss With Extracapsular Versus Intracapsular Hip Fractures: What Is the Difference?

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Harper, Katharine D; Navo, Paul; Ramsey, Frederick; Jallow, Sainabou; Rehman, Saqib

2017-12-01

Excessive blood loss with hip fracture management has been shown to result in increased rates of complications. Our goal is to compare blood loss and transfusion rates between patients with intracapsular and extracapsular (both intertrochanteric (IT) and subtrochanteric (ST)) hip fractures. 472 patients were evaluated over a five-year period. Those who presented to the hospital with a proximal femur fracture (femoral neck, IT or ST) were considered for the study. Exclusion criteria included polytrauma, gunshot injuries, periprosthetic fractures, and non-operative management. Primary endpoint was hemoglobin (Hgb) drop from admission to day of surgery (DOS); secondary endpoint was need for pre-op transfusion and discharge location. 304 patients were analyzed who sustained a proximal femur fracture. Median IC Hgb drop was 0.6g/dL; median EC Hgb drop was 1.1g/dL from admission to DOS ( p = 0.0272). Rate of pre-operative transfusions was higher in EC (36/194 = 18.6%) than IC fractures (5/105 = 4.5%) ( p = 0.0006), and overall transfusion rates remained higher throughout hospital stay (55.7% EC vs. 32.7% IC; p = 0.0001). Breakdown of bleeding rate and tranfusion rates between IT and ST fractures were not significant ( p = 0.07; p = 0.4483). Extracapsular hip fractures were more likely to be discharged to a skilled nursing facility (SNF) (84.4% EC vs. 73.8% IC; p = 0.027). Intracapsular hip fractures have significantly less pre-operative blood loss and fewer pre-operative transfusions than their extracapsular counterparts. These findings can be used to establish appropriate pre-operative resuscitative efforts, ensuring that hip fracture protocols account for the increased likelihood of blood loss in extracapsular fractures.

Which Route of Tranexamic Acid Administration is More Effective to Reduce Blood Loss Following Total Knee Arthroplasty?

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Keyhani, Sohrab; Esmailiejah, Ali Akbar; Abbasian, Mohammad Reza; Safdari, Farshad

2016-01-01

The most appropriate route of tranexamic acid administration is controversial. In the current study, we compared the efficacy of intravenous (IV) and topical intra-articular tranexamic acid in reducing blood loss and transfusion rate in patients who underwent primary total knee arthroplasty. One hundred twenty 120 patients were scheduled to undergo primary total knee arthroplasty. Patients were randomly allocated to three equal groups: IV tranexamic acid (500 mg), topical tranexamic acid (3 g in 100 mL normal saline) and the control. In the topical group, half of the volume was used to irrigate the joint and the other half was injected intra-articularly. The volume of blood loss, hemoglobin (Hb) level at 24 hours postoperative, and rate of transfusion was compared between groups. The blood loss and Hb level were significantly greater and lower in the control group, respectively (P=0.031). Also, the rate of transfusion was significantly greater in the control group (P=0.013). However, IV and topical groups did not differ significantly in terms of measured variables. No patient experienced a thromboembolic event in our study. Tranexamic acid is a useful antifibrinolytic drug to reduce postoperative blood loss, Hb drop, and rate of blood transfusion in patients undergoing total knee arthroplasty. The route of tranexamic acid administration did not affect the efficacy and safety.

Estimation and comparison of intra operative blood loss in patients with and without venous thromboembolism prophylaxis

International Nuclear Information System (INIS)

Ahsin, S.; Bashir, A.; Faiz, S.A.; Tahir, J.; Ijaz, A.

2014-01-01

To estimate and compare intraoperative blood loss in surgical patients with and without deep vein thrombosis (DVT) prophylaxis using unfractionated heparin Study Design: Clinical Trial Place and Duration: Surgery Department of Fauji Foundation Hospital and Physiology Department Foundation University Medical College from October 2011 to August 2012 Patients and Methodology: Patients were selected by non probability purposive sampling. Patients fulfilling the inclusion criteria were divided into 2 groups 25 each on the basis of order of presentation at Fauji Foundation Hospital until cohort numbers were reached. Group I received no heparin whereas group II received heparin. Written informed consent was taken from the patient after explaining the procedure of the study. Coagulation profile was done for both groups before the planned surgery. Heparin in a dose of 5000 units was administered subcutaneously to group II on the morning of the planned surgery and it was stopped 24 hours post operatively. Blood loss was estimated in both groups by weighing cotton swabs pre and post operatively. Data was analyzed by SPSS version 17. Results: Demographic data and surgical procedure time between the two groups did not differ. Blood loss between the two groups did not show any statistically significant difference. Conclusion: DVT prophylaxis using unfractionated heparin did not lead to any significant overt blood loss when compared with those without it. (author)

Intraoperative blood loss in bimaxillary orthognathic surgery with multisegmental Le Fort I osteotomies and additional procedures.

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Kretschmer, W B; Baciut, G; Bacuit, Mihaela; Zoder, W; Wangerin, K

2010-06-01

Autologous blood donation is not currently recommended by most authors for routine bimaxillary osteotomies. There are few data about bimaxillary procedures with multisegmental maxillary osteotomies. Our aim was to investigate the effect of additional osteotomies and iliac crest grafts on operative blood loss. A total of 225 consecutive patients having bimaxillary multisegmental osteotomies during a three-year period (January 2006-January 2009) were examined to see if their haemoglobin concentration and packed cell volume were reduced. The influence of iliac crest grafts, additional osteotomies (genioplasty, malar osteotomy, iliac crest graft, anterior mandibular segmental osteotomy), operating time, age, and sex were assessed. Neither age nor sex influenced blood loss, whereas operating time correlated significantly with reductions in haemoglobin concentration and packed cell volume. Blood loss was significantly higher in the group who had additional procedures (p 0.001 for haemoglobin concentration and packed cell volume) than in the group who had no additional procedures, whereas there were no significant differences among the three subgroups who had additional procedures (additional osteotomies, iliac crest grafts, or both procedures). Four patients who had additional procedures required transfusion, whereas no blood was given in the group who had no additional procedures. Because the transfusion rate was so low, we could make no general recommendation for preoperative blood donation in such cases. Copyright 2009 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Narrating your life after 65 (or: to tell or not to tell, that is the question).

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Lieblich, Amia

2014-01-01

This chapter examines differential circumstances whereby aging individuals construct their selves as a narrative or, alternatively, seem to prefer other routes to manifest their identity. The preliminary exploration of questions about the characteristics of those aged who prefer to tell and those who do not, as well as the salutary role of telling, is based on two studies of 65-80-year-old well-functioning Israeli-Jewish seniors. While approximately half of them were willing to conduct a life review, the other half constructed their robust identity through activities and a here-and-now focus. Historical circumstances that involve seeing one's life story as heroic or having an important historical message, as opposed to a series of haphazard events, are considered a major factor in the preference to tell or not to tell. The chapter concludes that there are different strategies for identity management, with an emphasis on either past events or present activities. Neither of these preferences can simply indicate success or failure in aging well. © 2014 Wiley Periodicals, Inc.

Vaccination with recombinant aspartic hemoglobinase reduces parasite load and blood loss after hookworm infection in dogs.

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Alex Loukas

2005-10-01

Full Text Available Hookworms infect 730 million people in developing countries where they are a leading cause of intestinal blood loss and iron-deficiency anemia. At the site of attachment to the host, adult hookworms ingest blood and lyse the erythrocytes to release hemoglobin. The parasites subsequently digest hemoglobin in their intestines using a cascade of proteolysis that begins with the Ancylostoma caninum aspartic protease 1, APR-1.We show that vaccination of dogs with recombinant Ac-APR-1 induced antibody and cellular responses and resulted in significantly reduced hookworm burdens (p = 0.056 and fecal egg counts (p = 0.018 in vaccinated dogs compared to control dogs after challenge with infective larvae of A. caninum. Most importantly, vaccinated dogs were protected against blood loss (p = 0.049 and most did not develop anemia, the major pathologic sequela of hookworm disease. IgG from vaccinated animals decreased the catalytic activity of the recombinant enzyme in vitro and the antibody bound in situ to the intestines of worms recovered from vaccinated dogs, implying that the vaccine interferes with the parasite's ability to digest blood.To the best of our knowledge, this is the first report of a recombinant vaccine from a hematophagous parasite that significantly reduces both parasite load and blood loss, and it supports the development of APR-1 as a human hookworm vaccine.

[Clinical signification of a modified dilution method (MDM) for blood loss assessment in the cases of nonvariceal upper gastrointestinal bleeding].

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Geogiev, G; Shishenkov, M; Ninov, B; Dosheva, I

2006-01-01

The aim of this study was to compare the modified dilution method (MDM) for in vivo bloodless assessment with the accepted in the clinical practice methods. We measured 148 blood samples from 134 patients with nonvariceal upper gastrointestinal bleeding (NUGB) and 21 blood samples from healthy persons as a negative control. In the randomized group of 53 patients with NUGB we compared accuracy of the blood loss determination by means of erythrocyte mass loss (estimated with MDM), Allgower-Burri index and American College of Surgeon Index (ACSI). The obtained results give us a reason to recommend a combination between American College of Surgeon classification for blood loss in patients with NUGB and a parallel measurement of the MDM values.

Comparative Aspects of the Regulation of Cutaneous and Cerebral Microcirculation During Acute Blood Loss

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I. A. Ryzhkov

2017-01-01

Full Text Available Objective. Using laser Doppler flowmetry (LDF and wavelet-analysis of microvascular blood flow oscillations to determine the features of regulation of cutaneous and cerebral microhemocirculation at early stages of acute fixed volume blood loss.Materials and methods.Experiments were carried out on 31 male outbred rats weighing 300 g to 400 g. The animals were anesthetized by intraperitoneal injection of pentobarbital (45 mg/kg. The tail artery was catheterized for invasive measurement of mean blood pressure (BP and blood withdrawal. The LDF method (ЛАКК-02 device, LAZMA, Russia was used to record microvascular blood flow simultaneously in the right ear and the pial vessels of the left parietal region. An acute fixed-volume hemorrhage model was used. The target blood loss volume was 30% of the total blood volume (TBV. Within 10 minutes after the end of hemorrhage (posthemorrhagic period, the blood pressure and the LDF-gram were recorded. The following LDF-gram parameters were analyzed: the mean value of IP; the maximum amplitude of blood flow oscillations (Amax and the corresponding frequency (Fmax in the frequency band 0.01—0.4 Hz. Statistical processing of the data was performed using Statistica 7.0.Results. At baseline, the values of IP, Аmax and Fmax in the brain were higher than in the skin. At posthemorrhagic period, BP decreased, on average, from 105 to 41 mm Hg. Against this background, IP in the skin decreased by 65%, while in the brain it reduced only by 17%, as compared with the baseline values (P0,0001. In the same time these organs were characterized by a unidirectional dynamics of patterns of fluxmotion. In both investigated organs, Amax increased sharply, and Fmax decreased. In posthemorrhagic period, fluxmotion not only «slowed down», but was also synchronized in a relatively narrow frequency band: for the skin Fmax was about 0.04 Hz (at the border of the endothelial and neurogenic band, for the brain about 0.09 Hz

Influence of curve magnitude and other variables on operative time, blood loss and transfusion requirements in adolescent idiopathic scoliosis.

LENUS (Irish Health Repository)

Nugent, M

2015-05-03

Posterior spinal instrumentation and fusion for correction of adolescent idiopathic scoliosis (AIS) typically requires lengthy operating time and may be associated with significant blood loss and subsequent transfusion. This study aimed to identify factors predictive of duration of surgery, intraoperative blood loss and transfusion requirements in an Irish AIS cohort.

The effect of aprotinin, tranexamic acid, and aminocaproic acid on blood loss and use of blood products in major pediatric surgery : A meta-analysis

NARCIS (Netherlands)

Schouten, Esther S.; van de Pol, Alma C.; Schouten, Anton N. J.; Turner, Nigel M.; Jansen, Nicolaas J. G.; Bollen, Casper W.

Objective: Aprotinin reduces the blood loss and transfusion of blood products in children undergoing major surgery. Aprotinin has been associated with severe side effects in adults, and tranexamic acid and aminocaproic acid have been found to be safer alternatives in adults. This systematic review

Intra-articular injection of tranexamic acid via a drain plus drain-clamping to reduce blood loss in cementless total knee arthroplasty

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Mutsuzaki Hirotaka

2012-09-01

Full Text Available Abstract Background Patients undergoing cementless total knee arthroplasty (TKA sometimes suffer large blood loss. In a retrospective study, we explored whether postoperative intra-articular retrograde injection of tranexamic acid (TA and leaving a drain clamp in place for 1 h reduced blood loss. Patients and methods Patients (n = 140 treated with unilateral primary cementless TKA (posterior cruciate ligament retained were divided into two groups: those who had an intra-articular injection of TA (1000 mg and drain clamping for 1 h postoperatively (study group, n = 70 and those who were not given TA and did not undergo clamping of their drains (control group, n = 70. Postoperative total blood loss, volume of drainage, hemoglobin level, transfusion amounts and rates, D-dimer level at postoperative day (POD 7, and complications were recorded. Results Total blood loss, total drainage, mean transfusion volume, and transfusion rates were lower in the study group than in controls (P P P  Conclusions Immediately postoperative intra-articular retrograde injection of TA and 1 h of drain-clamping effectively reduced blood loss and blood transfusion after cementless TKA. We believe that this method is simple, easy, and suitable for these patients.

Blood Density Is Nearly Equal to Water Density: A Validation Study of the Gravimetric Method of Measuring Intraoperative Blood Loss.

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Vitello, Dominic J; Ripper, Richard M; Fettiplace, Michael R; Weinberg, Guy L; Vitello, Joseph M

2015-01-01

Purpose. The gravimetric method of weighing surgical sponges is used to quantify intraoperative blood loss. The dry mass minus the wet mass of the gauze equals the volume of blood lost. This method assumes that the density of blood is equivalent to water (1 gm/mL). This study's purpose was to validate the assumption that the density of blood is equivalent to water and to correlate density with hematocrit. Methods. 50 µL of whole blood was weighed from eighteen rats. A distilled water control was weighed for each blood sample. The averages of the blood and water were compared utilizing a Student's unpaired, one-tailed t-test. The masses of the blood samples and the hematocrits were compared using a linear regression. Results. The average mass of the eighteen blood samples was 0.0489 g and that of the distilled water controls was 0.0492 g. The t-test showed P = 0.2269 and R (2) = 0.03154. The hematocrit values ranged from 24% to 48%. The linear regression R (2) value was 0.1767. Conclusions. The R (2) value comparing the blood and distilled water masses suggests high correlation between the two populations. Linear regression showed the hematocrit was not proportional to the mass of the blood. The study confirmed that the measured density of blood is similar to water.

Tranexamic acid reduces intraoperative occult blood loss and tourniquet time in obese knee osteoarthritis patients undergoing total knee arthroplasty: a prospective cohort study.

Science.gov (United States)

Meng, Yutong; Li, Zhirui; Gong, Ke; An, Xiao; Dong, Jiyuan; Tang, Peifu

2018-01-01

Obesity can result in increased blood loss, which is correlated with poor prognosis in total knee arthroplasty (TKA). Clinical application of tranexamic acid is effective in reducing blood loss in TKA. However, most previous studies focused on the effect of tranexamic acid in the whole population, neglecting patients with specific health conditions, such as obesity. We hypothesized that tranexamic acid would reduce blood loss to a greater extent in obese patients than in those of normal weight. A total of 304 patients with knee osteoarthritis treated with TKA from October 2013 to March 2015 were separated into tranexamic, non-tranexamic, obese, and non-obese groups. The demographic characteristics, surgical indices, and hematological indices were all recorded. We first investigated the ability of intravenous tranexamic acid to reduce intraoperative blood loss in knee osteoarthritis patients undergoing unilateral TKA. Second, we performed subgroup analysis to compare the effects of tranexamic acid between obese and non-obese patients separately. Of the 304 patients, 146 (52.0%) received tranexamic acid and 130 (42.8%) were obese. In the analysis of the whole group, both the actual and occult blood loss volume were lower in the tranexamic acid group (both P tranexamic acid group ( P tranexamic acid was shown to reduce theoretical and actual blood loss in both the obese and non-obese groups ( P Tranexamic acid reduced occult blood loss and tourniquet time in the obese group ( P 0.05). Tranexamic acid can reduce occult blood loss and tourniquet time in obese patients to a greater extent than in patients of normal weight. Therefore, obese knee osteoarthritis patients undergoing TKA can benefit more from tranexamic acid.

Blood Loss and Transfusion After Topical Tranexamic Acid Administration in Primary Total Knee Arthroplasty.

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Wang, Hao; Shen, Bin; Zeng, Yi

2015-11-01

There has been much debate and controversy about the safety and efficacy of the topical use of tranexamic acid in primary total knee arthroplasty (TKA). The purpose of this study was to perform a meta-analysis to evaluate whether there is less blood loss and lower rates of transfusion after topical tranexamic acid administration in primary TKA. A systematic review of the electronic databases PubMed, CENTRAL, Web of Science, and Embase was undertaken. All randomized, controlled trials and prospective cohort studies evaluating the effectiveness of topical tranexamic acid during primary TKA were included. The focus of the analysis was on the outcomes of blood loss results, transfusion rate, and thromboembolic complications. Subgroup analysis was performed when possible. Of 387 studies identified, 16 comprising 1421 patients (1481 knees) were eligible for data extraction and meta-analysis. This study indicated that when compared with the control group, topical application of tranexamic acid significantly reduced total drain output (mean difference, -227.20; 95% confidence interval, -347.11 to -107.30; Ptranexamic acid in primary TKA. Furthermore, the currently available evidence does not support an increased risk of deep venous thrombosis or pulmonary embolism due to tranexamic acid administration. Topical tranexamic acid was effective for reducing postoperative blood loss and transfusion requirements without increasing the prevalence of thromboembolic complications. Copyright 2015, SLACK Incorporated.

Intravenous dexmedetomidine infusion in adult patients undergoing open nephrolithotomy: Effects on intraoperative hemodynamics and blood loss; a random

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Doaa A. Rashwan

2015-10-01

Conclusion: Dexmedetomidine infusion in patients undergoing open nephrolithotomy under general anesthesia was associated with intraoperative hemodynamic stability, which decreases intraoperative blood loss and the need for intraoperative blood transfusion.

"The Tramp", a blood donation propagandist?

Science.gov (United States)

Lefrère, J-J; Garraud, O

2016-02-01

The French pioneer for blood transfusion, who eventually organized the very early blood transfusion centers worldwide, went to imagine a scenario written in purpose for Charlie Chaplin, the unique character of "The Tramp" ("Charlot" in French). The movie Star was offered to feature a blood donation propagandist, and no longer the perpetual, well-known, "loser". This anecdote, besides being amusing, tells a lot on how Arnault Tzank encompassed all the difficulties in collecting blood enough to meet the demand, at all times; his proposal turns out to be extremely modern and questions nowadays marketing for blood donation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Measuring Post-Partum Haemorrhage in Low-Resource Settings: The Diagnostic Validity of Weighed Blood Loss versus Quantitative Changes in Hemoglobin.

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Esther Cathyln Atukunda

Full Text Available Accurate estimation of blood loss is central to prompt diagnosis and management of post-partum hemorrhage (PPH, which remains a leading cause of maternal mortality in low-resource countries. In such settings, blood loss is often estimated visually and subjectively by attending health workers, due to inconsistent availability of laboratory infrastructure. We evaluated the diagnostic accuracy of weighed blood loss (WBL versus changes in peri-partum hemoglobin to detect PPH.Data from this analysis were collected as part of a randomized controlled trial comparing oxytocin with misoprostol for PPH (NCT01866241. Blood samples for complete blood count were drawn on admission and again prior to hospital discharge or before blood transfusion. During delivery, women were placed on drapes and had pre-weighed sanitary towels placed around their perineum. Blood was then drained into a calibrated container and the sanitary towels were added to estimate WBL, where each gram of blood was estimated as a milliliter. Sensitivity, specificity, negative and positive predictive values (PPVs were calculated at various blood volume loss and time combinations, and we fit receiver-operator curves using blood loss at 1, 2, and 24 hours compared to a reference standard of haemoglobin decrease of >10%.A total of 1,140 women were enrolled in the study, of whom 258 (22.6% developed PPH, defined as a haemoglobin drop >10%, and 262 (23.0% had WBL ≥500mL. WBL generally had a poor sensitivity for detection of PPH (85% in high prevalence settings when WBL exceeds 750mL.WBL has poor sensitivity but high specificity compared to laboratory-based methods of PPH diagnosis. These characteristics correspond to a high PPV in areas with high PPH prevalence. Although WBL is not useful for excluding PPH, this low-cost, simple and reproducible method is promising as a reasonable method to identify significant PPH in such settings where quantifiable red cell indices are unavailable.

Telling Teaching Stories.

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Gomez, Mary Louise; Tabachnick, B. Robert

1992-01-01

Telling teaching stories assists prospective teachers in becoming effective teachers of elementary school children. It offers preservice teachers and teacher educators the challenge of seeing themselves and the opportunity to reflect on their goals and practices. (IAH)

The beneficial effect of Batroxobin on blood loss reduction in spinal fusion surgery

DEFF Research Database (Denmark)

Hu, Hui-Min; Chen, Li; Frary, Charles Edward

2015-01-01

Objective Our objective was to evaluate the efficacy and safety of Batroxobin on blood loss during spinal operations. Methods After obtaining approval from the ethics committee at the hospital along with informed written consent, we performed a double-blind, randomized, placebo-controlled study w...

Use of tranexamic acid in primary total knee replacement: effects on perioperative blood loss.

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Volquind, Daniel; Zardo, Remi Antônio; Winkler, Bruno Costamilan; Londero, Bruno Bertagnolli; Zanelatto, Natália; Leichtweis, Gisele Perondi

2016-01-01

The use of tranexamic acid in primary total knee replacement surgeries has been the subject of constant study. The strategies to reduce bleeding are aimed at reducing the need for blood transfusion due to the risks involved. In this study we evaluated the use of tranexamic acid in reducing bleeding, need for blood transfusion, and prevalence of postoperative deep vein thrombosis in primary total knee replacement. 62 patients undergoing primary total knee replacement were enrolled in the study, from June 2012 to May 2013, and randomized to receive a single dose of 2.5g of intravenous tranexamic acid (Group TA) or saline (Group GP), 5min before opening the pneumatic tourniquet, respectively. Hemoglobin, hematocrit, and blood loss were recorded 24h after surgery. Deep vein thrombosis was investigated during patient's hospitalization and 15 and 30 days after surgery in review visits. There was no demographic difference between groups. Group TA had 13.89% decreased hematocrit (p=0.925) compared to placebo. Group TA had a decrease of 12.28% (p=0.898) in hemoglobin compared to Group GP. Group TA had a mean decrease of 187.35mL in blood loss (25.32%) compared to group GP (p=0.027). The number of blood transfusions was higher in Group GP (p=0.078). Thromboembolic events were not seen in this study. Tranexamic acid reduced postoperative bleeding without promoting thromboembolic events. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

Uptake and Loss Kinetics of 57Co, 85Sr and 134Cs on Blood Cockle Anadara granosa

International Nuclear Information System (INIS)

Srisuksawad, K; Prasertchiewchan, N.; Tungkitjanukij, S.; Pakkong, P.

2005-02-01

Adult blood cockle (A. granosa) were exposed in the laboratory to 57 Co, 85 Sr, and 134 Cs in seawater at average +- s.e. stable activities of 0.725+-0.010 Bq/ml, 0.917+-0.066 Bq/ml and 1.37+-0.105 Bq/ml, respectively. The study aims to determine key contaminant bioaccumulation, retention and loss parameters for bio-indicator organisms used in assessment of the impact of the effluent discharge from nuclear and non-nuclear facilities on coastal area. Natural coastal water conditions in dry season with a salinity of 30 ppt, at 30οC and p H 8.1+-0.1 of the study area (Bang Pa Kong river basin) were simulated as far as practicable. 19 d uptake of radiotracers showed that blood cockle did not accumulate 134 Cs and 85 Sr but considerably accumulated 57 Co. Non-linear regression model fitting of a 1-compartment exponential uptake model derived overall weight concentration factors for the whole cockle at saturation of 687.6+-6.23 ml/g for 57 Co. 22 d loss experiment showed that 57 Co is tightly bounded in blood cockle and 63.2+-15.2% retained in the whole body. Loss of 57 Co displayed 2-compartment loss kinetic. The calculated half time for the short and long components of loss model was estimated 1.4 dand 41 d, respectively

Role of Local Infiltration of Tranexamic Acid in Reducing Blood Loss in Peritrochanteric Fracture Surgery in the Elderly Population

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Virani SR

2016-11-01

Full Text Available Introduction: Peritrochanteric fractures are common injuries occurring in elderly patients. Surgeries for these fractures are associated with significant blood loss. Intravenous tranexamic acid has a proven track record in many orthopaedic surgeries including trauma, arthroplasty and spine surgeries. Objective: To study the effect of local subfascial and intramuscular infiltration of tranexamic acid in reducing blood loss and the requirement for blood transfusion in intertrochanteric fracture surgery. Study Design: Single centre prospective analytical study. Materials and Methods: One hundred and thirty seven patients above 65 years of age were included in the study, divided into two groups: the intervention group received subfascial and intramuscular infiltration of 2g tranexamic acid before wound closure and the control group of alternate patients did not receive any tranexamic acid infiltration. The postoperative drain output was recorded, as well as the haemoglobin level and the patients needing blood transfusion. Results and Conclusions: The preoperative and postoperative haemoglobin values were recorded. The mean preoperative haemoglobin was 10.9% and 10.8% (p=0.79 in the trial and control groups respectively. The mean postoperative haemoglobin was 9.5gm% and 9.2gm% (p=0.36 in the two groups. The total postoperative blood loss in the tranexamic acid group and the control group was 190.3ml and 204.3ml respectively (p=0.25. Ten patients (14.9% in the intervention group and 12 patients (17.1% in the control group required blood transfusion. We conclude that tranexamic acid does not play a significant role in reducing postoperative blood loss and blood transfusion when used locally in peritochanteric fracture surgery. However a larger double blinded study comparing various modalities of use of tranexamic acid is needed to conclusively establish its role.

Toriyeh: the Way of Escaping from Telling Lies to Patients

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Ali Reza Alinouri

2015-06-01

Full Text Available Toriyeh means concealing real intention of speech using its parallel and common words so that the listener constructs from speaker's speech a meaning what he/she meant. The purpose of this research is studying jurisprudential dimensions of toriyeh in order to clarify its distinction from lying and related jurisprudential commandments by explanation of the most important discussions about toriyeh. This research was conducted via library method using verses, narratives, jurisprudence sources and decrees by religious authorities. two types of Second type: the speaker`s intention is the outward meaning but the listener misunderstands due to his mental moods. Some of the contemporaries regard the first type as forbidden and they regard the second type to allowable Toriyeh is not equivalent in the meaning with lying and jurists have mentioned narrative-based reasons to prove it. Therefore, in cases of emergency in which man is allowable to tell lie for removing inevitable loss he should use toriyeh as much as possible, and not tell a lie. Of course, toriyeh in the first sense is permissible and if a forbidden thing is conformed to it as a subordinate, it will lose its legality.

[Single intravenous tranexamic acid dose to reduce blood loss in primary total knee replacement].

Science.gov (United States)

Sanz-Reig, J; Parra Ruiz, B; Ferrández Martínez, J; Martínez López, J F

2016-01-01

To evaluate the effectiveness and safety of a single intravenous dose of tranexamic acid in order to reduce blood loss in total knee replacement. Prospective observational study of the administration of tranexamic acid in patients undergoing primary total knee arthroplasty from November 2013 to February 2015, in which an autologous blood recovery system was used. The study included 98 patients, distributed into two groups of 49 patients according to whether or not they received intravenous tranexamic acid. The primary endpoint was the number of patients requiring autologous transfusion from the recovery system autologous blood recovery system. No drop-outs were recorded during follow-up. There were no significant differences between groups as regards the preoperative and hospital variables. The mean preoperative haemoglobin and haematocrit at 24 and 48 hours postoperatively were similar in both groups. The average volume of bleeding in the autologous blood recovery system and estimated average blood loss was lower in patients who had been administered tranexamic acid, with significant differences. No patients in the group that was administered tranexamic acid required blood autotransfusion. The transfusion rate was zero in the two groups. No adverse events related to the administration of tranexamic acid were recorded. Intravenous administration of tranexamic acid, according to the described protocol, has presented a non-autotransfusion or allo-transfusion rate of 100%, with no increased incidence of thrombotic events. Thus, its use in this group of patients is recommended. The indication should be individualized, its use justified in the patient medical records, and informed consent is mandatory. Copyright © 2015 SECOT. Published by Elsevier Espana. All rights reserved.

A new topical hemostatic agent TT-173 reduces blood loss in a sheep model of total knee arthroplasty.

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Centeno, Alberto; Rojas, Santiago; Arias, Belén; Miquel, Ignasi; Sánchez, Pilar; Ureta, Claudia; Rincón, Esther; López, Ramón; Murat, Jesús

2017-12-01

Total knee arthroplasty is associated with blood loss during the intervention and may require allogenic blood transfusion. Treatments such as tranexamic acid and fibrin sealants improved the bleeding control in several clinical trials, but the hemorrhage associated with the intervention is still significant. Thus far, very few studies have evaluated hemostatic treatments in animal models of total knee arthroplasty. This work describes a sheep model of bleeding associated with total knee arthroplasty and investigates a new class of hemostatic treatment based on recombinant tissue factor. Sheep were treated with the anticoagulant heparin, and the joint was accessed by a paramedial incision. Ligaments and menisci were eliminated and femoral condyles and tibia plateau were sectioned exposing the trabecular bone. An intra-articular drain was used to recover and quantify the blood loss during the 90-min period after treatment. The efficacy of one milligram and three milligrams of TT-173 was evaluated and compared with tranexamic acid. The occurrence of analytical alterations and systemic absorption was also investigated. Treatment with TT-173 reduced the blood loss in comparison with control or tranexamic acid. No significant differences were observed between the two doses evaluated. Moreover, a dose of six milligrams of TT-173 did not induce any clinical or analytical alteration, and significant systemic absorption was not observed. Data obtained strongly suggest that TT-173 could be useful in reducing the blood loss associated with total knee arthroplasty and without safety concerns derived from the systemic absorption of the product. Copyright © 2017 Elsevier B.V. All rights reserved.

Telling Feminist Stories

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Clare Hemmings

2009-01-01

Full Text Available This article identifies and analyses the dominant stories that academics tell about the development of Western second wave feminist theory. Through an examination of recent production of interdisciplinary feminist and cultural theory journals, I suggest that despite a rhetorical insistence on multiple feminisms, Western feminist trajectories emerge as startlingly singular. In particular, I am critical of an insistent narrative that sees the development of feminist thought as a relentless march of progress or loss. This dominant approach oversimplifies the complex history of Western feminisms, fixes writers and perspectives within a particular decade, and repeatedly (and erroneously positions poststructuralist feminists as ‘the first’ to challenge the category ‘woman’ as the subject and object of feminist knowledge. Rather than provide a corrective history of Western feminist theory, the article interrogates the techniques through which this dominant story is secured, despite the fact that we (feminist theorists know better. My focus, therefore, is on citation patterns, discursive framings and some of their textual, theoretical and political effects. As an alternative, I suggest a realignment of key theorists purported to provide a critical break in feminist theory with their feminist citational traces, to force a concomitant re-imagining of our historical legacy and our place within it.

Telling time in the Fourth Gospel

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Jerome H. Neyrey

2008-01-01

Full Text Available When we begin the task of telling time in the Fourth Gospel, we bring something not found in any previous study, namely, a model of time articulated by cross- ultural anthropologists (Bordieu, in Pitt-Rivers 1963:55-72, Ayoade, in Wright 1984:71-89. As much as we admire Davies’ study, she has no notes to her chapter on time nor any citations in her bibliography to indicate that she has any conversation partners, much less cultural experts, a deficit to be filled in this study. Learning to tell time entails three theoretical considerations: a definition of time, key classifications of it, and special attention to what the ancients meant by past, present and future. With these lenses we are prepared to do as thorough a study as we can on telling time in the Fourth Gospel. As we consider each classification, we will suggest a brief meaning of it from the experts on time, then present a body of Greco-Roman materials illustrative of the classification, and finally use it to gather and interpret data in John. Proving the native existence of these classifications for telling time in antiquity is essential for readers to have a background against which to compare their usage with that of the Fourth Gospel.

No Effect of a Bipolar Sealer on Total Blood Loss or Blood Transfusion in Nonseptic Revision Knee Arthroplasty-A Prospective Study With Matched Retrospective Controls

DEFF Research Database (Denmark)

Nielsen, Christian Skovgaard; Gromov, Kirill; Jans, Øivind

2017-01-01

deviation, ± 452) mL in the bipolar sealer group vs 1452 (SD, ± 530) mL in the control group (P = .66), nor for blood transfusion rates of 53% and 46% (P = .89), respectively. Four controls were readmitted within 90 days follow-up. CONCLUSION: The use of a bipolar sealer in a TKA revision setting without......BACKGROUND: Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The aim......-five prospectively enrolled patients received treatment with both a bipolar sealer and electrocautery, whereas 26 patients had received treatment with a conventional electrocautery only in the retrospective group. RESULTS: No significant differences were found neither for calculated blood loss, with 1397 (standard...

Tranexamic acid: optimal blood loss management in surface replacement arthroplasty.

Science.gov (United States)

Sassoon, A; Nam, D; Jackups, R; Johnson, S R; Nunley, R M; Barrack, R L

2016-02-01

This study investigated whether the use of tranexamic acid (TXA) decreased blood loss and transfusion related cost following surface replacement arthroplasty (SRA). A retrospective review of patients treated with TXA during a SRA, who did not receive autologous blood (TXA group) was performed. Two comparison groups were established; the first group comprised of patients who donated their own blood pre-operatively (auto group) and the second of patients who did not donate blood pre-operatively (control). Outcomes included transfusions, post-operative haemoglobin (Hgb), complications, and length of post-operative stay. Between 2009 and 2013, 150 patients undergoing SRA were identified for inclusion: 51 in the auto, 49 in the control, and 50 in the TXA group. There were no differences in the pre-operative Hgb concentrations between groups. The mean post-operative Hgb was 11.3 g/dL (9.1 to 13.6) in the auto and TXA groups, and 10.6 g/dL (8.1 to 12.1)in the control group (p = 0.001). Accounting for cost of transfusions, administration of TXA, and length of stay, the cost per patient was $1731, $339, and $185 for the auto, control and TXA groups, respectively. TXA use demonstrated higher post-operative Hgb concentrations when compared with controls and decreased peri-operative costs. Tranexamic acid safely limits allogeneic transfusion, maintains post-operative haemoglobin, and decreases direct and indirect transfusion related costs in surface replacement arthroplasty. ©2016 The British Editorial Society of Bone & Joint Surgery.

TEACHING SPEAKING THROUGH THE IMPLEMENTATION OF STORY TELLING TECHNIQUE BY USING STORY-TELLING

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Purwatiningsih Purwatiningsih

2015-12-01

Full Text Available Learning a language especially English is expected to help students to be able to use it as a means of communication. Communicating is understanding and expressing information, thought and feeling, and expanding science, technology and culture. Communicating ability means being able to understand a discourse, namely being able to understand and produce spoken and written texts through the four language skills: listening, speaking, reading and writing this classroom action research was conducted to solve the students’ problems in speaking. It is to improve the students’ ability in speaking through story-telling technique using picture series in terms of content and delivery of the story. The design of this study is classroom action research which was conducted in two cycles consisting of six meetings. The subjects of this study were students of grade x-9 of MAN 2 Madiun in 2012/2013 academic year. The instruments to collect the data were observation checklists, field notes, speaking task measured using scoring rubrics, and questionnaire. The criteria of success were determined on the basis of the students’ participation in the teaching-learning process, the students’ speaking achievement in terms of score (telling a story individually, and the students’ responses to the implementation of story-telling technique using picture series. The finding of the study indicated that the implementation of the technique was successful in improving the students’ speaking ability, since the criteria of success were achieved. The first criterion was if 70% of the students participate or are actively involved in the teaching and learning process, and the data analysis confirmed that 84% of students were actively involved. Concerning the second criterion was if 70% of the students achieve the score greater than or equal to 75, the finding showed that 81% of the students already achieved scores greater than 75. The last criterion, if 70% of students

Continuous Postoperative Pericardial Flushing: A Pilot Study on Safety, Feasibility, and Effect on Blood Loss

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Johan S.J. Manshanden

2015-09-01

Conclusions: CPPF after cardiac surgery was found to be safe and feasible in this experimental setting. The clinically relevant effect on blood loss needs to be confirmed in a randomized clinical trial.

Can local application of Tranexamic acid reduce post-coronary bypass surgery blood loss? A randomized controlled trial

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Latter David

2009-06-01

Full Text Available Abstract Background Diffuse microvascular bleeding remains a common problem after cardiac procedures. Systemic use of antifibrinolytic reduces the postoperative blood loss. The purpose of this study was to examine the effectiveness of local application of tranexamic acid to reduce blood loss after coronary artery bypass grafting (CABG. Methods Thirty eight patients scheduled for primary isolated coronary artery bypass grafting were included in this double blind, prospective, randomized, placebo controlled study. Tranexamic acid (TA group (19 patients received 1 gram of TA diluted in 100 ml normal saline. Placebo group (19 patients received 100 ml of normal saline only. The solution was purred in the pericardial and mediastinal cavities. Results Both groups were comparable in their baseline demographic and surgical characteristics. During the first 24 hours post-operatively, cumulative blood loss was significantly less in TA group (median of 626 ml compared to Placebo group (median of 1040 ml (P = 0.04. There was no significant difference in the post-op Packed RBCs transfusion between both groups (median of one unit in each (P = 0.82. Significant less platelets transfusion required in TA group (median zero unit than in placebo group (median 2 units (P = 0.03. Apart from re-exploration for excessive surgical bleeding in one patient in TA group, no difference was found in morbidity or mortality between both groups. Conclusion Topical application of tranexamic acid in patients undergoing primary coronary artery bypass grafting led to a significant reduction in postoperative blood loss without adding extra risk to the patient.

Combined Intra-Articular and Intravenous Tranexamic Acid Reduces Blood Loss in Total Knee Arthroplasty

DEFF Research Database (Denmark)

Nielsen, Christian Skovgaard; Jans, Øivind; Ørsnes, Thue

2016-01-01

BACKGROUND: In total knee arthroplasty, both intravenous (IV) and intra-articular (IA) administration of tranexamic acid (TXA) have been shown to reduce blood loss in several randomized controlled trials, although routine use of systemic TXA is considerably more common. However, to our knowledge...

Operative blood loss and the frequency of haemorrhage associated with adenotonsillectomy in children: a double-blind trial of ethamsylate.

Science.gov (United States)

Arora, Y R; Manford, M L

1979-06-01

One hundred children were allocated randomly to receive either ethamsylate (Dicynene) or a placebo before undergoing adenotonsillectomy. Blood loss at operation was estimated from the haemoglobin content of swabs and aspirated fluid. Mean blood loss in the ethamsylate-treated group was not significantly less than in the controls. The frequency of secondary haemorrhage was significantly less in children treated with ethamsylate (P less than 0.01). No side-effects were reported in either group.

Effect of antifibrinolytic drugs on transfusion requirement and blood loss during orthotopic liver transplantation: Results from a single center

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Devi A

2008-01-01

Full Text Available Background: During orthotopic liver transplantation (OLT, activation of the fibrinolytic system can contribute significantly to perioperative bleeding. Prophylactic administration of antifibrinolytic agents has been shown to reduce blood loss and the need for allogenic transfusion. Objective: To study the effect of antifibrinolytics on requirement of blood components, blood loss and operative time during OLT in patients with end stage liver disease, reporting to a single centre. Materials and Methods: Consecutive patients who underwent OLT at this centre during the period February 2003-October 2007 were the subjects of this study. Based on the individual anesthesiologist′s preference, patients were assigned to receive either two million units of aprotinin (AP as a bolus followed by 5,00,000 units/hour or 10 mg/kg tranexamic acid (TAas a bolus followed by 10 mg/kg every six to eight hours, administered from the induction till the end of the surgery. Transfusion policy was standardized in all patients. Intraoperative red cell salvage was done wherever possible. The effect of these two antifibrinolytic drugs on transfusion requirement was evaluated as a whole and in a sub group of patients from each treatment group and compared with a concurrent control group that did not receive antifibrinolytic drugs. Results: Fifty patients (40 M / 10 F, 44 adults, 6 pediatric patients underwent OLT in the study period. Fourteen patients were given AP, 25 patients were given TA and 11 patients did not receive any of the agents(control group. The median volume of total blood components transfused in antifibrinolytic group (n=39 was 4540 ml(0-19,200ml, blood loss 5 l(0.7-35l and operative time 9h (4.5-17h and that of control group(n=11 was 5700 ml(0-15,500ml, 10 l(0.6-25 l and 9h (6.4-15.8h respectively. The median volume of blood transfusions, blood loss and operative time was lesser in AP group(n=14 than that of TA group(n=25. Conclusion: There is definite

Detection of Low-volume Blood Loss: Compensatory Reserve Versus Traditional Vital Signs

Science.gov (United States)

2014-01-01

follows: heart rate (HR), blood pressure (BP), respiratory rate, and oxygen saturation. These vital signs are, however, notoriously unreliable.2,3 As...additional tests using specific equipment.22 Base deficit (BD) is a rapidly and widely available serum laboratory marker of systemic acidosis that...and mortality.23,24 BD can increase, however, because of any derangement causing metabolic acidosis and is not limited to intravascular volume loss

Fecal blood loss in patients with colonic polyps: a comparison of measurements with 51chromium-labeled erythrocytes and with the Haemoccult test

International Nuclear Information System (INIS)

Herzog, P.; Holtermueller, K.H.; Preiss, J.; Fischer, J.; Ewe, K.; Schreiber, H.J.; Berres, M.

1982-01-01

The quantitative determinations of fecal daily blood loss after intravenous administration of 51 Cr-labeled erythrocytes in 44 patients with colonic polyps and in 11 controls were compared with the results of the daily performed Haemoccult test without dietary restrictions. A total of 642 stool specimens was analyzed for 51 Cr loss and the Haemoccult test. The mean fecal daily blood loss in the 34 patients with adenomatous polyps of the descending colon and rectosigmoid was 1.36 +/- 0.14 ml/day (mean +/- SEM), in the 10 patients with polyps of the ascending and transverse colon it was 1.28 +/- 0.31 ml/day, and in the 11 controls 0.62 +/- 0.07 ml/day. There was no positive Haemoccult test in the controls. In fecal specimens from patients with polyps in the descending colon and rectosigmoid containing 2.0-3.99 ml blood/day, the Haemoccult-test was positive in 86%. Fecal specimens from patients with polyps in the ascending colon and transverse colon containing equal blood loss yielded a positive Haemoccult test result in 26%. Thus, the positivity of the Haemoccult test is determined by the fecal daily blood loss and the anatomic location of colonic bleeding sites

The association between low levels of lead in blood and occupational noise-induced hearing loss in steel workers

Energy Technology Data Exchange (ETDEWEB)

Hwang, Yaw-Huei [Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC Rm. 735, 17, Xu-Zhou Rd., Taipei, Taiwan, ROC (China); Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC Rm. 735, 17, Xu-Zhou Rd., Taipei, Taiwan, ROC (China); Chiang, Han-Yueh [Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC Rm. 735, 17, Xu-Zhou Rd., Taipei, Taiwan, ROC (China); Yen-Jean, Mei-Chu [Division of Family Medicine, E-Da Hospital, Taiwan, ROC 1, E-Da Rd., Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung County, Taiwan, ROC (China); I-Shou University, Kaohsiung County, Taiwan, ROC 1, Sec. 1, Syuecheng Rd., Da-Shu Shiang, Kaohsiung County, Taiwan, ROC (China); Wang, Jung-Der, E-mail: jdwang@ntu.edu.tw [Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC Rm. 735, 17, Xu-Zhou Rd., Taipei, Taiwan, ROC (China); Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC Rm. 735, 17, Xu-Zhou Rd., Taipei, Taiwan, ROC (China); Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, ROC No. 1, Chang-Teh St., Taipei, Taiwan, ROC (China)

2009-12-15

As the use of leaded gasoline has ceased in the last decade, background lead exposure has generally been reduced. The aim of this study was to examine the effect of low-level lead exposure on human hearing loss. This study was conducted in a steel plant and 412 workers were recruited from all over the plant. Personal information such as demographics and work history was obtained through a questionnaire. All subjects took part in an audiometric examination of hearing thresholds, for both ears, with air-conducted pure tones at frequencies of 500, 1000, 2000, 3000, 4000, 6000 and 8000 Hz. Subjects' blood samples were collected and analyzed for levels of manganese, copper, zinc, arsenic, cadmium and lead with inductive couple plasma-mass spectrometry. Meanwhile, noise levels in different working zones were determined using a sound level meter with A-weighting network. Only subjects with hearing loss difference of no more than 15 dB between both ears and had no congenital abnormalities were included in further data analysis. Lead was the only metal in blood found significantly correlated with hearing loss for most tested sound frequencies (p < 0.05 to p < 0.0001). After adjustment for age and noise level, the logistic regression model analysis indicated that elevated blood lead over 7 {mu}g/dL was significantly associated with hearing loss at the sound frequencies of 3000 through 8000 Hz with odds ratios raging from 3.06 to 6.26 (p < 0.05 {approx} p < 0.005). We concluded that elevated blood lead at level below 10 {mu}g/dL might enhance the noise-induced hearing loss. Future research needs to further explore the detailed mechanism.

The association between low levels of lead in blood and occupational noise-induced hearing loss in steel workers

International Nuclear Information System (INIS)

Hwang, Yaw-Huei; Chiang, Han-Yueh; Yen-Jean, Mei-Chu; Wang, Jung-Der

2009-01-01

As the use of leaded gasoline has ceased in the last decade, background lead exposure has generally been reduced. The aim of this study was to examine the effect of low-level lead exposure on human hearing loss. This study was conducted in a steel plant and 412 workers were recruited from all over the plant. Personal information such as demographics and work history was obtained through a questionnaire. All subjects took part in an audiometric examination of hearing thresholds, for both ears, with air-conducted pure tones at frequencies of 500, 1000, 2000, 3000, 4000, 6000 and 8000 Hz. Subjects' blood samples were collected and analyzed for levels of manganese, copper, zinc, arsenic, cadmium and lead with inductive couple plasma-mass spectrometry. Meanwhile, noise levels in different working zones were determined using a sound level meter with A-weighting network. Only subjects with hearing loss difference of no more than 15 dB between both ears and had no congenital abnormalities were included in further data analysis. Lead was the only metal in blood found significantly correlated with hearing loss for most tested sound frequencies (p < 0.05 to p < 0.0001). After adjustment for age and noise level, the logistic regression model analysis indicated that elevated blood lead over 7 μg/dL was significantly associated with hearing loss at the sound frequencies of 3000 through 8000 Hz with odds ratios raging from 3.06 to 6.26 (p < 0.05 ∼ p < 0.005). We concluded that elevated blood lead at level below 10 μg/dL might enhance the noise-induced hearing loss. Future research needs to further explore the detailed mechanism.

EFFICACY OF TRANEXAMIC ACID IN DECREASING BLOOD LOSS DURING AND AFTER CAESAREAN SECTION IN MULTIGRAVIDA PARTURIENTS: A CASE CONTROLLED PROSPECTIVE STUDY

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Gunavathi Kandappan

2016-06-01

Full Text Available OBJECTIVES To study the efficacy of Tranexamic acid in reducing blood loss during and after the lower segment caesarean section in Multigravida parturients. METHODOLOGY A case controlled prospective study was conducted in 50 multigravida parturient women undergoing elective lower segment caesarean section in our hospital after getting Institutional Ethical Committee approval, over a period of two months. 25 of them were given Tranexamic acid 15 mg/kg immediately before caesarean section. Blood loss was collected and measured during two periods. The first period was from placental delivery to end of LSCS and the second from the end LSCS to 2 hours postpartum. RESULTS Tranexamic acid significantly reduces the quantity of blood loss from the end of LSCS to 2 hours post-partum in multigravida parturients. No complications or side effects are noted in both the groups. CONCLUSION Tranexamic acid significantly reduces the amount of blood loss during and after the lower segment caesarean section in multigravida parturients and its use was not associated with any side effects or complications.

Gamers Telling Stories

DEFF Research Database (Denmark)

Albrechtslund, Anne-Mette Bech

2010-01-01

of Warcraft , make sense of their gaming experience, and how they build and uphold a community identity by telling stories online. I argue that in studying and conceptualizing these types of texts through the proposed theoretical framework, we can gain insights into the process of the formation of meaning...

Productivity loss due to premature mortality caused by blood cancer: a study based on patients undergoing stem cell transplantation.

Science.gov (United States)

Ortega-Ortega, Marta; Oliva-Moreno, Juan; Jiménez-Aguilera, Juan de Dios; Romero-Aguilar, Antonio; Espigado-Tocino, Ildefonso

2015-01-01

Stem cell transplantation has been used for many years to treat haematological malignancies that could not be cured by other treatments. Despite this medical breakthrough, mortality rates remain high. Our purpose was to evaluate labour productivity losses associated with premature mortality due to blood cancer in recipients of stem cell transplantations. We collected primary data from the clinical histories of blood cancer patients who had undergone stem cell transplantation between 2006 and 2011 in two Spanish hospitals. We carried out a descriptive analysis and calculated the years of potential life lost and years of potential productive life lost. Labour productivity losses due to premature mortality were estimated using the Human Capital method. An alternative approach, the Friction Cost method, was used as part of the sensitivity analysis. Our findings suggest that, in a population of 179 transplanted and deceased patients, males and people who die between the ages of 30 and 49 years generate higher labour productivity losses. The estimated loss amounts to over €31.4 million using the Human Capital method (€480,152 using the Friction Cost method), which means an average of €185,855 per death. The highest labour productivity losses are produced by leukaemia. However, lymphoma generates the highest loss per death. Further efforts are needed to reduce premature mortality in blood cancer patients undergoing transplantations and reduce economic losses. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Blood profile of proteins and steroid hormones predicts weight change after weight loss with interactions of dietary protein level and glycemic index.

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Ping Wang

2011-02-01

Full Text Available Weight regain after weight loss is common. In the Diogenes dietary intervention study, high protein and low glycemic index (GI diet improved weight maintenance.To identify blood predictors for weight change after weight loss following the dietary intervention within the Diogenes study.Blood samples were collected at baseline and after 8-week low caloric diet-induced weight loss from 48 women who continued to lose weight and 48 women who regained weight during subsequent 6-month dietary intervention period with 4 diets varying in protein and GI levels. Thirty-one proteins and 3 steroid hormones were measured.Angiotensin I converting enzyme (ACE was the most important predictor. Its greater reduction during the 8-week weight loss was related to continued weight loss during the subsequent 6 months, identified by both Logistic Regression and Random Forests analyses. The prediction power of ACE was influenced by immunoproteins, particularly fibrinogen. Leptin, luteinizing hormone and some immunoproteins showed interactions with dietary protein level, while interleukin 8 showed interaction with GI level on the prediction of weight maintenance. A predictor panel of 15 variables enabled an optimal classification by Random Forests with an error rate of 24±1%. A logistic regression model with independent variables from 9 blood analytes had a prediction accuracy of 92%.A selected panel of blood proteins/steroids can predict the weight change after weight loss. ACE may play an important role in weight maintenance. The interactions of blood factors with dietary components are important for personalized dietary advice after weight loss.ClinicalTrials.gov NCT00390637.

Topical fibrin sealant versus intravenous tranexamic acid for reducing blood loss following total knee arthroplasty: A systematic review and meta-analysis.

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Gao, Fuqiang; Ma, Jinhui; Sun, Wei; Guo, Wanshou; Li, Zirong; Wang, Weiguo

2016-08-01

Efficacy and safety of topical application of a fibrin sealant (FS) compared with intravenous administration of tranexamic acid (TXA) for reducing blood loss after total knee arthroplasty (TKA) is controversial. We undertook a meta-analysis to compare the effects of topical application of FS or intravenous administration of TXA on blood loss after TKA. PubMed, Medline, Embase, Web of Science and the Cochrane Library were searched to identify studies comparing FS with TXA for TKA patients. The mean difference (MD) of blood loss, hemoglobin value, and odds ratios (ORs) of transfusion requirements and adverse events in FS and TXA groups were pooled throughout the study. Relevant data were analyzed using RevMan v5.3. Five studies involving 359 patients were included (181 FS vs. 178 TXA). TXA use had a significantly lower prevalence of blood transfusion (OR = 3.14; 95% confidence interval (CI), 1.67 to 5.90, P = 0.0004) and higher hemoglobin level (MD = -1.23; 95% CI, -2.19 to -0.27, P = 0.01) than FS in the early postoperative period. No significant difference was seen in total blood loss between the two groups (MD = 198.06; 95% CI, -267.45 to 663.57; P = 0.40). There were no significant differences in adverse events, superficial infections, or deep-vein thrombosis among study groups. Our meta-analysis suggests that intravenous administration of TXA for patients undergoing TKA may reduce blood-transfusion requirements and maintain higher hemoglobin levels compared with topical application of FS in the early postoperative period. There were no significant differences in total calculated blood loss and prevalence of complications between the two groups. However, owing to the variation of included studies, no firm conclusions can be drawn. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

The Effect of Telling Lies on Belief in the Truth

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Danielle Polage

2017-11-01

Full Text Available The current study looks at the effect of telling lies, in contrast to simply planning lies, on participants’ belief in the truth. Participants planned and told a lie, planned to tell a lie but didn’t tell it, told an unplanned lie, or neither planned nor told a lie (control about events that did not actually happen to them. Participants attempted to convince researchers that all of the stories told were true. Results show that telling a lie plays a more important role in inflating belief scores than simply preparing the script of a lie. Cognitive dissonance may lead to motivated forgetting of information that does not align with the lie. This research suggests that telling lies may lead to confusion as to the veracity of the lie leading to inflated belief scores.

Children's Reasoning about Lie-Telling and Truth-Telling in Politeness Contexts

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Heyman, Gail D.; Sweet, Monica A.; Lee, Kang

2009-01-01

Children's reasoning about lying and truth-telling was examined among participants ages 7-11 (total N = 181) with reference to conflicts between being honest and protecting the feelings of others. In Study 1, participants showed different patterns of evaluation and motivational inference in politeness contexts vs. transgression contexts: in…

Continuing versus discontinuing antiplatelet drugs, vasodilators, and/or cerebral ameliorators on perioperative total blood loss in total knee arthroplasty without pneumatic tourniquet

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Sachiyuki Tsukada, MD

2018-03-01

Full Text Available Background: Although studies have supported the utility of perioperative continuation of antiplatelet drugs, vasodilators, and cerebral ameliorators in most procedures, no study compared total volume of blood loss after total knee arthroplasty (TKA in patients continuing and discontinuing these drugs. Methods: We retrospectively reviewed 266 consecutive patients undergoing TKA, and included 67 patients (25.2% taking antiplatelet drugs, vasodilators, or cerebral ameliorators in this study. All TKAs were performed without a pneumatic tourniquet. The primary outcome was perioperative total blood loss calculated from blood volume and change in hemoglobin. As subgroup analysis, we compared perioperative total blood loss in patients taking antiplatelet drugs. Results: There was no significant difference between the continuing group (n = 38 and discontinuing group (n = 29 in terms of the perioperative total blood loss (1025 ± 364 vs 1151 ± 327 mL, respectively; mean difference 126 mL; 95% confidence interval −45 to 298 mL; P = .15. No major bleeding or thrombotic events occurred in either group until postoperative 3-month follow-up. In patients taking antiplatelet drugs (n = 51, no significant difference was observed in the total blood loss between the continuing group (n = 30 and discontinuing group (n = 21 (1056 ± 287 vs 1151 ± 305 mL, respectively; mean difference 95 mL; 95% confidence interval −75 to 264 mL; P = .27. Conclusions: No significant differences in terms of perioperative total blood loss were observed between patients continuing and discontinuing study drugs. Continuing these drugs may be preferable in the perioperative period of TKA. Keywords: Knee, Primary arthroplasty, Bleeding events, Thrombotic events, Noncardiac surgery

The effect of three different doses of tranexamic acid on blood loss after cardiac surgery with mild systemic hypothermia (32 degrees C).

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Karski, J M; Dowd, N P; Joiner, R; Carroll, J; Peniston, C; Bailey, K; Glynn, M F; Teasdale, S J; Cheng, D C

1998-12-01

Prophylactic administration of tranexamic acid (TA), an antifibrinolytic agent, decreases bleeding after cardiac surgery with systemic hypothermia (25 degrees C to 29 degrees C). Warmer systemic temperatures during cardiopulmonary bypass (CPB) may reduce bleeding and thus alter the requirement for TA. The effect of three different doses of TA on bleeding after cardiac surgery with mild systemic hypothermia (32 degrees C) is evaluated. Double-blind, prospective, randomized study. University hospital. One hundred fifty adult patients undergoing aortocoronary bypass or valvular cardiac surgery. Patients received TA, 50 (n = 50), 100 (n = 50), or 150 (n = 50) mg/kg intravenously before CPB with mild systemic hypothermia. Blood loss through chest drains over 6, 12, and 24 hours after surgery and total hemoglobin loss were measured. Autotransfused blood, transfused banked blood and blood products, and coagulation profiles were measured. Analysis of variance on log-transformed data for blood loss and confidence intervals (CIs) of 0.95 were calculated and transformed to milliliters of blood. No patient was re-explored for bleeding. Blood loss at 6 hours was statistically greater in the 50-mg/kg group compared with the other two groups (p = 0.03; p = 0.02). Total hemoglobin loss was statistically greater in the 50-mg/kg group compared with the 150-mg/kg group (p = 0.04). There was no statistical difference in blood tranfusion rate or coagulation profiles among the three groups. However, preoperative hemoglobin level was statistically lower in the 150-mg/kg group compared with the other two groups (p = 0.01). Of the three doses of TA studied, the most efficacious and cost-effective dose to reduce bleeding after cardiac surgery with mild hypothermic systemic perfusion is 100 mg/kg.

Predicting Factors for Allogeneic Blood Transfusion and Excessive Postoperative Blood Loss after Single Low-Dosage Intra-Articular Tranexamic Acid Application in Total Knee Replacement

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Paphon Sa-ngasoongsong

2017-01-01

Full Text Available Background. Recently, intra-articular tranexamic acid (IA-TXA application has become a popular method for perioperative blood loss (PBL reduction in total knee replacement (TKR. Nevertheless, through our knowledge, no previous studies had shown the correlation perioperative factors and the risk of excessive PBL or need of blood transfusion (BT after IA-TXA. Materials and Methods. A retrospective study was conducted in patients underwent 299 primary TKRs, using IA-TXA, during 2-year period (2013-2014. Patient’s characteristic and perioperative data were reviewed and collected. PBL was measured as total hemoglobin loss (THL, estimated total blood loss (ETBL, and drainage volume per kg (DV/kg. Excessive PBL was defined as PBL that exceeded 90th percentile. Results. From multivariate analysis, low preoperative hemoglobin (Hb level and body mass index (BMI were the significant predictors of postoperative BT (p<0.0001 and 0.003, resp.. Excessive THL significant associated with preoperative Hb (p<0.0001. Excessive ETBL significantly associated with preoperative Hb, height, preoperative range-of-motion, and creatinine clearance (p<0.05 all. Low BMI and large prosthesis size were the significant predictors of excessive DV/kg (p=0.0001 and 0.002, resp.. Conclusions. Low preoperative Hb and BMI were the significant risks of postoperative transfusion after TKR with IA-TXA. Moreover, multiple perioperative factors could result in higher PBL.

A randomized trial of the effect of low dose epinephrine infusion in addition to tranexamic acid on blood loss during total hip arthroplasty

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Jans, Ø.; Grevstad, U.; Mandoe, H.

2016-01-01

procedure. Intraoperative tranexamic acid (TXA) was administered to all subjects. The primary outcome was intraoperative blood loss directly measured by drains and weighing swabs. Secondary outcome was total blood loss at 24 h postoperatively calculated using the Gross formula. Results: Of 106 subjects...

Effect of Tranexamic Acid on Blood Loss, D-Dimer, and Fibrinogen Kinetics in Adult Spinal Deformity Surgery.

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Pong, Ryan P; Leveque, Jean-Christophe A; Edwards, Alicia; Yanamadala, Vijay; Wright, Anna K; Herodes, Megan; Sethi, Rajiv K

2018-05-02

Antifibrinolytics such as tranexamic acid reduce operative blood loss and blood product transfusion requirements in patients undergoing surgical correction of scoliosis. The factors involved in the unrelenting coagulopathy seen in scoliosis surgery are not well understood. One potential contributor is activation of the fibrinolytic system during a surgical procedure, likely related to clot dissolution and consumption of fibrinogen. The addition of tranexamic acid during a surgical procedure may mitigate the coagulopathy by impeding the derangement in D-dimer and fibrinogen kinetics. We retrospectively studied consecutive patients who had undergone surgical correction of adult spinal deformity between January 2010 and July 2016 at our institution. Intraoperative hemostatic data, surgical time, estimated blood loss, and transfusion records were analyzed for patients before and after the addition of tranexamic acid to our protocol. Each patient who received tranexamic acid and met inclusion criteria was cohort-matched with a patient who underwent a surgical procedure without tranexamic acid administration. There were 17 patients in the tranexamic acid cohort, with a mean age of 60.7 years, and 17 patients in the control cohort, with a mean age of 60.9 years. Estimated blood loss (932 ± 539 mL compared with 1,800 ± 1,029 mL; p = 0.005) and packed red blood-cell transfusions (1.5 ± 1.6 units compared with 4.0 ± 2.1 units; p = 0.001) were significantly lower in the tranexamic acid cohort. In all single-stage surgical procedures that met inclusion criteria, the rise of D-dimer was attenuated from 8.3 ± 5.0 μg/mL in the control cohort to 3.3 ± 3.2 μg/mL for the tranexamic acid cohort (p tranexamic acid cohort to 60.6 ± 35.1 mg/dL (p = 0.004). In patients undergoing spinal surgery, intravenous administration of tranexamic acid is effective at reducing intraoperative blood loss. Monitoring of D-dimer and fibrinogen during spinal surgery suggests that tranexamic acid

The physiology of blood loss and shock: New insights from a human laboratory model of hemorrhage.

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Schiller, Alicia M; Howard, Jeffrey T; Convertino, Victor A

2017-04-01

The ability to quickly diagnose hemorrhagic shock is critical for favorable patient outcomes. Therefore, it is important to understand the time course and involvement of the various physiological mechanisms that are active during volume loss and that have the ability to stave off hemodynamic collapse. This review provides new insights about the physiology that underlies blood loss and shock in humans through the development of a simulated model of hemorrhage using lower body negative pressure. In this review, we present controlled experimental results through utilization of the lower body negative pressure human hemorrhage model that provide novel insights on the integration of physiological mechanisms critical to the compensation for volume loss. We provide data obtained from more than 250 human experiments to classify human subjects into two distinct groups: those who have a high tolerance and can compensate well for reduced central blood volume (e.g. hemorrhage) and those with low tolerance with poor capacity to compensate.We include the conceptual introduction of arterial pressure and cerebral blood flow oscillations, reflex-mediated autonomic and neuroendocrine responses, and respiration that function to protect adequate tissue oxygenation through adjustments in cardiac output and peripheral vascular resistance. Finally, unique time course data are presented that describe mechanistic events associated with the rapid onset of hemodynamic failure (i.e. decompensatory shock). Impact Statement Hemorrhage is the leading cause of death in both civilian and military trauma. The work submitted in this review is important because it advances the understanding of mechanisms that contribute to the total integrated physiological compensations for inadequate tissue oxygenation (i.e. shock) that arise from hemorrhage. Unlike an animal model, we introduce the utilization of lower body negative pressure as a noninvasive model that allows for the study of progressive

Experimental studies on the blood loss and intake of 51Cr labelled red cells by Clonorchis sinensis in rabbits

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Lee, M.J.; Kim, J.R.; Rim, H.J.

1982-01-01

Experimental study was carried out to observe the blood loss due to the ingestion of host blood by Colonorchis sinensis in the rabbits by using chromium radioisotope 51 Cr. On the other hand, in order to confirm the blood intake activity by the worms, the radioactivity was measured on blood, bile juice and flukes removed from the bile ducts of the rabbits experimentally infected with C. sinensis. (Author)

The effect of prophylactic intravenous tranexamic acid on blood loss after vaginal delivery in women at low risk of postpartum haemorrhage: a double-blind randomised controlled trial.

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Mirghafourvand, Mojgan; Mohammad-Alizadeh, Sakineh; Abbasalizadeh, Fatemeh; Shirdel, Mina

2015-02-01

To determine the effect of prophylactic tranexamic acid (TA) on calculated and measured blood loss after vaginal delivery in women at low risk of postpartum haemorrhage. In this double-blind randomised controlled trial, 120 women with a singleton pregnancy were randomly allocated to receive either one gram intravenous TA or placebo in addition to 10 IU oxytocin after delivery of the fetus. Calculated blood loss was determined based on haematocrit before delivery and 12-24 h postdelivery. The quantity of blood loss was measured during two time periods: from delivery of the fetus to placental expulsion and from placental expulsion to the end of the second hour after childbirth. The mean (SD) calculated total blood loss (519 (320) vs 659 (402) mL, P = 0.036) and measured blood loss from placental delivery to 2 h postpartum (69 (39) vs 108 (53) mL, P  1000 mL was lower in the TA group (7% vs 18%, P = 0.048). Prophylactic TA reduces blood loss after vaginal delivery in women with a low risk of postpartum haemorrhage. The prophylactic use of TA may reduce blood loss complications and enhance maternal health. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

NARRATIVE STRUCTURES ACROSS TELLINGS OF THE SAME “GOOD” TEACHING EXPERIENCE

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Joseph Ernest Mambu

2013-01-01

Full Text Available Abstract: This paper investigates narrative structures of the same story told three times by an advanced male EFL (i.e., English as a foreign language learner. By narrative structures in this paper, I mean the sequence of narrative, especially in the light of the Labovian tradition of narrative analysis (Labov & Waletzky, 1997; Labov, 1972; Wu, 1995, and how each narrative component (e.g., abstract, orientation, complicating action, result/resolution, evaluation, and coda is fleshed out within and across tellings. Data analysis in this paper will attempt to answer the question of the extent to which these structures in one telling are similar or different across tellings of the same “good” experiences (cf. Chafe, 1998; Polanyi, 1981; Prior, 2011. In Labov’s (1972 data, “bad” near-death experiences were elicited, and yet a “good” result is conspicuous: death was overcome. Being asked to tell his “good” story, the EFL learner concentrated on the favorable experience. This said, some hints at unfavorable experiences—typically filling in the complicating action slot, like in telling bad or embarrassing stories (as in Wu, 1995—also emerged, which make analysis of “good” experiences worthwhile in its own right. In particular, it can be hypothesized that the underlying structure of good experiences fits into the Labovian narrative structure with some nuanced variations across tellings. The findings support the hypothesis and suggest that repeated tellings of the same story provided the speaker in this study ample room to reflect on his past experience such that subsequent tellings can be more engaging than the first (or previous telling.

Efficacy of tranexamic acid in reducing blood loss in posterior lumbar spine surgery for degenerative spinal stenosis with instability: a retrospective case control study

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Endres Stefan

2011-11-01

Full Text Available Abstract Background Degenerative spinal stenosis and instability requiring multilevel spine surgery has been associated with large blood losses. Factors that affect perioperative blood loss include time of surgery, surgical procedure, patient height, combined anterior/posterior approaches, number of levels fused, blood salvage techniques, and the use of anti-fibrinolytic medications. This study was done to evaluate the efficacy of tranexamic acid in reducing blood loss in spine surgery. Methods This retrospective case control study includes 97 patients who had to undergo surgery because of degenerative lumbar spinal stenosis and instability. All operations included spinal decompression, interbody fusion and posterior instrumentation (4-5 segments. Forty-six patients received 1 g tranexamic acid intravenous, preoperative and six hours and twelve hours postoperative; 51 patients without tranexamic acid administration were evaluated as a control group. Based on the records, the intra- and postoperative blood losses were measured by evaluating the drainage and cell saver systems 6, 12 and 24 hours post operation. Additionally, hemoglobin concentration and platelet concentration were reviewed. Furthermore, the number of red cell transfusions given and complications associated with tranexamic acid were assessed. Results The postoperative hemoglobin concentration demonstrated a statistically significant difference with a p value of 0.0130 showing superiority for tranexamic acid use (tranexamic acid group: 11.08 g/dl, SD: 1.68; control group: 10.29 g/dl, SD: 1.39. The intraoperative cell saver volume and drainage volume after 24 h demonstrated a significant difference as well, which indicates a less blood loss in the tranexamic acid group than the control group. The postoperative drainage volume at12 hours showed no significant differences; nor did the platelet concentration Allogenic blood transfusion (two red cell units was needed for eight patients

The reversible P2Y12 antagonist ACT-246475 causes significantly less blood loss than ticagrelor at equivalent antithrombotic efficacy in rat.

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Rey, Markus; Kramberg, Markus; Hess, Patrick; Morrison, Keith; Ernst, Roland; Haag, Franck; Weber, Edgar; Clozel, Martine; Baumann, Martine; Caroff, Eva; Hubler, Francis; Riederer, Markus A; Steiner, Beat

2017-10-01

The P2Y 12 receptor is a validated target for prevention of major adverse cardiovascular events in patients with acute coronary syndrome. The aim of this study was to compare two direct-acting, reversible P2Y 12 antagonists, ACT-246475 and ticagrelor, in a rat thrombosis model by simultaneous quantification of their antithrombotic efficacy and surgery-induced blood loss. Blood flow velocity was assessed in the carotid artery after FeCl 3 -induced thrombus formation using a Doppler flow probe. At the same time, blood loss after surgical wounding of the spleen was quantified. Continuous infusions of ACT-246475 and ticagrelor prevented the injury-induced reduction of blood flow in a dose-dependent manner. High doses of both antagonists normalized blood flow and completely abolished thrombus formation as confirmed by histology. Intermediate doses restored baseline blood flow to ≥65%. However, ACT-246475 caused significantly less increase of blood loss than ticagrelor; the difference in blood loss was 2.6-fold (P ACT-246475 and ticagrelor on vascular tone. At concentrations needed to achieve maximal antithrombotic efficacy, ticagrelor compared with ACT-246475 significantly increased carotid blood flow velocity in vivo (P = 0.003), induced vasorelaxation of precontracted rat femoral arteries, and inhibited contraction of femoral artery induced by electrical field stimulation or by phenylephrine. Overall, ACT-246475 showed a significantly wider therapeutic window than ticagrelor. The absence of vasodilatory effects due to high selectivity of ACT-246475 for P2Y 12 provides potential arguments for the observed safety advantage of ACT-246475 over ticagrelor. © 2017 The Authors. Pharmacology Research & Perspectives published by John Wiley & Sons Ltd, British Pharmacological Society and American Society for Pharmacology and Experimental Therapeutics.

Tranexamic acid for control of blood loss in bilateral total knee replacement in a single stage

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Mandeep S Dhillon

2011-01-01

Full Text Available Background: Tranexamic acid (TEA reduces blood loss and red cell transfusions in patients undergoing unilateral total knee arthroplasty (TKA. However, there is not much literature regarding the use of TEA in patients undergoing bilateral TKA in a single stage and the protocols for administration of TEA in such patients are ill-defined. Materials and Methods: We carried out a case control study evaluating the effect of TEA on postoperative hemoglobin (Hb, total drain output, and number of blood units transfused in 52 patients undergoing bilateral TKA in a single stage, and compared it with 56 matched controls who did not receive TEA. Two doses of TEA were administered in doses of 10 mg / kg each (slow intravenous (IV infusion, with the first dose given just before tourniquet release of the first knee and the second dose three hours after the first one. Results: A statistically significant reduction in the total drain output and requirement of allogenic blood transfusion in cases who received TEA, as compared to the controls was observed. The postoperative Hb and Hb at the time of discharge were found to be lower in the control group, and this result was found to be statistically significant. Conclusion: TEA administered in patients undergoing single stage bilateral TKA helped reduce total blood loss and decreased allogenic blood transfusion requirements. This might be particularly relevant, where facilities such as autologous reinfusion might not be available.

The efficacy of bipolar sealer on blood loss in spine surgery: a meta-analysis.

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Lan, Tao; Hu, Shi-Yu; Yang, Xin-Jian; Chen, Yang; Qiu, Yi-Yan; Guo, Wei-Zhuang; Lin, Jian-Ze; Ren, Kai

2017-07-01

The purpose of this meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to gather data to evaluate the efficacy and safety of bipolar sealer versus standard electrocautery in the management of spinal disease. The electronic databases including Embase, PubMed and Cochrane library were searched to identify relevant studies published from the time of the establishment of these databases up to January 2017. The primary outcomes were total blood loss, requirement of transfusion (rate and amount), and operation time. The secondary outcomes were length of hospital stay and postoperative wound infection. Data analysis was conducted with RevMan 5.3 software. A total of five studies involving 500 patients (261 patients in the BS group and 239 in the control group) were included in the meta-analysis. The pooled results revealed that application of bipolar sealer could decrease the total blood loss in spine surgery [WMD = -467.49, 95% CI (685.47 to -249.51); p SMD = -0.36, 95% CI (-0.60 to -0.13), p infection [OR = 0.88, 95% CI (0.31-2.48), p = 0.81; I 2  = 0.0%] between both groups. The available evidence suggests that bipolar sealer is superior to standard electrocautery with less blood loss, shorter operation time and less transfusion requirement. There is no significant difference between both groups regarding length of hospitalization and wound infection. Hence, bipolar sealer is recommended in spine surgery. Because of the limitation of our study, more well-designed RCTs with large sample are required to provide further evidence of safety and efficacy between bipolar sealer and standard electrocautery in the treatment of spinal disease.

Tellings, Retellings, and Tellings Within Tellings: The Structuring and Organization of Narrative in Kuna Indian Discourse. Sociolinguistic Working Paper Number 83.

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Sherzer, Joel

A system of classification for tellings and retellings by Panama's Kuna Indians reveals the dimensions of their structure and function, textually, contextually, strategically, and ethnographically. Kuna verbal life can be characterized in terms of three distinct ritual-ceremonial traditions marked by three distinct languages, settings, sets of…

Comparison of Two Methods of Bolus and Infusion of Tranexamic Acid in Reduction of Blood Loss in Total Knee Arthroplasty

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Mohammadreza Moshari

2018-01-01

Full Text Available AbstractBackground: So far, many studies have been performed to determine the optimal dose and regimen of tranexamic acid to reduce preoperative and postoperative blood loss in primary total knee arthroplasty. In the present study, two different methods of administration (bolus and infusion, were compared.Materials and Methods: Forty patients were randomized in the two groups (A and B of 20 patients each. All patients received 500 mg tranexamic acid before inflation of tourniquet. Group A (mean age, 64± 6.1 years received 500 mg tranexamic acid 10 minutes before loosening of tourniquet and group B (mean age, 63.5 ± 7.7 years received 500 mg tranexamic acid through IV infusion during 6 hours from the time of tourniquet loosening (total dose of TA, 1 g in both groups. Intraoperative blood loss,postoperative drainage (in 6 and 12 hours, blood transfusion (in 48 hours, and decrease in hematocrit and hemoglobin (6 and 12 hours later, were compared between the two groups.Results: The patients in group B had lower intra- and postoperative blood loss in 6 and 12 hours and also had lower decrease in hemoglobin, and their packed cell transfusion rate was significantly lower compared to the group A.Conclusion: The findings of this study indicated that infusion administration of tranexamic acid in primary total knee arthroplasty, was more effective in the reduction of perioperative blood loss as well as need for blood transfusion in 48 hours.

Comparative study of topical vs. intravenous tranexamic acid regarding blood loss in total knee arthroplasty

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Ari Zekcer

Full Text Available ABSTRACT Objective: To compare topical vs. intravenous tranexamic acid (TA in total knee arthroplasty regarding blood loss and transfusion., Methods: Ninety patients were randomized to receive TA intravenously (20 mg/kg in 100 mL of saline; group IV, topically (1.5 g in 50 mL of saline, sprayed over the operated site, before release of the tourniquet; topical group, or intravenous saline (100 mL with anesthesia; control group. The volume of drained blood in 48, h, the amount of transfused blood, and the serum levels of hemoglobin and hematocrit before and after surgery were evaluated., Results: The groups were similar for gender, age, weight, laterality, and preoperative hemoglobin and hematocrit levels (p> 0.2. The hemoglobin level dropped in all groups when comparing the preoperative and the 48-h evaluations: the control group decreased 3.8 mg/dL on average, while the IV, group had a decrease of 3.0, and the topical group, of 3.2 (p= 0.019. The difference between the control and IV, groups was confirmed by Bonferroni test (p= 0.020. The difference between the control group and the topical group was not significant (p= 0.130, although there was less reduction in hemoglobin in the topical group; the comparison between the IV, group and the topical group was also not significant (p= 1.000. Conclusion: Using topic and IV, tranexamic acid decreased blood loss and the need for transfusion in total knee arthroplasty. Topical application showed results similar to IV use regarding the need for blood transfusion, but without the possible side effects of IV, administration.

Experimental studies on the blood loss and intake of /sup 51/Cr labelled red cells by Clonorchis sinensis in rabbits

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Lee, M.J.; Kim, J.R.; Rim, H.J. (Korea Univ, Seoul (Republic of Korea). Coll. of Medicine)

1982-03-01

Experimental study was carried out to observe the blood loss due to the ingestion of host blood by Colonorchis sinensis in the rabbits by using chromium radioisotope /sup 51/Cr. On the other hand, in order to confirm the blood intake activity by the worms, the radioactivity was measured on blood, bile juice and flukes removed from the bile ducts of the rabbits experimentally infected with C. sinensis.

Effects of Clonidine Premedication on Intraoperative Blood Loss in Patients With and Without Opium Addiction During Elective Femoral Fracture Surgeries.

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Ommi, Davood; Teymourian, Houman; Zali, Alireza; Ashrafi, Farzad; Jabbary Moghaddam, Morteza; Mirkheshti, Alireza

2015-08-01

Opium is an addictive agent and one of the most common narcotics With great challenges of intraoperative hemodynamic instabilities. The current study aimed to assess the effects of clonidine on intraoperative blood loss in patients with and without opium addiction in femoral fracture surgeries. In a randomized clinical trial, 160 candidates for elective femoral fracture operations under general anesthesia were divided into four groups of 40 subjects: group 1 (placebo 1), subjects without addiction received placebo 90 minutes before the operation; group 2 (placebo 2), patients with opium addiction received placebo as group 1; group 3 (Clonidine 1), patients without addiction received clonidine 90 minutes before the operation and group 4 (Clonidine 2), patients with opium addiction received clonidine as premedication. Intraoperative blood loss in clonidine recipient groups, patients with and without addiction, was less than that of the placebos (both P values opium addiction. Premedication with clonidine to decrease intraoperative blood loss can be more effective in patients with opium addiction than the ones without addiction.

Predictive Value of Intraoperative Thromboelastometry for the Risk of Perioperative Excessive Blood Loss in Infants and Children Undergoing Congenital Cardiac Surgery: A Retrospective Analysis.

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Kim, Eunhee; Shim, Haeng Seon; Kim, Won Ho; Lee, Sue-Young; Park, Sun-Kyung; Yang, Ji-Hyuk; Jun, Tae-Gook; Kim, Chung Su

2016-10-01

Laboratory hemostatic variables and parameters of rotational thromboelastometry (ROTEM) were evaluated for their ability to predict perioperative excessive blood loss (PEBL) after congenital cardiac surgery. Retrospective and observational. Single, large university hospital. The study comprised 119 children younger than 10 years old undergoing congenital cardiac surgery with cardiopulmonary bypass (CPB). Intraoperative excessive blood loss was defined as estimated blood loss≥50% of estimated blood volume (EBV). Postoperative excessive blood loss was defined as measured postoperative chest tube and Jackson-Pratt drainage≥30% of EBV over 12 hours or≥50% of EBV over 24 hours in the intensive care unit. PEBL was defined as either intraoperative or postoperative excessive blood loss. External temogram (EXTEM) and fibrinogen temogram (FIBTEM) were analyzed before and after CPB with ROTEM and laboratory hemostatic variables. Multivariate logistic regression was performed. Incidence of PEBL was 19.3% (n = 23). Independent risk factors for PEBL were CPB time>120 minutes, post-CPB FIBTEM alpha-angle, clot firmness after 10 minutes20%. Laboratory hemostatic variables were not significant in multivariate analysis. The risk prediction model was developed from the results of multivariate analysis. The area under the receiver operating characteristic curve was 0.94 (95% confidence interval: 0.90-0.99). Post-CPB ROTEM may be useful for predicting both intraoperative and postoperative excessive blood loss in congenital cardiac surgery. This study provided an accurate prediction model for PEBL and supported intraoperative transfusion guidance using post-CPB FIBTEM-A10 and EXTEM-A10. Copyright © 2016 Elsevier Inc. All rights reserved.

Tell me! The right of the child to information

NARCIS (Netherlands)

Koren, A.M.Th.L.

1996-01-01

Tell me! considers the child as a seeker, an information seeker, and researches the role information plays in the child's developmental process. Information on how to become a full-grown human being is essential. Which sources are important to the child? Tell me! examines the extent to which these

Truth telling in medical practice: students' opinions versus their observations of attending physicians' clinical practice.

Science.gov (United States)

Tang, Woung-Ru; Fang, Ji-Tseng; Fang, Chun-Kai; Fujimori, Maiko

2013-07-01

Truth telling or transmitting bad news is a problem that all doctors must frequently face. The purpose of this cross-sectional study was to investigate if medical students' opinions of truth telling differed from their observations of attending physicians' actual clinical practice. The subjects were 275 medical clerks/interns at a medical center in northern Taiwan. Data were collected on medical students' opinions of truth telling, their observations of physicians' clinical practice, students' level of satisfaction with truth telling practiced by attending physicians, and cancer patients' distress level when they were told the truth. Students' truth-telling awareness was significantly higher than the clinical truth-telling practice of attending physicians (pmedical students' opinions on truth telling and attending physicians' actual clinical practice. More research is needed to objectively assess physicians' truth telling in clinical practice and to study the factors affecting the method of truth telling used by attending physicians in clinical practice. Copyright © 2012 John Wiley & Sons, Ltd.

The relationship between blood lead levels and periodontal bone loss in the United States, 1988-1994.

OpenAIRE

Dye, Bruce A; Hirsch, Rosemarie; Brody, Debra J

2002-01-01

An association between bone disease and bone lead has been reported. Studies have suggested that lead stored in bone may adversely affect bone mineral metabolism and blood lead (PbB) levels. However, the relationship between PbB levels and bone loss attributed to periodontal disease has never been reported. In this study we examined the relationship between clinical parameters that characterize bone loss due to periodontal disease and PbB levels in the U.S. population. We used data from the T...

Evaluation of the impact of density gradient centrifugation on fetal cell loss during enrichment from maternal peripheral blood.

Science.gov (United States)

Emad, Ahmed; Drouin, Régen

2014-09-01

Physical separation by density gradient centrifugation (DGC) is usually used as an initial step of multistep enrichment protocols for purification of fetal cells (FCs) from maternal blood. Many protocols were designed but no single approach was efficient enough to provide noninvasive prenatal diagnosis. Procedures and methods were difficult to compare because of the nonuniformity of protocols among different groups. Recovery of FCs is jeopardized by their loss during the process of enrichment. Any loss of FCs must be minimized because of the multiplicative effect of each step of the enrichment process. The main objective of this study was to evaluate FC loss caused by DGC. Fetal cells were quantified in peripheral blood samples obtained from both euploid and aneuploid pregnancies before and after enrichment by buoyant DGC using Histopaque 1.119 g/mL. Density gradient centrifugation results in major loss of 60% to 80% of rare FCs, which may further complicate subsequent enrichment procedures. Eliminating aggressive manipulations can significantly minimize FC loss. Data obtained raise questions about the appropriateness of the DGC step for the enrichment of rare FCs and argues for the use of the alternative nonaggressive version of the procedure presented here or prioritizing other methods of enrichments. © 2014 John Wiley & Sons, Ltd.

Will They or Won't They? Secret Telling in Interpersonal Interactions.

Science.gov (United States)

Kowalski, Robin Marie; Morgan, Chad Alan; Whittaker, Elizabeth; Zaremba, Brittany; Frazee, Laura; Dean, Jessica

2015-01-01

This study investigated predictors of within-gender secret telling. Eighty-eight participants were exposed to either a "positive" or a "negative" secret about another individual. Just under 20% of participants told the secret. Conscientiousness, secret condition, empathy, and the conscientiousness by secret condition interaction had effects on the rate of secret telling, χ(2) (5,82) = 17.78, p = .003, AIC = 80.60. Conscientiousness had a negative effect on secret telling among participants that told the "negative" secret.

Neural, Endocrine and Local Mechanisms in the Effects of Environmental Stressors on the Cardiovascular Response to Blood Loss

National Research Council Canada - National Science Library

Schadt, James C

2006-01-01

Our studies have provided important, new information about the role of neurohumoral systems as well as the interaction of these systems with local mechanisms in cardiovascular control during blood loss...

Varicose vein surgery using a pneumatic tourniquet: reduced blood loss and improved cosmesis.

OpenAIRE

Thompson, J. F.; Royle, G. T.; Farrands, P. A.; Najmaldin, A.; Clifford, P. C.; Webster, J. H.

1990-01-01

A prospective controlled randomised study has been performed of 100 consecutive patients undergoing varicose vein surgery. One group underwent saphenofemoral flush ligation and multiple lower leg avulsions with the leg exsanguinated with a Rhys-Davies cuff, and ischaemia maintained with a pneumatic tourniquet. The other group underwent identical surgery but with a 30 degree head down tilt only. Blood loss was significantly less (13.5 +/- 12 ml vs 133 +/- 78 ml; P less than 0.01) and postopera...

[Truth telling and advance care planning at the end of life].

Science.gov (United States)

Hu, Wen-Yu; Yang, Chia-Ling

2009-02-01

One of the core values in terminal care the respect of patient 'autonomy'. This essay begins with a discussion of medical ethics principles and the Natural Death Act in Taiwan and then summarizes two medical ethical dilemmas, truth telling and advance care planning (ACP), faced in the development of hospice and palliative care in Taiwan. The terminal truth telling process incorporates the four basic principles of Assessment and preparation, Communication with family, Truth-telling process, and Support and follow up (the so-called "ACTs"). Many experts suggest practicing ACP by abiding by the following five steps: (1) presenting and illustrating topics; (2) facilitating a structured discussion; (3) completing documents with advanced directives (ADs); (4) reviewing and updating ADs; and (5) applying ADs in clinical circumstances. Finally, the myths and challenges in truth telling and ADs include the influence of healthcare system procedures and priorities, inadequate communication skills, and the psychological barriers of medical staffs. Good communication skills are critical to truth telling and ACP. Significant discussion about ACP should help engender mutual trust between patients and the medical staffs who take the time to establish such relationships. Promoting patient autonomy by providing the opportunity of a good death is an important goal of truth telling and ACP in which patients have opportunities to choose their terminal treatment.

DOES TRANEXAMIC ACID REDUCE BLOOD LOSS IN OFF-PUMP CORONARY ARTERY BYPASS?

Directory of Open Access Journals (Sweden)

A. Mehr-Aein

2006-09-01

Full Text Available Tranexamic acid is now used on a routine basis for on-pump coronary artery bypass grafting (CABG. We assessed the hemostatic effects of tranexamic acid to decrease bleeding tendency and transfusion requirements in patients undergoing off-pump coronary artery bypass surgery (OPCAB. A total of 66 patients were enrolled to elective OPCAB in a double-blind, prospective randomized study. Of these, 33 patients received tranexamic acid (15 mg/kg before the infusion of heparin and 15 mg/kg after protamin infusion, and 33 patients received only saline. Preoperative hematologic variables, postoperative bleeding and allogeneic transfusions were considered. D-dimer plasma levels were also evaluated to monitor the activation of fibrinolysis. Postoperative bleeding was significantly lower in the tranexamic acid group compared with the control group (320 ± 38 mL vs. 480 ± 75 mL at 12 hour, P < 0.001. The tranexamic acid group had significantly lesser need for allogeneic blood products (0.46 units/patients vs. 0.94 units/patients, P < 0.001. They had also lower post-operative D-dimer plasma levels. No postoperative thrombotic complications were observed in either group. The defective hemostasis occurs even in the OPCABG. Tranexamic acid effectively reduces postoperative blood loss and the need for allogeneic blood products after OPCAB is decreased.

Progressive sensorineural hearing loss, subjective tinnitus and vertigo caused by elevated blood lipids.

Science.gov (United States)

Pulec, J L; Pulec, M B; Mendoza, I

1997-10-01

The otologist frequently sees patients with progressive sensorineural hearing loss, subjective aural tinnitus and vertigo with no apparent cause. Elevated blood lipids may be a cause of inner ear malfunction on a biochemical basis. To establish the true incidence of this condition, all new patients (4,251) seen during an eight-year period were evaluated; of these, 2,332 patients had complaints of inner ear disease. All had a complete neurotologic examination, appropriate audiometric and vestibular studies and imaging, and blood tests including lipid phenotype studies. Hyperlipoproteinemia was found in 120 patients (5.1%). Most patients were found to be overweight and had additional coexisting conditions such as diabetes mellitus. Treatment with vasodilators and a 500-calorie, high-protein, low-carbohydrate diet yielded improvement of symptoms in 83% of patients within five months of initiation of treatment.

The 3D Digital Story-telling Media on Batik Learning in Vocational High Schools

Science.gov (United States)

Widiaty, I.; Achdiani, Y.; Kuntadi, I.; Mubaroq, S. R.; Zakaria, D.

2018-02-01

The aim of this research is to make 3D digital Story-telling Media on Batik Learning in Vocational High School. The digital story-telling developed in this research is focused on 3D-based story-telling. In contrast to the digital story-telling that has been developed in existing learning, this research is expected to be able to improve understanding of vocational students about the value of local wisdom batik more meaningful and “live”. The process of making 3D digital story-telling media consists of two processes, namely the creation of 3D objects and the creation of 3D object viewer.

Helping medical students to acquire a deeper understanding of truth-telling.

Science.gov (United States)

Hurst, Samia A; Baroffio, Anne; Ummel, Marinette; Burn, Carine Layat

2015-01-01

Truth-telling is an important component of respect for patients' self-determination, but in the context of breaking bad news, it is also a distressing and difficult task. We investigated the long-term influence of a simulated patient-based teaching intervention, integrating learning objectives in communication skills and ethics into students' attitudes and concerns regarding truth-telling. We followed two cohorts of medical students from the preclinical third year to their clinical rotations (fifth year). Open-ended responses were analysed to explore medical students' reported difficulties in breaking bad news. This intervention was implemented during the last preclinical year of a problem-based medical curriculum, in collaboration between the doctor-patient communication and ethics programs. Over time, concerns such as empathy and truthfulness shifted from a personal to a relational focus. Whereas 'truthfulness' was a concern for the content of the message, 'truth-telling' included concerns on how information was communicated and how realistically it was received. Truth-telling required empathy, adaptation to the patient, and appropriate management of emotions, both for the patient's welfare and for a realistic understanding of the situation. Our study confirms that an intervention confronting students with a realistic situation succeeds in making them more aware of the real issues of truth-telling. Medical students deepened their reflection over time, acquiring a deeper understanding of the relational dimension of values such as truth-telling, and honing their view of empathy.

Study on the Measurement of 51Cr-tagged Red Cell Survival: Reevaluation of its method and the effect of Blood loss on red cell survival with 51Cr

International Nuclear Information System (INIS)

Choi, Hak Yong; Koh, Chang Soon; Lee, Moon Ho

1970-01-01

Reappraisal measurement of apparent half survival time of red cell by 51 Cr method was made and effects of blood-letting over red cell survival were observed. The study was performed on 53 normal male subjects under three different experimental conditions. 1) Group 1: Mean 51 Cr red cell half survival by ACD wash method was 29.7 days. T 1 /2 of Ascorbic acid method was 29.0 days in group with 100 mg dose and 29.1 days in group with 50 mg dose respectively. There was no difference between these two methods in regards to red cell half survival. No difference were noted in amount of ascorbic acid administered. 2) Group 2: As daily amount of blood loss in increased the shortening of red cell half survival was noted. Rapid phase was seen when blood loss ranged 10 to 25 ml per day, while slow phase noted when more loss amounted 25 ml more daily. Thus, it was clear that there was more than an exponential relation between T 1 /2 and the amount of blood loss. 3) Group 3: T 1 /2 measured cpm per whole blood was within normal range and T 1 /2 measured by cpm per red mass showed shortening tendency when compared with the former in the group measured after blood loss (from 25 ml daily up to 100 ml daily in 10 days). In the group with rather constant blood loss of 100 ml daily for 10 consecutive days revealed the significant difference in two measurement (P 1 /2 in non-steady state. When red cell production is increased compared with red cell destruction, T 1 /2 measured by cpm per red cell mass shorter than that by cpm per whole blood. Shortening of T 1 /2 measured by cpm per whole blood is more prominent, if red destruction is enhanced and exceeds production. 5) It is clear that when expressing red cell destruction rate, T 1 /2 measured by cpm per whole blood is more adequate and production more consistent with cpm red cell mass. 6) T 1 /2 measured during blood-letting, when corrected by amount of blood loss, it remains normal. It is erroneous to use conventional equational

16 CFR 460.17 - What installers must tell their customers.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false What installers must tell their customers... AND ADVERTISING OF HOME INSULATION § 460.17 What installers must tell their customers. If you are an installer, you must give your customers a contract or receipt for the insulation you install. For all...

Mosaic Loss of Chromosome Y in Blood Is Associated with Alzheimer Disease.

Science.gov (United States)

Dumanski, Jan P; Lambert, Jean-Charles; Rasi, Chiara; Giedraitis, Vilmantas; Davies, Hanna; Grenier-Boley, Benjamin; Lindgren, Cecilia M; Campion, Dominique; Dufouil, Carole; Pasquier, Florence; Amouyel, Philippe; Lannfelt, Lars; Ingelsson, Martin; Kilander, Lena; Lind, Lars; Forsberg, Lars A

2016-06-02

Men have a shorter life expectancy compared with women but the underlying factor(s) are not clear. Late-onset, sporadic Alzheimer disease (AD) is a common and lethal neurodegenerative disorder and many germline inherited variants have been found to influence the risk of developing AD. Our previous results show that a fundamentally different genetic variant, i.e., lifetime-acquired loss of chromosome Y (LOY) in blood cells, is associated with all-cause mortality and an increased risk of non-hematological tumors and that LOY could be induced by tobacco smoking. We tested here a hypothesis that men with LOY are more susceptible to AD and show that LOY is associated with AD in three independent studies of different types. In a case-control study, males with AD diagnosis had higher degree of LOY mosaicism (adjusted odds ratio = 2.80, p = 0.0184, AD events = 606). Furthermore, in two prospective studies, men with LOY at blood sampling had greater risk for incident AD diagnosis during follow-up time (hazard ratio [HR] = 6.80, 95% confidence interval [95% CI] = 2.16-21.43, AD events = 140, p = 0.0011). Thus, LOY in blood is associated with risks of both AD and cancer, suggesting a role of LOY in blood cells on disease processes in other tissues, possibly via defective immunosurveillance. As a male-specific risk factor, LOY might explain why males on average live shorter lives than females. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

Telling the truth.

OpenAIRE

Jackson, J

1991-01-01

Are doctors and nurses bound by just the same constraints as everyone else in regard to honesty? What, anyway, does honesty require? Telling no lies? Avoiding intentional deception by whatever means? From a utilitarian standpoint lying would seem to be on the same footing as other forms of intentional deception: yielding the same consequences. But utilitarianism fails to explain the wrongness of lying. Doctors and nurses, like everyone else, have a prima facie duty not to lie--but again like ...

Every Picture Tells a Story

NARCIS (Netherlands)

Dr. Piet Bakker

2011-01-01

Het doel van het project Every Picture Tells a Story is om samen met het werkveld methoden, technieken en kennis te ontwikkelen voor het produceren van effectieve infographics. Dit is nodig omdat de vraag naar infographics in de markt snel toeneemt. Bedrijfsleven en overheden kiezen er steeds vaker

Relative blood loss and operative time can predict length of stay following orthognathic surgery.

Science.gov (United States)

Andersen, K; Thastum, M; Nørholt, S E; Blomlöf, J

2016-10-01

The aim of this study was to investigate the length of stay (LOS) following orthognathic surgery and thereby to establish a benchmark. The secondary aim was to identify predictors of postoperative LOS following orthognathic surgery. Patients were treated consecutively during the period 2010 to 2012. Inclusion criteria were (1) patient age ≥18 years, and (2) surgery involving a three-piece Le Fort I osteotomy, or a bilateral sagittal split osteotomy (BSSO), or bimaxillary surgery. A total of 335 patients were included. The following data were recorded: height, weight, body mass index (BMI), age, sex, operative time, intraoperative blood loss, and type of surgery. LOS was defined as the duration of time from date of surgery to date of discharge. The average LOS was 1.3 days following Le Fort I osteotomy, 1.3 days following BSSO, and 1.8 days following bimaxillary surgery. In the multivariate regression model (R(2)=0.11), predictors of a prolonged LOS were operative time (P<0.001) and relative blood loss (P=0.002). No significant effect of age, BMI, sex, or treatment on LOS was observed. The short duration of LOS found in this study supports the possibility of increasing outpatient pathways for selected patients. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

RN students need to tell their stories.

Science.gov (United States)

Blecke, J; Flatt, M M

1993-04-01

Finally, what is it about RN students' experiences in the transition process in nursing education that makes their stories need to be told? Actually this question is asked from both the side of the RN students who are the learners and need to tell the stories, and the side of the educator/advisor who needs to have the stories told. In short, the answer to both is that these stories reveal very graphically and meaningfully what is happening in the learning and professional development processes and, simultaneously, they facilitate the progression of those processes. The RN students seem to have an innate sense about what telling their stories will do for them in relation to their learning and professional development processes. They require very little encouragement to prompt their story telling. For the educators/advisors, no other strategy is as adaptable and achieves as much in relation to facilitating the learning and development processes. For both parties, the graphic revelations in stories paint a picture of how past, present, and future blend together to form a meaningful, coherent view of a position in the world. According to Antonovsky's (1979) work on stress and coping, such a view is necessary if stress is to be resisted and health maintained.(ABSTRACT TRUNCATED AT 400 WORDS)

Cerebral blood flow studied by 133Xe inhalation technique in parkinsonism: loss of hyperfrontal pattern

International Nuclear Information System (INIS)

Bes, A.; Gueell, A.; Fabre, N.; Dupui, P.; Victor, G.; Geraud, G.

1983-01-01

Cerebral blood flow (grey matter flow) in parkinsonism requires further investigation. The noninvasive method of 133 Xe inhalation permits study of larger numbers of subjects than previously used invasive techniques such as the intracarotid 133 Xe injection method. Measurements were made in this laboratory in 30 subjects having Parkinson's disease. Mean hemispheric blood flow (F1) values were 70.4 +/- 9.3 ml/100 g/min, compared to 76.3 for a group of age-matched normal subjects, which is a decrease of -7.8%. The most striking difference was the loss of the hyperfrontal distribution in parkinsonism. The prefrontal F1 values were only 1.8% greater than the hemisphere grey matter flow, compared with 8.5% in controls of a similar age group

Comparison of topical and intravenous administration of tranexamic acid for blood loss control during total joint replacement: Review of literature

Directory of Open Access Journals (Sweden)

Georgi P. Georgiev

2018-04-01

Full Text Available Purpose: Many randomised controlled trials and meta-analysis studies have presented the efficacy of tranexamic acid (TXA without an increase of complications. However, questions still remain about the type of administration, optimal dose and secondary outcomes of TXA in total hip arthroplasty and total knee arthroplasty. The aim of this review is to summarise the existing information in literature concerning the pharmacological characteristics of TXA, forms, doses, types of application and contraindications for its use. Methods: A literature review containing 63 articles from the PubMed data starting from the first description of tranexamic acid until now was made in trying to present the existing information in a simple and effective way. Results: TXA leads to statistically significant reduction of peri and postoperative bleeding and in that way decreases blood transfusion rates and the infection risk. Topical and intravenous (IV use of TXA revealed similar results, with no increase of deep venous thrombosis. Therefore, topical TXA could be a reasonable alternative in patients with contraindications for IV application of TXA. Conclusions: Blood loss control with TXA, a synthetic analogue of the amino acid lysine, may be an excellent and safe alternative to allogeneic blood transfusion after total hip arthroplasty and total knee arthroplasty. Further studies are needed to establish the efficacy of combined IV and topical administration of TXA with regard to diminishing blood loss and reducing hospital stay. The Translational Potential of this Article: This review briefly presents the pharmacological characteristics of TXA, forms, doses, types of application and contraindications for its use with regard to diminishing blood loss and reducing hospital stay for better therapeutic strategies in orthopaedics. Keywords: Arthroplasty, Review, Tranexamic acid

Menstrual blood loss measurement: validation of the alkaline hematin technique for feminine hygiene products containing superabsorbent polymers.

Science.gov (United States)

Magnay, Julia L; Nevatte, Tracy M; Dhingra, Vandana; O'Brien, Shaughn

2010-12-01

To validate the alkaline hematin technique for measurement of menstrual blood loss using ultra-thin sanitary towels that contain superabsorbent polymer granules as the absorptive agent. Laboratory study using simulated menstrual fluid (SMF) and Always Ultra Normal, Long, and Night "with wings" sanitary towels. Keele Menstrual Disorders Laboratory. None. None. Recovery of blood, linearity, and interassay variation over a range of SMF volumes applied to towels. Because of the variable percentage of blood in menstrual fluid, blood recovery was assessed from SMF constituted as 10%, 25%, 50%, and 100% blood. The lower limit of reliable detection and the effect of storing soiled towels for up to 4 weeks at 15°C-20°C, 4°C, and -20°C before analysis were determined. Ninety percent recovery was reproducibly achieved up to 30 mL applied volume at all tested SMF compositions, except at low volume or high dilution equivalent to sanitary towels that contain superabsorbent polymers. Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Effect of a high-protein diet on maintenance of blood pressure levels achieved after initial weight loss : the DiOGenes randomized study

NARCIS (Netherlands)

Engberink, M. F.; Geleijnse, J. M.; Bakker, S. J. L.; Larsen, T. M.; Handjieva-Darlesnka, T.; Kafatos, A.; Martinez, J. A.; Pfeiffer, A. F. H.; Kunesova, M.; Jebb, S. A.; Holst, C.; Astrup, A.; Saris, W. H. M.; Brink, E. J.; van Baak, M. A.

Randomized trials have shown significant blood pressure (BP) reductions after increased protein compared with carbohydrate intake, but the effect on BP maintenance after initial weight loss is unclear. We examined the effect of a high-protein diet on the maintenance of reduced BP after weight loss

Effect of a high-protein diet on maintenance of blood pressure levels achieved after initial weight loss: the DiOGenes randomized study

NARCIS (Netherlands)

Engberink, M.F.; Geleijnse, J.M.; Bakker, S.J.L.; Larsen, T.

2015-01-01

Randomized trials have shown significant blood pressure (BP) reductions after increased protein compared with carbohydrate intake, but the effect on BP maintenance after initial weight loss is unclear. We examined the effect of a high-protein diet on the maintenance of reduced BP after weight loss

Mathematical tablets from Tell Harmal

CERN Document Server

Gonçalves, Carlos

2015-01-01

This work offers a re-edition of twelve mathematical tablets from the site of Tell Harmal, in the borders of present-day Baghdad. In ancient times, Tell Harmal was Šaduppûm, a city representative of the region of the Diyala river and of the kingdom of Ešnunna, to which it belonged for a time. These twelve tablets were originally published in separate articles in the beginning of the 1950s and mostly contain solved problem texts. Some of the problems deal with abstract matters such as triangles and rectangles with no reference to daily life, while others are stated in explicitly empirical contexts, such as the transportation of a load of bricks, the size of a vessel, the number of men needed to build a wall and the acquisition of oil and lard. This new edition of the texts is the first to group them, and takes into account all the recent developments of the research in the history of Mesopotamian mathematics. Its introductory chapters are directed to readers interested in an overview of the mathematical con...

High-throughput sequencing of microRNAs in peripheral blood mononuclear cells: identification of potential weight loss biomarkers.

Directory of Open Access Journals (Sweden)

Fermín I Milagro

Full Text Available INTRODUCTION: MicroRNAs (miRNAs are being increasingly studied in relation to energy metabolism and body composition homeostasis. Indeed, the quantitative analysis of miRNAs expression in different adiposity conditions may contribute to understand the intimate mechanisms participating in body weight control and to find new biomarkers with diagnostic or prognostic value in obesity management. OBJECTIVE: The aim of this study was the search for miRNAs in blood cells whose expression could be used as prognostic biomarkers of weight loss. METHODS: Ten Caucasian obese women were selected among the participants in a weight-loss trial that consisted in following an energy-restricted treatment. Weight loss was considered unsuccessful when 5% (responders. At baseline, total miRNA isolated from peripheral blood mononuclear cells (PBMC was sequenced with SOLiD v4. The miRNA sequencing data were validated by RT-PCR. RESULTS: Differential baseline expression of several miRNAs was found between responders and non-responders. Two miRNAs were up-regulated in the non-responder group (mir-935 and mir-4772 and three others were down-regulated (mir-223, mir-224 and mir-376b. Both mir-935 and mir-4772 showed relevant associations with the magnitude of weight loss, although the expression of other transcripts (mir-874, mir-199b, mir-766, mir-589 and mir-148b also correlated with weight loss. CONCLUSIONS: This research addresses the use of high-throughput sequencing technologies in the search for miRNA expression biomarkers in obesity, by determining the miRNA transcriptome of PBMC. Basal expression of different miRNAs, particularly mir-935 and mir-4772, could be prognostic biomarkers and may forecast the response to a hypocaloric diet.

What history tells us XLIII Bacteriophage

Indian Academy of Sciences (India)

Home; Journals; Journal of Biosciences; Volume 42; Issue 3. What history tells us XLIII Bacteriophage: The contexts in which it was discovered. MICHEL MORANGE. Series Volume 42 Issue 3 September 2017 pp 359-362. Fulltext. Click here to view fulltext PDF. Permanent link:

How to Tell Bad News

Science.gov (United States)

Long, Nicholas J.

2012-01-01

Therapists, physicians, police officers, and emergency staff often are the messengers of bad news. They have to tell a patient, a parent, or a loved one about a death, an accident, a school shooting, a life-threatening diagnosis, a terrorist attack, or a suicide. Usually the messenger bears a heavy responsibility but has little training and seeks…

Influence of sibutramine in addition to diet and exercise on the relationship between weight loss and blood glucose changes

DEFF Research Database (Denmark)

Kamil, S; Finer, N; James, W P T

2017-01-01

on glycemic control. METHODS AND RESULTS: 8192 obese patients with diabetes were randomized to sibutramine or placebo plus diet and exercise after a preliminary 6 weeks in which all patients received sibutramine. Patients were classified into four groups of weight change. A total of 1582 patients had a weight...... loss induced by sibutramine, diet, and exercise attenuates falls in blood glucose levels and HbA1c compared with similar weight loss with placebo, diet and exercise....

Helping medical students to acquire a deeper understanding of truth-telling

Directory of Open Access Journals (Sweden)

Samia A. Hurst

2015-11-01

Full Text Available Problem: Truth-telling is an important component of respect for patients’ self-determination, but in the context of breaking bad news, it is also a distressing and difficult task. Intervention: We investigated the long-term influence of a simulated patient-based teaching intervention, integrating learning objectives in communication skills and ethics into students’ attitudes and concerns regarding truth-telling. We followed two cohorts of medical students from the preclinical third year to their clinical rotations (fifth year. Open-ended responses were analysed to explore medical students’ reported difficulties in breaking bad news. Context: This intervention was implemented during the last preclinical year of a problem-based medical curriculum, in collaboration between the doctor–patient communication and ethics programs. Outcome: Over time, concerns such as empathy and truthfulness shifted from a personal to a relational focus. Whereas ‘truthfulness’ was a concern for the content of the message, ‘truth-telling’ included concerns on how information was communicated and how realistically it was received. Truth-telling required empathy, adaptation to the patient, and appropriate management of emotions, both for the patient's welfare and for a realistic understanding of the situation. Lessons learned: Our study confirms that an intervention confronting students with a realistic situation succeeds in making them more aware of the real issues of truth-telling. Medical students deepened their reflection over time, acquiring a deeper understanding of the relational dimension of values such as truth-telling, and honing their view of empathy.

Ethamsylate and blood loss in total hip replacement.

Science.gov (United States)

Keith, I

1979-01-01

Nineteen consecutive patients undergoing total hip replacement under epidural anaesthesia were randomly divided into two groups. The treatment group received 1000 mg of ethamsylate intravenously before induction of anaesthesia. Blood lost during surgery was measured by a colorimetric technique. Closed suction drains were used and all blood lost after operation collected for measurement. Ethamsylate did not decrease the average volumes of blood lost during or after the operation. Neither did it reduce the requirements for blood transfusion. Although there were no side-effects attributable to ethamyslate, there seems to be no indication for its use in total hip replacement under epidural anaesthesia.

The efficiency and safety of fibrin sealant for reducing blood loss in primary total hip arthroplasty: A systematic review and meta-analysis.

Science.gov (United States)

Wang, Zhiyuan; Xiao, Lin; Guo, Hao; Zhao, Guanghui; Ma, Jianbing

2017-01-01

Total hip arthroplasty (THA) is associated with substantial blood loss. The objective of present systematic review and meta-analysis is to provide evidence from randomized controlled trials (RCTs) on the efficiency and safety of administration of fibrin sealant (FS) for reducing blood loss in patients undergoing primary THA. Potential relevant studies were identified from electronic databases including Medline, PubMed, Embase, ScienceDirect, web of science and Cochrane Library. Gray academic studies were also identified from the reference list of included studies. There was no language restriction. Pooling of data was carried out by using RevMan 5.1. Six randomized controlled trials (RCTs) met the inclusion criteria. Current meta-analysis indicated that there were significant differences in terms of total blood loss (MD = -153.77, 95% CI: -287.21 to -20.34, P = 0.02), postoperative hemoglobin level (MD = -0.25, 95% CI: -0.46 to -0.05, P = 0.02) and transfusion rate (RD = -0.12, 95% CI: -0.22 to -0.03, P = 0.01) between groups. No significant differences were found regarding the incidence of deep venous thrombosis (DVT) (RD = 0.00, 95% CI: -0.01to 0.01, P = 0.51) or other side effects. Administration of fibrin sealant in total hip arthroplasty may reduce total blood loss, postoperative hemoglobin decline and transfusion requirements. Moreover, no adverse effect was related to FS. Due to the limited quality of the evidence currently available, higher quality RCTs are required. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Rectal red blood loss in a healthy toddler is not always a juvenile polyp.

Science.gov (United States)

Rousseff, T; Matthyssens, L; Van Renterghem, K; Van de Putte, D; De Wulf, D; Van Winckel, M; Van de Velde, S; De Bruyne, R; Van Biervliet, S

2017-01-01

Aim Heterotopic gastric mucosa is a well-known congenital anomaly in Meckel's diverticula and duplication cysts. Solitary heterotopic gastric mucosa in the rectum is a rare and frequently overlooked abnormality. Starting from a patient history, the literature is searched and all cases reported over the past 20 years are reviewed and compared to a summary of the older cases. Differences between adult and childhood presentation are outlined and our patient is compared with prior reported cases. Case A 3-year-old girl presented with recurrent rectal blood loss caused by heterotopic gastric mucosa without duplication cyst. She was endoscopically treated with two-stage endoscopic surgical dissection (ESD). Up to now, rectal heterotopic gastric mucosa has been reported in 34 adults and 24 children, including this patient. There is an overall male dominance (69%). Presenting complaints in children were recurrent fresh blood loss per anum (96%), pain (46%), perineal ulcers (25%), diarrhoea (8%) and one patient had an ano-cutaneous fistula. Endoscopy revealed a mucosal elevation with a slightly different aspect (33%), a polyp (42%) and a solitary ulcer (25%). Endoscopy in adults reveals more frequently polyps compared to children. Treatment in childhood is mainly surgical where adults are more frequently treated with endoscopic techniques. Conclusion In a child with recurrent rectal bleeding in good general health, it is important to withhold heterotopic gastric mucosa in the differential diagnosis and take sufficient biopsies during endoscopy. © Acta Gastro-Enterologica Belgica.

Telling the truth.

Science.gov (United States)

Jackson, J

1991-03-01

Are doctors and nurses bound by just the same constraints as everyone else in regard to honesty? What, anyway, does honesty require? Telling no lies? Avoiding intentional deception by whatever means? From a utilitarian standpoint lying would seem to be on the same footing as other forms of intentional deception: yielding the same consequences. But utilitarianism fails to explain the wrongness of lying. Doctors and nurses, like everyone else, have a prima facie duty not to lie--but again like everyone else, they are not duty-bound to avoid intentional deception, lying apart; except where it would involve a breach of trust.

Management of major blood loss: an update

DEFF Research Database (Denmark)

Johansson, P I; Ostrowski, S R; Secher, N H

2010-01-01

the early control of the cause of bleeding by non-definitive means, while haemostatic control resuscitation seeks early control of coagulopathy. Haemostatic resuscitation provides transfusions with plasma and platelets in addition to red blood cells (RBCs) in an immediate and sustained manner as part...... of the transfusion protocol for massively bleeding patients. Transfusion of RBCs, plasma and platelets in a similar proportion as in whole blood prevents both hypovolaemia and coagulopathy. Although an early and effective reversal of coagulopathy is documented, the most effective means of preventing coagulopathy....... Furthermore, viscoelastic whole blood assays, such as thrombelastography (TEG)/rotation thromboelastometry (ROTEM), appear advantageous for identifying coagulopathy in patients with severe haemorrhage, as opposed to conventional coagulation assays. In our view, patients with uncontrolled bleeding, regardless...

Effects of Hypotensive Anesthesia on Reducing Intraoperative Blood Loss, Duration of Operation, and Quality of Surgical Field During Orthognathic Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Science.gov (United States)

Lin, Susie; McKenna, Samuel J; Yao, Chuan-Fong; Chen, Yu-Ray; Chen, Chit

2017-01-01

The objective of this study was to evaluate the efficacy of hypotensive anesthesia in reducing intraoperative blood loss, decreasing operation time, and improving the quality of the surgical field during orthognathic surgery. A systematic review and meta-analysis of randomized controlled trials addressing these issues were carried out. An electronic database search was performed. The risk of bias was evaluated with the Jadad Scale and Delphi List. The inverse variance statistical method and a random-effects model were used. Ten randomized controlled trials were included for analysis. Our meta-analysis indicated that hypotensive anesthesia reduced intraoperative blood loss by a mean of about 169 mL. Hypotensive anesthesia was not shown to reduce the operation time for orthognathic surgery, but it did improve the quality of the surgical field. Subgroup analysis indicated that for blood loss in double-jaw surgery, the weighted mean difference favored the hypotensive group, with a reduction in blood loss of 175 mL, but no statistically significant reduction in blood loss was found for anterior maxillary osteotomy. If local anesthesia with epinephrine was used in conjunction with hypotensive anesthesia, the reduction in intraoperative blood loss was increased to 254.93 mL. Hypotensive anesthesia was effective in reducing blood loss and improving the quality of the surgical field, but it did not reduce the operation time for orthognathic surgery. The use of local anesthesia in conjunction with hypotensive general anesthesia further reduced the amount of intraoperative blood loss for orthognathic surgery. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Effect of a high-protein diet on maintenance of blood pressure levels achieved after initial weight loss

DEFF Research Database (Denmark)

Engberink, M F; Geleijnse, J M; Bakker, S J L

2015-01-01

Randomized trials have shown significant blood pressure (BP) reductions after increased protein compared with carbohydrate intake, but the effect on BP maintenance after initial weight loss is unclear. We examined the effect of a high-protein diet on the maintenance of reduced BP after weight loss......(-2), BP was 118/73 mm Hg and 28 subjects (6.5%) used antihypertensive agents. Systolic BP during 26 weeks of weight maintenance dietary intervention increased in both treatment groups, but it was 2.2 mm Hg less (95% CI: -4.6 to 0.2 mm Hg, P=0.08) in the high-protein group than in the lower...

Tourniquets do not increase the total blood loss or re-amputation risk in transtibial amputations

DEFF Research Database (Denmark)

Wied, Christian; Tengberg, Peter T; Holm, Gitte

2017-01-01

AIM: To investigate the total blood loss (TBL) and the safety with respect to the re-amputation rate after transtibial amputation (TTA) conducted with and without a tourniquet. METHODS: The study was a single-centre retrospective cohort study of patients with a primary TTA admitted between January...... 2013 and April 2015. All patients with a primary TTA were assessed for inclusion if the amputation was performed because of arteriosclerosis or diabetic complications. All patients underwent a standardized TTA procedure that was performed approximately 10 cm below the knee joint and performed...... portion, which equals 55 g/L of haemoglobin. The TBL during the first four postoperative days was calculated based on the haemoglobin level and the estimated blood volume. The re-amputation rate was evaluated within 30 d. RESULTS: Seventy-four out of 86 consecutive patients who underwent TTA within...

The optimal protocol to reduce blood loss and blood transfusion after unilateral total knee replacement: Low-dose IA-TXA plus 30-min drain clamping versus drainage clamping for the first 3 h without IA-TXA.

Science.gov (United States)

Park, Joo Hyun; Choi, Sung Wook; Shin, Eun Ho; Park, Myung Hoon; Kim, Myung Ku

2017-01-01

Although intraarticular tranexamic acid (IA-TXA) administration or drainage clamping are popular methods used to reduce blood loss after total knee replacement (TKR), the protocol remains controversial. We aimed (1) to establish new protocols through investigating whether two methods, that is, low-dose (500 mg) IA-TXA plus 30-min drain clamping and drainage clamping for the first 3 h without IA-TXA, can reduce blood loss and blood transfusion after unilateral TKR and (2) to make recommendations related to clinical application. This study, conducted from September 2014 to June 2016 related to enrolled 95 patients with primary osteoarthritis who were to have a unilateral cemented TKR, was nonrandomized and retrospective. In group A, the drain was released following tourniquet deflation. In group B, 500-mg TXA was injected into the knee joint via a drain tube after fascia closure and the drain was clamped for the first 30 min to prevent leakage. In group C, the drain was clamped for the first 3-h postoperation. Demographic characteristics and clinical data were collected, including the levels of hematocrit (Hct), the total blood loss (TBL), drained blood volume (BV), the amount of blood transfused, and any complications that developed. We found a significantly lower postoperative TBL, drained BV, decreasing Hct level, and less transfused BV in the IA-TXA injection group (group B) and the 3-h drainage clamping group (group C) compared to the conventional negative drainage group (group A; p optimal than drainage clamping in patients with high bleeding tendency or lateral retinacular release during TKR, who would be concerned about postoperative wound complication.

Defining clinically important perioperative blood loss and transfusion for the Standardised Endpoints for Perioperative Medicine (StEP) collaborative: a protocol for a scoping review.

Science.gov (United States)

Bartoszko, Justyna; Vorobeichik, Leon; Jayarajah, Mohandas; Karkouti, Keyvan; Klein, Andrew A; Lamy, Andre; Mazer, C David; Murphy, Mike; Richards, Toby; Englesakis, Marina; Myles, Paul S; Wijeysundera, Duminda N

2017-06-30

'Standardised Endpoints for Perioperative Medicine' (StEP) is an international collaboration undertaking development of consensus-based consistent definitions for endpoints in perioperative clinical trials. Inconsistency in endpoint definitions can make interpretation of trial results more difficult, especially if conflicting evidence is present. Furthermore, this inconsistency impedes evidence synthesis and meta-analyses. The goals of StEP are to harmonise definitions for clinically meaningful endpoints and specify standards for endpoint reporting in clinical trials. To help inform this endeavour, we aim to conduct a scoping review to systematically characterise the definitions of clinically important endpoints in the existing published literature on perioperative blood loss and transfusion. The scoping review will be conducted using the widely adopted framework developed by Arksey and O'Malley, with modifications from Levac. We refined our methods with guidance from research librarians as well as researchers and clinicians with content expertise. The electronic literature search will involve several databases including Medline, PubMed-not-Medline and Embase. Our review has three objectives, namely to (1) identify definitions of significant blood loss and transfusion used in previously published large perioperative randomised trials; (2) identify previously developed consensus-based definitions for significant blood loss and transfusion in perioperative medicine and related fields; and (3) describe the association between different magnitudes of blood loss and transfusion with postoperative outcomes. The multistage review process for each question will involve two reviewers screening abstracts, reading full-text articles and performing data extraction. The abstracted data will be organised and subsequently analysed in an iterative process. This scoping review of the previously published literature does not require research ethics approval. The results will be used

Telling the truth.

Science.gov (United States)

Jackson, J

1991-01-01

Are doctors and nurses bound by just the same constraints as everyone else in regard to honesty? What, anyway, does honesty require? Telling no lies? Avoiding intentional deception by whatever means? From a utilitarian standpoint lying would seem to be on the same footing as other forms of intentional deception: yielding the same consequences. But utilitarianism fails to explain the wrongness of lying. Doctors and nurses, like everyone else, have a prima facie duty not to lie--but again like everyone else, they are not duty-bound to avoid intentional deception, lying apart; except where it would involve a breach of trust. PMID:2033634

Comparative effectiveness of a portion-controlled meal replacement program for weight loss in adults with and without diabetes/high blood sugar.

Science.gov (United States)

Coleman, C D; Kiel, J R; Mitola, A H; Arterburn, L M

2017-07-10

Individuals with type 2 diabetes (DM2) may be less successful at achieving therapeutic weight loss than their counterparts without diabetes. This study compares weight loss in a cohort of adults with DM2 or high blood sugar (D/HBS) to a cohort of adults without D/HBS. All were overweight/obese and following a reduced or low-calorie commercial weight-loss program incorporating meal replacements (MRs) and one-on-one behavioral support. Demographic, weight, body composition, anthropometric, pulse and blood pressure data were collected as part of systematic retrospective chart review studies. Differences between cohorts by D/HBS status were analyzed using Mann-Whitney U-tests and mixed model regression. A total of 816 charts were included (125 with self-reported D/HBS). The cohort with D/HBS had more males (40.8 vs 25.6%), higher BMI (39.0 vs 36.3 kg m - 2 ) and was older (56 vs 48 years). Among clients continuing on program, the cohorts with and without D/HBS lost, on average, 5.6 vs 5.8 kg (NS) (5.0 vs 5.6%; P=0.005) of baseline weight at 4 weeks, 11.0 vs 11.6 kg (NS) (9.9 vs 11.1%; P=0.027) at 12 weeks and 16.3 vs 17.1 kg (13.9 vs 15.7%; NS) at 24 weeks, respectively. In a mixed model regression controlling for baseline weight, gender and meal plan, and an intention-to-treat analysis, there was no significant difference in weight loss between the cohorts at any time point. Over 70% in both cohorts lost ⩾5% of their baseline weight by the final visit on their originally assigned meal plan. Both cohorts had significant reductions from baseline in body fat, blood pressure, pulse and abdominal circumference. Adults who were overweight/obese and with D/HBS following a commercial weight-loss program incorporating MRs and one-on-one behavioral support achieved therapeutic weight loss. The program was equally effective for weight loss and reductions in cardiometabolic risk factors among adults with and without D/HBS.

The Analysis of the Gothic Element--High Emotion in The Tell-tale Heart

Institute of Scientific and Technical Information of China (English)

李莎

2014-01-01

The Tell-tale Heart is one of the most typical gothic novel of Allen Poe’s. This article intends to analyse one of the gothic elements, that is, high emotion which is employed in The Tell-tale Heart to contribute to the horror effect.

The effect of different dosage regimens of tranexamic acid on blood loss in bimaxillary osteotomy: a randomized, double-blind, placebo-controlled study.

Science.gov (United States)

Apipan, B; Rummasak, D; Narainthonsaenee, T

2018-05-01

The purpose of this study was to compare the effects of three dosage regimens of intravenous tranexamic acid and normal saline placebo on blood loss and the requirement for transfusion during bimaxillary osteotomy. A prospective, randomized, double-blind, placebo-controlled study was performed. Eighty patients scheduled for elective bimaxillary osteotomy were divided into four groups: a placebo group and three groups receiving a single dose of tranexamic acid 10, 15, or 20mg/kg body weight after the induction of anaesthesia. Demographic data, the anaesthetic time, the operative time, and the experience of the surgical team were similar in the four groups. Patients receiving placebo had increased blood loss compared to those receiving tranexamic acid. No significant difference in blood loss was found among those who received 10, 15, or 20mg/kg body weight of tranexamic acid. There was no significant difference in transfusion requirement, amount of 24-h postoperative vacuum drainage, length of hospital stay, or complications among the four groups. Prophylactic tranexamic acid decreased bleeding during bimaxillary osteotomy. Of the three dosages of tranexamic acid studied, the most efficacious and cost-effective dose to reduce bleeding was 10mg/kg body weight. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Hypotensive anesthesia: Comparing the effects of different drug combinations on mean arterial pressure, estimated blood loss, and surgery time in orthognathic surgery.

Science.gov (United States)

Jeong, James; Portnof, Jason E; Kalayeh, Mona; Hardigan, Patrick

2016-07-01

Sevoflurane, an inhalational hypotensive anesthetic agent with a vasodilatory property, has been commonly used as a single agent to induce hypotension and effectively decrease blood loss in orthognathic surgery. However, it is common for patients to receive other hypotensive anesthetic agents in combination with sevoflurane. The purpose of our retrospective cohort study is to investigate whether administering an additional hypotensive agent has greater effect at reducing mean arterial pressure (MAP), estimated blood loss (EBL) and surgery time during orthognathic surgery. 57 subjects, aged 0-89 of both genders, who underwent orthognathic surgery were investigated in this study. Each patient's anesthesia records were reviewed to record the following variables of interest: EBL, duration of surgery, and MAP reduction in %. 41 subjects were placed in Group I and they received sevoflurane alone. 16 subjects were placed in Group II and they received sevoflurane plus a "supportive" agent. These "supportive" agents were esmolol, labetalol, metoprolol, nicardipine, and dexmedetomidine. The significant differences between two groups were assessed by using ANCOVA and p surgery time. Subjects in Group II experienced a greater reduction in MAP during surgery than subjects in Group I, 27.30% and 20.44%, respectively (p = 0.027). There was no significant difference for sex (p = 0.417) or age group (p = 0.113) in estimated blood loss, however. The mean surgery time in Group I was 1.93, 2.77, and 4.54 h with respect to LeFort, BSSO/IVRO, and double jaw surgery. Patients in Group II had a mean surgery time of 1.73, 2.07, and 5.64 h with respect to LeFort, BSSO/IVRO, and double jaw surgery. No statistically significant difference was demonstrated in surgery time between Group I vs. Group II (p > 0.05). Subjects in Group II experienced, on average, more blood loss than subjects in Group I, 355.50 ml and 238.90 ml, respectively. The use of multi-drug combination may offer

Telling Stories: Past and Present Heroes

Science.gov (United States)

Smith, Colin Bridges

2007-01-01

Among the Xhosa tribe in South Africa storytelling is a magnificent art. But these stories are more than mere entertainment. Xhosa scholar Harold Scheub says story-telling for the Xhosa people is "not only a primary means of entertainment and artistic expression in the society, it is also the major educational device." Beyond education,…

Effect of a Modest Weight Loss in Normalizing Blood Pressure in Obese Subjects on Antihypertensive Drugs

Directory of Open Access Journals (Sweden)

Luisa Gilardini

2016-07-01

Full Text Available Objective: To assess the effect of a lifestyle intervention in lowering/normalizing blood pressure (BP levels in hypertensive (controlled or not obese patients. Methods: In this prospective observational study, 490 obese hypertensive patients, 389 controlled (BP Results: 18.9% of CH and 20.0% of UH were on ≥ 3 antihypertensive drugs. Weight change (average -4.9 ± 2.7% was independent of the antihypertensive drugs employed. Systolic BP (SBP decreased by 23 mm Hg and diastolic BP (DBP by 9 mm Hg, in patients with UH most of whom (89% normalized BP levels (in 49% after a weight loss Conclusion: Lifestyle interventions are useful for all obese hypertensive patients in most of whom a modest weight loss is sufficient to normalize BP levels avoiding the aggressive use of multiple antihypertensive drugs.

Tranexamic Acid Safely Reduced Blood Loss in Hemi- and Total Hip Arthroplasty for Acute Femoral Neck Fracture: A Randomized Clinical Trial.

Science.gov (United States)

Watts, Chad D; Houdek, Matthew T; Sems, S Andrew; Cross, William W; Pagnano, Mark W

2017-07-01

We aimed to determine whether (1) tranexamic acid (TXA) reduces the incidence of transfusion (2) TXA reduces the calculated blood loss, and (3) there are any observable differences in 30- and 90-day complications with TXA administration during arthroplasty for femoral neck fracture (FNF). Prospective, double-blinded, randomized controlled trial. Level 1 Academic Trauma Center. One hundred thirty-eight patients who presented with a low-energy, isolated, FNF (AO 31B) treated with either hemi- or total hip arthroplasty within 72 hours of injury were randomized to either the TXA group (69 patients) or placebo group (69 patients). In the TXA group, patients received 2 doses of 15 mg/kg intravenous TXA dissolved in 100 mL of saline, each administered over 10 minutes; 1 dose just before incision, and the second at wound closure. In the placebo group, 100 mL of saline solution was administered in a similar fashion. Perioperative care was otherwise standardized including conservative transfusion criteria. Our primary outcome was to determine the proportion of patients who underwent blood transfusion during hospitalization. Secondary outcomes were calculated blood loss, number of units transfused during hospitalization, and incidence of adverse events at 30 and 90 days including thromboembolic event, wound complications, reoperation, hospital readmission, and all-cause mortality. TXA reduced mean incidence of transfusion by 305 mL (P = 0.0005). There was a trend toward decreased transfusion rate in the TXA group (17% vs. 26%, P = 0.22). TXA was safe with no differences in adverse events at 30 and 90 days. This randomized clinical trial found that TXA administration safely reduced blood loss with a tendency for decreased transfusion rate and total blood product consumption for patients undergoing hip arthroplasty for acute FNF. More studies are needed to further ascertain the role of TXA in the management of patients with FNF. Therapeutic Level I. See Instructions for Authors

Transitional Justice: History-Telling, Collective Memory, and the Victim-Witness

Directory of Open Access Journals (Sweden)

Chrisje Brants

2013-06-01

Full Text Available This article examines the complex, inherently political, and often contradictory processes of truth-finding, history-telling, and formation of collective memory through transitional justice. It explores tensions between history-telling and the normative goals of truth commissions and international criminal courts, taking into account the increasing importance attributed to victims as witnesses of history. The legal space these instruments of transitional justice offer is determined by both their historical and political roots, and specific goals and procedures. Because the legal space that truth commissions offer for history-telling ismore flexible and their report open to public debate, they may open up alternative public spaces and enable civil society to contest the master narrative. The legal truth laid down in the rulings of an international criminal court is by definition closed. The verdict of a court is definite and authoritative; closure, not continued debate about what it has established as the truth, is its one and only purpose. In conclusion, the article calls for a critical appraisal of transitional justice as acclaimed mediator of collective memories in post-conflict societies.

Geophysical survey at Tell Barri (Syria)

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Florio, Giovanni; Cella, Federico; Pierobon, Raffaella; Castaldo, Raffaele; Castiello, Gabriella; Fedi, Maurizio

2010-05-01

A geophysical survey at the archaeological site of Tell Barri (Northeasterm Syria) was carried out. The Tell (Arab word for "hill") is 32 m high with a whole covered area of 37 hectares. The Tell, with its huge dimensions and with a great amount of pottery on the surface, is a precious area to study the regional history from IV mill. BC to Islamic and Medieval period. The geophysical study consisted in magnetic and electromagnetic measurements in the lower town area. The aim of this survey was to provide evidence of the presence of buried archaeological structures around an already excavated area. The wall structures in the Tell Barri are made by backed or crude clay bricks. The instrument used for the magnetic survey was an Overhauser-effect proton magnetometer (Gem GSM-19GF), in gradiometric configuration. The electromagnetic instrument used, Geonics Ltd. EM31, implements a Frequency Domain Electromagnetic Method (FDEM). It was used in vertical coils configuration, and this choice should grant a maximum theoretical investigation depth of about 6 m. Before starting the measurements on a larger scale, we conducted a magnetic and EM test profile on some already excavated, outcropping, baked bricks walls. Results were encouraging, because clear and strong magnetic and EM anomalies were recorded over the outcropping walls. However, in the survey area these structures are covered by 3 to 4 meters of clay material and the increased sensors-structures distance will reduce the anomalies amplitude. Moreover, the cover material is disseminated with bricks, basalt blocks and ceramics, all of which have relevant magnetic properties. After magnetic surveying some 50 m side square areas, we verified that unfortunately their effect resulted to be dominant with respect to the deeper wall structures, degrading too much the signal-to-noise ratio. The processing and analysis of magnetic data is however currently underway and will determine decisions about further use of this method

Preventing Excessive Blood Loss During Percutaneous Nephrolithotomy by Using Tranexamic Acid: A Double Blinded Prospective Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Adnan Siddiq

2017-12-01

Full Text Available Objective: Percutaneous nephrolithotomy (PCNL is most frequently performed procedure for renal stones 2 cm and larger. Perioperative hemorrhage being most common complication, warrants as important predicting factor of adverse outcomes. Prevention with inexpensive and safe drug like tranexamic acid (TA would ultimately turn out to be cornerstone for establishing future guidelines. Aim of this study is to evaluate whether TA is efficacious in preventing blood loss during PCNL. Materials and Methods: Ethical review board approval taken. Sample size calculation yielded 240 patients, comprising 120 in each group. Group A receiving TA and group B receiving placebo. Age, gender, body mass index (BMI, stone size, volume and location, preoperative blood count, creatinine, urine analysis, coagulation profile and necessary radiological investigations done. Randomization through lottery method. Both patient and investigator were blinded. Hemoglobin (Hb and hematocrit (Hct levels done at 24 hours postoperatively and fall in values recorded. Results: Both groups were equal in characteristics like age, gender, BMI, stone size, volume and location (p>0.05. Operative variables like calyx punctured, position of puncture and operative time were also found to be similar in both groups. Median change in Hb in placebo group was 1.6 interquartile range (IQR 4, while in TA group was 1.3 (IQR 7.8 (p=0.001. Similarly, median change in Hct level in placebo group was 3.6 (IQR 11.8 and in TA group was 2.4 (IQR 13 (p<0.001. Sixteen patients were transfused after surgery; 12 (75% belonged to placebo group while 4 (25% belonged to TA group (p=0.038. Hospital stay was not significantly different in both groups (p=0.177 with median of 4.0 and IQR of 0 in both groups. Conclusion: TA during PCNL reduces blood loss and minimizes blood transfusion rate.

The Analysis of the Gothic Element——High Emotion in The Tell-tale Heart

Institute of Scientific and Technical Information of China (English)

李莎

2014-01-01

The Tell-tale Heart is one of the most typical gothic novel of Allen Poe’s. This article intends to analyse one of the gothic elements, that is, high emotion which is employed in The Tell-tale Heart to contribute to the horror effect.

Should physicians tell the truth without taking social complications into account? A striking case.

Science.gov (United States)

Avci, Ercan

2018-03-01

The principle of respect for autonomy requires informing patients adequately and appropriately about diagnoses, treatments, and prognoses. However, some clinical cases may cause ethical dilemmas regarding telling the truth. Under the existence especially of certain cultural, social, and religious circumstances, disclosing all the relevant information to all pertinent parties might create harmful effects. Even though the virtue of telling the truth is unquestionable, sometimes de facto conditions compel physicians to act paternalistically to protect the patient/patients from imminent dangers. This article, which aims to study the issue of whether a physician should always tell the truth, analyzes an interesting case that represents the detection of misattributed paternity during pre-transplant tests for a kidney transplant from the son to the father in Turkey, where social, cultural, and religious factors have considerable impact on marital infidelity. After analyzing the concept of telling the truth and its relationship with paternalism and two major ethical theories, consequentialism and deontology, it is concluded that the value of the integrity of life and survival overrides the value of telling the truth. For this reason, in the case of a high possibility of severe and imminent threats, withholding some information is ethically justifiable.

The effect of blood volume loss on cardiovascular response to lower body negative pressure using a mathematical model

Science.gov (United States)

Karam, E. H.; Srinivasan, R. S.; Charles, J. B.; Fortney, S. M.

1994-01-01

Different mathematical models of varying complexity have been proposed in recent years to study the cardiovascular (CV) system. However, only a few of them specifically address the response to lower body negative pressure (LBNP), a stress that can be applied in weightlessness to predict changes in orthostatic tolerance. Also, the simulated results produced by these models agree only partially with experimental observations. In contrast, the model proposed by Melchior et al., and modified by Karam et al. is a simple representation of the CV system capable of accurately reproducing observed LBNP responses up to presyncopal levels. There are significant changes in LBNP response due to a loss of blood volume and other alterations that occur in weightlessness and related one-g conditions such as bedrest. A few days of bedrest can cause up to 15% blood volume loss (BVL), with consequent decreases in both stroke volume and cardiac output, and increases in heart rate, mean arterial pressure, and total peripheral resistance. These changes are more pronounced at higher levels of LBNP. This paper presents the results of a simulation study using our CV model to examine the effect of BVL on LBNP response.

Uudised : Rossini "Wilhelm Tell" Estonias. Cavalli ooper Amsterdamis

Index Scriptorium Estoniae

2008-01-01

Gioachino Rossini ooperi "Wilhelm Tell" kontsertettekandest 18. ja 20. dets. Rahvusooper Estonias (peaosas Rauno Elp, külalisesinejaks Mario Zeffiri). Itaalia barokihelilooja Francesco Cavalli ooperi "Ercole amante" lavastamisest Madalmaade Ooperis Amsterdamis (lavastaja David Alden, esietendus 11. jaanuaril)

Cytokine-Mediated Loss of Blood Dendritic Cells During Epstein-Barr Virus-Associated Acute Infectious Mononucleosis: Implication for Immune Dysregulation.

Science.gov (United States)

Panikkar, Archana; Smith, Corey; Hislop, Andrew; Tellam, Nick; Dasari, Vijayendra; Hogquist, Kristin A; Wykes, Michelle; Moss, Denis J; Rickinson, Alan; Balfour, Henry H; Khanna, Rajiv

2015-12-15

Acute infectious mononucleosis (IM) is associated with altered expression of inflammatory cytokines and disturbed T-cell homeostasis, however, the precise mechanism of this immune dysregulation remains unresolved. In the current study we demonstrated a significant loss of circulating myeloid and plasmacytoid dendritic cells (DCs) during acute IM, a loss correlated with the severity of clinical symptoms. In vitro exposure of blood DCs to acute IM plasma resulted in loss of plasmacytoid DCs, and further studies with individual cytokines showed that exposure to interleukin 10 could replicate this effect. Our data provide important mechanistic insight into dysregulated immune homeostasis during acute IM. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Changes in glucose-elicited blood metabolite responses following weight loss and long term weight maintenance in obese individuals with impaired glucose tolerance.

Science.gov (United States)

Geidenstam, Nina; Danielsson, Anders P H; Spégel, Peter; Ridderstråle, Martin

2016-03-01

Weight loss improves insulin sensitivity and glucose tolerance in obese subjects with impaired glucose tolerance (IGT), but the long term dynamic effects on blood metabolites other than glucose during an oral glucose tolerance test (OGTT), are largely unknown. Here, we studied changes in OGTT-elicited metabolite patterns in obese subjects during a diet-induced weight loss study. Blood samples from 14 obese individuals with IGT were collected at 0, 30 and 120 min during a standard 75 g OGTT at baseline (BMI 44 ± 2 kg/m(2)), after weight loss (BMI 36 ± 2 kg/m(2)) and after weight maintenance (BMI 35 ± 2 kg/m(2)). Serum metabolite levels were analyzed by gas chromatography/mass spectrometry and compared to a lean glucose tolerant group. Changes in the OGTT-elicited metabolite patterns occurred differentially during weight loss and weight maintenance. Enhanced suppression of aromatic amino acids were associated with decreased insulinogenic index observed after weight loss (tyrosine: r=0.72, p=0.013; phenylalanine: r=0.63, p=0.039). The OGTT-elicited suppression and/or lack of increase in levels of glutamate, glutamine, isoleucine, leucine, and the fatty acids laurate, oleate and palmitate, improved towards the lean profile after weight maintenance, paralleling an improvement in glucose tolerance. The greater heterogeneity in the response before and after weight loss in the obese, compared to lean subjects, was markedly reduced after weight maintenance. Diet-induced weight loss followed by weight maintenance results in changes in metabolite profiles associated with either hepatic insulin sensitivity or peripheral glucose tolerance. Our results highlight the importance of evaluating the effects of weight loss and weight maintenance separately. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Intrathoracic Pressure Regulator for Blood Loss

Science.gov (United States)

2016-05-24

hepatitis A antibody, and human immunodeficiency virus antibody), urine tests (drug screen I-abuse, marijuana, and a pregnancy test), and a 12-lead... sodium chloride; 250 mL over 2.5 minutes) were administered if systolic BP < 85 mmHg. Blood pressure, other hemodynamics, UO, and total amount of

Pregnancy Loss and Miscarriage

Science.gov (United States)

... D linked to miscarriage among women with prior pregnancy loss Release: Anti-HIV drug combination does not increase preterm birth risk, study suggests Release: Elevated blood pressure before pregnancy may increase chance of pregnancy loss All related ...

To Tell the Truth: The Challenge of Military Leadership

National Research Council Canada - National Science Library

Henderson, Jr, Ronald H

1998-01-01

The story of Regulus, while certainly apocryphal, nevertheless illustrates a fundamental tension of military leadership -- the moral imperative for military leaders to tell the truth, even when that...

Appropriateness of Intra-Operative Blood Transfusion In Children at ...

African Journals Online (AJOL)

Background: The decision to transfuse intra-operatively is based on preoperative haemoglobin (Hb), estimated blood loss and physiological variables. The visual estimate of blood loss is notoriously unreliable especially with small volumes of blood losses in children. Objectives :We sought therefore to determine the ...

What is the role of autologous blood transfusion in major spine surgery?

Science.gov (United States)

Kumar, Naresh; Chen, Yongsheng; Nath, Chinmoy; Liu, Eugene Hern Choon

2012-06-01

Major spine surgery is associated with significant blood loss, which has numerous complications. Blood loss is therefore an important concern when undertaking any major spine surgery. Blood loss can be addressed by reducing intraoperative blood loss and replenishing perioperative blood loss. Reducing intraoperative blood loss helps maintain hemodynamic equilibrium and provides a clearer operative field during surgery. Homologous blood transfusion is still the mainstay for replenishing blood loss in major spine surgery across the world, despite its known adverse effects. These significant adverse effects can be seen in up to 20% of patients. Autologous blood transfusion avoids the risks associated with homologous blood transfusion and has been shown to be cost-effective. This article reviews the different methods of autologous transfusion and focuses on the use of intraoperative cell salvage in major spine surgery. Autologous blood transfusion is a proven alternative to homologous transfusion in major spine surgery, avoiding most, if not all of these adverse effects. However, autologous blood transfusion rates in major spine surgery remain low across the world. Autologous blood transfusion may obviate the need for homologous transfusion completely. We encourage spine surgeons to consider autologous blood transfusion wherever feasible.

Time telling devices used in Danish health care are not synchronized

DEFF Research Database (Denmark)

Brabrand, Mikkel; Hosbond, Susanne; Petersen, Dan Brun

2012-01-01

Many patients begin their encounter with the health-care services in an ambulance. In some critical patients, it is pivotal that the timing of treatment and events is registered correctly. When patients are transferred from one health care provider to another, there is a risk that the time telling...... devices used are not synchronized. It has never been examined if this is a problem in Denmark. We performed the present study to examine if time telling devices used in the pre-hospital setting were synchronized with devices used in emergency departments....

Story Telling With Storyboards: Enhancements and Experiences

Science.gov (United States)

King, T. A.; Grayzeck, E. J.; Galica, C.; Erickson, K. J.

2016-12-01

A year ago a tool to help tell stories, called the Planetary Data Storyboard, was introduced. This tool is designed to use today's technologies to tell stories that are rich multi-media experiences, blending text, animations, movies and infographics. The Storyboard tool presents a set of panels that contain representative images of an event with associated notes or instructions. The panels are arranged in a timeline that allow a user to experience a discovery or event in the same way it occurred. Each panel can link to a more detailed source such as a publication, the data that was collected or items derived from the research (like movies or animations). A storyboard can be used to make science discovery more accessible to people by presenting events in an easy to follow layout. A storyboard can also help to teach the scientific method, by following the experiences of a researcher as they investigate a phenomenon or try to understand a new set of observations. We present the new features of Storyboard tool and show example stories for scientific discoveries.

The effect of tranexamic acid on blood loss and maternal outcome in the treatment of persistent postpartum hemorrhage: A nationwide retrospective cohort study.

Directory of Open Access Journals (Sweden)

Ada Gillissen

Full Text Available Recent results show a protective effect of tranexamic acid on death due to bleeding in patients with postpartum hemorrhage in low- and middle-resource countries. We quantify the association between early administration of tranexamic acid compared to late or no administration and severe acute maternal morbidity and blood loss among women suffering from persistent severe postpartum hemorrhage in a high-income country.We performed a nationwide retrospective cohort study in 61 hospitals in the Netherlands. The study population consisted of 1260 women with persistent postpartum hemorrhage who had received at least four units of red cells, or fresh frozen plasma or platelets in addition to red cells. A review of medical records was performed and cross-referenced with blood bank data. The composite endpoint comprised maternal morbidity (hysterectomy, ligation of the uterine arteries, emergency B-Lynch suture, arterial embolization or admission into an intensive care unit and mortality.247 women received early tranexamic acid treatment. After adjustment for confounding, odds ratio for the composite endpoint for early tranexamic acid (n = 247 versus no/late tranexamic acid (n = 984 was 0.92 (95% confidence interval (CI 0.66 to 1.27. Propensity matched analysis confirmed the absence of a difference between women with and without tranexamic acid. Blood loss after administration of first line therapy did not differ significantly between the two groups (adjusted difference -177 mL, CI -509.4 to +155.0.Our findings suggest that in a high-resource country the effect of tranexamic acid on both blood loss and the combined endpoint of maternal mortality and morbidity may be disappointing.

The effect of tranexamic acid on blood loss and maternal outcome in the treatment of persistent postpartum hemorrhage: A nationwide retrospective cohort study

Science.gov (United States)

Henriquez, Dacia D. C. A.; van den Akker, Thomas; Wind, Merlijn; Zwart, Joost J.; van Roosmalen, Jos; Eikenboom, Jeroen; Bloemenkamp, Kitty W. M.; van der Bom, Johanna G.

2017-01-01

Background Recent results show a protective effect of tranexamic acid on death due to bleeding in patients with postpartum hemorrhage in low- and middle-resource countries. We quantify the association between early administration of tranexamic acid compared to late or no administration and severe acute maternal morbidity and blood loss among women suffering from persistent severe postpartum hemorrhage in a high-income country. Methods and findings We performed a nationwide retrospective cohort study in 61 hospitals in the Netherlands. The study population consisted of 1260 women with persistent postpartum hemorrhage who had received at least four units of red cells, or fresh frozen plasma or platelets in addition to red cells. A review of medical records was performed and cross-referenced with blood bank data. The composite endpoint comprised maternal morbidity (hysterectomy, ligation of the uterine arteries, emergency B-Lynch suture, arterial embolization or admission into an intensive care unit) and mortality. Results 247 women received early tranexamic acid treatment. After adjustment for confounding, odds ratio for the composite endpoint for early tranexamic acid (n = 247) versus no/late tranexamic acid (n = 984) was 0.92 (95% confidence interval (CI) 0.66 to 1.27). Propensity matched analysis confirmed the absence of a difference between women with and without tranexamic acid. Blood loss after administration of first line therapy did not differ significantly between the two groups (adjusted difference -177 mL, CI -509.4 to +155.0). Conclusions Our findings suggest that in a high-resource country the effect of tranexamic acid on both blood loss and the combined endpoint of maternal mortality and morbidity may be disappointing. PMID:29107951

Telling it like it is: the adaptive function of narratives in coping with loss in later life.

Science.gov (United States)

Caplan, Scott E; Haslett, Beth J; Burleson, Brant R

2005-01-01

As the population ages, caregivers and health care providers need more insight into how people experience old age and their attitudes and emotions about growing older. It is particularly critical to understand how communication processes change and how older adults communicate their concerns and feelings. This article proposes that some discursive activities may play a crucial role in successfully adapting to, and coping with, loss in later life. Thus, this study explored how older adults reflect on and express themselves concerning recent experiences of loss. A sample of 41 residents of 2 independent-living retirement communities wrote in journals about a recent significant loss. Participants wrote about their losses during brief lab sessions over the course of 3 consecutive days. Each set of 3 journals was content-analyzed to measure the frequency with which the participants employed emotional expression, factual recounting, account giving, religious-account giving, humor, intensifiers, and referential statements. The analysis indicates that, overall, participants shifted from a primarily factual mode (what the loss was, how the loss occurred, etc.) to more of a focus on the impact of this loss on their lives (e.g., handling new tasks and expressions of emotions) over the 3 sessions. In addition, most participants offered accounts of their losses; that is, they attempted to find some meaning in the loss and integrate the loss into an overall framework for their lives. Many of these accounts focused on religion. Final sections of the article discuss the implications of journaling as a mechanism for effective coping with loss, as a useful tool for expressing emotions, and as a means for older adults' caregivers and health care providers to better adapt their supportive messages.

Evaluation of the carotid artery stenosis based on minimization of mechanical energy loss of the blood flow.

Science.gov (United States)

Sia, Sheau Fung; Zhao, Xihai; Li, Rui; Zhang, Yu; Chong, Winston; He, Le; Chen, Yu

2016-11-01

Internal carotid artery stenosis requires an accurate risk assessment for the prevention of stroke. Although the internal carotid artery area stenosis ratio at the common carotid artery bifurcation can be used as one of the diagnostic methods of internal carotid artery stenosis, the accuracy of results would still depend on the measurement techniques. The purpose of this study is to propose a novel method to estimate the effect of internal carotid artery stenosis on the blood flow based on the concept of minimization of energy loss. Eight internal carotid arteries from different medical centers were diagnosed as stenosed internal carotid arteries, as plaques were found at different locations on the vessel. A computational fluid dynamics solver was developed based on an open-source code (OpenFOAM) to test the flow ratio and energy loss of those stenosed internal carotid arteries. For comparison, a healthy internal carotid artery and an idealized internal carotid artery model have also been tested and compared with stenosed internal carotid artery in terms of flow ratio and energy loss. We found that at a given common carotid artery bifurcation, there must be a certain flow distribution in the internal carotid artery and external carotid artery, for which the total energy loss at the bifurcation is at a minimum; for a given common carotid artery flow rate, an irregular shaped plaque at the bifurcation constantly resulted in a large value of minimization of energy loss. Thus, minimization of energy loss can be used as an indicator for the estimation of internal carotid artery stenosis.

Exploring the Identities of Hearing Parents Who Chose Cochlear Implantation for Their Children with Hearing Loss

Science.gov (United States)

Scharp, Kristina M.; Barker, Brittan A.; Rucker, Sidney N.; Jones, Hannah D.

2018-01-01

We aimed to determine the types of identities hearing parents construct when telling online stories about their children with hearing loss (HL) who use cochlear implants (CIs). To do so, we employed a qualitative design and sampled 20 different blogs United States origins and written by parents of children who use CIs. We then used thematic…

Bodily Synchronization Underlying Joke Telling

Directory of Open Access Journals (Sweden)

R. C. Schmidt

2014-08-01

Full Text Available Advances in video and time series analysis have greatly enhanced our ability to study the bodily synchronization that occurs in natural interactions. Past research has demonstrated that the behavioral synchronization involved in social interactions is similar to dynamical synchronization found generically in nature. The present study investigated how the bodily synchronization in a joke telling task is spread across different nested temporal scales. Pairs of participants enacted knock-knock jokes and times series of their bodily activity were recorded. Coherence and relative phase analyses were used to evaluate the synchronization of bodily rhythms for the whole trial as well as at the subsidiary time scales of the whole joke, the setup of the punch line, the two-person exchange and the utterance. The analyses revealed greater than chance entrainment of the joke teller’s and joke responder’s movements at all time scales and that the relative phasing of the teller’s movements led those of the responder at the longer time scales. Moreover, this entrainment was greater when visual information about the partner’s movements was present but was decreased particularly at the shorter time scales when explicit gesturing in telling the joke was performed. In short, the results demonstrate that a complex interpersonal bodily dance occurs during structured conversation interactions and that this dance is constructed from a set of rhythms associated with the nested behavioral structure of the interaction.

A Mobile Phone-Based Health Coaching Intervention for Weight Loss and Blood Pressure Reduction in a National Payer Population: A Retrospective Study.

Science.gov (United States)

Mao, Alice Yuqing; Chen, Connie; Magana, Candy; Caballero Barajas, Karla; Olayiwola, J Nwando

2017-06-08

The prevalence of obesity and associated metabolic conditions continue to be challenging and costly to address for health care systems; 71% of American adults were overweight, with 35% of men and 40% of women diagnosed with obesity in 2014. Digital health coaching is an innovative approach to decreasing the barriers of cost and accessibility of receiving health coaching for the prevention and management of chronic disease in overweight or obese individuals. To evaluate the early impact of a mobile phone-based health coaching service on weight loss and blood pressure management in a commercially insured population. This was a retrospective study using existing registry data from a pilot commercial collaboration between Vida Health and a large national insurance provider, which enrolled adult members who were overweight (body mass index >25 kg/m2) and able to engage in a mobile phone-based coaching intervention. Participants received 4 months of intensive health coaching via live video, phone, and text message through the Vida Health app. Participants were also provided with a wireless scale, pedometer, and blood pressure cuff. Of the 1012 enrolled, 763 (75.40%) participants had an initial weight upon enrollment and final weight between 3 and 5 months from enrollment; they served as our intervention group. There were 73 participants out of the 1012 (7.21%) who had weight data 4 months prior to and after Vida coaching, who served as the matched-pair control group. Participants in the intervention group lost an average of 3.23% total body weight (TBW) at 4 months of coaching and 28.6% (218/763) intervention participants achieved a clinically significant weight loss of 5% or more of TBW, with an average of 9.46% weight loss in this cohort. In the matched-pair control group, participants gained on average 1.81% TBW in 4 months without Vida coaching and lost, on average, 2.47% TBW after 4 months of Vida coaching, demonstrating a statistically significant difference of 4

The Telling Takes Us Home

Science.gov (United States)

Lazic, G. M.

2013-04-01

Carl Sagan reminded us in Cosmos that we have wondered about the stars for as long as we have been human. “Star tellers” like Von Del Chamberlain and Lynn Moroney remind us that, for just as long, we have been telling stories about the stars to explain what we observed. This presentation describes methods of reuniting science and storytelling as complementary approaches to comprehending the cosmos. Examples illustrate how stories can serve as “springboards,” inspire their listeners to new awareness, and involve astronomy educators as reporters, tellers, and mediators.

Nursing and Midwifery Education in Rwanda: Telling our Story ...

African Journals Online (AJOL)

Nursing and Midwifery Education in Rwanda: Telling our Story. ... Journal Home > Vol 2, No 2 (2015) > ... The establishment of the Kigali Health Institute in1996 greatly advanced nursing and midwifery education with the awarding of an ...

Truth telling and informed consent: is "primum docere" the new motto of clinical practice?

Science.gov (United States)

Byk, Christian

2007-09-01

Autonomy has become in many countries a key concept in the patient-physician relationship, leaving the old paternalistic medical attitude out of the realm of common good clinical practice. Consequently, the validity of the informed consent procedure which is related to any medical intervention, should imply that the information given is true. Raising the question as such obliges us to consider the truth not for itself but in regard to the validity of the consent to a medical intervention. Although a clinical approach reveals that loyalty should guide the patient-physician relationship, there are still some situations in which informed consent and truth telling may be controversial: in some circumstances, the physician should or may not tell the truth, in others he can simply forget to tell.

Member State Event: Telling CERN's story !

CERN Multimedia

2004-01-01

As part of the events to mark the Laboratory's fiftieth anniversary, members of the CERN personnel are telling the story of CERN. Robert Cailliau (on the right), currently responsible for CERN's external communications, and Chiara Mariotti (in the center), a physicist working at CMS, were invited to talk about the history of CERN and the Web at a conference in the 'Science Thursdays' series entitled 'From the Quark to the Web' in Turin on 26 February.

Tranexamic acid administration to older patients undergoing primary total hip arthroplasty conserves hemoglobin and reduces blood loss.

Science.gov (United States)

El Beheiry, Hossam; Lubberdink, Ashley; Clements, Nigel; Dihllon, Kiran; Sharma, Vicky

2018-06-01

Tranexamic acid effects in older people are difficult to predict. This study investigated the following research questions: 1) Is tranexamic acid effective in older patients undergoing primary total hip arthroplasty (THA)? and 2) Is there a difference in the effect of tranexamic acid between younger and older patients? This was a 2-phase retrospective matched-pair study of patients who underwent THA in 2007-2013. All procedures were performed by surgeons with at least 10 years' experience as senior consultant. In the first phase, 58 patients aged 65 years or more who received tranexamic acid were matched 1:1 with patients who did not receive tranexamic acid for age, sex, American Society of Anesthesiologists (ASA) classification and body mass index. In the second phase, 58 patients aged 65 years or more who received tranexamic acid were matched 1:1 with patients less than 65 years of age who received tranexamic acid for sex, ASA classification and body mass index. The primary outcome measures were percent maximum decrease in hemoglobin level and estimated blood loss after surgery. In the first phase, patients who received tranexamic acid conserved postoperative hemoglobin by a mean of 10.26 g/L (standard deviation [SD] 9.89 g/L) compared to the control group ( p Tranexamic acid reduced the postoperative decrease in hemoglobin level and blood loss in older patients. Moreover, the significant hemoglobin-sparing effect of tranexamic acid in older patients was similar to that observed in younger patients.

Quality of pre-school children's pretend play and subsequent development of semantic organization and narrative re-telling skills.

Science.gov (United States)

Stagnitti, Karen; Lewis, Fiona M

2015-04-01

This study investigated if the quality of pre-school children's pretend play predicted their semantic organization and narrative re-telling ability when they were in early primary school. It was hypothesized that the elaborateness of a child's play and the child's use of symbols in play were predictors of their semantic organization and narrative re-tell scores of the School Age Oral Language Assessment. Forty-eight children were assessed using the Child-Initiated Pretend Play Assessment when they were aged 4-5 years. Three-to-five years after this assessment their semantic organization and narrative re-telling skills were assessed. Results indicate that the elaborateness of a child's play and their ability to use symbols was predictive of semantic organization skills. Use of symbols in play was the strongest play predictor of narrative re-telling skills. The quality of a pre-school child's ability to elaborate complex sequences in pretend play and use symbols predicted up to 20% of a child's semantic organization and narrative re-telling skills up to 5 years later. The study provides evidence that the quality of pretend play in 4-5 year olds is important for semantic organization and narrative re-telling abilities in the school-aged child.

What history tells us XXIX. Transfers from plant biology

Indian Academy of Sciences (India)

Home; Journals; Journal of Biosciences; Volume 37; Issue 6. What history tells us XXIX. Transfers from plant biology: From cross protection to RNA interference and DNA vaccination. Michel Morange. Series Volume 37 Issue 6 December 2012 pp 949-952 ...

Management of major blood loss: an update

DEFF Research Database (Denmark)

Johansson, P I; Ostrowski, S R; Secher, N H

2010-01-01

the early control of the cause of bleeding by non-definitive means, while haemostatic control resuscitation seeks early control of coagulopathy. Haemostatic resuscitation provides transfusions with plasma and platelets in addition to red blood cells (RBCs) in an immediate and sustained manner as part...

The plant macroremains from PPNB Tell Labwe (Lebanon)

DEFF Research Database (Denmark)

Gyurova, Dobrina; Otaegui, Amaia Arranz; Richter, Tobias

Tell Labwe constitutes the oldest Neolithic settlement in the Beqaa Valley (Lebanon). This site was excavated by D. Kirkbride in 1966 and revealed a sequence dated from the Late PPNB to the Pottery Neolithic. In 2011, a Lebanese-Spanish team carried out a fieldwork season in order to complete...... the Neolithic in Lebanon....

Tell-Tale Signs: Reflection towards the Acquisition of Academic ...

African Journals Online (AJOL)

Tell-Tale Signs: Reflection towards the Acquisition of Academic Discourses as Second Languages. ... Stellenbosch Papers in Linguistics ... After enrolling in a sign language course, we – lecturers teaching academic discourses – decided to explore this phenomenon and determine the implications for pedagogical practice.

[Walter Matthias Diggelmann--the healing effect of story telling].

Science.gov (United States)

Schmid, H J

2001-06-21

"Stories are weapons against disease" wrote Swiss writer WM Diggelmann (1927-1979). In writing stories he hoped to counteract the lethal course of his cancer. In the past it had helped him to overcome destitution and social disgrace and had given him identity. His last story Walking on the Island of St. Margaret is a ritual which conjures up an intact future by celebrating the past. Stories try to explain the world. They inform or clarify emotions. In telling stories, doctors and nurses demonstrate sympathy and understanding. Perhaps even greater benefits might be derived from patients telling their own stories. In doing so they emerge as individuals and give their lives purpose. Language is more than communication: it is shelter, link, home, ritual. Storytelling helps patients cope with their diseases. It is not clear whether this or any technique of psychotherapy has any effect upon the course of cancer.

Critical Inquiry for the Social Good: Methodological Work as a Means for Truth-Telling in Education

Science.gov (United States)

Kuntz, Aaron M.; Pickup, Austin

2016-01-01

This article questions the ubiquity of the term "critical" in methodological scholarship, calling for a renewed association of the term with projects concerned with social justice, truth-telling, and overt articulations of the social good. Drawing on Michel Foucault's work with parrhesia (or truth-telling) and Aristotle's articulation of…

First Trimester Pregnancy Loss and the Expression of alternatively spliced NKp30 isoforms in Maternal Blood and Placental Tissue

Directory of Open Access Journals (Sweden)

Avishai eShemesh

2015-06-01

Full Text Available In this study, we aimed to investigate whether first trimester pregnancy loss is associated with differences in expression of NKp30 splice variants (isoforms in maternal peripheral blood or placental tissue. We conducted a prospective case-control study; a total of 33 women undergoing dilation and curettage due to first trimester pregnancy loss were further subdivided into groups with sporadic or recurrent pregnancy loss. The control group was comprised of women undergoing elective termination of pregnancy. The qPCR approach was employed to assess the relative expression of NKp30 isoforms as well as the total expression of NKp30 and NKp46 receptors between the selected groups. Results show that in both PBMC and placental tissue, NKp46 and NKp30 expression was mildly elevated in the pregnancy loss groups compared with the elective group. In particular, NKp46 elevation was significant. Moreover, expression analysis of NKp30 isoforms manifested a different profile between PBMC and the placenta. NKp30-a and NKp30-b isoforms in the placental tissue, but not in PBMC, showed a significant increase in the pregnancy loss groups compared with the elective group. Placental expression of NKp30 activating isoforms -a and -b in the pregnancy loss groups was negatively correlated with PLGF expression. In contrast, placental expression of these isoforms in the elective group was positively correlated with TNFα, IL-10 and VEGF-A expression. The altered expression of NKp30 activating isoforms in placental tissue from patients with pregnancy loss compared to the elective group and the different correlations with cytokine expression point to the involvement of NKp30-mediated function in pregnancy loss.

TellTable: Collaborative Work Using Single User Applications

Directory of Open Access Journals (Sweden)

John C. Nash

2009-07-01

Full Text Available Many work environments require collaborative writing and editing of documents in diverse formats. In simple cases, there is essentially one author who receives approvals and comments from others. In other cases, the document is genuinely collaboratively authored using asynchronous or synchronous methods. A common way to collaboratively edit a document is to exchange draft versions between authors via email. This method introduces the possibility of conflicting changes and missed contributions as well as a significant burden as all members of the team are responsible for version control. The principle difficulty is that independent changes can be made to different versions, which must later be reconciled manually. It is also difficult to determine when and why a change was made. This article introduces TellTable, an open source system designed to allow single-user software applications to be managed in a collaborative manner. We will discuss current collaboration models, the technical aspects of the TellTable software framework, security issues in its implementation, and tests of performance.

Selling or telling? A theory of ruin value:Selling or Telling? Paradoxes in tourism, culture and heritage

OpenAIRE

Pihl, Ole Verner

2011-01-01

Selling or telling? : A theory of ruin value  Abstract: To what extent can tourism be described as an agent of peace? Can war and conflict be reconciled through tourism? Why is the children's memorial in Hiroshima so important and why is the Holocaust memorial in Berlin a reconciliating and fascinating monument?  The post apocalyptic vision in our mainstream mass culture is a broad genre and is loaded with heavy, dramatic architecture and landscapes of destruction; most religions have these d...

Socially Rooted Authoritarianism in Lygia Fagundes Telles's "As Meninas"

Science.gov (United States)

Nielson, Rex P.

2017-01-01

Lygia Fagundes Telles's novel "As meninas" portrays the oppressive social atmosphere of Brazil's authoritarian military dictatorship in a way that few other novels accomplish. Though the novel eschews the documentary "romance-reportagem" mode famously adopted by other writers from the period, "As meninas" provides a…

Influence of social factors on the relation between lie-telling and children's cognitive abilities.

Science.gov (United States)

Talwar, Victoria; Lavoie, Jennifer; Gomez-Garibello, Carlos; Crossman, Angela M

2017-07-01

Lie-telling may be part of a normative developmental process for children. However, little is known about the complex interaction of social and cognitive factors related to this developmental behavior. The current study examined parenting style, maternal exposure to stressors, and children's cognitive abilities in relation to children's antisocial lie-telling behavior in an experimental setting. Children (3-6years, N=157) participated in a modified temptation resistance paradigm to elicit spontaneous lies. Results indicate that high authoritative parenting and high inhibitory control interact to predict a lower propensity to lie, but those who did lie had better semantic leakage control. This suggests that although children's lie-telling may be normative during early development, the relation to children's cognitive abilities can be moderated by responsive parenting behaviors that discourage lying. Copyright © 2017 Elsevier Inc. All rights reserved.

The Effect of Radioactive Lantern Mantle Powder and Bentonite-Zeoloite Minerals on the Volume of Blood Loss, Bleeding and Clotting Time

Directory of Open Access Journals (Sweden)

M Atefi

2009-04-01

Full Text Available ABSTRACT Introduction & Objective: Over the past decade the US army has widely studied new technologies for stopping sever hemorrhages and has introduced an effective Zeolite based hemostatic agent. On the other hand, Mortazavi and his colleagues previously reported the bio-stimulatory effects of the topical application of radioactive lantern mantle powder on wound healing. Their subsequent studies showed significant changes in some histological parameters concerning healing. In this light, here the bio-stimulatory effect of burned radioactive lantern mantles powder as well as two minerals bentonite and zeolite are presented. Materials & Methods: This experimental study was conducted in the center for radiological studies, Shiraz University of Medical Sciences in 2008. Fifty male Wistar rats were divided randomly into 5 groups of 10 animals each. Following anesthesia, animals’ tails were cut at a thickness of 5 mm by using a surgical scissor. No intervention was made on the animals of the 1st group. The 2nd to 4th group received topical non-radioactive lantern mantle powder, radioactive lantern mantle powder, Bentonite mineral or a mixture of Bentonite-Zeoliteat minerals respectively. After treatment with above mentioned agents, the volume of blood loss was measured using a scaled test-tube. The bleeding time and clotting time were also measured using a chronometer. SPSS software was used for statistical analysis. ANOVA was used for comparing the means of each parameter in the 5 groups. Results: The the volume of blood loss, bleeding and clotting times in control animals were 4.39±1.92 cc, 112.10±39.60 sec and 94.9±54.26 sec, respectively. In the 5th group in which the animals were treated with a mixture of Bentonite-Zeoliteat minerals, the volume of blood loss, bleeding and clotting times were 1.31±0.60 cc, 34.50±4.65 sec and 24.2±4.61 sec, respectively. Conclusion: This is the 1st investigation that studied the alterations of bleeding

How To Tell Your Literacy Stories through Radio.

Science.gov (United States)

Martini, Michael A.

This paper offers advice to educators on how to tell their literacy stories through the medium of radio. It suggests educators examine their story idea closely and decide if radio is the best medium. It also suggests that educators should become familiar with the radio stations in the local market and get to know the personnel at the particular…

Burning Down the House: the Burnt Building V6 at Late Neolithic Tell Sabi Abyad, Syria

DEFF Research Database (Denmark)

Akkermans, Peter M.M.G.; Brüning, Merel L.; Hammers, Neeke Mineke

2012-01-01

This article presents the remains of a T-shaped burnt building found in trench V6 in Operation II at Late Neolithic Tell Sabi Abyad, Syria. The burnt building closely resembles the so-called Burnt Village excavated earlier at Tell Sabi Abyad in Operation I, level 6, but is slightly older. Many...

41 CFR 105-64.104 - What must the system manager tell me when soliciting personal information?

Science.gov (United States)

2010-07-01

... manager tell me when soliciting personal information? 105-64.104 Section 105-64.104 Public Contracts and... Responsibilities § 105-64.104 What must the system manager tell me when soliciting personal information? When soliciting information from you or a third party for a system of records, system managers must: Cite the...

Predictors of children's prosocial lie-telling: Motivation, socialization variables, and moral understanding.

Science.gov (United States)

Popliger, Mina; Talwar, Victoria; Crossman, Angela

2011-11-01

Children tell prosocial lies for self- and other-oriented reasons. However, it is unclear how motivational and socialization factors affect their lying. Furthermore, it is unclear whether children's moral understanding and evaluations of prosocial lie scenarios (including perceptions of vignette characters' feelings) predict their actual prosocial behaviors. These were explored in two studies. In Study 1, 72 children (36 second graders and 36 fourth graders) participated in a disappointing gift paradigm in either a high-cost condition (lost a good gift for a disappointing one) or a low-cost condition (received a disappointing gift). More children lied in the low-cost condition (94%) than in the high-cost condition (72%), with no age difference. In Study 2, 117 children (42 preschoolers, 41 early elementary school age, and 34 late elementary school age) participated in either a high- or low-cost disappointing gift paradigm and responded to prosocial vignette scenarios. Parents reported on their parenting practices and family emotional expressivity. Again, more children lied in the low-cost condition (68%) than in the high-cost condition (40%); however, there was an age effect among children in the high-cost condition. Preschoolers were less likely than older children to lie when there was a high personal cost. In addition, compared with truth-tellers, prosocial liars had parents who were more authoritative but expressed less positive emotion within the family. Finally, there was an interaction between children's prosocial lie-telling behavior and their evaluations of the protagonist's and recipient's feelings. Findings contribute to understanding the trajectory of children's prosocial lie-telling, their reasons for telling such lies, and their knowledge about interpersonal communication. Copyright © 2011 Elsevier Inc. All rights reserved.

Determinants of economic growth: will data tell?

OpenAIRE

Ciccone, Antonio; Jarociński, Marek

2008-01-01

Many factors inhibiting and facilitating economic growth have been suggested. Will international income data tell which matter when all are treated symmetrically a priori? We find that growth determinants emerging from agnostic Bayesian model averaging and classical model selection procedures are sensitive to income differences across datasets. For example, many of the 1975-1996 growth determinants according to World Bank income data turn out to be irrelevant when using Penn World Table data ...

Choose and Tell Cards: A 4-H Cloverbud Resource for Promoting Public Speaking and Life Skills

Science.gov (United States)

Stechschulte, Jill; Scheer, Scott D.

2017-01-01

Choose and Tell is a curriculum for 4-H Cloverbud members that introduces them to public speaking and life skill enhancement (communication and social interaction). Choose and Tell consists of activity cards analogous to a deck of cards. Activity card titles include Wash and Comb Your Hair, Plant a Seed, and Floss Your Teeth. The activities are…

A double-blind, placebo-controlled randomized clinical trial to evaluate the efficacy of tranexamic acid in irrigant solution on blood loss during percutaneous nephrolithotomy: a pilot study from tertiary care center of North India.

Science.gov (United States)

Bansal, Ankur; Arora, Aditi

2017-08-01

To evaluate the efficacy and safety of 0.1% tranexamic acid in irrigant fluid in reducing blood loss during PCNL. The study involved 400 patients who were planned for PCNL and were prospectively randomized into two equal groups. In tranexamic group, 0.1% tranexamic acid was given in irrigant fluid, while in placebo group, distilled water was added to irrigant fluid during surgery. Operative data were recorded which included fall in hemoglobin, total blood loss, operative time, irrigation fluid, length of stay in hospital, requirement of blood transfusion, complications related to PCNL and adverse events of tranexamic acid. Baseline parameters were comparable between two groups. The fall in hemoglobin and total blood loss in the tranexamic group was significantly lower than placebo group (1.71 vs. 2.67 gm/dL, 154.55 vs. 212.61 mL, respectively, p tranexamic group were significantly less compared to placebo (p tranexamic group versus 82% in placebo (p = 0.12). The blood transfusion requirement was significantly lower in the tranexamic group versus placebo (5 vs. 12.5%, p = 0.012), as was the complication rate (19 vs. 28%, p = 0.044). The requirement of angioembolization in the tranexamic group was significantly less as compared to placebo (0.5 vs. 4%, p = 0.03). No adverse events related to administration of tranexamic acid were noted. 0.1% tranexamic acid in irrigant fluid is safe and significantly reduces perioperative blood loss and requirement of blood transfusion during percutaneous nephrolithotomy. It is associated with lower perioperative complication rates.

Narrative Story-Telling in Autism and Down Syndrome.

Science.gov (United States)

Loveland, Katherine A.; And Others

Sixteen subjects with autism and 16 with Down Syndrome (aged 5 to 27), matched on verbal mental age, watched a short puppet show or video skit and were then asked to tell the story to a listener and answer follow-up questions. The majority of both groups were able to produce recognizable, though primitive, narratives. The groups did not differ in…

Blood loss predictive factors and transfusion practice during percutaneous nephrolithotomy of kidney stones: a prospective study [version 1; referees: 1 approved, 2 approved with reservations

Directory of Open Access Journals (Sweden)

Firtantyo Adi Syahputra

2016-06-01

Full Text Available Objectives Bleeding is the most common complication of percutaneous nephrolithotomy (PCNL. Injudicious transfusion is frequently performed in current practice, even though it is not always needed. This study aimed to identify the predictive factors of blood loss in the PCNL procedure and evaluate the perioperative transfusion practice.   Methods A prospective study of PCNL was randomly performed by two consultants of endo-urology at our institution. The inclusion criteria were adults with kidney pelvic stones >20 mm or stone in inferior calyx >10 mm or staghorn stone. Those with coagulopathy, under anti-coagulant treatment or open conversion were excluded. A full blood count was taken at baseline and during 12, 24, 36, 72-hours post-operatively. Factors such as stone burden, sex, body surface area, shifting of hematocrit level and amount of blood transfused were analyzed statistically using line regression to identify the predictive factors of total blood loss (TBL.   Results Eighty-five patients were enrolled in this study. Mean TBL was 560.92 ± 428.43 mL for both endo-urology surgeons. Stone burden was the most influential factor for TBL (p=0.037. Our results revealed that TBL (mL = -153.379 + 0.229 × stone burden (mm2 + 0.203 x baseline serum hematocrit (%; thus considerably predicted the need for blood transfusion. A total of 87.1% patients did not receive perioperative transfusion, 3.5% received intra-operative transfusion, 7.1% received post-operative transfusion, 23% had both intra and post-operative transfusion, resulting in a cross-matched transfusion ratio of 7.72. Mean perioperative blood transfused was 356.00 ± 145.88 mL.

Analysis of the impact of race on blood transfusion in pediatric scoliosis surgery.

Science.gov (United States)

Maher, Keila M; Owusu-Akyaw, Kwadwo; Zhou, Jingzhu; Cooter, Mary; Ross, Allison K; Lark, Robert K; Taicher, Brad M

2018-04-01

Surgical correction of pediatric scoliosis is associated with significant blood loss. Minimizing estimated blood loss and blood transfusion is beneficial as transfusions have been associated with increased morbidity, including risk of surgical site infections, longer hospitalizations, and increased cost. Although there is evidence that African-American or Black adults are more likely to require intraoperative blood transfusion compared with Caucasian or White adults, the reasons for this difference are unclear. The electronic records for all patients blood loss/transfusion in primary pediatric scoliosis surgery. In a multivariate model, Black race was independently associated with 1.61 times higher estimated blood loss than White race (P blood transfusion was 6.25 times higher (P = .03; 95% CI = 1.56-25.06) and among the patients who received blood transfusion, Black race was independently associated with 2.61 times greater volume of blood transfusion than White race (P blood loss, increased rate of blood transfusion, and increased amount of blood transfused during surgical correction of pediatric scoliosis. Further investigation is needed to better understand the etiology of the disparity and assess opportunities for improving outcomes. © 2018 John Wiley & Sons Ltd.

What history tells us XXI. Apoptosis and programmed cell death

Indian Academy of Sciences (India)

2010-04-30

Apr 30, 2010 ... Home; Journals; Journal of Biosciences; Volume 35; Issue 2. What history tells us XXI. Apoptosis and programmed cell death: when biological categories are blurred. Michel Morange. Series Volume 35 Issue 2 June 2010 pp 177-181 ...

Anthropogenic sediments and soils of tells of the Balkans and Anatolia: Composition, genesis, and relationships with the history of landscape and human occupation

Science.gov (United States)

Sedov, S. N.; Aleksandrovskii, A. L.; Benz, M.; Balabina, V. I.; Mishina, T. N.; Shishkov, V. A.; Şahin, F.; Özkaya, V.

2017-04-01

Soils and sediments composing Tell Körtik Tepe (Epipaleolithic, Turkey) and Tell Yunatsite (Chalcolithic (Eneolithic), Bulgaria) have been studied with the aim to gain a better insight into their microfabrics, determine the composition of anthropogenic artifacts, and, on this basis, to analyze similarities and distinctions between these objects and the modern soils of urban areas. The methods of micromorphology, scanning electron microscopy with an energy dispersive X-ray microanalyzer, X-ray fluorometry, and other techniques to determine the chemical and physical properties of the soils and sediments have been applied. Two paleosols have been identified in Tell Yunatsite with a total thickness of 9 m: the paleosol buried under the tell and the paleosol in its middle part. Sediments of Tell Körtik Tepe have a total thickness of up to 5 m; their accumulation began at the end of Pleistocene over the surface of buried paleosol. The cultural layer of the tells consists of construction debris mainly represented by a mixture of clay and sand and of domestic wastes with the high content of phosphorus. The major source of phosphorus is calcium phosphate (apatite) of bone tissues. The abundance of various anthropogenic materials in the sediments is clearly seen in thin sections. Even in the paleosols developed within the cultural layer (the mid-profile paleosol in Tell Yunatsite), the amount of microinclusions of bone fragments, charcoal, and burnt clay (ceramics) is very high. Micromorphological data indicate that up to 50% of the layered material filling an Epipaleolithic construction in Tell Körtik Tepe consists of the anthropogenic inclusions: bone fragments, charcoal, etc. The features of pedogenic transformation are present in the sediments. Such sediments can be classified as synlithogenic soils similar to the modern Urbic Technosols. It is shown that the formation of paleosols and sediments of Tell Körtik Tepe took place under extreme environmental conditions�

Superconductivity. Discoveries and discoverers. Ten physics nobel laureates tell their story

Energy Technology Data Exchange (ETDEWEB)

Fossheim, Kristian [Norwegian Univ. of Science and Technology, Trondheim (Norway). Dept. of Physics

2013-10-01

Displays the life and work of 10 Nobel laureates. Presents interesting background information on how great science is achieved. Presents the history of superconductivity through 100 years of progress. 10 great scientists tell their unique stories in their own words. Personal stories of Bednorz, Mueller and 8 other Nobel laureates. This book is about the work of 10 great scientists; who they were and are, their personal background and how they achieved their outstanding results and took their prominent place in science history. We follow one of physics and science history's most enigmatic phenomena, superconductivity, through 100 years, from its discovery in 1911 to the present, not as a history book in the usual sense, but through close ups of the leading characters and their role in that story, the Nobel laureates, who were still among us in the years 2001-2004 when the main round of interviews was carried out. Since then two of them already passed away. For each one of the 10 laureates, the author tells their story by direct quotation from interviews in their own words. Each chapter treats one laureate. The author first gives a brief account of the laureates' scientific background and main contribution. Then each laureate tells his own story in his own words. This book is unique in its approach to science history.

Superconductivity. Discoveries and discoverers. Ten physics nobel laureates tell their story

International Nuclear Information System (INIS)

Fossheim, Kristian

2013-01-01

Displays the life and work of 10 Nobel laureates. Presents interesting background information on how great science is achieved. Presents the history of superconductivity through 100 years of progress. 10 great scientists tell their unique stories in their own words. Personal stories of Bednorz, Mueller and 8 other Nobel laureates. This book is about the work of 10 great scientists; who they were and are, their personal background and how they achieved their outstanding results and took their prominent place in science history. We follow one of physics and science history's most enigmatic phenomena, superconductivity, through 100 years, from its discovery in 1911 to the present, not as a history book in the usual sense, but through close ups of the leading characters and their role in that story, the Nobel laureates, who were still among us in the years 2001-2004 when the main round of interviews was carried out. Since then two of them already passed away. For each one of the 10 laureates, the author tells their story by direct quotation from interviews in their own words. Each chapter treats one laureate. The author first gives a brief account of the laureates' scientific background and main contribution. Then each laureate tells his own story in his own words. This book is unique in its approach to science history.

Osmolality - blood

Science.gov (United States)

... water loss Poisoning from harmful substances such as ethanol , methanol , or ethylene glycol Problems producing urine In ... may be due to: Diabetes insipidus High blood sugar level ( hyperglycemia ) High level of nitrogen waste products ...

Truth-telling contra perfectionist liberalism: Muslim parrhēsíastes in Denmark

DEFF Research Database (Denmark)

Renders, Johannes

In this paper, I first offer a general outline and reflection on the notion of parrhēsía (truth-telling), as popularized by Foucault. Secondly, I discuss Foucault’s history of problematizations, with comments on what he called “games of truth” and the Cartesian conception of truth-telling. Thirdly......, I sketch a trend in the current Danish public and political sphere, defining the notion of “perfectionist liberalism” and how it translates to the Danish context, including concrete examples and notes on “liberal intolerance arguments”. Lastly, I address the condition of Muslim parrhēsíastes (truth...

Tailoring of the Tell-us Card communication tool for nurses to increase patient participation using Intervention Mapping.

Science.gov (United States)

van Belle, Elise; Zwakhalen, Sandra M G; Caris, Josien; Van Hecke, Ann; Huisman-de Waal, Getty; Heinen, Maud

2018-02-01

To describe the tailoring of the Tell-us Card intervention for enhanced patient participation to the Dutch hospital setting using Intervention Mapping as a systematic approach. Even though patient participation is essential in any patient-to-nurse encounter, care plans often fail to take patients' preferences into account. The Tell-us Card intervention seems promising, but needs to be tailored and tested before implementation in a different setting or on large scale. Description of the Intervention Mapping framework to systematically tailor the Tell-us Card intervention to the Dutch hospital setting. Intervention Mapping consists of: (i) identification of the problem through needs assessment and determination of fit, based on patients and nurses interviews and focus group interviews; (ii) developing a logic model of change and matrices, based on literature and interviews; (iii) selection of theory-based methods and practical applications; (iv) producing programme components and piloting; (v) planning for adoption, implementation and sustainability; and (vi) preparing for programme evaluation. Knowledge, attitude, outcome expectations, self-efficacy and skills were identified as the main determinants influencing the use of the Tell-us Card. Linking identified determinants and performance objectives with behaviour change techniques from the literature resulted in a well-defined and tailored intervention and evaluation plan. The Tell-us Card intervention was adapted to fit the Dutch hospital setting and prepared for evaluation. The Medical Research Council framework was followed, and the Intervention Mapping approach was used to prepare a pilot study to confirm feasibility and relevant outcomes. This article shows how Intervention Mapping is applied within the Medical Research Council framework to adapt the Tell-us Card intervention, which could serve as a guide for the tailoring of similar interventions. © 2017 John Wiley & Sons Ltd.

Alternative procedures for reducing allogeneic blood transfusion in elective orthopedic surgery.

Science.gov (United States)

Kleinert, Kathrin; Theusinger, Oliver M; Nuernberg, Johannes; Werner, Clément M L

2010-09-01

Perioperative blood loss is a major problem in elective orthopedic surgery. Allogeneic transfusion is the standard treatment for perioperative blood loss resulting in low postoperative hemoglobin, but it has a number of well-recognized risks, complications, and costs. Alternatives to allogeneic blood transfusion include preoperative autologous donation and intraoperative salvage with postoperative autotransfusion. Orthopedic surgeons are often unaware of the different pre- and intraoperative possibilities of reducing blood loss and leave the management of coagulation and use of blood products completely to the anesthesiologists. The goal of this review is to compare alternatives to allogeneic blood transfusion from an orthopedic and anesthesia point of view focusing on estimated costs and acceptance by both parties.

Telling Anthropocene Tales: Localizing the impacts of global change using data-driven story maps

Science.gov (United States)

Mychajliw, A.; Hadly, E. A.

2016-12-01

Navigating the Anthropocene requires innovative approaches for generating scientific knowledge and for its communication outside academia. The global, synergistic nature of the environmental challenges we face - climate change, human population growth, biodiversity loss, pollution, invasive species and diseases - highlight the need for public outreach strategies that incorporate multiple scales and perspectives in an easily understandable and rapidly accessible format. Data-driven story-telling maps are optimal in that they can display variable geographic scales and their intersections with the environmental challenges relevant to both scientists and non-scientists. Maps are a powerful way to present complex data to all stakeholders. We present an overview of best practices in community-engaged scientific story-telling and data translation for policy-makers by reviewing three Story Map projects that map the geographic impacts of global change across multiple spatial and policy scales: the entire United States, the state of California, and the town of Pescadero, California. We document a chain of translation from a primary scientific manscript to a policy document (Scientific Consensus Statement on Maintaining Humanity's Life Support Systems in the 21st Century) to a set of interactive ArcGIS Story Maps. We discuss the widening breadth of participants (students, community members) and audiences (White House, Governor's Office of California, California Congressional Offices, general public) involved. We highlight how scientists, through careful curation of popular news media articles and stakeholder interviews, can co-produce these communication modules with community partners such as non-governmental organizations and government agencies. The placement of scientific and citizen's everyday knowledge of global change into an appropriate geographic context allows for effective dissemination by political units such as congressional districts and agency management units

Relationship among visual field, blood flow, and neural structure measurements in glaucoma.

Science.gov (United States)

Hwang, John C; Konduru, Ranjith; Zhang, Xinbo; Tan, Ou; Francis, Brian A; Varma, Rohit; Sehi, Mitra; Greenfield, David S; Sadda, Srinivas R; Huang, David

2012-05-17

To determine the relationship among visual field, neural structural, and blood flow measurements in glaucoma. Case-control study. Forty-seven eyes of 42 patients with perimetric glaucoma were age-matched with 27 normal eyes of 27 patients. All patients underwent Doppler Fourier-domain optical coherence tomography to measure retinal blood flow and standard glaucoma evaluation with visual field testing and quantitative structural imaging. Linear regression analysis was performed to analyze the relationship among visual field, blood flow, and structure, after all variables were converted to logarithmic decibel scale. Retinal blood flow was reduced in glaucoma eyes compared to normal eyes (P flow and structural loss of rim area and retinal nerve fiber layer (RNFL). There was no correlation or paradoxical correlation between blood flow and structure. Multivariate regression analysis revealed that reduced blood flow and structural loss are independent predictors of visual field loss. Each dB decrease in blood flow was associated with at least 1.62 dB loss in mean deviation (P ≤ 0.001), whereas each dB decrease in rim area and RNFL was associated with 1.15 dB and 2.56 dB loss in mean deviation, respectively (P ≤ 0.03). There is a close link between reduced retinal blood flow and visual field loss in glaucoma that is largely independent of structural loss. Further studies are needed to elucidate the causes of the vascular dysfunction and potential avenues for therapeutic intervention. Blood flow measurement may be useful as an independent assessment of glaucoma severity.

Blood management and transfusion strategies in 600 patients undergoing total joint arthroplasty: an analysis of pre-operative autologous blood donation.

Science.gov (United States)

Perazzo, Paolo; Viganò, Marco; De Girolamo, Laura; Verde, Francesco; Vinci, Anna; Banfi, Giuseppe; Romagnoli, Sergio

2013-07-01

Blood loss during total joint arthroplasty strongly influences the time to recover after surgery and the quality of the recovery. Blood conservation strategies such as pre-operative autologous blood donation and post-operative cell salvage are intended to avoid allogeneic blood transfusions and their associated risks. Although widely investigated, the real effectiveness of these alternative transfusion practices remains controversial. The surgery reports of 600 patients undergoing total joint arthroplasty (312 hip and 288 knee replacements) were retrospectively reviewed to assess transfusion needs and related blood management at our institute. Evaluation parameters included post-operative blood loss, haemoglobin concentration measured at different time points, ASA score, and blood transfusion strategies. Autologous blood donation increased the odds of receiving a red blood cell transfusion. Reinfusion by a cell salvage system of post-operative shed blood was found to limit adverse effects in cases of severe post-operative blood loss. The peri-operative net decrease in haemoglobin concentration was higher in patients who had predeposited autologous blood than in those who had not. The strengths of this study are the high number of cases and the standardised procedures, all operations having been performed by a single orthopaedic surgeon and a single anaesthesiologist. Our data suggest that a pre-operative autologous donation programme may often be useless, if not harmful. Conversely, the use of a cell salvage system may be effective in reducing the impact of blood transfusion on a patient's physiological status. Basal haemoglobin concentration emerged as a useful indicator of transfusion probability in total joint replacement procedures.

Teachers' Orientation to Kindergartners' Different Interactional Competences: Telling Personal Experiences during Shared Readings of Picture Books

Science.gov (United States)

Gosen, Myrte N.

2015-01-01

This paper is centered around 106 tellings of personal experiences during shared readings of picture books in kindergarten classrooms. It is shown that teachers orient to different interactional storytelling competences of their pupils. Teachers are found to contribute to pupils' tellings by inviting them, by showing recipiency, by asking…

Effect of tranexamic acid irrigation on perioperative blood loss during orthognathic surgery: a double-blind, randomized controlled clinical trial.

Science.gov (United States)

Eftekharian, Hamidreza; Vahedi, Ruhollah; Karagah, Tuba; Tabrizi, Reza

2015-01-01

Perioperative hemorrhage is an important concern during orthognathic surgery. The purpose of this study was to assess the effect of tranexamic acid (TXA) irrigation on perioperative hemorrhage during orthognathic surgery. In this double-blind, randomized controlled clinical trial, 56 participants who underwent orthognathic surgery were divided into 2 groups. The patients in the first group received TXA irrigation with normal saline (1 mg/mL), and the patients in the second group had normal saline for irrigation during orthognathic surgery. Age, gender, operation duration, the amount of irrigation solution used, and preoperative hemoglobin, hematocrit, and weight were the variables that were studied. The use of TXA solution for irrigation was the predictive factor of the study. Each group consisted of 28 patients. Group 1 consisted of 15 male patients (53.6%) and 13 female patients (46.4%) and group 2 consisted of 14 male patients (50%) and 14 female patients (50%). There was no difference in the distributions of the variables between the 2 groups, except for the duration of the operation. The mean duration of the operation was 3.94 ± 0.61 hours in group 1 and 4.17 ± 0.98 hours in group 2, and the difference in this respect between the 2 groups was statistically significant (P .05). TXA is effective in reducing intraoperative blood loss in patients for whom substantial blood loss is anticipated. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

[Persistent pulmonary hypertension in a neonate caused by blood aspiration following vaginal blood loss].

Science.gov (United States)

Krüse-Ruijter, M F; Zimmermann, L J I

2007-07-14

A preterm neonate, with a gestational age of 30 1/7 weeks, was born after a period of prolonged rupture of the membranes and a retroplacental haematoma causing vaginal bleeding. During admission to the neonatal intensive-care unit, mechanical ventilation was indicated because of acute respiratory failure following blood aspiration, which was causing oxygenation and ventilation problems. Endotracheal surfactant was administered and, because of persistent pulmonary hypertension of the newborn (PPHN), NO-inhalation therapy was started. A quick recovery was seen and two days post partum the patient could be extubated. Blood aspiration may cause acute respiratory problems and PPHN, with quick recovery after effective mechanical ventilation, surfactant and NO-inhalation therapy.

Microsphere estimates of blood flow: Methodological considerations

International Nuclear Information System (INIS)

von Ritter, C.; Hinder, R.A.; Womack, W.; Bauerfeind, P.; Fimmel, C.J.; Kvietys, P.R.; Granger, D.N.; Blum, A.L.

1988-01-01

The microsphere technique is a standard method for measuring blood flow in experimental animals. Sporadic reports have appeared outlining the limitations of this method. In this study the authors have systematically assessed the effect of blood withdrawals for reference sampling, microsphere numbers, and anesthesia on blood flow estimates using radioactive microspheres in dogs. Experiments were performed on 18 conscious and 12 anesthetized dogs. Four blood flow estimates were performed over 120 min using 1 x 10 6 microspheres each time. The effects of excessive numbers of microspheres pentobarbital sodium anesthesia, and replacement of volume loss for reference samples with dextran 70 were assessed. In both conscious and anesthetized dogs a progressive decrease in gastric mucosal blood flow and cardiac output was observed over 120 min. This was also observed in the pancreas in conscious dogs. The major factor responsible for these changes was the volume loss due to the reference sample withdrawals. Replacement of the withdrawn blood with dextran 70 led to stable blood flows to all organs. The injection of excessive numbers of microspheres did not modify hemodynamics to a greater extent than did the injection of 4 million microspheres. Anesthesia exerted no influence on blood flow other than raising coronary flow. The authors conclude that although blood flow to the gastric mucosa and the pancreas is sensitive to the minor hemodynamic changes associated with the microsphere technique, replacement of volume loss for reference samples ensures stable blood flow to all organs over a 120-min period

Duration of works, flight hours, and blood pressure related to noise-induced hearing loss among Indonesian Air Force helicopter pilots

Directory of Open Access Journals (Sweden)

Kholidah Hanum

2006-09-01

Full Text Available Helicopter pilots exposed to high intensity noise and other risk factors had increased risk to be noise-induced hearing loss (NIHL. Therefore, it is beneficial to study several risk factors related to NIHL. This study was a nested case-control. Data was extracted from available medical records among helicopter pilots who performed routine aerophysiology training indoctrination (ILA during 1980 through March 2004 at Saryanto Institute for Aviation and Aerospace Medicine (Lakespra, Jakarta. Case was those who had audiogram with a notch of 40 dB or more and of 4000 Hertz on one site or bilateral ears. A case was matched by two controls who free from NIHL up to 2004. All risk factors for cases and controls were counted as of reference date of cases diagnosed. There were 187 medical records available for this study. A number of 32 cases and 64 controls were identified. The final model reveals that NIHL was related to total duration of works, flight hours, and blood pressure. Those who had 500 hours or more than less 500 hours had a moderate increased risk for 2.5 to be NIHL [Adjusted odds ratio (ORa= 2.50; 95% confidence intervals (CI = 0.66-9.29; p = 0.180]. Those who had total duration works 11-24 years had a moderate increased to be NIHL for 2.7 times (ORa = 2.71; 95% CI=0.90-8.10; p = 0.075. Furthermore, prehypertension and hypertension stage 1 subjects than normal blood pressure had moderate trend increased risk to be NIHL. In conclusion total flight hours for 500 hours or more, total duration works 11-24 years, or prehypertension and hypertension stage 1 increased risk NIHL. (Med J Indones 2006; 15:185-90 Keywords: noise induced hearing loss, flight hours, working duration, blood pressure

Mirror Neurons, the Development of Empathy, and Digital Story Telling

Science.gov (United States)

Hess, Mary

2012-01-01

This article explores the intersection of work in media education, religious education, concerns about digital cultures' impact on human relationality, and the possible role that mirror neurons might play in the development of empathy. Digital story telling--particularly as embodied in the work of the Center for Digital Storytelling…

A story-telling approach for a software engineering course design

DEFF Research Database (Denmark)

Christensen, Henrik Bærbak

2009-01-01

patterns to increase maintainability when student exercises are never maintained? In this paper, we outline the contextual problems that software engineering teaching has to deal with and present a story telling approach for course design as a remedy. We outline the stories that over the last five years...

Technology-enhanced language learning (TeLL: An update and a principled framework for English for Academic Purposes (EAP courses / L'apprentissage des langues assisté par la technologie (TeLL: mise à jour et énoncé de principes pour les cours

Directory of Open Access Journals (Sweden)

Juliana Chau

2014-05-01

Full Text Available The range and number of technologies currently available have yielded both opportunities and challenges for language educators. This study aims to review recent technology-enhanced language learning (TeLL research, and to examine their potential relevance to EAP pedagogy, curricula, assessment and instruction. The results of this study show TeLL research with rising interest in vocabulary, grammar and writing, but less so in speaking, listening, and reading. The results also reveal a shift from a tool-centric view of technology use to one that emphasises the technology-pedagogy-human alliance in the last decade, noting three emerging trends in recent TeLL studies, namely, those that are multi-purpose, multi-genre, and multi-role/skill in design and evaluation. The lack of a holistic approach to TeLL for EAP courses to date, however, has made it necessary and desirable to develop a framework for EAP-specific TeLL, to identify a principle for a generic TeLL programme, and to propound ways of operationalizing such a framework. L'apprentissage des langues assisté par la technologie (TeLL: mise à jour et énoncé de principes pour les cours d’anglais à des fins universitaires La variété et la profusion de technologies actuellement disponibles ont engendré des possibilités nouvelles et des défis pour les enseignants en langue. Cette étude passe en revue la recherche récente consacrée à l'apprentissage des langues assisté par la technologie (TeLL et examine sa pertinence éventuelle pour la pédagogie, les programmes, l'évaluation et l'enseignement de l’anglais à des fins universitaires. Les résultats de cette étude révèlent un intérêt croissant de la recherche sur l'apprentissage des langues assisté par la technologie pour le vocabulaire, la grammaire et l'écriture, mais un intérêt moindre pour la langue parlée, la langue écoutée et pour la lecture. Les résultats révèlent aussi que, dans la dernière décennie, on

Impact of blood sampling in very preterm infants

DEFF Research Database (Denmark)

Madsen, L P; Rasmussen, M K; Bjerregaard, L L

2000-01-01

; the groups were then subdivided into critically ill or not. Diagnostic blood sampling and blood transfusion events were recorded. In total, 1905 blood samples (5,253 analysis) were performed, corresponding to 0.7 samples (1.9 analysis) per day per infant. The highest frequencies were found during the first....../kg. For the extremely preterm infants a significant correlation between sampled and transfused blood volume was found (mean 37.1 and 33.3 ml/kg, respectively, r = + 0.71, p = 0.0003). The most frequently requested analyses were glucose, sodium and potassium. Few blood gas analyses were requested (1.9/ infant). No blood...... losses attributable to excessive generous sampling were detected. The results show an acceptable low frequency of sampling and transfusion events for infants of GA 28-32 weeks. The study emphasizes the necessity of thorough reflection and monitoring of blood losses when ordering blood sampling...

‘..there is so much to tell now, really now'

DEFF Research Database (Denmark)

Balle, Søren Hattesen

of scepticism towards continuous narrative left by modernist poetics and its emphasis on the lyrical or epiphanic moment, postmodern poetry’s reinvestment in storytelling is never made in perfectly good faith. So, if postmodern poets tell stories, they only do so by “allud[ing] to story” or “foreground...

Journalism Curiosity and Story Telling Frame

DEFF Research Database (Denmark)

Grunwald, Ebbe; Rupar, Verica

2009-01-01

This comparative study of journalism practices in Australia and Denmark explores the interplay between two concepts relevant for journalism's meaning-making activity: a curiosity seen as an action meant to close an information gap, and a story telling frame seen as a form of structuring information...... the epistemological and organisational dimension of frames relates to the process of  meaning-making. We suggest refining the concept of frame in journalism studies by making a distinction between a frame (an epistemological category) and an angle (a textual organisation category). Our investigation shows...... that this distinction better serves the analysis and understanding of the mechanisms behind journalism in comparative contexts. Udgivelsesdato: December...

Autologous blood transfusion in total knee replacement surgery.

Science.gov (United States)

Sarkanović, Mirka Lukić; Gvozdenović, Ljiljana; Savić, Dragan; Ilić, Miroslav P; Jovanović, Gordana

2013-03-01

Total knee replacement (TKR) surgery is one of the most frequent and the most extensive procedures in orthopedic surgery, accompanied with some serious complications. Perioperative blood loss is one of the most serious losses, so it is vital to recognize and treat such losses properly. Autologous blood transfusion is the only true alternative for the allogeneic blood. The aim of this study was to to examine if autologous blood transfusion reduces usage of allogenic blood in total knee replacement surgery, as well as to examine possible effect of autologous blood transfusion on postoperative complications, recovery and hospital stay of patients after total knee replacement surgery. During the controlled, prospective, randomised study we compared two groups of patients (n = 112) with total prosthesis implanted in their knee. The group I consisted of the patients who received the transfusion of other people's (allogeneic) blood (n = 57) and the group II of the patients whose blood was collected postoperatively and then given them [their own (autologous) blood] (n = 55). The transfusion trigger for both groups was hemoglobin level of 85 g/L. In the group of patients whose blood was collected perioperatively only 9 (0.9%) of the patients received transfusion of allogeneic blood, as opposed to the control group in which 98.24% of the patients received the transfusion of allogeneic blood (p blood was collected stayed in hospital for 6.18 days, while the patients of the control group stayed 7.67 days (p blood transfusion is a very effective method for reducing consumption of allogenic blood and thus, indirectly for reducing all complications related to allogenic blood transfusion. There is also a positive influence on postoperative recovery after total knee replacement surgery due to the reduction of hospital stay, and indirectly on the reduction of hospital costs.

Influence of sibutramine in addition to diet and exercise on the relationship between weight loss and blood glucose changes.

Science.gov (United States)

Kamil, Sadaf; Finer, Nicholas; James, William Philip T; Caterson, Ian D; Andersson, Charlotte; Torp-Pedersen, Christian

2017-07-01

Weight loss is expected to improve glycaemic control in patients with diabetes or at high risk hereof. Sibutramine causes weight loss and is associated with an increased risk of myocardial infarction and stroke in high-risk patients. We examined the impact of sibutramine-induced weight loss on glycaemic control. In total, 8192 obese patients with diabetes were randomized to sibutramine or placebo plus diet and exercise after a preliminary 6 weeks in which all patients received sibutramine. Patients were classified into four groups of weight change. A total of 1582 patients had a weight loss >5.7 kg; 2047 patients lost 3.7-5.7 kg; 2432 patients lost sibutramine lost slightly more weight than those on placebo (-0.2 kg on average, P sibutramine-treated patients were -0.4 mmol/L (±3.2, P = 0.0002), +0.1 mmol/L (±3.0, P = 0.04), +0.4 mmol/L (±2.8, P = 0.01), and +0.2 mmol/L (±3.4, P = 0.003). Mean values of HbA1c followed the same pattern though the HbA1c changes were smaller with weight loss and greater with weight gain in the sibutramine group. All results were statistically significant (P sibutramine, diet, and exercise attenuates falls in blood glucose levels and HbA1c compared with similar weight loss with placebo, diet, and exercise. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For Permissions, please email: journals.permissions@oup.com.

Effect of heat-killed Lactobacillus brevis SBC8803 on cutaneous arterial sympathetic nerve activity, cutaneous blood flow and transepidermal water loss in rats.

Science.gov (United States)

Horii, Y; Kaneda, H; Fujisaki, Y; Fuyuki, R; Nakakita, Y; Shigyo, T; Nagai, K

2014-05-01

To evaluate the efficacy of the effects of heat-killed Lactobacillus brevis SBC8803 (HK-SBC8803) on the standard physiological markers of skin health of cutaneous arterial sympathetic nerve activity (CASNA), cutaneous blood flow and transepidermal water loss (TEWL) and to determine whether SBC8803 targets serotonin 5-HT3 receptors in rats. A set of three experiments were conducted to examine the effects of SBC8803 on CASNA, cutaneous blood flow and TEWL using Wistar and hairless rats. Two additional experiments further attempted to determine whether HK-SBC8803 was targeting the serotonin 5-HT3 receptors by pretreatment with the 5-HT3 antagonist granisetron. Administration of HK-SBC8803 in the first three experiments caused marked inhibition of CASNA and significant elevation of cutaneous blood flow under urethane anaesthesia as well as significant decrease in TEWL on the dorsal skin of conscious hairless rats. Pretreatment with granisetron decreased the effects of HK-SBC8803 on CASNA and cutaneous blood flow. These findings suggest that HK-SBC8803 reduces CASNA, increases cutaneous blood flow and decreases TEWL and that 5-HT3 receptors may be involved in CASNA and cutaneous blood flow responses. HK-SBC8803 could be a useful substance in the treatment/prevention of skin problems, specifically chapped or dry skin. © 2014 The Society for Applied Microbiology.

Telling stories: opportunities for word-of-mouth communication.

OpenAIRE

Cownie, Fiona

2017-01-01

Word-of-mouth is an important aspect of marketing communications and can be conceived as the story-telling of everyday life. This working paper suggests that marketing communicators’ understanding of word-of-mouth might usefully be enhanced by the consideration of the tools of the screenwriter, in particular the premise and the active question. The jeopardy of the premise and unresolved nature of the active questions the premise generates may contribute to the potency of word-of-mouth message...

Triggers of blood transfusion in percutaneous nephrolithotomy

International Nuclear Information System (INIS)

Zehri, A.K.; Biyabani, S.R.; Siddiqui, K.M.; Memon, A.

2011-01-01

To determine the triggers of blood transfusion in patients undergoing percutaneous nephrolithotomy (PCNL). The percutaneous surgery database was retrospectively reviewed to identify patients with postoperative haemorrhage and need for blood transfusion. Blood loss was estimated by the postoperative drop in haemoglobin factored by the quantity of any blood transfusion. Various patients and procedure-related factors were assessed for association with total blood loss or blood transfusion requirement using stepwise univariate, forward multivariate regression analysis. A total of 326 procedures were performed in 316 patients. Two hundred and thirty two procedures were included in the study. There were 167 males and 65 females. The mean age was 41+14 years. The mean haemoglobin drop was 1.68 +1.3 gm/dL. The overall blood transfusion rate was 14.2%. Stepwise multivariate regression analysis showed that female gender (p = 0.003), staghorn stone (p = 0.023), stone fragmentation with ultrasound (p = 0.054) and chronic renal failure (p = 0.001) were significantly predictive of the need for blood transfusion. Chronic renal failure, female gender, presence of staghorn calculi and stone fragmentation using ultrasonic device were predictive of blood transfusion in this cohort of patients. (author)

Fetal blood drawing.

Science.gov (United States)

Hobbins, J C; Mahoney, M J

1975-07-19

A small sample of fetal blood suitable for studies of haemoglobin synthesis was obtained from a placental vessel under endoscopic visualisation in 23 of 26 patients in whom the procedure was attempted prior to second-trimester abortion. Fetal blood loss, calculated in 23 cases, was between 0-2 ml. and 2-5 ml., and fetal blood-volume depletion varied from 0-5% to 15%. No short-term ill-effects were demonstrated in mother or fetus in any of 16 patients in whom the injection of aborti-facient was postponed for between 16 and 24 hours after the procedure.

Truth telling in a South African tertiary hospital | Vangu | South ...

African Journals Online (AJOL)

Introduction. Truth telling forms part of the contemporary debate in clinical bioethics and centres around the right of the patient to receive honest information concerning his or her medical condition/illness and the duty of the doctor to give this information to the patient. Many patients complain that they are not being informed, ...

Open Craniosynostosis Surgery: Effect of Early Intraoperative Blood Transfusion on Postoperative Course.

Science.gov (United States)

Kurnik, Nicole M; Bristol, Ruth; Maneri, Celia; Singhal, Raj; Singh, Davinder J

2017-07-01

Correction of craniosynostosis can result in blood loss when the patient already has physiologic anemia. The aim of this study was to determine whether patients benefit from early blood transfusion and whether the timing of blood transfusion affects metabolic disturbances and the postoperative course. In this retrospective review, 71 patients who underwent open calvarial vault remodeling for correction of craniosynostosis were separated into 2 groups according to whether they received blood transfusions early (within the first 30 minutes of surgery) or later (after the first 30 minutes of surgery). Patients were further separated into nonsyndromic and syndromic cohorts. Tracked variables included hemoglobin, hematocrit, arterial blood gas values, lactate level, length of stay, estimated blood loss, and amount of blood transfused in the operating room, amount transfused postoperatively, and total amount transfused.Among all patients, the early transfusion group had a higher hemoglobin nadir overall and received less postoperative blood. Within the nonsyndromic cohort, the early transfusion group had a higher estimated blood loss and received more transfused blood. In the syndromic cohort, the early transfusion group had a hemoglobin nadir that was significantly higher than in the late transfusion group and a lower estimated blood loss, shorter pediatric intensive care unit stay, and less postoperative blood transfused. Syndromic patients also received significantly more blood overall. For syndromic patients undergoing open calvarial vault remodeling, transfusion within the first 30 minutes of surgery should be considered.

KEEFEKTIFAN MODEL SHOW NOT TELL DAN MIND MAP PADA PEMBELAJARAN MENULIS TEKS EKSPOSISI BERDASARKAN MINAT PESERTA DIDIK KELAS X SMK

Directory of Open Access Journals (Sweden)

Wiwit Lili Sokhipah

2015-03-01

Full Text Available Tujuan penelitian ini adalah (1 menentukan keefektifan penggunaan model show not tell pada pembelajaran keterampilan menulis teks eksposisi berdasarkan minat peserta didik SMK Kelas X, (2 menentukan keefektifan penggunaan model mind map pada pembelajaran keterampilan menulis teks eksposisi berdasarkan minat peserta didik SMK kelas X, (3 menentukan keefektifan interaksi show not tell dan mind map pada pembelajaran keterampilan menulis teks eksposisi berdasarkan minat peserta didik SMK kelas X. Penelitian ini adalah quasi experimental design (pretes-postes control group design. Dalam desain ini terdapat dua kelompok eksperimen yakni penerapan model show not tell dalam pembelajaran keterampilan menulis teks eksposisipeserta didik dengan minat tinggi dan penerapan model mind map dalam pembelajaran keterampilan menulis teks eksposisi  peserta didik dengan minat rendah. Hasil penelitian adalah (1 model show not tell efektif digunakan  dalam membelajarkan menulis teks eksposisi bagi peserta didik yang memiliki minat tinggi, (2 model mind map efektif digunakan dalam membelajarkan menulis teks eksposisi bagi peserta didik yang memiliki minat rendah, dan (3 model show not tell lebih efektif digunakan dalam membelajarkan menulis teks eksposisi bagi peserta didik yang memiliki minat tinggi, sedangkan model mind map efektif digunakan dalam membelajarkan teks eksposisi pagi peserta didik yang memiliki minat rendah.

Koncept "telling" a "showing" v románech The Bluest Eye a To Kill a Mockingbird

OpenAIRE

Felcmanová, Martina

2015-01-01

TITLE Telling and Showing in The Bluest Eye and To Kill a Mockingbird AUTOR Martina Felcmanová DEPARTMENT Department of English Language and Literature SUPERVISOR PhDr. Petr Chalupský, Ph.D. ABSTRACT This bachelor thesis focuses on similarities and differences in the narrative strategies in the novels To Kill a Mockingbird and The Bluest Eye. The main objective lies in the analysis of how, and for what purpose, the two modes of narration, telling and showing (also diegesis and mimesis) are us...

Comparison of Two Methods of Bolus and Infusion of Tranexamic Acid in Reduction of Blood Loss in Total Knee Arthroplasty

OpenAIRE

Mohammadreza Moshari; Bahman Malek; Mohammadreza Minator-Sajjadi; Maryam Vosoghian; Mastaneh Dahi; Mahshid Ghasemi; Razieh Shekari

2018-01-01

AbstractBackground: So far, many studies have been performed to determine the optimal dose and regimen of tranexamic acid to reduce preoperative and postoperative blood loss in primary total knee arthroplasty. In the present study, two different methods of administration (bolus and infusion), were compared.Materials and Methods: Forty patients were randomized in the two groups (A and B) of 20 patients each. All patients received 500 mg tranexamic acid before inflation of tourniquet. Group A (...

Story-telling, women's authority and the "Old Wife's Tale": "The Story of the Bottle of Medicine".

Science.gov (United States)

Abrams, Lynn

2012-01-01

The focus of this article is a single personal narrative – a Shetland woman's telling of a story about two girls on a journey to fetch a cure for a sick relative from a wise woman. The story is treated as a cultural document which offers the historian a conduit to a past that is respectful of indigenous woman-centred interpretations of how that past was experienced and understood. The "story of the bottle of medicine" is more than a skilful telling of a local tale; it is a memory practice that provides a path to a deeper and more nuanced understanding of a culture. Applying perspectives from anthropology, oral history and narrative analysis, three sets of questions are addressed: the issue of authenticity; the significance of the narrative structure and storytelling strategies employed; and the nature of the female performance. Ultimately the article asks what this story can tell us about women's interpretation of their own history.

If You Listen, the Patient Will Tell You the Diagnosis

Science.gov (United States)

Holmes, Frederick

2007-01-01

Since the time of Hippocrates, professors in medical schools have been telling their students to listen to patients. Medical students and young doctors all come to realize that the medical history, the patient's account of his or her own illness, is the best source of information with which to make an accurate diagnosis. The physical examination,…

Living and telling stories of illness and hospitalization through fairy tales.

Directory of Open Access Journals (Sweden)

Rossella Caso

2012-06-01

Full Text Available What link exists beetween health and storytelling? The hypothesis that reading aloud could be an effective instrument in order to support the well-being of the hospitalized child, and that writing to stimulate the expression of their own inner world is the theoretical reference of the bibliotherapy, methology based on the notion that reading could be an effective instrument to promote the development and the well-being of the child and to favour him/her to get the maximum gain during the hospitalization experience. As for the writing, when they tell, children “tell about themselves” and they speak their wishes, feelings, emotions, fears, in a way that is figurative. Read their writings can become, in this sense, as well as a way to take-care-in, an useful key to the world of childhood and, ultimately, a way to improve the quality of care given to them. 

Differing associations between Aβ accumulation, hypoperfusion, blood-brain barrier dysfunction and loss of PDGFRB pericyte marker in the precuneus and parietal white matter in Alzheimer's disease.

Science.gov (United States)

Miners, J Scott; Schulz, Isabel; Love, Seth

2018-01-01

Recent studies implicate loss of pericytes in hypoperfusion and blood-brain barrier (BBB) leakage in Alzheimer's disease (AD). In this study, we have measured levels of the pericyte marker, platelet-derived growth factor receptor-β (PDGFRB), and fibrinogen (to assess blood-brain barrier leakage), and analyzed their relationship to indicators of microvessel density (von Willebrand factor level), ante-mortem oxygenation (myelin-associated glycoprotein:proteolipid protein-1 ratio and vascular endothelial growth factor level), Aβ level and plaque load, in precuneus and underlying white matter from 49 AD to 37 control brains. There was reduction in PDGFRB and increased fibrinogen in the precuneus in AD. These changes correlated with reduction in oxygenation and with plaque load. In the underlying white matter, increased fibrinogen correlated with reduced oxygenation, but PDGFRB level was unchanged. The level of platelet-derived growth factor-ββ (PDGF-BB), important for pericyte maintenance, was increased in AD but mainly in the insoluble tissue fraction, correlating with insoluble Aβ level. Loss of the PDGFRB within the precuneus in AD is associated with fibrinogen leakage and reduced oxygenation, and related to fibrillar Aβ accumulation. In contrast, fibrinogen leakage and reduced oxygenation of underlying white matter occur independently of loss of PDGFRB, perhaps secondary to reduced transcortical perfusion.

When is Deceptive Message Production More Effortful than Truth-Telling? A Baker's Dozen of Moderators.

Science.gov (United States)

Burgoon, Judee K

2015-01-01

Deception is thought to be more effortful than telling the truth. Empirical evidence from many quarters supports this general proposition. However, there are many factors that qualify and even reverse this pattern. Guided by a communication perspective, I present a baker's dozen of moderators that may alter the degree of cognitive difficulty associated with producing deceptive messages. Among sender-related factors are memory processes, motivation, incentives, and consequences. Lying increases activation of a network of brain regions related to executive memory, suppression of unwanted behaviors, and task switching that is not observed with truth-telling. High motivation coupled with strong incentives or the risk of adverse consequences also prompts more cognitive exertion-for truth-tellers and deceivers alike-to appear credible, with associated effects on performance and message production effort, depending on the magnitude of effort, communicator skill, and experience. Factors related to message and communication context include discourse genre, type of prevarication, expected response length, communication medium, preparation, and recency of target event/issue. These factors can attenuate the degree of cognitive taxation on senders so that truth-telling and deceiving are similarly effortful. Factors related to the interpersonal relationship among interlocutors include whether sender and receiver are cooperative or adversarial and how well-acquainted they are with one another. A final consideration is whether the unit of analysis is the utterance, turn at talk, episode, entire interaction, or series of interactions. Taking these factors into account should produce a more nuanced answer to the question of when deception is more difficult than truth-telling.

Less impairment of hemostasis and reduced blood loss in pigs after resuscitation from hemorrhagic shock using the small-volume concept with hypertonic saline/hydroxyethyl starch as compared to administration of 4% gelatin or 6% hydroxyethyl starch solution.

Science.gov (United States)

Haas, Thorsten; Fries, Dietmar; Holz, Carmen; Innerhofer, Petra; Streif, Werner; Klingler, Anton; Hanke, Alexander; Velik-Salchner, Corinna

2008-04-01

Small-volume resuscitation using hypertonic saline/hydroxyethyl starch 200/0.62 (HS-HES) has been shown to be an effective alternative to the administration of crystalloids or colloids in trauma patients. All i.v. fluids cause dose-related dilutional coagulopathy and show intrinsic effects on the hemostatic system, but only few data refer to functional consequences after small-volume resuscitation. Using thrombelastometry (ROTEM), we studied 30 pigs (weighing 35-45 kg) after withdrawal of 60% of blood volume [1484 mL (1369-1624 mL)] and receiving 4 mL/kg HS-HES for compensation of blood loss or 4% gelatin or 6% HES 130/0.4 in a 1:1 ratio to lost blood volume. To compare the ROTEM variables (coagulation time, clot formation time, alpha angle, clot firmness, and fibrinogen polymerization) with bleeding tendency, a hepatic incision was made and blood loss was measured. Median (25th, 75th percentile) fibrinogen polymerization was significantly higher after HS-HES infusion [11 mm (10, 11), P = 0.0034] when compared with administration of 4% gelatin [4.5 mm (3.0, 5.8)] or HES 130/0.4 [3.5 mm (2.3, 4.0)]. Median blood loss after liver incision was 725 mL (900, 375) after HS-HES, 1625 mL (1275, 1950) after 4% gelatin, and 1600 mL (1500, 1800) after 6% HES 130/0.4 (P = 0.004). Hemodynamic stabilization was traceable in all groups but showed differences regarding filling pressures. Resuscitation from hemorrhagic shock with HS-HES 200/0.62 results in less impairment of clot formation when compared with compensation of blood loss by administering 6% HES 130/0.4 or 4% gelatin.

Blood conservation with membrane oxygenators and dipyridamole.

Science.gov (United States)

Teoh, K H; Christakis, G T; Weisel, R D; Madonik, M M; Ivanov, J; Wong, P Y; Mee, A V; Levitt, D; Benak, A; Reilly, P

1987-07-01

Cardiopulmonary bypass induces platelet activation and dysfunction, which result in platelet deposition and depletion. Reduced platelet numbers and abnormal platelet function may contribute to postoperative bleeding. A membrane oxygenator may preserve platelets and reduce bleeding more than a bubble oxygenator, and the antiplatelet agent dipyridamole may protect platelets intraoperatively and reduce bleeding postoperatively. A prospective randomized trial was performed in 44 patients undergoing elective coronary artery bypass grafting to assess the effects of the membrane oxygenator and dipyridamole on platelet counts, platelet activation products, and postoperative bleeding. Patients who were randomized to receive a bubble oxygenator and no dipyridamole had the lowest postoperative platelet counts, the greatest blood loss, and the most blood products transfused. Platelet counts were highest and blood loss was least in patients randomized to receive a membrane oxygenator and dipyridamole (p less than .05). A bubble oxygenator with dipyridamole and a membrane oxygenator without dipyridamole resulted in intermediate postoperative platelet counts and blood loss. Arterial thromboxane B2 and platelet factor 4 concentrations were elevated on cardiopulmonary bypass in all groups. Both the membrane oxygenator and dipyridamole were independently effective (by multivariate analysis) in preserving platelets. Optimal blood conservation was achieved with a membrane oxygenator and dipyridamole.

TRANSFUSION OF BLOOD AND BLOOD COMPONENTS IN POLYTRAUMATISED PATIENTS AT CELJE HOSPITAL (1998–2001

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Slavomir Milovanović

2003-12-01

Full Text Available Background. The replacement of fluids after severe injuries is always a complex issue, either in medical doctrine or in clinical practice. Regardless of the fact, daily work with patients requires the clearest possible guidelines and their regular monitoring.Methods. We made a chart showing the number of patients and the quantity of blood or blood components used in the Celje General Hospital in the past four years.Results. The analyses have shown that indications for the use of blood or blood components have narrowed. At the same time, it is quite evident that it is difficult and also risky to decide on a transfusion only on the given laboratory values. Only a careful analysis of the therapy has shown that the decision on a transfusion is based on both, the clinical picture and its development, the evaluation of visible and invisible loss of blood, and on regular and extensive laboratory monitoring.Conclusions. Despite improved surgical techniques and introduction of new transfusion strategies loss of blood and need for transfusion during and after polytrauma surgeries is still rather high. In the analysed four year period, the maintained level of haemoglobin in patients that had a major surgery has slightly declined. It is therefore essential to cooperate with the respective hospital transfusion committee and prepare as well as follow up some clear guidelines for the rationalisation, not only restriction of transfusion of blood and blood components.

Audit of blood transfusion practice during anaesthesia for spine ...

African Journals Online (AJOL)

Background: Blood loss during spine surgery is often considerable, necessitating blood transfusion. The elective nature and other peculiarities of most spine surgeries, however, make them amenable to several blood conservation techniques, such that reduction in allogeneic blood transfusion is considered high priority in ...

Genetic basis of rare blood group variants

NARCIS (Netherlands)

Wigman, L.

2013-01-01

A transfusion of donor red blood cells can be life saving In individuals with massive blood loss due to an accident or surgery or in individuals with constitutive anemia due to a defect in erythropoiesis. Donor blood can, however, not be simply transfused to every patient. When a recipient of a red

Blood transfusion in the surgical treatment of adolescent idiopathic scoliosis-a single-center experience of patient blood management in 210 cases.

Science.gov (United States)

Ohrt-Nissen, Søren; Bukhari, Naeem; Dragsted, Casper; Gehrchen, Martin; Johansson, Pär I; Dirks, Jesper; Stensballe, Jakob; Dahl, Benny

2017-07-01

The surgical treatment of adolescent idiopathic scoliosis can be associated with substantial blood loss, requiring allogeneic red blood cell (RBC) transfusion. This study describes the use of RBC and the effect of a standardized perioperative patient blood management program. Patients treated with posterior instrumented fusion were consecutively enrolled over a 6-year period. Patient blood management strategies were implemented in 2011, including prophylactic tranexamic acid, intraoperative permissive hypotension, restrictive fluid therapy (including avoidance of synthetic colloids), restrictive RBC trigger according to institutional standardized protocol, the use of cell savage, and goal-directed therapy according to thrombelastography. In total, 210 patients were included. 64 patients (31%) received RBC transfusions. A decline in the intraoperative rate of RBC transfusion was observed, from 77% in 2011 to 13% in 2016 (p transfusion group had a significantly larger major curve, lower preoperative hemoglobin, higher estimated blood loss, and an increased use of crystalloid volume resuscitation. Multiple logistic regression showed that significant predictors for RBC transfusion were preoperative hemoglobin level (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.27-0.57), estimated blood loss (OR, 1.26; 95% CI, 1.15-1.42), and year of surgery (indicating the effect of patient blood management) (OR per year, 0.76; 95% CI, 0.58-0.99). A perioperative patient blood management program substantially reduced the need for RBC transfusion. A preoperative evaluation of anemia is essential to further minimize transfusion rates. © 2017 AABB.

To Tell a New Story: Reinventing Narratives of Culture, Identity, and Education.

Science.gov (United States)

Florio-Ruane, Susan

1997-01-01

Reflects on stories educators tell about culture, identity, and education. If stories of self are to help educators reform institutions or build new communities, they must be reinvented to embrace others rather than to defend against contact with others. (SLD)

Truth-telling, decision-making, and ethics among cancer patients in nursing practice in China.

Science.gov (United States)

Ling, Dong-Lan; Yu, Hong-Jing; Guo, Hui-Ling

2017-01-01

Truth-telling toward terminally ill patients is a challenging ethical issue in healthcare practice. However, there are no existing ethical guidelines or frameworks provided for Chinese nurses in relation to decision-making on truth-telling of terminal illness and the role of nurses thus is not explicit when encountering this issue. The intention of this paper is to provide ethical guidelines or strategies with regards to decision-making on truth-telling of terminal illness for Chinese nurses. This paper initially present a case scenario and then critically discuss the ethical issue in association with ethical principles and philosophical theories. Instead of focusing on attitudes toward truth disclosure, it aims to provide strategies regarding this issue for nurses. It highlights and discusses some of the relevant ethical assumptions around the perceived role of nurses in healthcare settings by focusing on nursing ethical virtues, nursing codes of ethics, and philosophical perspectives. And Confucian culture is discussed to explicate that deontology does not consider family-oriented care in China. Treating each family individually to explore the family's beliefs and values on this issue is essential in healthcare practice and nurses should tailor their own approach to individual needs regarding truth-telling in different situations. Moreover, the Chinese Code of Ethics should be modified to be more specific and applicable. Finally, a narrative ethics approach should be applied and teamwork between nurses, physicians and families should be established to support cancer patients and to ensure their autonomy and hope. Ethical considerations: This paper was approved by the Ethics Committee of The Second Affiliated Hospital of Guangzhou Medical University. The authors have obtained consent to use the case study and it has been anonymised to preserve the patient's confidentiality.

Wireless Capsule Endoscopy Detects Meckel’s Diverticulum in a Child with Unexplained Intestinal Blood Loss

Directory of Open Access Journals (Sweden)

I. Xinias

2012-10-01

Full Text Available Meckel’s diverticulum (MD is the most common congenital anomaly of the gastrointestinal (GI tract, affecting about 2% of the population. Most cases of Meckel’s diverticula are asymptomatic. The diagnosis of symptomatic MD is often difficult to make. We report the case of an 8-year-old boy who presented with GI bleeding due to MD. The diagnostic difficulties after an initial negative endoscopic evaluation and the diagnostic value of the various endoscopic procedures are discussed. The patient had suffered from bright red stools for 20 h before hospital admission. GI scintigraphy with 99mTc-Na-pertechnetate was negative for heterotopic gastric tissue in the small bowel area. Colonoscopy performed in order to exclude Crohn’s disease was also negative. He was placed on ranitidine at a dose of 6 mg/kg body weight twice daily. The patient remained asymptomatic over a period of 6 months before he was readmitted due to macroscopic rectal bleeding. Upper endoscopy and colonoscopy used to investigate the source of bleeding showed normal macroscopic findings. Radiolabeling of blood constituents with 99mTc on delayed imaging showed radionucleotide concentration in the ascending and transverse colon suggestive of a lesion in the ileocecal area. Further investigation with the use of wireless capsule endoscopy revealed a MD. Wireless capsule endoscopy may thus be indicated for patients with GI blood loss when other diagnostic methods, such as upper and lower endoscopy and colonoscopy, have failed to identify the source of bleeding.

NASA tells physicists to aim for the stars

CERN Multimedia

MacIlwain, C

1999-01-01

Dan Goldin, administrator at NASA, suggested that the next generation of instruments for high-energy physics research should be built in space. This did not go down well at Fermilab where a case is being made for a new ground-based accelerator. Goldin's aim though was simply to tell the scientific community that NASA is prepared to spend big money on physics in space. NASA also wants to work more closely with the DOE and the NSF to support space-based experiments (1 page).

[The demand for blood transfusion agents and blood substitutes in the treatment of wounded patients].

Science.gov (United States)

Zhiburt, E B; Danil'chenko, V V; Popova, N N; Vil'ianinov, V N

1999-09-01

Modern arms in combat tend to increase sanitary losses, change their structure and make combat traumas more severe. Blood transfusion therapy became a necessity in the wounds treatment. The recent armed conflicts made military medics move the blood transfusion service to the front lines. The authors present some data obtained in Afghanistan and Chechnya.

[Alternatives to allogenous blood transfusion].

Science.gov (United States)

Cernea, Daniela; Vlădoianu, Alice; Stoica, Maria; Novac, M; Berteanu, Cristina

2009-01-01

Blood transfusion is usually meant to lower morbidity and mortality rates. Allogenous blood transfusion implies certain risks that can be avoided by autologous blood transfusions techniques including: preoperatory autologous blood donation, acute normovolemic hemodilution, intraoperatory and postoperatory blood salvage. Preoperatory blood donation and acute normovolemic hemodilution are used for planned interventions with an estimated blood loss higher than 20% of blood volume. These methods imply Erythropoietin and iron treatment. Intraoperatory and postoperatory blood salvage is performed by personnel trained in blood donation, handling and storage. Autologous blood transfusions are used for certain surgical procedures that commonly require transfusions: orthopedic surgery, radical prostatectomy, cardiovascular surgery, organ transplantation. An alternative to allogenous blood transfusion is the use of artificial oxygen transporters: human or animal hemoglobin solutions or pefluorocarbonate solutions. These solutions do not require cross reactions, do not carry diseases and are generally well tolerated and easily stored in the operating room, ambulance and other transport means. They have however a slight degree of toxicity.

Encountering Gender in Student Life at UDSM: Chrester Tells Her ...

African Journals Online (AJOL)

The article tells the life history of a young female student, Chrester, as she enjoyed her life while encountering gender contradictions throughout her student life during 1970s, 1980s, 1990s and 2000s at the University of Dar es Salaam. The narration covers the age of naiveté as well as her mature age as a senior student.

Models for truth-telling in physician-patient encounters: what can we learn from Yoruba concept of Ooto?

Science.gov (United States)

Ewuoso, Cornelius

2017-09-29

Empirical studies have now established that many patients make clinical decisions based on models other than Anglo American model of truth-telling and patient autonomy. Some scholars also add that current medical ethics frameworks and recent proposals for enhancing communication in health professional-patient relationship have not adequately accommodated these models. In certain clinical contexts where health professional and patients are motivated by significant cultural and religious values, these current frameworks cannot prevent communication breakdown, which can, in turn, jeopardize patient care, cause undue distress to a patient in certain clinical contexts or negatively impact his/her relationship with the community. These empirical studies have now recommended that additional frameworks developed around other models of truth-telling; and which take very seriously significant value-differences which sometimes exist between health professional and patients, as well as patient's cultural/religious values or relational capacities, must be developed. This paper contributes towards the development of one. Specifically, this study proposes a framework for truth-telling developed around African model of truth-telling by drawing insights from the communitarian concept of ootọ́ amongst the Yoruba people of south west Nigeria. I am optimistic that if this model is incorporated into current medical ethics codes and curricula, it will significantly enhance health professional-patient communication. © 2017 John Wiley & Sons Ltd.

A randomised controlled trial of oxytocin 5IU and placebo infusion versus oxytocin 5IU and 30IU infusion for the control of blood loss at elective caesarean section--pilot study. ISRCTN 40302163.

LENUS (Irish Health Repository)

Murphy, Deirdre J

2012-02-01

OBJECTIVE: To compare the blood loss at elective lower segment caesarean section with administration of oxytocin 5IU bolus versus oxytocin 5IU bolus and oxytocin 30IU infusion and to establish whether a large multi-centre trial is feasible. STUDY DESIGN: Women booked for an elective caesarean section were recruited to a pilot randomised controlled trial and randomised to either oxytocin 5IU bolus and placebo infusion or oxytocin 5IU bolus and oxytocin 30IU infusion. We wished to establish whether the study design was feasible and acceptable and to establish sample size estimates for a definitive multi-centre trial. The outcome measures were total estimated blood loss at caesarean section and in the immediate postpartum period and the need for an additional uterotonic agent. RESULTS: A total of 115 women were randomised and 110 were suitable for analysis (5 protocol violations). Despite strict exclusion criteria 84% of the target population were considered eligible for study participation and of those approached only 15% declined to participate and 11% delivered prior to the planned date. The total mean estimated blood loss was lower in the oxytocin infusion arm compared to placebo (567 ml versus 624 ml) and fewer women had a major haemorrhage (>1000 ml, 14% versus 17%) or required an additional uterotonic agent (5% versus 11%). A sample size of 1500 in each arm would be required to demonstrate a 3% absolute reduction in major haemorrhage (from baseline 10%) with >80% power. CONCLUSION: An additional oxytocin infusion at elective caesarean section may reduce blood loss and warrants evaluation in a large multi-centre trial.

The rise of repeal: policy entrepreneurship and Don't Ask, Don't Tell.

Science.gov (United States)

Neff, Christopher L; Edgell, Luke R

2013-01-01

We report on policy entrepreneurship by Servicemembers Legal Defense Network (SLDN) and how its legislative strategies used mini-windows of opportunity to shift Capitol Hill perspectives of Don't Ask, Don't Tell (DADT) from political plutonium to an emerging issue requiring a second look. Four phases in the legislative history of DADT are identified: radioactive, contested, emerging, and viable. In all, this article argues that SLDN's entrepreneurship focused on contesting congressional sensibilities to wait or defer on repeal, maintained that every discharge was damaging and transitioned toward a post-repeal mind set. Finally, we illustrate the importance of these transitions by comparing SLDN's 2004 estimated vote count for the introduction of the Military Readiness Enhancement Act with the final 2010 voting results on the Don't Ask, Don't Tell Repeal Act.

Video Tells a Mother's Story of Caring Support | NIH MedlinePlus the Magazine

Science.gov (United States)

... JavaScript on. Feature: Palliative Care Video Tells a Mother's Story of Caring Support Past Issues / Spring 2014 ... introduced to palliative care, she actually fell in love with her doctor and ran to see him ...

Don\\'t Ask, Don\\'t Tell: Ethical Issues Concerning Learning and ...

African Journals Online (AJOL)

Informed consent procedures and requirements must be clearly established and communicated. The learning and proficiency practices should be restricted to the staff that can truly benefit from the experience. The practice of 'don't ask, don't tell' is not an option. South African Journal of Family Practice Vol. 50 (4) 2008: pp.

Reduced Operating Time but Not Blood Loss With Cruciate Retaining Total Knee Arthroplasty

Science.gov (United States)

Vermesan, Dinu; Trocan, Ilie; Prejbeanu, Radu; Poenaru, Dan V; Haragus, Horia; Gratian, Damian; Marrelli, Massimo; Inchingolo, Francesco; Caprio, Monica; Cagiano, Raffaele; Tatullo, Marco

2015-01-01

Background There is no consensus regarding the use of retaining or replacing cruciate implants for patients with limited deformity who undergo a total knee replacement. Scope of this paper is to evaluate whether a cruciate sparing total knee replacement could have a reduced operating time compared to a posterior stabilized implant. Methods For this purpose, we performed a randomized study on 50 subjects. All procedures were performed by a single surgeon in the same conditions to minimize bias and only knees with a less than 20 varus deviation and/or maximum 15° fixed flexion contracture were included. Results Surgery time was significantly shorter with the cruciate retaining implant (P = 0.0037). The mean duration for the Vanguard implant was 68.9 (14.7) and for the NexGen II Legacy was 80.2 (11.3). A higher range of motion, but no significant Knee Society Scores at 6 months follow-up, was used as controls. Conclusions In conclusion, both implants had the potential to assure great outcomes. However, if a decision has to be made, choosing a cruciate retaining procedure could significantly reduce the surgical time. When performed under tourniquet, this gain does not lead to reduced blood loss. PMID:25584102

"Shall I Tell You a Story?" Sharing Love and Values through Storytelling.

Science.gov (United States)

Collins, Chase

1992-01-01

Parents can share love and values with their children through story telling. Because parents know their children intimately, they can create stories that impact their children's developing minds most effectively. The article describes how to create a classic tale in less than 10 minutes. (SM)

Preconception Blood Pressure Levels and Reproductive Outcomes in a Prospective Cohort of Women Attempting Pregnancy.

Science.gov (United States)

Nobles, Carrie J; Mendola, Pauline; Mumford, Sunni L; Naimi, Ashley I; Yeung, Edwina H; Kim, Keewan; Park, Hyojun; Wilcox, Brian; Silver, Robert M; Perkins, Neil J; Sjaarda, Lindsey; Schisterman, Enrique F

2018-05-01

Elevated blood pressure in young adulthood is an early risk marker for cardiovascular disease. Despite a strong biological rationale, little research has evaluated whether incremental increases in preconception blood pressure have early consequences for reproductive health. We evaluated preconception blood pressure and fecundability, pregnancy loss, and live birth in the EAGeR trial (Effects of Aspirin on Gestational and Reproduction; 2007-2011), a randomized clinical trial of aspirin and reproductive outcomes among 1228 women attempting pregnancy with a history of pregnancy loss. Systolic and diastolic blood pressure were measured during preconception in the first observed menstrual cycle and in early pregnancy and used to derive mean arterial pressure. Fecundability was assessed as number of menstrual cycles until pregnancy, determined through human chorionic gonadotropin testing. Pregnancy loss included both human chorionic gonadotropin-detected and clinical losses. Analyses adjusted for treatment assignment, age, body mass index, race, marital status, smoking, parity, and time since last loss. Mean preconception systolic and diastolic blood pressure were 111.6 mm Hg (SD, 12.1) and 72.5 (SD, 9.4) mm Hg. Risk of pregnancy loss increased 18% per 10 mm Hg increase in diastolic blood pressure (95% confidence interval, 1.03-1.36) and 17% per 10 mm Hg increase in mean arterial pressure (95% confidence interval, 1.02-1.35) in adjusted analyses. Findings were similar for early pregnancy blood pressure. Preconception blood pressure was not related to fecundability or live birth in adjusted analyses. Findings suggest that preconception blood pressure among healthy women is associated with pregnancy loss, and lifestyle interventions targeting blood pressure among young women may favorably impact reproductive health. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00467363. © 2018 American Heart Association, Inc.

Telling the history of self-advocacy: a challenge for inclusive research.

Science.gov (United States)

Walmsley, Jan

2014-01-01

This paper tells the story of Central England People First's (CEPF) History Project. This was an inclusive research project, owned and controlled by members of CEPF which sought to chart its 21-year history, 1990-2012. It illustrates both the strengths of such a project and some of the challenges. It concludes that using inclusive research methods enabled the story to be told, but that it was less successful in addressing questions about why the organization grew and prospered in the 1990s, only to struggle in its later years, and what this tells us about the conditions which enable self-advocacy to flourish. The paper was collaboratively written by the CEPF History Project team and an academic ally. Different fonts differentiate the contributions, although it is acknowledged that lots of the ideas were shared. This paper explores issues in telling the history of self advocacy using inclusive research methods. It explains how and why CEPF recorded its history, what we found out, and some of the questions we have had to think about: whose voices we hear what to include, what to leave out what parts of the research people with learning difficulties can do what self advocacy means to different people how to make use of research other people have done. It raises some new questions about directions for inclusive research. The Paper was written by the CEPF History team - Craig Hart, Ian Davies, Angela Still and Catherine O'Byrne - working with Jan Walmsley. We wanted to make it clear what were Jan Walmsley's ideas and what were our ideas. We have done this by writing our ideas in a different font. BUT lots of the ideas belong to all of us. © 2013 John Wiley & Sons Ltd.

How (and Why) to Tell Others about Your Epilepsy, Part 1

Science.gov (United States)

Mittan, Robert J.

2009-01-01

Probably one of the most challenging dilemmas facing people with epilepsy and parents of children with epilepsy are the questions of "if," "who," "when," and "how" to tell others about the epilepsy. There is fear of stigma and rejection. Yet there remains the need to reveal seizures before they reveal themselves without one's control. Telling…

When is deceptive message production more effortful than truth-telling? A baker’s dozen of moderators

Directory of Open Access Journals (Sweden)

Judee K Burgoon

2015-12-01

Full Text Available Deception is thought to be more effortful than telling the truth. Empirical evidence from many quarters supports this general proposition. However, there are many factors that qualify and even reverse this pattern. Guided by a communication perspective, I present a baker’s dozen of moderators that may alter the degree of cognitive difficulty associated with producing deceptive messages. Among sender-related factors are memory processes, motivation, incentives, and consequences. Lying increases activation of a network of brain regions related to executive memory, suppression of unwanted behaviors, and task switching that is not observed with truth-telling. High motivation coupled with strong incentives or the risk of adverse consequences also prompts more cognitive exertion--for truth-tellers and deceivers alike--to appear credible, with associated effects on performance and message production effort, depending on the magnitude of effort, communicator skill and experience. Factors related to message and communication context include discourse genre, type of prevarication, expected response length, communication medium, preparation, and recency of target event/issue. These factors can attenuate the degree of cognitive taxation on senders so that truth-telling and deceiving are similarly effortful. Factors related to the interpersonal relationship among interlocutors include whether sender and receiver are cooperative or adversarial and how well-acquainted they are with one another. A final consideration is whether the unit of analysis is the utterance, turn at talk, episode, entire interaction, or series of interactions. Taking these factors into account should produce a more nuanced answer to the question of when deception is more difficult than truth-telling.

Archaeological and chemical analysis of Tell el Yahudiyeh ware

International Nuclear Information System (INIS)

Kaplan, M.F.; Harbottle, G.; Sayre, E.V.

1978-01-01

Typological and geographic analyses indicate that Tell el Yahudiyeh ware (found in Cyprus, Egypt, Nubia, and the Levant during the Middle Bronze period, c. 1750-1550 B.C.) were probably manufactured in two areas, the Nile Valley and the Levant. Activation analysis was carried out and correlated with the archaeological analyses. Results confirm the two ''families'' of the ware, one Egyptian and one Levantine. Speculations are offered on the social interaction of the period. 11 figures, 2 tables

Superconductivity discoveries and discoverers : ten physics Nobel laureates tell their story

CERN Document Server

Fossheim, Kristian

2013-01-01

This book is about the work of 10 great scientists; who they were and are, their personal background and how they achieved their outstanding results and took their prominent place in science history. We follow one of physics and science history's most enigmatic phenomena, superconductivity, through 100 years, from its discovery in 1911 to the present, not as a history book in the usual sense, but through close ups of the leading characters and their role in that story, the Nobel laureates, who were still among us in the years 2001-2004 when the main round of interviews was carried out. Since then two of them already passed away. For each one of the 10 laureates, the author tells their story by direct quotation from interviews in their own words. Each chapter treats one laureate. The author first gives a brief account of the laureates' scientific background and main contribution. Then each laureate tells his own story in his own words. This book is unique in its approach to science history.

Removal of α-tocopherol from blood and its comparison with other lipids

International Nuclear Information System (INIS)

Gardner, H.K.; Vang, M.J.; Mavis, R.D.

1986-01-01

The blood decay curve of α-tocopherol in rats was compared with those of the two major blood lipids by labeling rat serum in vitro with 3 H-α-tocopherol (AT), 3 H-cholesterol (CHO) or 3 H-trioleoylglycerol (TO) and injecting it into the bloodstream. For the three lipids, loss from blood was biphasic. The half time of the faster decay was 2-4 minutes. The slower curve decayed with half times of 42, 289 and 990 minutes for TO, AT and CHO, respectively. This intermediate rate of AT removal is consistent with its accompanying both of the major blood lipids as they are removed by their respective mechanisms or with a process specific for AT. To investigate the role of liver in the faster curve, animals were hepatectomized. TO and CHO loss remained biphasic after liver removal. However, AT loss became monophasic, with a loss rate intermediate between the non-hepatectomized fast and slow decays. This demonstrates a central role for liver in the metabolism of blood-borne AT and a mode of removal distinct from the other two lipids

What history tells us XIII. Fifty years of the Central Dogma

Indian Academy of Sciences (India)

2008-05-14

May 14, 2008 ... Home; Journals; Journal of Biosciences; Volume 33; Issue 2. What history tells us XIII. Fifty years of the Central Dogma. Michel Morange. Series Volume 33 Issue 2 June 2008 pp 171-175. Fulltext. Click here to view fulltext PDF. Permanent link: https://www.ias.ac.in/article/fulltext/jbsc/033/02/0171-0175 ...

What history tells us XL. The success story of the expression ...

Indian Academy of Sciences (India)

Home; Journals; Journal of Biosciences; Volume 41; Issue 1. What history tells us XL. The success story of the expression 'genome editing'. Michel Morange. Series Volume 41 Issue 1 March 2016 pp 9-11. Fulltext. Click here to view fulltext PDF. Permanent link: https://www.ias.ac.in/article/fulltext/jbsc/041/01/0009-0011 ...

Moral Disengagement and Children's Propensity to Tell Coached Lies

Science.gov (United States)

Doyle, Frances Lee; Bussey, Kay

2018-01-01

This study investigated the relationship between children's proneness to endorse moral disengagement mechanisms and their anticipated antisocial lie telling. Participants were 107 predominantly white Australian children in Grade 1 (27 boys, 27 girls; M[subscript age] = 6.69 years) and Grade 4 (24 boys, 29 girls; M[subscript age] = 9.69 years).…

Meir Sternberg, Telling in Time II: Chronology, Theleology, Narrativity

Directory of Open Access Journals (Sweden)

Franco Passalacqua

2010-06-01

Full Text Available The central section of Telling in Time II directs the attention to the consequences coming from the meeting between time and narrative considered in the first part of this essay: rhetorical strategies, narratives effects, teleological dynamic of surprise are all questions that belong to the pragmatic dimension of Sternberg’s critical perspective. The first chapters concern these narratives effects that took part in the critical debate since Aristotle and they are developed beginning from theoretical premises (pragmatical and teleological that enable to examine them from a renew point of view: if the Aristotelian concept of «discovery» (anagnorisis and «reversal» (peripeteia went in the modern narrative theorizations without facing any alteration, keeping their anchorage to the narrated world and not to the narrative modalities, Telling in Time II on the contrary, suggest to consider them in relation of their «communicative functioning» and in the so-called Proteus Principle. In the last chapters of the essay, Sternberg, after having explained such theoretical setting, takes these narrative dynamics – with the addition of “curiosity” and “surprise” – as constant element of the narrative genre, placing them at the base of the relations between the teleological level and the representative one that constitutes the central point of Sternberg’s critical purpose.

PRC2 inhibition counteracts the culture-associated loss of engraftment potential of human cord blood-derived hematopoietic stem and progenitor cells.

Science.gov (United States)

Varagnolo, Linda; Lin, Qiong; Obier, Nadine; Plass, Christoph; Dietl, Johannes; Zenke, Martin; Claus, Rainer; Müller, Albrecht M

2015-07-22

Cord blood hematopoietic stem cells (CB-HSCs) are an outstanding source for transplantation approaches. However, the amount of cells per donor is limited and culture expansion of CB-HSCs is accompanied by a loss of engraftment potential. In order to analyze the molecular mechanisms leading to this impaired potential we profiled global and local epigenotypes during the expansion of human CB hematopoietic stem and progenitor cells (HPSCs). Human CB-derived CD34+ cells were cultured in serum-free medium together with SCF, TPO, FGF, with or without Igfbp2 and Angptl5 (STF/STFIA cocktails). As compared to the STF cocktail, the STFIA cocktail maintains in vivo repopulation capacity of cultured CD34+ cells. Upon expansion, CD34+ cells genome-wide remodel their epigenotype and depending on the cytokine cocktail, cells show different H3K4me3 and H3K27me3 levels. Expanding cells without Igfbp2 and Angptl5 leads to higher global H3K27me3 levels. ChIPseq analyses reveal a cytokine cocktail-dependent redistribution of H3K27me3 profiles. Inhibition of the PRC2 component EZH2 counteracts the culture-associated loss of NOD scid gamma (NSG) engraftment potential. Collectively, our data reveal chromatin dynamics that underlie the culture-associated loss of engraftment potential. We identify PRC2 component EZH2 as being involved in the loss of engraftment potential during the in vitro expansion of HPSCs.

Truth Telling in the Setting of Cultural Differences and Incurable Pediatric Illness

Science.gov (United States)

Rosenberg, Abby R.; Starks, Helene; Unguru, Yoram; Feudtner, Chris; Diekema, Douglas

2017-01-01

IMPORTANCE Navigating requests from parents or family caregivers not to disclose poor prognosis to seriously ill children can be challenging, especially when the requests seem culturally mediated. Pediatric clinicians must balance obligations to respect individual patient autonomy, professional truth telling, and tolerance of multicultural values. OBSERVATIONS To provide suggestions for respectful and ethically appropriate responses to nondisclosure requests, we used a hypothetical case example of a Middle Eastern adolescent patient with incurable cancer and conducted an ethical analysis incorporating (1) evidence from both Western and Middle Eastern medical literature and (2) theories of cultural relativism and justice. While Western medical literature tends to prioritize patient autonomy and corresponding truth telling, the weight of evidence from the Middle East suggests high variability between and within individual countries, patient-physician relationships, and families regarding truth-telling practices and preferences. A common reason for nondisclosure in both populations is protecting the child from distressing information. Cultural relativism fosters tolerance of diverse beliefs and behaviors by forbidding judgment on foreign societal codes of conduct. It does not justify assumptions that all individuals within a single culture share the same values, nor does it demand that clinicians sacrifice their own codes of conduct out of cultural respect. We suggest some phrases that may help clinicians explore motivations behind nondisclosure requests and gently confront conflict in order to serve the patient’s best interest. CONCLUSIONS AND RELEVANCE It is sometimes ethically permissible to defer to family values regarding nondisclosure, but such deferral is not unique to cultural differences. Early setting of expectations and boundaries, as well as ongoing exploration of family and health care professional concerns, may mitigate conflict. PMID:28873121

Effect of dietary patterns differing in carbohydrate and fat content on blood lipid and glucose profiles based on weight-loss success of breast-cancer survivors.

Science.gov (United States)

Thompson, Henry J; Sedlacek, Scot M; Paul, Devchand; Wolfe, Pamela; McGinley, John N; Playdon, Mary C; Daeninck, Elizabeth A; Bartels, Sara N; Wisthoff, Mark R

2012-01-06

Healthy body weight is an important factor for prevention of breast cancer recurrence. Yet, weight loss and weight gain are not currently included in clinical-practice guidelines for posttreatment of breast cancer. The work reported addresses one of the questions that must be considered in recommending weight loss to patients: does it matter what diet plan is used, a question of particular importance because breast cancer treatment can increase risk for cardiovascular disease. Women who completed treatment for breast cancer were enrolled in a nonrandomized, controlled study investigating effects of weight loss achieved by using two dietary patterns at the extremes of macronutrient composition, although both diet arms were equivalent in protein: high fat, low carbohydrate versus low fat, high carbohydrate. A nonintervention group served as the control arm; women were assigned to intervention arms based on dietary preferences. During the 6-month weight-loss program, which was menu and recipe defined, participants had monthly clinical visits at which anthropometric data were collected and fasting blood was obtained for safety monitoring for plasma lipid profiles and fasting glucose. Results from 142 participants are reported. Adverse effects on fasting blood lipids or glucose were not observed in either dietary arm. A decrease in fasting glucose was observed with progressive weight loss and was greater in participants who lost more weight, but the effect was not statistically significant, even though it was observed across both diet groups (P = 0.21). Beneficial effects of weight loss on cholesterol (4.7%; P = 0.001), triglycerides (21.8%; P = 0.01), and low-density lipoprotein (LDL) cholesterol (5.8%; P = 0.06) were observed in both groups. For cholesterol (P = 0.07) and LDL cholesterol (P = 0.13), greater reduction trends were seen on the low-fat diet pattern; whereas, for triglycerides (P = 0.01) and high-density lipoprotein (HDL) cholesterol (P = 0.08), a decrease

Atmosphere Impact Losses

Science.gov (United States)

Schlichting, Hilke E.; Mukhopadhyay, Sujoy

2018-02-01

Determining the origin of volatiles on terrestrial planets and quantifying atmospheric loss during planet formation is crucial for understanding the history and evolution of planetary atmospheres. Using geochemical observations of noble gases and major volatiles we determine what the present day inventory of volatiles tells us about the sources, the accretion process and the early differentiation of the Earth. We further quantify the key volatile loss mechanisms and the atmospheric loss history during Earth's formation. Volatiles were accreted throughout the Earth's formation, but Earth's early accretion history was volatile poor. Although nebular Ne and possible H in the deep mantle might be a fingerprint of this early accretion, most of the mantle does not remember this signature implying that volatile loss occurred during accretion. Present day geochemistry of volatiles shows no evidence of hydrodynamic escape as the isotopic compositions of most volatiles are chondritic. This suggests that atmospheric loss generated by impacts played a major role during Earth's formation. While many of the volatiles have chondritic isotopic ratios, their relative abundances are certainly not chondritic again suggesting volatile loss tied to impacts. Geochemical evidence of atmospheric loss comes from the {}3He/{}^{22}Ne, halogen ratios (e.g., F/Cl) and low H/N ratios. In addition, the geochemical ratios indicate that most of the water could have been delivered prior to the Moon forming impact and that the Moon forming impact did not drive off the ocean. Given the importance of impacts in determining the volatile budget of the Earth we examine the contributions to atmospheric loss from both small and large impacts. We find that atmospheric mass loss due to impacts can be characterized into three different regimes: 1) Giant Impacts, that create a strong shock transversing the whole planet and that can lead to atmospheric loss globally. 2) Large enough impactors (m_{cap} ≳ √{2

Academic Training: Telling the truth with statistics

CERN Multimedia

Françoise Benz

2005-01-01

2004-2005 ACADEMIC TRAINING PROGRAMME LECTURE SERIES 21, 22, 23, 24 & 25 February from 11.00 to 12.00 hrs - Main Auditorium, bldg. 500 Telling the truth with statistics by G. D'Agostini / NFN, Roma, Italy The issue of evaluating and expressing the uncertainty in measurements, as well as that of testing hypotheses, is reviewed, with particular emphasis on the frontier cases typical of particle physics experiments. Fundamental aspects of probability will be addressed and the applications, solely based on probability theory, will cover several topics of practical interest, including counting experiments, upper/lower bounds, systematic errors, fits and comparison of hypotheses. ENSEIGNEMENT ACADEMIQUE ACADEMIC TRAINING Françoise Benz 73127 academic.training@cern.ch

TELL1 data acquisition system for LHCb detectors

International Nuclear Information System (INIS)

Gong Guanghua; Xue Tao; Gong Hui; Shao Beibei

2004-01-01

A FPGA based data acquisition readout board has been developed for the LHCb detectors. With optical or analogue daughter cards, it can readout data from several different off-detector electronics. The data synchronization, buffering, pre-processing, zero-suppression and many interfaces to memory chips and communication buses are all implemented by the FPGA in VHDL code. The board sends data out via a 4 channel Gigabit Ethernet adapter. The TELL1 can accepts 24 optical links running at 1.6 GHz and provides for the analogue option 64 10-bit ADC channels sampling at 40 MHz. (authors)

Intra-operative blood transfusion among adult surgical patients in a ...

African Journals Online (AJOL)

This retrospective study was designed to audit the pattern of intra-operative whole blood transfusion among adult surgical patients over a two-year period. Data were collected on the rate of intra-operative transfusion, estimated blood loss, units of donor blood transfused, pattern of use of autologous blood and circumstances ...

Micromorphological investigation on ring road sediments of the Early Bronze Age site Tell Chuera, Syria

Science.gov (United States)

Fritzsch, Dagmar; Thiemeyer, Heinrich

2010-05-01

Tell Chuera is an Early Bronze Age settlement mount in NE-Syria close to the Turkish border. With a diameter of almost 1 km and a height of 18 m it is one of the biggest tells in the region between the rivers Balikh and Khabur. In 1958 the structures of the city wall was known first by Orthmann (1990). This city wall was built of air-dried mud bricks. The age of the founding of this construction is not yet clear. The earliest pottery from the place is dated around 2500 BC to 2350 BC. Inside the fortification a road was detected, which was first excavated by Novak (1995). We took sediment monoliths in 2004 from a new trench, which shows the same situation of the road. A geomagnetic prospection, that included the whole site, suggests that the road was part of the planned extension of the lower town and serves as a circular road (Meyer, in prep.). The micromorphological investigation focussed on the question, how the road was used. Did animals have had access to the town? The thin sections show different indications of the anthropogenic influence. In all samples pseudomorphs after straw are visible. In many parts ash, charred wood fragments, bone fragments, melted material and fragments of basalt and flint were observable, too. These materials are typical for sediments in streets (cf. Goldberg & Macphail, 2006). In some parts of the thin sections faecal spherulites and dung remains with faecal spherulites give an idea that ruminants used the road as well as men. Trampling structures support this assumption. Moreover, leaching of calcite, its redeposition in mottles, pseudomycels and concretions, hydromorphic stains and the translocation of silt indicate postdepositional pedogenic processes. Literature Goldberg, P., & Macphail, R. I. (2006). Practical and theoretical geoarchaeology: UK Blackwell Publishing. Meyer, J.-W. (in prep.). Überlegungen zur Siedlungsstruktur - eine erste Analyse der Ergebnisse der geomagnetischen Prospektion. In J.-W. Meyer (Ed.), Ausgrabungen

Low-level environmental metals and metalloids and incident pregnancy loss.

Science.gov (United States)

Buck Louis, Germaine M; Smarr, Melissa M; Sundaram, Rajeshwari; Steuerwald, Amy J; Sapra, Katherine J; Lu, Zhaohui; Parsons, Patrick J

2017-04-01

Environmental exposure to metals and metalloids is associated with pregnancy loss in some but not all studies. We assessed arsenic, cadmium, mercury, and lead concentrations in 501 couples upon trying for pregnancy and followed them throughout pregnancy to estimate the risk of incident pregnancy loss. Using Cox proportional hazard models, we estimated hazard ratios (HR) and 95% confidence intervals (CIs) for pregnancy loss after covariate adjustment for each partner modeled individually then we jointly modeled both partners' concentrations. Incidence of pregnancy loss was 28%. In individual partner models, the highest adjusted HRs were observed for female and male blood cadmium (HR=1.08; CI 0.81, 1.44; HR=1.09; 95% CI 0.84, 1.41, respectively). In couple based models, neither partner's blood cadmium concentrations were associated with loss (HR=1.01; 95% CI 0.75, 1.37; HR=0.92; CI 0.68, 1.25, respectively). We observed no evidence of a significant relation between metal(loids) at these environmentally relevant concentrations and pregnancy loss. Published by Elsevier Inc.

Blood Conservation Strategies in Total Hip and Knee Arthroplasty

Directory of Open Access Journals (Sweden)

David Liu

2015-01-01

Full Text Available Peri-operative blood management is one of a number of components important for successful patient care in total joint arthroplasty and surgeons should be proactive in its application. The aims of blood conservation are to reduce the risks of blood transfusion whilst at the same time maximizing haemaglobin in the post-operative period, thereby leading to a positive effect on early and long term outcomes and costs. An individualized strategy based on patient specific risk factors, anticipated blood loss and co-morbidities is useful in achieving this aim. Multiple blood conservation strategies are available in the pre-operative, intra-operative and post-operative periods and can be utilised either individually or in combination. Recent literature has highlighted the importance of identifying and correcting pre-operative anaemia, salvaging peri-operative red cells and the use of tranexamic acid in reducing blood loss. Given total hip and knee arthroplasty is an elective procedure, a zero allogenic blood transfusion rate should be the aim and an achievable goal.

Confidence in the safety of blood for transfusion: the effect of message framing.

Science.gov (United States)

Farrell, K; Ferguson, E; James, V; Lowe, K C

2001-11-01

Blood transfusion is a universally used, life-saving medical intervention. However, there are increasing concerns among patients about blood safety. This study investigates the effect of message framing, a means of presenting information, on confidence in blood transfusion safety. The same factual information regarding the safety of blood for transfusion was presented to a sample of 254 adult students (donors and nondonors) as either a gain frame (lives saved), a loss frame (lives lost), or a combined frame (a loss frame expressed in a positive context). This provided a basic two-way, between-subjects design with 1) blood donation history (donors vs. nondonors) and 2) message frame (gain, loss, and combined) functioning as the between-groups factors. It was hypothesized that participants would consider blood safer if information was presented as a gain frame. The role of stress appraisals as potential mediators of the framing effect was also explored. As predicted, participants receiving the gain-frame information were significantly more confident of the safety of blood for transfusion than those receiving loss-frame information or both. This was unaffected by donation history or appraisals of stress associated with transfusion. The extent to which blood was considered safe was negatively associated, independently of framing effects, with perceptions that transfusion was threatening. Information about transfusion should be conveyed to patients in a form focusing on the positive, rather than the negative, known facts about the safety of blood.

Destination memory in Alzheimer's Disease: when I imagine telling Ronald Reagan about Paris.

Science.gov (United States)

El Haj, Mohamad; Postal, Virginie; Allain, Philippe

2013-01-01

Destination memory refers to remembering the destination of information that people output. This present paper establishes a new distinction between external and internal processes within this memory system for both normal aging and Alzheimer's Disease (AD). Young adults, older adults, and mild AD patients were asked either to tell facts (i.e., external destination memory condition) or to imagine telling facts (i.e., internal destination memory condition) to pictures of famous people. The experiment established three major findings. First, the destination memory performance of the AD patients was significantly poorer than that of older adults, which in turn was poorer than that of the young adults. Furthermore, internal destination processes were more prone to being forgotten than external destination memory processes. In other words, participants had more difficulty in remembering whether they had previously imagined telling the facts to the pictures or not (i.e., imagined condition) than in remembering whether they had previously told the facts to the pictures or not (i.e., enacted condition). Second, significant correlations were detected between performances on destination memory and several executive measures such as the Stroop, the Plus-Minus and the Binding tasks. Third, among the executive measures, regression analyses showed that performance on the Stroop task was a main factor in explaining variance in destination memory performance. Our findings reflect the difficulty in remembering the destination of internally generated information. They also demonstrate the involvement of inhibitory processes in destination memory. Copyright © 2011 Elsevier Ltd. All rights reserved.

Systemic Inflammatory Response to Malaria During Pregnancy Is Associated With Pregnancy Loss and Preterm Delivery.

Science.gov (United States)

Fried, Michal; Kurtis, Jonathan D; Swihart, Bruce; Pond-Tor, Sunthorn; Barry, Amadou; Sidibe, Youssoufa; Gaoussou, Santara; Traore, Moussa; Keita, Sekouba; Mahamar, Almahamoudou; Attaher, Oumar; Dembele, Adama B; Cisse, Kadidia B; Diarra, Bacary S; Kanoute, Moussa B; Dicko, Alassane; Duffy, Patrick E

2017-10-30

Pregnancy malaria (PM) is associated with a proinflammatory immune response characterized by increased levels of cytokines and chemokines such as tumor necrosis factor-α, interferon-γ, interleukin 10 (IL-10), and CXCL9. These changes are associated with poor outcomes including low birthweight delivery and maternal anemia. However, it is unknown if inflammatory pathways during malaria are related to pregnancy loss and preterm delivery (PTD). Cytokine and chemokine levels were measured in maternal peripheral blood at enrollment, gestational week 30-32, and delivery, and in placental blood, of 638 women during a longitudinal cohort study in Ouelessebougou, Mali. Plasmodium falciparum infection was assessed by blood smear microscopy at all visits. PM was associated with increased levels of cytokines and chemokines including IL-10 and CXCL9. In a competing risks model adjusted for known covariates, high CXCL9 levels measured in the peripheral blood during pregnancy were associated with increased risk of pregnancy loss and PTD. At delivery, high IL-10 levels in maternal blood were associated with an increase in pregnancy loss, and increased IL-1β levels in placental blood were associated with pregnancy loss and PTD. PM is associated with increased proinflammatory cytokine and chemokine levels in placental and maternal peripheral blood. Systemic inflammatory responses to malaria during pregnancy predict increased risk of pregnancy loss and PTD. NCT01168271. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Avaliação da perda sanguínea na artroplastia total do joelho com e sem soltura do torniquete Blood loss in total knee arthroplasty with and without tourniquet release

Directory of Open Access Journals (Sweden)

José Wanderley Vasconcelos

2011-01-01

Full Text Available OBJETIVO: Avaliar a perda sanguínea em pacientes submetidos à artroplastia total cimentada do joelho com e sem soltura trans-operatória do torniquete pneumático para a hemostasia. MÉTODOS: Foram estudados 72 pacientes submetidos à artroplastia total, num total de 80 joelhos, divididos em dois grupos: Grupo 1 onde se manteve o torniquete pneumático até a sutura e curativo da ferida operatória, e Grupo 2 onde foi realizada a soltura do torniquete pneumático após a cimentação da prótese, com realização de hemostasia direta, antes da sutura e curativo. Os pacientes foram avaliados quanto ao sangramento pelo dreno de sucção e à contagem de hemoglobina e hematócrito, considerando os intervalos de duas, 24 e 48 horas de pós-operatório. RESULTADOS: Não houve diferença significante entre os dois grupos quanto ao sangramento pós-operatório e decréscimo dos parâmetros hematimétricos. Somente um paciente do Grupo 2 necessitou transfusão de concentrado de hemáceas no pós-operatório. CONCLUSÃO: O sangramento pós-operatório na ATJ mostrou-se igual com e sem a soltura do torniquete pneumático para a realização da hemostasia.OBJECTIVE: To evaluate blood loss in patients submitted to cemented total knee arthroplasty with and without perioperative tourniquet release for hemostasis. METHODS: Seventy-two patients (eighty knees were submitted to total knee arthroplasty, allocated into two groups: in Group 1, in which the pneumatic tourniquet was maintained until suture and dressing of the operated wound, and Group 2, in which the pneumatic tourniquet was released intraoperatively after cementing the prosthesis, with direct hemostasis, before the suture and dressing. The patients were evaluated for blood loss by the suction drain, and hemoglobin and hematocrit counts, at intervals of 2, 24 and 48 hours in the postoperative period tube. RESULTS: There was no significant difference between the groups in terms of postoperative blood

Telling business stories as fellowship-tales

DEFF Research Database (Denmark)

Smith, Robert; Neergaard, Helle

2015-01-01

Purpose – This paper aims to explore the “Fellowship-Tale” as an alternative tale type for narrating entrepreneur stories. The authors illustrate this by telling the Pilgrim business story. It is common for the deeds of men who founded businesses to be narrated as heroic entrepreneur stories...... – The research indicates that “fellowship-tales” provide a viable and credible alternative to the fairy-tale rendition common in entrepreneur and business stories. Research limitations/implications – An obvious limitation is that one merely swaps one narrative framework for another, albeit it offers dissenting...... voices a real choice. Practical implications – This study has the potential to be far reaching because at a practical level, it allows disengaged entrepreneurs and significant others the freedom to exercise their individual and collective voices within a framework of nested stories. Originality...

[Economic environment and blood transfusion].

Science.gov (United States)

Durand-Zaleski, I

2015-08-01

The increasing pressure on healthcare resources affects blood donation and transfusion. We attempted a survey of the efficiency of different strategies, actual or proposed to improve the management of blood products. We found an important disconnect between the cost effectiveness ratio of strategies and their uptake by policy makers. In other words, the least efficient strategies are those which increase transfusion safety by increasing the number of biological markers and are those preferred by health authorities in developed countries. Other more efficient strategies are more slowly implemented and included a systematic use of transfusion guidelines, reducing blood losses or increasing pre operative blood levels in elective surgeries. Copyright © 2015. Published by Elsevier SAS.

How to Tell the Schlock from the Good Stuff in Science Fiction.

Science.gov (United States)

Harris, June

1992-01-01

Asserts that not all science fiction is great. Discusses ways to tell the difference between the good and the bad. Encourages even those teachers who are most leery of a genre with which they are unfamiliar to jump in and try science fiction as a way of opening up student minds and imaginations. (PRA)

Blood transfusion practices in obstetric anaesthesia

Directory of Open Access Journals (Sweden)

Ashok Jadon

2014-01-01

Full Text Available Blood transfusion is an essential component of emergency obstetric care and appropriate blood transfusion significantly reduces maternal mortality. Obstetric haemorrhage, especially postpartum haemorrhage, remains one of the major causes of massive haemorrhage and a prime cause of maternal mortality. Blood loss and assessment of its correct requirement are difficult in pregnancy due to physiological changes and comorbid conditions. Many guidelines have been used to assess the requirement and transfusion of blood and its components. Infrastructural, economic, social and religious constraints in blood banking and donation are key issues to formulate practice guidelines. Available current guidelines for transfusion are mostly from the developed world; however, they can be used by developing countries keeping available resources in perspective.

Measurement of regional cerebral blood flow by positron emission tomography

International Nuclear Information System (INIS)

Herscovitch, P.; Powers, W.J.

1987-01-01

The principal advantage of positron emission tomography over other methods for measuring cerebral blood flow stems from the accurate, quantitative three-dimensional measurements of regional brain radioactivity that are possible with this technique. As a result, accurate quantitative measurements of regional cerebral blood flow can be obtained for both superficial and deep cerebral structures. The value of PET for investigating central nervous system physiology and pathology extends far beyond this, however. Through the use of different radiotracers and appropriate mathematical models, PET can be applied to the measurement of a wide variety of physiologic variables. Measurements of rCBF tell only part of the story. Experience with PET and with a variety of other techniques has taught us that rCBF is at times a poor indicator of the metabolic, functional, and biochemical status of cerebral tissue. It is only by understanding the interaction of all of these factors that our understanding of neurologic disease can advance. It is in the investigation of these complex relationships that the real value of PET resides

Earnings management through loss avoidance: Does South Africa have a good story to tell?

Directory of Open Access Journals (Sweden)

Mangakane Lehlogonolo Pududu

2016-03-01

Full Text Available The purpose of this study is to determine whether South African managers manage earnings to avoid reporting small losses (small earnings decreases. The study covers all the companies listed on the Johannesburg Stock Exchange (JSE from 2003 to 2011. In line with Burgstahler and Dichev (1997, the cross-sectional distributions of earnings and changes in earnings are examined and the distributions are shown in histograms. Previous research (using data from the United States has shown that the distribution curve for both the earnings and the change in earnings variable had noticeably fewer observations just below zero than would normally be expected, and a significantly higher number of observations just above zero. This pattern in the distributions suggests that managers manage reported earnings to ensure that earnings do not fall below a specific threshold, this being zero or the previous year’s performance. Interestingly, and in contrast with  the previous  literature, using the Burgstahler and Dichev (1997 research model of analysis, our results show no evidence in South Africa of managers managing earnings to avoid reporting small losses or small decreases in earnings. A possible reason for this could be the relatively smaller size of the JSE (compared with stock exchanges in the United States. In addition, and more important, is the possibility that investors and analysts in South Africa may be fixated on other performance indicators, such as revenue and headline earnings per share, rather than on earnings (profits.  This study adds to the limited research on earnings management in South Africa, which is a developing economy. Furthermore, previous research shows an inverse relationship between earnings management and earnings quality. The results of this study may therefore be useful to the users and the regulators of financial reports, both are concerned with earnings for the purposes of assessing the cost of capital and how companies

Ways of Telling About Society. Howard S. Becker in Conversation With Reiner Keller

Directory of Open Access Journals (Sweden)

Howard S. Becker

2016-04-01

Full Text Available In the following conversation, Howard S. BECKER talks about his lifelong travel with and between sociology and jazz music, his professional training as a sociologist, the hazards of a career, and his involvement with photography and performance. He reflects on the different ways used by artists and sociologists to tell solid stories about social phenomena, and tells a compelling account in its own right about the methodology of sound sociological field work and case study research. By explaining core concepts of his sociological perspective (such as the concept of labeling and "doing things together" and referring to concrete research examples, BECKER in all modesty fully engages with what could be called today's sociological imagination, leaving narrow disciplinary constraints behind in order to explore society with curiosity, using methodologically sensible but nevertheless refreshing approaches. The audio file is accessible from http://dx.doi.org/10.5281/zenodo.49829. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1602122

[Blood conservation effect and safety of shed mediastinal blood autotransfusion after cardiac surgery].

Science.gov (United States)

Komiya, T; Ban, K; Yamazaki, K; Date, O; Nakamura, T; Kanzaki, Y

1998-10-01

Autotransfusion of shed mediastinal blood after cardiac surgery has been used to reduce risks related to homologous blood transfusions. To document the efficacy and safety of autotransfusion, we compared clinical findings of 80 patients receiving shed mediastinal blood (autotransfusion group) with those of the control group of 52 patients. The amount of the autotransfusion was limited to 800 ml, given the potentially harmful effects of shed blood transfusion. The mean transfused shed volume was 314 +/- 236 ml (S.D.). The serum levels of FDP-E, D-dimer and TAT after autotransfusion were higher in the autotransfusion group than in the control group (p = 0.01, p = 0.0004, p = 0.001, respectively). However, postoperative blood loss and the rate of reexploration for bleeding were similar in the two groups. The patients receiving blood products were fewer in the autotransfusion group than those in the control group (21% vs 44%; p = 0.005). Autotransfusion did not increase postoperative complications, including infection. Thus, although autotransfusion of mediastinal shed blood has the potential to affect hemostasis, unless the amount of autotransfusion exceeds 800 ml, it appears that this method is clinically safe and effective as a mean of blood conservation.

Telling tales.

Science.gov (United States)

Denning, Stephen

2004-05-01

A carefully chosen story can help the leader of an organization translate an abstract concept into a meaningful mandate for employees. The key is to know which narrative strategies are right for what circumstances. Knowledge management expert Stephen Denning explains that, for optimal effect, form should follow function. Challenging one professional storyteller's view that more is better, Denning points out that it's not always desirable (or practical) to launch into an epic that's jam-packed with complex characters, cleverly placed plot points, an intricate rising action, and a neatly resolved denouement. True, if listeners have time and interest, a narrative-savvy leader can use a vividly rendered tale to promote communication between management and staff, for instance, or even to foster collaboration--especially when the story is emotionally moving. However, if the aim is to motivate people to act when they might not be inclined to do so, it's best to take an approach that's light on detail. Otherwise, the particulars can bog listeners down and prevent them from focusing on the message. Drawing on his experiences at the World Bank and observations made elsewhere, the author provides several dos and don'ts for organizational storytellers, along with examples of narratives that get results. The sidebar "A Storytelling Catalog" presents seven distinct types of stories, the situations in which they should be told, and tips on how to tell them. Many of these aren't even stories in the "well-told" sense--they run the rhetorical gamut from one-liners to full-blown speeches--but they succeed because they're tailored to fit the situation. So even though it's common in business to favor the analytical over the anecdotal, leaders with the strength to push past some initial skepticism about the enterprise of storytelling will find that the creative effort pays off.

A possible "grinder" from Tell Arbid, Syria.

Science.gov (United States)

Pitre, Mindy C; Koliński, Rafał; Sołtysiak, Arkadiusz

2017-12-01

Cereal grinding has been practiced in Mesopotamia since the Upper Palaeolithic. While evidence of cereal grinding is clear from the archaeological and textual records, what remains unclear is whether the activity leaves signs on the skeleton in the form of markers of occupational stress (MOS). A particular constellation of MOS (e.g., osteoarthritis, traumatic injuries, and accessory articular facets) has previously been used to infer the habitual grinding of grain. These same MOS were recently observed in the skeleton of a female discovered in the Middle Bronze Age cemetery at Tell Arbid, NE Syria. Through differential diagnosis our results suggest that it remains problematic to identify grain-processing activities from the skeleton, even when a bioarchaeological approach is carried out.

Fasting blood glucose and haemoglobin concentrations of healthy ...

African Journals Online (AJOL)

Menstruation is associated with loss of blood monthly in women of reproductive age. In some women this physiological phenomenon is also associated with some complaints such as menstrual pain, vomiting, and tiredness. We investigated the fasting blood glucose concentration and hemoglobin concentration before and ...

What history tells us XXX. The emergence of the fluid mosaic model

Indian Academy of Sciences (India)

Home; Journals; Journal of Biosciences; Volume 38; Issue 1. What history tells us XXX. The emergence of the fluid mosaic model of membranes. Michel Morange. Series Volume 38 Issue 1 March 2013 pp 3-7. Fulltext. Click here to view fulltext PDF. Permanent link: https://www.ias.ac.in/article/fulltext/jbsc/038/01/0003-0007 ...

Patient blood management -- the GP's guide.

Science.gov (United States)

Minck, Sandra; Robinson, Kathryn; Saxon, Ben; Spigiel, Tracey; Thomson, Amanda

2013-05-01

There is accumulating evidence of a strong association between blood transfusion and adverse patient outcomes. Patient blood management aims to achieve improved patient outcomes by avoiding unnecessary exposure to blood products through effective conservation and management of a patient's own blood. To introduce the general practitioner's role in patient blood management. There are a number of ways in which GPs can contribute to patient blood management, particularly in the care of patients scheduled for elective surgery. These include awareness, identification, investigation and management of patients with or at risk of anaemia; assessment of the adequacy of iron stores in patients undergoing planned procedures in which substantial blood loss is anticipated; awareness and assessment of medications and complementary medicines that might increase bleeding risk; and awareness of and ability to discuss with patients, the possible risks associated with blood transfusion and alternatives that may be available.

The Nordic Obstetric Surveillance Study: a study of complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery.

Science.gov (United States)

Colmorn, Lotte B; Petersen, Kathrine B; Jakobsson, Maija; Lindqvist, Pelle G; Klungsoyr, Kari; Källen, Karin; Bjarnadottir, Ragnheidur I; Tapper, Anna-Maija; Børdahl, Per E; Gottvall, Karin; Thurn, Lars; Gissler, Mika; Krebs, Lone; Langhoff-Roos, Jens

2015-07-01

To assess the rates and characteristics of women with complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery in the Nordic countries. Prospective, Nordic collaboration. The Nordic Obstetric Surveillance Study (NOSS) collected cases of severe obstetric complications in the Nordic countries from April 2009 to August 2012. Cases were reported by clinicians at the Nordic maternity units and retrieved from medical birth registers, hospital discharge registers, and transfusion databases by using International Classification of Diseases, 10th revision codes on diagnoses and the Nordic Medico-Statistical Committee Classification of Surgical Procedure codes. Rates of the studied complications and possible risk factors among parturients in the Nordic countries. The studied complications were reported in 1019 instances among 605 362 deliveries during the study period. The reported rate of severe blood loss at delivery was 11.6/10 000 deliveries, complete uterine rupture was 5.6/10 000 deliveries, abnormally invasive placenta was 4.6/10 000 deliveries, and peripartum hysterectomy was 3.5/10 000 deliveries. Of the women, 25% had two or more complications. Women with complications were more often >35 years old, overweight, with a higher parity, and a history of cesarean delivery compared with the total population. The studied obstetric complications are rare. Uniform definitions and valid reporting are essential for international comparisons. The main risk factors include previous cesarean section. The detailed information collected in the NOSS database provides a basis for epidemiologic studies, audits, and educational activities. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

Circadian melatonin concentration rhythm is lost in pregnant women with altered blood pressure rhythm.

Science.gov (United States)

Tranquilli, A L; Turi, A; Giannubilo, S R; Garbati, E

2004-03-01

We assessed the correlation between the rhythm of melatonin concentration and circadian blood pressure patterns in normal and hypertensive pregnancy. Ambulatory 24-h blood pressure and blood samples every 4 h were monitored in 16 primigravidae who had shown an abnormal circadian blood pressure pattern (eight pre-eclamptic and eight normotensive) in pregnancy and 6-12 months after pregnancy. The circadian rhythm was analyzed by chronobiological measures. Eight normotensive women with maintained blood pressure rhythm served as controls. During pregnancy, melatonin concentration was significantly higher in pre-eclamptic than in normotensive women (pre-eclampsia, 29.4 +/- 1.9 pg/ml, normotensin, altered rhythm, 15.6 +/- 2.1; controls, 22.7 +/- 1.8; p lost in all pregnant women with loss of blood pressure rhythm. After pregnancy, normotensive women showed a reappearance of both melatonin and blood pressure rhythm, whereas pre-eclamptic women showed a reappearance of blood pressure but not melatonin rhythm. The loss of blood pressure rhythm in pregnancy is consistent with the loss of melatonin concentration rhythm. In pre-eclamptic women, the normalization of blood pressure rhythm, while melatonin rhythm remained altered, suggests a temporal or causal priority of circadian concentration of melatonin in the determination of blood pressure trend.

Intraoperative blood loss independently predicts survival and recurrence after resection of colorectal cancer liver metastasis.

Directory of Open Access Journals (Sweden)

Wu Jiang

Full Text Available BACKGROUND: Although numerous prognostic factors have been reported for colorectal cancer liver metastasis (CRLM, few studies have reported intraoperative blood loss (IBL effects on clinical outcome after CRLM resection. METHODS: We retrospectively evaluated the clinical and histopathological characteristics of 139 patients who underwent liver resection for CRLM. The IBL cutoff volume was calculated using receiver operating characteristic curves. Overall survival (OS and recurrence free survival (RFS were assessed using the Kaplan-Meier and Cox regression methods. RESULTS: All patients underwent curative resection. The median follow up period was 25.0 months (range, 2.1-88.8. Body mass index (BMI and CRLM number and tumor size were associated with increased IBL. BMI (P=0.01; 95% CI = 1.3-8.5 and IBL (P500mL were 71%, 33%, and 0%, respectively (P<0.01. RFS of patients within three IBL volumes at the end of the first year were 67%, 38%, and 18%, respectively (P<0.01. CONCLUSIONS: IBL during CRLM resection is an independent predictor of long term survival and tumor recurrence, and its prognostic value was confirmed by a dose-response relationship.

Gone with the Wind: Three Years of MAVEN Measurements of Atmospheric Loss at Mars

Science.gov (United States)

Brain, David; MAVEN Team

2017-10-01

The Mars Atmosphere and Volatile EvolutioN (MAVEN) mission is making measurements of the Martian upper atmosphere and near space environment, and their interactions with energy inputs from the Sun. A major goal of the mission is to evaluate the loss of atmospheric gases to space in the present epoch, and over Martian history. MAVEN is equipped with instruments that measure both the neutral and charged upper atmospheric system (thermosphere, ionosphere, exosphere, and magnetosphere), inputs from the Sun (extreme ultraviolet flux, solar wind and solar energetic particles, and interplanetary magnetic field), and escaping atmospheric particles. The MAVEN instruments, coupled with models, allow us to more completely understand the physical processes that control atmospheric loss and the particle reservoirs for loss.Here, we provide an overview of the significant results from MAVEN over approximately 1.5 Mars years (nearly three Earth years) of observation, from November 2014 to present. We argue that the MAVEN measurements tell us that the loss of atmospheric gases to space was significant over Martian history, and present the seasonal behavior of the upper atmosphere and magnetosphere. We also discuss the influence of extreme events such as solar storms, and a variety of new discoveries and observations of the Martian system made by MAVEN.

Tell Me More: Issues and Challenges

Directory of Open Access Journals (Sweden)

Harwati Hashim

2012-07-01

Full Text Available Integration of technology into language education has become an everyday occurrence. Educational multimedia courseware as resource materials to enhance the teaching and learning of English language was produced extensively. Regardless of the cost, computers and courseware are becoming important tools for learning in institutions. Therefore, a considerable pressure is being put on the ESL teachers to make use of the courseware marvels in their lesson since the cost of the courseware is rather expensive. This paper aims to investigate the issues and challenges faced by the ESL lecturers on the use of a courseware named TELL ME MORE in a polytechnic in Melaka. Data was collected via semi-structured interviews with four ESL lecturers at the polytechnic. Findings show that the courseware is a useful tool for language learning. However, there are certain challenges that the ESL lecturers had to face such as time and lack of facilities.

Young Children's Meaning-Making through Drawing and "Telling": Analogies to Filmic Textual Features

Science.gov (United States)

Wright, Susan

2007-01-01

Young children's meaning-making is a multifaceted, complex experience, where thought, body and emotion unite. Rich and intricate creations are brought to life through children's formation, communication and interpretation of "signs" which stand for or represent something else. The term drawing-telling is used to describe children's use of a range…

Effect of a Modest Weight Loss in Normalizing Blood Pressure in Obese Subjects on Antihypertensive Drugs.

Science.gov (United States)

Gilardini, Luisa; Redaelli, Gabriella; Croci, Marina; Conti, Antonio; Pasqualinotto, Lucia; Invitti, Cecilia

2016-01-01

To assess the effect of a lifestyle intervention in lowering/normalizing blood pressure (BP) levels in hypertensive (controlled or not) obese patients. In this prospective observational study, 490 obese hypertensive patients, 389 controlled (BP < 140/90 mm Hg; CH) and 101 uncontrolled (BP ≥ 140/90 mm Hg; UH) attended a 3-month lifestyle intervention. Before and after the intervention we assessed weight, waist circumference, fat mass, BP, metabolic and renal variables, and physical activity. A multivariate regression model was used to determine the predictors of BP changes. 18.9% of CH and 20.0% of UH were on ≥ 3 antihypertensive drugs. Weight change (average -4.9 ± 2.7%) was independent of the antihypertensive drugs employed. Systolic BP (SBP) decreased by 23 mm Hg and diastolic BP (DBP) by 9 mm Hg, in patients with UH most of whom (89%) normalized BP levels (in 49% after a weight loss < 5%). Age, gender, whole and central obesity, concomitance of type 2 diabetes, chronic renal disease, physical activity intensification, and pharmacological therapy did not affect BP lowering. In the regression analysis with SBP change as dependent variable, weight reduction (β = 0.523, p = 0.005) and group (UH vs. CH, β = -19.40, p = 0.0005) remained associated with SBP reduction. When DBP change was entered as dependent variable, baseline uric acid remained associated with DBP reduction (β = 0.824, p < 0.05). Lifestyle interventions are useful for all obese hypertensive patients in most of whom a modest weight loss is sufficient to normalize BP levels avoiding the aggressive use of multiple antihypertensive drugs. © 2016 The Author(s) Published by S. Karger GmbH, Freiburg.

Analytical investigations of cooking pottery from Tell Beydar (NE-Syria)

International Nuclear Information System (INIS)

Broekmans, T.; Adriaens, A.; Pantos, E.

2004-01-01

Within the framework of a technological and socio-economical study of pottery production in Tell Beydar (NE-Syria) during the third millennium BC, the chemical composition and mineralogy of cooking pottery from that site has been studied using polarizing microscopy, scanning electron microscopy with energy dispersive X-ray detection (SEM-EDX) and X-ray diffraction by means of synchrotron radiation (SR-XRD). The obtained data were used to make inferences concerning the pottery's technology, such as clay preparation and firing techniques

Blood inventory management: hospital best practice.

Science.gov (United States)

Stanger, Sebastian H W; Yates, Nicola; Wilding, Richard; Cotton, Sue

2012-04-01

Blood is a perishable product, and hence good management of inventories is crucial. Blood inventory management is a trade-off between shortage and wastage. The challenge is to keep enough stock to ensure a 100% supply of blood while keeping time expiry losses at a minimum. This article focuses on inventory management of red blood cells in hospital transfusion laboratories to derive principles of best practice and makes recommendations that will ensure losses due to time expiry are kept to a minimum. The literature was reviewed to identify available models for perishable inventory management. Historical data from the UK blood supply chain was analyzed to identify hospitals with good inventory management practice and low wastage levels. Transfusion laboratory managers in the selected hospitals were interviewed in 7 case studies with the aim of identifying drivers for low wastage and good inventory management practice. The findings from the case studies were compared with the literature. The extant literature asserts that the drivers for good inventory performance are the use of complex inventory models and algorithms. This study has found this not to be the case. Instead, good performance is driven by the quality of transfusion laboratory staff, who must be skilled, regularly trained, and experienced. Electronic crossmatching, transparency of the inventory, and simple management procedures also facilitate good performance. Copyright © 2012 Elsevier Inc. All rights reserved.

Increased protein intake reduces lean body mass loss during weight loss in athletes.

Science.gov (United States)

Mettler, Samuel; Mitchell, Nigel; Tipton, Kevin D

2010-02-01

To examine the influence of dietary protein on lean body mass loss and performance during short-term hypoenergetic weight loss in athletes. In a parallel design, 20 young healthy resistance-trained athletes were examined for energy expenditure for 1 wk and fed a mixed diet (15% protein, 100% energy) in the second week followed by a hypoenergetic diet (60% of the habitual energy intake), containing either 15% (approximately 1.0 g x kg(-1)) protein (control group, n = 10; CP) or 35% (approximately 2.3 g x kg(-1)) protein (high-protein group, n = 10; HP) for 2 wk. Subjects continued their habitual training throughout the study. Total, lean body, and fat mass, performance (squat jump, maximal isometric leg extension, one-repetition maximum (1RM) bench press, muscle endurance bench press, and 30-s Wingate test) and fasting blood samples (glucose, nonesterified fatty acids (NEFA), glycerol, urea, cortisol, free testosterone, free Insulin-like growth factor-1 (IGF-1), and growth hormone), and psychologic measures were examined at the end of each of the 4 wk. Total (-3.0 +/- 0.4 and -1.5 +/- 0.3 kg for the CP and HP, respectively, P = 0.036) and lean body mass loss (-1.6 +/- 0.3 and -0.3 +/- 0.3 kg, P = 0.006) were significantly larger in the CP compared with those in the HP. Fat loss, performance, and most blood parameters were not influenced by the diet. Urea was higher in HP, and NEFA and urea showed a group x time interaction. Fatigue ratings and "worse than normal" scores on the Daily Analysis of Life Demands for Athletes were higher in HP. These results indicate that approximately 2.3 g x kg(-1) or approximately 35% protein was significantly superior to approximately 1.0 g x kg(-1) or approximately 15% energy protein for maintenance of lean body mass in young healthy athletes during short-term hypoenergetic weight loss.

Modeling skin blood flow: a neuro-physiological approach

NARCIS (Netherlands)

Kingma, B.R.M.; Saris, W.H.M.; Frijns, A.J.H.; Steenhoven, van A.A.; Marken Lichtenbelt, van W.D.

2010-01-01

In humans skin blood flow (SBF) plays a major role in body heat loss. Therefore the accuracy of models ofhuman thermoregulation depends for a great deal on their ability to predict skin blood flow. Most SBFmodelsuse body temperatures directly for calculation of skin perfusion. However, humans do not

[Blood volume for biochemistry determinations--laboratory needs and everyday practice].

Science.gov (United States)

Sztefko, Krystyna; Mamica, Katarzyna; Bugajska, Jolanta; Maziarz, Barbara; Tomasik, Przemysław

2014-01-01

Blood loss due to diagnostic phlebotomy jest a very serious problem, especially for newborn, infants and critically ill patients on intensive care units. Although single blood loss can be easily tolerated in adults, in small babies and in patients who are frequently monitored based on laboratory tests iatrogenic anaemia can occur. To evaluate the blood volume drawn for routine biochemistry tests in relation to patient age and the number of parameters requested. Blood volume drawn for routine biochemistry measurements from patients hospitalized in University Children's Hospital (N = 2980, children age from one day to 18 years) and in University Hospital (N = 859, adults, aged > 1.8 years) in Cracow has been analyzed. Blood volume was calculated based on regular tube diameter and blood heights in the tube. In case of microvettes the blood volume was 0.2 ml. Statistical analysis has been performed by using PRISM 5.0. The statistical significance was set at p nurses and doctors should include the information about current laboratory automation and methods miniaturization; 2) The amount of blood volume needed by laboratory for the requested number of tests should always be taken into account when diagnostic phlebotomy is necessary.

Tranexamic Acid Reduced the Percent of Total Blood Volume Lost During Adolescent Idiopathic Scoliosis Surgery.

Science.gov (United States)

Jones, Kristen E; Butler, Elissa K; Barrack, Tara; Ledonio, Charles T; Forte, Mary L; Cohn, Claudia S; Polly, David W

2017-01-01

Multilevel posterior spine fusion is associated with significant intraoperative blood loss. Tranexamic acid is an antifibrinolytic agent that reduces intraoperative blood loss. The goal of this study was to compare the percent of total blood volume lost during posterior spinal fusion (PSF) with or without tranexamic acid in patients with adolescent idiopathic scoliosis (AIS). Thirty-six AIS patients underwent PSF in 2011-2014; the last half (n=18) received intraoperative tranexamic acid. We retrieved relevant demographic, hematologic, intraoperative and outcomes information from medical records. The primary outcome was the percent of total blood volume lost, calculated from estimates of intraoperative blood loss (numerator) and estimated total blood volume per patient (denominator, via Nadler's equations). Unadjusted outcomes were compared using standard statistical tests. Tranexamic acid and no-tranexamic acid groups were similar (all p>0.05) in mean age (16.1 vs. 15.2 years), sex (89% vs. 83% female), body mass index (22.2 vs. 20.2 kg/m2), preoperative hemoglobin (13.9 vs. 13.9 g/dl), mean spinal levels fused (10.5 vs. 9.6), osteotomies (1.6 vs. 0.9) and operative duration (6.1 hours, both). The percent of total blood volume lost (TBVL) was significantly lower in the tranexamic acid-treated vs. no-tranexamic acid group (median 8.23% vs. 14.30%, p = 0.032); percent TBVL per level fused was significantly lower with tranexamic acid than without it (1.1% vs. 1.8%, p=0.048). Estimated blood loss (milliliters) was similar across groups. Tranexamic acid significantly reduced the percentage of total blood volume lost versus no tranexamic acid in AIS patients who underwent PSF using a standardized blood loss measure.Level of Evidence: 3. Institutional Review Board status: This medical record chart review (minimal risk) study was approved by the University of Minnesota Institutional Review Board.

Leg loss in Lutzomyia longipalpis (Diptera: Psychodidae) due to pyrethroid exposure: Toxic effect or defense by autotomy?

Science.gov (United States)

Santamaría, E; Cabrera, O L; Avendaño, J; Pardo, R H

2016-01-01

Phlebotomine sandflies lose their legs after exposure to pyrethroids. In some insects leg loss helps to defend them from intoxication and predation, a phenomenon known as autotomy. A field observation has shown that sandflies that have lost some legs are still able to blood-feed. The aims of the study were to determine whether leg loss in sandflies, after exposure to deltamethrin, is due to autotomy and to establish the effect of the leg loss on blood-feeding. Two experiments were carried out with Lutzomyia longipalpis: (i) Females were individually exposed to a sublethal time of deltamethrin and mortality and the number of leg loss were recorded; and (ii) Groups of females with complete legs or with 1-3 legs lost due to pyrethroid exposure were offered a blood meal and percentages of blood-fed and fully-fed females were recorded. Most females lost a median of 1 leg within 1-48 h post-exposure to deltamethrin. Mortality (after 24 h) was significantly higher for exposed females with lost legs (31.1%), compared to exposed females with complete legs (7.3%), and there were no differences in mortality between females with complete legs and the control (unexposed females). There were no differences between the three treatments in the percentages of blood-fed and fully-fed females. Leg loss in sandflies is a toxic effect of pyrethroids and there was no evidence of autotomy. The loss of up to three legs after exposure to pyrethroids does not affect blood-feeding behaviour in laboratory and probably also in wild conditions.

Hug a Pillow, Slug a Pillow: Using Your Body To Tell the Story.

Science.gov (United States)

Miller, Bruce

2000-01-01

Presents a sequence of exercises that requires students to think about telling their stories in terms of physicalization. Requires students to think about their blocking: their chosen movements on stage, the gestures they use to communicate their stories, and the business they must create to keep their stories believable and clear. (SC)

Newborn Dried Blood Spot Polymerase Chain Reaction to Identify Infants with Congenital Cytomegalovirus-Associated Sensorineural Hearing Loss.

Science.gov (United States)

Ross, Shannon A; Ahmed, Amina; Palmer, April L; Michaels, Marian G; Sánchez, Pablo J; Stewart, Audra; Bernstein, David I; Feja, Kristina; Fowler, Karen B; Boppana, Suresh B

2017-05-01

To determine the utility of dried blood spot (DBS) polymerase chain reaction (PCR) in identifying infants with cytomegalovirus (CMV) infection-associated sensorineural hearing loss (SNHL). Newborns at 7 US hospitals between March 2007 and March 2012 were screened for CMV by saliva rapid culture and/or PCR. Infected infants were monitored for SNHL during the first 4 years of life to determine sensitivity, specificity, and positive and negative likelihood ratios of DBS PCR for identifying CMV-associated SNHL. DBS at birth was positive in 11 of 26 children (42%) with SNHL at age 4 years and in 72 of 270 children (27%) with normal hearing (P = .11). The sensitivity (42.3%; 95% CI, 23.4%-63.1%) and specificity (73.3%; 95% CI, 67.6%-78.5%) was low for DBS PCR in identifying children with SNHL at age 4 years. The positive and negative likelihood ratios of DBS PCR positivity to detect CMV-associated SNHL at age 4 years were 1.6 (95% CI, 0.97-2.6) and 0.8 (95% CI, 0.6-1.1), respectively. There was no difference in DBS viral loads between children with SNHL and those without SNHL. DBS PCR for CMV has low sensitivity and specificity for identifying infants with CMV-associated hearing loss. These findings, together with previous reports, demonstrate that DBS PCR does not identify either the majority of CMV-infected newborns or those with CMV-associated SNHL early in life. Copyright © 2017 Elsevier Inc. All rights reserved.

This Is My (Post) Truth, Tell Me Yours

Science.gov (United States)

Powell, Martin

2017-01-01

This is a commentary on the article ‘The rise of post-truth populism in pluralist liberal democracies: challenges for health policy.’ It critically examines two of its key concepts: populism and ‘post truth.’ This commentary argues that there are different types of populism, with unclear links to impacts, and that in some ways, ‘post-truth’ has resonances with arguments advanced in the period at the beginning of the British National Health Service (NHS). In short, ‘post-truth’ populism’ may be ‘déjà vu all over again,’ and there are multiple (post) truths: this is my (post) truth, tell me yours. PMID:29172380

Telling young children they have a reputation for being smart promotes cheating.

Science.gov (United States)

Zhao, Li; Heyman, Gail D; Chen, Lulu; Lee, Kang

2018-05-01

The present research examined the consequences of telling young children they have a reputation for being smart. Of interest was how this would affect their willingness to resist the temptation to cheat for personal gain as assessed by a temptation resistance task, in which children promised not to cheat in the game. Two studies with 3- and 5-year-old children (total N = 323) assessed this possibility. In Study 1, participants were assigned to one of three conditions: a smart reputation condition in which they were told they have a reputation for being smart, an irrelevant reputation control condition, or a no reputation control condition. Children in the smart reputation condition were significantly more likely to cheat than their counterparts in either control condition. Study 2 confirmed that reputational concerns are indeed a fundamental part of our smart reputation effect. These results suggest that children as young as 3 years of age are able to use reputational cues to guide their behavior, and that telling young children they have a positive reputation for being smart can have negative consequences. © 2017 John Wiley & Sons Ltd.

�Telling a past, dreaming a future� (Walter Brueggemann - Die essensie van die narratiewe pastoraat

Directory of Open Access Journals (Sweden)

J. C. M�ller

2000-09-01

Full Text Available �Telling a past, dreaming a future� - The essence of narrative pastoral counsellingThe article examines the possibilities of negotiating the double movement created by living towards the future and dreaming out of the future into the present. Story telling in the pastoral environment is suggested as a means of bringing together the past and the expected future. A circular approach to time can help immensely by bringing together past and future in a meaningful way. This becomes possible in the pastoral environment where there is real understanding between pastor and client through thorough communication and the reframing of the past. The importance of language in understanding and the transformative power of narrative are stressed, as well as Christian hope as the most fundamental way of finding meaning out of the future into the present.

Member State Event: Telling CERN's Story

CERN Multimedia

2004-01-01

As part of the events to mark the Laboratory's fiftieth anniversary, members of the CERN personnel are telling the story of CERN. Robert Cailliau (on the right of the photograph), co-inventor of the Web and currently responsible for CERN's external communications, and Chiara Mariotti (in the center), a physicist working at CMS, were invited to talk about the history of CERN and the Web at a conference in the 'Science Thursdays' series entitled 'From the Quark to the Web' in Turin on 26 February. This was not their first appearance before a non-specialist audience (almost 1000 people that day!) eager to find out what goes on in a unique research centre like CERN as talking about the Laboratory's activities and its history are part and parcel of their work for the Organization. Anniversary Events in the Member States: This 'Science Thursday' event devoted to CERN was one of Italy's contributions to CERN's fiftieth anniversary celebrations. Coming up soon in the Member States: Italy International Centre...

A Review and Critique of the Tell-Me-A-Story (TEMAS) Apperceptive Test.

Science.gov (United States)

Gesek, Glenn J.

The Tell-Me-A-Story Apperceptive Test (TEMAS) is an individual apperceptive test, similar to the Thematic Apperception Test (TAT) of personality assessment. The TEMAS is intended for use with children and adolescents ages 5-18 years old, and is marketed as a personality assessment tool for minority, primarily Hispanic and African-American, and…

Combined effects of resistance training and carbohydrate-restrictive or conventional diets on weight loss, blood variables and endothelium function

Directory of Open Access Journals (Sweden)

Claudia Mello MEIRELLES

Full Text Available ABSTRACT Objective: To compare the effects of either a carbohydrate-restrictive diets or a conventional hypoenergetic diet combined with resistance training. Methods: Twenty-one overweight and obese adults participated in an eight-week program consisting of progressive resistance training combined with carbohydrate-restrictive diets (initially set at <30 g carbohydrate; n=12 or conventional hypoenergetic diet (30% energetic restriction; carbohydrate/protein/lipid: 51/18/31% of total energy consumption; n=9. It was hypothesized that the carbohydrate-restrictive diets would induce greater weight loss but that both diets would elicit similar effects on selected health markers. Body mass, and body composition, blood variables and flow-mediated brachial artery dilation (flow-mediated brachial artery dilation; by ultrasound were used to assess changes due to the interventions. Results: Significant within-group reductions in body mass (-5.4±3.5%; p=0.001 versus -3.7±3.0%; p=0.015 and body fat (body fat; -10.2±7.0%; p=0.005 versus -9.6±8.8%; p=0.017 were identified for carbohydrate-restrictive diets and conventional hypoenergetic diet, respectively, but there were no significant differences between groups as the result of the interventions. Fat free mass, blood variables and flow-mediated brachial artery dilation did not significantly change, except for the total cholesterol/high-density lipoprotein ratio, which was reduced 10.4±16.9% in carbohydrate-restrictive diets (p=0.037 and 0.5±11.3% in conventional hypoenergetic diet (p=0.398. Conclusion: Carbohydrate-restrictive diets associated with resistance training was as effective as conventional hypoenergetic diet in decreasing body mass and body fat, as well as maintaining fat free mass, blood variables and flow-mediated brachial artery dilation, however it was more effective at lowering the total cholesterol/low density lipoprotein ratio.

Mutation of p107 exacerbates the consequences of Rb loss in embryonic tissues and causes cardiac and blood vessel defects.

Science.gov (United States)

Berman, Seth D; West, Julie C; Danielian, Paul S; Caron, Alicia M; Stone, James R; Lees, Jacqueline A

2009-09-01

The retinoblastoma tumor-suppressor protein, pRb, is a member of the pocket protein family that includes p107 and p130. These proteins have well-defined roles in regulating entry into and exit from the cell cycle and also have cell cycle-independent roles in facilitating differentiation. Here we investigate the overlap between pocket protein's function during embryonic development by using conditional mutant alleles to generate Rb;p107 double-mutant embryos (DKOs) that develop in the absence of placental defects. These DKOs die between e13.5 and e14.5, much earlier than either the conditional Rb or the germline p107 single mutants, which survive to birth or are largely viable, respectively. Analyses of the e13.5 DKOs shows that p107 mutation exacerbates the phenotypes resulting from pRb loss in the central nervous system and lens, but not in the peripheral nervous system. In addition, these embryos exhibit novel phenotypes, including increased proliferation of blood vessel endothelial cells, and heart defects, including double-outlet right ventricle (DORV). The DORV is caused, at least in part, by a defect in blood vessel endothelial cells and/or heart mesenchymal cells. These findings demonstrate novel, overlapping functions for pRb and p107 in numerous murine tissues.

Strategies to reduce blood product utilization in obstetric practice.

Science.gov (United States)

Neb, Holger; Zacharowski, Kai; Meybohm, Patrick

2017-06-01

Patient blood management (PBM) aims to improve patient outcome and safety by reducing the number of unnecessary RBC transfusions and vitalizing patient-specific anemia reserves. Although PBM is increasingly recognized as best clinical practice in elective surgery, implementation of PBM is restrained in the setting of obstetrics. This review summarizes recent findings to reduce blood product utilization in obstetric practice. PBM-related evidence-based benefits should be urgently adopted in the field of obstetric medicine. Intravenous iron can be considered a safe, effective strategy to replenish iron stores and to correct both pregnancy-related and hemorrhage-related iron deficiency anemia. In addition to surgical techniques and the use of uterotonics, recent findings support early administration of tranexamic acid, fibrinogen and a coagulation factor concentrate-based, viscoelastically guided practice in case of peripartum hemorrhage to manage coagulopathy. In patients with cesarean section, autologous red cell blood salvage may reduce blood product utilization, although its use in this setting is controversial. Implementation of PBM in obstetric practice offers large potential to reduce blood loss and transfusion requirements of allogeneic blood products, even though large clinical trials are lacking in this specific field. Intravenous iron supplementation may be suggested to increase peripartum hemoglobin levels. Additionally, tranexamic acid and point-of-care-guided supplementation of coagulation factors are potent methods to reduce unnecessary blood loss and blood transfusions in obstetrics.

Blood flow dynamic improvement with aneurysm repair detected by a patient-specific model of multiple aortic aneurysms.

Science.gov (United States)

Sughimoto, Koichi; Takahara, Yoshiharu; Mogi, Kenji; Yamazaki, Kenji; Tsubota, Ken'ichi; Liang, Fuyou; Liu, Hao

2014-05-01

Aortic aneurysms may cause the turbulence of blood flow and result in the energy loss of the blood flow, while grafting of the dilated aorta may ameliorate these hemodynamic disturbances, contributing to the alleviation of the energy efficiency of blood flow delivery. However, evaluating of the energy efficiency of blood flow in an aortic aneurysm has been technically difficult to estimate and not comprehensively understood yet. We devised a multiscale computational biomechanical model, introducing novel flow indices, to investigate a single male patient with multiple aortic aneurysms. Preoperative levels of wall shear stress and oscillatory shear index (OSI) were elevated but declined after staged grafting procedures: OSI decreased from 0.280 to 0.257 (first operation) and 0.221 (second operation). Graftings may strategically counter the loss of efficient blood delivery to improve hemodynamics of the aorta. The energy efficiency of blood flow also improved postoperatively. Novel indices of pulsatile pressure index (PPI) and pulsatile energy loss index (PELI) were evaluated to characterize and quantify energy loss of pulsatile blood flow. Mean PPI decreased from 0.445 to 0.423 (first operation) and 0.359 (second operation), respectively; while the preoperative PELI of 0.986 dropped to 0.820 and 0.831. Graftings contributed not only to ameliorate wall shear stress or oscillatory shear index but also to improve efficient blood flow. This patient-specific modeling will help in analyzing the mechanism of aortic aneurysm formation and may play an important role in quantifying the energy efficiency or loss in blood delivery.

16 CFR 460.16 - What new home sellers must tell new home buyers.

Science.gov (United States)

2010-01-01

... LABELING AND ADVERTISING OF HOME INSULATION § 460.16 What new home sellers must tell new home buyers. If you are a new home seller, you must put the following information in every sales contract: The type... exception to this rule. If the buyer signs a sales contract before you know what type of insulation will be...

Every picture tells a story. Communicatie door gebruik van innovatieve datavisualisatie : Aanvraag RAAK-MKB

NARCIS (Netherlands)

Dr. Piet Bakker

2011-01-01

Het doel van het project Every Picture Tells a Story is om samen met het werkveld methoden, technieken en kennis te ontwikkelen voor het produceren van effectieve infographics. Dit is nodig omdat de vraag naar infographics in de markt snel toeneemt. Bedrijfsleven en overheden kiezen er steeds vaker

A paródia da autobiografia em Lygia Fagundes Telles = A parody of autobiographies in Lygia Fagundes Telles

Directory of Open Access Journals (Sweden)

Carlos Magno Santos Gomes

2008-01-01

Full Text Available Este artigo defende a hipótese de que o romance As horas nuas (1989, de Lygia Fagundes Telles, apresenta um sofisticado jogo auto-referencial da obra dentro da obra. As cenas em que Rosa, a protagonista, tenta escrever suas memórias, mas é consumida peloalcoolismo, fortalecem as idéias de paródia e de descentramento estético, presentes nesse romance. Rosa narra e comenta a superficialidade de suas memórias até abandonar seu projeto de escrita, que pode ser lido como uma paródia das autobiografias. Essa hipótese será sustentada metodologicamente pelos conceitos pós-estruturalistas propostos por Jacques Derrida, que defende a escrita como jogo, remédio, veneno ou teatro, entre outrosconceitos. A partir dos suplementos estéticos da encenação de Rosa, o leitor, preocupado com o “como” a obra foi construída, descobre novos roteiros desse romance que se autoquestiona no próprio desenrolar da narrativa. Ao final, interpreta-se o silêncio de Rosa como uma crítica à superficialidade e ao narcisismo do gênero autobiográfico.This study defends the idea that the novel As horas nuas (1989, by Lygia Fagundes Telles, presents a sophisticated auto-referential game concerning the artistic production in itself. The scenes in which Rosa, the main character, tries to write her memories, but is absorbed by alcoholism, strengths the idea of parody and esthetic disorder in this novel. Rosa narrates and comments the superficiality of her memories until the moment that she abandons herwriting project, which can be read as a parody of autobiographies. This hypothesis is supported methodologically by the post-structuralism concepts proposed by Jacques Derrida, which defends the writing as a game, medicine, poison or theater, beyond other concepts. Using the esthetic supplements of Rosa’s staging, which narrates her memories to a recorder, the reader concerned about “how” the novel was built discovers new scripts of the novel that provokes

Peripheral blood film review. The demise of the eyecount leukocyte differential.

Science.gov (United States)

Pierre, Robert V

2002-03-01

initiate blood film review based on findings of the CBC and automated differential is a more sensitive and accurate method of detecting patients with blood film abnormalities than routine blood film review of all specimens by technologists. Clinicians need to recognize that daily differential results or differentials at intervals of less than a week are not medically necessary in most patients. The laboratory, however, must provide opportunities for the clinician to request differentials at any time for specific medical reasons. The laboratory must establish the validity of screening criteria for detection of distribution and morphologic abnormalities of leukocytes by clinical correlation studies or adopt criteria established by laboratories with the same instrumentation and which have conducted clinical evaluations. A final observation on the eyecount differential is that it was the only way to identify cell types and their relative proportion for nearly 100 years. Cells were identified by their shape, intracellular structures, and staining characteristics. Many studies were able eventually to correlate some aspect of each cell type's function with their morphologic appearance. It has also been learned that the bone marrow is the source of production of most circulating cells and a great deal of the controls of cell production and release into the peripheral blood have been learned. But leukocytes have many functions, almost none of which are performed in the peripheral blood. The peripheral blood is mainly a conduit from the bone marrow to the tissues where the leukocytes perform their function in the case of the neutrophils and monocytes. It is mainly a recirculation and redistribution system for lymphocytes that usually receive their instructions from antigen processing cells in the tissues and allow these modified cells to home to sites where their functions occur. Cellular morphology and staining characteristics tell little about the maturation stage and functional

Non-blood medical care in gynecologic oncology: a review and update of blood conservation management schemes.

Science.gov (United States)

Simou, Maria; Thomakos, Nikolaos; Zagouri, Flora; Vlysmas, Antonios; Akrivos, Nikolaos; Zacharakis, Dimitrios; Papadimitriou, Christos A; Dimopoulos, Meletios-Athanassios; Rodolakis, Alexandros; Antsaklis, Aris

2011-11-03

This review attempts to outline the alternative measures and interventions used in bloodless surgery in the field of gynecologic oncology and demonstrate their effectiveness. Nowadays, as increasingly more patients are expressing their fears concerning the potential risks accompanying allogenic transfusion of blood products, putting the theory of bloodless surgery into practice seems to gaining greater acceptance. An increasing number of institutions appear to be successfully adopting approaches that minimize blood usage for all patients treated for gynecologic malignancies. Preoperative, intraoperative and postoperative measures are required, such as optimization of red blood cell mass, adequate preoperative plan and invasive hemostatic procedures, assisting anesthetic techniques, individualization of anemia tolerance, autologous blood donation, normovolemic hemodilution, intraoperative cell salvage and pharmacologic agents for controlling blood loss. An individualised management plan of experienced personnel adopting a multidisciplinary team approach should be available to establish non-blood management strategies, and not only on demand of the patient, in the field of gynecologic oncology with the use of drugs, devices and surgical-medical techniques.

Truth Telling in the Setting of Cultural Differences and Incurable Pediatric Illness: A Review.

Science.gov (United States)

Rosenberg, Abby R; Starks, Helene; Unguru, Yoram; Feudtner, Chris; Diekema, Douglas

2017-11-01

Navigating requests from parents or family caregivers not to disclose poor prognosis to seriously ill children can be challenging, especially when the requests seem culturally mediated. Pediatric clinicians must balance obligations to respect individual patient autonomy, professional truth telling, and tolerance of multicultural values. To provide suggestions for respectful and ethically appropriate responses to nondisclosure requests, we used a hypothetical case example of a Middle Eastern adolescent patient with incurable cancer and conducted an ethical analysis incorporating (1) evidence from both Western and Middle Eastern medical literature and (2) theories of cultural relativism and justice. While Western medical literature tends to prioritize patient autonomy and corresponding truth telling, the weight of evidence from the Middle East suggests high variability between and within individual countries, patient-physician relationships, and families regarding truth-telling practices and preferences. A common reason for nondisclosure in both populations is protecting the child from distressing information. Cultural relativism fosters tolerance of diverse beliefs and behaviors by forbidding judgment on foreign societal codes of conduct. It does not justify assumptions that all individuals within a single culture share the same values, nor does it demand that clinicians sacrifice their own codes of conduct out of cultural respect. We suggest some phrases that may help clinicians explore motivations behind nondisclosure requests and gently confront conflict in order to serve the patient's best interest. It is sometimes ethically permissible to defer to family values regarding nondisclosure, but such deferral is not unique to cultural differences. Early setting of expectations and boundaries, as well as ongoing exploration of family and health care professional concerns, may mitigate conflict.

Acute visual loss and intraretinal hemorrhages associated to energy drink consumption.

Science.gov (United States)

Pagano, Christina W; Wu, Max; Wu, Lihteh

2017-12-01

To report the association of acute visual loss secondary to intraretinal hemorrhages and energy drink consumption. Case report and literature review. A 48-year-old hypertensive man developed an elevation in systemic blood pressure, tachycardia, and acute visual loss secondary to intraretinal hemorrhages shortly after drinking several cans of energy drinks. High consumption of energy drinks may lead to intraretinal hemorrhages and acute visual loss.

Tell it like it is

International Nuclear Information System (INIS)

Sandman, P.M.

2006-01-01

This article is about lessons to be learned from communication problems after Three Mile Island (TMI) accident. Frightened people pick up more on negative information than on positive information; Vincent Covello, Director of the Center for Risk Communication in New York, argues that in a crisis it takes three pieces of good news to balance one piece of bad news. The information that something previously assumed to be safe may or may not be hazardous naturally strikes people as alarming, almost regardless of the amount of attention paid to the two sides. (Imagine reading this evening that scientists disagree over whether your favourite food is carcinogenic.) Thus, sociologist Allan Mazur has found that public fearfulness about risky new technologies is proportional to the amount of coverage, not to its character. TMI was a big, big story; even if the content was reassuring, the amount of content was itself alarming. Most importantly, over-reassuring content is alarming. The public, especially the local public, could tell that the authorities were deeply worried and thoroughly bewildered; in that context, seeing them on TV insisting that the plant was cooling according to design and everything was under control had to make things worse

Why tell children: A synthesis of the global literature on reasons for disclosing or not disclosing an HIV diagnosis to children 12 and under

Directory of Open Access Journals (Sweden)

Beatrice J. Krauss

2016-09-01

Full Text Available While the psychological and health benefits of knowing one’s HIV diagnosis have been documented for adults and adolescents, practice is still in development for younger children. Moderating conditions for whether or not to tell a child he/she has HIV vary by region and local context. They include accessibility of treatment, consideration of HIV as a stigmatizing condition, prevalence of HIV and an accompanying presumption that any illness is HIV-related, parent or caregiver concerns about child reactions, child’s worsening health, assumptions about childhood and child readiness to know a diagnosis, and lack of policies such as those that would prevent bullying of affected children in schools. In this systematic review of the global literature, we summarize the reasons caregivers give for telling or not telling children 12 and under their HIV diagnosis. We also include articles in which children reflect on their desires for being told. While a broad number of reasons are given for telling a child—e.g., to aid in prevention, adaptation to illness (e.g., primarily to promote treatment adherence, understanding social reactions, and maintaining the child-adult relationship—a narrower range of reasons, often related to immediate child or caregiver well-being or discomfort, are given for not telling. Recommendations are made to improve the context for disclosure by providing supports before, during and after disclosure and to advance the research agenda by broadening samples and refining approaches.

Blood conservation in cardiac surgery.

Science.gov (United States)

Blaudszun, G; Butchart, A; Klein, A A

2017-09-21

This article aims at reviewing the currently available evidence about blood conservation strategies in cardiac surgery. Pre-operative anaemia and perioperative allogeneic blood transfusions are associated with worse outcomes after surgery. In addition, transfusions are a scarce and costly resource. As cardiac surgery accounts for a significant proportion of all blood products transfused, efforts should be made to decrease the risk of perioperative transfusion. Pre-operative strategies focus on the detection and treatment of anaemia. The management of haematological abnormalities, most frequently functional iron deficiency, is a matter for debate. However, iron supplementation therapy is increasingly commonly administered. Intra-operatively, antifibrinolytics should be routinely used, whereas the cardiopulmonary bypass strategy should be adapted to minimise haemodilution secondary to circuit priming. There is less evidence to recommend minimally invasive surgery. Cell salvage and point-of-care tests should also be a part of the routine care. Post-operatively, any unnecessary iatrogenic blood loss should be avoided. © 2017 British Blood Transfusion Society.

Acute Blood Loss During Burn and Soft Tissue Excisions: An Observational Study of Blood Product Resuscitation Practices and Focused Review

Science.gov (United States)

2015-06-24

prospective observational study. Number, component type , volume, and age of the blood products transfused were recorded during burn excision/grafting or soft...tissue debridement . Component bags (packed red blood cells, fresh frozen plasma, platelets, and cryoprecipitate) were collected, and the remaining...collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE 24 JUN 2015 2. REPORT TYPE N/A 3. DATES

Impedance spectroscopy of PZT ceramics--measuring diffusion coefficients, mixed conduction, and Pb loss.

Science.gov (United States)

Donnelly, Niall J; Randall, Clive A

2012-09-01

Sintering of lead zirconate titanate (PZT) at high temperatures results in loss of Pb unless an ambient Pb activity is maintained. The tell-tale sign of Pb loss is an increased conductivity, usually manifested in unacceptably high values of tanδ. The conductivity is caused by oxygen vacancies and/or electron holes which are a byproduct of Pb evaporation. In the first part of this paper, it is shown how impedance spectroscopy can be used to separate ionic and electronic conductivity in a properly designed sample by selection of appropriate boundary conditions. Subsequently, impedance is used to probe defect concentrations in PZT during prolonged annealing at 700°C. It is found that oxygen vacancies are generated during annealing in air but the rate of generation actually decreases upon lowering the ambient pO(2). These results are explained by a model of Pb evaporation which, in this case, leads predominantly to oxygen vacancy generation. In principle, this effect could be used to generate a specific vacancy concentration in similar Pb-based oxides.

Transfer of liraglutide from blood to cerebrospinal fluid is minimal in patients with type 2 diabetes

DEFF Research Database (Denmark)

Christensen, M; Sparre-Ulrich, A H; Hartmann, B

2015-01-01

Treatment with liraglutide leads to weight loss. We investigated whether blood-to-cerebrospinal fluid (CSF) transfer of liraglutide occurs, and if so, whether it associates with clinical weight loss following liraglutide treatment in humans. We performed lumbar puncture and blood sampling in eight...

Transfusion of blood and blood component therapy for postpartum haemorrhage at a tertiary referral center

International Nuclear Information System (INIS)

Hussain, N.; Shah, T.; Shah, N.; Khan, N.H.

2011-01-01

Objective: To determine the practice of transfusion of blood and blood products in cases of postpartum haemorrhage, at a tertiary referral center. Methods: A retrospective study was conducted where medical records were reviewed for women, who either delivered or were admitted in labour suite with diagnosis of postpartum haemorrhage. The study period extended from Jan 2008 to Oct 2009. During a period of 22 months, records were reviewed for transfusion of blood and blood products in above group of women. Data were analyzed for descriptive statistics. Results: During the study period, a total of 4744 patients were admitted in the labour suite. A total of 113 (2.36%) women were diagnosed with Post partum haemorrhage. Uterine atony was the commonest cause of PPH, followed by genital tract trauma. A total of 81(71%) women received transfusion of blood and blood components (1.6%). The mean blood loss was 1088 ml (+- 584ml). Transfusion of blood and blood component therapy was significantly more in women who underwent caesarean section, compared to those women who delivered vaginally. There was one case of acute tubular necrosis due to PPH, and seven maternal deaths. The mean hospital stay was of +- 3 days. Conclusion: In this hospital based study, the prevalence of PPH was 2.36 +- %, and the rate of transfusion of blood and blood products was 1.6%.

Stories and story telling in first-levellanguage learning: a re-evaluation

Directory of Open Access Journals (Sweden)

Robert W. Blair

2013-02-01

Full Text Available This paper proposes that in the midst of all our theories on language teaching and language learning, we might have overlooked an age-old tool that has always been at the disposal of mankind; the telling of stories. Attention is drawn to how some have found in stories and story telling a driving force of natural language acquisition, a key that can unlock the intuitive faculties ofthe mind. A case is being made out for the re-instalment of stories and associated activities as a means of real, heart-felt functional communication in a foreign language, rather than through a direct assault on the structure of the language itself. Met hierdie artikel word daar voorgestel dat daar opnuut gekyk moet word na 'n hulpmiddel wat so oud is as die mensheid self en wat nog altyd tot ons beskikking was, naamlik stories en die vertel daarvan. Die aandag word daarop gevestig dat daar persone is wat in stories en die verbale oordrag daarvan 'n stukrag ontdek het tot natuurlike taalvaardigheid, 'n sleutel tot die intultiewe breinfunksies. Daar word 'n saak uitgemaak vir die terugkeer na stories en gepaardgaande aktiwiteite as middel tot 'n egte, diep deurleefde en funksionele wyse van kommunikasie in 'n vreemde taal, eerder as 'n direkte aanslag op die taalstruktuur self.

Temporary Intraoperative Porto-Caval Shunts in Piggy-Back Liver Transplantation Reduce Intraoperative Blood Loss and Improve Postoperative Transaminases and Renal Function: A Meta-Analysis.

Science.gov (United States)

Pratschke, Sebastian; Rauch, Alexandra; Albertsmeier, Markus; Rentsch, Markus; Kirschneck, Michaela; Andrassy, Joachim; Thomas, Michael; Hartwig, Werner; Figueras, Joan; Del Rio Martin, Juan; De Ruvo, Nicola; Werner, Jens; Guba, Markus; Weniger, Maximilian; Angele, Martin K

2016-12-01

The value of temporary intraoperative porto-caval shunts (TPCS) in cava-sparing liver transplantation is discussed controversially. Aim of this meta-analysis was to analyze the impact of temporary intraoperative porto-caval shunts on liver injury, primary non-function, time of surgery, transfusion of blood products and length of hospital stay in cava-sparing liver transplantation. A systematic search of MEDLINE/PubMed, EMBASE and PsycINFO retrieved a total of 909 articles, of which six articles were included. The combined effect size and 95 % confidence interval were calculated for each outcome by applying the inverse variance weighting method. Tests for heterogeneity (I 2 ) were also utilized. Usage of a TPCS was associated with significantly decreased AST values, significantly fewer transfusions of packed red blood cells and improved postoperative renal function. There were no statistically significant differences in primary graft non-function, length of hospital stay or duration of surgery. This meta-analysis found that temporary intraoperative porto-caval shunts in cava-sparing liver transplantation reduce blood loss as well as hepatic injury and enhance postoperative renal function without prolonging operative time. Randomized controlled trials investigating the use of temporary intraoperative porto-caval shunts are needed to confirm these findings.

Perioperative blood saving measures in total hip and knee arthroplasty

NARCIS (Netherlands)

Horstmann, W.G.

2011-01-01

This dissertation explores and discusses different aspects of blood loss and blood-saving measures in total hip and knee arthroplasty. Background: Worldwide, approximately 1 million total hip and 1 million total knee prostheses are implanted each year. Total hip arthroplasty and total

THE TROLL book 3: The man with a tale to tell

OpenAIRE

Monaghan, Nicola

2015-01-01

The third novella in THE TROLL series, thrillers set in real life and online. Three friends. A dark secret from their past. An internet troll threatening to tell the world. The terrifying climax of THE TROLL; a creepy, page turning psychological thriller from the prize winning author of The Killing Jar. Perfect for fans of Gone Girl and The Girl on the Train Radio presenter Kelly is beyond worried when her friend Louisa, a university lecturer, goes missing. She’s convinced her fr...

Lie-Telling Behavior in Children with Autism and Its Relation to False-Belief Understanding

Science.gov (United States)

Talwar, Victoria; Zwaigenbaum, Lonnie; Goulden, Keith J.; Manji, Shazeen; Loomes, Carly; Rasmussen, Carmen

2012-01-01

Children's lie-telling behavior and its relation to false-belief understanding was examined in children with autism spectrum disorders (ASD; n = 26) and a comparison group of typically developing children (n = 27). Participants were assessed using a temptation resistance paradigm, in which children were told not to peek at a forbidden toy while…

Telling stories and adding scores: Measuring resilience in young children affected by maternal HIV and AIDS.

Science.gov (United States)

Ebersöhn, Liesel; Eloff, Irma; Finestone, Michelle; Grobler, Adri; Moen, Melanie

2015-01-01

"Telling stories and adding scores: Measuring resilience in young children affected by maternal HIV and AIDS", demonstrates how a concurrent mixed method design assisted cross-cultural comparison and ecological descriptions of resilience in young South African children, as well as validated alternative ways to measure resilience in young children. In a longitudinal randomised control trial, which investigated psychological resilience in mothers and children affected by HIV/AIDS, we combined a qualitative projective story-telling technique (Düss Fable) with quantitative data (Child Behaviour Checklist). The children mostly displayed adaptive resilience-related behaviours, although maladaptive behaviours were present. Participating children use internal (resolve/agency, positive future expectations, emotional intelligence) and external protective resources (material resources, positive institutions) to mediate adaptation. Children's maladaptive behaviours were exacerbated by internal (limited problem-solving skills, negative emotions) and external risk factors (chronic and cumulative adversity).

Business continuity in blood services: two case studies from events with potentially catastrophic effect on the national provision of blood components.

Science.gov (United States)

Morgan, S J; Rackham, R A; Penny, S; Lawson, J R; Walsh, R J; Ismay, S L

2015-02-01

NHS Blood and Transplant (NHSBT) and the Australian Red Cross Blood Service (ARCBS) are national blood establishments providing blood components to England and North Wales, and Australia, respectively. In 2012, both services experienced potentially catastrophic challenges to key assets. NHSBT suffered a flood that closed the largest blood-manufacturing centre in Europe, whilst ARCBS experienced the failure of a data centre network switch that rendered the national blood management system inaccessible for 42 h. This paper describes both crisis events, including the immediate actions, recovery procedures and lessons learned. Both incidents triggered emergency response plans. These included hospital reprovisioning and recovery from the incident. Once normal services had been restored, both events were subjected to root cause analysis (RCA) and production of 'lessons learned' reports. In both scenarios, the key enablers of rapid recovery were established emergency plans, clear leadership and the support of a flexible workforce. Product issues to hospitals were unaffected, and there were no abnormal trends in hospital complaints. RCA identified the importance of risk mitigations that require co-operation with external organizations. Reviews of both events identified opportunities to enhance business resilience through prior identification of external risks and improvements to contingency plans, for example by implementing mass messaging to staff and other stakeholders. Blood establishment emergency plans tend to focus on responding to mass casualty events. However, consolidation of manufacturing to fewer sites combined with a reliance on national IT systems increases the impact of loss of function. Blood services should develop business continuity plans which include prevention of such losses, and the maintenance of services and disaster recovery. © 2014 International Society of Blood Transfusion.

Work loss associated with increased menstrual loss in the United States.

Science.gov (United States)

Côté, Isabelle; Jacobs, Philip; Cumming, David

2002-10-01

To estimate the effect of increased menstrual flow on the loss of work. Heavy or otherwise abnormal menstrual bleeding is a common problem among women in the reproductive age range. Until now, there has been no evidence of its effect on absences from work. We used data from the National Health Interview Survey 1999, a personal interview household survey using a nationwide representative sample of the civilian noninstitutionalized population of the United States. Participants were 3133 women aged between 18 and 64 years who reported having a natural menstrual period in the last 12 months and in the last 3 months, never having taken medication containing estrogen (except past use of oral contraceptives), and never having been told that they had reproductive cancer. Analysis was performed using data from 2805 women, 373 having self-described heavy flow and 2432 having normal flow. The main outcome measure was work loss associated with the degree of menstrual flow. Using binary logistic regression, age, marital status, education, family size, perception of health, and flow of menstrual periods are associated with work losses (P women who have a heavier flow are 72% as likely to be working as are women who have a lighter or normal flow. Menstrual bleeding has significant economic implications for women in the workplace: work loss from increased blood flow is estimated to be $1692 annually per woman.

Telling Ghost Stories with the Voice of an Ogre: Deleuze, Identity, and Disruptive Pedagogies

Science.gov (United States)

Beighton, Christian

2017-01-01

French philosopher Gilles Deleuze (1925-95) was something of a cult figure among his university students in the 1970s and 1980s, "telling ghost stories with the voice of an ogre" (Jaeglé, 2005:10). More recently, academic interest in the educational possibilities of his work has grown considerably in Anglophone countries. Perhaps texts…

The role of executive functions and theory of mind in children's prosocial lie-telling.

Science.gov (United States)

Williams, Shanna; Moore, Kelsey; Crossman, Angela M; Talwar, Victoria

2016-01-01

Children's prosocial lying was examined in relation to executive functioning skills and theory of mind development. Prosocial lying was observed using a disappointing gift paradigm. Of the 79 children (ages 6-12 years) who completed the disappointing gift paradigm, 47 (59.5%) told a prosocial lie to a research assistant about liking their prize. In addition, of those children who told prosocial lies, 25 (53.2%) maintained semantic leakage control during follow-up questioning, thereby demonstrating advanced lie-telling skills. When executive functioning was examined, children who told prosocial lies were found to have significantly higher performance on measures of working memory and inhibitory control. In addition, children who lied and maintained semantic leakage control also displayed more advanced theory of mind understanding. Although children's age was not a predictor of lie-telling behavior (i.e., truthful vs. lie-teller), age was a significant predictor of semantic leakage control, with older children being more likely to maintain their lies during follow-up questioning. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinical and experimental studies on the sensorineural hearing loss caused by irradiation

Energy Technology Data Exchange (ETDEWEB)

Yamamoto, M [Kobe Univ. (Japan). School of Medicine

1979-08-01

In our study, 43 patients whose ears were presumably irradiated, were examined periodically before and after the irradiation; 10 were found to be affected by the sensorineural hearing loss, and these 10 were classified into two types. Type I; Patients of this group had a hearing impairment during or soon after irradiation and usually revealed marked deterioration of bone conduction in high frequencies accompanied by worsening of air conduction in low frequencies. The impaired hearing of this group soon recovered to the pre-treatment level. Type II; Patients of this group developed a slow progressive sensorineural hearing loss. They noticed the deafness with tinnitus several months after irradiation. To clarify the mechanism of the sensorineural hearing loss, histopathological investigations were done using nembutal anesthetized guinea pigs which were irradiated in the confined ear region unilaterally. We also examined histopathologically one human temporal bone belonging to a patient who had been irradiated for middle ear carcinoma. The histopathology of the guinea pigs and human case revealed the following conclusions: Type I hearing loss may be caused by toxic labyrinthitis secondary to the radiation otitis media or by the aseptic labyrinthitis as the result of hyperemia and increased permeability of the irradiated blood vessels in the cochlea. Type II hearing loss may be caused by the late rediation response of the cochleal blood vessels i.e. by the vasculitis which gives rise to obliteration of the vascular lumen and affects the blood supply of the hair cells.

Clinical and experimental studies on the sensorineural hearing loss caused by irradiation

International Nuclear Information System (INIS)

Yamamoto, Matsunori

1979-01-01

In our study, 43 patients whose ears were presumably irradiated, were examined periodically before and after the irradiation; 10 were found to be affected by the sensorineural hearing loss, and these 10 were classified into two types. Type I; Patients of this group had a hearing impairment during or soon after irradiation and usually revealed marked deterioration of bone conduction in high frequencies accompanied by worsening of air conduction in low frequencies. The impaired hearing of this group soon recovered to the pre-treatment level. Type II; Patients of this group developed a slow progressive sensorineural hearing loss. They noticed the deafness with tinnitus several months after irradiation. To clarify the mechanism of the sensorineural hearing loss, histopathological investigations were done using nembutal anesthetized guinea pigs which were irradiated in the confined ear region unilaterally. We also examined histopathologically one human temporal bone belonging to a patient who had been irradiated for middle ear carcinoma. The histopathology of the guinea pigs and human case revealed the following conclusions: Type I hearing loss may be caused by toxic labyrinthitis secondary to the radiation otitis media or by the aseptic labyrinthitis as the result of hyperemia and increased permeability of the irradiated blood vessels in the cochlea. Type II hearing loss may be caused by the late rediation response of the cochleal blood vessels i.e. by the vasculitis which gives rise to obliteration of the vascular lumen and affects the blood supply of the hair cells. (author)

Ambulatory blood pressure and urinary albumin excretion in clinically healthy subjects

DEFF Research Database (Denmark)

Clausen, Peter Vilhelm; Jensen, J S; Borch-Johnsen, K

1998-01-01

UAER. Because 24-hour ambulatory blood pressure is a superior predictor of hypertensive target organ involvement, we aimed to investigate blood pressure profile in clinically healthy subjects with elevated UAER. Ambulatory blood pressure monitoring was performed with a portable recorder in 27 subjects...... loss of albumin could not be solely related to the higher blood pressure. In conclusion, apparently healthy subjects with elevated UAER had slightly but significantly higher 24-hour systolic and diastolic blood pressure levels in addition to increased blood pressure loads but normal circadian variation...

Pressure passive cerebral blood flow and breakdown of the blood-brain barrier in experimental fetal asphyxia

DEFF Research Database (Denmark)

Lou, H C; Lassen, N A; Tweed, W A

1979-01-01

reaching CBF values up to 6 times normal at normal MABP of about 60 to 70 mmHg, and severe ischemia reaching CBF values close to zero in large cortical areas at MABP of 30 mmHg. CVP remained essentially unchanged at 10--15 mmHg. The severe and prolonged asphyxia rendered the blood-brain barrier leaky......Cerebral blood flow (CBF) was studied in non-exteriorized near-term sheep fetuses using the radioactive microsphere technique. By partially occluding the umbilical vessels for a period of 1--1 1/2 hours a progressive and severe asphyxia with a final arterial pH of 6.90 was achieved. Varying...... the mean arterial blood pressure in the fetuses by blood withdrawal or infusion in this state, CBF was measured at different perfusion pressures (mean arterial blood pressure (MABP) minus central venous pressure (CVP)). A passive flow/pressure relationship--loss of autoregulation--was found, with hyperemia...

What mirror self-recognition can tell us about aspects of self

DEFF Research Database (Denmark)

Schilhab, Theresa

2007-01-01

great apes and the rest of the animal kingdom. However, methodological and theoretical inconsistencies regarding the empirical approach prevail. For instance, the observation of self-directed behaviour might not be as straightforward as it seems. In addition, the interpretation of mirror self......Biology and Philosophy Vol. 19(no.1):111-126. 2004 Short description: What does the capacity to recognize self by mirrors tell about self-consciousness? Abstract: Research on mirror self-recognition where animals are observed for mirror-guided self-directed behaviour has predominated the empirical...

Blood lead levels and bone turnover with weight reduction in women

OpenAIRE

RIEDT, CLAUDIA S.; BUCKLEY, BRIAN T.; BROLIN, ROBERT E.; AMBIA-SOBHAN, HASINA; RHOADS, GEORGE G.; SHAPSES, SUE A.

2008-01-01

High bone turnover states are known to raise blood lead levels (BPb). Caloric restriction will increase bone turnover, yet it remains unknown if weight reduction increases BPb due to mobilization of skeletal stores. We measured whole blood Pb levels (206Pb) by inductively coupled plasma mass spectrometry in 73 women (age 24–75 years; BMI 23– 61 kg/m2) before and after 6 months of severe weight loss (S-WL), moderate weight loss (M-WL), or weight maintenance (WM). Baseline BPb levels were relat...

Non-blood medical care in gynecologic oncology: a review and update of blood conservation management schemes

Directory of Open Access Journals (Sweden)

Simou Maria

2011-11-01

Full Text Available Abstract This review attempts to outline the alternative measures and interventions used in bloodless surgery in the field of gynecologic oncology and demonstrate their effectiveness. Nowadays, as increasingly more patients are expressing their fears concerning the potential risks accompanying allogenic transfusion of blood products, putting the theory of bloodless surgery into practice seems to gaining greater acceptance. An increasing number of institutions appear to be successfully adopting approaches that minimize blood usage for all patients treated for gynecologic malignancies. Preoperative, intraoperative and postoperative measures are required, such as optimization of red blood cell mass, adequate preoperative plan and invasive hemostatic procedures, assisting anesthetic techniques, individualization of anemia tolerance, autologous blood donation, normovolemic hemodilution, intraoperative cell salvage and pharmacologic agents for controlling blood loss. An individualised management plan of experienced personnel adopting a multidisciplinary team approach should be available to establish non-blood management strategies, and not only on demand of the patient, in the field of gynecologic oncology with the use of drugs, devices and surgical-medical techniques.

Splitting blood and blood product packaging reduces donor exposure for patients undergoing cardiopulmonary bypass.

Science.gov (United States)

Nuszkowski, M M; Jonas, R A; Zurakowski, D; Deutsch, N

2015-11-01

Cardiopulmonary bypass for congenital heart surgery requires packed red cells (PRBC) and fresh frozen plasma (FFP) to be available, both for priming of the circuit as well as to replace blood loss. This study examines the hypothesis that splitting one unit of packed red blood cells and one unit of fresh frozen plasma into two half units reduces blood product exposure and wastage in the Operating Room. Beginning August 2013, the blood bank at Children's National Medical Center began splitting one unit of packed red blood cells (PRBC) and one unit of fresh frozen plasma (FFP) for patients undergoing cardiopulmonary bypass (CPB). The 283 patients who utilized CPB during calendar year 2013 were divided into 2 study groups: before the split and after the split. The principal endpoints were blood product usage and donor exposure intra-operatively and within 72 hours post-operatively. There was a significant decrease in median total donor exposures for FFP and cryoprecipitate from 5 to 4 per case (p = 0.007, Mann-Whitney U-test). However, there was no difference in the volume of blood and blood products used; in fact, there was a significant increase in the amount of FFP that was wasted with the switch to splitting the unit of FFP. We found that modification of blood product packaging can decrease donor exposure. Future investigation is needed as to how to modify packaging to minimize wastage. © The Author(s) 2015.

[Empirical study on non-point sources pollution based on landscape pattern & ecological processes theory: a case of soil water loss on the Loess Plateau in China].

Science.gov (United States)

Suo, An-ning; Wang, Tian-ming; Wang, Hui; Yu, Bo; Ge, Jian-ping

2006-12-01

Non-point sources pollution is one of main pollution modes which pollutes the earth surface environment. Aimed at soil water loss (a typical non-point sources pollution problem) on the Losses Plateau in China, the paper applied a landscape patternevaluation method to twelve watersheds of Jinghe River Basin on the Loess Plateau by means of location-weighted landscape contrast index(LCI) and landscape slope index(LSI). The result showed that LSI of farm land, low density grass land, forest land and LCI responded significantly to soil erosion modulus and responded to depth of runoff, while the relationship between these landscape index and runoff variation index and erosion variation index were not statistically significant. This tell us LSI and LWLCI are good indicators of soil water loss and thus have big potential in non-point source pollution risk evaluation.

Plateletpheresis before redo CABG diminishes excessive blood transfusion.

Science.gov (United States)

Christenson, J T; Reuse, J; Badel, P; Simonet, F; Schmuziger, M

1996-11-01

Blood conservation remains an important element for patients undergoing cardiac operations with cardiopulmonary bypass. Preoperative platelet-rich plasma (PRP) harvest is an autologous blood conservation method. The efficacy of preoperative PRP harvest and post-cardiopulmonary bypass reinfusion on postoperative bleeding and need for postoperative blood transfusion was evaluated in patients undergoing redo coronary artery bypass grafting in a prospective, randomized manner. All adult patients admitted for redo coronary artery bypass grafting entered into the study. The PRP harvest aim was 20% or more of the total estimated circulating platelets. Immediately preoperatively three sequestration cycles were performed. The PRP was reinfused after weaning from cardiopulmonary bypass. One hundred seven parameters/patient were recorded. There were 20 patients in the RPR group and 20 controls (without PRP harvest). Patient characteristics, operative data, and preoperative hematologic parameters did not differ between the groups. In the PRP group, the mean platelet count in the PRP was 864 +/- 139 x 10(3)/microL, and the platelet yield was 27% +/- 5% (range, 20% to 37%). The average total chest tube blood loss was 423 mL (PRP) compared with 1,462 mL (controls; p platelets and reinfusion of the PRP after cardiopulmonary bypass resulted in significantly less postoperative blood loss and decreased fluid and blood transfusion requirements compared with controls. Postextubation gas exchange, ventilation time, and time required in the intensive care unit were also better, and the method was found cost-effective.

Blood-conservation techniques for coronary-artery bypass surgery at a private hospital.

Science.gov (United States)

Davies, M J; Picken, J; Buxton, B F; Fuller, J A

1988-11-21

The utilization of homologous blood and blood products was recorded in 100 consecutive patients who underwent primary coronary-artery bypass surgery. Nine patients underwent saphenous-vein grafts only, 55 patients underwent a single internal-mammary-artery graft that was supplemented by vein grafts and 36 patients underwent bilateral internal-mammary-artery grafts and vein grafts. All patients underwent normovolaemic haemodilution, and autologous blood was collected before bypass surgery. Residual blood was collected from the cardiopulmonary bypass machine and was washed and concentrated in a cell processor, and blood also was scavenged postoperatively from the mediastinal drainage tubes as methods to conserve blood. The mean (+/- SD) utilization of homologous blood was 1.3 +/- 1.5 units with 0.2 +/- 0.7 units of fresh-frozen plasma being used, and 0.8 +/- 2.1 units of platelets being used. The utilization of homologous blood was not different among the three different methods of coronary-artery bypass surgery, but patients who underwent bilateral internal-mammary-artery grafts suffered a greater postoperative loss of blood than did those patients who underwent saphenous-vein grafts or single internal-mammary-artery grafts. A comparison of patients who were taking aspirin or a non-steroidal anti-inflammatory drug preoperatively with those patients who were not showed no difference in the utilization of homologous blood but a statistically-significant difference was found in the loss of blood postoperatively.

Costume Cinema and Materiality Telling the Story of Marie Antoinette through Dress

OpenAIRE

Therése Andersson

2011-01-01

In ‘Costume Cinema and Materiality: Telling the Story of Marie Antoinette through Dress’ a materiality-based approach for analysing film narratives through costumes is examined. Sofia Coppola’s film Marie Antoinette (2006) serves as the empirical starting point and the theme of dressing and redressing is pursued throughout the film, crystallizing costume as a significant feature for reading the movie. The article argues that costumes, on a symbolic level, work as agents. It thus focuses on th...

Research results: preserving newborn blood samples.

Science.gov (United States)

Lewis, Michelle Huckaby; Scheurer, Michael E; Green, Robert C; McGuire, Amy L

2012-11-07

Retention and use, without explicit parental permission, of residual dried blood samples from newborn screening has generated public controversy over concerns about violations of family privacy rights and loss of parental autonomy. The public debate about this issue has included little discussion about the destruction of a potentially valuable public resource that can be used for research that may yield improvements in public health. The research community must advocate for policies and infrastructure that promote retention of residual dried blood samples and their use in biomedical research.

The Narrative Aspect of Scenario Building -How Story Telling may give people a memory of the future

DEFF Research Database (Denmark)

Rasmussen, Lauge Baungaard

2005-01-01

The quality of scenarios depends on relevant assumptions and authentic scenario stories. The article explore how the narrative approach may enrich the scenario . in addition, criteria are suggested for evaluation of the qualioty of scenario story telling...

Tell el Yahudiyeh Ware: a re-evaluation

International Nuclear Information System (INIS)

Kaplan, M.F.; Harbottle, G.; Sayre, E.V.

1980-01-01

The TY (Tell el Yahudiyeh ware) project has implications for understanding the cultural interactions. The Second Intermediate Period (1750-1550 B.C.), one during which centraized government in Egypt collapses and, it is generally assumed, so does her trade network. Foreigners - the Hyksos - are able to enter the country and rule at least part of it. Results of this study (which includes activation analysis), however, indicate the TY is primarily an Egyptian pottery which appeared before the Hyksos entered and may have continued in use after they left. It cannot, therefore, be tightly associated with the Hyksos nor can it be used to judge the extent of their influence. Its wide distribution shows that Egypt continued to trade goods outside her boundaries throughout this period. Finally, not only goods travelled between what were generally considered to have been hostile neighbors, but the trade appears to have included ideas and technology as well

What Gay-Lussac didn't tell us

Science.gov (United States)

Holbrow, C. H.; Amato, J. C.

2011-01-01

Gay-Lussac's 1801 experiments establishing the law of volumes for gases are brilliantly simple, and he described them with a level of detail that was new to physics writing. But he did not present his actual measurements or tell us how he analyzed them to conclude that between 0 to 100 °C, a volume of any gas will expand by about 37.5%. We review his experiments and conclude that he measured initial and final volumes at slightly different pressures. By using the gas laws and his apparatus diagrams, we corrected his data so that they correspond to constant pressure. His corrected results give ΔV/V=36.6%, the currently accepted value for nearly ideal gases. Aside from their intrinsic interest, our analyses can provide students intriguing applications of the gas laws and Pascal's law and motivate them to consider Pascal's paradox. We also note the influence of ballooning and of the French Revolution on Gay-Lussac.

Desmopressin use for minimising perioperative blood transfusion

Science.gov (United States)

Desborough, Michael J; Oakland, Kathryn; Brierley, Charlotte; Bennett, Sean; Doree, Carolyn; Trivella, Marialena; Hopewell, Sally; Stanworth, Simon J; Estcourt, Lise J

2017-01-01

Background Blood transfusion is administered during many types of surgery, but its efficacy and safety are increasingly questioned. Evaluation of the efficacy of agents, such as desmopressin (DDAVP; 1-deamino-8-D-arginine-vasopressin), that may reduce perioperative blood loss is needed. Objectives To examine the evidence for the efficacy of DDAVP in reducing perioperative blood loss and the need for red cell transfusion in people who do not have inherited bleeding disorders. Search methods We searched for randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (2017, issue 3) in the Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (from 1937), the Transfusion Evidence Library (from 1980), and ongoing trial databases (all searches to 3 April 2017). Selection criteria We included randomised controlled trials comparing DDAVP to placebo or an active comparator (e.g. tranexamic acid, aprotinin) before, during, or immediately after surgery or after invasive procedures in adults or children. Data collection and analysis We used the standard methodological procedures expected by Cochrane. Main results We identified 65 completed trials (3874 participants) and four ongoing trials. Of the 65 completed trials, 39 focused on adult cardiac surgery, three on paediatric cardiac surgery, 12 on orthopaedic surgery, two on plastic surgery, and two on vascular surgery; seven studies were conducted in surgery for other conditions. These trials were conducted between 1986 and 2016, and 11 were funded by pharmaceutical companies or by a party with a commercial interest in the outcome of the trial. The GRADE quality of evidence was very low to moderate across all outcomes. No trial reported quality of life. DDAVP versus placebo or no treatment Trial results showed considerable heterogeneity between surgical settings for total volume of red cells transfused (low

Rumours about blood and reimbursements in a microbicide gel trial.

Science.gov (United States)

Stadler, Jonathan; Saethre, Eirik

2010-12-01

A rumour that emerged during a microbicide gel trial tells the tale of clinic staff purchasing trial participants' blood. This paper documents the rumour and explores its divergent interpretations and meanings in relation to the context of the trial and the social and economic setting at two of the trial sites (Soweto and Orange Farm) in South Africa. The article is based on qualitative research conducted during the Microbicides Development Programme (MDP) 301 trial to evaluate a microbicide vaginal gel for HIV prevention in women. The research incorporated in-depth interviews with female trial participants and their male partners, focus group discussions with male and female community members, and participant observation in the trial clinic and community setting at the two sites. The article analyses the different perspectives among the clinic staff, community and trial participants in terms of which the rumour about the exchange of blood for cash is seen as: 1) the result of ignorance of the clinical trial procedures; 2) the exploitation of poor and vulnerable women; 3) an example of young women's desire for material gain; and 4) a reciprocal exchange of 'clean blood' for cash between women trial participants and the health services. We suggest that the rumours about selling blood verbalise notions of gender and morality while also providing an appraisal of the behaviour of young women and a critique of social relationships between foreign researchers and local participants. Through stories about the clinical trial procedures and its potential reimbursements, the participants were creating and reconfiguring social relationships. Ultimately, rumours are one way in which foreign enterprises such as a clinical trial are rendered local.

Efficacy of tranexamic acid in reducing allogeneic blood products in adolescent idiopathic scoliosis surgery.

Science.gov (United States)

Sui, Wen-yuan; Ye, Fang; Yang, Jun-lin

2016-04-27

Adolescent idiopathic scoliosis (AIS) surgery usually require prolonged operative times with extensive soft tissue dissection and significant perioperative blood loss, and allogeneic blood products are frequently needed. Methods to reduce the requirement for transfusion would have a beneficial effect on these patients. Although many previous studies have revealed the efficacy of tranexamic acid (TXA) in spinal surgery, there is still a lack of agreement concerning the reduction of both blood loss and transfusion requirements of large dose tranexamic acid (TXA) in surgery for adolescent idiopathic scoliosis (AIS). The objective of this study was to elevate the efficacy and safety of a large dose tranexamic acid (TXA) in reducing transfusion requirements of allogeneic blood products in adolescent idiopathic scoliosis (AIS) surgery using a retrospective study designed with historical control group. One hundred thirty seven consecutive AIS patients who underwent surgery treatment with posterior spinal pedicle systems from August 2011 to March 2015 in our scoliosis center were retrospectively reviewed. Patients were divided into two groups, the TXA group and the historical recruited no TXA group (NTXA). Preoperative demographics, radiographic parameters, operative parameters, estimated blood loss (EBL), total irrigation fluid, number of patients requiring blood transfusion, mean drop of Hb (Pre-op Hb-Post-op Hb), haematocrit pre and post-surgery, mean volume of blood transfusion, hospitalization time, and adverse effect were recorded and compared. All the patients were successfully treated with satisfied clinical and radiographic outcomes. There were 71 patients in the TXA group and 66 patients in the NTXA group. The preoperative demographics were homogeneity between two groups (P > 0.05). There were no significant difference in average operative time between two groups (209 min vs 215 min, p >0.05). Number of patients in the TXA group showed a significant decrease in

Automatic detection of blood vessels in retinal images for diabetic retinopathy diagnosis.

Science.gov (United States)

Raja, D Siva Sundhara; Vasuki, S

2015-01-01

Diabetic retinopathy (DR) is a leading cause of vision loss in diabetic patients. DR is mainly caused due to the damage of retinal blood vessels in the diabetic patients. It is essential to detect and segment the retinal blood vessels for DR detection and diagnosis, which prevents earlier vision loss in diabetic patients. The computer aided automatic detection and segmentation of blood vessels through the elimination of optic disc (OD) region in retina are proposed in this paper. The OD region is segmented using anisotropic diffusion filter and subsequentially the retinal blood vessels are detected using mathematical binary morphological operations. The proposed methodology is tested on two different publicly available datasets and achieved 93.99% sensitivity, 98.37% specificity, 98.08% accuracy in DRIVE dataset and 93.6% sensitivity, 98.96% specificity, and 95.94% accuracy in STARE dataset, respectively.

Virtual Reality as a Story Telling Platform for Geoscience Communication

Science.gov (United States)

Lazar, K.; Moysey, S. M.

2017-12-01

Capturing the attention of students and the public is a critical step for increasing societal interest and literacy in earth science issues. Virtual reality (VR) provides a means for geoscience engagement that is well suited to place-based learning through exciting and immersive experiences. One approach is to create fully-immersive virtual gaming environments where players interact with physical objects, such as rock samples and outcrops, to pursue geoscience learning goals. Developing an experience like this, however, can require substantial programming expertise and resources. At the other end of the development spectrum, it is possible for anyone to create immersive virtual experiences with 360-degree imagery, which can be made interactive using easy to use VR editing software to embed videos, audio, images, and other content within the 360-degree image. Accessible editing tools like these make the creation of VR experiences something that anyone can tackle. Using the VR editor ThingLink and imagery from Google Maps, for example, we were able to create an interactive tour of the Grand Canyon, complete with embedded assessments, in a matter of hours. The true power of such platforms, however, comes from the potential to engage students as content authors to create and share stories of place that explore geoscience issues from their personal perspective. For example, we have used combinations of 360-degree images with interactive mapping and web platforms to enable students with no programming experience to create complex web apps as highly engaging story telling platforms. We highlight here examples of how we have implemented such story telling approaches with students to assess learning in courses, to share geoscience research outcomes, and to communicate issues of societal importance.

Intracorneal blood removal six weeks after canaloplasty

Directory of Open Access Journals (Sweden)

Alberto Rossetti

2013-01-01

Full Text Available In a 71-year-old patient with bilateral open-angle glaucoma, intracorneal blood was found after a canaloplasty procedure in the right eye. Six weeks after surgery on ultrasound biomicroscopy examination, liquified blood and blood clots could be observed nasally in the deep corneal stroma close to the Descemet′s membrane. The intracorneal blood was washed out with balanced saline solution following deep corneal incision and lamellar dissection. Descemet′s membrane was reattached with air injection into the anterior chamber. Two months later, visual acuity improved to 20/50, intraocular pressure was 16 mm Hg without medication and confocal microscopy showed deep stromal folds and limited endothelial cell loss. Viscoelastic entering the cornea at Schwalbe′s line and reflux of blood from the collector channels to Schlemm′s canal can account for corneal hematoma. Even six weeks after canaloplasty, successful blood removal could be fulfilled without rupturing the Descemet′s membrane.

Loss of Brain Aerobic Glycolysis in Normal Human Aging.

Science.gov (United States)

Goyal, Manu S; Vlassenko, Andrei G; Blazey, Tyler M; Su, Yi; Couture, Lars E; Durbin, Tony J; Bateman, Randall J; Benzinger, Tammie L-S; Morris, John C; Raichle, Marcus E

2017-08-01

The normal aging human brain experiences global decreases in metabolism, but whether this affects the topography of brain metabolism is unknown. Here we describe PET-based measurements of brain glucose uptake, oxygen utilization, and blood flow in cognitively normal adults from 20 to 82 years of age. Age-related decreases in brain glucose uptake exceed that of oxygen use, resulting in loss of brain aerobic glycolysis (AG). Whereas the topographies of total brain glucose uptake, oxygen utilization, and blood flow remain largely stable with age, brain AG topography changes significantly. Brain regions with high AG in young adults show the greatest change, as do regions with prolonged developmental transcriptional features (i.e., neoteny). The normal aging human brain thus undergoes characteristic metabolic changes, largely driven by global loss and topographic changes in brain AG. Copyright © 2017 Elsevier Inc. All rights reserved.

Detection of gastrointestinal blood loss with 99mTc-labeled, heat-treated red blood cells

International Nuclear Information System (INIS)

Som, P.; Oster, Z.H.; Atkins, H.L.; Goldman, A.G.; Sacker, D.F.; Harold, W.H.; Fairchild, R.G.; Richards, P.; Brill, A.B.

1981-01-01

Studies in dogs showed that heat-treated 99mTc-labeled red blood cells (HT/RBC) afford a highly sensitive means of detecting gastrointetinal bleeding as low as 0.12 ml/min., which could not be seen with unheated 99mTc-RBC, 99mTc-sulfur colloid, or 99mTc-DTPA. In addition, as the right upper quadrant and epigastrium remained free of activity, only one fifth to one tenth of the dose of 99mTc was needed. The safety of HT/RBC in humans has been documented, and the experiments in dogs suggest that it may have advantages over other agents in detecting gastrointestinal bleeding

FORTUNE TELLINGS THAT RELATED FRUITS / MEYVELERIN DILINDEN FAL VE ISARETLER

Directory of Open Access Journals (Sweden)

Dr. Saadettin EĞRİ

2008-10-01

Full Text Available This study discusses the meanings attributed tovarious fruit in the fortune telling book Hursidname.Hursidname is located in the Library of Manuscripts andAncient Printed Books in Bursa and it’s characteristicsare interesting. It was written in the 18th century bySıdki and it is the only copy. In this book there are 36fruit and plant names. Every fruit’s loacations in the textwere given and all the fruit’s means were defined.Generally in this book there are some expectations andinformations about health, richness, chair, journey,sadness, beauty, pain, life, commerce, friends andenemies. There are good predictions for each person whomake a wish .

Tracks FAQs: How Can I Tell If Asthma Hospitalization Rates In My Area Are Changing Over Time?

Centers for Disease Control (CDC) Podcasts

In this podcast, CDC Tracking experts discuss asthma hospitalization rates and how you can tell if they've changed in your area over time. Do you have a question for our Tracking experts? Please e-mail questions to trackingsupport@cdc.gov.

Process Improvement Project Using Tranexamic Acid Is Cost-Effective in Reducing Blood Loss and Transfusions After Total Hip and Total Knee Arthroplasty.

Science.gov (United States)

Demos, Harry A; Lin, Zilan X; Barfield, William R; Wilson, Sylvia H; Robertson, Dawn C; Pellegrini, Vincent D

2017-08-01

Tranexamic acid (TXA) has been associated with decreased blood loss and transfusion after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of this study was to examine both transfusion utilization and the economic impact of a Process Improvement Project implementing TXA for THA and TKA. After standardization of TXA administration in THA and TKA patients, retrospective data were compared from 12 consecutive months before (group A, n = 336 procedures) and after (group B, n = 436 procedures) project initiation. TXA administration increased with project implementation (group A = 3.57%, group B = 86.01%) and was associated with reductions in perioperative hemoglobin decrement (20.2%), patients transfused (45%), and number of units transfused per patient (61.9%). Cost savings were notable per patient ($128) and annually program wide ($55,884) with the primary THA subgroup contributing the most to the savings. No increase in adverse effects was observed. Standardized administration of TXA is an effective and economically favorable blood-reduction strategy for patients undergoing elective THA or TKA. Although reduction in transfusions with TXA may be greater after TKA, the economic and clinical impact of transfusion reduction is more substantial in THA patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Schooling and Globalization: What Do We Tell Our Kids & Clients? What Are We Being Told?

Science.gov (United States)

Grant, Carl A.; Grant, Alicia

2007-01-01

With the effects of globalization everywhere, what should we say to our children and grandchildren about globalization and education? What are the print media--the books and magazines--telling us about globalization and education? This article examines what a person may take from the print media to talk with their children about effects of…

All The Work Of Artisans : Reconstructing society at Tell Deir ‘All? through the study of ceramic traditions: Studies of Late Bronze Age Faience vessels and Iron IIc-III ceramics from Tell Deir ‘All?, Jordan

NARCIS (Netherlands)

Groot, N.C.F.

2011-01-01

For already 50 years the site of Tell Deir ‘All? in the Eastern Central Jordan Valley has been the focus of Dutch research. Despite the amount of research many aspects of the regional cultures in which the inhabitants of the subsequent occupational phases of this site were incorporated, remain

[Patient blood management].

Science.gov (United States)

Folléa, G

2016-11-01

In a context of regular review of transfusion practice, the aim of this review is to present an update of the scientific basis of the so-called "patient blood management" (PBM), the state of its development in Europe, and possible ways to progress its development further in France. Analysis and synthesis of the data from scientific literature on the scientific basis of PBM (methods, indications, efficacy, risks, efficiency). PBM appears as an evidence-based, patient centred, multidisciplinary approach, aiming to optimise the care of patients who might need transfusion and, consequently, the use of blood products. PBM is based on three pillars: optimise the patient's own blood supplies, minimise blood loss, optimise patient's tolerance of anaemia. Available scientific evidence can be considered as sufficient to consider PBM guidelines and practices as an indispensable complement to the transfusion medicine guidelines and practices. Several countries have launched PBM programmes (alternatives to allogeneic transfusion and optimisation of the use of blood components). Although current French national transfusion guidelines contain some PBM measures, PBM programmes should be further developed in France, primarily for medical reasons. Possible ways, using the existing basis having proved to be effective, are proposed to further develop PBM in France, as a complement to transfusion medicine, with the participation of involved stakeholders, including experts from relevant medical specialties, both at local and national levels. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Analysis of blood transfusion predictors in patients undergoing elective oesophagectomy for cancer

Directory of Open Access Journals (Sweden)

Welch Neil T

2008-01-01

Full Text Available Abstract Background Oesophagectomy for cancers is a major operation with significant blood loss and usage. Concerns exist about the side effects of blood transfusion, cost and availability of donated blood. We are not aware of any previous study that has evaluated predictive factors for perioperative blood transfusion in patients undergoing elective oesophagectomy for cancer. This study aimed to audit the pattern of blood crossmatch and to evaluate factors predictive of transfusion requirements in oesophagectomy patients. Methods Data was collected from the database of all patients who underwent oesophagectomy for cancer over a 2-year period. Clinico-pathological data collected included patients demographics, clinical factors, tumour histopathological data, preoperative and discharge haemoglobin levels, total blood loss, number of units of blood crossmatched pre-, intra- and postoperatively, number of blood units transfused, crossmatched units reused for another patient and number of blood units wasted. Clinico-pathological variables were evaluated and logistic regression analysis was performed to determine which factors were predictive of blood transfusion. Results A total of 145 patients with a male to female ratio of 2.5:1 and median age of 68 (40–85 years were audited. The mean preoperative haemoglobin (Hb was 13.0 g/dl. 37% of males (Hb 70 years, Hb level Conclusion The cohort of patients audited was over-crossmatched. The identified independent predictors of blood transfusion should be considered in preoperative blood ordering for oesophagectomy patients. This study has directly led to a reduction in the maximum surgical blood-ordering schedule for oesophagectomy to 2 units and a reaudit is underway.

Kynurenine 3-monooxygenase inhibition in blood ameliorates neurodegeneration

Science.gov (United States)

Zwilling, Daniel; Huang, Shao-Yi; Sathyasaikumar, Korrapati V.; Notarangelo, Francesca M.; Guidetti, Paolo; Wu, Hui-Qiu; Lee, Jason; Truong, Jennifer; Andrews-Zwilling, Yaisa; Hsieh, Eric W.; Louie, Jamie Y.; Wu, Tiffany; Scearce-Levie, Kimberly; Patrick, Christina; Adame, Anthony; Giorgini, Flaviano; Moussaoui, Saliha; Laue, Grit; Rassoulpour, Arash; Flik, Gunnar; Huang, Yadong; Muchowski, Joseph M.; Masliah, Eliezer; Schwarcz, Robert; Muchowski, Paul J.

2011-01-01

SUMMARY Metabolites in the kynurenine pathway of tryptophan degradation are thought to play an important role in neurodegenerative disorders such as Alzheimer’s disease and Huntington’s disease. Metabolites that cause glutamate receptor-mediated excitotoxicity and free radical formation are elevated in the blood and vulnerable brain regions in these diseases, while levels of the neuroprotective metabolite kynurenic acid are often decreased. Here we describe the synthesis and characterization of JM6, a novel small-molecule pro-drug inhibitor of kynurenine 3-monooxygenase (KMO). JM6 raises kynurenic acid and reduces extracellular glutamate in the brain after chronic oral administration by inhibiting KMO in blood. In a transgenic mouse model of Alzheimer’s disease, JM6 prevented spatial memory deficits, anxiety-related behavior, and synaptic loss. JM6 also extended life span, prevented synaptic loss, and decreased microglial activation in a mouse model of Huntington’s disease. These findings support a critical link between blood cells and neurodegeneration that is mediated by KMO and the kynurenine pathway. PMID:21640374

Relationship Between Changes in Fat and Lean Depots Following Weight Loss and Changes in Cardiovascular Disease Risk Markers.

Science.gov (United States)

Clifton, Peter M

2018-04-04

Gluteofemoral fat mass has been associated with improved cardiovascular disease risk factors. It is not clear if loss of this protective fat during weight loss partially negates the effect of loss of visceral fat. The aim of this study was to examine regional fat loss in a large weight-loss cohort from one center and to determine if fat loss in the leg and total lean tissue loss is harmful. We combined the data from 7 of our previously published 3-month weight-loss studies and examined the relationship between regional fat and lean tissue loss and changes in cardiovascular disease risk factors in 399 participants. At baseline, leg fat was positively associated with high-density lipoprotein cholesterol in women and inversely with fasting triglyceride level in both sexes. Abdominal lean tissue was also related to systolic blood pressure in men. Changes in regional fat and lean tissue were positively associated with changes in glucose, insulin, total cholesterol, triglycerides, low-density lipoprotein cholesterol and systolic and diastolic blood pressure ( r =0.11-0.22, P lean tissue dominating in multivariate regression. After adjustment for total weight or total fat change, these relationships disappeared except for a positive relationship between arm and lean leg mass loss and changes in triglycerides and systolic blood pressure. Loss of leg fat and leg lean tissue was directly associated with beneficial changes in cardiovascular disease risk markers. Loss of lean tissue may not have an adverse effect on cardiovascular disease risk, and measures to retain lean tissue during weight loss may not be necessary. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

An elapsed time-temperature monitor for blood storage.

Science.gov (United States)

Harris, G E; Cloud, S; Myhre, B A

1977-01-01

Blood should not be allowed to exceed 10 C while being stored or transported. However, one cannot test the internal temperature of a unit of blood without contaminating it. Most blood banks have established an arbitrary time limit beyond which a blood unit cannot be kept out of the refrigerator. This method is ineffective if blood is stored in a satellite refrigerator, since the blood may be moved in and out of the refrigerator and the blood bank personnel will be unaware of it. An elapsed time indicator is described which employs a small condenser (E-Cell-Plessey Electronics) charged with a known amount of electricity. If the device is removed from the refrigerator, it begins to discharge at a known rate. The amount of time subsequently can be determined by the loss of charge. The prototype of this instrument has been found to be quite accurate and small (2 inches X 2 inches X 1 inch). It would be rather inexpensive if made in considerable numbers.

Effect of bariatric surgery-induced weight loss on renal and systemic inflammation and blood pressure: a 12-month prospective study.

Science.gov (United States)

Fenske, Wiebke K; Dubb, Sukhpreet; Bueter, Marco; Seyfried, Florian; Patel, Karishma; Tam, Frederick W K; Frankel, Andrew H; le Roux, Carel W

2013-01-01

Bariatric surgery improves arterial hypertension and renal function; however, the underlying mechanisms and effect of different surgical procedures are unknown. In the present prospective study, we compared the 12-month follow-up results after Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, and laparoscopic sleeve gastrectomy on weight loss, hypertension, renal function, and inflammatory status. A total of 34 morbidly obese patients were investigated before, one and 12 months after Roux-en-Y gastric bypass (n = 10), laparoscopic adjustable gastric banding (n = 13), and laparoscopic sleeve gastrectomy (n = 11) for hypertension, kidney function, urinary and serum cytokine levels of macrophage migration inhibitory factor, monocyte chemotactic protein-1, and chemokine ligand-18. At 12 months after surgery, the patients in all 3 treatment arms showed a significant decrease in the mean body mass index, mean arterial pressure, and urinary and serum inflammatory markers (all P .8 mg/L) had a marked improvement in renal function 12 months after surgery (P < .05). Surgically induced weight loss is associated with a marked decrease in renal and systemic inflammation and arterial hypertension and improvement in renal function in patients with pre-existing renal impairment. These effects appear to be independent of surgical procedure. The improvement in renal inflammation could be 1 of the mechanisms contributing to the beneficial effects of bariatric surgery on arterial blood pressure, proteinuria, and renal function. Copyright © 2013 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

The stability of iso-α-acids and reduced iso-α-acids in stored blood specimens.

Science.gov (United States)

Rodda, Luke N; Gerostamoulos, Dimitri; Drummer, Olaf H

2014-06-01

The long-term stability of the iso-α-acids, and three structurally similar but chemically altered iso-α-acids (known as 'reduced iso-α-acids' and consisting of the rho-, tetrahydro- and hexahydro-iso-α-acid groups) were investigated in whole blood. Pools of blank blood spiked with the four beer-specific ingredient congener groups at two different concentration levels were stored at 20°C, 4°C and -20°C; and extracted in duplicate in weeks 1, 3, 5 and 8, using a previously published method. A loss of 15% of the initial concentration was considered to indicate possible instability and losses greater than 30% demonstrated significant losses. The individual analytes within the four iso-α-acid groups were also measured to determine which iso-α-acids were subject to greater degradation and were responsible for the overall group instability. All four iso-α-acid groups showed significant losses after 8 weeks of storage under room temperature conditions in particularly the natural iso-α-acid group where major losses were observed (96% and 85% losses for low and high concentrations, respectively). Some degradation in all iso-α-acid groups were seen at 4°C samples predominantly due to the 'n' analogs of the groups showing an increased instability in blood. The -20°C storage conditions resulted in minimal changes in concentrations of all analytes. Higher than frozen storage temperatures can result in substantial changes on the stability of the iso-α-acid type groups in blood. The aim of this study was to highlight the stabilities of the IAA analytes in order to assist in the interpretation of IAA in stored blood specimens. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

“Telling Feminist Stories” and the Reconstruction of the Recent Feminism

Directory of Open Access Journals (Sweden)

Liane Schneider

2009-01-01

Full Text Available This essay discusses the article “Telling Feminist Stories” published by Claire Hemmings in Feminist Theory, trying to verify the ways through which the construction/deconstruction of the story of recent feminist discussed by the author influences (or not the more frequent circulation of some texts considered fundamental for the structuring of feminist studies. We also discuss the way references influence the consolidation of specific theories, mainly those connected to the poststructuralist perspective. We discuss the main points defended by the author, exemplifying our agreement or disagreement through examples taken from the critic-literary sphere.

Selling or telling? A theory of ruin value

DEFF Research Database (Denmark)

Pihl, Ole Verner

2011-01-01

number of possible apocalyptic scenarios. But what do they tell us these visions of "the end of days" and hell, why are there always demons, flames and fire? Why are hell and heaven always in a different place on the other side, in the after life, is it rather the reverse, that hell is here...... on this planet? War and disasters have a deep impact and are major aesthetic objects of fascination. The Nazi death cult was carefully designed mass propaganda based on a fascinating, mass hysterical carnival of the dead. Architecture and design play an important yet unpleasant part in this.   This paper...... games, comics and films that unfold the aesthetics of the vision of the apocalypse, and the important question, is the message pacifistic or just blind speculation and fascination? Cases on: "Half life 2", "Barefoot Gen", "Akira", "Spawn", "Doom", and "Constantine". 4. Finally, this paper will look...