46 CFR 97.37-42 - Markings for lifesaving appliances, instructions to passengers, and stowage locations.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Markings for lifesaving appliances, instructions to..., Etc. § 97.37-42 Markings for lifesaving appliances, instructions to passengers, and stowage locations. Lifesaving appliances, instructions to passengers, and stowage locations must be marked in accordance with...

33 CFR 150.506 - When must the operator service inflatable lifesaving appliances and marine evacuation systems?

Science.gov (United States)

2010-07-01

... inflatable lifesaving appliances and marine evacuation systems? 150.506 Section 150.506 Navigation and...: OPERATIONS Emergency and Specialty Equipment Inflatable Lifesaving Appliances § 150.506 When must the operator service inflatable lifesaving appliances and marine evacuation systems? (a) The operator must...

Electron and positive ion emission accompanying fracture of Wint-o-Green Lifesavers and single-crystal sucrose

International Nuclear Information System (INIS)

Dickinson, J.T.; Brix, L.B.; Jensen, L.C.

1984-01-01

It is a well-known fact that, when Wint-o-Green Lifesavers (Lifesaver is a registered trademark of Lifesaver, Inc.) are broken in air, one observes intense triboluminescence. Measurements of the emission of electrons and positive ions from the fracture of these Lifesavers under vacuum, as well as from single-crystal sucrose are reported herein. The emission of photons and radio waves during fracture under vacuum is also presented for sucrose, indicating the occurrence of a gaseous discharge in the crack tip during crack growth. Comparisons of the various emission curves are presented and discussed in terms of stress-induced charge separation

29 CFR 1918.97 - First aid and lifesaving facilities. (See appendix V of this part).

Science.gov (United States)

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false First aid and lifesaving facilities. (See appendix V of... LONGSHORING General Working Conditions. § 1918.97 First aid and lifesaving facilities. (See appendix V of this... injury, regardless of severity, to the employer. (b) First aid. A first aid kit shall be available at or...

New Partnership Seeks to Increase Availability of Lifesaving Transplants | FNLCR

Science.gov (United States)

The Frederick National Laboratory for Cancer Research has entered into a new partnership with Fred Hutchinson Cancer Research Center that if successful, could improve current methods of donor selection and thereby make lifesaving transplant procedure

29 CFR 1917.26 - First aid and lifesaving facilities.

Science.gov (United States)

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false First aid and lifesaving facilities. 1917.26 Section 1917..., DEPARTMENT OF LABOR (CONTINUED) MARINE TERMINALS Marine Terminal Operations § 1917.26 First aid and..., to the employer. (b) A first aid kit shall be available at the terminal, and at least one person...

Can children aged 12 years or more refuse life-saving treatment ...

African Journals Online (AJOL)

The best interests of the child are paramount, and should the child unreasonably refuse to consent to life-saving treatment, the Minister of Social Development may give consent for such treatment in terms of the Children's Act. Otherwise, should a parent, guardian, caregiver or healthcare provider believe that such a refusal ...

Autonomy, religious values, and refusal of lifesaving medical treatment.

OpenAIRE

Wreen, M J

1991-01-01

The principal question of this paper is: Why are religious values special in refusal of lifesaving medical treatment? This question is approached through a critical examination of a common kind of refusal of treatment case, one involving a rational adult. The central value cited in defence of honouring such a patient's refusal is autonomy. Once autonomy is isolated from other justificatory factors, however, possible cases can be imagined which cast doubt on the great valuational weight assign...

46 CFR 109.301 - Operational readiness, maintenance, and inspection of lifesaving equipment.

Science.gov (United States)

2010-10-01

... and cleaning each fuel tank, and refilling it with fresh fuel. (2) Each davit, winch, fall and other...(e); (ii) Maintenance and repair instructions; (iii) A schedule of periodic maintenance; (iv) A... repair equipment. Spare parts and repair equipment must be provided for each lifesaving appliance and...

Willingness to pay per quality-adjusted life year for life-saving treatments in Thailand.

Science.gov (United States)

Nimdet, Khachapon; Ngorsuraches, Surachat

2015-10-05

To estimate the willingness to pay (WTP) per quality-adjusted life year (QALY) value for life-saving treatments and to determine factors affecting the WTP per QALY value. A cross-sectional survey with multistage sampling and face-to-face interviews. General population in the southern part of Thailand. A total of 600 individuals were included in the study. Only 554 (92.3%) responses were usable for data analyses. Participants were asked for the maximum amount of WTP value for life-saving treatments by an open-ended question. EQ-5D-3L and visual analogue scale (VAS) were used to estimate additional QALY. The amount of WTP values varied from 0 to 720,000 Baht/year (approximately 32 Baht=US$1). The averages of additional QALY obtained from VAS and EQ-5D-3L were only slightly different (0.872 and 0.853, respectively). The averages of WTP per QALY obtained from VAS and EQ-5D-3L were 244,720 and 243,120 Baht/QALY, respectively. As compared to male participants, female participants were more likely to pay less for an additional QALY (p=0.007). In addition, participants with higher household incomes tended to have higher WTP per QALY values (pper QALY value specifically for life-saving treatments, which would complement the current cost-effectiveness threshold used in Thailand and optimise patient access to innovative treatments or technologies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Imperfect repair and lifesaving in heterogeneous populations

Energy Technology Data Exchange (ETDEWEB)

Finkelstein, Maxim [Department of Mathematical Statistics, University of the Free State, PO Box 339, 9300 Bloemfontein (South Africa) and Max Planck Institute for Demographic Research, Rostock (Germany)]. E-mail: FinkelM.SCl@mail.uovs.ac.za

2007-12-15

In this theoretical paper we generalize the notion of minimal repair to the heterogeneous case, when the lifetime distribution function can be modeled by continuous or a discrete mixture of distributions. The statistical (black box) minimal repair and the minimal repair based on information just before the failure of an object are considered. The corresponding failure (intensity) rate processes are defined and analyzed. Demographic lifesaving model is also considered: each life is saved (cured) with some probability (or equivalently a proportion of individuals who would have died are now resuscitated and given another chance). Those who are saved experience the statistical minimal repair. Both of these models are based on the Poisson or non-homogeneous Poisson processes of underlying events, which allow for considering heterogeneity. We also consider the new model of imperfect repair in the homogeneous case and present generalizations to the heterogeneous setting.

The calculus lifesaver all the tools you need to excel at calculus

CERN Document Server

Banner, Adrian

2009-01-01

For many students, calculus can be the most mystifying and frustrating course they will ever take. The Calculus Lifesaver provides students with the essential tools they need not only to learn calculus, but to excel at it. All of the material in this user-friendly study guide has been proven to get results. The book arose from Adrian Banner's popular calculus review course at Princeton University, which he developed especially for students who are motivated to earn A's but get only average grades on exams. The complete course will be available for free on the Web in a series of

Exploring the Potential for Increased Production from the Wave Energy Converter Lifesaver by Reactive Control

Directory of Open Access Journals (Sweden)

Marta Molinas

2013-07-01

Full Text Available Fred Olsen is currently testing their latest wave energy converter (WEC, Lifesaver, outside of Falmouth Bay in England, preparing it for commercial operation at the Wavehub test site. Previous studies, mostly focusing on hydrodynamics and peak to average power reduction, have shown that this device has potential for increased power extraction using reactive control. This article extends those analyses, adding a detailed model of the all-electric power take-off (PTO system, consisting of a permanent magnet synchronous generator, inverter and DC-link. Time domain simulations are performed to evaluate the PTO capabilities of the modeled WEC. However, when tuned towards reactive control, the generator losses become large, giving a very low overall system efficiency. Optimal control with respect to electrical output power is found to occur with low added mass, and when compared to pure passive loading, a 1% increase in annual energy production is estimated. The main factor reducing the effect of reactive control is found to be the minimum load-force constraint of the device. These results suggest that the Lifesaver has limited potential for increased production by reactive control. This analysis is nevertheless valuable, as it demonstrates how a wave-to-wire model can be used for investigation of PTO potential, annual energy production estimations and evaluations of different control techniques for a given WEC device.

Averting the foul taste of pediatric medicines improves adherence and can be lifesaving ? Pheburane? (sodium phenylbutyrate)

OpenAIRE

Koren, Gideon; Rieder, Michael J; Amitai, Yona

2016-01-01

Background Children?s aversions to poor and mostly bitter tastes and their inability to swallow tablets and capsules are major challenges in pediatric medicine. Sodium phenylbutyrate (NaPB) is a lifesaving waste nitrogen, alternative to urea nitrogen, for individuals suffering from urea cycle disorders. A major issue in the use of NaPB is its highly foul taste, which often leads to children being unable to consume it, resulting in ineffective treatment, or alternatively, necessitating the app...

Basic-CPR and AIDS: are volunteer life-savers prepared for a storm?

Science.gov (United States)

Bierens, J J; Berden, H J

1996-10-01

Professional health care workers have access to guidelines, equipment and techniques to reduce the exposure to infectious material in case of resuscitation. The current official content of national courses for volunteer life-savers do not address this issue, as far as we know. Concern about the risks of infection due to resuscitation is increasing in this group. This article describes a rational approach of the problem, that includes data on the infection risk of basic-CPR, and an approach that accepts that the concern can not be controlled by objective data. In such an emotional approach, direct contact has to be minimised by using devices. Requirements for resuscitation devices with a barrier function are listed. Although both approaches will reduce the fear of infection, we advice a rational approach.

Law enforcement-applied tourniquets: a case series of life-saving interventions.

Science.gov (United States)

Callaway, David W; Robertson, Joshua; Sztajnkrycer, Matthew D

2015-01-01

Although the epidemiology of civilian trauma is distinct from that encountered in combat, in both settings, extremity hemorrhage remains a major preventable cause of potential mortality. The current paper describes the largest case series in the literature in which police officers arriving prior to emergency medical services applied commercially available field tourniquets to civilian victims of violent trauma. Although all 3 patients with vascular injury arrived at the receiving emergency department in extremis, they were successfully resuscitated and survived to discharge without major morbidity. While this outcome is likely multifactorial and highlights the exceptional care delivered by the modern trauma system, tourniquet application appears to have kept critically injured patients alive long enough to reach definitive trauma care. No patient had a tourniquet-related complication. This case series suggests that law enforcement officers can effectively identify indications for tourniquets and rapidly apply such life-saving interventions.

An Ethical Framework for Allocating Scarce Life-Saving Chemotherapy and Supportive Care Drugs for Childhood Cancer.

Science.gov (United States)

Unguru, Yoram; Fernandez, Conrad V; Bernhardt, Brooke; Berg, Stacey; Pyke-Grimm, Kim; Woodman, Catherine; Joffe, Steven

2016-06-01

Shortages of life-saving chemotherapy and supportive care agents for children with cancer are frequent. These shortages directly affect patients' lives, compromise both standard of care therapies and clinical research, and create substantial ethical challenges. Efforts to prevent drug shortages have yet to gain traction, and existing prioritization frameworks lack concrete guidance clinicians need when faced with difficult prioritization decisions among equally deserving children with cancer. The ethical framework proposed in this Commentary is based upon multidisciplinary expert opinion, further strengthened by an independent panel of peer consultants. The two-step allocation process includes strategies to mitigate existing shortages by minimizing waste and addresses actual prioritization across and within diseases according to a modified utilitarian model that maximizes total benefit while respecting limited constraints on differential treatment of individuals. The framework provides reasoning for explicit decision-making in the face of an actual drug shortage. Moreover, it minimizes bias that might occur when individual clinicians or institutions are forced to make bedside rationing and prioritization decisions and addresses the challenge that individual clinicians face when confronted with bedside decisions regarding allocation. Whenever possible, allocation decisions should be supported by evidence-based recommendations. "Curability," prognosis, and the incremental importance of a particular drug to a given patient's outcome are the critical factors to consider when deciding how to allocate scarce life-saving cancer drugs. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The Rhode Island Life Saving Score (RILSS)--a proposed life-saving definition for EMS and emergency medicine.

Science.gov (United States)

Williams, Kenneth A; Sullivan, Francis M

2013-12-03

Emergency Medical Services (EMS) and Emergency Medicine staff are often described as life-saving providers, but there is no generally accepted objective definition of a life saved by these providers. Therefore, a proposed definition is described. Development of this definition began with conceptual rules, followed by a survey of physician EMS medical directors, and then by the development of a tool to implement the definition, and measure its validity and reliability through a review of 100 critical care transport EMS patient charts.

Autonomy, religious values, and refusal of lifesaving medical treatment.

Science.gov (United States)

Wreen, M J

1991-09-01

The principal question of this paper is: Why are religious values special in refusal of lifesaving medical treatment? This question is approached through a critical examination of a common kind of refusal of treatment case, one involving a rational adult. The central value cited in defence of honouring such a patient's refusal is autonomy. Once autonomy is isolated from other justificatory factors, however, possible cases can be imagined which cast doubt on the great valuational weight assigned it by strong anti-paternalists. This weight is sufficient, in their estimation, to justify honouring the patient's refusal. There is thus a tension between the strong anti-paternalist's commitment to the sufficiency of autonomy and our intuitions respecting such cases. Attempts can be made to relieve this tension, such as arguing that patients aren't really rational in the circumstances envisaged, or that other values, such as privacy or bodily integrity, if added to autonomy, are sufficient to justify an anti-paternalistic stance. All such attempts fail, however. But what does not fail is the addition of religious freedom, freedom respecting a patient's religious beliefs and values. Why religious freedom reduces the tension is then explained, and the specialness of religious beliefs and values examined.

Averting the foul taste of pediatric medicines improves adherence and can be lifesaving – Pheburane® (sodium phenylbutyrate)

OpenAIRE

Koren G; Rieder MJ; Amitai Y

2016-01-01

Gideon Koren,1 Michael J Rieder,1 Yona Amitai2 1Department of Physiology and Pharmacology, The University of Western Ontario, London, ON, Canada; 2Bar-Ilan University, Ramat Gan, Israel Background: Children’s aversions to poor and mostly bitter tastes and their inability to swallow tablets and capsules are major challenges in pediatric medicine. Sodium phenylbutyrate (NaPB) is a lifesaving waste nitrogen, alternative to urea nitrogen, for individuals suffering from urea cycle disorder...

Snake Venom: From Deadly Toxins to Life-saving Therapeutics.

Science.gov (United States)

Waheed, Humera; Moin, Syed F; Choudhary, M I

2017-01-01

Snakes are fascinating creatures and have been residents of this planet well before ancient humans dwelled the earth. Venomous snakes have been a figure of fear, and cause notable mortality throughout the world. The venom constitutes families of proteins and peptides with various isoforms that make it a cocktail of diverse molecules. These biomolecules are responsible for the disturbance in fundamental physiological systems of the envenomed victim, leading to morbidity which can lead to death if left untreated. Researchers have turned these life-threatening toxins into life-saving therapeutics via technological advancements. Since the development of captopril, the first drug that was derived from bradykininpotentiating peptide of Bothrops jararaca, to the disintegrins that have potent activity against certain types of cancers, snake venom components have shown great potential for the development of lead compounds for new drugs. There is a continuous development of new drugs from snake venom for coagulopathy and hemostasis to anti-cancer agents. In this review, we have focused on different snake venom proteins / peptides derived drugs that are in clinical use or in developmental stages till to date. Also, some commonly used snake venom derived diagnostic tools along with the recent updates in this exciting field are discussed. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

The lifesaving potential of specialized on-scene medical support for urban tactical operations.

Science.gov (United States)

Metzger, Jeffery C; Eastman, Alexander L; Benitez, Fernando L; Pepe, Paul E

2009-01-01

Since the 1980s, the specialized field of tactical medicine has evolved with growing support from numerous law-enforcement and medical organizations. On-scene backup from tactical emergency medical support (TEMS) providers has not only permitted more immediate advanced medical aid to injured officers, victims, bystanders, and suspects, but also allows for rapid after-incident medical screening or minor treatments that can obviate an unnecessary transport to an emergency department. The purpose of this report is to document one very explicit benefit of TEMS deployment, namely, a situation in which a police officer's life was saved by the routine on-scene presence of specialized TEMS physicians. In this specific case, a police officer was shot in the anterior neck during a law-enforcement operation and became moribund with massive hemorrhage and compromised airway. Two TEMS physicians, who had been integrated into the tactical law-enforcement team, were on scene, controlled the hemorrhage, and provided a surgical airway. By the time of arrival at the hospital, the patient had begun purposeful movements and, within 12 hours, was alert and oriented. Considering the rapid decline in the patient's condition, it was later deemed by quality assurance reviewers that the on-scene presence of these TEMS providers was lifesaving.

[FORCE-FEEDING OR LIFE-SAVING? - DEALING WITH HUNGER STRIKES IN ISRAEL].

Science.gov (United States)

Siegal, Gil; Glick, Shimon; Offer-Stark, Irit; Steinberg, Avraham

2018-01-01

Force feeding of fasting hunger-striking prisoners is the subject of considerable controversy in Israel and elsewhere, posing a direct conflict between two basic ethical values: that of human life and respect for autonomy. The Israel Medical Association, as well as the World Medical Association, has taken the position that force feeding of such prisoners is an act of torture and is therefore unethical. However this paper presents an opposing view, which recently became the law in Israel, that, whereas the rights of prisoners to decree a hunger strike as a form of protest should be respected, if the prolongation of the strike reaches a stage of clear and present danger to the life and health of a prisoner, the saving of the prisoner's life must take precedence over considerations of autonomy. The paper present the steps that should be taken, including extensive and empathic efforts to persuade the prisoner to end his/her fast; gaining the approval of a hospital's ethics committee; and gaining the approval of a district court judge; the feeding is to be carried out in the most humane and sensitive manner as befitting a lifesaving procedure for any patient. This position is consistent with Israel's Basic Law: Human Dignity and Liberty, Israel's Patient Rights Law, Israel's "Do not stand idly by your fellow man's blood" Law, with several Israeli court decisions and in keeping with the dominant Israeli culture. Finally, instructions for physicians who object to such measures are discussed, ascertaining the freedom of conscience as well as preserving the life of the hunger-strikers.

Averting the foul taste of pediatric medicines improves adherence and can be lifesaving - Pheburane® (sodium phenylbutyrate).

Science.gov (United States)

Koren, Gideon; Rieder, Michael J; Amitai, Yona

2016-01-01

Children's aversions to poor and mostly bitter tastes and their inability to swallow tablets and capsules are major challenges in pediatric medicine. Sodium phenylbutyrate (NaPB) is a lifesaving waste nitrogen, alternative to urea nitrogen, for individuals suffering from urea cycle disorders. A major issue in the use of NaPB is its highly foul taste, which often leads to children being unable to consume it, resulting in ineffective treatment, or alternatively, necessitating the application of the drug through a nasogastric tube or gastrostomy. This study reviews the published data on a novel formulation of NaPB, Pheburane ® granules, which begin to release their NaPB after a lag time of ~10 seconds followed by a slow release over several minutes. The taste-masked granule formulation of NaPB dramatically improves the acceptability of the drug by children and appears in initial studies to be both safe and effective. While more studies are needed to substantiate and enrich these initial trials, the available data provide a telling example where masking the drug taste of medicine for children can sometimes be the difference between life and death.

Gorilla endoscopic sinus surgery: a life-saving collaboration between human and veterinary medicine.

Science.gov (United States)

Davis, Greg E; Baik, Fred M; Liddell, Robert M; Ayars, Andrew G; Branch, Kelley R; Pottinger, Paul S; Hillel, Allen D; Helmick, Kelly; Collins, Darin

2018-03-23

Chronic rhinosinusitis is a common disease process in humans; however, in the primate population of gorillas, it has rarely been described. This case describes lifesaving sinus surgery on a critically ill gorilla performed by a human otolaryngology team in collaboration with the gorilla's veterinary medicine team. The 35-year-old western silverback gorilla was treated for 3 months with aggressive medical therapy for a worsening sinus infection. When his condition became severe, a computed tomography (CT) scan was performed showing advanced chronic rhinosinusitis with nasal polyps vs other masses and some bone erosion. As his condition deteriorated further, a tertiary otolaryngology team performed sinus surgery using the latest technology available, including image guidance, steroid-eluting sinus stents, and balloon sinus dilation. The postoperative course was complicated by subcutaneous infection and eventual fistulization. Fortunately, with culture-directed antibiotic therapy his condition gradually improved. One year later he required revision sinus surgery. At that point allergy testing was performed followed by appropriate allergy medical therapy. Now, 3 years out from his initial surgery, he continues to do well and has fathered a young female gorilla. This case represents a unique collaboration between human physicians and veterinarians. The combined medical approach was critical to heal this ailing gorilla. This case discusses many of the challenges and offers recommendations for physicians who may be involved with similar care of animals in the future. The success of the surgical and medical treatment of this gorilla's life-threatening sinus infection required many experts, careful planning, and corporate generosity. The interaction between human and animal medicine would not have been successful without the close and trusting collaborations between human and veterinary health providers. We encourage human healthcare providers to seek volunteer

Averting the foul taste of pediatric medicines improves adherence and can be lifesaving – Pheburane® (sodium phenylbutyrate)

Science.gov (United States)

Koren, Gideon; Rieder, Michael J; Amitai, Yona

2016-01-01

Background Children’s aversions to poor and mostly bitter tastes and their inability to swallow tablets and capsules are major challenges in pediatric medicine. Sodium phenylbutyrate (NaPB) is a lifesaving waste nitrogen, alternative to urea nitrogen, for individuals suffering from urea cycle disorders. A major issue in the use of NaPB is its highly foul taste, which often leads to children being unable to consume it, resulting in ineffective treatment, or alternatively, necessitating the application of the drug through a nasogastric tube or gastrostomy. Methods This study reviews the published data on a novel formulation of NaPB, Pheburane® granules, which begin to release their NaPB after a lag time of ~10 seconds followed by a slow release over several minutes. Results The taste-masked granule formulation of NaPB dramatically improves the acceptability of the drug by children and appears in initial studies to be both safe and effective. Conclusion While more studies are needed to substantiate and enrich these initial trials, the available data provide a telling example where masking the drug taste of medicine for children can sometimes be the difference between life and death. PMID:27799750

Portrayal of medical decision making around medical interventions life-saving encounters on three medical television shows.

Science.gov (United States)

Schwei, Rebecca J; Jacobs, Elizabeth A; Wingert, Katherine; Montague, Enid

2015-07-01

Previous literature has shown that patients obtain information about the medical system from television shows. Additionally, shared decision making is regularly cited as the ideal way to make decisions during a medical encounter. Little information exists surrounding the characteristics of medical decision-making, such as who makes the decision, on medical television shows. We evaluate the characteristics of medical decisions in lifesaving encounters on medical television shows and evaluate if these characteristics were different on staged and reality television shows. We coded type of medical intervention, patient's ability to participate in decision, presence of patient advocate during decision, final decision maker, decision to use intervention, and controversy surrounding decision on three television shows. Frequencies by show were calculated and differences across the three television shows and between staged (ER) and reality ( BostonMed and Hopkins ) television shows were assessed with chi-square tests. The final data set included 37 episodes, 137 patients and 593 interventions. On ER, providers were significantly more likely to make the decision about the medical intervention without informing the patient when a patient was capable of making a decision compared to BostonMed or Hopkins (ptelevision shows we analyzed. It is possible that what patients see on television influences their expectations surrounding the decision making process and the use of medical interventions in everyday healthcare encounters.

Trauma Simulation Training Increases Confidence Levels in Prehospital Personnel Performing Life-Saving Interventions in Trauma Patients

Directory of Open Access Journals (Sweden)

Christine M. Van Dillen

2016-01-01

Full Text Available Introduction. Limited evidence is available on simulation training of prehospital care providers, specifically the use of tourniquets and needle decompression. This study focused on whether the confidence level of prehospital personnel performing these skills improved through simulation training. Methods. Prehospital personnel from Alachua County Fire Rescue were enrolled in the study over a 2- to 3-week period based on their availability. Two scenarios were presented to them: a motorcycle crash resulting in a leg amputation requiring a tourniquet and an intoxicated patient with a stab wound, who experienced tension pneumothorax requiring needle decompression. Crews were asked to rate their confidence levels before and after exposure to the scenarios. Timing of the simulation interventions was compared with actual scene times to determine applicability of simulation in measuring the efficiency of prehospital personnel. Results. Results were collected from 129 participants. Pre- and postexposure scores increased by a mean of 1.15 (SD 1.32; 95% CI, 0.88–1.42; P<0.001. Comparison of actual scene times with simulated scene times yielded a 1.39-fold difference (95% CI, 1.25–1.55 for Scenario 1 and 1.59 times longer for Scenario 2 (95% CI, 1.43–1.77. Conclusion. Simulation training improved prehospital care providers’ confidence level in performing two life-saving procedures.

Placing Human Behavior at the Center of the Fight to Eradicate Polio: Lessons Learned and Their Application to Other Life-Saving Interventions.

Science.gov (United States)

Guirguis, Sherine; Obregon, Rafael; Coleman, Michael; Hickler, Benjamin; SteelFisher, Gillian

2017-07-01

Today, acceptance of oral polio vaccine is the highest ever. Reaching this level of acceptance has depended on decades of engaging with communities, building trust amid extraordinary social contexts, and responding to the complex variables that trigger behavioral and social change. Drawing on both the successes and setbacks in the 28 years of the Global Polio Eradication Initiative (GPEI), this article articulates what happened when the GPEI began to pay more attention to the dynamics of human and social behavior change. Three particular lessons for other health and immunization programs can be drawn from the experience of GPEI: change begins from within (ie, success needs institutional recognition of the importance of human behavior), good data are not enough for good decision-making, and health workers are important agents of behavior change. These lessons should be harnessed and put into practice to build demand and trust for the last stages of polio eradication, as well as for other life-saving health interventions. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Chemical protective clothing; a study into the ability of staff to perform lifesaving procedures

Science.gov (United States)

Coates, M.; Jundi, A.; James, M.

2000-01-01

Objective—To investigate the ability of medical and nursing staff to perform certain tasks while wearing a chemical protection suit with a respirator. Tasks chosen were those that would be required before decontamination. Methods—Ten experienced accident and emergency doctors (middle grade and consultants) and 10 nurses were asked to perform certain tasks that were judged to be life saving, relevant to triage, or necessary to confirm death, on an advanced life support manikin, while wearing a TST-Sweden chemical protection suit. The operators were objectively assessed by one of the authors for achieving each task, then asked to make a subjective assessment of the difficulty experienced. Results—Medical staff were asked to ventilate the manikin using a bag-valve-mask, intubate within 30 seconds, apply monitor electrodes and cables and check cardiac rhythm, apply gel pads and defibrillate safely, and finally, fold the cruciform triage card to show "RED", and attach it to the manikin. All the doctors completed these tasks, except for one, who could only intubate the manikin after several attempts. Nursing staff were asked to open and apply an oxygen mask, adjust oxygen flow, size and insert an oropharyngeal airway, ventilate the manikin using a bag-valve-mask, apply a pressure bandage to a limb, and fold the cruciform triage card to show "YELLOW", and attach it to the manikin. All the nurses completed these tasks. Operators reported varying degrees of difficulty, the most difficult tasks were those requiring fine movements or delicate control. Generally, operators found the butyl rubber gloves cumbersome. Communication difficulties were frequently reported. Although only intubation was formally timed, tasks were perceived to take longer. Some operators found the suits too warm and uncomfortable. Conclusion—Should the need arise, the TST-Sweden chemical protection suits would enable experienced doctors and nurses to perform lifesaving measures effectively

Averting the foul taste of pediatric medicines improves adherence and can be lifesaving – Pheburane® (sodium phenylbutyrate

Directory of Open Access Journals (Sweden)

Koren G

2016-10-01

Full Text Available Gideon Koren,1 Michael J Rieder,1 Yona Amitai2 1Department of Physiology and Pharmacology, The University of Western Ontario, London, ON, Canada; 2Bar-Ilan University, Ramat Gan, Israel Background: Children’s aversions to poor and mostly bitter tastes and their inability to swallow tablets and capsules are major challenges in pediatric medicine. Sodium phenylbutyrate (NaPB is a lifesaving waste nitrogen, alternative to urea nitrogen, for individuals suffering from urea cycle disorders. A major issue in the use of NaPB is its highly foul taste, which often leads to children being unable to consume it, resulting in ineffective treatment, or alternatively, necessitating the application of the drug through a nasogastric tube or gastrostomy. Methods: This study reviews the published data on a novel formulation of NaPB, Pheburane® granules, which begin to release their NaPB after a lag time of ~10 seconds followed by a slow release over several minutes. Results: The taste-masked granule formulation of NaPB dramatically improves the acceptability of the drug by children and appears in initial studies to be both safe and effective. Conclusion: While more studies are needed to substantiate and enrich these initial trials, the available data provide a telling example where masking the drug taste of medicine for children can sometimes be the difference between life and death. Keywords: sodium phenylbutyrate, adherence, urea cycle disorders, Pheburane®, taste, children

Maintaining Life-saving Testing for Patients With Infectious Diseases: Infectious Diseases Society of America, American Society for Microbiology, and Pan American Society for Clinical Virology Recommendations on the Regulation of Laboratory-developed Tests.

Science.gov (United States)

Caliendo, Angela M; Couturier, Marc R; Ginocchio, Christine C; Hanson, Kimberly E; Miller, Melissa B; Walker, Kimberly E; Frank, Gregory M

2016-07-15

In 2014, the US Food and Drug Administration (FDA) proposed to regulate laboratory-developed tests (LDTs)-diagnostics designed, manufactured, and used within a single laboratory. The Infectious Diseases Society of America, the American Society for Microbiology, and the Pan American Society for Clinical Virology recognize that the FDA is committed to protecting patients. However, our societies are concerned that the proposed regulations will limit access to testing and negatively impact infectious diseases (ID) LDTs. In this joint commentary, our societies discuss why LDTs are critical for ID patient care, hospital infection control, and public health responses. We also highlight how the FDA's proposed regulation of LDTs could impair patient access to life-saving tests and stifle innovation in ID diagnostics. Finally, our societies make specific recommendations for the FDA's consideration to reduce the burden of the proposed new rules on clinical laboratories and protect patients' access to state-of-the art, quality LDTs. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

46 CFR 160.062-3 - Materials, construction, workmanship, and performance requirements.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Materials, construction, workmanship, and performance...) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Releases. Lifesaving Equipment, Hydraulic and Manual § 160.062-3 Materials, construction, workmanship, and performance...

Emergency room thoracotomy for acute traumatic cardiac tamponade caused by a blunt cardiac injury: A case report

Directory of Open Access Journals (Sweden)

Kenichiro Ishida

2017-01-01

Conclusion: A prompt diagnosis using FAST and treatment can be lifesaving in traumatic acute cardiac tamponade. A pericardiotomy via a thoracotomy is mandatory for lifesaving cardiac decompression in acute traumatic cardiac tamponade in cases of ineffective drainage due to clot formation within the pericardial space.

46 CFR 199.160 - Rescue boat embarkation, launching and recovery arrangements.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Rescue boat embarkation, launching and recovery...) LIFESAVING APPLIANCES AND ARRANGEMENTS LIFESAVING SYSTEMS FOR CERTAIN INSPECTED VESSELS Requirements for All Vessels § 199.160 Rescue boat embarkation, launching and recovery arrangements. (a) Each rescue boat must...

46 CFR 199.03 - Relationship to international standards.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Relationship to international standards. 199.03 Section 199.03 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) LIFESAVING APPLIANCES AND ARRANGEMENTS LIFESAVING SYSTEMS FOR CERTAIN INSPECTED VESSELS General § 199.03 Relationship to international...

Solar Refrigerators Store Life-Saving Vaccines

Science.gov (United States)

2014-01-01

Former Johnson Space Center engineer David Bergeron used his experience on the Advanced Refrigeration Technology Team to found SunDanzer Refrigeration Inc., a company specializing in solar-powered refrigerators. The company has created a battery-free unit that provides safe storage for vaccines in rural and remote areas around the world.

Hypothyroidism: causes, killers, and life-saving treatments.

Science.gov (United States)

Dubbs, Sarah B; Spangler, Ryan

2014-05-01

Hypothyroidism is a very common, yet often overlooked disease. It can have a myriad of signs and symptoms, and is often nonspecific. Identification requires analysis of thyroid hormones circulating in the bloodstream, and treatment is simply replacement with exogenous hormone, usually levothyroxine (Synthroid). The deadly manifestation of hypothyroidism is myxedema coma. Similarly nonspecific and underrecognized, treatment with exogenous hormone is necessary to decrease the high mortality rate. Copyright © 2014 Elsevier Inc. All rights reserved.

Livreddende praehospital indsats

DEFF Research Database (Denmark)

Ramberg, Emilie; Skak, Claus; Nielsen, Søren Loumann

2009-01-01

were classified as lifesaving in 2005, corresponding to 4.3% of all patient contacts in 2005. The most frequent diagnoses were "opioid-poisoning" and cardiac arrest. The treatment given in those cases was lifesaving in 34% and 16%, respectively. This is significantly higher than in the cases......INTRODUCTION: The Mobile Emergency Care Unit (MECU) in Copenhagen provides prehospital healthcare for the citizens in the Capital Region in case of acute illness or accidents. The aim of this study was to describe the patients whose treatment was categorized by the MECU as lifesaving and to compare...... these with all other patients. MATERIAL AND METHODS: We analysed the MECU database contents and ambulance records from 2005 with emphasis on treatment and diagnosis. Data related to admission to hospital and 30-day survival were retrieved via the Central Population Registry. RESULTS: A total of 296 treatments...

Medair: providing life-saving services to the most vulnerable

African Journals Online (AJOL)

2016-08-03

Aug 3, 2016 ... management and emergency vaccination campaigns. ... cases of malaria rose to unprecedented levels, well beyond ... This was no small undertaking, given that the target ... As you are protecting the people against this disease, we ... Many thanks to everyone who helped to prepare this issue including ...

Duration and predictors of emergency surgical operations - basis for medical management of mass casualty incidents

Directory of Open Access Journals (Sweden)

Huber-Wagner S

2009-12-01

Full Text Available Abstract Background Hospitals have a critically important role in the management of mass causality incidents (MCI, yet there is little information to assist emergency planners. A significantly limiting factor of a hospital's capability to treat those affected is its surgical capacity. We therefore intended to provide data about the duration and predictors of life saving operations. Methods The data of 20,815 predominantly blunt trauma patients recorded in the Trauma Registry of the German-Trauma-Society was retrospectively analyzed to calculate the duration of life-saving operations as well as their predictors. Inclusion criteria were an ISS ≥ 16 and the performance of relevant ICPM-coded procedures within 6 h of admission. Results From 1,228 patients fulfilling the inclusion criteria 1,793 operations could be identified as life-saving operations. Acute injuries to the abdomen accounted for 54.1% followed by head injuries (26.3%, pelvic injuries (11.5%, thoracic injuries (5.0% and major amputations (3.1%. The mean cut to suture time was 130 min (IQR 65-165 min. Logistic regression revealed 8 variables associated with an emergency operation: AIS of abdomen ≥ 3 (OR 4,00, ISS ≥ 35 (OR 2,94, hemoglobin level ≤ 8 mg/dL (OR 1,40, pulse rate on hospital admission 120/min (OR 1,39, blood pressure on hospital admission Conclusions The mean operation time of 130 min calculated for emergency life-saving surgical operations provides a realistic guideline for the prospective treatment capacity which can be estimated and projected into an actual incident admission capacity. Knowledge of predictive factors for life-saving emergency operations helps to identify those patients that need most urgent operative treatment in case of blunt MCI.

Biosimilars: More Treatment Choices and Innovation

Science.gov (United States)

... ol Search FDA Submit search ... Information Biosimilar products provide more treatment options to patients, potentially lowering treatment costs and increasing access to lifesaving medications. The U.S. ...

Hope or hype: the obsession with medical advances and the high cost of false promises

National Research Council Canada - National Science Library

Patrick, Donald L; Deyo, Richard A

2005-01-01

.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XV PART I Can There Be Too Much of a Good Uncritically Embracing Medical Advances Thing? The Hazards of 1 What's the Problem? Don't We Need Lifesaving New...

Cancer Detection and Diagnosis Methods - Annual Plan

Science.gov (United States)

Early cancer detection is a proven life-saving strategy. Learn about the research opportunities NCI supports, including liquid biopsies and other less-invasive methods, for detecting early cancers and precancerous growths.

76 FR 76025 - World AIDS Day, 2011

Science.gov (United States)

2011-12-06

... efforts and provide lifesaving medicine to millions of people living with HIV. We are integrating cutting... prevent new HIV infections, including more effective drug regimens to prevent mother-to-child HIV...

46 CFR 160.047-1 - Incorporation by reference.

Science.gov (United States)

2010-10-01

...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Specification for a Buoyant Vest, Kapok or Fibrous Glass, Adult... reference to the following documents: (1) Federal Specification: L-P-375C—Plastic Film, Flexible, Vinyl...

Chemical Safety Alert: First Responders’ Environmental Liability Due To Mass Decontamination Runoff

Science.gov (United States)

CERCLA's good Samaritan provisions protect responders such as the Chemical Weapons Improved Response Team during lifesaving actions. Once imminent threats are addressed, responders should contain contamination and avoid/mitigate environmental consequences.

78 FR 54735 - National Alcohol and Drug Addiction Recovery Month, 2013

Science.gov (United States)

2013-09-06

... on Pathways to Wellness'' encourages all Americans to walk alongside family, friends, and neighbors... moving along the life-saving path to recovery. NOW, THEREFORE, I, BARACK OBAMA, President of the United...

Cerebral aspects of neonatal extracorporeal membrane oxygenation: a review.

NARCIS (Netherlands)

Mol, A.C. de; Liem, K.D.; Heijst, A.F.J. van

2013-01-01

Background: Neonatal extracorporeal membrane oxygenation (ECMO) is a lifesaving therapeutic approach in newborns suffering from severe, but potentially reversible, respiratory insufficiency, mostly complicated by neonatal persistent pulmonary hypertension. However, cerebral damage, intracerebral

Peer-support suicide prevention in a non-metropolitan U.S. community.

Science.gov (United States)

Walker, Rheeda L; Ashby, Judy; Hoskins, Olivia D; Greene, Farrah N

2009-01-01

Though suicide is a leading cause of death for high school age youth, the overall base rates for suicide deaths are relatively low. Consequently, very few evidence-based suicide prevention programs that address suicide death have emerged. Relative to urban areas, non-metropolitan and rural communities in particular tend to report higher suicide rates that are compounded by poor access to mental health care. In the current study, 63 high school youth participated in the three-day, LifeSavers peer-support suicide prevention training program. The goals of the program are to teach youth to engage in teamwork and listen to others without judgment in addition to recognizing the signs for youth who may be at risk for suicide. The overall aim of LifeSavers is to create a culture whereby primary prevention is active and crisis situations are preempted. Each participant in the current study completed pre-test and posttraining measures of suicide attitudes and knowledge, self-esteem, and also self-acceptance. Findings demonstrated a significant increase in knowledge and positive attitudes toward suicide prevention and also self-esteem, but not self-acceptance. Though more work is needed, these preliminary data reveal that youth in rural communities may benefit from programming such as LifeSavers that commit to advancing peer support and peer-gatekeeping efforts.

Medicinal compounds of Marine origin | Pandey | Journal of ...

African Journals Online (AJOL)

Medicinal compounds of Marine origin. ... Furthermore, the oceans are also the source of chemically inimitable natural products that are mainly ... The lifesaving drugs are mainly found abundantly in microorganisms, algae and invertebrates, ...

National Institute of Occupational Safety and Health (NIOSH) Partnered Development of Cryogenic Life Support Technologies

Data.gov (United States)

National Aeronautics and Space Administration — Cryogenic life support technology, used by NASA to protect crews working around hazardous gases soon could be called on for a number of life-saving applications as...

Screening for Breast Cancer: #BeBrave: A Life-Saving Test

Science.gov (United States)

... of my age and the fact that the cancer had spread to my sentinel lymph node, my oncologist felt the responsible next step was eight rounds of chemotherapy. After seven months of expanders in my breasts, I just had reconstructive surgery with implants. Now I begin 10 years of tamoxifen, starting ...

Reactor emergency preparedness: lifesaving or as low as reasonable achievable

International Nuclear Information System (INIS)

Hull, A.P.

1981-01-01

An emergency is defined as an unforseen combination of circumstances or the resultant state that calls for immediate action. Although not explicitly indicated, the implication is that the action is intended to protect life, limb and or property from extreme peril. For the most part, the kind and extent of the emergency planning required under current regulations of the USNRC do not appear to be so much related to emergencies (within the above definition) as they do toward the reduction of the off-site radiation doses from uncontrolled releases during reactor accident conditions to as low as reasonably achievable levels. Not only do the latter appear to be of questionable cost-effectiveness, but in their extent and complexity beyond normal disaster planning they may in fact be counter productive to optimum public safety

Reactor emergency preparedness: lifesaving or as low as reasonable achievable

Energy Technology Data Exchange (ETDEWEB)

Hull, A.P.

1981-01-01

An emergency is defined as an unforseen combination of circumstances or the resultant state that calls for immediate action. Although not explicitly indicated, the implication is that the action is intended to protect life, limb and or property from extreme peril. For the most part, the kind and extent of the emergency planning required under current regulations of the USNRC do not appear to be so much related to emergencies (within the above definition) as they do toward the reduction of the off-site radiation doses from uncontrolled releases during reactor accident conditions to as low as reasonably achievable levels. Not only do the latter appear to be of questionable cost-effectiveness, but in their extent and complexity beyond normal disaster planning they may in fact be counter productive to optimum public safety.

46 CFR 175.400 - Definitions of terms used in this subchapter.

Science.gov (United States)

2010-10-01

... rate, piping, and similar factors for the space. Dead cover means a metal cover to close or protect a... jacket. Wood vessel means, for the purposes of subdivision and lifesaving equipment requirements in this...

Search Results | Page 29 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Results 281 - 290 of 8528 ... A lifesaver for women and children, WawaRed will also improve ... Innovative tools to fight chronic diseases in Lebanon ... IDRC funds research that supports gender equality and facilitates women's empowerment.

ORIGINAL ARTICLES

African Journals Online (AJOL)

balance ART in terms of three primary dimensions: total resource allocation ... access to life-saving medication is a basic human right. Unfortunately the .... How could this planning approach work in practice? The three ... successful response.

Editorial/Van die Redaksie

African Journals Online (AJOL)

1991-01-05

Jan 5, 1991 ... most successful agencies, the World Health Organisation. ... contributions made by South Mricans to its work were of major ... On balance, South Mrica gave ... been life-saving. .... Cost-benefit analysis ofhepatitis B vaccination.

Approaches and strategies used in the training and supervision of ...

African Journals Online (AJOL)

the original work is properly cited. ... tleneck in scaling up life-saving interventions especially in low-income countries. ..... a sense of job satisfaction among HEWs, minimised staff ... However, there needs to be a balance between formalised.

Daily Aspirin Therapy: Understand the Benefits and Risks

Science.gov (United States)

Daily aspirin therapy: Understand the benefits and risks Daily aspirin therapy can be a lifesaving option, but it's not ... everyone. Get the facts before considering a daily aspirin. By Mayo Clinic Staff Daily aspirin therapy may ...

Blood Transfusion and Donation

Science.gov (United States)

... people in the United States receive life-saving blood transfusions. During a transfusion, you receive whole blood or ... have liver failure or a severe infection. Most blood transfusions go very smoothly. Some infectious agents, such as ...

The Use of Noninvasive Mechanical Ventilation for the Treatment of Acute Exacerbations of Copd in Canada

Directory of Open Access Journals (Sweden)

Jennifer Drummond

2005-01-01

Full Text Available BACKGROUND: Noninvasive mechanical ventilation (NIMV is accepted as a life-saving treatment for patients presenting to the emergency department and other acute care settings with severe exacerbations of chronic obstructive pulmonary disease (COPD.

Caesarean section – desired rate versus actual need

African Journals Online (AJOL)

Arun Kumar Agnihotri

2016-03-11

Mar 11, 2016 ... If conducted when medically justified, a caesarean section can effectively prevent ... vested interests.4 This lifesaving procedure can be a cause of short and long term ... nervous system depression among infants delivered by ...

What to Expect During a Colonoscopy

Medline Plus

Full Text Available ... for Clinical Research and Education, underscores the lifesaving importance of colorectal screening by colonoscopy. The video instills confidence in patients about the effectiveness, safety and importance of colonoscopy. Featuring the experience of a female ...

Proposed EU-India free trade agreement could impede manufacture of generic HIV drugs.

Science.gov (United States)

Chu, Sandra Ka Hon

2011-04-01

Medical experts are warning that an international trade agreement being brokered between the European Union (EU) and India could greatly restrict the access of people living with HIV in the developing world to life-saving antiretroviral medication.

Maternal health enters the information age in Peru | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

2017-01-20

Jan 20, 2017 ... ... technology to improve the health-care system's efficiency could one day ... Women in Ventanilla, Peru, connect with life-saving information on their ... was recognized for its efforts to improve health service provision and the ...

Better cassava boosts food security | IDRC - International ...

International Development Research Centre (IDRC) Digital Library (Canada)

2010-10-28

Oct 28, 2010 ... ... of IDRC continues to this day to support my breeding work,” explains Nassar, now 72 years old ... Life-saving applications in Africa ... It improved national food security, restored economic balance to agricultural communities, ...

L-027: EPR-First Responders: First Medical Response in a radiological emergency

International Nuclear Information System (INIS)

2011-01-01

The main topics covered in this conference are the tasks and the roles of medical emergency services and the local hospital such as firsts aid in a radiological emergency, protective measures, contamination level of the victims and lifesaving

Search Results | Page 34 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Results 331 - 340 of 8585 ... A lifesaver for women and children, WawaRed will also improve ... that supports gender equality and facilitates women's empowerment. ... Every line in a budget affects women and girls differently than men and boys.

Stress

Science.gov (United States)

... can be life-saving. But chronic stress can cause both physical and mental harm. There are at least three different types of stress: Routine stress related to the pressures of work, family, and other daily responsibilities Stress brought about ...

Decompressive craniectomy in aneurysmal subarachnoid haemorrhage for hematoma or oedema versus secondary infarction

NARCIS (Netherlands)

Goedemans, Taco; Verbaan, Dagmar; Coert, Bert A.; Sprengers, Marieke E. S.; van den Berg, René; Vandertop, W. Peter; van den Munckhof, Pepijn

2017-01-01

Decompressive craniectomy (DC) has been proposed as lifesaving treatment in aneurysmal subarachnoid haemorrhage (aSAH) patients with elevated intracranial pressure (ICP). However, data is sparse and controversy exists whether the underlying cause of elevated ICP influences neurological outcome. The

Sepsis: Primary indication for peripartum hysterectomies in a South ...

African Journals Online (AJOL)

Background. Peripartum hysterectomies are lifesaving procedures but definitions vary. Indications are variable and dependant on resources and geographical factors. Objectives. To evaluate the incidence, aetiology and complications associated with peripartum hysterectomies in a tertiary hospital in South Africa. Methods.

Poisoning with organophosphates

African Journals Online (AJOL)

No other agent was associated with a death in this series (Table 1). .... work by reactivating cholinesterase. The loading dose is ... Fluid balance charts. 3. Glasgow Coma ... alert the medical team to life-saving intervention. The mortality can be ...

Transcatheter embolization in a haemophiliac with post-traumatic renal haemorrhage

Energy Technology Data Exchange (ETDEWEB)

Klamut, M; Szczerbo-Trojanowska, M; Kowalewski, J; Nowakowski, A [Akademia Medyczna, Lublin (Poland)

1979-01-01

Percutaneous transcatheter arterial embolization was performed in a case of severe haemophilia A to control haemorrhage secondary to renal trauma. The treatment proved to be life-saving. Eighteen months follow-up revealed no evidence of hypertension, renal failure or infection.

Dynamic Rectus Abdominis Muscle Sphincter for Stomal Continence

NARCIS (Netherlands)

Bardoel, J.W.J.M. (Janou)

2002-01-01

Some life-saving surgeries result in the necessity to establish permanent intestinal stomas; this outcome has an undeniable physical and emotional effect on the patient's life. Although patients with permanent stomas reasonably adjust, complications that include peristomal skin irritation, pouching

Part 3: Adult Basic Life Support and Automated External Defibrillation 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

NARCIS (Netherlands)

Travers, Andrew H.; Perkins, Gavin D.; Berg, Robert A.; Castren, Maaret; Considine, Julie; Escalante, Raffo; Gazmuri, Raul J.; Koster, Rudolph W.; Lim, Swee Han; Nation, Kevin J.; Olasveengen, Theresa M.; Sakamoto, Tetsuya; Sayre, Michael R.; Sierra, Alfredo; Smyth, Michael A.; Stanton, David; Vaillancourt, Christian; Bierens, Joost J. L. M.; Bourdon, Emmanuelle; Brugger, Hermann; Buick, Jason E.; Charette, Manya L.; Chung, Sung Phil; Couper, Keith; Daya, Mohamud R.; Drennan, Ian R.; Gräsner, Jan-Thorsten; Idris, Ahamed H.; Lerner, E. Brooke; Lockhat, Husein; Løfgren, Bo; McQueen, Carl; Monsieurs, Koenraad G.; Mpotos, Nicolas; Orkin, Aaron M.; Quan, Linda; Raffay, Violetta; Reynolds, Joshua C.; Ristagno, Giuseppe; Scapigliati, Andrea; Vadeboncoeur, Tyler F.; Wenzel, Volker; Yeung, Joyce

2015-01-01

This review comprises the most extensive literature search and evidence evaluation to date on the most important international BLS interventions, diagnostics, and prognostic factors for cardiac arrest victims. It reemphasizes that the critical lifesaving steps of BLS are (1) prevention, (2)

Endovascular management of renal artery aneurysm rupture in pregnancy – A case report

Directory of Open Access Journals (Sweden)

E. Maughan

2015-01-01

Conclusion: In the shocked pregnant patient with an acute abdominal presentation, visceral artery aneurysm rupture may be comparatively more common, and should be considered in the absence of other localizing symptoms. Prompt interventional radiological treatment may be lifesaving in such cases.

Population pharmacokinetics of artesunate and dihydroartemisinin following intra-rectal dosing of artesunate in malaria patients

NARCIS (Netherlands)

Simpson, Julie A.; Agbenyega, Tsiri; Barnes, Karen I.; Di Perri, Gianni; Folb, Peter; Gomes, Melba; Krishna, Sanjeev; Krudsood, Srivicha; Looareesuwan, Sornchai; Mansor, Sharif; McIlleron, Helen; Miller, Raymond; Molyneux, Malcolm; Mwenechanya, James; Navaratnam, Visweswaran; Nosten, Francois; Olliaro, Piero; Pang, Lorrin; Ribeiro, Isabela; Tembo, Madalitso; van Vugt, Michele; Ward, Steve; Weerasuriya, Kris; Win, Kyaw; White, Nicholas J.

2006-01-01

Intra-rectal artesunate has been developed as a potentially life-saving treatment of severe malaria in rural village settings where administration of parenteral antimalarial drugs is not possible. We studied the population pharmacokinetics of intra-rectal artesunate and the relationship with

46 CFR 160.023-3 - Materials, workmanship, construction, and performance requirements.

Science.gov (United States)

2010-10-01

... requirements. 160.023-3 Section 160.023-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination... requirements. (a) The materials, construction, workmanship, general and detail requirements shall conform to...

Recurrent impetigo herpetiformis with diabetes and hypoalbuminemia successfully treated with cyclosporine, albumin, insulin and metformin

Directory of Open Access Journals (Sweden)

Lakshmi Chembolli

2010-01-01

Full Text Available We report the case of a patient with recurrent impetigo herpetiformis associated with diabetes mellitus, hypoalbuminemia, and hypocalcaemia; who was refractory to corticosteroids. Cyclosporine along with other supportive measures proved to be life-saving with maintenance of pregnancy.

46 CFR 160.057-3 - Materials, workmanship, construction, and performance requirements.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Materials, workmanship, construction, and performance...) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (15 Minutes) § 160.057-3 Materials, workmanship, construction, and performance...

46 CFR 160.037-3 - Materials, workmanship, construction, and performance requirements.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Materials, workmanship, construction, and performance...) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Orange Smoke Distress Signals § 160.037-3 Materials, workmanship, construction, and performance requirements. (a...

46 CFR 160.031-3 - Materials, construction, workmanship, and performance requirements.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Materials, construction, workmanship, and performance...) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Line-Throwing Appliance, Shoulder Gun Type (and Equipment) § 160.031-3 Materials, construction, workmanship, and...

46 CFR 160.036-3 - Materials, workmanship, construction and performance requirements.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Materials, workmanship, construction and performance...) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals § 160.036-3 Materials, workmanship, construction and...

46 CFR 160.040-3 - Materials, construction, workmanship, and performance requirements.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Materials, construction, workmanship, and performance...) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Line-Throwing Appliance, Impulse-Projected Rocket Type (and Equipment) § 160.040-3 Materials, construction, workmanship...

46 CFR 160.024-3 - Materials, workmanship, construction, and performance requirements.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Materials, workmanship, construction, and performance...) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Pistol-Projected Parachute Red Flare Distress Signals § 160.024-3 Materials, workmanship, construction, and performance...

46 CFR 160.058-3 - Materials, workmanship, construction and performance requirements.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Materials, workmanship, construction and performance...) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Desalter Kits, Sea Water, for Merchant Vessels § 160.058-3 Materials, workmanship, construction and performance...

Liver transplantation for erythropoietic protoporphyria in Europe

DEFF Research Database (Denmark)

Wahlin, Staffan; Stal, Per; Adam, Rene

2011-01-01

Liver transplantation is an established lifesaving treatment for patients with severe protoporphyric liver disease, but disease recurrence in the graft occurs for the majority of recipients. Severe burn injuries may occur when protective light filters are not used with surgical luminaires. Motor ...

Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study

NARCIS (Netherlands)

Hontelez, J.A.C.; Newell, M.L.; Bland, R.M.; Munnelly, K.; Lessells, R.J.; Barnighausen, T.

2012-01-01

ABSTRACT: BACKGROUND: Although access to life-saving treatment for patients infected with HIV patients in South Africa has improved substantially since 2004, treating all eligible patients (universal access) remains elusive. As the prices of antiretroviral drugs have dropped over the past years,

Effectiveness of oncogenetics training on general practitioners' consultation skills: a randomized controlled trial

NARCIS (Netherlands)

Houwink, E.J.; Muijtjens, A.M.M.; Teeffelen, S.R. van; Henneman, L.; Rethans, J.J.; Jagt, L.E. van der; Luijk, S.J. van; Dinant, G.J.; Vleuten, C.P.M. van der; Cornel, M.C.

2014-01-01

PURPOSE: General practitioners are increasingly called upon to deliver genetic services and could play a key role in translating potentially life-saving advancements in oncogenetic technologies to patient care. If general practitioners are to make an effective contribution in this area, their

Effectiveness of oncogenetics training on general practitioners' consultation skills: a randomized controlled trial

NARCIS (Netherlands)

Houwink, E.J.F.; Muijtjens, A.M.M.; van Teeffelen, S.R.; Henneman, L.; Rethans, J.J.; van der Jagt, L.E.J.; van Luijk, S.J.; Dinant, G.J.; van der Vleuten, C.; Cornel, M.C.

2014-01-01

Purpose:General practitioners are increasingly called upon to deliver genetic services and could play a key role in translating potentially life-saving advancements in oncogenetic technologies to patient care. If general practitioners are to make an effective contribution in this area, their

Comparison of an anti-rabies human monoclonal antibody combination with human polyclonal anti-rabies immune globulin

NARCIS (Netherlands)

Goudsmit, Jaap; Marissen, Wilfred E.; Weldon, William C.; Niezgoda, Michael; Hanlon, Cathleen A.; Rice, Amy B.; Kruif, John de; Dietzschold, Bernhard; Bakker, Alexander B. H.; Rupprecht, Charles E.

2006-01-01

The World Health Organization estimates human mortality from endemic canine rabies to be 55,000 deaths/year. Limited supply hampers the accessibility of appropriate lifesaving treatment, particularly in areas where rabies is endemic. Anti-rabies antibodies are key to protection against lethal

Usefulness of C1 Esterase Inhibitor Protein Concentrate in the ...

African Journals Online (AJOL)

2018-04-04

Apr 4, 2018 ... 2018 Nigerian Journal of Clinical Practice | Published by Wolters Kluwer ‑ Medknow ... of this case report is to describe the lifesaving use of a novel C1‑INH protein ... edema of the upper lip, uvula, and tongue [Figure 1].

Real-world costs of autologous and allogeneic stem cell transplantations for haematological diseases: a multicentre study.

NARCIS (Netherlands)

Blommestein, H.M.; Verelst, S.G.; Huijgens, P.C.; Blijlevens, N.M.A.; Cornelissen, J.J.; Uyl-de Groot, C.A.

2012-01-01

Haematopoietic stem cell transplantation (SCT) is an expensive lifesaving procedure, which is increasingly performed in patients with haematological diseases. Developments in the protocol for SCT have resulted in cost estimates that require updating. We aimed to calculate actual costs for SCT and to

Discomfort and factual recollection in intensive care unit patients

NARCIS (Netherlands)

van de Leur, JP; van der Schans, CP; Loef, BG; Deelman, BG; Geertzen, JHB; Zwaveling, JH

2004-01-01

Introduction A stay in the intensive care unit (ICU), although potentially life-saving, may cause considerable discomfort to patients. However, retrospective assessment of discomfort is difficult because recollection of stressful events may be impaired by sedation and severe illness during the ICU

Semen collection and preservation in African catfish, Clarias gariepinus

NARCIS (Netherlands)

Viveiros, A.

2002-01-01

Stock improvement using quantitative and molecular genetics is an essential part of nowadays production of farm animals and fish. To achieve this in aquaculture, germplasm of both parental sexes should be obtained in a life-saving manner. In captivity, male African catfish,

Child Passenger Safety (A Minute of Health with CDC)

Centers for Disease Control (CDC) Podcasts

Using the correct car seat for your child can be a lifesaver. This podcast discusses the importance of ensuring children are buckled up in car seats or booster seats that are appropriate for their age and size until adult seat belts fit properly.

Screening for Breast Cancer: Staging and Treatment

Science.gov (United States)

... of this page please turn JavaScript on. Feature: Screening For Breast Cancer Staging and Treatment Past Issues / Summer 2014 Table ... oncology nurse and a registered dietitian. Read More "Screening For Breast Cancer" Articles #BeBrave: A life-saving test / Breast Cancer ...

Regular oral screening and vigilance: can it be a potential lifesaver?

Directory of Open Access Journals (Sweden)

Madhu Singh Ratre

2018-01-01

Full Text Available Acute myeloid leukemia (AML is a malignant neoplasm of myeloid series defined by the presence of immature blast cells (<30% in peripheral circulation. Oral manifestations are the potential indicators of systemic health and disease. Oral cavity is the frequently and early involved sites in AML. Gingival overgrowth due to leukemia is one such condition encountered by periodontists. Hence, understanding, identifying, and correlating oral manifestations with systemic diseases are the ultimate responsibility of every dental clinician because of its lethal and unpredictable course. In the present case, we are discussing an undiagnosed case of AML who presented to us with oral complaints.

Lifesavers and Samaritans: emergency use of cellular (mobile) phones in Australia.

Science.gov (United States)

Chapman, S; Schofield, W N

1998-11-01

There has been highly publicised concern about possible radiation health effects from mobile phones and towers, but scant attention has been paid to the use of mobile phones in reducing notification times in emergencies. National random telephone survey of Australian mobile phone users (n = 720) and extrapolation to national user population (n = 5.1 million). Using a cellular phone, 1 in 8 users have reported a traffic accident; 1 in 4 a dangerous situation; 1 in 16 a non-road medical emergency; 1 in 20 a crime; and 1 in 45 being lost in the bush or being in difficulty at sea. Any debate about the net health impact of mobile phone proliferation must balance possible negative effects (cancer, driving incidents) with the benefits from what appears to be their widespread use in rapidly reporting emergencies and in numerous acts of often health-relevant 'cellular Samaritanism'.

Can children aged 12 years or more refuse life-saving treatment ...

African Journals Online (AJOL)

National Health Act[3] (section 6(1)(d)) and the common law. Constitutional ... the right to bodily and psychological integrity (section 12(2)) and the right to privacy ... development; (iii) any disability that the child may have; and (iv) any chronic ... healthcare provider in deciding whether a child of 12 years of age or more is 'of ...

[FORCE-FEEDING OR LIFE-SAVING? - DEALING WITH HUNGER STRIKES IN ISRAEL].

Science.gov (United States)

Shmueli, Amir

2018-01-01

Although the management of quality of care by the health funds has contributed to its improvement, medical teams criticize the way it is performed. Many call for renewed values-driven thinking and to leave the concern for quality in the hands of the medical teams, relying on "self control and enforcement", based on values, compassion, concern for others, patient service, discipline and personal responsibility. This article aims to present an economic perspective on the measurement of quality of care. It places the development of "measuring the quality of care and its management" within the development of the organization of care, health insurance and payment arrangements for medical teams. The conclusion is that there is no "first best" method to improve the quality of care. Each method - including the quantitative-functional measurement-based method used in many systems and the value-driven, self enforced method proposed by many - has advantages and disadvantages. The choice of a method should be based on these two sides, discussed jointly by medical teams, the health funds, hospitals and the Health Ministry.

78 FR 42739 - Lifesaving Devices-Uninspected Commercial Barges and Sailing Vessels

Science.gov (United States)

2013-07-17

....482. Therefore, $18.67 * 1.482 = $27.70. Lifebuoy: $72. http://www.amazon.com/RING-BUOY-WHITE-COAST... more Indian tribes, on the relationship between the Federal Government and Indian tribes, or on the distribution of power and responsibilities between the Federal Government and Indian tribes. K. Energy Effects...

46 CFR 199.220 - Survival craft and rescue boat embarkation arrangements.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Survival craft and rescue boat embarkation arrangements... APPLIANCES AND ARRANGEMENTS LIFESAVING SYSTEMS FOR CERTAIN INSPECTED VESSELS Additional Requirements for Passenger Vessels § 199.220 Survival craft and rescue boat embarkation arrangements. (a) Survival craft...

Failure modes of conducting yarns in electronic-textile applications

NARCIS (Netherlands)

Kok, M. de; Vries, H. de; Pacheco, K.; Heck, G. van

2015-01-01

Integration of electronic functionalities into textiles adds to the value of textiles. It allows measuring, detecting, actuating and treating or communicating with a body or object. These added values can render the smart textiles very useful, fun, supporting, protecting or even lifesaving. It is,

Decompressive craniectomy following brain injury: factors important ...

African Journals Online (AJOL)

2010-01-07

Jan 7, 2010 ... Background: Decompressive craniectomy (DC) is often performed as an empirical lifesaving measure to protect the injured brain from the damaging effects of propagating oedema and intracranial hypertension. However, there are no clearly defined indications or specified guidelines for patient selection for ...

When access to drugs meets catch-up: Insights from the use of CL threats to improve access to ARV drugs in Brazil

NARCIS (Netherlands)

Ramani, Shyama V.; Urias, E.

2018-01-01

Access to affordable lifesaving medicines is considered a human right. This leads to a question largely understudied in the catch-up literature on accumulation of industrial capabilities. Can the need to improve access to an essential commodity impact the sectoral catch-up trajectory of the

46 CFR 160.005-1 - Incorporation by reference.

Science.gov (United States)

2010-10-01

...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Life Preservers, Fibrous Glass, Adult and Child (Jacket Type... makes reference to the following documents: (1) Federal Specification: L-P-375C—Plastic Film, Flexible....005-1: (Sheet 1) Cutting Pattern and General Arrangement (Adult). (Sheet 2) Alternate Stitching of...

Long-term neurodevelopmental outcome after fetal therapy

NARCIS (Netherlands)

Klink, Jeanine Monica Maria van

2015-01-01

An increasing number of fetal diseases are being detected prior to birth due to major improvements in prenatal ultrasound examinations and the wide implementation of screening programs. For various diseases, fetal therapy may be a life-saving option or an alternative to postnatal treatment, to

46 CFR 180.150 - Survival craft embarkation arrangements.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Survival craft embarkation arrangements. 180.150 Section... (UNDER 100 GROSS TONS) LIFESAVING EQUIPMENT AND ARRANGEMENTS Survival Craft Arrangements and Equipment § 180.150 Survival craft embarkation arrangements. (a) A launching appliance approved under approval...

Anafylaksi

DEFF Research Database (Denmark)

Malling, Hans-Jørgen; Hansen, Kirsten Skamstrup; Garvey, Lene Heise

2014-01-01

Anaphylaxis is a potentially life-threatening systemic allergic reaction involving several organ systems. Recognition of the reaction leading to prompt treatment is essential for a good outcome. The lifesaving treatment is intramuscular injection of adrenaline (0.3-0.5 mg for adults and children...

46 CFR 108.503 - Relationship to international standards.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Relationship to international standards. 108.503 Section 108.503 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Lifesaving Equipment § 108.503 Relationship to international standards. For...

46 CFR 160.174-9 - Construction.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Construction. 160.174-9 Section 160.174-9 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Thermal Protective Aids § 160.174-9 Construction. (a) General...

46 CFR 160.171-9 - Construction.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Construction. 160.171-9 Section 160.171-9 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Immersion Suits § 160.171-9 Construction. (a) General. Each...

46 CFR 160.042-3 - Construction.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Construction. 160.042-3 Section 160.042-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Skids, Liferaft, for Merchant Vessels § 160.042-3 Construction...

46 CFR 160.176-9 - Construction.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Construction. 160.176-9 Section 160.176-9 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Inflatable Lifejackets § 160.176-9 Construction. (a) General...

46 CFR 160.171-11 - Performance.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Performance. 160.171-11 Section 160.171-11 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Immersion Suits § 160.171-11 Performance. (a) Buoyancy. Each...

46 CFR 160.176-11 - Performance.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Performance. 160.176-11 Section 160.176-11 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Inflatable Lifejackets § 160.176-11 Performance. (a) General...

Sadhana | Indian Academy of Sciences

Indian Academy of Sciences (India)

Keywords. Arnold transform; discrete wavelet transform (DWT); tele-medicine; Noise Visibility Function (NVF); Set Partitioning In Hierarchical Trees (SPIHT). ... need to be securely transmitted over the internet for various life-saving consultation and treatments.Watermarking is used to protect such documents from being ...

46 CFR 160.053-3 - Materials, construction and workmanship.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Materials, construction and workmanship. 160.053-3..., CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Work Vests, Unicellular Plastic Foam § 160.053-3 Materials, construction and workmanship. (a) General. Except as otherwise specifically...

46 CFR 160.038-3 - Materials, workmanship, and construction.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Materials, workmanship, and construction. 160.038-3..., CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Magazine Chests, Portable, for Merchant Vessels § 160.038-3 Materials, workmanship, and construction. (a) Portable magazine chests shall...

Expression of recombinant Streptokinase from local Egyptian ...

African Journals Online (AJOL)

Jane

2011-08-17

Aug 17, 2011 ... Streptokinase (SK) is a life-saving clot-dissolving drug routinely .... cycler (MJ Research, model PTC-200 Peltier, USA). Purification of ..... complex computational and mathematical skills that give only theoretical prediction of the outcome and most are .... resistance of SK to proteolysis by glycosylation.

46 CFR 160.076-13 - Approval procedures for inflatable PFDs.

Science.gov (United States)

2010-10-01

..., CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Inflatable Recreational Personal..., construction specifications, and bill of materials. (2) The information specified in § 159.005-5(a)(2) (i... or construction, it is not possible for the PFD to fail that test. (g) Alternative requirements. A...

Recent advances in mechanical ventilation in patients without acute respiratory distress syndrome

NARCIS (Netherlands)

Serpa Neto, Ary; Filho, Roberto R.; Rocha, Leonardo L.; Schultz, Marcus J.

2014-01-01

While being an essential part of general anesthesia for surgery and at times even a life-saving intervention in critically ill patients, mechanical ventilation has a strong potential to cause harm. Certain ventilation strategies could prevent, at least to some extent, the injury caused by this

46 CFR 160.151-29 - Additional approval tests for SOLAS A and SOLAS B inflatable liferafts.

Science.gov (United States)

2010-10-01

... (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT... appendage must be attached to a testing jig similar in material and construction to the appendage's intended... water. The dry weight must be recorded. (2) The appendage and jig must then be quickly lowered into the...

Are routine tuberculosis programme data suitable to report on antiretroviral therapy use of HIV-infected tuberculosis patients?

NARCIS (Netherlands)

Brouwer, Miranda; Gudo, Paula Samo; Simbe, Chalice Mage; Perdigão, Paula; van Leth, Frank

2013-01-01

Antiretroviral therapy (ART) is lifesaving for HIV-infected tuberculosis (TB) patients. ART-use by these patients lag behind compared to HIV-testing and co-trimoxazole preventive therapy. TB programmes provide the data on ART-use by HIV-infected TB patients, however often the HIV services provide

Facilitators and barriers to antiretroviral therapy adherence among adolescents in Ghana

NARCIS (Netherlands)

Ankrah, D.; Koster, E.S.; Teeuwisse, A.K.; Arhinful, D.K.; Agyepong, I.A.; Lartey, Margaret

2016-01-01

INTRODUCTION: Adherence to antiretroviral therapy (ART) is known to be challenging among adolescents living with HIV/AIDS, notwithstanding the life-saving importance of this therapy. Of the global total number of adolescents living with HIV in 2013, 83% reside in sub-Saharan Africa. The study aimed

Factors associated with the use of irreversible contraception and continuous use of reversible contraception in a cohort of HIV-positive women

NARCIS (Netherlands)

Kancheva Landolt, Nadia; Ramautarsing, Reshmie Ashmanie; Phanuphak, Nittaya; Teeratakulpisarn, Nipat; Pinyakorn, Suteeraporn; Rodbamrung, Piyanee; Chaithongwongwatthana, Surasith; Ananworanich, Jintanat

2013-01-01

Effective contraception can be lifesaving by reducing maternal mortality linked to childbirth and unsafe abortion and by reducing vertical and horizontal transmission of HIV, in the case of an HIV-positive woman. This study is a secondary analysis of a prospective cohort study. We assessed factors

46 CFR 160.174-13 - Storage case.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Storage case. 160.174-13 Section 160.174-13 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Thermal Protective Aids § 160.174-13 Storage case. Each thermal...

Hospital Bioethics: A Beginning Knowledge Base for the Neonatal Social Worker.

Science.gov (United States)

Silverman, Ed

1992-01-01

Notes that life-saving advances in medicine have created difficult ethical and legal dilemmas for health care professionals. Presents beginning knowledge base for bioethical practice, especially in hospital neonatal units. Outlines key elements of bioethical decision making and examines potential social work role from clinical and organizational…

46 CFR 108.550 - Survival craft launching and recovery arrangements: General.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Survival craft launching and recovery arrangements...-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Lifesaving Equipment § 108.550 Survival craft.... (c) Each survival craft must be arranged to clear each leg, column, footing, brace, mat, and each...

46 CFR 133.110 - Survival craft muster and embarkation arrangements.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Survival craft muster and embarkation arrangements. 133... VESSELS LIFESAVING SYSTEMS Requirements for All OSVs § 133.110 Survival craft muster and embarkation... lighting supplied from the emergency source of electrical power. (e) Each davit-launched survival craft...

46 CFR 133.150 - Survival craft launching and recovery arrangements: General.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Survival craft launching and recovery arrangements...) OFFSHORE SUPPLY VESSELS LIFESAVING SYSTEMS Requirements for All OSVs § 133.150 Survival craft launching and recovery arrangements: General. (a) All survival craft required for abandonment by the total number of...

46 CFR 133.03 - Relationship to international standards.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Relationship to international standards. 133.03 Section 133.03 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS LIFESAVING SYSTEMS General § 133.03 Relationship to international standards. This subpart and subpart B of...

46 CFR 160.056-2 - Construction.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Construction. 160.056-2 Section 160.056-2 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Rescue Boat § 160.056-2 Construction. (a) General. Rescue boats...

46 CFR 160.017-13 - Construction.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Construction. 160.017-13 Section 160.017-13 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Chain Ladder § 160.017-13 Construction. (a) General. Each chain...

46 CFR 160.017-15 - Performance.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Performance. 160.017-15 Section 160.017-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Chain Ladder § 160.017-15 Performance. (a) Each chain ladder...

46 CFR 169.563 - Firehose.

Science.gov (United States)

2010-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Lifesaving and Firefighting Equipment Firefighting Equipment § 169.563 Firehose. (a) One length of firehose must be provided... protection is afforded to the hose, it may be temporarily removed from the hydrant in heavy weather and...

The Safe Harbor Mouse Retreat(™) is an innovative enrichment shelter that saves mice and money.

Science.gov (United States)

Froberg-Fejko, Karen M; Lecker, Jaime L

2013-10-01

Environmental enrichment can be defined as altering the living environment of captive animals in order to provide them with opportunities to express their natural behavioral repertoire. As important as offering an enriched environment is assuring lab animals are housed in the safest conditions possible. Cage flooding events are an unfortunate reality; however, technology is advancing to minimize these events. Bio-Serv, in collaboration with Allentown, Inc., has developed an innovative and economical shelter called the Safe Harbor Mouse Retreat (Fig. 1). This shelter offers a life-saving refuge for mice during these occasional, but devastating cage-flooding accidents. Mice will not be lost due to chilling or drowning caused by water exposure. Breeding mice can save their litters by moving their pups to the second level, and all mice can escape to the higher level where they can remain warm and dry until they are rescued. This clever shelter is not only life-saving for mice but offers several other significant benefits as well.

Risk-benefit analysis of 18FDG PET cancer screening

International Nuclear Information System (INIS)

Murano, Takeshi; Daisaki, Hiromitsu; Terauchi, Takashi; Iinuma, Takeshi; Tateno, Yukio; Tateishi, Ukihide; Kato, Kazuaki; Inoue, Tomio

2008-01-01

The benefits of 18 F-fluorodeoxyglucose ( 18 FDG) positron emission tomography (PET) cancer screening are expected to include a large population of examinees and are intended for a healthy group. Therefore, we attempted to determine the benefit/risk ratio, estimated risk of radiation exposure, and benefit of cancer detection. We used software that embodied the method of the International Commission on Radiological Protection (ICRP) to calculate the average duration of life of radiation exposure. We calculated the lifesaving person years of benefit to be obtained by 18 FDG PET cancer screening detection. We also calculated the benefit/risk ratio using life-shortening and lifesaving person years. According to age, the benefit/risk ratio was more than 1 at 35-39 years old for males and 30-34 years old for females. 18 FDG PET cancer screening also is effective for examinees older than this. A risk-benefit analysis of 18 FDG-PET/computed tomography (CT) cancer screening will be necessary in the future. (author)

Clinical and psychological impact of prophylactic implantable cardioverter-defibrillators in a community heart failure population.

LENUS (Irish Health Repository)

Arnous, S

2012-02-01

AIMS: ICD implantation for primary prevention of sudden cardiac death in patients with left ventricular systolic dysfunction (ejection fraction <\\/= 35%) has increased since the publication of the SCD-HEFT and MADIT-II data. The aim of this study is to examine the effectiveness and safety of prophylactic ICD use in a community heart failure population and to assess the impact on patient\\'s quality of life. METHODS AND RESULTS: Seventy-one ICDs were inserted between the years 2002 and 2006. The mean follow-up from time of insertion was 24 +\\/- 11 months. Eighteen patients (25%) had potentially life-saving therapy. Seven (10%) patients received inappropriate shocks. Complications were encountered in five patients (7%). CONCLUSION: In a community heart failure population, prophylactic ICD implantation is associated with a high incidence of life-saving therapy, a low complication rate and a high level of tolerability. These data indicate translation of clinical trial benefits to the general heart failure population.

Implicit discount rates of vascular surgeons in the management of abdominal aortic aneurysms.

Science.gov (United States)

Enemark, U; Lyttkens, C H; Troëng, T; Weibull, H; Ranstam, J

1998-01-01

A growing empirical literature has investigated attitudes towards discounting of health benefits with regard to social choices of life-saving and health-improving measures and individuals' time preferences for the management of their own health. In this study, the authors elicited the time preferences of vascular surgeons in the context of management of small abdominal aortic aneurysms, for which the choice between early elective surgery and watchful waiting is not straightforward. They interviewed 25 of a random sample of 30 Swedish vascular surgeons. Considerable variation in the time preferences was found in the choices between watchful waiting and surgical intervention among the otherwise very homogeneous group of surgeons. The discount rates derived ranged from 5.3% to 19.4%. The median discount rate (10.4%) is similar to those usually reported for social choices concerning life-saving measures. The surgeons who were employed in university hospitals had higher discount rates than did their colleagues in county and district hospitals.

46 CFR 199.180 - Training and drills.

Science.gov (United States)

2010-10-01

... problems of hypothermia, first aid treatment for hypothermia, and other appropriate first aid procedures... 46 Shipping 7 2010-10-01 2010-10-01 false Training and drills. 199.180 Section 199.180 Shipping... LIFESAVING SYSTEMS FOR CERTAIN INSPECTED VESSELS Requirements for All Vessels § 199.180 Training and drills...

46 CFR 133.160 - Rescue boat embarkation, launching and recovery arrangements.

Science.gov (United States)

2010-10-01

...) OFFSHORE SUPPLY VESSELS LIFESAVING SYSTEMS Requirements for All OSVs § 133.160 Rescue boat embarkation, launching and recovery arrangements. (a) Each davit for a rescue boat must be approved under approval series... 46 Shipping 4 2010-10-01 2010-10-01 false Rescue boat embarkation, launching and recovery...

Download this PDF file

African Journals Online (AJOL)

AJRH Managing Editor

Nigeria; 3Department of Maternal and Child Health, Faculty of ... It can be a lifesaving procedure for both mother and baby in obstructed ... This paper highlights our experiences with symphysiotomy in a rural Roman ... malaria, viral hepatitis, sickle cell disease etc. are ... developing countries are still characterized by high.

33 CFR 149.323 - What are the requirements for first aid kits?

Science.gov (United States)

2010-07-01

... first aid kits? 149.323 Section 149.323 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF... Lifesaving Equipment Manned Deepwater Port Requirements § 149.323 What are the requirements for first aid kits? (a) Each manned deepwater port must have an industrial first aid kit, approved by an appropriate...

Triage Simulation in a Virtual Environment

NARCIS (Netherlands)

Dumay, A.C.M.

1995-01-01

Triage is the assessment of physical conditions of casualties with limited support of staff and equipment. The critical factor in handling a mass casualty situation is time. The focus is on the quick and accurate assessment of the physical conditions of casualties and the application of life-saving

46 CFR 160.050-3 - Materials.

Science.gov (United States)

2010-10-01

...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Specification for a Buoy, Life Ring, Unicellular Plastic § 160...) Unicellular plastic. The unicellular plastic material used in fabrication of the buoy body shall meet the... degradation. (e) Thread. Each thread must meet the requirements of subpart 164.023 of this chapter. Only one...

46 CFR 160.055-1 - Incorporation by reference.

Science.gov (United States)

2010-10-01

...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Life Preservers, Unicellular Plastic Foam, Adult and Child, for... Resistance of Plastic Film and Sheeting—160.055-3 (5) Coast Guard specification: 164.015—Plastic Foam.... 160.055-IA: Sheet 1—Construction and Arrangement, Vinyl Dip Coated, Model 62, Adult. Sheet 2...

46 CFR 160.002-1 - Incorporation by reference.

Science.gov (United States)

2010-10-01

...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Life Preservers, Kapok, Adult and Child (Jacket Type), Models 3.... General Purpose, Natural or in Colors. (2) Federal Specification: L-P-375—Plastic Film, Flexible, Vinyl...: (Sheet 1) Cutting Pattern and General Arrangement (adult). (Sheet 1A) Alternate stitching of tapes and...

Anvendelse af præhospital tourniquet ved livstruende ekstremitetstraumer

DEFF Research Database (Denmark)

Lyngsaa Lang, Christian; Lauridsen, Trine; Boel, Thomas

2015-01-01

Tourniquets have been used for centuries. They have been called lifesavers and "an invention of the evil one". 90.9% of deaths on the battlefields result from haemorrhage. Lessons learned du­ring the wars in Iraq and Afghanistan have developed the treat­ment given to hypovolaemic patients...

46 CFR 160.176-23 - Marking.

Science.gov (United States)

2010-10-01

... of the vessel. (2) The type of vessel. (3) Specific purpose or limitation approved by the Coast Guard...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Inflatable Lifejackets § 160.176-23 Marking. (a) General. Each inflatable lifejacket must be marked with the information required by this section. Each marking must be...

How to set up an effective national primary angioplasty network: lessons learned from five European countries

DEFF Research Database (Denmark)

Knot, Jiri; Widimsky, Petr; Wijns, William

2009-01-01

AIMS: Percutaneous coronary interventions (PCI) are used to treat acute and chronic forms of coronary artery disease. While in chronic forms the main goal of PCI is to improve the quality of life, in acute coronary syndromes (ACS) timely PCI is a life-saving procedure - especially in the setting ...

Study of the Junior Reserve Officers Training Corps: Should the Services’ Four Curricula Be Merged?

Science.gov (United States)

2003-03-01

one song, one book , and their authors that became popular during the 1850s and 1860s that symbolized slavery Review the personal achievements of...on the human body Identify risks associated with secondhand smoke 194 Table E8. Marine Corps First Aid The Four Life-Saving Steps Lesson

46 CFR 180.175 - Survival craft equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Survival craft equipment. 180.175 Section 180.175... TONS) LIFESAVING EQUIPMENT AND ARRANGEMENTS Survival Craft Arrangements and Equipment § 180.175 Survival craft equipment. (a) General. Each item of survival craft equipment must be of good quality, and...

46 CFR 117.207 - Survival craft-vessels operating on lakes, bays, and sounds routes.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Survival craft-vessels operating on lakes, bays, and... 49 PASSENGERS LIFESAVING EQUIPMENT AND ARRANGEMENTS Number and Type of Survival Craft § 117.207 Survival craft—vessels operating on lakes, bays, and sounds routes. (a) Each vessel with overnight...

46 CFR 108.525 - Survival craft number and arrangement.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Survival craft number and arrangement. 108.525 Section... UNITS DESIGN AND EQUIPMENT Lifesaving Equipment § 108.525 Survival craft number and arrangement. (a... arrangement of survival craft: (1) Lifeboats with an aggregate capacity to accommodate the total number of...

46 CFR 117.202 - Survival craft-vessels operating on oceans routes.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Survival craft-vessels operating on oceans routes. 117... LIFESAVING EQUIPMENT AND ARRANGEMENTS Number and Type of Survival Craft § 117.202 Survival craft—vessels... number of overnight persons allowed, the survival craft requirements contained in paragraph (e) of this...

46 CFR 108.540 - Survival craft muster and embarkation arrangements.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Survival craft muster and embarkation arrangements. 108... OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Lifesaving Equipment § 108.540 Survival craft muster and... craft muster station and embarkation station for a survival craft which is boarded before it is launched...

46 CFR 117.204 - Survival craft-vessels operating on coastwise routes.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Survival craft-vessels operating on coastwise routes... PASSENGERS LIFESAVING EQUIPMENT AND ARRANGEMENTS Number and Type of Survival Craft § 117.204 Survival craft... allowed, the following survival craft requirements apply when not engaged in an overnight voyage: (1...

46 CFR 133.105 - Survival craft.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Survival craft. 133.105 Section 133.105 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS LIFESAVING SYSTEMS Requirements for All OSVs § 133.105 Survival craft. (a) Each survival craft must be approved and equipped as...

46 CFR 160.026-3 - Container.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Container. 160.026-3 Section 160.026-3 Shipping COAST...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Water, Emergency Drinking (In Hermetically Sealed Containers), for Merchant Vessels § 160.026-3 Container. (a) General. The emergency drinking water container shall...

46 CFR 133.135 - Rescue boats.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Rescue boats. 133.135 Section 133.135 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS LIFESAVING SYSTEMS Requirements for All OSVs § 133.135 Rescue boats. (a) Each OSV must carry at least one rescue boat. Each rescue...

46 CFR 199.203 - Marshalling of liferafts.

Science.gov (United States)

2010-10-01

... LIFESAVING SYSTEMS FOR CERTAIN INSPECTED VESSELS Additional Requirements for Passenger Vessels § 199.203 Marshalling of liferafts. (a) Each passenger vessel must have a lifeboat or rescue boat for each six liferafts when— (1) Each lifeboat and rescue boat is loaded with its full complement of persons; and (2) The...

46 CFR 196.13-1 - Muster lists, emergency signals, and manning.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Muster lists, emergency signals, and manning. 196.13-1... VESSELS OPERATIONS Station Bills § 196.13-1 Muster lists, emergency signals, and manning. The requirements for muster lists, emergency signals, and manning must be in accordance with subchapter W (Lifesaving...

46 CFR 78.13-1 - Muster lists, emergency signals, and manning.

Science.gov (United States)

2010-10-01

... 46 Shipping 3 2010-10-01 2010-10-01 false Muster lists, emergency signals, and manning. 78.13-1... OPERATIONS Station Bills § 78.13-1 Muster lists, emergency signals, and manning. The requirements for muster lists, emergency signals, and manning must be in accordance with subchapter W (Lifesaving Appliances and...

46 CFR 97.13-1 - Muster lists, emergency signals, and manning.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Muster lists, emergency signals, and manning. 97.13-1... VESSELS OPERATIONS Station Bills § 97.13-1 Muster lists, emergency signals, and manning. The requirements for muster lists, emergency signals, and manning must be in accordance with subchapter W (Lifesaving...

46 CFR 160.151-59 - Operating instructions and information for the ship's training manual.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Operating instructions and information for the ship's training manual. 160.151-59 Section 160.151-59 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Inflatable Liferafts (SOLAS) § 160.151-59...

SAMJ CORRESPONDENCE.indd

African Journals Online (AJOL)

8. HPV vaccine: Can we afford to hesitate? To the Editor: Cervical cancer, caused by human papillomavirus ... Australia, Canada, Belgium, France, Germany and Italy in 2007, and the UK and others in 2008 were among the ... government are applauded for the bold decision to implement and finance this lifesaving initiative.

Chest injuries in Tikur Anbessa Hospital, Addis Ababa: a three year ...

African Journals Online (AJOL)

Chest drainage is a life-saving procedure for patients with chest injuries which all doctors should be confident with. Introduction. Trauma is a leading cause of .... This retrospective review of 72 cases demonstrated that the majority of patients presenting with chest injury can be treated with simple pleural cavity drainage.

46 CFR 25.25-1 - Application.

Science.gov (United States)

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Application. 25.25-1 Section 25.25-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY UNINSPECTED VESSELS REQUIREMENTS Life Preservers and Other Lifesaving Equipment § 25.25-1 Application. This subpart applies to each vessel to which this part applies...

Search Results | Page 8 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Results 71 - 80 of 96 ... ... DISEASE VECTORS 3 Apply DISEASE VECTORS filter · HEALTH ... Tourism is an important driver of economic growth throughout Southeast Asia. ... on our website last year showcase IDRC-funded research tackling some of the most ... A lifesaver for women and children, WawaRed will also improve ...

46 CFR 180.202 - Survival craft-vessels operating on oceans routes.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Survival craft-vessels operating on oceans routes. 180... VESSELS (UNDER 100 GROSS TONS) LIFESAVING EQUIPMENT AND ARRANGEMENTS Number and Type of Survival Craft § 180.202 Survival craft—vessels operating on oceans routes. (a) Each vessel certificated to operate on...

46 CFR 108.530 - Stowage of survival craft.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Stowage of survival craft. 108.530 Section 108.530... AND EQUIPMENT Lifesaving Equipment § 108.530 Stowage of survival craft. (a) General. Each survival craft required to be served by a launching appliance or marine evacuation system must be stowed as...

46 CFR 180.208 - Survival craft-vessels operating on rivers routes.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Survival craft-vessels operating on rivers routes. 180... VESSELS (UNDER 100 GROSS TONS) LIFESAVING EQUIPMENT AND ARRANGEMENTS Number and Type of Survival Craft § 180.208 Survival craft—vessels operating on rivers routes. (a) Except as allowed by paragraphs (c), (d...

46 CFR 117.206 - Survival craft-vessels operating on Great Lakes routes.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Survival craft-vessels operating on Great Lakes routes... PASSENGERS LIFESAVING EQUIPMENT AND ARRANGEMENTS Number and Type of Survival Craft § 117.206 Survival craft... vessel certificated to operate on a Great Lakes route must be provided with the survival craft required...

46 CFR 185.726 - Annual inspections.

Science.gov (United States)

2010-10-01

... repairs made at least once each year, including emptying and cleaning of each fuel tank, and refilling it with fresh fuel. (b) Each davit, winch, fall and other launching appliance must be thoroughly inspected, and any necessary repairs made, at least once each year. (c) Each item of lifesaving equipment with an...

33 CFR 149.321 - How many ring life buoys must be on each deepwater port?

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false How many ring life buoys must be on each deepwater port? 149.321 Section 149.321 Navigation and Navigable Waters COAST GUARD... EQUIPMENT Lifesaving Equipment Manned Deepwater Port Requirements § 149.321 How many ring life buoys must be...

Using digital tech to improve life for refugees | IDRC - International ...

International Development Research Centre (IDRC) Digital Library (Canada)

2016-12-20

Dec 20, 2016 ... Using digital tech to improve life for refugees ... and netbooks - can help to close the access and quality-of-service gaps for Palestinians ... individuals to enjoy more accessible and better quality health care on a continuous basis. ... health challenges by bringing life-saving information to those most in need.

The Special Educator's Toolkit: Everything You Need to Organize, Manage, and Monitor Your Classroom

Science.gov (United States)

Golden, Cindy

2012-01-01

Overwhelmed special educators: Reduce your stress and support student success with this practical toolkit for whole-classroom organization. A lifesaver for special educators in any K-12 setting, this book-and-CD set will help teachers expertly manage everything, from schedules and paperwork to student supports and behavior plans. Cindy Golden, a…

46 CFR 180.130 - Stowage of survival craft.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Stowage of survival craft. 180.130 Section 180.130... TONS) LIFESAVING EQUIPMENT AND ARRANGEMENTS Survival Craft Arrangements and Equipment § 180.130 Stowage of survival craft. (a) Each survival craft must be: (1) Secured to the vessel by a painter with a...

33 CFR 149.305 - What are the survival craft requirements for temporary personnel?

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false What are the survival craft... EQUIPMENT Lifesaving Equipment Manned Deepwater Port Requirements § 149.305 What are the survival craft... complement exceeds the capacity of the survival craft required under § 149.304 of this subpart, the port must...

46 CFR 108.520 - Type of survival craft.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Type of survival craft. 108.520 Section 108.520 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Lifesaving Equipment § 108.520 Type of survival craft. (a) Each lifeboat must be a fire-protected...

46 CFR 117.205 - Survival craft-vessels operating on limited coastwise routes.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Survival craft-vessels operating on limited coastwise... PASSENGERS LIFESAVING EQUIPMENT AND ARRANGEMENTS Number and Type of Survival Craft § 117.205 Survival craft... the survival craft required by §§ 117.204 (a) through (d) of this part, as applicable. (b) Each vessel...

46 CFR 117.208 - Survival craft-vessels operating on rivers routes.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Survival craft-vessels operating on rivers routes. 117... LIFESAVING EQUIPMENT AND ARRANGEMENTS Number and Type of Survival Craft § 117.208 Survival craft—vessels... vessel certificated to operate on a rivers route in warm water is not required to carry survival craft...

Social and cultural aspects of HIV and AIDS in West Africa: A ...

African Journals Online (AJOL)

Helle Samuelsen * Helle Samuelsen is Associate Professor and Head of Department at the Department of Anthropology, University of Copenhagen, Denmark. Her main research interests are within medical anthropology and global health. She has conducted research in various African countries, particularly in Burkina Faso and Ghana. She is currently starting up a new research project entitled ‘Fragile Futures: Rural Lives in Times of Conflict’. The project is funded by Danida's research council and fieldwork will take place in Burkina Faso and includes four PhD students and two post docs. h.samuelsen@anthro.ku.dk, Ole Norgaard & Lise Rosendal Ostergaard

2012-06-20

Jun 20, 2012 ... The main study groups were people living with HIV, young people or female sex workers. ... duced significant results, particularly in terms of the development of life-saving ... main inputs of qualitative research in this particular region: ... dence from urban Senegal and Nigeria indicate that more than. 20% of ...

NEONATES (BIRTH – 1 MONTH)

African Journals Online (AJOL)

Chantel

Major defects in neonatal skin have serious consequences for the health of the baby, but fortunately these are very rare. Early diagnosis of the genodermatoses can be life-saving. Birthmarks, also known as naevi, are usually first noted in neonates, and can be very alarming for parents. A variety of infections can.

An unusual case of sepsis and petechial rash.

Science.gov (United States)

Gardner, Christina

2017-05-01

This article describes a man who presented to the ED in acute distress with signs and symptoms of sepsis, pneumonia, and a new petechial rash on his chest. He was eventually diagnosed with Rocky Mountain spotted fever. Aggressive treatment of sepsis and timely administration of empiric antibiotics were lifesaving in this situation.

46 CFR 160.026-4 - Water.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Water. 160.026-4 Section 160.026-4 Shipping COAST GUARD... APPROVAL LIFESAVING EQUIPMENT Water, Emergency Drinking (In Hermetically Sealed Containers), for Merchant Vessels § 160.026-4 Water. (a) Only water meeting the U.S. Public Health Service “Drinking Water Standards...

46 CFR 160.176-21 - User manuals.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false User manuals. 160.176-21 Section 160.176-21 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Inflatable Lifejackets § 160.176-21 User manuals. (a) The manufacturer must develop a user's manual for each model of inflatable lifejacket. The content of the manual...

76 FR 62961 - Lifesaving Equipment: Production Testing and Harmonization With International Standards

Science.gov (United States)

2011-10-11

.... Protection of Children J. Indian Tribal Governments K. Energy Effects L. International Trade Impacts M... appropriate Coast Guard oversight ultimately promotes safety, flexibility, and autonomy by permitting experts... will accept test reports from Coast Guard-accepted independent laboratories in support of approvals for...

75 FR 53457 - Lifesaving Equipment: Production Testing and Harmonization With International Standards

Science.gov (United States)

2010-08-31

.... Protection of Children J. Indian Tribal Governments K. Energy Effects L. International Trade Impacts M... appropriate Coast Guard oversight ultimately promotes safety, flexibility, and autonomy by permitting experts...- contained air support used in self- 7(b)(25). system. contained air support systems meet the requirements of...

46 CFR 199.190 - Operational readiness, maintenance, and inspection of lifesaving equipment.

Science.gov (United States)

2010-10-01

... each fuel tank must be emptied, cleaned, and refilled with fresh fuel. (2) Each davit, winch, fall, and... expiration date has passed. (4) Each battery clearly marked with an expiration date and used in an item of...) Except for a storage battery used in a lifeboat or rescue boat, each battery without an expiration date...

77 FR 9859 - Lifesaving Equipment: Production Testing and Harmonization With International Standards

Science.gov (United States)

2012-02-21

... Prototype testing.... Manufacturers must obtain Units with rated All tests use the Units with rated (160.151... Liferafts Prototype testing.... Existing Certificates of No cost or benefit as All tests use the Costs of... designs, overseeing prototype construction, witnessing prototype testing, and monitoring production of the...

77 FR 70390 - Lifesaving Equipment: Production Testing and Harmonization With International Standards

Science.gov (United States)

2012-11-26

... components within the system to be made of corrosion-resistant materials without the need for galvanizing... resistant in the marine environment without the need for coatings or galvanizing,'' the current ASTM.... This standard would no longer be appropriate because these steels require coatings or galvanizing to be...

46 CFR 199.45 - Tests and inspections of lifesaving equipment and arrangements.

Science.gov (United States)

2010-10-01

... such as lifebuoys, lifejackets, immersion suits, work vests, lifefloats, buoyant apparatus, and..., immersion suits, work vests, lifefloats, buoyant apparatus, and associated equipment; (4) The proper...

46 CFR 133.45 - Tests and inspections of lifesaving equipment and arrangements.

Science.gov (United States)

2010-10-01

... of flotation equipment such as lifebuoys, lifejackets, immersion suits, work vests, lifefloats... mechanisms; (3) The proper condition of flotation equipment such as lifebuoys, lifejackets, immersion suits, work vests, lifefloats, buoyant apparatus, and associated equipment; (4) That each inflatable liferaft...

Coastal Fishermen as Lifesavers While Sailing at High Speed: A Crossover Study

Directory of Open Access Journals (Sweden)

Ramón Fungueiriño-Suárez

2018-01-01

Full Text Available Purpose. Starting basic cardiopulmonary resuscitation (CPR early improves survival. Fishermen are the first bystanders while at work. Our objective was to test in a simulated scenario the CPR quality performed by fishermen while at port and while navigating at different speeds. Methods. Twenty coastal fishermen were asked to perform 2 minutes of CPR (chest compressions and mouth-to-mouth ventilations on a manikin, in three different scenarios: (A at port on land, (B on the boat floor sailing at 10 knots, and (C sailing at 20 knots. Data was recorded using quality CPR software, adjusted to current CPR international guidelines. Results. The quality of CPR (QCPR was significantly higher at port (43%±10 than sailing at 10 knots (30%±15; p=0.01 or at 20 knots (26%±12; p=0.001. The percentage of ventilation that achieved some lung insufflation was also significantly higher when CPR was done at port (77%±14 than while sailing at 10 knots (59%±18 or 20 knots (57%±21 (p=0.01. Conclusion. In the event of drowning or cardiac arrest on a small boat, fishermen should immediately start basic CPR and navigate at a relatively high speed to the nearest port if the sea conditions are safe.

Comparison of Provider Types Who Performed Prehospital Lifesaving Interventions: A Prospective Study

Science.gov (United States)

2014-12-01

In less than 2 hours, 15 critically ill children were triaged and admitted to the PICU or surge spaces. Conclusions:Identified strengths included...details increasing telemedicine uti - lization during a 4 year period and outlines program structural changes that improved utilization. Methods: The study...population survival. CSC ICU resource- allocation algorithms (ALGs) exist for adults. Our goal was to evaluate a CSC pandemic ALG for children . Methods

Can primary health care staff be trained in basic life-saving surgery?

African Journals Online (AJOL)

2012-08-03

Aug 3, 2012 ... Traditional vs. on-the-job training .... Right hemiplegia and right facial weakness; smoked more than ... chronic left sided striatum infarct demonstrated. Radiological Report. A non enhanced CT of the brain has been acquired.

The effects of acute and elective cardiac surgery on the anxiety traits of patients with Marfan syndrome.

Science.gov (United States)

Benke, Kálmán; Ágg, Bence; Pólos, Miklós; Sayour, Alex Ali; Radovits, Tamás; Bartha, Elektra; Nagy, Péter; Rákóczi, Balázs; Koller, Ákos; Szokolai, Viola; Hedberg, Julianna; Merkely, Béla; Nagy, Zsolt B; Szabolcs, Zoltán

2017-07-17

Marfan syndrome is a genetic disease, presenting with dysfunction of connective tissues leading to lesions in the cardiovascular and skeletal muscle system. Within these symptoms, the most typical is weakness of the connective tissue in the aorta, manifesting as aortic dilatation (aneurysm). This could, in turn, become annuloaortic ectasia, or life-threatening dissection. As a result, life-saving and preventative cardiac surgical interventions are frequent among Marfan syndrome patients. Aortic aneurysm could turn into annuloaortic ectasia or life-threatening dissection, thus life-saving and preventive cardiac surgical interventions are frequent among patients with Marfan syndrome. We hypothesized that patients with Marfan syndrome have different level of anxiety, depression and satisfaction with life compared to that of the non-clinical patient population. Patients diagnosed with Marfan syndrome were divided into 3 groups: those scheduled for prophylactic surgery, those needing acute surgery, and those without need for surgery (n = 9, 19, 17, respectively). To examine the psychological features of the patients, Spielberger's anxiety (STAI) test, Beck's Depression questionnaire (BDI), the Berne Questionnaire of Subjective Well-being, and the Satisfaction with Life scale were applied. A significant difference was found in trait anxiety between healthy individuals and patients with Marfan syndrome after acute life-saving surgery (p Marfan syndrome patients was 48.56 (standard deviation (SD): 5.8) as compared to the STAI population mean score of 43.72 (SD: 8.53). No difference was found between groups on the BDI (p > 0.1). Finally, a significant, medium size effect was found between patient groups on the Joy in Living scale (F (2.39) = 3.51, p = 0.040, η 2  = 0.15). Involving psychiatric and mental-health care, in addition to existing surgical treatment interventions, is essential for more successful recovery of patients with Marfan syndrome.

Game-Based Learning as a Vehicle to Teach First Aid Content: A Randomized Experiment

Science.gov (United States)

Charlier, Nathalie; De Fraine, Bieke

2013-01-01

Background: Knowledge of first aid (FA), which constitutes lifesaving treatments for injuries or illnesses, is important for every individual. In this study, we have set up a group-randomized controlled trial to assess the effectiveness of a board game for learning FA. Methods: Four class groups (120 students) were randomly assigned to 2…

Comparison of the Airtraq and Truview laryngoscopes to the Macintosh laryngoscope for use by Advanced Paramedics in easy and simulated difficult intubation in manikins.

LENUS (Irish Health Repository)

Nasim, Sajid

2009-01-01

Paramedics are frequently required to perform tracheal intubation, a potentially life-saving manoeuvre in severely ill patients, in the prehospital setting. However, direct laryngoscopy is often more difficult in this environment, and failed tracheal intubation constitutes an important cause of morbidity. Novel indirect laryngoscopes, such as the Airtraq and Truview laryngoscopes may reduce this risk.

46 CFR 180.200 - Survival craft-general.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Survival craft-general. 180.200 Section 180.200 Shipping...) LIFESAVING EQUIPMENT AND ARRANGEMENTS Number and Type of Survival Craft § 180.200 Survival craft—general. (a) Each survival craft required on a vessel by this part must meet one of the following: (1) For an...

Development and Validation of a Low Cost, Flexible, Open Source Robot for Use as a Teaching and Research Tool across the Educational Spectrum

Science.gov (United States)

Howell, Abraham L.

2012-01-01

In the high tech factories of today robots can be used to perform various tasks that span a wide spectrum that encompasses the act of performing high-speed, automated assembly of cell phones, laptops and other electronic devices to the compounding, filling, packaging and distribution of life-saving pharmaceuticals. As robot usage continues to…

46 CFR 160.037-6 - Container.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Container. 160.037-6 Section 160.037-6 Shipping COAST...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Orange Smoke Distress Signals § 160.037-6 Container. (a) General. The container for storing the signals on lifeboats and liferafts is not required to be of a...

Multimedia Design Principles in the Psychomotor Domain: The Effect of Multimedia and Spatial Contiguity on Students' Learning of Basic Life Support with Task Cards

Science.gov (United States)

Iserbyt, Peter; Mols, Liesbet; Elen, Jan; Behets, Daniel

2012-01-01

This study adds to the literature by introducing multimedia research in the psychomotor area. In this study, 87 freshman students in pedagogy used task cards to learn Basic Life Support (BLS), a psychomotor skill consisting of nine lifesaving actions to be performed in a specific order. Task cards are printed materials and are often implemented…

Beneficial Effects of Isoproterenol and Quinidine in the Treatment of Ventricular Fibrillation in Brugada Syndrome

Directory of Open Access Journals (Sweden)

Melissa Dakkak

2015-01-01

Full Text Available The use of an implantable cardiac defibrillator has been advocated as the only effective treatment for the management of ventricular fibrillation (VF in patients with Brugada Syndrome (BrS. However, this device is only useful for terminating VF. Intermittent and/or recalcitrant VF for which lifesaving cardioversion occurs is a problematic situation in this patient population. The immediate use of appropriate antiarrhythmics in the acute setting has proven to be lifesaving. Quinidine has been well established as an effective antiarrhythmic in BrS, while isoproterenol (ISP has had some recognition as well. The addition of drug therapy to prevent the induction of these arrhythmias has been shown to reduce the morbidity and mortality associated with BrS. It was proven to be especially effective in the presence of early repolarization, evidenced by the reduction or normalization of the early repolarization pattern on ECG. Thus, for the prophylactic management and long term suppression of VF in BrS, further prospective studies should be performed to determine the effectiveness of quinidine and ISP in this patient population.

Examination of image diagnosis system at high level emergency medical service

International Nuclear Information System (INIS)

Hirose, Masaharu; Endo, Toshio; Aoki, Tomio

1983-01-01

This is a report of the basic idea on imaging system focussing on a necessary X-ray system for high-level emergencies which was worked out due to the establishment of the independent emergency medical institute specialized in the tertiary lifesaving and emergency, and of examinations on satisfactory results we gained for about three years of usage. (author)

Child Passenger Safety (A Minute of Health with CDC)

Centers for Disease Control (CDC) Podcasts

2016-09-29

Using the correct car seat for your child can be a lifesaver. This podcast discusses the importance of ensuring children are buckled up in car seats or booster seats that are appropriate for their age and size until adult seat belts fit properly. .  Created: 9/29/2016 by MMWR.   Date Released: 9/29/2016.

46 CFR 122.726 - Annual inspections.

Science.gov (United States)

2010-10-01

... emptying and cleaning of each fuel tank, and refilling it with fresh fuel. (b) Each davit, winch, fall and... inspection and repair if the expiration date has passed. (d) Each battery used in an item of lifesaving... expiration date of the battery has passed. The expiration date of the battery may be marked on the battery in...

33 CFR 144.01-30 - First-aid kit.

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false First-aid kit. 144.01-30 Section...) OUTER CONTINENTAL SHELF ACTIVITIES LIFESAVING APPLIANCES Manned Platforms § 144.01-30 First-aid kit. On each manned platform a first-aid kit approved by the Commandant or the U.S. Bureau of Mines shall be...

46 CFR 160.047-3 - Materials.

Science.gov (United States)

2010-10-01

...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Specification for a Buoyant Vest, Kapok or Fibrous Glass, Adult... flexible vinyl film not less than 0.006″ in thickness meeting the requirements of Federal Specification L-P-375 for Type I or II, class 1, film. (f) Tie tapes and body strap loops. The tie tapes and body strap...

Familial aggregation of anxiety associated with bruxism

Directory of Open Access Journals (Sweden)

David Gorski

2015-07-01

Practical Implications: Anxiety disorders are highly related to suicidal behaviors, particularly in children and adolescents. Additionally, awaken bruxism can often serve as an indicator of anxiety or stress. By recognizing bruxism as a possible manifestation of psychological distress, the dental practitioner may be able to direct patients to life-saving services like psychologists and crisis hotlines when appropriate.

46 CFR 160.174-11 - Performance.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Performance. 160.174-11 Section 160.174-11 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Thermal Protective Aids § 160.174-11 Performance. (a) Thermal... between −30 °C (−22 °F) and +65 C (149 °F). (d) In water performance. The thermal protective aid must be...

Evaluation of Retention of Knowledge and Skills Imparted to First-Year Medical Students through Basic Life Support Training

Science.gov (United States)

Pande, Sushma; Pande, Santosh; Parate, Vrushali; Pande, Sanket; Sukhsohale, Neelam

2014-01-01

Poor awareness among medical graduates about basic life support (BLS) is a matter of great concern. The presence of a trained rescuer is the key determinant of ultimate survival from life-threatening emergencies. To achieve this goal, early exposure to such life-saving skills is the right decision to foster these skills for medical students, which…

Organisational fundamentals of medical care in catastrophes

International Nuclear Information System (INIS)

Ahnefeld, F.W.

1983-01-01

The author presents definitions, considerations, and fundamentals of discussion. He starts by listing the institutions, equipment and traning required for medical care and life-saving services in cases of emergency. A central coordination service for medical care and life saving is proposed. The present situation is reviewed, future needs are stated, and the necessary components of a medical service are listed. (DG) [de

Starting infants on antiretroviral therapy | Clayden | Southern African ...

African Journals Online (AJOL)

5 years or more, that most start at a late stage of the disease, and that mortality in the first few months of treatment remains high.5,6 A recent study shows that starting treatment in early infancy can be lifesaving, and this has informed revisions in World Health Organization (WHO) guidelines7,8 (see WHO 'Dear Health Care ...

Welded tracheal stent removal in a child under cardiopulmonary bypass.

Science.gov (United States)

Kao, S C; Chang, W K; Pong, M W; Cheng, K W; Chan, K H; Tsai, S K

2003-08-01

Metallic tracheal stents have been used in the treatment of paediatric tracheomalacia for more than a decade. We describe a case in which critical airway obstruction occurred during removal of a welded tracheal stent using a rigid bronchoscope under general anaesthesia. Life-saving cardiopulmonary bypass was instituted urgently, and the welded stent was then removed successfully by directly opening the trachea.

A review of fire interactions and mass fires

Science.gov (United States)

Mark A. Finney; Sara S. McAllister

2011-01-01

The character of a wildland fire can change dramatically in the presence of another nearby fire. Understanding and predicting the changes in behavior due to fire-fire interactions cannot only be life-saving to those on the ground, but also be used to better control a prescribed fire to meet objectives. In discontinuous fuel types, such interactions may elicit fire...

Millions of cancer victims in developing countries lack access to life-saving radiotherapy

International Nuclear Information System (INIS)

2003-01-01

The number of cancer patients in the developing world will double to 10 million new cases annually by 2015 (World Cancer Report, World Health Organization, 2003), most of whom will have no access to the radiation therapy that could save or prolong their lives, and decrease their pain and suffering, the International Atomic Energy Agency (IAEA) says. Radiotherapy ranks with surgery as the most important methods of curing local cancer, according to the World Health Organization (WHO). 'A silent crisis in cancer treatment exists in developing countries and is intensifying every year,' says Mohamed ElBaradei, IAEA Director General. Over the next decade, the IAEA estimates that at least $2.5 billion is needed to provide adequate treatment facilities in the developing world, half to purchase machines, and half to train the physicians and physicists required to ensure safe and effective treatment. The IAEA works in partnership with the WHO on most of its cancer projects. The WHO works to address the full spectrum of the health-disease continuum from prevention to end-of-life care. The role of the IAEA in cancer control programs has grown rapidly as radiotherapy and nuclear imaging become increasingly important for the management of cancer. IAEA programmes in some 80 countries around the world demonstrate the value of radiation therapy. The four main IAEA goals are: Mobilizing the required funding to bring machines and training for local specialists in the 15 African countries that do not have any and where the technology is sustainable; Increasing the number of machines to enable people to access radiation therapy when they need it - to a far higher proportion than the present one machine for one million people; Increasing the utilization of existing machines by training more doctors and other health professionals in their safe and effective use; Establishing good clinical and safety practices in radiotherapy institutions. With help from the IAEA, modern radiotherapy facilities have been set up for the first time in several African countries, including Ghana, Ethiopia, Namibia, and Uganda. Second radiotherapy centers have been added in Nigeria and Sudan. Countries currently receiving assistance to initiate radiotherapy services include Angola, Yemen and Zambia. The IAEA is providing expert advice and training on advanced techniques for shaping the radiation doses to conform with tumours for more effective treatment. The Agency is also implementing quality assurance and quality control procedures for the operation of these machines, as well as training in the technique known as 'dynamic wedge' therapy. In Africa, the IAEA is working with 22 countries: Egypt, Tunisia, Kenya, Tanzania, Zimbabwe, Algeria, Libya, Morocco, South Africa, Gabon, Senegal, Cameroon, Madagascar and Mauritius, Ghana, Ethiopia, Namibia, Uganda, Nigeria, Sudan, Angola, Yemen and Zambia. In Europe, the IAEA is working with 27 countries: Albania, Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Estonia, Georgia, Greece, Hungary, Latvia, Lithuania, Malta, Poland, Portugal, Republic of Moldova, Romania, Russian Federation, Serbia and Montenegro, Slovakia, Slovenia, the former Yugoslav Republic of Macedonia, Turkey, and Ukraine. In Asia, the IAEA is working with 17 countries: China, Singapore, Philippine, Korea, Thailand, Vietnam, Malaysia, Mongolia, New Zealand, Pakistan, Sri Lanka, Australia, India, Japan, Bangladesh, Indonesia and Myanmar. In Latin America and the Caribbean, the IAEA is working with 19 countries: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Mexico, Nicaragua, Panama, Paraguay, Peru, Uruguay and Venezuela

GLOBAL PUBLIC PRIVATE PARTNERSHIP: AN ANALOGICAL REASONING MODEL

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Hyuk KIM

2015-06-01

Full Text Available This paper aims to introduce a new strategic direction for the multinational pharmaceutical companies in terms of the access to essential, life-saving medicines. The multinational pharmaceutical companies have been severely criticized by their various stakeholders because of their business models, particularly because of the stringent patent protection on the pharmaceutical products. The multinational pharmaceutical companies should find a new strategic direction to balance their R&D-intensive, expensive business with the access to essential, lifesaving medicines since favorable public relations are critical for the multinational pharmaceutical companies to maintain their profitable business. This paper adopts an Analogical Reasoning Model (ARM to propose a new strategic direction for the multinational pharmaceutical companies in an effort to balance their expensive business with the enhanced social responsibility. In essence, the ARM helps the multinational pharmaceutical companies formulate viable strategies that can realize a win-win situation not only for their stakeholders but also for the pharmaceutical companies themselves. The ARM is constructed, analyzing the food and beverage industry as a source environment, and suggests a comprehensive, industry-wide, multi-stakeholder public-private partnership, led not by the public sector but by the multinational pharmaceutical companies.

Patients struggle to access effective health care due to ongoing violence, distance, costs and health service performance in Afghanistan.

Science.gov (United States)

Nic Carthaigh, Niamh; De Gryse, Benoit; Esmati, Abdul Sattar; Nizar, Barak; Van Overloop, Catherine; Fricke, Renzo; Bseiso, Jehan; Baker, Corinne; Decroo, Tom; Philips, Mit

2015-05-01

The Afghan population suffers from a long standing armed conflict. We investigated patients' experiences of their access to and use of the health services. Data were collected in four clinics from different provinces. Mixed methods were applied. The questions focused on access obstacles during the current health problem and health seeking behaviour during a previous illness episode of a household member. To access the health facilities 71.8% (545/759) of patients experienced obstacles. The combination of long distances, high costs and the conflict deprived people of life-saving healthcare. The closest public clinics were underused due to perceptions regarding their lack of availability or quality of staff, services or medicines. For one in five people, a lack of access to health care had resulted in death among family members or close friends within the last year. Violence continues to affect daily life and access to healthcare in Afghanistan. Moreover, healthcare provision is not adequately geared to meet medical and emergency needs. Impartial healthcare tailored to the context will be vital to increase access to basic and life-saving healthcare. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Management options for cholestatic liver disease in children.

Science.gov (United States)

Catzola, Andrea; Vajro, Pietro

2017-11-01

Due to a peculiar age-dependent increased susceptibility, neonatal cholestasis affects the liver of approximately 1 in every 2500 term infants. A high index of suspicion is the key to an early diagnosis, and to implement timely, often life-saving treatments. Even when specific treatment is not available or curative, prompt medical management and optimization of nutrition are of paramount importance to survival and avoidance of complications. Areas covered: The present article will prominently focus on a series of newer diagnostic and therapeutic options of cholestasis in neonates and infants blended with consolidated established paradigms. The overview of strategies for the management reported here is based on a systematic literature search published in English using accessible databases (PubMed, MEDLINE) with the keywords biliary atresia, choleretics and neonatal cholestasis. References lists from retrieved articles were also reviewed. Expert commentary: A large number of uncommon and rare hepatobiliary disorders may present with cholestasis during the neonatal and infantile period. Potentially life-saving disease-specific pharmacological and surgical therapeutic approaches are currently available. Advances in hepatobiliary transport mechanisms have started clarifying fundamental aspects of inherited and acquired cholestasis, laying the foundation for the development of possibly more effective specific therapies.

An evaluation of gastric mass survey from the standpoint of expectation of life

International Nuclear Information System (INIS)

Yokoyama, Michio; Kitabatake, Takashi.

1977-01-01

The authors reexamined the evaluation of mass gastric survey, which had previously been reported by them, from the standpoint of expectation of life and advocated new theories, the number of years of expected lifesaving and the rate of loss and gain of years. Comparison between the new evaluation and the pre-existing evaluation produces the following differences. (1) The number of years of expected lifesaving increases rapidly from the 50s to reach a peak in the 60s and to decrease from the 70s. This is more realistic and reasonable than the pre-existing method by which the higher the age, the more is gain increased. (2) The rate of loss and gain of mass gastric survey increases in each age group. In other words, the value of mass gastric survey is evaluated more highly. While the importance of mass gastric survey has recently been recognized, the number of examinees increasing, injury due to exposure to radiation has become a serious problem. Therefore, it was thought to be important to perform mass gastric survey efficiently on subjects limited based on the theory investigated from both aspects of advantage and disadvantage. (Chiba, N.)

Selecting Candidates for Liver Transplantation: A Medical Ethics Perspective on the Microallocation of a Scarce and Rationed Resource

Directory of Open Access Journals (Sweden)

Eric M Yoshida

1998-01-01

Full Text Available Liver transplantation has evolved over the past 35 years from an experimental procedure with high perioperative mortality to an accepted form of treatment with an approximate 85% one-year and 80% three-year patient survival rate. Following the success and acceptance of transplantation in the treatment of end-stage liver disease, there has been a progressive increase in the number of patients seeking a limited supply of donor organs. The ethical focus, on a microallocation level, has therefore changed from that of the 1960s, when the question was whether the procedure should be offered at all, to that of the 1990s and beyond, when the focus is on the proper allocation of a scarce, life-saving resource. The ethical issues concerning fair allocation surrounding liver transplantation are explored, from both the referring physician's perspective and the perspective of the transplant physician. In particular, the contrasting viewpoints of bioethicists Nicholas Rescher and James Childress, with respect to nonmedical and social criteria in the selection of patients for scarce, life-saving therapies, are explored. Lastly, some alternative ethical models for patient selection are reviewed.

A Primer on a Domestic Catastrophic Disaster Response for the Joint Logistics Enterprise

Science.gov (United States)

2017-04-30

collectively referred to as the Joint Logistics Enterprise (JLEnt) [2]. Participation in the JLEnt is fluid and depends on the situation, the area affected by...seamless collaboration [3]. An appreciation and understanding of the different JLEnt agencies’ response mechanisms can help mitigate roadblocks to...responses by providing shelter, emergency supplies, food , water, medical supplies, and other life-saving provisions through their own funding lines

A Communications Strategy for Disaster Relief

Science.gov (United States)

2015-03-01

there were “ pockets ” of cellular coverage in the immediate aftermath of the earthquake, thus enabling some critical life-saving SMS traffic.105 4...Accessed 30 October 2014. http://www.oxfam.org/en/haiti-earthquake-our-response. Oxford Learners Dictionary . “Definition of Wicked.” Oxford University...Press. Assessed 02 September 2014. http://www.oxfordlearnersdictionaries.com/ definition/ english /wicked_1. Pacific Disaster Center. “Disaster Response

A case of Occupational Methemoglobinemia (MetHb: A Rare Entity and Unique Treatment

Directory of Open Access Journals (Sweden)

Suvarna Patil

2017-11-01

Full Text Available Methemoglobinemia is acute emergency which have precise and effective treatment if instituted in time. Methemoglobinemia due to chemical exposure is a known entity. But it required a high index of suspicion to look for it in busy casualty. Treatment with methylene blue is safe and truly lifesaving if instituted in time. Here we are presenting a case of Occupational methemoglobinemia who was treated successfully.

2017 American Heart Association Focused Update on Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

Science.gov (United States)

Kleinman, Monica E; Goldberger, Zachary D; Rea, Thomas; Swor, Robert A; Bobrow, Bentley J; Brennan, Erin E; Terry, Mark; Hemphill, Robin; Gazmuri, Raúl J; Hazinski, Mary Fran; Travers, Andrew H

2018-01-02

Cardiopulmonary resuscitation is a lifesaving technique for victims of sudden cardiac arrest. Despite advances in resuscitation science, basic life support remains a critical factor in determining outcomes. The American Heart Association recommendations for adult basic life support incorporate the most recently published evidence and serve as the basis for education and training for laypeople and healthcare providers who perform cardiopulmonary resuscitation. © 2017 American Heart Association, Inc.

Guidelines for the Standard Monitoring of Patients With Thalassemia: Report of the Thalassemia Longitudinal Cohort.

Science.gov (United States)

Tubman, Venée N; Fung, Ellen B; Vogiatzi, Maria; Thompson, Alexis A; Rogers, Zora R; Neufeld, Ellis J; Kwiatkowski, Janet L

2015-04-01

Chronic transfusion therapy has played a central role in extending life expectancy for patients with hemoglobinopathies such as thalassemia. However, this life-saving therapy is associated with numerous complications that now comprise the bulk of management considerations for patients with thalassemia. This review reports on the experience of the Thalassemia Longitudinal Cohort and reviews available literature to establish guidelines for the management of patients with thalassemia.

Human cost as a factor used in the cost-benefit analysis

Directory of Open Access Journals (Sweden)

Karol RÁSTOČNÝ

2008-01-01

Full Text Available Cost-benefit analysis (CBA is a prescriptive technique that is performed for the purpose of informing policy makers about what they ought to do. The paper discusses the problem of assigning a monetary value to human life (lifesaving or quality of life as an important factor used in the CBA. Presented ideas come from the project SELCAT solved within the 6th Frame Program.

Ethics in scientific communication: study of a problem case.

Science.gov (United States)

Berger, R L

1994-12-01

The hypothermia experiments performed on humans during the Second World War at the German concentration camp in Dachau have been regarded as crimes against humanity, disguised as medical research. For almost 50 years, scientists maintained that the study produced valuable, even if not totally reliable, information. In recent years, the results from the Dachau hypothermia project were glamorized with life-saving potential and a heated ethical dialogue was activated about the use of life-saving but tainted scientific information. In the wake of the debate, an in-depth examination of the scientific rigour of the project was performed and revealed that neither the science nor the scientists from Dachau could be trusted and that the data were worthless. The body of medical opinion accepted the unfavourable determination but a few scientists and ethicists have continued to endorse the validity, of at least parts, of the Dachau hypothermia data. The conduct of the scientific communications about the Dachau hypothermia experiments by the scientific and ethical communities invites serious consideration of a possible ethical misadventure. It appears that for almost 50 years, the results of the study had been endorsed without careful examination of the scientific base of the experiments and that secondary citation of relevant original material may have been commonly employed. These infractions contributed to a myth that good science was practised by the Nazis at Dachau. The more recent emphasis on the life-saving potential of the Dachau data, without citation of credible supporting evidence, has also been misleading. Similarly, acceptance of a determination by an in-depth examination that the 'whole' Dachau project if flawed with simultaneous endorsement of the validity of 'parts' of the results, poses an ethical problem. It is advisable that before seeking ethical consultation about the use of unethically obtained data, scientists should examine the quality of science behind

A comparison of the Glidescope, Pentax AWS, and Macintosh laryngoscopes when used by novice personnel: a manikin study.

LENUS (Irish Health Repository)

Malik, Muhammad A

2009-11-01

Direct laryngoscopic tracheal intubation is a potentially lifesaving procedure, but a difficult skill to acquire and maintain. The consequences of poorly performed intubation attempts are potentially severe. The Pentax AWS and the Glidescope are indirect laryngoscopes that may require less skill to use. We therefore hypothesized that AWS and Glidescope would prove superior to the Macintosh laryngoscope when used by novices in the normal and simulated difficult airway.

Abuse of Rachel Carson and Misuse of DDT Science in the Service of Environmental Deregulation.

Science.gov (United States)

Yang, Jingxiang; Ward, Michael D; Kahr, Bart

2017-08-14

Fake news?? The contact insecticide DDT has been reappraised as a safe, life-saving compound by special interest groups committed to repealing environmental regulations. It is shown in this essay how some specific toxicological data has been misused by those aiming to disingenuously influence public policy. Graphic: Pestroy, a DDT-laced coating marketed in 1946 by Sherwin-Williams Research Laboratories. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Self-Expanding, Tough Biodegradable Elastomers for Wound Stasis

Science.gov (United States)

2015-08-06

experts1) during Operation Iraqi Freedom and Operation Enduring Freedom.1Y4 In the home- land, severe abdominal trauma affects nearly 50,000 patients...foam, while lifesaving, resulted in transient intra-abdominal hypertension , raising the potential concern of end-organ injury from abdominal com...ab- sence of abdominal compartment syndrome or end-organ dys- function with 100-mL and 120-mL doses. Although transient intra-abdominal hypertension is

A State Partnership Program (SPP) for Afghanistan

Science.gov (United States)

2009-03-01

former eastern bloc countries (Estonia, Latvia, Lithuania ) that emerged from the Cold War independent, but potentially precarious following the fall of the...asserts the necessity to “engage and involve the private sector in reconstruction” and also “to secure and protect the natural resources, energy production ...military working dogs , and combat lifesaver training amongst many38 15 An increasingly important country in terms of CENTCOM’s security cooperation

Conscientious objection to deceased organ donation by healthcare professionals

OpenAIRE

Shaw, David; Gardiner, Dale; Lewis, Penney; Jansen, Nichon; Wind, Tineke; Samuel, Undine; Georgieva, Denie; Ploeg, Rutger; Broderick, Andrew

2017-01-01

In this article, we analyse the potential benefits and disadvantages of permitting healthcare professionals to invoke conscientious objection to deceased organ donation. There is some evidence that permitting doctors and nurses to register objections can ultimately lead to attitudinal change and acceptance of organ donation. However, while there may be grounds for conscientious objection in other cases such as abortion and euthanasia, the life-saving nature of donation and transplantation ren...

Teleradiology service for mission hospitals: initial experiences in Ethiopia and Kenya

OpenAIRE

Matthew Larrison; Stanley G. Cheng; Stephen McManus

2016-01-01

Throughout their history, mission hospitals have provided high quality and lifesaving medical care to regions of the world where medical care is sparse. These hospitals are generally built and equipped through a combination of governmental and non-governmental sources. As advances in diagnostic medical imaging have progressed and become mainstream in the developed world, mission hospitals have adopted advanced imaging modalities. These modalities provide early diagnosis and treatment options ...

Choosing wisely - when to mend a broken heart with ECMO?

OpenAIRE

Stephens, R Scott; Fan, Eddy

2014-01-01

Refractory cardiac shock in the cardiac surgical intensive care unit confers significant morbidity and mortality. Extracorporeal membrane oxygenation (ECMO) has become a common intervention for refractory cardiogenic shock when other therapies have failed. However, it is difficult to predict who will benefit from this costly, resource-intensive, but potentially life-saving technology. Here, we discuss the utility of a novel biomarker, serum butylcholinesterase, in determining survival in pati...

Identifying barriers to emergency care services.

Science.gov (United States)

Cannoodt, Luk; Mock, Charles; Bucagu, Maurice

2012-01-01

This paper aims to present a review of published evidence of barriers to emergency care, with attention towards both financial and other barriers. With the keywords (financial) accessibility, barriers and emergency care services, citations in PubMed were searched and further selected in the context of the objective of this article. Forty articles, published over a period of 15 years, showed evidence of significant barriers to emergency care. These barriers often tend to persist, despite the fact that the evidence was published many years ago. Several publications stressed the importance of the financial barriers in foregoing or delaying potentially life-saving emergency services, both in poor and rich countries. Other publications report non-financial barriers that prevent patients in need of emergency care (pre-hospital and in-patient care) from seeking care, from arriving in the proper emergency department without undue delay or from receiving proper treatment when they do arrive in these departments. It is clear that timely access to life-saving and disability-preventing emergency care is problematic in many settings. Yet, low-cost measures can likely be taken to significantly reduce these barriers. It is time to make an inventory of these measures and to implement the most cost-effective ones worldwide. Copyright © 2011 John Wiley & Sons, Ltd.

Effect of lipid emulsion during resuscitation of a patient with cardiac arrest after overdose of chlorpromazine and mirtazapine.

Science.gov (United States)

Matsumoto, Hisatake; Ohnishi, Mitsuo; Takegawa, Ryosuke; Hirose, Tomoya; Hattori, Yuji; Shimazu, Takeshi

2015-10-01

No specific treatment exists for poisoning with most fat-soluble drugs. Intravenous lipid emulsion (ILE) may be effective therapy against such drugs, but effects of ILE treatment are unclear. A 24-year-old woman with depression seen sleeping in the morning was found comatose in the evening, and an emerging lifesaving technologies service was called. After emerging lifesaving technologies departure to hospital, she stopped breathing, became pulseless, and cardiopulmonary life support was started immediately. Electrocardiographic monitoring showed asystole during resuscitation even after arrival at hospital. Empty packaging sheets of 60-tablet chlorpromazine (CPZ) (50 mg/tablet) and 66-tablet mirtazapine (MZP) (15 mg/tablet) found at the scene suggested drug-related cardiopulmonary arrest. Along with conventional administration of adrenaline (total dose, 5 mg), 20% Intralipid 100 mLwas given intravenously 8 minutes after hospital arrival and readministered 27 minutes after hospital arrival because of continued asystole. Return of spontaneous circulation occurred 29 minutes after arrival (70 minutes after cardiac arrest). The patient recovered without any major complications and was transferred to another hospital for psychiatric treatment 70 days after admission. Concentrations of CPZ and MZP were still high when return of spontaneous circulation was achieved with ILE. This case suggested the possible benefit of ILE in treating life threatening cardiotoxicity from CPZ and MZP overdose.

Novel use of a supraclavicular transverse cervical artery customised perforator flap: a paediatric emergency.

LENUS (Irish Health Repository)

Dolan, R T

2013-08-01

Perforation of the piriform fossa is a rare, potentially life-threatening paediatric emergency. Prompt diagnosis and early operative intervention is key to patient survival, yet restoring aerodigestive continuity can pose a significant reconstructive challenge. A seven-month old baby girl presented to an emergency department acutely unwell with a twenty-four-hour history of haemoptysis, cough and worsening respiratory distress. A contrast swallow demonstrated extension of contrast into the retropharyngeal region necessitating immediate surgical intervention. A 3.0 cm×1.0 cm perforation within the left posterolateral piriform fossa was identified. The defect was repaired with a supraclavicular transverse cervical artery customised perforator flap. This was inset into the piriform fossa luminal defect as a life-saving procedure. Following a stormy post-operative course, the child was discharged home on day 28 of admission and admitted electively 6 weeks later for division of flap pedicle. This case highlights the novel use of this fasciocutaneous island flap to reconstruct an extensive, potentially fatal, piriform fossa defect in an acute paediatric setting. This simple flap design offers timely mobilisation, reliable blood supply, adequate tenuity and surface area, to reconstruct this extensive defect as a life-saving intervention in a profoundly septic child.

Artemisinins from folklore to modern medicine--transforming an herbal extract to life-saving drugs.

Science.gov (United States)

Weina, P J

2008-06-01

The history of the artemisinins from Ge Hong in China during the 4th century, to the re-discovery of the qing hao derivatives in the 1970s, to the explosion of artemisinin derivatives and combinations throughout the world today is a fascinating story. The central and underappreciated role of the United States Army's 'drug company' known as the Division of Experimental Therapeutics at the Walter Reed Army Institute of Research is a story worth relating. From being the first group outside China to extract the active component of qing hao, to leading the work on neurotoxicity of the class in animals, to bringing a Good Manufacturing Practices intravenous formulation to the worldwide market is traced.

Passport to promiscuity or lifesaver: press coverage of HPV vaccination and risky sexual behavior.

Science.gov (United States)

Forster, Alice; Wardle, Jane; Stephenson, Judith; Waller, Jo

2010-03-01

A significant minority of parents are concerned about adolescents engaging in risky sexual behavior following human papillomavirus (HPV) vaccination. The way the HPV vaccine is reported in the media has the potential to influence public understanding and vaccination decisions. The present study examined the content of articles published between 2003 and 2008 in British national newspapers that addressed the issue of adolescents engaging in risky sexual behavior following HPV vaccination. We used mixed methods to analyze 92 articles in which the issue was mentioned. Qualitative framework analysis highlighted three main types of discussion: news stories proposing that adolescents will engage in risky sexual behavior following HPV vaccination, counterarguments insisting that adolescents will not engage in risky sexual behavior after HPV vaccination, and parents' views of the issue of risky sexual behavior. The results indicated that newspapers provide parents with broadly positive descriptive norms about vaccination; however, the issue that adolescents will engage in risky sexual behaviors following HPV vaccination is regularly discussed in the national press and has the potential to increase parents' concerns about vaccination.

The community speaks: understanding ethical values in allocation of scarce lifesaving resources during disasters.

Science.gov (United States)

Daugherty Biddison, Elizabeth L; Gwon, Howard; Schoch-Spana, Monica; Cavalier, Robert; White, Douglas B; Dawson, Timothy; Terry, Peter B; London, Alex John; Regenberg, Alan; Faden, Ruth; Toner, Eric S

2014-06-01

Pandemic influenza or other crises causing mass respiratory failure could easily overwhelm current North American critical care capacity. This threat has generated large-scale federal, state, and local efforts to prepare for a public health disaster. Few, however, have systematically engaged the public regarding which values are most important in guiding decisions about how to allocate scarce healthcare resources during such crises. The aims of this pilot study were (1) to test whether deliberative democratic methods could be used to promote engaged discussion about complex, ethically challenging healthcare-related policy issues and (2) to develop specific deliberative democratic procedures that could ultimately be used in a statewide process to inform a Maryland framework for allocating scarce healthcare resources during disasters. Using collaboratively developed focus group materials and multiple metrics for assessing outcomes, we held 5-hour pilot community meetings with a combined total of 68 community members in two locations in Maryland. The key outcomes used to assess the project were (1) the comprehensibility of the background materials and ethical principles, (2) the salience of the ethical principles, (3) the perceived usefulness of the discussions, (4) the degree to which participants' opinions evolved as a result of the discussions, and (5) the quality of participant engagement. Most participants were thoughtful, reflective, and invested in this pilot policy-informing process. Throughout the pilot process, changes were made to background materials, the verbal introduction, and pre- and post-surveys. Importantly, by holding pilot meetings in two distinct communities (an affluent suburb and inner city neighborhood), we discerned that participants' ethical reflections were framed in large part by their place-based life experiences. This pilot process, coupled with extensive feedback from participants, yielded a refined methodology suitable for wider-scale use and underscored the need for involvement of diverse communities in a statewide engagement process on this critical policy issue.

Assessing Trauma Care Provider Judgement in the Prediction of Need for Life-saving Interventions

Science.gov (United States)

2015-01-13

suggest that agreement among groups of clinicians is far less dependable. The overall patterns of agreement among provider groups in our study are not...Gabbe BJ, Cameron P, Victorian State Trauma Outcomes Registry and Monitoring Group (VSTORM). Is paramedic judgement useful in prehospital trauma triage...2007;63:1338–46. [13] Gruen RL, Jurkovich GJ, McIntyre LK, Foy HM, Maier RV. Patterns of errors contributing to trauma mortality: lessons learned from

Continuous quality improvement process pin-points delays, speeds STEMI patients to life-saving treatment.

Science.gov (United States)

2011-11-01

Using a multidisciplinary team approach, the University of California, San Diego, Health System has been able to significantly reduce average door-to-balloon angioplasty times for patients with the most severe form of heart attacks, beating national recommendations by more than a third. The multidisciplinary team meets monthly to review all cases involving patients with ST-segment-elevation myocardial infarctions (STEMI) to see where process improvements can be made. Using this continuous quality improvement (CQI) process, the health system has reduced average door-to-balloon times from 120 minutes to less than 60 minutes, and administrators are now aiming for further progress. Among the improvements instituted by the multidisciplinary team are the implementation of a "greeter" with enough clinical expertise to quickly pick up on potential STEMI heart attacks as soon as patients walk into the ED, and the purchase of an electrocardiogram (EKG) machine so that evaluations can be done in the triage area. ED staff have prepared "STEMI" packets, including items such as special IV tubing and disposable leads, so that patients headed for the catheterization laboratory are prepared to undergo the procedure soon after arrival. All the clocks and devices used in the ED are synchronized so that analysts can later review how long it took to complete each step of the care process. Points of delay can then be targeted for improvement.

Sexual orientation differences in treatment expectation, alliance, and outcome among patients at risk for suicide in a public psychiatric hospital

OpenAIRE

Pl?derl, Martin; Kunrath, Sabine; Cramer, Robert J.; Wang, Jen; Hauer, Larissa; Fartacek, Clemens

2017-01-01

Background Sexual minority (SM) individuals (gay, lesbian, bisexual, or otherwise nonheterosexual) are at increased risk for mental disorders and suicide and adequate mental healthcare may be life-saving. However, SM patients experience barriers in mental healthcare that have been attributed to the lack of SM-specific competencies and heterosexist attitudes and behaviors on the part of mental health professionals. Such barriers could have a negative impact on common treatment factors such as ...

History of the molecular biology of cytomegaloviruses.

Science.gov (United States)

Stinski, Mark F

2014-01-01

The history of the molecular biology of cytomegaloviruses from the purification of the virus and the viral DNA to the cloning and expression of the viral genes is reviewed. A key genetic element of cytomegalovirus (the CMV promoter) contributed to our understanding of eukaryotic cell molecular biology and to the development of lifesaving therapeutic proteins. The study of the molecular biology of cytomegaloviruses also contributed to the development of antivirals to control the viral infection.

Classical Galactosaemia and CDG, the N-Glycosylation Interface. A Review

OpenAIRE

Maratha, Ashwini; Colhoun, Hugh-Owen; Knerr, Ina; Coss, Karen P.; Doran, Peter; Treacy, Eileen P.

2016-01-01

Classical galactosaemia is a rare disorder of carbohydrate metabolism caused by galactose-1-phosphate uridyltransferase (GALT) deficiency (EC 2.7.7.12). The disease is life threatening if left untreated in neonates and the only available treatment option is a long-term galactose restricted diet. While this is lifesaving in the neonate, complications persist in treated individuals, and the cause of these, despite early initiation of treatment, and shared GALT genotypes remain poorly understood...

Interhospital Transport of Children Undergoing Cardiopulmonary Resuscitation: A Practical and Ethical Dilemma.

Science.gov (United States)

Noje, Corina; Fishe, Jennifer N; Costabile, Philomena M; Klein, Bruce L; Hunt, Elizabeth A; Pronovost, Peter J

2017-10-01

To discuss risks and benefits of interhospital transport of children in cardiac arrest undergoing cardiopulmonary resuscitation. Narrative review. Not applicable. Transporting children in cardiac arrest with ongoing cardiopulmonary resuscitation between hospitals is potentially lifesaving if it enables access to resources such as extracorporeal support, but may risk transport personnel safety. Research is needed to optimize outcomes of patients transported with ongoing cardiopulmonary resuscitation and reduce risks to the staff caring for them.

Soy-based Infant Formula: A Safe Choice for Babies?

OpenAIRE

Su, Tien-l Karleen

2002-01-01

Making up about 25% of the current infant-formula market in the U.S., soy-based infant formulas are lifesaving alternatives for infants who cannot rely on traditional sources of milk for complete nutrition. While many studies have supported the effectiveness of soy-formula consumption for normal growth and development, the controversy over the potentially harmful effects of early exposure to isoflavones (phytoestrogens found in soy formulas) remains to be resolved. The plasma concentration of...

9. The Contribution of Animal Experiments to Kidney Transplantation

OpenAIRE

Botting, Jack Howard

2016-01-01

Haemodialysis is life-saving and curative in acute renal failure. By reversing the build-up of metabolic products normally excreted by a functioning kidney, dialysis enables the temporarily affected kidneys to heal and resume normal function. In chronic renal failure however, the burden of regular dialysis is necessary unless a healthy kidney from a donor can be grafted. Chronic Renal Failure Chronic renal failure (CRF) due to glomerulonephritis, pyelonephritis or polycystic kidney disease is...

Comparison of three cuffed emergency percutaneous cricothyroidotomy devices to conventional surgical cricothyroidotomy in a porcine model.

LENUS (Irish Health Repository)

Murphy, C

2011-01-01

Emergency cricothyroidotomy is a potentially life-saving procedure in the \\'cannot intubate cannot ventilate (CICV)\\' scenario. Although surgical cricothyroidotomy remains the technique recommended in many \\'CICV\\' algorithms, the insertion of a tracheostomy as a cannula over a trocar, or using the Seldinger method, may have advantages as they are more familiar to the anaesthetist. We compared the utility of three cuffed cricothyroidotomy devices: cuffed Melker®, Quicktrach 2®, and PCK® devices, with surgical cricothyroidotomy.

[Acute surgical treatment of malignant stroke].

Science.gov (United States)

Lilja-Cyron, Alexander; Eskesen, Vagn; Hansen, Klaus; Kondziella, Daniel; Kelsen, Jesper

2016-10-24

Malignant stroke is an intracranial herniation syndrome caused by cerebral oedema after a large hemispheric or cerebellar stroke. Malignant middle cerebral artery infarction is a devastating disease with a mortality around 80% despite intensive medical treatment. Decompressive craniectomy reduces mortality and improves functional outcome - especially in younger patients (age ≤ 60 years). Decompression of the posterior fossa is a life-saving procedure in patients with malignant cerebellar infarctions and often leads to good neurological outcome.

An Examination of Women Experiencing Obstetric Complications Requiring Emergency Care: Perceptions and Sociocultural Consequences of Caesarean Sections in Bangladesh

Science.gov (United States)

Khan, Rasheda; Sultana, Marzia; Bilkis, Sayeda; Koblinsky, Marge

2012-01-01

Little is known about the physical and socioeconomic postpartum consequences of women who experience obstetric complications and require emergency obstetric care (EmOC), particularly in resource-poor countries such as Bangladesh where historically there has been a strong cultural preference for births at home. Recent increases in the use of skilled birth attendants show socioeconomic disparities in access to emergency obstetric services, highlighting the need to examine birthing preparation and perceptions of EmOC, including caesarean sections. Twenty women who delivered at a hospital and were identified by physicians as having severe obstetric complications during delivery or immediately thereafter were selected to participate in this qualitative study. Purposive sampling was used for selecting the women. The study was carried out in Matlab, Bangladesh, during March 2008–August 2009. Data-collection methods included in-depth interviews with women and, whenever possible, their family members. The results showed that the women were poorly informed before delivery about pregnancy-related complications and medical indications for emergency care. Barriers to care-seeking at emergency obstetric facilities and acceptance of lifesaving care were related to apprehensions about the physical consequences and social stigma, resulting from hospital procedures and financial concerns. The respondents held many misconceptions about caesarean sections and distrust regarding the reason for recommending the procedure by the healthcare providers. Women who had caesarean sections incurred high costs that led to economic burdens on family members, and the blame was attributed to the woman. The postpartum health consequences reported by the women were generally left untreated. The data underscore the importance of educating women and their families about pregnancy-related complications and preparing families for the possibility of caesarean section. At the same time, the health

First Turkish Experience with the MicroMed DeBakey VAD®

OpenAIRE

Kucukaksu, Deniz Suha; Sener, Erol; Undar, Akif; Noon, George P.; Tasdemir, Oguz

2003-01-01

Mechanical bridging to cardiac transplantation with a ventricular assist device may be a life-saving procedure for patients with end-stage heart failure. Here we report our 3 cases of patients implanted with the MicroMed DeBakey VA® (ventricular assist device). Three male patients, aged 37, 41, and 40, had end-stage left heart failure due to idiopathic cardiomyopathy and were listed for cardiac transplantation. They had progressive hemodynamic deterioration. Although Patient 1 underwent surge...

Giant Adrenal Myelolipoma Masquerading as Heart Failure

Directory of Open Access Journals (Sweden)

Parijat S. Joy

2014-03-01

Full Text Available Adrenal myelolipomas are rare benign tumors of the adrenal cortex composed of adipose and hematopoietic cells. They have been postulated to arise from repeated stimulation by stress, inflammation and ACTH oversecretion. Myelolipomas are usually detected incidentally on imaging and do not require any active intervention besides regular follow-up by imaging. However, myelolipomas may insidiously grow to large sizes and cause mass effects and hemorrhage. Timely diagnosis and surgical resection are curative and lifesaving.

A case of appropriate inappropriate device therapy: Hyperkalemia-induced ventricular oversensing

OpenAIRE

Oudit, Gavin Y; Cameron, Doug; Harris, Louise

2008-01-01

The present case describes a patient who received inappropriate, but potentially life-saving, therapy from her implantable cardioverter defibrillator (ICD) in the setting of acute hyperkalemia (plasma potassium concentration = 8 mM). Hyperkalemia was associated with the development of a slow sinusoidal ventricular tachycardia, at a rate of 100 beats/min to 125 beats/min (610 ms to 480 ms) in a patient who is pacemaker-dependent. There was associated fractionation of the ICD electrogram and T ...

Intraoperative echocardiography of a dislodged Björk-Shiley mitral valve disc.

Science.gov (United States)

Tanaka, M; Abe, T; Takeuchi, E; Watanabe, T; Tamaki, S

1991-02-01

The successful management of a patient who suffered an outlet strut fracture of a Björk-Shiley 60-degree convexo-concave mitral valve prosthesis is reported. Emergency operation was life-saving. Preoperative echocardiography assisted in making a prompt diagnosis, and intraoperative echocardiography allowed the detection and removal of the dislodged disc from the left ventricle at the time of the operation. The role of intraoperative echocardiography in the diagnosis of prosthetic strut fracture is emphasized.

Percutaneous Emergency Needle Caecostomy for Prevention of Caecal Perforation

OpenAIRE

Limmer, Alexandra M.; Clement, Zackariah

2017-01-01

Caecal perforation is a life-threatening complication of large bowel obstruction with a reported mortality of 34% to 72%. This case describes the novel use of percutaneous needle caecostomy as a life-saving measure to prevent imminent caecal perforation in a 68-year-old lady with large bowel obstruction secondary to an incarcerated incisional hernia. After careful review of computed tomography images and measurement of distances from the abdominal wall to the caecum, the patient's caecum was ...

Importance of back blow maneuvers in a 6 month old patient with sudden upper airway obstruction

OpenAIRE

Gencpinar, Pinar; Duman, Murat

2016-01-01

Foreign body aspiration in children under four years old is one of the most frequently observed reasons for accident related deaths. It is more common in this age group due to inadequate swallowing functions and exploration of objects with the mouth. The most frequently encountered foreign bodies are food and toy parts. Life threatening complete laryngeal obstruction is rarely observed. Dyspnea, hypersalivation, cough and cyanosis can be seen. The basic and life-saving treatment approach is c...

In reply to: "Intra-aortic balloon pump protects against hydrostatic pulmonary oedema during peripheral venoarterial-extracorporeal membrane oxygenation".

Science.gov (United States)

Privratsky, Jamie R; Diaz, Sebastian; Nicoara, Alina; Daneshmand, Mani A

2018-05-01

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an increasingly utilized life-saving measure. However, left-ventricular distention from inadequate left-ventricular off-loading can lead to unwanted pulmonary and cardiac complications. We are writing to indicate our agreement with a recent article by Brechot et al. published in the June 2017 issue where the authors demonstrated that intra-aortic balloon pump provides mechanical support to off-load the left ventricle during VA-ECMO, which prevents pulmonary edema.

The Suicide Paradigm: Insights from Ancient Hindu Scriptures.

Science.gov (United States)

Agoramoorthy, Govindasamy; Hsu, Minna J

2017-06-01

The world religions in general promote peace and happiness. They strongly discourage all sorts of violence in society including suicide. Religious commitments toward life-saving value are known to prevent suicide attempts since all world religions promote unity, reducing interpersonal hostilities. Therefore, understanding the basics on what religious scriptures narrate on life and death including suicide is essential. This paper highlights the seldom discussed topic on the concept and consequences of suicide portrayed in the ancient Hindu religious scriptures.

Præhospital behandling af svært tilskadekomne patienter med fokus på damage control-kirurgi

DEFF Research Database (Denmark)

Sørensen, Anne Marie; Larsen, Claus Falck; Steinmetz, Jacob

2011-01-01

The majority of patients undergoing damage control surgery initially receive prehospital treatment. Bleeding causes 40% of trauma deaths, half of which happen in the prehospital setting. Future research and improved treatment before hospital admission should focus on control of the bleeding, avoi......, avoidance of hypothermia, minimising the time to definitive surgery, and a restrictive and goal directed therapy with regard to the intake of fluids. On occasion, lifesaving procedures could be performed during transport to the hospital....

A Systematic Review on the Existing Screening Pathways for Lynch Syndrome Identification

OpenAIRE

Tognetto, Alessia; Michelazzo, Maria Benedetta; Calabró, Giovanna Elisa; Unim, Brigid; Di Marco, Marco; Ricciardi, Walter; Pastorino, Roberta; Boccia, Stefania

2017-01-01

Background Lynch syndrome (LS) is the most common hereditary colon cancer syndrome, accounting for 3–5% of colorectal cancer (CRC) cases, and it is associated with the development of other cancers. Early detection of individuals with LS is relevant, since they can take advantage of life-saving intensive care surveillance. The debate regarding the best screening policy, however, is far from being concluded. This prompted us to conduct a systematic review of the existing screening pathways for ...

Corporate social responsibility practices of pharmaceutical companies in China: a scale development & empirical study

OpenAIRE

Qian Yiyun

2017-01-01

JEL Classification: M14 - Corporate Culture; Social Responsibility; I11 - Analysis of Health Care Markets Corporate Social Responsibility (CSR) has been a hot topic in literature ever since a couple of decades ago, and it roughly refers to the positive influence that a company’s operations have on its stakeholders. Amongst various industries, the pharmaceutical sector is one of the most debated in that these companies produce disease-curing and even life-saving products in a for-profit man...

Infectious Disease Management through Point-of-Care Personalized Medicine Molecular Diagnostic Technologies

Directory of Open Access Journals (Sweden)

Luc Bissonnette

2012-05-01

Full Text Available Infectious disease management essentially consists in identifying the microbial cause(s of an infection, initiating if necessary antimicrobial therapy against microbes, and controlling host reactions to infection. In clinical microbiology, the turnaround time of the diagnostic cycle (>24 hours often leads to unnecessary suffering and deaths; approaches to relieve this burden include rapid diagnostic procedures and more efficient transmission or interpretation of molecular microbiology results. Although rapid nucleic acid-based diagnostic testing has demonstrated that it can impact on the transmission of hospital-acquired infections, we believe that such life-saving procedures should be performed closer to the patient, in dedicated 24/7 laboratories of healthcare institutions, or ideally at point of care. While personalized medicine generally aims at interrogating the genomic information of a patient, drug metabolism polymorphisms, for example, to guide drug choice and dosage, personalized medicine concepts are applicable in infectious diseases for the (rapid identification of a disease-causing microbe and determination of its antimicrobial resistance profile, to guide an appropriate antimicrobial treatment for the proper management of the patient. The implementation of point-of-care testing for infectious diseases will require acceptance by medical authorities, new technological and communication platforms, as well as reimbursement practices such that time- and life-saving procedures become available to the largest number of patients.

Pharmacokinetics and pharmacodynamics of qinghaosu derivatives: how do they impact on the choice of drug and the dosage regimens?

Science.gov (United States)

Kyle, D E; Teja-Isavadharm, P; Li, Q; Leo, K

1998-01-01

The critical decisions of which artemisinin derivative(s) to use and by which route(s) of administration for falciparum malaria are complex scientifically and politically. Despite the need for additional pharmacokinetic, pharmacodynamic and toxicokinetic data, these drugs are too important to delay concise, rational recommendations any longer. These types of decisions must be made now, implemented on a multinational level with WHO leadership, and revised as new findings emerge. For acute, uncomplicated disease, per os dosing of artesunate or artemether for three days is recommended, but only in combination with other antimalarial drugs like mefloquine. For severe falciparum malaria, intravenous administration is the preferred route, yet current formulations for intravenous dosing are not optimal and should be an area for future development emphasis. Clearly intramuscular administration of artemether has proven effective for severe disease, yet dosing regimens shouldn't be designed with ultimate parasitological cure as the aim and the problem of bioavailability of the sesame oil formulations must be examined further. Once the life-saving reduction in parasitemia and pathophysiological sequelae have been achieved, the patient can be given oral medication to affect radical cure. Much more data will be required to define the role of per rectum dosing for the treatment of severe malaria, yet this approach holds great promise as a life-saving intervention in rural areas where this disease has it most dramatic impact.

Balancing omega-6 and omega-3 fatty acids in ready-to-use therapeutic foods (RUTF)

OpenAIRE

Brenna, Thomas; Akomo, Peter; Bahwere, Paluku; Berkley, James; Calder, Phillip; Jones, Kelsey; Liu, Lei; Manary, Mark; Trehan, Indi; Briend, André

2015-01-01

Ready-to-use therapeutic foods (RUTFs) are a key component of a life-saving treatment for young children who present with uncomplicated severe acute malnutrition in resource limited settings. Increasing recognition of the role of balanced dietary omega-6 and omega-3 polyunsaturated fatty acids (PUFA) in neurocognitive and immune development led two independent groups to evaluate RUTFs. Jones et al. (BMC Med 13:93, 2015), in a study in BMC Medicine, and Hsieh et al. (J Pediatr Gastroenterol Nu...

Imaging and Percutaneous Management of Acute Complicated Pancreatitis

International Nuclear Information System (INIS)

Shankar, Sridhar; Sonnenberg, Eric van; Silverman, Stuart G.; Tuncali, Kemal; Banks, Peter A.

2004-01-01

Acute pancreatitis varies from a mild, self-limited disease to one with significant morbidity and mortality in its most severe forms. While clinical criteria abound, imaging has become indispensable to diagnose the extent of the disease and its complications, as well as to guide and monitor therapy. Percutaneous interventional techniques offer options that can be life-saving, surgery-sparing or important adjuncts to operation. Close cooperation and communication between the surgeon, gastroenterologist and interventional radiologist enhance the likelihood of successful patient care

Radiation recall supraglottitis. A hazard in head and neck chemotherapy

International Nuclear Information System (INIS)

Wallenborn, P.A.; Postma, D.S.

1984-01-01

The enhanced effects of chemotherapy on previously irradiated tissue have been well demonstrated. When chemotherapy is given some time after irradiation and elicits a tissue reaction in the radiation field, the reaction is termed radiation recall. We review known interactions between chemotherapy and radiotherapy and report, to our knowledge, the first case of a supraglottitis radiation recall reaction. Familiarity with this phenomenon and potential complications of chemotherapy following head and neck irradiation may expedite early diagnosis and appropriate lifesaving treatment

[Water and sanitation in disaster situations.

DEFF Research Database (Denmark)

Jensen, Peter Kjær Mackie; Meyrowitsch, Dan Wolf; Konradsen, Flemming

2010-01-01

When implementing water and sanitation in a disaster situation, it is of crucial importance that the intervention is grounded in the local cultural and socioeconomic context. The assistance provided in the response phase should facilitate short and long-term recovery and sustainable development...... of the affected community. The new model for disaster management which comprises an integrated continuous risk reduction phase, calls for a cross-disciplinary approach which combines the known life-saving response methods with modern development practices. Udgivelsesdato: 2010-Jan...

Should Selecting Saviour Siblings be Banned?

OpenAIRE

Sheldon, Sally; Wilkinson, Stephen

2004-01-01

By using tissue typing in conjunction with preimplantation genetic diagnosis doctors are able to pick a human embryo for implantation which, if all goes well, will become a "saviour sibling", a brother or sister capable of donating life-saving tissue to an existing child. \\ud \\ud This paper addresses the question of whether this form of selection should be banned and concludes that it should not. Three main prohibitionist arguments are considered and found wanting: (a) the claim that saviour ...

Detection of nerve gases using surface-enhanced Raman scattering substrates with high droplet adhesion

DEFF Research Database (Denmark)

Hakonen, Aron; Rindzevicius, Tomas; Schmidt, Michael Stenbæk

2016-01-01

Threats from chemical warfare agents, commonly known as nerve gases, constitute a serious security issue of increasing global concern because of surging terrorist activity worldwide. However, nerve gases are difficult to detect using current analytical tools and outside dedicated laboratories. Here...... adhesion and nanopillar clustering due to elasto-capillary forces, resulting in enrichment of target molecules in plasmonic hot-spots with high Raman enhancement. The results may pave the way for strategic life-saving SERS detection of chemical warfare agents in the field....

Medical Advances in Diagnosing Neurological and Genetic Disorders

OpenAIRE

Simon B. N. Thompson

2016-01-01

Retinoblastoma is a rare type of childhood genetic cancer that affects children worldwide. The diagnosis is often missed due to lack of education and difficulty in presentation of the tumor. Frequently, the tumor on the retina is noticed by photography when the red-eye flash, commonly seen in normal eyes, is not produced. Instead, a yellow or white colored patch is seen or the child has a noticeable strabismus. Early detection can be life-saving though often results in removal of the affected...

Spontaneous Hemopericardium Leading to Cardiac Tamponade in a Patient with Essential Thrombocythemia

Directory of Open Access Journals (Sweden)

Anand Deshmukh

2011-01-01

thrombocythemia (ET has never been reported in the literature. We report a case of a 72-year-old Caucasian female who presented with spontaneous hemopericardium and tamponade requiring emergent pericardiocentesis. The patient was subsequently diagnosed to have ET. ET is characterized by elevated platelet counts that can lead to thrombosis but paradoxically it can also lead to a bleeding diathesis. Physicians should be aware of this complication so that timely life-saving measures can be taken if this complication arises.

Emergency percutaneous tracheostomy in a severely burned patient with upper airway obstruction and circulatory arrest.

Science.gov (United States)

Schlossmacher, Pascal; Martinet, Olivier; Testud, Richard; Agesilas, Fabrice; Benhamou, Léon; Gauzëre, Bernard Alex

2006-02-01

We report the life-saving use of Griggs percutaneous tracheostomy in an arrested patient with complex upper airway obstruction, as a result of burns, smoke injuries and iterative tracheal intubation attempts. The technique was performed blindly at bedside to treat an acute episode of failed ventilation and intubation and cardiac arrest in a patient with altered neck anatomy. The intervention salvaged the situation, leaving a definitive airway. The feasibility of using an emergency Griggs percutaneous tracheostomy versus cricothyroidotomy is suggested in selected cases.

Changing concepts of life-saving procedures in 19th century Polish popular first-aid publications.

Science.gov (United States)

Nieznanowska, Joanna

2006-12-01

Throughout Europe, before the era of health insurance, access to professional medical help in an emergency was limited, for the vast majority of people, especially for those living outside big cities. This did not improve in the nineteenth century, even though the number of physicians grew rapidly. The industrial revolution added a range of previously unknown threats and, with the dramatic rise in population, many more people could not afford medical help. Therefore, the need for popular, easy-to-understand instructions on first aid became urgent. In Poland, such publications were especially needed because of the country's political situation, which resulted in restricted access to university medical education. During the nineteenth century, approximately 50 works on first aid were published in Polish, with almost 90% addressed to non-physicians. Evaluation of the contents of these books and the instructions which they contained gives a good insight into the evolution that first aid concepts underwent in the nineteenth century. These range from changes in the most urgent threats (from epidemic disorders to industrial accidents and combat injuries) and the accelerating development of medical knowledge (especially the asepsis / antisepsis concept), to the changing spectrum of readers (with growing numbers of those who could read but were otherwise poorly educated).

Incompatible blood transfusion: Challenging yet lifesaving in the management of acute severe autoimmune hemolytic anemia

Directory of Open Access Journals (Sweden)

Sudipta Sekhar Das

2014-01-01

Full Text Available Background and Aim: Autoimmune hemolytic anemia (AIHA is characterized by the production of autoantibodies directed against red cell antigens. Most patients of AIHA arrive in the emergency or out-patient department (OPD with severe anemia requiring urgent blood transfusion. Here we share our experience of managing these patients with incompatible blood transfusions and suggest the minimal test required to assure patient safety. Materials and Methods: A total of 14 patients admitted with severe anemia, diagnosed with AIHA and requiring blood transfusion urgently were included in the study. A series of immunohematological investigations were performed to confirm the diagnosis and issue "best match" packed red blood cells (PRBC to these patients. Results: A total of 167 PRBC units were crossmatched for 14 patients of which 46 units (28% were found to be best match ones and 26 (56.5% of these units were transfused. A mean turn around time of 222 min was observed in issuing the ′best match′ blood. Severe hemolysis was observed in all patients with a median hemoglobin increment of 0.88 g/dl after each unit PRBC transfusion. Conclusion: Decision to transfuse in AIHA should be based on the clinical condition of the patient. No critical patient should be denied blood transfusion due to serological incompatibility. Minimum investigations such as direct antiglobulin test (DAT, antibody screening and autocontrol should be performed to ensure transfusion safety in patients. All transfusion services should be capable of issuing "best match" PRBCs in AIHA.

Incompatible blood transfusion: Challenging yet lifesaving in the management of acute severe autoimmune hemolytic anemia.

Science.gov (United States)

Das, Sudipta Sekhar; Zaman, Rafiq Uz; Safi, Mohammad

2014-07-01

Autoimmune hemolytic anemia (AIHA) is characterized by the production of autoantibodies directed against red cell antigens. Most patients of AIHA arrive in the emergency or out-patient department (OPD) with severe anemia requiring urgent blood transfusion. Here we share our experience of managing these patients with incompatible blood transfusions and suggest the minimal test required to assure patient safety. A total of 14 patients admitted with severe anemia, diagnosed with AIHA and requiring blood transfusion urgently were included in the study. A series of immunohematological investigations were performed to confirm the diagnosis and issue best match packed red blood cells (PRBC) to these patients. A total of 167 PRBC units were crossmatched for 14 patients of which 46 units (28%) were found to be best match ones and 26 (56.5%) of these units were transfused. A mean turn around time of 222 min was observed in issuing the "best match" blood. Severe hemolysis was observed in all patients with a median hemoglobin increment of 0.88 g/dl after each unit PRBC transfusion. Decision to transfuse in AIHA should be based on the clinical condition of the patient. No critical patient should be denied blood transfusion due to serological incompatibility. Minimum investigations such as direct antiglobulin test (DAT), antibody screening and autocontrol should be performed to ensure transfusion safety in patients. All transfusion services should be capable of issuing "best match" PRBCs in AIHA.

Additive Manufacturing for Robust and Affordable Medical Devices

OpenAIRE

Wolozny Gomez Robelo, Daniel Andre

2016-01-01

Additive manufacturing in the form of 3D printing is a revolutionary technology that has developed within the last two decades. Its ability to print an object with accurate features down to the micro scale have made its use in medical devices and research feasible. A range of life-saving technologies can now go from the laboratory and into field with the application of 3D-printing. This technology can be applied to medical diagnosis of patients in at-risk populations. Living biosensors a...

Embolization of a Hemorrhoid Following 18 Hours of Life-Threatening Bleeding

International Nuclear Information System (INIS)

Berczi, Viktor; Gopalan, Deepa; Cleveland, Trevor J

2008-01-01

Hemorrhoids usually do not pose diagnostic difficulties and they rarely cause massive bleeding. We report a case of massive rectal bleeding over 18 h needing 22 U blood transfusion treated by superselective transcatheter coil embolization 12 h following operative treatment performed in a different hospital. Diagnostic angiography with a view to superselective embolization, following failure of sigmoidoscopy to localize and treat the cause of hemorrhage, might act as a life-saving treatment in massive rectal bleeding, obviating the need for repeated endoscopy or emergency surgery

Purpura fulminans

DEFF Research Database (Denmark)

Jordan, Karina; Kristensen, Kim

2010-01-01

Varicella-associated purpura fulminans (PF) is a rare complication to varicella infection. The condition is due to autoantibodies directed against protein S which forms part of the anticoagulation system. Lack of protein S leads to disseminated intravascular coagulation in the small vessels, whic...... causes thrombosis and ischemia. Despite early treatment, amputation and skin-grafting is often necessary. In this case story, we give a brief review of the pathogenesis and possible modes of treatment. Knowledge of PF is necessary since early treatment may be life-saving....

Aggressive cutaneous zygomycosis caused by Apophysomyces variabilis in an immunocompetent child

Directory of Open Access Journals (Sweden)

Ibrahim A. Al-Zaydani

2015-12-01

Full Text Available A zygomycetous fungus was observed in a biopsy of a 9-year-old male. The patient was presented with severe cutaneous lesions subsequent to a traumatic car accident. Following fungal detection, antifungal treatment was prescribed but condition deteriorated rapidly and above knee amputation was done as lifesaving and to control fungal infection. Analysis of the 28 S rRNA gene (accession KT149770 aligned the isolate with members of the genus Apophysomyces and the pathogen was identified as Apophysomces variabilis.

Personal Flotation Devices Research. Volume 2. Research Report.

Science.gov (United States)

1978-01-01

approval if it was not designed to the Type I, I , I , or IV criteria. This approach allows high life-saving effectiveness devices to enter the market if...Type X devices enjoy a market reception on the order of the reception given to Type III (the costs for Type Xs and Type Ills would be similar), an...addition to attempts to document the rate of wear of PFDs , previous researc h has measured various design features of PFDs and boater ’s attitudes . The

Targeted mass spectrometry analysis of neutrophil-derived proteins released during sepsis progression

DEFF Research Database (Denmark)

Malmström, E; Davidova, A; Mörgelin, M

2014-01-01

systemic stimulation an immediate increase of neutrophil-borne proteins can be observed into the circulation of sepsis patients. We applied a combination of mass spectrometry (MS) based approaches, LC-MS/MS and selected reaction monitoring (SRM), to characterise and quantify the neutrophil proteome......Early diagnosis of severe infectious diseases is essential for timely implementation of lifesaving therapies. In a search for novel biomarkers in sepsis diagnosis we focused on polymorphonuclear neutrophils (PMNs). Notably, PMNs have their protein cargo readily stored in granules and following...

Vasoplegic syndrome during Whipple procedure.

Science.gov (United States)

Anandaswamy, Tejesh C; Rajappa, Geetha C; Krishnamachar, Harish

2017-02-01

Vasoplegic syndrome is an unusual cause of refractory hypotension under general anesthesia. It is commonly described in the setting of cardiac surgery, but rarely seen in noncardiac setting. We describe successful management of vasoplegic syndrome during Whipple procedure with vasopressin infusion. A high index of suspicion and prompt treatment with vasopressin can be lifesaving in patients with risk factors for vasoplegic syndrome who present with severe refractory hypotension and who respond poorly to fluid administration and routine vasopressor infusion. Copyright © 2016 Elsevier Inc. All rights reserved.

Crural Amputation of a Newborn as a Consequence of Intraosseous Needle Insertion and Calcium Infusion

DEFF Research Database (Denmark)

Oesterlie, Gorm Erlend; Petersen, Klaus Kjaer; Knudsen, Lars

2014-01-01

Intraosseous needle insertion and infusion is considered an easy and reliable method of achieving a vascular access in acute circulatory collapse where other methods have not been successful within reasonable time. Complications are considered few but may be serious. We present a case of a newborn...... girl, where intraosseous cannulation of the tibia was lifesaving. Despite following most standard recommendations, the treatment resulted in transtibial amputation due to necrosis. We suspect that the necrosis was a consequence of extravasation of tissue-toxic calcium infusion....

From global framing to local action : translation of climate change impacts in Africa

Energy Technology Data Exchange (ETDEWEB)

Ogunseitan, O.A. [Harvard Univ., Cambridge, MA (United States)

2000-06-01

There is considerable controversy regarding policy and climate change mitigation in Africa. Its resolution will require integrating local knowledge and values into climate impact assessments. Africa's vulnerability to climate change can be traced to the frequency of socio-ecological devastation that comes from major climate variations on the continent. The incidence of famines, homelessness and disease epidemics that require international assistance are reflections of weak policies and institution action frames used to cope with climate and weather related emergencies. However, the valuation of climate change impacts has a subjective dimension that can be gained only through indigenous experience and an understanding of values associated with life-saving intervention programs. A recent study showed that discount rates applied to future life-saving programs by Africans are very different from the rates applied in developed countries, and that the difference should be reflected in national development programs and transnational initiatives for capacity building. The study suggests that if the boundary institutions responsible for public health security have not been too effective in resolving the policy controversy surrounding Africa's participation in climate change assessments, it is due partly to the limitations imposed by cross-scale issues in framing. It was concluded that efforts to reduce Africa's dependence on global emergency health response systems will necessitate the development of autonomous capacity to adapt to natural disasters. Appropriate frame reflection is needed at the local level. 56 refs., 3 tabs., 1 fig.

Preparing for Emergency

DEFF Research Database (Denmark)

Melchiors, Jacob; Todsen, Tobias; Nilsson, Philip

2015-01-01

OBJECTIVE: Emergency cricothyrodotomy (EC) is a lifesaving procedure. Evidence-based assessment of training effects and competency levels is relevant to all departments involved in emergency airway management. As most training uses low-fidelity models, the predictive value of good performance....... Sixteen physicians (7 experienced surgeons and 9 novice physicians) performed an EC on a low-fidelity model and a cadaver. Two blinded raters assessed video recordings of performances using the assessment tool. RESULTS: We found a high interrater reliability, based on a Pearson's r (0.81), and good...

Polyacrylamide Gel Treatment of Antiretroviral Therapy-induced Facial Lipoatrophy in HIV Patients

DEFF Research Database (Denmark)

Mansor, Samreen; Breiting, Vibeke Bro; Dahlstrøm, Karin

2011-01-01

BACKGROUND: Today, highly active antiretroviral therapy is lifesaving for most HIV-infected patients, but the treatment can result in facial lipoatrophy, which changes the face so radically that patients may develop severe psychological and social problems. Since 2001 polyacrylamide gel (PAAG) has......) with a 14-day interval. Patient satisfaction, injector's evaluation, evaluation by an external specialist in plastic surgery, and long-term aesthetic effect and complications were registered with follow-up until 2 years. RESULTS: All patients were very satisfied or satisfied with the result. The injector...

Trust in Vaccines: Why It Takes More than Good Faith.

Science.gov (United States)

Begg, Norman

2013-08-12

This Vaccines issue on "Confidence in Vaccines" provides sound evidence through multiple perspectives of life-saving impacts when vaccination programs are effectively implemented in a population. Yet there remain challenges to achieving this impact, including scientific, medical, manufacturing, policy-related and logistical issues. Additionally, socio-cultural, religious and political agendas can come into play, taking public health hostage and sometimes allowing the circulation of myths regarding vaccination. All of these challenges play a role in public confidence in vaccines and vaccination. What we trust, we embrace. What we do not trust, we do not embrace.

The U.S. Food and Drug Administration should solidify the legal basis for its authority over reproductive cloning.

Science.gov (United States)

Siegel, Bernard; Friede, Arnold I

2013-12-01

The promise and potential of stem cell research is apparent. However, ethical questions still linger. There is as yet no consensus in the U.S. Congress on how to address the issue of reproductive cloning and media confusion of this and the quite separate issue of therapeutic cloning inhibits therapeutic advance. This paper outlines the need for the FDA to undertake a deliberate process, with input from all stakeholders, to authoritatively establish its jurisdiction over human reproductive cloning so as to foster the life-saving potential of therapeutic cloning.

The Future of HIV Treatment

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Hirsch, Martin S.; Kuritzkes, Daniel R.

2012-01-01

Antiretroviral therapy has transformed the management of HIV-infected individuals over the past quarter century. However, important challenges remain. These include attempts to eradicate HIV from reservoirs within the body, thereby eliminating the need for lifetime therapy. In addition, improvements in drug development, clinical trial, and regulatory pathways are necessary to expeditiously evaluate novel therapeutic regimens and strategies. Antiretroviral drug scarcity remains a major problem in underserved populations worldwide, and partnerships among pharmaceutical companies, academic investigators, and both governmental and nongovernmental agencies are necessary to improve access to these lifesaving regimens. PMID:22772389

Medical Care of the Homeless: An American and International Issue.

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Fleisch, Sheryl B; Nash, Robertson

2017-03-01

Homeless persons die significantly younger than their housed counterparts. In many cases, relatively straightforward primary care issues escalate into life-threatening, expensive emergencies. Poor health outcomes driven by negative interactions between comorbid symptoms meet the definition of a health syndemic in this population. Successful primary care of patients struggling with homelessness may result in long-term lifesaving measures along with decreased expenditure to hospital systems. This primary prevention requires patience, creativity, and acknowledgment that the source of many confounders may lay outside the control of these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Management of Mechanical Ventilation in Decompensated Heart Failure

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Brooks T. Kuhn

2016-12-01

Full Text Available Mechanical ventilation (MV is a life-saving intervention for respiratory failure, including decompensated congestive heart failure. MV can reduce ventricular preload and afterload, decrease extra-vascular lung water, and decrease the work of breathing in heart failure. The advantages of positive pressure ventilation must be balanced with potential harm from MV: volutrauma, hyperoxia-induced injury, and difficulty assessing readiness for liberation. In this review, we will focus on cardiac, pulmonary, and broader effects of MV on patients with decompensated HF, focusing on practical considerations for management and supporting evidence.

A Rare Cause of Right-Sided Air Bubble on Chest Radiograph: Intrathoracic Gastric Volvulus Related to Morgagni Hernia

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Abdurrahman Sahin

2017-03-01

Full Text Available Morgagni hernia is a rare disorder in adulthood, and most of the cases are asymptomatic. Symptomatic cases are extremely rare and present with life-threatening complications. Early diagnosis and surgery are lifesaving. We hereby present an adult case of symptomatic Morgagni hernia. Diaphragmatic herniation of the stomach and mesenteroaxial rotation led to intrathoracic gastric volvulus in this case. A right-sided air bubble on a chest radiogram was the only finding leading to the suspicion of diaphragmatic hernia. Computed tomography in the diagnosis of diaphragmatic hernias is of great importance.

Temperature measurement systems in wearable electronics

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Walczak, S.; Gołebiowski, J.

2014-08-01

The aim of this paper is to present the concept of temperature measurement system, adapted to wearable electronics applications. Temperature is one of the most commonly monitored factor in smart textiles, especially in sportswear, medical and rescue products. Depending on the application, measured temperature could be used as an initial value of alert, heating, lifesaving or analysis system. The concept of the temperature measurement multi-point system, which consists of flexible screen-printed resistive sensors, placed on the T-shirt connected with the central unit and the power supply is elaborated in the paper.

Parental refusal of life-saving treatments for adolescents: Chinese familism in medical decision-making re-visited.

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Hui, Edwin

2008-06-01

This paper reports two cases in Hong Kong involving two native Chinese adolescent cancer patients (APs) who were denied their rights to consent to necessary treatments refused by their parents, resulting in serious harm. We argue that the dynamics of the 'AP-physician-family-relationship' and the dominant role Chinese families play in medical decision-making (MDM) are best understood in terms of the tendency to hierarchy and parental authoritarianism in traditional Confucianism. This ethic has been confirmed and endorsed by various Chinese writers from Mainland China and Hong Kong. Rather than giving an unqualified endorsement to this ethic, based more on cultural sentimentalism than rational moral reasoning, we warn that a strong familism in MDM, which deprives 'weak' family members of rights, represents the less desirable elements of this tradition, against which healthcare professionals working in this cultural milieu need to safeguard. Specifically for APs, we suggest that parental authority and family integrity should be re-interpreted in terms of parental responsibility and the enhancement of children's interests respectively, as done in the West. This implies that when parents refuse to consent to necessary treatment and deny their adolescent children's right to consent, doctors, as the only remaining advocates of the APs' interest, have the duty to inform the state, which can override parental refusal to enable the doctors to fulfill their professional and moral obligations. In so doing the state exercises its 'parens patriae' power to defend the defenseless in society and the integrity of the medical profession.

Treating tobacco dependence: guidance for primary care on life-saving interventions. Position statement of the IPCRG.

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Van Schayck, O C P; Williams, S; Barchilon, V; Baxter, N; Jawad, M; Katsaounou, P A; Kirenga, B J; Panaitescu, C; Tsiligianni, I G; Zwar, N; Ostrem, A

2017-06-09

Tobacco smoking is the world's leading cause of premature death and disability. Global targets to reduce premature deaths by 25% by 2025 will require a substantial increase in the number of smokers making a quit attempt, and a significant improvement in the success rates of those attempts in low, middle and high income countries. In many countries the only place where the majority of smokers can access support to quit is primary care. There is strong evidence of cost-effective interventions in primary care yet many opportunities to put these into practice are missed. This paper revises the approach proposed by the International Primary Care Respiratory Group published in 2008 in this journal to reflect important new evidence and the global variation in primary-care experience and knowledge of smoking cessation. Specific for primary care, that advocates for a holistic, bio-psycho-social approach to most problems, the starting point is to approach tobacco dependence as an eminently treatable condition. We offer a hierarchy of interventions depending on time and available resources. We present an equitable approach to behavioural and drug interventions. This includes an update to the evidence on behaviour change, gender difference, comparative information on numbers needed to treat, drug safety and availability of drugs, including the relatively cheap drug cytisine, and a summary of new approaches such as harm reduction. This paper also extends the guidance on special populations such as people with long-term conditions including tuberculosis, human immunodeficiency virus, cardiovascular disease and respiratory disease, pregnant women, children and adolescents, and people with serious mental illness. We use expert clinical opinion where the research evidence is insufficient or inconclusive. The paper describes trends in the use of waterpipes and cannabis smoking and offers guidance to primary-care clinicians on what to do faced with uncertain evidence. Throughout, it recognises that clinical decisions should be tailored to the individual's circumstances and attitudes and be influenced by the availability and affordability of drugs and specialist services. Finally it argues that the role of the International Primary Care Respiratory Group is to improve the confidence as well as the competence of primary care and, therefore, makes recommendations about clinical education and evaluation. We also advocate for an update to the WHO Model List of Essential Medicines to optimise each primary-care intervention. This International Primary Care Respiratory Group statement has been endorsed by the Member Organisations of World Organization of Family Doctors Europe.

Psychosocial factors influencing parental decision to allow or refuse potentially lifesaving enucleation in children with retinoblastoma

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Rolando Enrique D. Domingo

2017-01-01

Full Text Available Objective: Retinoblastoma is the most common malignancy of the eye and ocular adnexa in the Philippines. It is curable when treated early, but delay in enucleation is common due to the parental refusal of surgery for varied reasons. The aim of this study is to identify the psychosocial barriers and facilitating factors for accepting versus refusing enucleation as treatment for retinoblastoma. Methods: This is a cross-sectional descriptive study utilizing structured interviews and a questionnaire. It was conducted at the Retinoblastoma Clinic of the Philippine General Hospital. A questionnaire using the Likert scale was constructed after performing key informant interviews and focus group discussions. It was pretested and revised before parents of patients with retinoblastoma were invited to participate in the study. Descriptive statistics, quantitative item analyses using inter-item correlations and item-total correlations was performed. Results: Factors that correlate with refusal to enucleate are the beliefs that cancer is a fatal illness, the fear of unacceptable esthetic outcome of the surgery, and the cost of treatment. Favorable factors include value of life, high regard for the opinion of medical practitioners, and appreciation of the efficacy of treatment. Conclusions: There are several favorable factors and barriers that health practitioners must consider in facilitating parental decision-making toward enucleation for retinoblastoma.

Value of multislice computed tomography angiography of the thorax in preparation for catheter ablation for the treatment of atrial fibrillation: The impact of unexpected cardiac and extracardiac findings on patient care

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Wissner, Erik; Wellnitz, Clinton V.; Srivathsan, Komandoor; Scott, Luis R. [Mayo Clinic Arizona - Mayo Clinic Hospital, Cardiovascular Diseases, 5777 East Mayo Boulevard, Phoenix, AZ 85054 (United States); Altemose, Gregory T. [Mayo Clinic Arizona - Mayo Clinic Hospital, Cardiovascular Diseases, 5777 East Mayo Boulevard, Phoenix, AZ 85054 (United States)], E-mail: altemose.gregory@mayo.edu

2009-11-15

Objective: In patients referred for catheter ablation for the treatment of atrial fibrillation, multislice computed tomography angiography of the thorax is routinely performed to assess pulmonary vein anatomy. We sought to investigate the incidence of unexpected cardiac and extracardiac findings in this select patient population and to establish how these findings influence subsequent patient care. Methods: Ninety-five patients (mean age 62 {+-} 10 years, 35% female) referred to our institution for ablation therapy for atrial fibrillation between July 2003 and October 2007 underwent multislice computed tomography angiography of the thorax. Radiologists interpreted all images. Need for additional testing, consultation and eventual diagnosis were assessed by electronic record review. Results: A total of 83 (5 cardiac, 78 extracardiac) unexpected findings were observed in 50/95 (53%) of patients. The findings prompted 23 additional tests (5 cardiac, 18 noncardiac) in 15/95 (16%) of patients and 8 subsequent referrals in 7/95 (7%) patients. In 6 patients the findings significantly altered future patient care and resulted in postponement of ablation therapy in 4 patients. In 2 patients, extracardiac findings (pulmonary emboli and adenocarcinoma of the lung) were of potentially life-saving consequence. Conclusions: In patients undergoing multislice computed tomography angiography of the thorax in anticipation of planned catheter ablation therapy for the treatment of atrial fibrillation, unexpected findings are common and of potentially significant value. In comparison, there is a higher prevalence of unexpected extracardiac, rather than cardiac findings. Further investigation of these findings may lead to postponement of ablation therapy, but may also be of potentially lifesaving consequence.

Value of multislice computed tomography angiography of the thorax in preparation for catheter ablation for the treatment of atrial fibrillation: The impact of unexpected cardiac and extracardiac findings on patient care

International Nuclear Information System (INIS)

Wissner, Erik; Wellnitz, Clinton V.; Srivathsan, Komandoor; Scott, Luis R.; Altemose, Gregory T.

2009-01-01

Objective: In patients referred for catheter ablation for the treatment of atrial fibrillation, multislice computed tomography angiography of the thorax is routinely performed to assess pulmonary vein anatomy. We sought to investigate the incidence of unexpected cardiac and extracardiac findings in this select patient population and to establish how these findings influence subsequent patient care. Methods: Ninety-five patients (mean age 62 ± 10 years, 35% female) referred to our institution for ablation therapy for atrial fibrillation between July 2003 and October 2007 underwent multislice computed tomography angiography of the thorax. Radiologists interpreted all images. Need for additional testing, consultation and eventual diagnosis were assessed by electronic record review. Results: A total of 83 (5 cardiac, 78 extracardiac) unexpected findings were observed in 50/95 (53%) of patients. The findings prompted 23 additional tests (5 cardiac, 18 noncardiac) in 15/95 (16%) of patients and 8 subsequent referrals in 7/95 (7%) patients. In 6 patients the findings significantly altered future patient care and resulted in postponement of ablation therapy in 4 patients. In 2 patients, extracardiac findings (pulmonary emboli and adenocarcinoma of the lung) were of potentially life-saving consequence. Conclusions: In patients undergoing multislice computed tomography angiography of the thorax in anticipation of planned catheter ablation therapy for the treatment of atrial fibrillation, unexpected findings are common and of potentially significant value. In comparison, there is a higher prevalence of unexpected extracardiac, rather than cardiac findings. Further investigation of these findings may lead to postponement of ablation therapy, but may also be of potentially lifesaving consequence.

Health system barriers to access and use of magnesium sulfate for women with severe pre-eclampsia and eclampsia in Pakistan: evidence for policy and practice.

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Maryam Bigdeli

Full Text Available Severe pre-eclampsia and eclampsia are rare but serious complications of pregnancy that threaten the lives of mothers during childbirth. Evidence supports the use of magnesium sulfate (MgSO4 as the first line treatment option for severe pre-eclampsia and eclampsia. Eclampsia is the third major cause of maternal mortality in Pakistan. As in many other Low- and Middle-Income Countries (LMIC, it is suspected that MgSO4 is critically under-utilized in the country. There is however a lack of information on context-specific health system barriers that prevent optimal use of this life-saving medicine in Pakistan. Combining quantitative and qualitative methods, namely policy document review, key informant interviews, focus group discussions and direct observation at health facility, we explored context-specific health system barriers and enablers that affect access and use of MgSO4 for severe pre-eclampsia and eclampsia in Pakistan. Our study finds that while international recommendations on MgSO4 have been adequately translated in national policies in Pakistan, the gap remains in implementation of national policies into practice. Barriers to access to and effective use of MgSO4 occur at health facility level where the medicine was not available and health staff was reluctant to use it. Low price of the medicine and the small market related to its narrow indications acted as disincentives for effective marketing. Results of our survey were further discussed in a multi-stakeholder round-table meeting and an action plan for increasing access to this life-saving medicine was identified.

Health system barriers to access and use of magnesium sulfate for women with severe pre-eclampsia and eclampsia in Pakistan: evidence for policy and practice.

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Bigdeli, Maryam; Zafar, Shamsa; Assad, Hafeez; Ghaffar, Adbul

2013-01-01

Severe pre-eclampsia and eclampsia are rare but serious complications of pregnancy that threaten the lives of mothers during childbirth. Evidence supports the use of magnesium sulfate (MgSO4) as the first line treatment option for severe pre-eclampsia and eclampsia. Eclampsia is the third major cause of maternal mortality in Pakistan. As in many other Low- and Middle-Income Countries (LMIC), it is suspected that MgSO4 is critically under-utilized in the country. There is however a lack of information on context-specific health system barriers that prevent optimal use of this life-saving medicine in Pakistan. Combining quantitative and qualitative methods, namely policy document review, key informant interviews, focus group discussions and direct observation at health facility, we explored context-specific health system barriers and enablers that affect access and use of MgSO4 for severe pre-eclampsia and eclampsia in Pakistan. Our study finds that while international recommendations on MgSO4 have been adequately translated in national policies in Pakistan, the gap remains in implementation of national policies into practice. Barriers to access to and effective use of MgSO4 occur at health facility level where the medicine was not available and health staff was reluctant to use it. Low price of the medicine and the small market related to its narrow indications acted as disincentives for effective marketing. Results of our survey were further discussed in a multi-stakeholder round-table meeting and an action plan for increasing access to this life-saving medicine was identified.

Infants born preterm, stress, and neurodevelopment in the neonatal intensive care unit: might music have an impact?

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Anderson, Dane E; Patel, Aniruddh D

2018-03-01

The neonatal intensive care unit (NICU) provides life-saving medical care for an increasing number of newborn infants each year. NICU care, while lifesaving, does have attendant consequences which can include repeated activation of the stress response and reduced maternal interaction, with possible negative long-term impacts on brain development. Here we present a neuroscientific framework for considering the impact of music on neurodevelopment in the NICU of infants born preterm and evaluate current literature on the use of music with this population to determine what is most reliably known of the physiological effects of music interventions. Using online academic databases we collected relevant, experimental studies aimed at determining effects of music listening in infants in the NICU. These articles were evaluated for methodological rigor, ranking the 10 most experimentally stringent as a representative sample. The selected literature seems to indicate that effects are present on the cardio-pulmonary system and behavior of neonates, although the relative effect size remains unclear. These findings indicate a need for more standardized longitudinal studies aimed at determining not only whether NICU music exposure has beneficial effects on the cardio-pulmonary system, but also on the hypothalamic-pituitary-adrenal axis, brain structures, and cognitive behavioral status of these children as well. Provides a neuroscience framework for considering how music might attenuate stress in neonatal intensive care unit (NICU) infants. Considers how repeated stress may cause negative neurodevelopmental impacts in infants born preterm. Posits epigenetics can serve as a mechanistic pathway for music moderating the stress response. © 2018 Mac Keith Press.

The rule of rescue.

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McKie, John; Richardson, Jeff

2003-06-01

Jonsen coined the term "Rule of Rescue"(RR) to describe the imperative people feel to rescue identifiable individuals facing avoidable death. In this paper we attempt to draw a more detailed picture of the RR, identifying its conflict with cost-effectiveness analysis, the preference it entails for identifiable over statistical lives, the shock-horror response it elicits, the preference it entails for lifesaving over non-lifesaving measures, its extension to non-life-threatening conditions, and whether it is motivated by duty or sympathy. We also consider the measurement problems it raises, and argue that quantifying the RR would probably require a two-stage procedure. In the first stage the size of the individual utility gain from a health intervention would be assessed using a technique such as the Standard Gamble or the Time Trade-Off, and in the second the social benefits arising from the RR would be quantified employing the Person Trade-Off. We also consider the normative status of the RR. We argue that it can be defended from a utilitarian point of view, on the ground that rescues increase well-being by reinforcing people's belief that they live in a community that places great value upon life. However, utilitarianism has long been criticised for failing to take sufficient account of fairness, and the case is no different here: fairness requires that we do not discriminate between individuals on morally irrelevant grounds, whereas being "identifiable" does not seem to be a morally relevant ground for discrimination.

Neurotrauma and the rule of rescue.

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Honeybul, S; Gillett, G R; Ho, K M; Lind, C R P

2011-12-01

The rule of rescue describes the powerful human proclivity to rescue identified endangered lives, regardless of cost or risk. Deciding whether or not to perform a decompressive craniectomy as a life-saving or 'rescue' procedure for a young person with a severe traumatic brain injury provides a good example of the ethical tensions that occur in these situations. Unfortunately, there comes a point when the primary brain injury is so severe that if the patient survives they are likely to remain severely disabled and fully dependent. The health resource implications of this outcome are significant. By using a web-based outcome prediction model this study compares the long-term outcome and designation of two groups of patients. One group had a very severe injury as adjudged by the model and the other group a less severe injury. At 18 month follow-up there were significant differences in outcome and healthcare requirements. This raises important ethical issues when considering life-saving but non-restorative surgical intervention. The discussion about realistic outcome cannot be dichotomised into simply life or death so that the outcome for the patient must enter the equation. As in other 'rescue situations', the utility of the procedure cannot be rationalised on a mere cost-benefit analysis. A compromise has to be reached to determine at what point either the likely outcome would be unacceptable to the person on whom the procedure is being performed or the social utility gained from the rule of rescue intervention fails to justify the utilitarian value and justice of equitable resource allocation.

Mechanisms of Memory Dysfunction during High Altitude Hypoxia Training in Military Aircrew.

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Nation, Daniel A; Bondi, Mark W; Gayles, Ellis; Delis, Dean C

2017-01-01

Cognitive dysfunction from high altitude exposure is a major cause of civilian and military air disasters. Pilot training improves recognition of the early symptoms of altitude exposure so that countermeasures may be taken before loss of consciousness. Little is known regarding the nature of cognitive impairments manifesting within this critical window when life-saving measures may still be taken. Prior studies evaluating cognition during high altitude simulation have predominantly focused on measures of reaction time and other basic attention or motor processes. Memory encoding, retention, and retrieval represent critical cognitive functions that may be vulnerable to acute hypoxic/ischemic events and could play a major role in survival of air emergencies, yet these processes have not been studied in the context of high altitude simulation training. In a series of experiments, military aircrew underwent neuropsychological testing before, during, and after brief (15 min) exposure to high altitude simulation (20,000 ft) in a pressure-controlled chamber. Acute exposure to high altitude simulation caused rapid impairment in learning and memory with relative preservation of basic visual and auditory attention. Memory dysfunction was predominantly characterized by deficiencies in memory encoding, as memory for information learned during high altitude exposure did not improve after washout at sea level. Retrieval and retention of memories learned shortly before altitude exposure were also impaired, suggesting further impairment in memory retention. Deficits in memory encoding and retention are rapidly induced upon exposure to high altitude, an effect that could impact life-saving situational awareness and response. (JINS, 2017, 23, 1-10).

The Emergency Department: Challenges and Opportunities for Suicide Prevention.

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Asarnow, Joan Rosenbaum; Babeva, Kalina; Horstmann, Elizabeth

2017-10-01

Emergency departments (EDs) can offer life-saving suicide prevention care. This article focuses on the ED and emergency services as service delivery sites for suicide prevention. Characteristics of EDs, models of emergency care, ED screening and brief intervention models, and practice guidelines and parameters are reviewed. A care process model for youths at risk for suicide and self-harm is presented, with guidance for clinicians based on the scientific evidence. Strengthening emergency infrastructure and integrating effective suicide prevention strategies derived from scientific research are critical for advancing suicide prevention objectives. Copyright © 2017 Elsevier Inc. All rights reserved.

Optical Coherence Tomography (OCT for Time-Resolved Imaging of Alveolar Dynamics in Mechanically Ventilated Rats

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Christian Schnabel

2017-03-01

Full Text Available Though artificial ventilation is an essential life-saving treatment, the mechanical behavior of lung tissue at the alveolar level is still unknown. Therefore, we need to understand the tissue response during artificial ventilation at this microscale in order to develop new and more protective ventilation methods. Optical coherence tomography (OCT combined with intravital microscopy (IVM is a promising tool for visualizing lung tissue dynamics with a high spatial and temporal resolution in uninterruptedly ventilated rats. We present a measurement setup using a custom-made animal ventilator and a gating technique for data acquisition of time-resolved sequences.

Unusual Clinical Presentation and Role of Decompressive Craniectomy in Herpes Simplex Encephalitis.

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Singhi, Pratibha; Saini, Arushi Gahlot; Sahu, Jitendra Kumar; Kumar, Nuthan; Vyas, Sameer; Vasishta, Rakesh Kumar; Aggarwal, Ashish

2015-08-01

Decompressive craniectomy in pediatric central nervous infections with refractory intracranial hypertension is less commonly practiced. We describe improved outcome of decompressive craniectomy in a 7-year-old boy with severe herpes simplex encephalitis and medically refractory intracranial hypertension, along with a brief review of the literature. Timely recognition of refractory intracranial hypertension and surgical decompression in children with herpes simplex encephalitis can be life-saving. Additionally, strokelike atypical presentations are being increasingly recognized in children with herpes simplex encephalitis and should not take one away from the underlying herpes simplex encephalitis. © The Author(s) 2014.

Medical students educate teens about skin cancer: what have we learned?

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Kamell, Jeanette M; Rietkerk, William; Lam, Ken; Phillips, Jason M; Wu, Jashin J; McCullough, Jerry L; Linden, Kenneth G; Osann, Kathryn

2011-03-01

Skin cancer is a serious societal problem, and public awareness outreach, including to youth, is crucial. Medical students have joined forces to educate adolescents about skin cancer with significant impacts; even one 50-min interactive outreach session led to sustained changes in knowledge and behavior in a cohort of 1,200 adolescents surveyed. Medical students can act as a tremendous asset to health awareness public outreach efforts: enthusiastic volunteerism keeps education cost-effective, results in exponential spread of information, reinforces knowledge and communication skills of future physicians, and can result in tangible, life-saving benefits such as early detection of melanoma.

Role of imaging in the management of neuro-ophthalmic disorders

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Gandhi Rashmin

2011-01-01

Full Text Available Advancements in physics, computers, and imaging science in the last century have seen neuro-imaging evolving from a plain X-ray to computed tomography, magnetic resonance imaging scans, noninvasive angiography, and special sequences such as fat suppression, fluid attenuation recovery and diffusion-weighted imaging. A prompt prescription of an appropriate imaging modality and the most suitable sequence can increase the diagnostic yield, and in many instances, it can be a sight-saving and even a life-saving decision. This article discusses basic principles of neuro-imaging, its common indications, and the appropriate application in an ophthalmology practice.

Corruption in emergency procurement.

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Schultz, Jessica; Søreide, Tina

2008-12-01

Corruption in emergency procurement reduces the resources available for life-saving operations, lowers the quality of products and services provided, and diverts aid from those who need it most.(1) It also negatively influences public support for humanitarian relief, both in the affected country and abroad. This paper aims to unpack and analyse the following question in order to mitigate risk: how and where does corruption typically occur, and what can be done? Suggested strategies reflect a multi-layered approach that stresses internal agency control mechanisms, conflict-sensitive management, and the need for common systems among operators.

The Economics of Reproducibility in Preclinical Research.

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Leonard P Freedman

2015-06-01

Full Text Available Low reproducibility rates within life science research undermine cumulative knowledge production and contribute to both delays and costs of therapeutic drug development. An analysis of past studies indicates that the cumulative (total prevalence of irreproducible preclinical research exceeds 50%, resulting in approximately US$28,000,000,000 (US$28B/year spent on preclinical research that is not reproducible-in the United States alone. We outline a framework for solutions and a plan for long-term improvements in reproducibility rates that will help to accelerate the discovery of life-saving therapies and cures.

Oxygenator in short-term LVAD circuit: a rescue in post-LVAD pulmonary complications.

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Mohite, Prashant N; Patil, Nikhil P; Popov, Aron-Frederik; Bahrami, Toufan; Simon, Andre R

2016-10-01

Pulmonary complications after left ventricular assist device (LVAD) implantation, though infrequent, can be potentially catastrophic. A 62-year-old female with cardiogenic shock, supported on short-term LVAD, developed pulmonary oedema. An oxygenator was introduced into the LVAD circuit, which improved the gas exchange and, eventually, after weaning off the oxygenator, the patient received long-term LVAD. The introduction of an oxygenator into the short-term LAVD circuit is a lifesaving manoeuvre in such a situation. It offers freedom of introducing and removing the oxygenator into the LVAD circuit without opening the chest and competing for LVAD flow. © The Author(s) 2016.

Go ahead and fire me!: the top three things generation Y does not like about working @ your medical practice.

Science.gov (United States)

Johnson, Meagan

2014-01-01

The face of healthcare is changing. Generation Y is the 70 million people that will not only be assisting with the transformation of healthcare, but leading the charge when it comes to medical equipment innovations, life-saving drugs, and quality patient care. The pressure will be focused on medical facilities to not only hire the brightest Gen Yers but also to engage them, keep them motivated, and keep them enthusiastic about their jobs. Here are the top three things Generation Y does not like about working in your medical facility and what you can do about them!

Self expandable polytetrafluoroethylene stent for carotid blowout syndrome.

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Tatar, E C; Yildirim, U M; Dündar, Y; Ozdek, A; Işik, E; Korkmaz, H

2012-01-01

Carotid blowout syndrome (CBS) is an emergency complication in patients undergoing treatment for head and neck cancers. The classical management of CBS is the ligation of the common carotid artery, because suturing is not be possible due to infection and necrosis of the field. In this case report, we present a patient with CBS, in whom we applied a self-expandable polytetrafluoroethylene (PTFE) stent and observed no morbidity. Endovascular stent is a life-saving technique with minimum morbidity that preserves blood flow to the brain. We believe that this method is preferable to ligation of the artery in CBS.

JDBC Pocket Reference

CERN Document Server

Bales, Donald

2003-01-01

JDBC--the Java Database Connectivity specification--is a complex set of application programming interfaces (APIs) that developers need to understand if they want their Java applications to work with databases. JDBC is so complex that even the most experienced developers need to refresh their memories from time to time on specific methods and details. But, practically speaking, who wants to stop and thumb through a weighty tutorial volume each time a question arises? The answer is the JDBC Pocket Reference, a data-packed quick reference that is both a time-saver and a lifesaver. The JDBC P

In vitro and in vivo models for testing arrhythmogenesis in drugs.

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Carlsson, L

2006-01-01

The steadily increasing list of drugs associated with prolongation of the QT interval and torsades de pointes (TdP) constitute a medical problem of major concern. Hence, there is a need at an early stage to identify drug candidates with an inherent capacity to induce repolarization-related proarrhythmias, avoiding exposure of large populations to potentially harmful drugs. Furthermore, the availability of clinically relevant and predictive animal models should reduce the risk that effective and potentially life-saving drugs never reach the market. This review will discuss the pros and cons of some in vivo and in vitro animal models for assessing proarrhythmia liability.

Inborn Errors of Metabolism with Acidosis: Organic Acidemias and Defects of Pyruvate and Ketone Body Metabolism.

Science.gov (United States)

Schillaci, Lori-Anne P; DeBrosse, Suzanne D; McCandless, Shawn E

2018-04-01

When a child presents with high-anion gap metabolic acidosis, the pediatrician can proceed with confidence by recalling some basic principles. Defects of organic acid, pyruvate, and ketone body metabolism that present with acute acidosis are reviewed. Flowcharts for identifying the underlying cause and initiating life-saving therapy are provided. By evaluating electrolytes, blood sugar, lactate, ammonia, and urine ketones, the provider can determine the likelihood of an inborn error of metabolism. Freezing serum, plasma, and urine samples during the acute presentation for definitive diagnostic testing at the provider's convenience aids in the differential diagnosis. Copyright © 2017 Elsevier Inc. All rights reserved.

Prolonged Barium-Impaction Ileus in Two Lung Transplant Recipients With Systemic Sclerosis: Case Report.

Science.gov (United States)

Tokman, S; Hays, S R; Leard, L E; Bush, E L; Kukreja, J; Kleinhenz, M E; Golden, J A; Singer, J P

2015-12-01

Lung transplantation can be a life-saving measure for people with end-stage lung disease from systemic sclerosis. However, outcomes of lung transplantation may be compromised by gastrointestinal manifestations of systemic sclerosis, which can involve any part of the gastrointestinal tract. Esophageal and gastric disease can be managed by enteral feeding with the use of a gastrojejunal feeding tube. In this report, we describe the clinical courses of 2 lung transplant recipients with systemic sclerosis who experienced severe and prolonged barium-impaction ileus after insertion of a percutaneous gastrojejunal feeding tube. Copyright © 2015 Elsevier Inc. All rights reserved.

BiDil: from another vantage point.

Science.gov (United States)

Puckrein, Gary

2006-01-01

In a recent Health Affairs Web Exclusive, Pamela Sankar and Jonathan Kahn argue against the Food and Drug Administration's approval of BiDil as a new drug for the treatment of heart failure in African Americans. Their paper questions the existence of disparities between African American and other heart-failure patients and the motivations of BiDil's developers and manufacturer. The disparities are confirmed and persistent, however, and BiDil's effectiveness is proven. If the authors' logic were to prevail, patients would be denied life-saving therapy. Continued investigation will likely narrow identification of patients who will benefit.

Psychoanalytic Thoughts on the European Refugee Crisis and the Other.

Science.gov (United States)

Volkan, Vamık D

2017-12-01

There are many aspects-political, economic, legal, medical, cultural, religious-of the present refugee crisis in Europe. Difficulties at border crossings, settlement programs, life-saving issues, and security measures come to mind immediately, but the refugee crisis also needs to be examined from a psychological angle. This paper outlines psychoanalytic findings on voluntary and forced immigration and human responses to the Other. Change in the twenty-first century is occurring at an unprecedented pace and scale. Globalization, incredible advances in communication technology, fast travel, recourse limitations, terrorist activities, and now the refugee crisis in Europe make psychoanalytic investigation of the Other a necessity.

Why miltefosine-a life-saving drug for leishmaniasis-is unavailable to people who need it the most.

Science.gov (United States)

Sunyoto, Temmy; Potet, Julien; Boelaert, Marleen

2018-01-01

Miltefosine, the only oral drug approved for the treatment of leishmaniasis-a parasitic disease transmitted by sandflies-is considered as a success story of research and development (R&D) by a public-private partnership (PPP). It epitomises the multiple market failures faced by a neglected disease drug: patients with low ability to pay, neglect by authorities and uncertain market size. Originally developed as an anticancer agent in the 1990s, the drug was registered in India in 2002 to treat the fatal visceral leishmaniasis. At the time, miltefosine was considered a breakthrough in the treatment, making it feasible to eliminate a regional disease. Today, access to miltefosine remains far from secure. The initial PPP agreement which includes access to the public sector is not enforced. The reality on the ground has been challenging: shortages due to inefficient supply chains, and use of a substandard product which led to a high number of treatment failures and deaths. Miltefosine received orphan drug status in the USA; when it was registered there in 2014, a priority review voucher (PRV) was awarded. The PRV, meant to facilitate drug development for neglected disease, was subsequently sold to another company for US$125 million without, to date, any apparent impact on drug access. At the heart of these concerns are questions on how to protect societal benefit of a drug developed with public investment, while clinicians worldwide struggle with its lack of affordability, limited availability and sustainability of access. This article analyses the reasons behind the postregistration access failure of miltefosine and provides the lessons learnt.

Safety, efficacy, and performance of implanted recycled cardiac rhythm management (CRM) devices in underprivileged patients.

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Hasan, Reema; Ghanbari, Hamid; Feldman, Dustin; Menesses, Daniel; Rivas, Daniel; Zakhem, Nicole C; Duarte, Carlos; Machado, Christian

2011-06-01

Patients in underdeveloped nations have limited access to life-saving medical technology including cardiac rhythm management (CRM) devices. We evaluated alternative means to provide such technology to this patient population while assessing the safety and efficacy of such a practice. Patients in the United States with clinical indications for extraction of CRM devices were consented. Antemortem CRM devices were cleaned and sterilized following a protocol established at our institution. Surveillance in vitro cultures were performed for quality assurance. The functional status of pulse generators was tested with a pacing system analyzer to confirm at least 70% battery life. Most generators were transported, in person, to an implanting institution in Nicaragua. Recipients with a Class I indication for CRM implantation, and meeting economical criteria set forth, were consented for implantation of a recycled device. Between 2003 and 2009, implantation was performed in 17 patients with an average age of 42.1 ± 20.3 years. Of the 17 patients, nine were male and eight were female. Mean follow-up was 68 ± 38 months. Device evaluation occurred prior to discharge, 4 weeks post implantation, and every 6 months thereafter. There were three deaths during the follow-up period secondary to myocardial infarction, stroke, and heart failure. Hematoma formation occurred in one patient. No infections, early battery depletion, or device malfunction were identified during follow-up. Our case series is the longest follow-up of recipients of recycled antemortem CRM devices. Our findings support the feasibility and safety of this alternative acquisition of life-saving technology. ©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.

THE ROLE OF IgM-ENRICHED INTRAVENOUS IMMUNOGLOBULIN IN TRANSPLANTATION

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Szabó Judit

2014-04-01

Full Text Available After organ transplantation, gamma globulin and intravenous immunoglobulin enriched with IgM are most frequently used in septic shock as early immune-support. If the explanted organ is infected, the transplantation, as a life-saving operation, can be performed if there is no systemic inflammation and the patient receives IgM enriched immunoglobulin prophylaxis during surgery. The period after transplantation can be divided into three parts from the infection point of view: the first month after transplantation, the first sixth months and the following six months. Infections within the first month are basically related to the surgical procedure. Because of the immunosuppressive therapy, the opportunistic and fungal infections are more common during the first sixth months. After this period, the occurrence and the type of infections are similar to that of the non-transplant population except for pulmonary infections. The latter is two to three times more frequent. This is explained by the secondary hypogammaglobulinaemia (lower blood levels of IgM and IgG which is caused by the steroids but most of mycophenolate mofetil by inhibition of the T and B lymphocyte proliferation. Septic shock develops with a continuing fall of IgM levels. Under these circumstances additional intravenous immunoglobulin therapy with IgM can be lifesaving. Besides, immunoglobulin concentrates with IgM may also be used in the case of viral infections without prophylaxis and/or without etiological therapy such as in the case of West Nile virus infection. As a result of the increase in antibiotic resistance, the application of immunotherapy, including immunoglobulins may become the mainstream in the treatment of septic shock.

Management of chest drains: A national survey on surgeons-in-training experience and practice

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Emeka B Kesieme

2015-01-01

Full Text Available Background: Chest tube insertion is a simple and sometimes life-saving procedure performed mainly by surgical residents. However with inadequate knowledge and poor expertise, complications may be life threatening. Objective: We aimed to determine the level of experience and expertise of resident surgeons in performing tube thoracostomy. Methodology: Four tertiary institutions were selected by simple random sampling. A structured questionnaire was administered to 90 residents after obtaining consent. Results: The majority of respondents were between 31 and 35 years. About 10% of respondents have not observed or performed tube thoracostomy while 77.8% of respondents performed tube thoracostomy for thefirst time during residency training. The mean score was 6.2 ± 2.2 and 59.3% of respondents exhibited good experience and practice. Rotation through cardiothoracic surgery had an effect on the score (P = 0.034. About 80.2% always obtained consent while 50.6% always used the blunt technique of insertion. About 61.7% of respondents routinely inserted a chest drain in the Triangle of safety. Only 27.2% of respondents utilized different sizes of chest tubes for different pathologies. Most respondents removed chest drains when the output is <50 mL. Twenty-six respondents (32.1% always monitored air leak before removal of tubes in cases of pneumothorax. Superficial surgical site infection, tube dislodgement, and tube blockage were the most common complications. Conclusion: Many of the surgical resident lack adequate expertise in this lifesaving procedure and they lose the opportunity to learn it as interns. There is a need to stress the need to acquire this skill early, to further educate and evaluate them to avoid complications.

A retropharyngeal-mediastinal hematoma with supraglottic and tracheal obstruction: The role of multidisciplinary airway management

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Birkholz Torsten

2010-01-01

Full Text Available A 77-year-old man suffered hypoxemic cardiac arrest by supraglottic and tracheal airway obstruction in the emergency department. A previously unknown cervical fracture had caused a traumatic retropharyngeal-mediastinal hematoma. A lifesaving surgical emergency tracheostomy succeeded. Supraglottic and tracheal obstruction by a retropharyngeal-mediastinal hematoma with successful resuscitation via emergency tracheostomy after hypoxemic cardiac arrest has never been reported in a context of trauma. This clinically demanding case outlines the need for multidisciplinary airway management systems with continuous training and well-implemented guidelines. Only multidisciplinary staff preparedness and readily available equipments for the unanticipated difficult airway solved the catastrophic clinical situation.

Addison's disease presenting with perimyocarditis.

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Baranski Lamback, Elisa; Morandi, Grazia; Rapti, Eleni; Christov, Georgi; Brogan, Paul A; Hindmarsh, Peter

2018-01-26

Polyglandular autoimmune syndrome (PGA) and eosinophilic granulomatosis with polyangiitis (EGPA) do not seem to represent a coincidental association. A case of a 15-year-old boy is reported who presented with severe systemic inflammation, perimyocarditis and cardiogenic shock, in whom EGPA was initially suspected and later diagnosed with autoimmune adrenalitis with PGA. The severity of the systemic inflammation and perimyocarditis suggests a more widespread autoimmune-mediated process. Autoimmune adrenal insufficiency should be considered in all cases of pericarditis and perimyocarditis, especially when the severity of clinical manifestations exceeds the expected for the severity of the cardiac findings, as timely identification and prompt treatment may be life-saving.

History of Mechanical Ventilation. From Vesalius to Ventilator-induced Lung Injury.

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Slutsky, Arthur S

2015-05-15

Mechanical ventilation is a life-saving therapy that catalyzed the development of modern intensive care units. The origins of modern mechanical ventilation can be traced back about five centuries to the seminal work of Andreas Vesalius. This article is a short history of mechanical ventilation, tracing its origins over the centuries to the present day. One of the great advances in ventilatory support over the past few decades has been the development of lung-protective ventilatory strategies, based on our understanding of the iatrogenic consequences of mechanical ventilation such as ventilator-induced lung injury. These strategies have markedly improved clinical outcomes in patients with respiratory failure.

Pigmented xerodermoid - Report of three cases

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Das Jayanta Kumar

2005-01-01

Full Text Available Pigmented xerodermoid, a rare genodermatosis, presents with clinical features and pathology similar to xeroderma pigmentosum, but at a later age. DNA repair replication is normal, but there is total depression of DNA synthesis after exposure to UV radiation. Two siblings in their teens and a man in his thirties with features of pigmented xerodermoid, e.g. photophobia, freckle-like lesions, keratoses, dryness of skin, and hypo- and hyper-pigmentation, are described. Although classically the onset of pigmented xerodermoid is said to be delayed till third to fourth decade of life, it seems the disease may appear earlier in the tropics. Early diagnosis and management could be life-saving.

Electro convulsive therapy in a pre-pubertal child with severe depression.

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Russell P

2002-10-01

Full Text Available Electro Convulsive Therapy (ECT in pre-pubertal children is a controversial and underreported treatment. Even though the effectiveness and side effects of ECT in adolescents are comparable with those in adults, there is a pervasive reluctance to use ECT in children and adolescents. We report the case of a pre-pubertal child in an episode of severe depression with catatonic features, where a protracted course of ECT proved life-saving in spite of prolonged duration of seizures and delayed response to treatment. The case illustrates the safety and efficacy of ECT in children. Relevant literature is also reviewed along with the case report.

[Knowledge about basic life support in European students].

Science.gov (United States)

Marton, József; Pandúr, Attila; Pék, Emese; Deutsch, Krisztina; Bánfai, Bálint; Radnai, Balázs; Betlehem, József

2014-05-25

Better knowledge and skills of basic life support can save millions of lives each year in Europe. The aim of this study was to measure the knowledge about basic life support in European students. From 13 European countries 1527 volunteer participated in the survey. The questionnaire consisted of socio-demographic questions and knowledge regarding basic life support. The maximum possible score was 18. Those participants who had basic life support training earned 11.91 points, while those who had not participated in lifesaving education had 9.6 points (pbasic life support between students from different European countries. Western European youth, and those who were trained had better performance.

Massive Pulmonary Embolism: Percutaneous Emergency Treatment Using an Aspirex Thrombectomy Catheter

International Nuclear Information System (INIS)

Popovic, Peter; Bunc, Matjaz

2010-01-01

Massive pulmonary embolism (PE) is a life-threatening condition with a high early mortality rate caused by acute right ventricular failure and cardiogenic shock. A 51-year-old woman with a massive PE and contraindication for thrombolytic therapy was treated with percutaneous mechanical thrombectomy using an Aspirex 11F catheter (Straub Medical AG, Wangs, Switzerland). The procedure was successfully performed and showed a good immediate angiographic result. The patient made a full recovery from the acute episode and was discharged on heparin treatment. Our case report indicates that in patients with contraindications to systemic thrombolysis, catheter thrombectomy may constitute a life-saving intervention for massive PE.

A review of the pathophysiology, diagnosis, and management of allergic reactions in the dental office.

Science.gov (United States)

Rochford, Christopher; Milles, Maano

2011-02-01

Since more than 50 million people in the United States have allergies, knowledge of the management of allergic reactions in the dental office is extremely important. Appropriate care may range from a simple referral to a primary care physician to lifesaving measures implemented during acute anaphylactic reactions. The authors present a basic review of the pathophysiology of allergic reactions and provide information detailing the diagnosis and management of allergic reactions that may be encountered in the dental office. Utilizing this information, the dental practitioner and ancillary staff will have a thorough understanding of allergic reactions and be prepared to successfully identify and treat these reactions.

Clinical aspects of accidents resulting in acute total body irradiation

International Nuclear Information System (INIS)

Cronkite, E.P.

1988-01-01

That the management of whole body radiation injury involves: (1) watchful waiting, (2) observation of the hematologic parameters, (3) use of antibiotics, platelet red cell and possibly granulocyte transfusions, (4) administration of hemopoietic molecular regulators of granulopoiesis, and (5) bone marrow transplantation as the last line of defense. The clinical indication for the preceding will not be discussed, since this will be a subject of later speakers in this conference. Certainly, if a radiation casualty is fortunate enough to have an identical twin, a marrow transplant may be lifesaving and certainly can do no harm to the patient, and there is little risk to the donor

The Body and its Able-ness: Articulating In/Eligibility through Rhetorics of Motherhood, Unjust Language, and Questionable Medical Authority

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Rachel D. Davidson

2016-03-01

Full Text Available This essay analyzes a controversy involving Amelia (Mia Rivera, a three-year old girl who was denied a life-saving kidney transplant in January 2012. As reported by Mia's mother, Chrissy, on her blog post, Mia was denied the kidney transplant because of her mental disability. Throughout the public discussion that took place over a few short weeks, we argue Mia's ineligibility was rearticulated through rhetorics of motherhood, unjust body language, and questions about medical authority. we suggest this indicates that descriptions of the body and its able-ness carry more weight in the public's understanding of health issues than does medical authority.

JAK inhibitors in autoinflammation.

Science.gov (United States)

Hoffman, Hal M; Broderick, Lori

2018-06-11

Interferonopathies are a subset of autoinflammatory disorders with a prominent type I IFN gene signature. Treatment of these patients has been challenging, given the lack of response to common autoinflammatory therapeutics including IL-1 and TNF blockade. JAK inhibitors (Jakinibs) are a family of small-molecule inhibitors that target the JAK/STAT signaling pathway and have shown clinical efficacy, with FDA and European Medicines Agency (EMA) approval for arthritic and myeloproliferative syndromes. Sanchez and colleagues repurposed baricitinib to establish a significant role for JAK inhibition as a novel therapy for patients with interferonopathies, demonstrating the power of translational rare disease research with lifesaving effects.

Conscientious objection to deceased organ donation by healthcare professionals.

Science.gov (United States)

Shaw, David; Gardiner, Dale; Lewis, Penney; Jansen, Nichon; Wind, Tineke; Samuel, Undine; Georgieva, Denie; Ploeg, Rutger; Broderick, Andrew

2018-02-01

In this article, we analyse the potential benefits and disadvantages of permitting healthcare professionals to invoke conscientious objection to deceased organ donation. There is some evidence that permitting doctors and nurses to register objections can ultimately lead to attitudinal change and acceptance of organ donation. However, while there may be grounds for conscientious objection in other cases such as abortion and euthanasia, the life-saving nature of donation and transplantation renders objection in this context more difficult to justify. In general, dialogue between healthcare professionals is a more appropriate solution, and any objections must be justified with a strong rationale in hospitals where such policies are put in place.

Problems and Approaches for Blood Transfusion in the Developing Countries.

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Roberts, David J; Field, Stephen; Delaney, Meghan; Bates, Imelda

2016-04-01

A safe supply of blood and the knowledge, skill, and resources for the appropriate use of blood are essential for medical services. Many problems are faced in the development of transfusion services in low- or medium-income countries (LMICs). Unfortunately, in many countries, providing safe blood is made more difficult by a lack of blood donors and the high frequency of transfusion-transmissible infections. The problems are compounded by the frequent need for urgent life-saving transfusions. This article examines the problems in supply, safety, and use of blood and how they are being addressed in LMICs, predominantly focusing on sub-Saharan Africa. Copyright © 2016 Elsevier Inc. All rights reserved.

The Hyper-Commons: how open science prizes can expand and level the medical research playing field.

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Hynek, Paul

2008-12-01

The largest industry in America is increasingly incapable of serving its customers. Over-fencing of the information commons has led to unaffordable medicine, for want of which millions of Americans and people around the world go without lifesaving treatments. Eliminating patent distribution exclusivity altogether, however, is not feasible, given the entrenched nature of the health-care industry. This paper proposes a program of voluntary Open Science Prizes that would draw large numbers of new players, who would in turn produce much new medical innovation, provide academic priority recognition, and develop a growing body of patent-beating prior art that would serve as public domain firewalls on a new supranational Hyper-Commons.

Bedside Endoscopic Retrograde Cholangiopancreatography Using Portable X-Ray in Acute Severe Cholangitis

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Rushikesh Shah

2018-01-01

Full Text Available Patients with acute cholangitis require emergent biliary decompression. Those who are hemodynamically unstable on vasopressor support and mechanical ventilation are too critically ill to move outside of the intensive care unit. This prohibits performing Endoscopic Retrograde Cholangiopancreatography (ERCP in the endoscopy unit. Fluoroscopic guidance is required to confirm deep biliary cannulation during ERCP. There are a few reported cases of bedside ERCP using portable C-arm fluoroscopy unit or ultrasound guided cannulation. We present a unique case of life-saving emergent bedside ERCP in a severely ill patient with cholangitis and septic shock, using simple portable X-ray to confirm biliary cannulation.

Malaria in Children.

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Cohee, Lauren M; Laufer, Miriam K

2017-08-01

Malaria is a leading cause of morbidity and mortality in endemic areas, leading to an estimated 438,000 deaths in 2015. Malaria is also an important health threat to travelers to endemic countries and should be considered in evaluation of any traveler returning from a malaria-endemic area who develops fever. Considering the diagnosis of malaria in patients with potential exposure is critical. Prompt provision of effective treatment limits the complications of malaria and can be life-saving. Understanding Plasmodium species variation, epidemiology, and drug-resistance patterns in the geographic area where infection was acquired is important for determining treatment choices. Copyright © 2017 Elsevier Inc. All rights reserved.

Diabetic foot syndrome as an interdisciplinary problem

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Emilia Rymkiewicz

2017-08-01

Full Text Available Diabetes is a metabolic disease of the growing maturity. Diabetic foot syndrome is a chronic complications of diabetes. In neuropathic sensory disorders, ischemia of the lower limbs, and improper alignment metabolic control may occur in minor injuries around the foot, giving rise to a difficult healing ulcers. Even minor wounds rapidly infection by pathogenic bacteria, which significantly hinders their treatment. Health and life-saving solution in situations of persistent symptoms of infection is amputation of the lower limb. Doing so, however, does not solve the problem of diabetic and should be the final proceedings after having exhausted all possible treatments for diabetic foot syndrome.

[Acid-base homeostasis: metabolic acidosis and metabolic alkalosis].

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Dussol, Bertrand

2014-07-01

Acid-base homeostasis ensured by the kidneys, which maintain the equilibrium between proton generation by cellular metabolism and proton excretion in urine. This requirement is lifesaving because of the protons' ability to bind to anionic proteins in the extracellular space, modifying their structure and functions. The kidneys also regenerate bicarbonates. The kidney is not the sole organ in charge of maintaining blood pH in a very narrow range; lungs are also involved since they allow a large amount of volatile acid generated by cellular respiration to be eliminated. Copyright © 2014 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

Social cognitive correlates of young adult sport competitors' sunscreen use.

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Berndt, Nadine C; O'Riordan, David L; Winkler, Elisabeth; McDermott, Liane; Spathonis, Kym; Owen, Neville

2011-02-01

Young adults participating in outdoor sports represent a high-risk group for excessive sun exposure. The purpose of this study was to identify modifiable social cognitive correlates of sunscreen use among young adult competitors. Participants aged 18 to 30 years who competed in soccer (n = 65), surf-lifesaving (n = 63), hockey (n = 61), and tennis (n = 48) completed a sun habits survey. Almost half (n = 113) of the participants used sunscreen inadequately and 30% (n = 70) reported not using sunscreen. In fully adjusted models, social cognitive attributes significantly (p competitors and as a result may be useful in informing behavior change interventions within the sporting context.

Vascular access in pediatric patients in the emergency department: types of access, indications, and complications [digest].

Science.gov (United States)

Whitney, Rachel; Langhan, Melissa; Pade, Kathryn H

2017-06-22

Vascular access is a potentially life-saving procedure that is a mainstay of emergency medicine practice. There are a number of challenges associated with obtaining and maintaining vascular access, and the choice of the route of access and equipment used will depend on patient- and provider-specific factors. In this issue, the indications and complications of peripheral intravenous access, intraosseous access, and central venous access are reviewed. Timely and effective assessment and management of difficult-access patients, pain control techniques that can assist vascular access, and contraindications to each type of vascular access are also discussed. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

Challenges around Access to and Cost of Life-Saving Medications after Allogeneic Hematopoietic Cell Transplantation for Medicare Patients.

Science.gov (United States)

Farnia, Stephanie; Ganetsky, Alex; Silver, Alicia; Hwee, Theresa; Preussler, Jaime; Griffin, Joan; Khera, Nandita

2017-08-01

Hematopoietic cell transplantation (HCT) is an expensive, medically complicated, and potentially life-threatening therapy for multiple hematologic and nonhematologic disorders with a prolonged trajectory of recovery. Similar to financial issues in other cancer treatments, adverse financial consequences of HCT are emerging as an important issue and may be associated with poor quality of life and increased distress in HCT survivors. Prescription medicine coverage for HCT for Medicare and some Medicaid beneficiaries, especially in the long-term, remains suboptimal because of inadequate payer formularies or prohibitive copays. With an increasing number of older patients undergoing HCT and improvement in the overall survival after HCT, the problem of financial burden faced by Medicare beneficiaries with fixed incomes is going to worsen. In this article, we describe the typical financial burden borne by HCT recipients based on estimated copayment amounts attached to the categories of key medications as elucidated through 2 case studies. We also suggest some possible solutions for consideration to help these patients and families get through the HCT by minimizing the financial burden from essential medications needed during the post-HCT period. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Lifesaving pericardiocentesis due to purulent pericarditis with growth of Gram-negative rods in an immune-competent Inuit male

DEFF Research Database (Denmark)

Simonÿ, Carl Frederik Brandt; Malham, Mikkel; Kanstrup, Jacob

2014-01-01

by echocardiography but is not the case in rural areas in common. Change in the infectious aetiology indicates broad-spectrum antibiotics. We describe a case of purulent pericarditis causing cardiac tamponade due to haematogenous spread of Escherichia coli (E. coli) and Proteus species in an immune-competent Inuit...

Advance directives for future dementia can be modified by a brief video presentation on dementia care: An experimental study.

Directory of Open Access Journals (Sweden)

Theresia Volhard

Full Text Available To investigate whether life-sustaining measures in medical emergency situations are less accepted for an anticipated own future of living with dementia, and to test whether a resource-oriented, in contrast to a deficit-oriented video about the same demented person, would increase the acceptance of such life-saving measures.Experimental study conducted between September 2012 and February 2013.Community dwelling female volunteers living in the region of Bonn, Germany.278 women aged 19 to 89 (mean age 53.4 years.Presentation of a video on dementia care focusing either on the deficits of a demented woman (negative framing, or focusing on the remaining resources (positive framing of the same patient.Approval of life-sustaining treatments in five critical medical scenarios under the assumption of having comorbid dementia, before and after the presentation of the brief videos on care.At baseline, the acceptance of life-sustaining measures in critical medical situations was significantly lower in subjects anticipating their own future life with dementia. Participants watching the resource-oriented film on living with dementia had significantly higher post-film acceptance rates compared to those watching the deficit-oriented negatively framed film. This effect particularly emerges if brief and efficient life-saving interventions with a high likelihood of physical recovery are available (eg, antibiotic treatment for pneumonia.Anticipated decisions regarding life-sustaining measures are negatively influenced by the subjective imagination of living with dementia, which might be shaped by common, unquestioned stereotypes. This bias can be reduced by providing audio-visual information on living with dementia which is not only centred around cognitive and functional losses but also focuses on remaining resources and the apparent quality of life. This is particularly true if the medical threat can be treated efficiently. These findings have implications for the

Health lessons learned from the recent earthquakes and Tsunami in Asia.

Science.gov (United States)

de Ville de Goyet, Claudele

2007-01-01

The evaluations following the Tsunami that affected 12 countries (December 2004) and the earthquakes in Bam, Iran (2003), and in Pakistan (2005) offered valuable lessons for public health preparedness against all types of risks (natural, complex, or technological) in all countries (regardless their level of development). The lessons learned, needs assessments, effectiveness of external life-saving assistance, disease surveillance and control, as well as donations management, were reviewed. Although hundreds of surveys or studies were conducted, the needs assessments were partial and uncoordinated. The findings often were not shared by individual agencies. The evaluations in each of the three disasters point to some additional issues: 1. Foreign mobile hospitals rarely arrived in time for immediate trauma care. Existing international guidelines for the use of field hospitals often were ignored and must be updated and promoted. Local and neighboring facilities are best at providing immediate, life-saving care; 2. Occassionally, the risk of epidemics was grossly overestimated by the agencies and the mass media. Surveillance and improved routine control programs work without resorting to costly, improvised immunization campaigns of doubtless value. Improving or re-establishing water and sanitation must be the first priority; 3. Health donations were not always appropriate, nor did they follow the World Health Organization guidelines. The costly destruction of inappropriate donations was a recurrent problem; and 4. Medical volunteers from within the affected country were abounding, but did not benefit from the external logistical and material support. The international community should provide logistical and material support before sending expatriate teams that are unfamiliar with the area and its alth problems. Investing in the preparedness of the national health services and communities should become a priority for disaster-prone countries and those assisting them in

Effect of mobile application-based versus DVD-based CPR training on students’ practical CPR skills and willingness to act: a cluster randomised study

Science.gov (United States)

Nord, Anette; Svensson, Leif; Hult, Håkan; Kreitz-Sandberg, Susanne; Nilsson, Lennart

2016-01-01

Objectives The aim was to compare students’ practical cardiopulmonary resuscitation (CPR) skills and willingness to perform bystander CPR, after a 30 min mobile application (app)-based versus a 50 min DVD-based training. Settings Seventh grade students in two Swedish municipalities. Design A cluster randomised trial. The classes were randomised to receive app-based or DVD-based training. Willingness to act and practical CPR skills were assessed, directly after training and at 6 months, by using a questionnaire and a PC Skill Reporting System. Data on CPR skills were registered in a modified version of the Cardiff test, where scores were given in 12 different categories, adding up to a total score of 12–48 points. Training and measurements were performed from December 2013 to October 2014. Participants 63 classes or 1232 seventh grade students (13-year-old) were included in the study. Primary and secondary outcome measures Primary end point was the total score of the modified Cardiff test. The individual variables of the test and self-reported willingness to make a life-saving intervention were secondary end points. Results The DVD-based group was superior to the app-based group in CPR skills; a total score of 36 (33–38) vs 33 (30–36) directly after training (pCPR skill components. Both groups improved compression depth from baseline to follow-up. If a friend suffered cardiac arrest, 78% (DVD) versus 75% (app) would do compressions and ventilations, whereas only 31% (DVD) versus 32% (app) would perform standard CPR if the victim was a stranger. Conclusions At 6 months follow-up, the 50 min DVD-based group showed superior CPR skills compared with the 30 min app-based group. The groups did not differ in regard to willingness to make a life-saving effort. PMID:27130166

Comparison of direct and indirect methods of estimating health state utilities for resource allocation: review and empirical analysis.

Science.gov (United States)

Arnold, David; Girling, Alan; Stevens, Andrew; Lilford, Richard

2009-07-22

Utilities (values representing preferences) for healthcare priority setting are typically obtained indirectly by asking patients to fill in a quality of life questionnaire and then converting the results to a utility using population values. We compared such utilities with those obtained directly from patients or the public. Review of studies providing both a direct and indirect utility estimate. Papers reporting comparisons of utilities obtained directly (standard gamble or time tradeoff) or indirectly (European quality of life 5D [EQ-5D], short form 6D [SF-6D], or health utilities index [HUI]) from the same patient. PubMed and Tufts database of utilities. Sign test for paired comparisons between direct and indirect utilities; least squares regression to describe average relations between the different methods. Mean utility scores (or median if means unavailable) for each method, and differences in mean (median) scores between direct and indirect methods. We found 32 studies yielding 83 instances where direct and indirect methods could be compared for health states experienced by adults. The direct methods used were standard gamble in 57 cases and time trade off in 60(34 used both); the indirect methods were EQ-5D (67 cases), SF-6D (13), HUI-2 (5), and HUI-3 (37). Mean utility values were 0.81 (standard gamble) and 0.77 (time tradeoff) for the direct methods; for the indirect methods: 0.59(EQ-5D), 0.63 (SF-6D), 0.75 (HUI-2) and 0.68 (HUI-3). Direct methods of estimating utilities tend to result in higher health ratings than the more widely used indirect methods, and the difference can be substantial.Use of indirect methods could have important implications for decisions about resource allocation: for example, non-lifesaving treatments are relatively more favoured in comparison with lifesaving interventions than when using direct methods.

Prevalence of health promotion policies in sports clubs in Victoria, Australia.

Science.gov (United States)

Dobbinson, Suzanne Jane; Hayman, Jane Amanda; Livingston, Patricia Mary

2006-06-01

In recent years, some health agencies offered sponsorship to sporting associations to promote healthy environments by encouraging clubs to develop health-related policies. However, the extent to which these sponsorship contracts reach their stated aims is of concern. This study aimed to quantify levels of policy development and practice in sports clubs for each of five key health areas, namely smoke-free facilities, sun protection, healthy catering, responsible serving of alcohol and sports injury prevention. Representatives from 932 Victorian sports clubs were contacted by telephone with 640 clubs (69%) participating in the survey. Results suggested that the establishment of written policies on the key health areas by sports clubs varied widely by affiliated sport and health area: 70% of all clubs with bar facilities had written policies on responsible serving of alcohol, ranging from 58% of tennis clubs to 100% of diving and surfing clubs. In contrast, approximately one-third of sports clubs had a smoke-free policy, with 36% of tennis, 28% of country football and 28% of men's cricket clubs having policy. Moreover, 34% of clubs overall had established sun protection policy, whereas clubs competing outside during summer months, [diving (86%) and life-saving (81%)] were most likely to have a written sun protection policy. Injury prevention policies were established in 30% of sports clubs, and were most common among football (56%), diving (43%) and life-saving (41%). This study suggests that policy development for health promotion can be achieved in sports clubs when it is well supported by health agencies and consideration is given to the appropriateness of the specific behaviours to be encouraged for a given sport. Communication between associations and clubs needs to be monitored by health agencies to ensure support and resources for policy development to reach the club level.

Should Sabbath Prohibitions Be Overridden to Provide Emotional Support to a Sick Relative?

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Chaya Greenberger

2016-07-01

Full Text Available Background There is a consensus among the halachic authorities that life-saving actions override Sabbath prohibitions. They are painstaking in securing that the sanctity of the Sabbath is maintained but that not a single life be lost. Objective This manuscript examines if and when a relative’s presence at the bedside of a seriously ill individual is potentially life-saving against the backdrop of the scientific literature. It specifically addresses the permissibility of traveling in a motorized vehicle, generally prohibited on the Sabbath, to be with one’s relative in hospital for the provision of emotional support. Methods Discourse of the halachic issues in the context of the scientific literature. Results Stress, mental or physical, has been determined as a potentially life-threatening condition in many disease entities. The literature attests to both the patient’s and the professionals’ perception of the curative potential of the presence of loved ones by advocating for the patient and relieving stress in the hospital experience. Emotional support from a loved one is perceived by some patients as vital to survival. There is halachic consensus that a patient’s perception of the emotional need for a relative’s presence is sufficient to permit overriding rabbinic prohibitions. Torah prohibitions, which may be overridden for medical needs, may be overridden for emotional support, providing a health professional or family member attests to the fulfilment of this specific need as diminishing the danger to the patient’s life. In certain cases, the latter contingency is unnecessary. Conclusions Emotional support has an impact on the patient’s health status; the degree to which its impact is strong enough to save life is still being studied. As more data from scientific studies emerge, they may be relevant to sharpening the halachic rulings with respect to the issue at hand.

A Case of Post Myocardial Infarction Papillary Muscle Rupture.

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Anuwatworn, Amornpol; Milnes, Christopher; Kumar, Vishesh; Raizada, Amol; Nykamp, Verlyn; Stys, Adam

2016-06-01

Papillary muscle rupture is a rare, life-threatening post myocardial infarction mechanical complication. Without surgical intervention, prognosis is very poor. Clinicians need to recognize this complication early, as prompt therapy is crucial. We present a case of inferior ST elevation myocardial infarction complicated by posteromedial papillary muscle rupture resulting in severe acute mitral regurgitation (flail anterior mitral leaflet), acute pulmonary edema and cardiogenic shock. In our patient, a new mitral regurgitation murmur suggested this mechanical complication. Complete disruption of papillary muscle was visualized by transesophageal echocardiography. This case illustrates the importance of good physical examination for early diagnosis of papillary muscle rupture, so that life-saving treatment can be administered without delay.

Slow coolant phaseout could worsen warming

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Reese, April

2018-03-01

In the summer of 2016, temperatures in Phalodi, an old caravan town on a dry plain in northwestern India, reached a blistering 51°C—a record high during a heat wave that claimed more than 1600 lives across the country. Wider access to air conditioning (AC) could have prevented many deaths—but only 8% of India's 249 million households have AC. As the nation's economy booms, that figure could rise to 50% by 2050. And that presents a dilemma: As India expands access to a life-saving technology, it must comply with international mandates—the most recent imposed just last fall—to eliminate coolants that harm stratospheric ozone or warm the atmosphere.

Commodity culture: tropical health and hygiene in the British Empire.

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Johnson, Ryan

2008-06-01

Before heading to a 'tropical' region of the Empire, British men and women spent considerable time and effort gathering outfit believed essential for their impending trip. Ordinary items such as soap, clothing, foodstuffs and bedding became transformed into potentially life-saving items that required the fastidious attention of any would-be traveller. Everyone from scientists and physicians to missionaries and administrators was bombarded by relentless advertising and abundant advice about the outfit needed to preserve health in a tropical climate. A closer look at this marketing exercise reveals much about the way people thought about tropical people, places, health and hygiene and how scientific and commercial influences shaped this Imperial commodity culture.

Extravascular complications following abdominal organ transplantation

International Nuclear Information System (INIS)

Low, G.; Jaremko, J.L.; Lomas, D.J.

2015-01-01

A variety of transplants have been performed in the abdomen including liver, kidney, pancreas and islet, bowel, and multivisceral transplants. Imaging plays an important role in graft surveillance particularly to exclude post-transplant complications. When complications occur, therapeutic image-guided interventions are invaluable as these may be graft-saving and even life-saving. Vascular complications following transplantation have been extensively reported in recent reviews. The focus of this review is to discuss post-transplant complications that are primarily extravascular in location. This includes biliary, urological, intestinal, malignancy, infections, and miscellaneous complications. Familiarity with the imaging appearances of these complications is helpful for radiologists as accurate diagnosis and expedient treatment has an impact on graft and patient survival

The introduction of emergency cricothyroidotomy simulation training in Zimbabwe contributed to the saving of two lives

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Avnstorp, M. B.; Jensen, P. V. F.; Dzongodza, T.

2016-01-01

and neck progressing to cardiac arrest. Cardiopulmonary resuscitation was initiated and a secure surgical airway was established via an emergency cricothyroidotomy, saving the patient. A 70-year-old male presented with upper airway obstruction secondary to intubation for an elective procedure. When...... extubated, the patient exhibited severe stridor followed by respiratory arrest. Re-intubation attempts were unsuccessful and emergency cricothyroidotomy was performed to secure the airway, preserving the life of the patient. Conclusion: Emergency cricothyroidotomy training should be considered for all......Background: In developing countries with limited access to ENT services, performing emergency cricothyroidotomy in patients with upper airway obstruction may be a life-saving last resort. An established Danish-Zimbabwean collaboration of otorhinolaryngologists enrolled Zimbabwean doctors...

Sudden Death by Pulmonary Thromboembolism due to a Large Uterine Leiomyoma with a Parasitic Vein to the Mesentery

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Varsha Podduturi

2014-01-01

Full Text Available The pathophysiology of venous thrombosis is classically attributed to alterations in one or more components of Virchow’s triad: hypercoagulability, stasis, and damage to the vascular endothelium. Deep vein thrombosis (DVT may lead to pulmonary thromboembolism (PE, and the latter is culpable for many deaths annually in the United States; however, DVT as a complication of uterine leiomyoma has rarely been reported. We report a case of a 57-year-old woman whose death was due to a large pedunculated subserosal leiomyoma externally compressing the pelvic veins resulting in stasis and venous thrombosis leading to fatal PE. The association of large pelvic masses with venous thrombosis has clinical implications, since prophylactic surgery could be life-saving.

AAGBI guidelines: the use of blood components and their alternatives 2016.

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Klein, A A; Arnold, P; Bingham, R M; Brohi, K; Clark, R; Collis, R; Gill, R; McSporran, W; Moor, P; Rao Baikady, R; Richards, T; Shinde, S; Stanworth, S; Walsh, T S

2016-07-01

Blood transfusion can be life-saving. Anaesthetists regularly request and administer blood components to their patients. All anaesthetists must be familiar with indications and appropriate use of blood and blood components and their alternatives, but close liaison with haematology specialists and their local blood sciences laboratory is encouraged. Considerable changes in approaches to optimal use of blood components, together with the use of alternative products, have become apparent over the past decade, leading to a need to update previous guidelines and adapt them for the use of anaesthetists working throughout the hospital system. © 2016 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists of Great Britain and Ireland.

Emerging fungal diseases: the importance of the host.

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Procop, Gary W; Roberts, Glenn D

2004-09-01

More yeasts and molds are now recognized to cause more human disease than ever before. This development is not due to a change in the virulence of these fungi, but rather to changes in the human host. These changes include immunosuppression secondary to the pandemic of HIV, the use of life-saving advances in chemotherapy and organ transplantation, and the use of corticosteroids and other immunosuppressive agents to treat a variety of diseases. Fungi that were once considered common saprophytes are now recognized as potential pathogens in these patients. This situation necessitates better communication than ever between the clinician, pathologist, and clinical mycologist to ensure the prompt and accurate determination of the cause of fungal diseases.

Preparing for the unexpected: violence in the home care environment, one agency's story.

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Browning, Sarah Via; Clark, Rebecca Culver; Glick, Roger E

2013-06-01

Home care and hospice agencies, bound by regulations, prepare for emergencies and disasters by creating policies and protocols for management of emergency situations, perhaps conducting table top or other types of drills, and discussing hazards likely to impact home care. Is this preparation merely an exercise to meet a requirement, or is it life-saving preparation? For one home care agency, the emergency exercise saved the day as the scenario enacted in the drill was actually lived out a few weeks after the exercise-a scenario the agency leaders hoped they would never face. This account explores how the agency prepared to meet the emergent situation and details lessons learned in the aftermath.

Practical consensus recommendations on fertility preservation in patients with breast cancer

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Jyoti Bajpai

2018-01-01

Full Text Available Young women diagnosed with cancer today have a greater chance of long-term survival than ever before. Successful survivorship for this group of patients includes maintaining a high quality of life after a cancer diagnosis and treatment; however, lifesaving treatments such as chemotherapy, radiation, and surgery can impact survivors by impairing reproductive and endocrine health. Expert oncologists along with reproductive medicine specialists discuss fertility preservation options in this chapter since fertility preservation is becoming a priority for young women with breast cancer. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations for the benefit of community oncologists.

Cerebral Pathophysiology in Extracorporeal Membrane Oxygenation: Pitfalls in Daily Clinical Management

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Syed Omar Kazmi

2018-01-01

Full Text Available Extracorporeal membrane oxygenation (ECMO is a life-saving technique that is widely being used in centers throughout the world. However, there is a paucity of literature surrounding the mechanisms affecting cerebral physiology while on ECMO. Studies have shown alterations in cerebral blood flow characteristics and subsequently autoregulation. Furthermore, the mechanical aspects of the ECMO circuit itself may affect cerebral circulation. The nature of these physiological/pathophysiological changes can lead to profound neurological complications. This review aims at describing the changes to normal cerebral autoregulation during ECMO, illustrating the various neuromonitoring tools available to assess markers of cerebral autoregulation, and finally discussing potential neurological complications that are associated with ECMO.

Emergency computed tomography for acute pelvic trauma: Where is the bleeder?

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Hallinan, J.T.P.D.; Tan, C.H.; Pua, U.

2014-01-01

Contrast medium extravasation at computed tomography (CT) is an accurate indicator of active haemorrhage in pelvic trauma. When this is present, potentially lifesaving surgical or endovascular treatment should be considered. Identification of the site or territory of haemorrhage is helpful for the interventional radiologist as it allows for focused angiographic evaluation and expedites haemostatic angio-embolisation. Even with thin-section arterial phase CT, tracing the bleeding vessel is not always possible and is often time consuming. We introduce a technique for predicting the bleeding vessel based on knowledge of the cross-sectional anatomical territory of the vessel as an alternative to tracing the vessel's course. Several case examples with digital subtraction angiography (DSA) correlation will be provided

Parenteral nutrition.

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Inayet, N; Neild, P

2015-03-01

Over the last 50 years, parenteral nutrition has been recognised as an invaluable and potentially lifesaving tool in the physician's arsenal in the management of patients with intestinal failure or inaccessibility; however, it may also be associated with a number of potentially life-threatening complications. A recent NCEPOD report (2010) identified a number of inadequacies in the overall provision and management of parenteral nutrition and recommendations were made with the aim of improving clinical practice in the future. This paper focuses on the practical aspects relating to parenteral nutrition for adults, including important concepts, such as patient selection, as well as general management. We also explore the various pitfalls and potential complications and how these may be minimised.

Biotinidase deficiency presenting as recurrent myelopathy in a 7-year-old boy and a review of the literature.

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Raha, Sarbani; Udani, Vrajesh

2011-10-01

Biotinidase deficiency may produce variable neurologic manifestations. Brainstem and spinal cord disease comprises an uncommon presentation of biotinidase deficiency. We describe a 7-year old boy with subacute progressive quadriplegia and "sighing" respirations. Severe biotinidase deficiency was established, and the patient demonstrated complete recovery with biotin supplementation. Genetic studies revealed presence of homozygous mutation in the BTD gene [c.133C>T (p.H447Y)]. Biotinidase deficiency should be considered in the differential diagnosis for subacute, long segment myelopathy, particularly with brainstem involvement. This entity is treatable; a high index of suspicion can be life-saving. We also review the literature on biotinidase deficiency presenting as spinal cord demyelinating disease. Copyright © 2011 Elsevier Inc. All rights reserved.

[Myxedema coma. A case reported].

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Rebollo-Gómez, Héctor

2010-01-01

Myxedema coma is a life-threatening condition; it is a complication of untreated hypothyroidism and an endocrine emergency. Most patients are elderly women with a previous history of long-standing hypothyroidism which presents during the winter. The myxedema coma has an insidious onset and it is very rare; its recognition can be quite difficult. Once suspected, treatment can be lifesaving and should be start promptly in anticipation of confirmation of the diagnosis by laboratory test. The mortality rate is high. I presented a case of an old woman with myxedema coma with an undiagnosed hypothyroidism, with altered mental status, normal temperature, pneumonia, hyponatremia and high level of creatine phosphokinase, who presented in the emergency room.

2 Major incident triage and the implementation of a new triage tool, the MPTT-24.

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Vassallo, James; Smith, Jason

2017-12-01

Over the last decade, a number of European cities including London, have witnessed high profile terrorist attacks resulting in major incidents with large numbers of casualties. Triage, the process of categorising casualties on the basis of their clinical acuity, is a key principle in the effective management of major incidents.The Modified Physiological Triage Tool (MPTT) is a recently developed primary triage tool which in comparison to existing triage tools, including the 2013 UK NARU Sieve, demonstrates the greatest sensitivity at predicting need for life-saving intervention (LSI) within both military and civilian populations.To improve the applicability and usability of the MPTT we increased the upper respiratory rate threshold to 24 breaths per minute (MPTT-24), to make it divisible by four, and included an assessment of external catastrophic haemorrhage. The aim of this study was to conduct a feasibility analysis of the proposed MPTT-24 (figure 1).emermed;34/12/A860-b/F1F1F1Figure 1MPTT-24 METHODS: A retrospective review of the Joint Theatre Trauma Registry (JTTR) and Trauma Audit Research Network (TARN) databases was performed for all adult ( > 18 years) patients presenting between 2006-2013 (JTTR) and 2014 (TARN). Patients were defined as priority one (P1) if they had received one or more life-saving interventions.Using first recorded hospital physiology, patients were categorised as P1 or not-P1 by existing triage tools and both MPTT and MPTT-24. Performance characteristics were evaluated using sensitivity, specificity, under and over-triage with a McNemar test to determine statistical significance. Basic study characteristics are shown in Table 1. Both the MPTT and MPTT-24 outperformed all existing triage methods with a statistically significant (p<0.001) absolute reduction of between 25.5%-29.5% in under-triage when compared to existing UK civilian methods (NARU Sieve). In both populations the MPTT-24 demonstrated an absolute reduction in sensitivity

Measuring teamwork and taskwork of community-based "teams" delivering life-saving health interventions in rural Zambia: a qualitative study.

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Yeboah-Antwi, Kojo; Snetro-Plewman, Gail; Waltensperger, Karen Z; Hamer, Davidson H; Kambikambi, Chilobe; MacLeod, William; Filumba, Stephen; Sichamba, Bias; Marsh, David

2013-06-27

The use of teams is a well-known approach in a variety of settings, including health care, in both developed and developing countries. Team performance is comprised of teamwork and task work, and ascertaining whether a team is performing as expected to achieve the desired outcome has rarely been done in health care settings in resource-limited countries. Measuring teamwork requires identifying dimensions of teamwork or processes that comprise the teamwork construct, while taskwork requires identifying specific team functions. Since 2008 a community-based project in rural Zambia has teamed community health workers (CHWs) and traditional birth attendants (TBAs), supported by Neighborhood Health Committees (NHCs), to provide essential newborn and continuous curative care for children 0-59 months. This paper describes the process of developing a measure of teamwork and taskwork for community-based health teams in rural Zambia. Six group discussions and pile-sorting sessions were conducted with three NHCs and three groups of CHW-TBA teams. Each session comprised six individuals. We selected 17 factors identified by participants as relevant for measuring teamwork in this rural setting. Participants endorsed seven functions as important to measure taskwork. To explain team performance, we assigned 20 factors into three sub-groups: personal, community-related and service-related. Community and culturally relevant processes, functions and factors were used to develop a tool for measuring teamwork and taskwork in this rural community and the tool was quite unique from tools used in developed countries.

Lifesaving emergency obstetric services are inadequate in south-west Ethiopia: a formidable challenge to reducing maternal mortality in Ethiopia.

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Girma, Meseret; Yaya, Yaliso; Gebrehanna, Ewenat; Berhane, Yemane; Lindtjørn, Bernt

2013-11-04

Most maternal deaths take place during labour and within a few weeks after delivery. The availability and utilization of emergency obstetric care facilities is a key factor in reducing maternal mortality; however, there is limited evidence about how these institutions perform and how many people use emergency obstetric care facilities in rural Ethiopia. We aimed to assess the availability, quality, and utilization of emergency obstetric care services in the Gamo Gofa Zone of south-west Ethiopia. We conducted a retrospective review of three hospitals and 63 health centres in Gamo Gofa. Using a retrospective review, we recorded obstetric services, documents, cards, and registration books of mothers treated and served in the Gamo Gofa Zone health facilities between July 2009 and June 2010. There were three basic and two comprehensive emergency obstetric care qualifying facilities for the 1,740,885 people living in Gamo Gofa. The proportion of births attended by skilled attendants in the health facilities was 6.6% of expected births, though the variation was large. Districts with a higher proportion of midwives per capita, hospitals and health centres capable of doing emergency caesarean sections had higher institutional delivery rates. There were 521 caesarean sections (0.8% of 64,413 expected deliveries and 12.3% of 4,231 facility deliveries). We recorded 79 (1.9%) maternal deaths out of 4,231 deliveries and pregnancy-related admissions at institutions, most often because of post-partum haemorrhage (42%), obstructed labour (15%) and puerperal sepsis (15%). Remote districts far from the capital of the Zone had a lower proportion of institutional deliveries (4% of deliveries, much higher than the average 1.9%). Based on a population of 1.7 million people, there should be 14 basic and four comprehensive emergency obstetric care (EmOC) facilities in the Zone. Our study found that only three basic and two comprehensive EmOC service qualifying facilities serve this large population which is below the UN's minimum recommendation. The utilization of the existing facilities for delivery was also low, which is clearly inadequate to reduce maternal deaths to the MDG target.

Uremic frost: a harbinger of impending renal failure.

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Saardi, Karl M; Schwartz, Robert A

2016-01-01

Uremic frost is a striking cutaneous finding seen in patients with severe kidney disease. Familiarity with this condition can be a life-saving signal to initiate urgent dialysis. Uremic frost generally occurs at blood urea nitrogen levels of approximately 200 mg/dl, although it may arise with less severe uremia. Recently confirmed urea transporters in the skin may play a role in the development of uremic frost. Alternatively, damage to the cutaneous microvasculature and pilosebaceous units, as seen in chronic kidney disease, could account for the high levels of urea deposited outside the skin. The treatment of uremic frost is largely aimed at correcting the underlying cause of uremia and the other life-threatening conditions associated with renal failure. © 2015 The International Society of Dermatology.

A java based simulator with user interface to simulate ventilated patients

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Stehle P.

2015-09-01

Full Text Available Mechanical ventilation is a life-saving intervention, which despite its use on a routine basis, poses the risk of inflicting further damage to the lung tissue if ventilator settings are chosen inappropriately. Medical decision support systems may help to prevent such injuries while providing the optimal settings to reach a defined clinical goal. In order to develop and verify decision support algorithms, a test bench simulating a patient’s behaviour is needed. We propose a Java based system that allows simulation of respiratory mechanics, gas exchange and cardiovascular dynamics of a mechanically ventilated patient. The implemented models are allowed to interact and are interchangeable enabling the simulation of various clinical scenarios. Model simulations are running in real-time and show physiologically plausible results.

Identification of Hollow Viscus Injury with FAST Examination in Kurdistan, Iraq.

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Al-Sindy, Ruj; Alaqrawy, Heleen; Hafdullah, Mahmood Sh; Butts, Christine

2018-01-01

Point-of-care ultrasound has become indispensable in the evaluation of trauma, particularly in low resource areas, where it may be the only rapidly available imaging modality. The FAST (Focused Assessment with Sonography in Trauma) in particular can be lifesaving, by rapidly detecting signs of intra-abdominal hemorrhage. However, the FAST is primarily designed to identify free fluid associated with solid organ injury and is thought to have less sensitivity and power in identifying evidence of hollow viscus injury. We present a case of an unidentified man that presented to a hospital in the Kurdistan region of northern Iraq, a region of low resources, surrounded by war. The FAST exam proved to be the key to identifying this patient's injuries.

A case of hemophagocytic lymphohistiocytosis presenting as pyrexia of unknown origin

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Indira Madhavan

2015-01-01

Full Text Available Hemophagocytic lymphohistiocytosis (HLH is a potentially fatal hyper inflammatory condition, which occurs as either primary (genetic or secondary (acquired due to impaired or absent function of natural killer cells and cytotoxic cells. Common secondary causes include viral and bacterial infections, autoimmune diseases, and hematological malignancies. Extensive phagocytosis of blood cells by histiocytes in bone marrow, spleen, liver and lymphnodes result in peripheral blood cytopenias, hepatosplenomegaly, and lymphadenopathy. We evaluated a case of pyrexia of unknown origin and found out that he fulfilled the criteria for diagnosing HLH. He was started on immunochemotherapy with etoposide, cyclosporine and steroids, but he succumbed to illness within 2 weeks of treatment. High index of suspicion is needed to diagnose HLH and prompt treatment on diagnosis can be lifesaving.

Great expectations - Epigenetics and the meandering path from bench to bedside

DEFF Research Database (Denmark)

Häfner, Sophia J; Lund, Anders H

2016-01-01

Making quick promises of major biomedical breakthroughs based on exciting discoveries at the bench is tempting. But the meandering path from fundamental science to life-saving clinical applications can be fraught with many hurdles. Epigenetics, the study of potentially heritable changes of gene...... function without modification of the underlying DNA sequence, has dominated the biological research field during the last decade and encountered a large public success. Driven by the unfolding of molecular biology and recent technological progress, the term has evolved significantly and shifted from....... However, while exciting reports of biological phenomena involving DNA methylation and histone modifications fill up the scientific literature, the realistic clinical applications of epigenetic medicines remain somewhat blurry. Here, we discuss the state of the art and speculate how epigenetics might...

Compassion fade: affect and charity are greatest for a single child in need.

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Daniel Västfjäll

Full Text Available Charitable giving in 2013 exceeded $300 billion, but why do we respond to some life-saving causes while ignoring others? In our first two studies, we demonstrated that valuation of lives is associated with affective feelings (self-reported and psychophysiological and that a decline in compassion may begin with the second endangered life. In Study 3, this fading of compassion was reversed by describing multiple lives in a more unitary fashion. Study 4 extended our findings to loss-frame scenarios. Our capacity to feel sympathy for people in need appears limited, and this form of compassion fatigue can lead to apathy and inaction, consistent with what is seen repeatedly in response to many large-scale human and environmental catastrophes.

Noncultured Autologous Adipose-Derived Stem Cells Therapy for Chronic Radiation Injury

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Akita, Sadanori; Akino, Kozo; Hirano, Akiyoshi; Ohtsuru, Akira; Yamashita, Shunichi

2010-01-01

Increasing concern on chronic radiation injuries should be treated properly for life-saving improvement of wound management and quality of life. Recently, regenerative surgical modalities should be attempted with the use of noncultured autologous adipose-derived stem cells (ADSCs) with temporal artificial dermis impregnated and sprayed with local angiogenic factor such as basic fibroblast growth factor, and secondary reconstruction can be a candidate for demarcation and saving the donor morbidity. Autologous adipose-derived stem cells, together with angiogenic and mitogenic factor of basic fibroblast growth factor and an artificial dermis, were applied over the excised irradiated skin defect and tested for Patients who were uneventfully healed with minimal donor-site morbidity, which lasts more than 1.5 years. PMID:21151652

Noncultured Autologous Adipose-Derived Stem Cells Therapy for Chronic Radiation Injury

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Sadanori Akita

2010-01-01

Full Text Available Increasing concern on chronic radiation injuries should be treated properly for life-saving improvement of wound management and quality of life. Recently, regenerative surgical modalities should be attempted with the use of noncultured autologous adipose-derived stem cells (ADSCs with temporal artificial dermis impregnated and sprayed with local angiogenic factor such as basic fibroblast growth factor, and secondary reconstruction can be a candidate for demarcation and saving the donor morbidity. Autologous adipose-derived stem cells, together with angiogenic and mitogenic factor of basic fibroblast growth factor and an artificial dermis, were applied over the excised irradiated skin defect and tested for Patients who were uneventfully healed with minimal donor-site morbidity, which lasts more than 1.5 years.

Should selecting saviour siblings be banned?

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Sheldon, S; Wilkinson, S

2004-12-01

By using tissue typing in conjunction with preimplantation genetic diagnosis doctors are able to pick a human embryo for implantation which, if all goes well, will become a "saviour sibling", a brother or sister capable of donating life-saving tissue to an existing child. This paper addresses the question of whether this form of selection should be banned and concludes that it should not. Three main prohibitionist arguments are considered and found wanting: (a) the claim that saviour siblings would be treated as commodities; (b) a slippery slope argument, which suggests that this practice will lead to the creation of so-called "designer babies"; and (c) a child welfare argument, according to which saviour siblings will be physically and/or psychologically harmed.

Validity of Newborn Clinical Assessment to Determine Gestational Age in Bangladesh.

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Lee, Anne Cc; Mullany, Luke C; Ladhani, Karima; Uddin, Jamal; Mitra, Dipak; Ahmed, Parvez; Christian, Parul; Labrique, Alain; DasGupta, Sushil K; Lokken, R Peter; Quaiyum, Mohammed; Baqui, Abdullah H

2016-07-01

Gestational age (GA) is frequently unknown or inaccurate in pregnancies in low-income countries. Early identification of preterm infants may help link them to potentially life-saving interventions. We conducted a validation study in a community-based birth cohort in rural Bangladesh. GA was determined by pregnancy ultrasound (distribution, agreement, and diagnostic accuracy of different clinical methods of GA assessment were determined compared with early ultrasound dating. In the live-born cohort (n = 1066), the mean ultrasound GA was 39.1 weeks (SD 2.0) and prevalence of preterm birth (births (community health worker prematurity scorecard [sensitivity/specificity: 70%/27%]; Capurro [5%/96%]; Eregie [75%/58%]; Bhagwat [18%/87%], foot length birth weight rates of fetal growth restriction. Copyright © 2016 by the American Academy of Pediatrics.

Domestic violence: legal issues for health care practitioners and institutions.

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Hyman, A

1996-01-01

If health care practitioners and institutions became familiar with legal options available to survivors of domestic violence, they could better facilitate their patients' access to potentially life-saving recourses. Such options include calling the police and obtaining civil protection orders and bringing custody, divorce, and support actions. Provider awareness of legal obligations and other legal considerations that arise when handling domestic violence cases is important for patient care and the practice of good risk management. Examples of such issues include domestic violence protocol requirements, documentation of abuse, and repercussions of mandatory reporting laws. Health care providers should work in collaboration with community domestic violence programs in educating staff on issues pertaining to domestic violence and in crafting policies that promote patient safety and autonomy.

Familial Pancreatic Cancer

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Stephen J. Lanspa

2010-11-01

Full Text Available Pancreatic cancer’s high mortality rate equates closely with its incidence, thereby showing the need for development of biomarkers of its increased risk and a better understanding of its genetics, so that high-risk patients can be better targeted for screening and early potential lifesaving diagnosis. Its phenotypic and genotypic heterogeneity is extensive and requires careful scrutiny of its pattern of cancer associations, such as malignant melanoma associated with pancreatic cancer, in the familial atypical multiple mole melanoma syndrome, due to the CDKN2A germline mutation. This review is designed to depict several of the hereditary pancreatic cancer syndromes with particular attention given to the clinical application of this knowledge into improved control of pancreatic cancer.

The Life Saving Effects of Hospital Proximity

DEFF Research Database (Denmark)

Bertoli, Paola; Grembi, Veronica

We assess the lifesaving effect of hospital proximity using data on fatality rates of road-traffic accidents. While most of the literature on this topic is based on changes in distance to the nearest hospital triggered by hospital closures and use OLS estimates, our identification comes from......) increases the fatality rate by 13.84% on the sample average. This is equal to a 0.92 additional death per every 100 accidents. We show that OLS estimates provide a downward biased measure of the real effect of hospital proximity because they do not fully solve spatial sorting problems. Proximity matters...... more when the road safety is low; the emergency service is not properly organized, and the nearest hospital has lower quality standards....

Adenosine Deaminase (ADA)-Deficient Severe Combined Immune Deficiency (SCID): Molecular Pathogenesis and Clinical Manifestations.

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Bradford, Kathryn L; Moretti, Federico A; Carbonaro-Sarracino, Denise A; Gaspar, Hubert B; Kohn, Donald B

2017-10-01

Deficiency of adenosine deaminase (ADA, EC3.5.4.4), a housekeeping enzyme of purine metabolism encoded by the Ada gene, is a cause of human severe combined immune deficiency (SCID). Numerous deleterious mutations occurring in the ADA gene have been found in patients with profound lymphopenia (T - B - NK - ), thus underscoring the importance of functional purine metabolism for the development of the immune defense. While untreated ADA SCID is a fatal disorder, there are multiple life-saving therapeutic modalities to restore ADA activity and reconstitute protective immunity, including enzyme replacement therapy (ERT), allogeneic hematopoietic stem cell transplantation (HSCT) and gene therapy (GT) with autologous gene-corrected hematopoietic stem cells (HSC). We review the pathogenic mechanisms and clinical manifestations of ADA SCID.

Kidney transplantation in the context of renal replacement therapy.

Science.gov (United States)

Pesavento, Todd E

2009-12-01

Kidney transplantation has dramatically evolved from a life-saving yet unproven therapy for patients with renal failure to a mature field that is the preferred treatment for those suffering from ESRD. Patients who receive a transplant experience a 68% lower risk of death compared with those waiting on dialysis for a transplant. This benefit is afforded to all patient subgroups including the elderly (> or =70 yr), and diabetics, who can gain 11 yr of extra life with transplantation. Prolonged transplant wait times result in a higher risk of death but this can be ameliorated with preemptive transplantation. Future challenges will focus on appropriate organ allocation and addressing long-term renal function and comorbid conditions so patients can enjoy the full benefits of transplantation.

Reversible antibiotic tolerance induced in Staphylococcus aureus by concurrent drug exposure

DEFF Research Database (Denmark)

Haaber, Jakob Krause; Friberg, Cathrine; McCreary, Mark

2015-01-01

UNLABELLED: Resistance of Staphylococcus aureus to beta-lactam antibiotics has led to increasing use of the glycopeptide antibiotic vancomycin as a life-saving treatment for major S. aureus infections. Coinfection by an unrelated bacterial species may necessitate concurrent treatment with a second...... antibiotic that targets the coinfecting pathogen. While investigating factors that affect bacterial antibiotic sensitivity, we discovered that susceptibility of S. aureus to vancomycin is reduced by concurrent exposure to colistin, a cationic peptide antimicrobial employed to treat infections by Gram......-negative pathogens. We show that colistin-induced vancomycin tolerance persists only as long as the inducer is present and is accompanied by gene expression changes similar to those resulting from mutations that produce stably inherited reduction of vancomycin sensitivity (vancomycin-intermediate S. aureus [VISA...

An overview of medical ECMO for neonates.

Science.gov (United States)

Fletcher, Kathryn; Chapman, Rachel; Keene, Sarah

2018-03-01

Extracorporeal membrane oxygenation (ECMO), a life-saving therapy for respiratory and cardiac failure, was first used in neonates in the 1970s. The indications and criteria for ECMO have changed over the years, but it continues to be an important option for those who have failed other medical therapies. Since the Extracorporeal Life Support Organization (ELSO) Registry was established in 1989, more than 29,900 neonates have been placed on ECMO for respiratory failure, with 84% surviving their ECMO course, and 73% surviving to discharge or transfer. In this chapter, we will review the basics of ECMO, patient characteristics and criteria, patient management, ECMO complications, special uses of neonatal ECMO, and patient outcomes. Copyright © 2018 Elsevier Inc. All rights reserved.

Signature movements lead to efficient search for threatening actions.

Directory of Open Access Journals (Sweden)

Jeroen J A van Boxtel

Full Text Available The ability to find and evade fighting persons in a crowd is potentially life-saving. To investigate how the visual system processes threatening actions, we employed a visual search paradigm with threatening boxer targets among emotionally-neutral walker distractors, and vice versa. We found that a boxer popped out for both intact and scrambled actions, whereas walkers did not. A reverse correlation analysis revealed that observers' responses clustered around the time of the "punch", a signature movement of boxing actions, but not around specific movements of the walker. These findings support the existence of a detector for signature movements in action perception. This detector helps in rapidly detecting aggressive behavior in a crowd, potentially through an expedited (subcortical threat-detection mechanism.

A knowledge translation collaborative to improve the use of therapeutic hypothermia in post-cardiac arrest patients: protocol for a stepped wedge randomized trial.

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Dainty, Katie N; Scales, Damon C; Brooks, Steve C; Needham, Dale M; Dorian, Paul; Ferguson, Niall; Rubenfeld, Gordon; Wax, Randy; Zwarenstein, Merrick; Thorpe, Kevin; Morrison, Laurie J

2011-01-14

Advances in resuscitation science have dramatically improved survival rates following cardiac arrest. However, about 60% of adults that regain spontaneous circulation die before leaving the hospital. Recently it has been shown that inducing hypothermia in cardiac arrest survivors immediately following their arrival in hospital can dramatically improve both overall survival and neurological outcomes. Despite the strong evidence for its efficacy and the apparent simplicity of this intervention, recent surveys show that therapeutic hypothermia is delivered inconsistently, incompletely, and often with delay. This study will evaluate a multi-faceted knowledge translation strategy designed to increase the utilization rate of induced hypothermia in survivors of cardiac arrest across a network of 37 hospitals in Southwestern Ontario, Canada. The study is designed as a stepped wedge randomized trial lasting two years. Individual hospitals will be randomly assigned to four different wedges that will receive the active knowledge translation strategy according to a sequential rollout over a number of time periods. By the end of the study, all hospitals will have received the intervention. The primary aim is to measure the effectiveness of a multifaceted knowledge translation plan involving education, reminders, and audit-feedback for improving the use of induced hypothermia in survivors of cardiac arrest presenting to the emergency department. The primary outcome is the proportion of eligible OHCA patients that are cooled to a body temperature of 32 to 34°C within six hours of arrival in the hospital. Secondary outcomes will include process of care measures and clinical outcomes. Inducing hypothermia in cardiac arrest survivors immediately following their arrival to hospital has been shown to dramatically improve both overall survival and neurological outcomes. However, this lifesaving treatment is frequently not applied in practice. If this trial is positive, our results

Collaborative effects of bystander-initiated cardiopulmonary resuscitation and prehospital advanced cardiac life support by physicians on survival of out-of-hospital cardiac arrest: a nationwide population-based observational study.

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Yasunaga, Hideo; Horiguchi, Hiromasa; Tanabe, Seizan; Akahane, Manabu; Ogawa, Toshio; Koike, Soichi; Imamura, Tomoaki

2010-01-01

There are inconsistent data about the effectiveness of prehospital physician-staffed advanced cardiac life support (ACLS) on the outcomes of out-of-hospital cardiac arrest (OHCA). Furthermore, the relative importance of bystander-initiated cardiopulmonary resuscitation (BCPR) and ACLS and the effectiveness of their combination have not been clearly demonstrated. Using a prospective, nationwide, population-based registry of all OHCA patients in Japan, we enrolled 95,072 patients whose arrests were witnessed by bystanders and 23,127 patients witnessed by emergency medical service providers between 2005 and 2007. We divided the bystander-witnessed arrest patients into Group A (ACLS by emergency life-saving technicians without BCPR), Group B (ACLS by emergency life-saving technicians with BCPR), Group C (ACLS by physicians without BCPR) and Group D (ACLS by physicians with BCPR). The outcome data included 1-month survival and neurological outcomes determined by the cerebral performance category. Among the 95,072 bystander-witnessed arrest patients, 7,722 (8.1%) were alive at 1 month, including 2,754 (2.9%) with good performance and 3,171 (3.3%) with vegetative status or worse. BCPR occurred in 42% of bystander-witnessed arrests. In comparison with Group A, the rates of good-performance survival were significantly higher in Group B (odds ratio (OR), 2.23; 95% confidence interval, 2.05 to 2.42; P < 0.01) and Group D (OR, 2.80; 95% confidence interval, 2.28 to 3.43; P < 0.01), while no significant difference was seen for Group C (OR, 1.18; 95% confidence interval, 0.86 to 1.61; P = 0.32). The occurrence of vegetative status or worse at 1 month was highest in Group C (OR, 1.92; 95% confidence interval, 1.55 to 2.37; P < 0.01). In this registry-based study, BCPR significantly improved the survival of OHCA with good cerebral outcome. The groups with BCPR and ACLS by physicians had the best outcomes. However, receiving ACLS by physicians without preceding BCPR significantly

Measuring teamwork and taskwork of community-based “teams” delivering life-saving health interventions in rural Zambia: a qualitative study

Science.gov (United States)

2013-01-01

Background The use of teams is a well-known approach in a variety of settings, including health care, in both developed and developing countries. Team performance is comprised of teamwork and task work, and ascertaining whether a team is performing as expected to achieve the desired outcome has rarely been done in health care settings in resource-limited countries. Measuring teamwork requires identifying dimensions of teamwork or processes that comprise the teamwork construct, while taskwork requires identifying specific team functions. Since 2008 a community-based project in rural Zambia has teamed community health workers (CHWs) and traditional birth attendants (TBAs), supported by Neighborhood Health Committees (NHCs), to provide essential newborn and continuous curative care for children 0–59 months. This paper describes the process of developing a measure of teamwork and taskwork for community-based health teams in rural Zambia. Methods Six group discussions and pile-sorting sessions were conducted with three NHCs and three groups of CHW-TBA teams. Each session comprised six individuals. Results We selected 17 factors identified by participants as relevant for measuring teamwork in this rural setting. Participants endorsed seven functions as important to measure taskwork. To explain team performance, we assigned 20 factors into three sub-groups: personal, community-related and service-related. Conclusion Community and culturally relevant processes, functions and factors were used to develop a tool for measuring teamwork and taskwork in this rural community and the tool was quite unique from tools used in developed countries. PMID:23802766

The importance of pelvic ring stabilization as a life-saving measure in pre-hospital - A case report commented by autopsy.

Science.gov (United States)

Durão, Carlos; Alves, Magda; Barros, André; Pedrosa, Frederico

2017-08-01

Hip fractures with unstable pelvic ring have great morbidity and mortality rates. These fractures result from high energy trauma such as falls from heights, road accidents and collapsing structures or other similar mechanisms of action. We report the case of a 63 years old man, construction worker, who stood inside a ditch during a wall construction when he was surprised by this collapse, which resulted in direct trauma to the right thigh and pelvis. The autopsy revealed diaphysis fracture of the right femur with an open book pelvic fracture with severe hemorrhagic infiltration and hematoma of the pelvic muscles without arterial injury. Bone bleeding and the vascular damage associated with disruption of the sacroiliac ligaments promote a very significant bleeding. Simple maneuvers such as sheet circumferential compression to promote pelvic ring closure are effective on stabilizing and closure of the sacroiliac joint. Hip manipulation of the fracture was performed during the necropsy to demonstrate and prove how a simple sheet contention can promote stabilization of the pelvic ring by closing the sacroiliac joints in open book fractures.

Resuscitation of sudden cardiac death caused by acute epileptic seizures: A case report

Directory of Open Access Journals (Sweden)

Dana-Oliviana Geavlete

2016-03-01

Full Text Available Symptomatic long QT syndrome in pediatric patients is a life-threatening condition. Sometimes, this pathology can be misdiagnosed and erroneously managed as generalized epilepsy due to similar clinical manifestations. The presented case discusses a 13-year-old female patient with generalized epilepsy since the age of 4, admitted for two episodes of resuscitated cardiac arrest due to torsades de pointes and ventricular fibrillation. The final diagnosis of congenital long QT was established and due to the patient's high-risk profile for future cardiac events, implantable cardiac defibrillator was subsequently indicated. Early recognition of congenital long QT and timing of cardiac therapy were crucial and potentially lower the incidence of fatal dysrhythmias commonly associated this condition. In high-risk patients, both medical and interventional therapy can be life-saving.

Sudden Onset of Life-Threatening Methaemoglobinaemia After Intake of Inappropriately Stored Vegetable (Collard Greens Meal in a 2.5-Year-Old Child

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Ozlem Cakmak Yilmaz

2015-06-01

Full Text Available Acquired methaemoglobinaemia most commonly occurs due to intake of or contact to certain drugs, such as local anesthetics. However, intake of certain vegetables which are essential for a healthy diet may also cause methaemoglobinaemia due to their high nitrate or nitrite content, and prolonged and inappropriate storage after preparation of vegetable meals increases the risk. We present a 2.5-year-old girl with Down's syndrome who presented with central cyanosis due to severe methaemoglobinemiae with a methaemoglobin level of 62% after intake of collard greens (Brassica oleracea var. acephala soup. Although development of methaemoglobinaemia after food intake has been reported rarely before, recognition of this potentially life-threatening condition early in its course may be life-saving. [Cukurova Med J 2015; 40(2.000: 353-357

Próba oceny sytuacji granicznych związanych z chorobą i umieraniem [DEATH AND DYING – BO RDERLINE CASES

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Bogna Wach

2013-06-01

Full Text Available The aim of this article is an attempt to evaluate the following issues related to thelast stage of illness and death: discontinue of artificial nutrition and hydration, discontinueor refrain from life-saving therapy or palliative sedation.Mentioned cases are borderline situations. Medical consultants, taking thedecisions of removing the tube feeding, discontinuing or not taking up the procedurewhich causes maintain the patient’s life or applying terminal sedation, are aware, thatabove will lead to patient’s death. This is the reason why above situations cause lotsof doubts, the most important of which is a question, whether we are dealing withpassive euthanasia. Is it possible to carry out the border between forbidden “kill” andpermitted “let die”. Any attempt to answer this question is a kind of consensus.

Tetanus trismus in a 2 year old child: Case report

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Menon Narayanankutty Sunilkumar, Vadakut Krishnan Parvathy

2014-07-01

Full Text Available Tetanus is still a major cause of mortality and morbidity in developing countries. It occurs in children mainly in the unimmunized, due to parental ignorance and objection to vaccination. This potentially fatal disease caused by a neurotoxin, tetanospasmin released from wounds infected with Clostridium tetani, an anaerobic gram–positive bacillus. As tetanus becomes less common, cases are likely to be misdiagnosed or go unrecognized. In this case report, we present a case of tetanus in a partially immunized 2 year old girl who presented with trismus. She was treated with the recent recommendations and adequate supportive care. Detection of tetanus at a very early stage can favor lifesaving interventions. Trismus, infected wound and partially immunized/unimmunized status of a child were the key features leading to the prompt diagnosis and early treatment.

Fundamental Cardiovascular Research: Returns on Societal Investment: A Scientific Statement From the American Heart Association.

Science.gov (United States)

Hill, Joseph A; Ardehali, Reza; Clarke, Kimberli Taylor; Del Zoppo, Gregory J; Eckhardt, Lee L; Griendling, Kathy K; Libby, Peter; Roden, Dan M; Sadek, Hesham A; Seidman, Christine E; Vaughan, Douglas E

2017-07-21

Recent decades have witnessed robust successes in conquering the acutely lethal manifestations of heart and vascular diseases. Many patients who previously would have died now survive. Lifesaving successes like these provide a tremendous and easily recognized benefit to individuals and society. Although cardiovascular mortality has declined, the devastating impact of chronic heart disease and comorbidities on quality of life and healthcare resources continues unabated. Future strides, extending those made in recent decades, will require continued research into mechanisms underlying disease prevention, pathogenesis, progression, and therapeutic intervention. However, severe financial constraints currently jeopardize these efforts. To chart a path for the future, this report analyzes the challenges and opportunities we face in continuing the battle against cardiovascular disease and highlights the return on societal investment afforded by fundamental cardiovascular research. © 2017 American Heart Association, Inc.

Bypassing non-adherence via PEG in a critically ill HIV-1-infected patient.

Science.gov (United States)

Leipe, J; Hueber, A J; Rech, J; Harrer, T

2008-08-01

This case study describes a 44-year-old, chronically non-adherent, HIV-infected male with relapsing, life threatening toxoplasmic encephalitis (TE) and other recurring opportunistic infections. Non-adherence resulted in critical illness, suppressed CD4 lymphocyte count and elevated viral load. In order to bypass the patient's complete psychological aversion to taking medication, and after exhausting various psychological interventions, a percutaneous endoscopic gastronomy (PEG) tube was inserted for delivery of indispensable medication. During the 15-month follow-up the patient was adherent, exhibiting a consistently undetectable viral load, high CD4 count and a remission of the opportunistic infections. This is an interesting case study demonstrating life-saving and long-term benefit of PEG in an exceptional setting, which has implications for future research and treatment of non-adherent HIV-infected patients.

Importance of back blow maneuvers in a 6 month old patient with sudden upper airway obstruction

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Pinar Gencpinar

2015-12-01

Full Text Available Foreign body aspiration in children under four years old is one of the most frequently observed reasons for accident related deaths. It is more common in this age group due to inadequate swallowing functions and exploration of objects with the mouth. The most frequently encountered foreign bodies are food and toy parts. Life threatening complete laryngeal obstruction is rarely observed. Dyspnea, hypersalivation, cough and cyanosis can be seen. The basic and life-saving treatment approach is complete removal of foreign body maneuvers in the sudden onset of total obstruction. Here we report a six-month old male, who ingested a foreign body and was treated with back blow maneuvers successfully. In this case we emphasized the importance of back blow maneuvers. Keywords: Upper airway obstruction, Child, Back blows maneuvers

Critical care of tropical disease in low income countries: Report from the Task Force on Tropical Diseases by the World Federation of Societies of Intensive and Critical Care Medicine.

Science.gov (United States)

Baker, Tim; Khalid, Karima; Acicbe, Ozlem; McGloughlin, Steve; Amin, Pravin

2017-12-01

Tropical disease results in a great burden of critical illness. The same life-saving and supportive therapies to maintain vital organ functions that comprise critical care are required by these patients as for all other diseases. In low income countries, the little available data points towards high mortality rates and big challenges in the provision of critical care. Improving critical care in low income countries requires a focus on hospital design, training, triage, monitoring & treatment modifications, the basic principles of critical care, hygiene and the involvement of multi-disciplinary teams. As a large proportion of critical illness from tropical disease is in low income countries, the impact and reductions in mortality rates of improved critical care in such settings could be substantial. Copyright © 2017. Published by Elsevier Inc.

Percutaneous Emergency Needle Caecostomy for Prevention of Caecal Perforation.

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Limmer, Alexandra M; Clement, Zackariah

2017-01-01

Caecal perforation is a life-threatening complication of large bowel obstruction with a reported mortality of 34% to 72%. This case describes the novel use of percutaneous needle caecostomy as a life-saving measure to prevent imminent caecal perforation in a 68-year-old lady with large bowel obstruction secondary to an incarcerated incisional hernia. After careful review of computed tomography images and measurement of distances from the abdominal wall to the caecum, the patient's caecum was decompressed in the emergency department using a needle under local anaesthetic. The patient subsequently underwent laparoscopic hernia repair and had an uncomplicated recovery. When conducted safely and with precision in an appropriate patient, percutaneous needle caecostomy can provide immediate symptom relief, reduce risk of caecal perforation, and allow a laparoscopic surgical approach.

Percutaneous Emergency Needle Caecostomy for Prevention of Caecal Perforation

Directory of Open Access Journals (Sweden)

Alexandra M. Limmer

2017-01-01

Full Text Available Caecal perforation is a life-threatening complication of large bowel obstruction with a reported mortality of 34% to 72%. This case describes the novel use of percutaneous needle caecostomy as a life-saving measure to prevent imminent caecal perforation in a 68-year-old lady with large bowel obstruction secondary to an incarcerated incisional hernia. After careful review of computed tomography images and measurement of distances from the abdominal wall to the caecum, the patient’s caecum was decompressed in the emergency department using a needle under local anaesthetic. The patient subsequently underwent laparoscopic hernia repair and had an uncomplicated recovery. When conducted safely and with precision in an appropriate patient, percutaneous needle caecostomy can provide immediate symptom relief, reduce risk of caecal perforation, and allow a laparoscopic surgical approach.

Embedding High-Fidelity Simulation Into a Foundations of Nursing Course.

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Talbot, Megan Sary

2015-01-01

Delay in recognizing the need for and initiating lifesaving measures is unacceptable in health care. It is never too early to teach novice nursing students to recognize and respond to early warning signs of patient deterioration. The rapid response system was developed to expedite recognition of and response to changes in a patient's condition. Use of high-fidelity simulation by beginning nursing students to practice recognizing and responding to patient deterioration is vital to both the welfare of patients and the edification of students. Recognizing and responding quickly to patients' early warning signs of deterioration can determine a patient's outcome. This article discusses the importance of instructing beginning nursing students in identifying and reacting appropriately to early signs of patient deterioration and in following the chain of command to activate the rapid response team.

Age-related mortality, clinical heart failure, and ventricular fibrillation in 4259 Danish patients after acute myocardial infarction

DEFF Research Database (Denmark)

Rask-Madsen, C; Jensen, G; Køber, L

1997-01-01

% for patients less than or = 80 years old. Two thirds of patients > or = 80 years old had heart failure, and cardiogenic shock was twice as common in this age group than in patients 60-69 years. Heart failure was a strong independent risk......AIMS: To evaluate the prognosis of patients > or = 80 years old, we analysed a large, community-based population with acute myocardial infarction who received intensive observation and similar pharmacotherapy regardless of age. METHODS AND RESULTS: In a 12-year period, before the introduction......, factor for post-discharge mortality, particularly in the oldest age groups. Four out of eight patients > or = 80 years survived one year if discharged alive after experiencing in-hospital ventricular fibrillation. CONCLUSION: The life-saving potential of preventing or treating heart failure seems...

Severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis.

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Kumar, Amandeep; Suri, Ashish; Sharma, Bhawani S

2014-07-01

Valproic acid (VPA) is a commonly used drug for epilepsy, psychiatric disorders and migraine and is frequently used in neurosurgical intensive care units. Though most of its side-effects are mild and transient, certain idiosyncratic side-effects have been attributed to VPA. Valproate induced hyperammonemia (VIH) is one such side-effect. VIH can produce symptoms of encephalopathy known as valproate induced hyperammonemic encephalopathy (VHE). VIH and VHE usually respond to withdrawal of VPA. However, in some cases VHE can be unresponsive to supportive measures and severe enough to be life-threatening. In such cases, dialysis can be used to rapidly reverse hyperammonemia and VHE and can prove to be a lifesaving measure. We report such a case of VIH and life-threatening VHE in a postoperative neurosurgical patient that was managed successfully with peritoneal dialysis.

Conceptualization of a Collaborative Decision Making for Flood Disaster Management

Science.gov (United States)

Nur Aishah Zubir, Siti; Thiruchelvam, Sivadass; Nasharuddin Mustapha, Kamal; Che Muda, Zakaria; Ghazali, Azrul; Hakimie, Hazlinda; Razak, Normy Norfiza Abdul; Aziz Mat Isa, Abdul; Hasini, Hasril; Sahari, Khairul Salleh Mohamed; Mat Husin, Norhayati; Ezanee Rusli, Mohd; Sabri Muda, Rahsidi; Mohd Sidek, Lariyah; Basri, Hidayah; Tukiman, Izawati

2016-03-01

Flooding is the utmost major natural hazard in Malaysia in terms of populations affected, frequency, area extent, flood duration and social economic damage. The recent flood devastation towards the end of 2014 witnessed almost 250,000 people being displaced from eight states in Peninsular Malaysia. The affected victims required evacuation within a short period of time to the designated evacuation centres. An effective and efficient flood disaster management would assure non-futile efforts for life-saving. Effective flood disaster management requires collective and cooperative emergency teamwork from various government agencies. Intergovernmental collaborations among government agencies at different levels have become part of flood disaster management due to the need for sharing resources and coordinating efforts. Collaborative decision making during disaster is an integral element in providing prompt and effective response for evacuating the victims.

Severe respiratory failure as a presenting feature of an interstitial lung disease associated with anti-synthetase syndrome (ASS).

Science.gov (United States)

Piroddi, Ines Maria Grazia; Ferraioli, Gianluca; Barlascini, Cornelius; Castagneto, Corrado; Nicolini, Antonello

2016-07-01

Anti-synthetase syndrome (ASS) is defined as a heterogeneous connective tissue disorder characterized by the association of an interstitial lung disease (ILD) with or without inflammatory myositis with the presence of anti-aminoacyl-tRNA-synthetase antibodies. ILD is one of the major extra-muscular manifestations of polymyositis and dermatomyositis. We report a case of a patient with dyspnea, cough, and intermittent fever as well as ILD associated ASS in the absence of muscular involvement. This patient was admitted to the emergency department with severe respiratory failure requiring non-invasive ventilation. Our patient's case demonstrates that the diagnosis of ASS may not be obvious. However, its diagnosis leads to appropriate and potentially life-saving treatment. Copyright © 2016 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Blast overpressure and fallout radiation dose models for casualty assessment and other purposes. Rev. ed.

International Nuclear Information System (INIS)

Bentley, P.R.

1981-12-01

The determination of blast overpressures and fallout radiation doses at points on a sufficiently fine grid, for any part or for the whole of the UK, and for any postulated attack, is an essential element in the systematic assessment of casualties, the estimation of numbers of homeless, and the evaluation of life-saving measures generally. Models are described which provide the required blast and dose values and which are intended to supersede existing models which were introduced in 1971. The factors which affect blast and, more particularly, dose values are discussed, and the way in which various factors are modelled is described. The models are incorporated into separate computer programs which are described, the outputs of which are stored on magnetic tape for subsequent use as required. (author)

Altered level of consciousness: evidence-based management in the emergency department [digest].

Science.gov (United States)

Song, Joo Lee; Wang, Vincent J; Vazquez, Michelle N

2017-01-22

A child who presents to the emergency department with an altered level of consciousness can be clinically unstable and can pose a great diagnostic challenge. The emergency clinician must quickly develop a wide differential of possible etiologies in order to administer potentially life-saving medications or interventions. The history, physical examination, and appropriate diagnostic tests can aid greatly in rapidly narrowing the differential diagnosis. Once initial stabilization, workup, and first-line interventions are completed, most patients who present with unresolved or unidentified altered level of consciousness should be admitted for further evaluation and close monitoring. This issue provides a review of the etiologies of altered level of consciousness as well as guidance for the management and disposition of patients with this condition. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

Clinical and Pathological Findings on Intoxication by Yellow Phosphorus After Ingesting Firework Cracker: A Rare Case of Autopsy.

Science.gov (United States)

Türkmen Şamdanci, Emine; Çakir, Ebru; Şahin, Nurhan; Elmali, Candan; Sayin, Sadegül

2016-01-01

Yellow phosphorus is a toxic substance used in the production of firework cracker, fireworks, ammunition and agricultural dung. When ingested, it shows its effects mainly in the liver, the kidneys, and the brain. A four-year-old girl had died as a result of acute hepatic failure caused by ingesting a firework cracker. The case showed high levels of hepatic enzymes, along with non-specific signs such as nausea, vomiting and diarrhea. Autopsy revealed diffuse microvesicular steatosis in the liver and disseminated degeneration in the proximal tubules of the kidneys. In cases with concomitant hepatorenal failure and cardiovascular collapse, death is inevitable. However, when only hepatic failure develops, hepatic transplantation may be lifesaving. Although intoxication from ingesting yellow phosphorus has a very high rate of mortality, forensic cases are extremely rare in the literature.

Promoting High-Value Practice by Reducing Unnecessary Transfusions With a Patient Blood Management Program.

Science.gov (United States)

Sadana, Divyajot; Pratzer, Ariella; Scher, Lauren J; Saag, Harry S; Adler, Nicole; Volpicelli, Frank M; Auron, Moises; Frank, Steven M

2018-01-01

Although blood transfusion is a lifesaving therapy for some patients, transfusion has been named 1 of the top 5 overused procedures in US hospitals. As unnecessary transfusions only increase risk and cost without providing benefit, improving transfusion practice is an effective way of promoting high-value care. Most high-quality clinical trials supporting a restrictive transfusion strategy have been published in the past 5 to 10 years, so the value of a successful patient blood management program has only recently been recognized. We review the most recent transfusion practice guidelines and the evidence supporting these guidelines. We also discuss several medical societies' Choosing Wisely campaigns to reduce or eliminate overuse of transfusions. A blueprint is presented for developing a patient blood management program, which includes discussion of specific methods for optimizing transfusion practice.

ATYPICAL CSF PICTURE IN VIRAL MENINGITIS HSV- TYPE-2

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Vikram

2016-05-01

Full Text Available INTRODUCTION Acute infections of nervous system are among the most important problems in medicine because early recognition, efficient decision making and rapid institution of therapy can be lifesaving. Making a clinical diagnosis of acute meningitis depends on the cornerstone of cerebrospinal fluid (CSF examination. We present a case with the above-mentioned difficulty and the approach involved in establishing the exact diagnosis and institution of appropriate treatment. CONCLUSION About findings in viral meningitis one should be careful while evaluating a CSF report so as to not make a mistaken diagnosis and delay treatment. The most important analysis in patients whose symptoms are consistent with herpes simplex meningitis is the detection of Herpes simplex Virus deoxy-ribo-nucleic acid (HSV-DNA in CSF with Polymerase Chain Reaction (PCR.

Heart block and acute kidney injury due to hyperparathyroidism-induced hypercalcemic crisis.

Science.gov (United States)

Brown, Taylor C; Healy, James M; McDonald, Mary J; Hansson, Joni H; Quinn, Courtney E

2014-12-01

We describe a patient who presented with multi-system organ failure due to extreme hypercalcemia (serum calcium 19.8 mg/dL), resulting from primary hyperparathyroidism. He was found to have a 4.8 cm solitary atypical parathyroid adenoma. His course was complicated by complete heart block, acute kidney injury, and significant neurocognitive disturbances. Relevant literature was reviewed and discussed. Hyperparathyroidism-induced hypercalcemic crisis (HIHC) is a rare presentation of primary hyperparathyroidism and only a small minority of these patients develop significant cardiac and renal complications. In cases of HIHC, a multidisciplinary effort can facilitate rapid treatment of life-threatening hypercalcemia and definitive treatment by surgical resection. As such, temporary transvenous cardiac pacing and renal replacement therapy can provide a life-saving bridge to definitive parathyroidectomy in cases of HIHC.

Studies of significant properties of filter-type self rescuer for its use in underground coal mine in carbon monoxide exposure

Energy Technology Data Exchange (ETDEWEB)

Kumar, A.; Mondal, P.C. [Central Institute of Mining and Fuel Research, Dhanbad (India)

2007-07-01

CO is a highly toxic gas; it is the outcome of fire or explosion in underground coal mines. It combines with hemoglobin of coal mine workers and carboxyhemoglobin forms, which reduces the oxygen carrying capacity of blood. A little intake of CO gas, even 0.1% in atmosphere, causes respiratory failure. Filter-type self rescuers (FSR) are a life-saving gas mask breathing apparatus against CO exposure in underground coal mine. The quality of FSR was evaluated in respect of its duration for use, CO conversion by hopcalite, breathing resistance, leak tightness properties, and so on. A scope of improvement is observed in cartridge of self rescuer as well as in the clauses of BIS 9563-1980 in order to increase the duration and improvement in the quality of self rescuers. 12 refs., 2 tabs.

Guardians of 'the gift'

DEFF Research Database (Denmark)

Jensen, Anja M. B.

2017-01-01

professionals carefully selecting, guiding and interacting with organ recipients before, during and after the transplant. Based on anthropological fieldwork at a Danish heart and lung transplant unit, the paper explores how doctors and nurses experience and handle the emotional challenges of their working life......This paper deals with the emotional challenges encountered by doctors and nurses caring for heart and lung transplant patients. Organ transplantation enables body parts from the dead to become usable in patients with no other life-saving option. These exchanges are not possible without transplant....... They must take the difficult decisions of whether to admit critically ill patients onto the organ waiting list; face the distress of post-transplant sufferings and deaths; and deal with organ recipients who do not behave according to post-transplant recommendations. Drawing on a familiar metaphor...

Optimal glucocorticoid replacement in adrenal insufficiency.

Science.gov (United States)

Øksnes, Marianne; Ross, Richard; Løvås, Kristian

2015-01-01

Adrenal insufficiency (glucocorticoid deficiency) comprises a group of rare diseases, including primary adrenal insufficiency, secondary adrenal insufficiency and congenital adrenal hyperplasia. Lifesaving glucocorticoid therapy was introduced over 60 years ago, but since then a number of advances in treatment have taken place. Specifically, little is known about short- and long-term treatment effects, and morbidity and mortality. Over the past decade, systematic cohort and registry studies have described reduced health-related quality of life, an unfavourable metabolic profile and increased mortality in patients with adrenal insufficiency, which may relate to unphysiological glucocorticoid replacement. This has led to the development of new modes of replacement that aim to mimic normal glucocorticoid physiology. Here, evidence for the inadequacy of conventional glucocorticoid therapy and recent developments in treatment are reviewed, with an emphasis on primary adrenal insufficiency. Copyright © 2014 Elsevier Ltd. All rights reserved.

Acute pancreatitis: The role of imaging in diagnosis and management

Energy Technology Data Exchange (ETDEWEB)

Bharwani, Nishat, E-mail: nishat.bharwani@nhs.ne [Imaging Department, Barts and The London NHS Trust, St Bartholomew' s Hospital, Ground Floor, King George V Wing, London EC1A 7BE (United Kingdom); Patel, Shilpa; Prabhudesai, Shirish; Fotheringham, Tim; Power, Niall [Imaging Department, Barts and The London NHS Trust, St Bartholomew' s Hospital, Ground Floor, King George V Wing, London EC1A 7BE (United Kingdom)

2011-02-15

Acute pancreatitis is one of the more commonly encountered aetiologies in the emergency setting and its incidence is rising. Presentations range from a mild-self limiting condition which usually responds to conservative management to one with significant morbidity and mortality in its most severe forms. While clinical criteria are necessary to make the initial diagnosis, contrast-enhanced CT is the mainstay of imaging and has a vital role in assessing the extent and evolution of the disease and its associated complications. The purpose of this article is to summarise the natural course of acute severe pancreatitis, clarify confusing nomenclature, demonstrate the morphological stages in conjunction with radiological scoring systems and illustrate the complications. We will review and illustrate the increasing and significant role interventional radiology has in the management of these patients, which are often life-saving and surgery-sparing.

Outcome and survival of patients aged 75 years and older compared to younger patients after ruptured abdominal aortic aneurysm repair: do the results justify the effort?

DEFF Research Database (Denmark)

Shahidi, S; Schroeder, T Veith; Carstensen, M.

2009-01-01

We evaluated early mortality (preoperative variables that may be predictive of 30-day mortality in elderly patients compared to younger patients after emergency open repair of ruptured abdominal aortic aneurysm (RAAA). The survey is a retrospective analysis based...... patients compared to the younger group. Between the survivors of the two groups, there were no significant differences in the total length of stay (LOS) and the LOS in the intensive care unit. Advanced age (>or=75) and the combination of this advanced age and serum creatinine of >or=0.150 mmol/L were...... the only significant (p preoperative risk factors in our single-center study. However, we believe that treatment for RAAA can be justified in elderly patients. In our experience, surgical open repair has been life-saving in 33% of patients aged 75 years and older, at a relatively low price for each...

A case of appropriate inappropriate device therapy: Hyperkalemia-induced ventricular oversensing

Science.gov (United States)

Oudit, Gavin Y; Cameron, Doug; Harris, Louise

2008-01-01

The present case describes a patient who received inappropriate, but potentially life-saving, therapy from her implantable cardioverter defibrillator (ICD) in the setting of acute hyperkalemia (plasma potassium concentration = 8 mM). Hyperkalemia was associated with the development of a slow sinusoidal ventricular tachycardia, at a rate of 100 beats/min to 125 beats/min (610 ms to 480 ms) in a patient who is pacemaker-dependent. There was associated fractionation of the ICD electrogram and T wave oversensing, leading to ventricular oversensing with resultant detection in the ventricular fibrillation rate zone. This was followed by shock therapy, even though the ventricular tachycardia rate was below the programmed detection rate of the ICD. The subsequent emergency treatment of the hyperkalemia normalized the electrogram, corrected the ventricular oversensing and arrhythmia, and restored rate-adaptive single-chamber ventricular pacing. PMID:18340383

Increase of survival of x-irradiated mice by postirradiation injections of a splenic extract prepared from vaccine or endotoxin-treated syngeneic animals

Energy Technology Data Exchange (ETDEWEB)

Tsuneoka, K; Takagi, Y; Shikita, M [National Inst. of Radiological Sciences, Chiba (Japan)

1977-05-01

Spleens of mice which had been treated with E. coli endotoxin or typhoid-paratyphoid vaccine were extracted with isotonic saline. The extract was filtered through an asbestos filter and chromatographed on a Sephadex G-200 column. The fraction which was excluded at around 2.5-void volume (molecular weight, about 20,000) was significantly effective in increasing survival of animals when it was repeatedly injected in mice after x irradiation (600 R). The injection caused an increase of the weight of spleen of the animals with an increased number of endogenous spleen colonies. The result suggests that the life-saving effect of the spleen extract is based on its effect of stimulating repopulation of autochthonous hematopoietic cells in the x-irradiated animals. A similar splenic extract prepared from normal mice had an ambiguous effect on the survival of x-irradiated animals.

Impacts of international sanctions on Iranian pharmaceutical market.

Science.gov (United States)

Cheraghali, Abdol Majid

2013-07-31

Iran in recent decade faced several regional and international sanctions in foreign trade, financial and banking services. Iran national pharmaceutical industry has always played a major role in providing medicines to the Iranian patients. However, following the sanctions it has faced profound difficulties for importing of both finished products and pharmaceutical raw materials. Although medicines are exempted from sanctions, due to restriction on money transaction and proper insurance Iranian pharmaceutical companies have to pay cash in advance for imports of medicines and raw materials or to secure offshore funds at very high risks. Current situation in Iran pharmaceutical market confirms that the sanctions against Iran are affecting ordinary citizens and national health sector which resulted to reduction of availability of lifesaving medicines in the local market and has caused increasing pain and suffering for Iranian patients.

Use of a Tourniquet by LIFE STAR Air Medical Crew: A Case Report.

Science.gov (United States)

Jacobs, Lenworth M; Burns, Karyl J; Priest, Heather Standish; Muskett, William

2015-10-01

For many years tourniquets were perceived as dangerous due to the belief that they led to loss of limb because of ischemia. Their use in civilian and military environments was discouraged. Emergency medical responders were not taught about tourniquets and commercial tourniquets were not available. However, research by the United States military during the wars in Iraq and Afghanistan has demonstrated that tourniquets are safe life-saving devices. As a consequence, they have been widely deployed in combat situations and there are now calls for the use of tourniquets in the civilian prehospital setting. This article presents a report of the successful application of a tourniquet by the LIFE STAR crew to control bleeding that local emergency medical services (EMS) personnel could not control with direct pressure. Tourniquets should be readily available in public places and carried by all EMS.

Gender bias in child care and child health: global patterns.

Science.gov (United States)

Khera, Rohan; Jain, Snigdha; Lodha, Rakesh; Ramakrishnan, Sivasubramanian

2014-04-01

Gender-based discrimination is reported across the spectrum of paediatric healthcare including emergency, inpatient, outpatient and preventive care and is mostly reported from South Asia and China with sporadic reports from Africa and South America. Biases against young girls have been documented even in immunisation percentage, home food allocation, seeking medical care for childhood ailments and percentage of household healthcare expenditures allocated to them. Such gender discrimination in access to medical care is likely to have an influence on the overall health of female children. Over the last five decades, the under-5 sex ratios are worsening in India with declining number of girls. Deliberate parental neglect of girls' essential and life-saving medical care is also an important contributing factor apart from sex-selective abortions to the declining gender ratios. Corrective measures and focused action are needed.

Quality of paediatric blood transfusions in two district hospitals in Tanzania: a cross-sectional hospital based study

DEFF Research Database (Denmark)

Mosha, Dominic; Poulsen, Anja; Reyburn, Hugh

2009-01-01

respectively, prior to the BT decision. Pre-transfusion haemoglobin and body temperature were recorded in 2/3 of the patients, but respiratory rate and pulse rate were not routinely recorded. In 40% of BTs, the transfusion time exceeded the recommended 4 hours. The zonal blood bank (ZBB) and local donors......BACKGROUND: Blood transfusion (BT) can be lifesaving for children; however, monitoring the quality of BT is important. The current study describes the quality of paediatric BT delivered in two district hospitals in north-east Tanzania in order to identify areas for quality assurance and improvement...... in the administration of BT. METHODS: All 166 children admitted in the paediatric wards and receiving BT through April to June 2007 were prospectively observed. Medical records, request forms and registers in the laboratories were reviewed to identify blood source, blood screening and indications for BT. BT...

Frequency of Cushing's syndrome due to ACTH-secreting adrenal medullary lesions: a retrospective study over 10 years from a single center.

Science.gov (United States)

Falhammar, Henrik; Calissendorff, Jan; Höybye, Charlotte

2017-01-01

Cushing's syndrome due to ectopic adrenocorticotropic hormone production from adrenal medullary lesions has occasionally been described. We retrospectively reviewed all 164 cases of Cushing's syndrome and 77 cases of pheochromocytomas during 10 years. Of all cases with Cushing's syndrome, only two cases (1.2 %) were due to ectopic adrenocorticotropic hormone production from adrenal medullary lesions (one case of pheochromocytoma and one case of adrenal medullary hyperplasia). Of all pheochromocytomas only the above-mentioned case (1.3 %) also gave rise to an ectopic adrenocorticotropic hormone syndrome. The clinical presentation of adrenocorticotropic hormone-secreting pheochromocytoma and adrenal medullary hyperplasia can be anything from mild to dramatic. These are rare conditions important to bear in mind in the workup of a patient with Cushing's syndrome or with pheochromocytoma. The identification of ectopic adrenocorticotropic hormone secretion from adrenal medullary lesions can be life-saving.

Domestic smoke detectors using radioactive material

International Nuclear Information System (INIS)

Anon.

1979-02-01

Increasing numbers of technical and consumer products incorporating radioactive material are becoming available to the Australian public. One consumer device of this type coming into common use is the domestic smoke detector that uses Americium 241 in detecting smoke. This device has obvious life-saving and property-saving advantages and is attractive in that it is attractive in that it is self-contained, battery powered and needs little maintenance. The National Health and Medical Research Council in October 1978 recommended conditions, which are listed, are intended to ensure that radiation safety is preserved. They provide for the testing and approval of all models of domestic smoke detectors using radioactive material. The National Health and Medical Research Council stated that provided these conditions are applied it had no objection to the sale of these detectors by retailers

The Psychosocial Treadmill: the Road to Improving High-risk Behavior in Advanced Therapy Candidates.

Science.gov (United States)

Newman, Laura

2018-04-01

The purpose of this review is to explore the evaluation and identification of psychosocial risk factors during the heart transplant evaluation process with the goal of improving psychosocial candidacy prior to transplant listing. Subsequently, more patients will be able to receive life-saving heart transplant and experience success after transplant. Evaluating and identifying psychosocial risk factors is an essential component of the transplant evaluation process. Less research exists demonstrating how patients may be able to reduce psychosocial risk factors over time to improve their candidacy for transplant. This review will describe a program developed for patients undergoing heart transplant evaluation at The Ohio State University Wexner Medical Center to improve their psychosocial risk. By implementing a comprehensive, multidisciplinary intervention to address psychosocial risk factors pre-transplant, patients can improve their psychosocial candidacy and go on to be listed for heart transplant.

Challenges in orphan drug development and regulatory policy in China.

Science.gov (United States)

Cheng, Alice; Xie, Zhi

2017-01-18

While regulatory policy is well defined for orphan drug development in the United States and Europe, rare disease policy in China is still evolving. Many Chinese patients currently pay out of pocket for international treatments that are not yet approved in China. The lack of a clear definition and therefore regulatory approval process for rare diseases has, until now, de-incentivized pharmaceutical companies to pursue rare disease drug development in China. In turn, many grassroots movements have begun to support rare disease patients and facilitate drug discovery through research. Recently, the Chinese FDA set new regulatory guidelines for drugs being developed in China, including an expedited review process for life-saving treatments. In this review, we discuss the effects of these new policy changes on and suggest potential solutions to innovate orphan drug development in China.

Successful selective arterial thrombolysis in patient with acute abdominal thromboembolism

Directory of Open Access Journals (Sweden)

Christo Tsekov

2016-06-01

Full Text Available The paper reports successful thrombolysis conducted in 64 years old woman admitted to the clinic with clinical and angiographic data for acute surgical abdomen caused by acute tromboembolia of arteria mesenterica superior (AMS. The therapeutic approach required to undertake lifesaving decision on i.e. surgical vs. invasive treatment in conditions of emergency. Finally, it was decided to undertake invasive treatment with successful restoration of blood flow in the related artery. The patient was discharged from the clinic with considerable clinical improvement on the fifth day of her stay. The case report includes discussion on issues relating the consequence of the diagnostic and interventional procedures in such patients, opportunities for conducting emergency thrombolysis in acute embolia of AMS and preventive measures in patients with high tromboembolic risk. Keywords: Mesenterial circulation, Abdominal thromboembolism, Arterial thrombolysis

Presence of voltage-gated potassium channel complex antibody in a case of genetic prion disease.

Science.gov (United States)

Jammoul, Adham; Lederman, Richard J; Tavee, Jinny; Li, Yuebing

2014-06-05

Voltage-gated potassium channel (VGKC) complex antibody-mediated encephalitis is a recently recognised entity which has been reported to mimic the clinical presentation of Creutzfeldt-Jakob disease (CJD). Testing for the presence of this neuronal surface autoantibody in patients presenting with subacute encephalopathy is therefore crucial as it may both revoke the bleak diagnosis of prion disease and allow institution of potentially life-saving immunotherapy. Tempering this optimistic view is the rare instance when a positive VGKC complex antibody titre occurs in a definite case of prion disease. We present a pathologically and genetically confirmed case of CJD with elevated serum VGKC complex antibody titres. This case highlights the importance of interpreting the result of a positive VGKC complex antibody with caution and in the context of the overall clinical manifestation. 2014 BMJ Publishing Group Ltd.

Is Heart Period Variability Associated with the Administration of Lifesaving Interventions in Individual Prehospital Trauma Patients with Normal Standard Vital Signs?

Science.gov (United States)

2010-08-01

heart period variability as an indicator of mortality in intensive care unit patients many hours before death. Similarly, re- cent studies using data...the Department of Health and Kinesiology (CAR), The University of Texas at San Antonio, San An- tonio, TX; U.S. Army Institute of Surgical Research (CAR

[New use of pulse-oximeter as a prophylactic Stimulator to the wearer and a lifesaving tools for prevention of hypoxic mishaps].

Science.gov (United States)

Morioka, Tohru; Terasaki, Hidenori

2014-03-01

Pulse-oximeter has been widely used for the clinical assessment of physical status of a patient and as an alarming tool of hypoxia to medical personnel at the bedside or in the observation center. However, it has never been used for direct stimulation of the wearer. We considered innovation of pulse-oximeter as a prophylactic alarm-oximeter for the wearer. If SPO2 goes down to unfavorable level, the alarm-oximeter starts to send signal through a control box to a stimulator, such as an electrical nerve stimulator, a cold thermal tip, or mechanical device like a vibrator or compressor. The dermal stimulator is usually fixed to the right or left wrist with a Velcro band. The control box is affixed to the wristband by using Velcro. The alarm may be sent to an earphone or speaker with a verbal command like "take a deep breath". Alarm-oximeter will be combined to an oxygen inhaler or mechanical ventilatory assist device, or a drug administration system through electric line or wireless transmitter to start or change its function before the arrival of medical personnel. It will prevent hypoxic mishaps during medical intervention or sleep apnea syndrome. It will be also applicable to stop snoring.

Variable penetration of primary angioplasty in Europe--what determines the implementation rate?

Science.gov (United States)

Kristensen, Steen D; Laut, Kristina G; Kaifoszova, Zuzana; Widimsky, Petr

2012-08-01

Primary percutaneous coronary intervention (PPCI) is the recommended treatment for patients with acute ST-segment elevation myocardial infarction (STEMI). A survey conducted in 2008 in the European Society of Cardiology (ESC) countries reported that the annual incidence of hospital admissions for acute STEMI is around 800 patients per million inhabitants. The survey also showed that STEMI patients' access to reperfusion therapy and the use of PPCI or thrombolytic therapy (TT) vary considerably among countries. Northern, Western and Central Europe already had well-developed PPCI services, offering PPCI to 60-90% of all STEMI patients. Southern Europe and the Balkans were still predominantly using TT and had a higher proportion of patients who were left without any reperfusion treatment. The survey concluded that a nationwide PPCI strategy results in more patients being offered reperfusion therapy. To address the inequalities in STEMI patients' access to life-saving PPCI and to support the implementation of the ESC STEMI treatment guidelines in Europe, the Stent for Life (SFL) Initiative was launched jointly by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and EuroPCR in 2008. The aim of the SFL Initiative is to improve the delivery of life-saving PPCI for STEMI patients. Currently, 10 national cardiac societies support the SFL Initiative in their respective countries. SFL national action programmes have been developed and are being implemented in several countries. The formation of regional PPCI networks involving emergency medical services, non-PPCI hospitals and PPCI centres is considered to be a critical factor in implementing PPCI services effectively. Better monitoring of STEMI incidence and prospective registration of PPCI in all countries is required to document improvements in health care and to identify areas where further effort is required. Furthermore, studies on potential factors or characteristics that explain the

Design and characterization of an ocean wave powered lifejacket using 2DOF floating boards

Science.gov (United States)

Mi, Jia; Xu, Lin; Yang, Yaling; Zuo, Lei

2018-04-01

Lifejacket is an indispensable life-saving equipment for ships and airplanes. Traditional lifejacket is designed to prevent human from drowning. However, the water temperature is usually low, especially in winter, which significantly reduces the human body temperature and leads to death. Meanwhile, power is critical for drowning people to use emergency communication equipment. This paper proposed an ocean wave powered lifejacket using 2DOF floating boards to provide both buoyance and electricity for drowning people. Hence, they can use this continuous electric power to keep key body warm and send distress signal. This lifejacket is featured with two 2DOF floating boards and the mechanical motion rectifier (MMR) can convert the 2-DOF motions to the unidirectional rotation of generator. The design principle is illustrated and the dynamic modelling for the 2-DOF motions has been analyzed. Bench test and lake test have been conducted to validate the design concept.

Fifty Years of Research in ARDS. Respiratory Mechanics in Acute Respiratory Distress Syndrome.

Science.gov (United States)

Henderson, William R; Chen, Lu; Amato, Marcelo B P; Brochard, Laurent J

2017-10-01

Acute respiratory distress syndrome is a multifactorial lung injury that continues to be associated with high levels of morbidity and mortality. Mechanical ventilation, although lifesaving, is associated with new iatrogenic injury. Current best practice involves the use of small Vt, low plateau and driving pressures, and high levels of positive end-expiratory pressure. Collectively, these interventions are termed "lung-protective ventilation." Recent investigations suggest that individualized measurements of pulmonary mechanical variables rather than population-based ventilation prescriptions may be used to set the ventilator with the potential to improve outcomes beyond those achieved with standard lung protective ventilation. This review outlines the measurement and application of clinically applicable pulmonary mechanical concepts, such as plateau pressures, driving pressure, transpulmonary pressures, stress index, and measurement of strain. In addition, the concept of the "baby lung" and the utility of dynamic in addition to static measures of pulmonary mechanical variables are discussed.

Cervical hemorrhage due to spontaneous rupture of the superior thyroid artery: Case report and review of the literature.

Science.gov (United States)

Stenner, Markus; Helmstaedter, Victor; Spuentrup, Elmar; Quante, Gero; Huettenbrink, Karl-Bernd

2010-09-01

Beneath the different reasons for cervical masses, a spontaneous hemorrhage presents a rare and life-threatening condition. We present the rare case of a 62-year-old man who was presented with a dramatically enlarging cervical mass causing respiratory distress because of upper airway compression. An endotracheal intubation was lifesaving and avoided tracheotomy. A CT scan revealed a hematoma in the region of the left external carotid artery. An emergency angiography embolized a ruptured branch of the superior thyroid artery and surgery evacuated the hematoma. We discuss the rarity of the condition, reasons for a spontaneous rupture of the artery, and the diagnostic and treatment strategy. In addition, we review the literature on spontaneous thyroid artery hemorrhages, which, up to now, have been described only for the inferior thyroid artery. We conclude that the optimal management for cases of cervical hematoma is intubation, diagnosis, and angiography before surgery.

Markets and Molecules: A Pharmaceutical Primer from the South.

Science.gov (United States)

Banerjee, Dwaipayan

2017-01-01

The Indian pharmaceutical industry has historically manufactured low-cost drugs for the global poor. Activist mobilizations at the height of the HIV/AIDS epidemic revealed a vast cost gap between global brands and Indian generics, much to the embarrassment of Euro-American corporations that were in the habit of pricing drugs for only the wealthy or well insured. As new drug access controversies focus on anticancer therapies, they reveal new flows of international capital, emergent genetic technologies, and increasingly coercive trade regimes. Together these favor multinational corporate oligopolies, which imperil the legacy of HIV/AIDS activism and the future availability of essential life-saving drugs for the work of global public health. In this essay, I describe how the future of the right to drug access rests uneasily, and potentially calamitously, on a shifting balance of power between global south interests and Euro-American pharmaceutical capital.

The role of interventional radiology in abdominopelvic trauma

Science.gov (United States)

Ierardi, Anna Maria; Duka, Ejona; Lucchina, Natalie; Floridi, Chiara; De Martino, Alessandro; Donat, Daniela; Fontana, Federico

2016-01-01

The management of trauma patients has evolved in recent decades owing to increasing availability of advanced imaging modalities such as CT. Nowadays, CT has replaced the diagnostic function of angiography. The latter is considered when a therapeutic option is hypothesized. Arterial embolization is a life-saving procedure in abdominopelvic haemorrhagic patients, reducing relevant mortality rates and ensuring haemodynamic stabilization of the patient. Percutaneous transarterial embolization has been shown to be effective for controlling ongoing bleeding for patients with high-grade abdominopelvic injuries, thereby reducing the failure rate of non-operative management, preserving maximal organ function. Surgery is not always the optimal solution for stabilization of a patient with polytrauma. Mini-invasivity and repeatability may be considered as relevant advantages. We review technical considerations, efficacy and complication rates of hepatic, splenic, renal and pelvic embolization to extrapolate current evidence about transarterial embolization in traumatic patients. PMID:26642310

Vaccines as a global imperative--a business perspective.

Science.gov (United States)

Stéphenne, Jean

2011-06-01

During the past thirty years, vaccines have experienced a renaissance. Advances in science, business, and distribution have transformed the field to the point where vaccines are recognized as a "best buy" in global health, a driver of pharmaceutical industry growth, and a key instrument of international development. With many new vaccines available and others on the horizon, the global community will need to explore new ways of ensuring access to vaccines in developing nations. So-called tiered pricing, which makes vaccines available at different prices for countries at different levels of economic development; innovative financing mechanisms such as advance market commitments or offers of long-term and high-volume contracts to vaccine producers; and technology transfers such as sharing intellectual property and production techniques among companies and countries can all play a part in bringing new life-saving vaccines for pneumonia, rotavirus, malaria, and other diseases to developing countries.

The Challenges of Providing Postpartum Education in Dar es Salaam, Tanzania: Narratives of Nurse-Midwives and Obstetricians.

Science.gov (United States)

Mselle, Lilian Teddy; Aston, Megan; Kohi, Thecla W; Mbekenga, Columba; Macdonald, Danielle; White, Maureen; Price, Sheri; Tomblin Murphy, Gail; O'Hearn, Shawna; Jefferies, Keisha

2017-10-01

Postpartum education can save lives of mothers and babies in developing countries, and the World Health Organization recommends all mothers receive three postpartum consultations. More information is needed to better understand how postpartum education is delivered and ultimately improves postpartum health outcomes. The purpose of this qualitative study was to examine how postpartum care was delivered in three postnatal hospital clinics in Dar es Salaam, Tanzania. Semistructured interviews with 10 nurse-midwives and three obstetricians were conducted. Feminist poststructuralism guided the research process. Postpartum education was seen to be an urgent matter; there was a lack of supportive resources and infrastructure in the hospital clinics, and nurse-midwives and obstetricians had to negotiate conflicting health and traditional discourses using various strategies. Nurse-midwives and obstetricians are well positioned to deliver life-saving postpartum education; however, improvements are required including increased number of nurse-midwives and obstetricians.

Intermediaries and the Framing of Use-Practices in Design-Use Relations

DEFF Research Database (Denmark)

, and of use, various network elements are in flux, serving at times as ‘intermediaries’ (here used in the delimited Actor-Network sense) and other times, as ‘actants’ in networks of relations. The paper grapples with the issue by drawing upon two delimited case studies, dealing with ‘public access...... by authorities and/or organizations seeking to strengthen life-saving efforts for victims of cardiac arrest in public settings, particular focus on this case is the situation in Denmark, where legislation paved the way for making the devices available to the general public. Some other countries have instead......-presentation (Law 2002, Cooper 2005). The relevance of intermediaries for design is addressed, where the cases in point show how aspects of use, and hereby the role of users and use-practices, are implicated and distributed through enactments in the heterogeneous orderings and networks of relations in design...

Teleradiology service for mission hospitals: initial experiences in Ethiopia and Kenya

Directory of Open Access Journals (Sweden)

Matthew Larrison

2016-01-01

Full Text Available Throughout their history, mission hospitals have provided high quality and lifesaving medical care to regions of the world where medical care is sparse. These hospitals are generally built and equipped through a combination of governmental and non-governmental sources. As advances in diagnostic medical imaging have progressed and become mainstream in the developed world, mission hospitals have adopted advanced imaging modalities. These modalities provide early diagnosis and treatment options for their patients. In addition to the installation and operation of advanced imaging equipment, the need for professional expert interpretation of these studies remains a challenge for mission hospitals. Historically these hospitals have used either voluntary services on site or paid for interpretations from local radiologists; however, with the introduction of high speed internet, teleradiology has become a possibility. This article describes the teleradiology experience of two mission hospitals in rural Africa.

Duration of red blood cell storage and inflammatory marker generation

Science.gov (United States)

Sut, Caroline; Tariket, Sofiane; Chou, Ming Li; Garraud, Olivier; Laradi, Sandrine; Hamzeh-Cognasse, Hind; Seghatchian, Jerard; Burnouf, Thierry; Cognasse, Fabrice

2017-01-01

Red blood cell (RBC) transfusion is a life-saving treatment for several pathologies. RBCs for transfusion are stored refrigerated in a preservative solution, which extends their shelf-life for up to 42 days. During storage, the RBCs endure abundant physicochemical changes, named RBC storage lesions, which affect the overall quality standard, the functional integrity and in vivo survival of the transfused RBCs. Some of the changes occurring in the early stages of the storage period (for approximately two weeks) are reversible but become irreversible later on as the storage is extended. In this review, we aim to decipher the duration of RBC storage and inflammatory marker generation. This phenomenon is included as one of the causes of transfusion-related immunomodulation (TRIM), an emerging concept developed to potentially elucidate numerous clinical observations that suggest that RBC transfusion is associated with increased inflammatory events or effects with clinical consequence. PMID:28263172

HNPCC (Lynch Syndrome): Differential Diagnosis, Molecular Genetics and Management - a Review

Science.gov (United States)

2003-01-01

HNPCC (Lynch syndrome) is the most common form of hereditary colorectal cancer (CRC), wherein it accounts for between 2-7 percent of the total CRC burden. When considering the large number of extracolonic cancers integral to the syndrome, namely carcinoma of the endometrium, ovary, stomach, hepatobiliary system, pancreas, small bowel, brain tumors, and upper uroepithelial tract, these estimates of its frequency are likely to be conservative. The diagnosis is based upon its natural history in concert with a comprehensive cancer family history inclusive of all anatomic sites. In order for surveillance and management to be effective and, indeed, lifesaving, among these high-risk patients, the linchpin to cancer control would be the physician, who must be knowledgeable about hereditary cancer syndromes, their molecular and medical genetics, genetic counseling, and, most importantly, the natural history of the disorders, so that the entirety of this knowledge can be melded to highly-targeted management.

A case of suicide by self-injection of adrenaline.

Science.gov (United States)

Palmiere, Cristian; Bévalot, Fabien; Malicier, Daniel; Grouzmann, Eric; Fracasso, Tony; Fanton, Laurent

2015-09-01

Adrenaline (epinephrine) auto-injectors provide life-saving pre-hospital treatment for individuals experiencing anaphylaxis in a community setting. Errors in handling adrenaline auto-injectors, particularly by children and healthcare professionals, have been reported. Reports of adrenaline overdoses are limited in the medical literature. In most of these cases, accidental adrenaline administration results from medical error. Exogenous administration of catecholamine is responsible for cardiovascular and metabolic responses, which may cause supraventricular tachycardia, ventricular dysrhythmias and myocardial ischemia. The authors present a unique autopsy case involving a 34 year-old woman who intentionally self-injected adrenaline using an adrenaline auto-injector as part of a suicide plan. Catecholamines and metanephrines were measured in peripheral and cardiac blood as well as urine and vitreous humor. Based on the results of all postmortem investigations, the cause of death was determined to be cardiac dysrhythmia and cardiac arrest following adrenaline self-injection.

A novel approach to severe acute pancreatitis in sequential liver-kidney transplantation: the first report on the application of VAC therapy.

Science.gov (United States)

Zanus, Giacomo; Boetto, Riccardo; D'Amico, Francesco; Gringeri, Enrico; Vitale, Alessandro; Carraro, Amedeo; Bassi, Domenico; Scopelliti, Michele; Bonsignore, Pasquale; Burra, Patrizia; Angeli, Paolo; Feltracco, Paolo; Cillo, Umberto

2011-03-01

This work is the first report of vacuum-assisted closure (VAC) therapy applied as a life-saving surgical treatment for severe acute pancreatitis occurring in a sequential liver- and kidney-transplanted patient who had percutaneous biliary drainage for obstructive "late-onset" jaundice. Surgical exploration with necrosectomy and sequential laparotomies was performed because of increasing intra-abdominal pressure with hemodynamic instability and intra-abdominal multidrug-resistant sepsis, with increasingly difficult abdominal closure. Repeated laparotomies with VAC therapy (applying a continuous negative abdominal pressure) enabled a progressive, successful abdominal decompression, with the clearance of infection and definitive abdominal wound closure. The application of a negative pressure is a novel approach to severe abdominal sepsis and laparostomy management with a view to preventing compartment syndrome and fatal sepsis, and it can lead to complete abdominal wound closure. © 2010 The Authors. Transplant International © 2010 European Society for Organ Transplantation.

Identifying the physical and anthropometric qualities explanatory of paddling adolescents.

Science.gov (United States)

Sinclair, Wade H; Leicht, Anthony S; Eady, Troy W; Marshall, Nick J; Woods, Carl T

2017-12-01

This study aimed to identify the physical and/or anthropometric qualities explanatory of adolescent surf lifesavers participating in paddling activities. Cross-sectional observational study. A total of 53 (14-18years) male participants were recruited and classified into two groups; paddlers (n=30; actively participating in paddling), non-paddlers (n=23; not actively participating in paddling). All participants completed a testing battery that consisted of 16 physical (isometric strength and muscular endurance) and anthropometric (height, mass, segment lengths and breadths) assessments. Binary logistic regression models and receiver operating characteristic curves were built to identify the physical and/or anthropometric qualities most explanatory of paddling status (two levels: 1=paddlers, 0=non-paddlers). Significant between group differences were noted for 14 of the 16 assessments (Ptalent detection programs focused toward the recognition of performance potential in paddling-oriented sports. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Scalp squamous cell carcinoma in xeroderma pigmentosum.

Science.gov (United States)

Awan, Basim A; Alzanbagi, Hanadi; Samargandi, Osama A; Ammar, Hossam

2014-02-01

Xeroderma pigmentosum is a rare autosomal-recessive disorder that appears in early childhood. Squamous cell carcinoma is not uncommon in patients with xeroderma pigmentosum and mostly involving the face, head, neck, and scalp. However, squamous cell carcinoma of the scalp may exhibit an aggressive course. Here, we present a huge squamous cell carcinoma of the scalp in a three-years-old child with xeroderma pigmentosum. In addition, we illustrate the challenges of a child with xeroderma pigmentosum who grows up in a sunny environment where the possibility of early onset of squamous cell carcinoma is extremely high in any suspected skin lesion. In xeroderma pigmentosum patients, squamous cell carcinoma of the scalp can present early and tends to be unusually aggressive. In sunny areas, proper education to the patient and their parents about ultra-violet light protection and early recognition of any suspicious lesion could be life-saving.

Options for improving effectiveness of rotavirus vaccines in developing countries.

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Tissera, Marion S; Cowley, Daniel; Bogdanovic-Sakran, Nada; Hutton, Melanie L; Lyras, Dena; Kirkwood, Carl D; Buttery, Jim P

2017-04-03

Rotavirus gastroenteritis is a leading global cause of mortality and morbidity in young children due to diarrhea and dehydration. Over 85% of deaths occur in developing countries. In industrialised countries, 2 live oral rotavirus vaccines licensed in 2006 quickly demonstrated high effectiveness, dramatically reducing severe rotavirus gastroenteritis admissions in many settings by more than 90%. In contrast, the same vaccines reduced severe rotavirus gastroenteritis by only 30-60% in developing countries, but have been proven life-saving. Bridging this "efficacy gap" offers the possibility to save many more lives of children under the age of 5. The reduced efficacy of rotavirus vaccines in developing settings may be related to differences in transmission dynamics, as well as host luminal, mucosal and immune factors. This review will examine strategies currently under study to target the issue of reduced efficacy and effectiveness of oral rotavirus vaccines in developing settings.

Availability and utilization of the WHO recommended priority lifesaving medicines for under five-year old children in public health facilities in Uganda

DEFF Research Database (Denmark)

Nsabagasani, Xavier; Ogwal-Okeng, Jasper; Mbonye, Anthony

2015-01-01

priority medicines for diarrhea, sepsis, pneumonia and malaria. 81 health workers from the facilities reported what they prescribed for children with the above diseases. RESULTS: Oral rehydration salt (ORS) and zinc sulphate dispersible tablets for diarrhea were available in all HC IIs and IIIs and in only...

Using the unmet obstetric needs indicator to map inequities in life-saving obstetric interventions at the local health care system in Kenya

DEFF Research Database (Denmark)

Echoka, Elizabeth; Dubourg, Dominique; Makokha, Anselimo

2014-01-01

BackgroundDeveloping countries with high maternal mortality need to invest in indicators that not only provide information about how many women are dying, but also where, and what can be done to prevent these deaths. The unmet Obstetric Needs (UONs) concept provides this information. This concept...... was applied at district level in Kenya to assess how many women had UONs and where the women with unmet needs were located.MethodsA facility based retrospective study was conducted in 2010 in Malindi District, Kenya. Data on pregnant women who underwent a major obstetric intervention (MOI) or died...... in facilities that provide comprehensive Emergency Obstetric Care (EmOC) services in 2008 and 2009 were collected. The difference between the number of women who experienced life threatening obstetric complications and those who received care was quantified. The main outcome measures in the study were...

Microbiota Manipulation With Prebiotics and Probiotics in Patients Undergoing Stem Cell Transplantation

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Andermann, Tessa M.; Rezvani, Andrew; Bhatt, Ami S.

2016-01-01

Hematopoietic stem cell transplantation (HSCT) is a potentially life-saving therapy that often comes at the cost of complications such as graft-versus-host disease and post-transplant infections. With improved technology to under-stand the ecosystem of microorganisms (viruses, bacteria, fungi, and microeukaryotes) that make up the gut microbiota, there is increasing evidence of the microbiota’s contribution to the development of post-transplant complications. Antibiotics have traditionally been the mainstay of microbiota-altering therapies available to physicians. Recently, interest is increasing in the use of prebiotics and probiotics to support the development and sustainability of a healthier microbiota. In this review, we will describe the evidence for the use of prebiotics and probiotics in combating microbiota dysbiosis and explore the ways in which they may be used in future research to potentially improve clinical outcomes and decrease rates of graft-versus-host disease (GVHD) and post-transplant infection. PMID:26780719

Arrhythmogenic Right Ventricular Cardiomyopathy: Risk Stratification and Indications for Defibrillator Therapy.

Science.gov (United States)

Zorzi, Alessandro; Rigato, Ilaria; Bauce, Barbara; Pilichou, Kalliopi; Basso, Cristina; Thiene, Gaetano; Iliceto, Sabino; Corrado, Domenico

2016-06-01

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetically determined disease which predisposes to life-threatening ventricular arrhythmias. The main goal of ARVC therapy is prevention of sudden cardiac death (SCD). Implantable cardioverter defibrillator (ICD) is the most effective therapy for interruption of potentially lethal ventricular tachyarrhythmias. Despite its life-saving potential, ICD implantation is associated with a high rate of complications and significant impact on quality of life. Accurate risk stratification is needed to identify individuals who most benefit from the therapy. While there is general agreement that patients with a history of cardiac arrest or hemodynamically unstable ventricular tachycardia are at high risk of SCD and needs an ICD, indications for primary prevention remain a matter of debate. The article reviews the available scientific evidence and guidelines that may help to stratify the arrhythmic risk of ARVC patients and guide ICD implantation. Other therapeutic strategies, either alternative or additional to ICD, will be also addressed.

The politics and anti-politics of the global fund experiment: understanding partnership and bureaucratic expansion in Uganda.

Science.gov (United States)

Taylor, E Michelle; Harper, Ian

2014-01-01

After a decade of operations, the Global Fund is an institutional form in flux. Forced to cancel its eleventh round of funding due to a shortfall in donor pledges, the Fund is currently in firefighting mode, overhauling its leadership, governance structures, and operations. Drawing on a case study of Uganda, we look at how the original Global Fund vision to be a simple financial instrument has played out at the country level. Even prior to the cancellation of round 11, the proliferation of partners required to sustain the Global Fund to Fight AIDS, Tuberculosis and Malaria experiment led to increasing bureaucratization and an undermining of the Fund's own intentions to award life-saving grants according to need. Understanding these effects through the ethnographic material presented here may be one way of reflecting on the Fund's structure and practices as it struggles to reinvent itself in the face of criticism that it has impeded resource distribution.

ERC initiatives to reduce the burden of cardiac arrest: the European Cardiac Arrest Awareness Day.

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Georgiou, Marios; Lockey, Andrew S

2013-09-01

The rate of survival from out-of-hospital cardiac arrest in Europe remains unacceptably low and could be increased by better bystander cardiopulmonary resuscitation (CPR) rates. The European Resuscitation Council has announced that there will be a European Cardiac Arrest Awareness Day every year on the 16th of October. This is to coincide with the goals of the Written Declaration passed by the European Parliament in June 2012 that emphasised the importance of equal access to CPR and automated external defibrillator (AED) training. The topic of this year's Awareness Day is 'Children Saving Lives' and it is hoped that all national resuscitation councils will promote awareness of the benefits of training all children in CPR and AED use and lobby for legislative change to ensure that all children receive this training. Children are not just the adults of tomorrow - they are the lifesavers of today and tomorrow. Copyright © 2013 Elsevier Ltd. All rights reserved.

Digital radiology

International Nuclear Information System (INIS)

Dallas, W.J.

1990-01-01

Radiology is vital to the life-saving efforts of surgeons and other physicians, but precious time can be lost generating the images and transferring them to and from the operating room. Furthermore, hospitals are straining under the task of storing and managing the deluge of diagnostic films produced every year. A 300-bed hospital generates about 1 gigabyte (8 x 10 9 bits) of picture information every day and is legally bound to hold it for three to seven years--30 years in the case of silicosis or black lung disease, illnesses that may have relevance to future lawsuits. Consequently, hospital warehouses are filling with x-ray film and written reports that are important for analysis of patient histories, for comparison between patients, and for analyzing the progress of disease. Yet only a fraction of the information's potential is being used because access is so complicated. What is more, films are easily lost, erasing valuable medical histories

Future Costs, Fixed Healthcare Budgets, and the Decision Rules of Cost-Effectiveness Analysis.

Science.gov (United States)

van Baal, Pieter; Meltzer, David; Brouwer, Werner

2016-02-01

Life-saving medical technologies result in additional demand for health care due to increased life expectancy. However, most economic evaluations do not include all medical costs that may result from this additional demand in health care and include only future costs of related illnesses. Although there has been much debate regarding the question to which extent future costs should be included from a societal perspective, the appropriate role of future medical costs in the widely adopted but more narrow healthcare perspective has been neglected. Using a theoretical model, we demonstrate that optimal decision rules for cost-effectiveness analyses assuming fixed healthcare budgets dictate that future costs of both related and unrelated medical care should be included. Practical relevance of including the costs of future unrelated medical care is illustrated using the example of transcatheter aortic valve implantation. Our findings suggest that guidelines should prescribe inclusion of these costs. Copyright © 2014 John Wiley & Sons, Ltd.

Postpartum haemorrhage: prevention and treatment.

Science.gov (United States)

Sentilhes, Loïc; Merlot, Benjamin; Madar, Hugo; Sztark, François; Brun, Stéphanie; Deneux-Tharaux, Catherine

2016-11-01

Postpartum hemorrhage (PPH) is one of the leading causes of maternal death and severe maternal morbidity worldwide and strategies to prevent and treat PPH vary among international authorities. Areas covered: This review seeks to provide a global overview of PPH (incidence, causes, risk factors), prevention (active management of the third stage of labor and prohemostatic agents), treatment (first, second and third-line measures to control PPH), by also underlining recommendations elaborated by international authorities and using algorithms. Expert commentary: When available, oxytocin is considered the drug of first choice for both prevention and treatment of PPH, while peripartum hysterectomy remains the ultimate life-saving procedure if pharmacological and resuscitation measures fail. Nevertheless, the level of evidence for preventing and treating PPH is globally low. The emergency nature of PPH makes randomized controlled trials (RCT) logistically difficult. Population-based observational studies should be encouraged as they can usefully strengthen the evidence base, particularly for components of PPH treatment that are difficult or impossible to assess through RCT.

Patients with uninjured lungs may also benefit from lung-protective ventilator settings [version 1; referees: 2 approved

Directory of Open Access Journals (Sweden)

Roger Alencar

2017-11-01

Full Text Available Although mechanical ventilation is a life-saving strategy in critically ill patients and an indispensable tool in patients under general anesthesia for surgery, it also acts as a double-edged sword. Indeed, ventilation is increasingly recognized as a potentially dangerous intrusion that has the potential to harm lungs, in a condition known as ‘ventilator-induced lung injury’ (VILI. So-called ‘lung-protective’ ventilator settings aiming at prevention of VILI have been shown to improve outcomes in patients with acute respiratory distress syndrome (ARDS, and, over the last few years, there has been increasing interest in possible benefit of lung-protective ventilation in patients under ventilation for reasons other than ARDS. Patients without ARDS could benefit from tidal volume reduction during mechanical ventilation. However, it is uncertain whether higher levels of positive end-expiratory pressure could benefit these patients as well. Finally, recent evidence suggests that patients without ARDS should receive low driving pressures during ventilation.

The US regulatory and pharmacopeia response to the global heparin contamination crisis.

Science.gov (United States)

Szajek, Anita Y; Chess, Edward; Johansen, Kristian; Gratzl, Gyöngyi; Gray, Elaine; Keire, David; Linhardt, Robert J; Liu, Jian; Morris, Tina; Mulloy, Barbara; Nasr, Moheb; Shriver, Zachary; Torralba, Pearle; Viskov, Christian; Williams, Roger; Woodcock, Janet; Workman, Wesley; Al-Hakim, Ali

2016-06-09

The contamination of the widely used lifesaving anticoagulant drug heparin in 2007 has drawn renewed attention to the challenges that are associated with the characterization, quality control and standardization of complex biological medicines from natural sources. Heparin is a linear, highly sulfated polysaccharide consisting of alternating glucosamine and uronic acid monosaccharide residues. Heparin has been used successfully as an injectable antithrombotic medicine since the 1930s, and its isolation from animal sources (primarily porcine intestine) as well as its manufacturing processes have not changed substantially since its introduction. The 2007 heparin contamination crisis resulted in several deaths in the United States and hundreds of adverse reactions worldwide, revealing the vulnerability of a complex global supply chain to sophisticated adulteration. This Perspective discusses how the US Food and Drug Administration (FDA), the United States Pharmacopeial Convention (USP) and international stakeholders collaborated to redefine quality expectations for heparin, thus making an important natural product better controlled and less susceptible to economically motivated adulteration.

Panhypopituitarism after multisystem trauma.

Science.gov (United States)

Wiechecka, Joanna; Krzewska, Aleksandra; Droń, Izabela; Beń-Skowronek, Iwona

2013-01-01

The pituitary gland plays a key role in hormonal regulation in the organism, contributing to maintenance of balance of basic vital functions. To emphasise the need for assessment of pituitary function after head injury, as correct diagnosis and hormone replacement therapy prove to be a life-saving therapy accelerating the recovery process. A healthy, normally developing 9-year-old girl, a child of young and healthy parents, was struck by a falling tree. The results of severe head trauma included adrenal crisis, hypothyroidism, and diabetes insipidus as manifestations of damage to the anterior and posterior pituitary gland. Administration of hormone replacement therapy, i.e. hydrocortisone, L-thyroxine, and desmopressin greatly improved the patient´s condition and facilitated effective rehabilitation. Determination of pituitary hormones in children after severe head injury should be an important part of diagnosis allowing identification of an early stage of acute hypopituitarism and acceleration of recovery through hormone replacement therapy.

Discussions of Adolescent Sexuality in News Media Coverage of the HPV Vaccine

Science.gov (United States)

Casciotti, Dana M.; Smith, Katherine C.; Tsui, Amy

2017-01-01

Given the sexually transmitted nature of human papillomavirus (HPV), some worry the HPV vaccine will create a false sense of security and promote adolescent sexual activity. Media coverage of vaccines can influence social norms, parental attitudes, and vaccine acceptance; in this paper we examine U.S. news media messages related to sexuality and HPV vaccination. Drawing on a structured analysis of 447 articles published during 2005-2009, we qualitatively analyzed a purposive sample of 49 articles discussing adolescent health behaviors related to HPV vaccination. Commonly, articles discussed vaccination in the context of abstinence-only versus comprehensive sexual health education; cited research findings to support vaccination or sex education; argued against connecting vaccination to promiscuous behavior; but included fear-inducing messages. Media messages concerning health behaviors related to HPV vaccination tended to support government and parental involvement in sex education, and dismiss concerns linking vaccination to sexual activity, while also presenting the vaccine as lifesaving. PMID:24439619

Prostaglandin E2 enhances long-term repopulation but does not permanently alter inherent stem cell competitiveness.

Science.gov (United States)

Hoggatt, Jonathan; Mohammad, Khalid S; Singh, Pratibha; Pelus, Louis M

2013-10-24

Hematopoietic stem cell (HSC) transplantation is a lifesaving therapy for malignant and nonmalignant hematologic diseases and metabolic disorders. Although successful, hematopoietic transplantation can be hindered by inadequate stem cell number or poor engrafting efficiency. To overcome these deficits, we and others have previously reported the HSC-enhancing ability of a short-term exposure of prostaglandin E2 (PGE2); this strategy has now progressed to phase 1 clinical trials in double cord blood transplantation. To further analyze the short- and long-term effects of HSC exposure to PGE2, we followed the repopulation kinetics of PGE2-treated hematopoietic grafts through 5 serial transplantations and compared inherent long-term competitiveness in a HSC head-to-head secondary transplantation model. Treatment with PGE2 did not result in a long-term increase in HSC competitiveness, lineage bias, or enhanced proliferative potential, demonstrating that pulse exposure to PGE2 results in transient increases in HSC homing and engraftment potential.

Update on cellular encapsulation.

Science.gov (United States)

Smith, Kate E; Johnson, Robert C; Papas, Klearchos K

2018-05-06

There is currently a significant disparity between the number of patients who need lifesaving transplants and the number of donated human organs. Xenotransplantation is a way to address this disparity and attempts to enable the use of xenogeneic tissues have persisted for centuries. While immunologic incompatibilities have presented a persistent impediment to their use, encapsulation may represent a way forward for the use of cell-based xenogeneic therapeutics without the need for immunosuppression. In conjunction with modern innovations such as the use of bioprinting, incorporation of immune modulating molecules into capsule membranes, and genetic engineering, the application of xenogeneic cells to treat disorders ranging from pain to liver failure is becoming increasingly realistic. The present review discusses encapsulation in the context of xenotransplantation, focusing on the current status of clinical trials, persistent issues such as antigen shedding, oxygen availability, and donor selection, and recent developments that may address these limitations. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Music preferences of mechanically ventilated patients participating in a randomized controlled trial

Science.gov (United States)

Heiderscheit, Annie; Breckenridge, Stephanie J.; Chlan, Linda L.; Savik, Kay

2014-01-01

Mechanical ventilation (MV) is a life-saving measure and supportive modality utilized to treat patients experiencing respiratory failure. Patients experience pain, discomfort, and anxiety as a result of being mechanically ventilated. Music listening is a non-pharmacological intervention used to manage these psychophysiological symptoms associated with mechanical ventilation. The purpose of this secondary analysis was to examine music preferences of 107 MV patients enrolled in a randomized clinical trial that implemented a patient-directed music listening protocol to help manage the psychophysiological symptom of anxiety. Music data presented includes the music genres and instrumentation patients identified as their preferred music. Genres preferred include: classical, jazz, rock, country, and oldies. Instrumentation preferred include: piano, voice, guitar, music with nature sounds, and orchestral music. Analysis of three patients’ preferred music received throughout the course of the study is illustrated to demonstrate the complexity of assessing MV patients and the need for an ongoing assessment process. PMID:25574992

Clinical Update on Dengue, Chikungunya, and Zika: What We Know at the Time of Article Submission.

Science.gov (United States)

Liu, Liang E; Dehning, Meaghan; Phipps, Ashley; Swienton, Ray E; Harris, Curtis A; Klein, Kelly R

2017-06-01

Mosquito-borne diseases pose a threat to individual health and population health on both a local and a global level. The threat is even more exaggerated during disasters, whether manmade or environmental. With the recent Zika virus outbreak, it is important to highlight other infections that can mimic the Zika virus and to better understand what can be done as public health officials and health care providers. This article reviews the recent literature on the Zika virus as well as chikungunya virus and dengue virus. The present findings give a better understanding of the similarities and differences between the 3 infections in terms of their characteristics, clinical presentation, diagnosis methodology, and treatment and what can be done for prevention. Additionally, the article highlights a special population that has received much focus in the latest outbreak, the pregnant individual. Education and training are instrumental in controlling the outbreak, and early detection can be lifesaving. (Disaster Med Public Health Preparedness. 2017;11:290-299).

Music preferences of mechanically ventilated patients participating in a randomized controlled trial.

Science.gov (United States)

Heiderscheit, Annie; Breckenridge, Stephanie J; Chlan, Linda L; Savik, Kay

2014-01-01

Mechanical ventilation (MV) is a life-saving measure and supportive modality utilized to treat patients experiencing respiratory failure. Patients experience pain, discomfort, and anxiety as a result of being mechanically ventilated. Music listening is a non-pharmacological intervention used to manage these psychophysiological symptoms associated with mechanical ventilation. The purpose of this secondary analysis was to examine music preferences of 107 MV patients enrolled in a randomized clinical trial that implemented a patient-directed music listening protocol to help manage the psychophysiological symptom of anxiety. Music data presented includes the music genres and instrumentation patients identified as their preferred music. Genres preferred include: classical, jazz, rock, country, and oldies. Instrumentation preferred include: piano, voice, guitar, music with nature sounds, and orchestral music. Analysis of three patients' preferred music received throughout the course of the study is illustrated to demonstrate the complexity of assessing MV patients and the need for an ongoing assessment process.

Concurrent central nervous system infective pathology in a severely immunocompromised patient

Directory of Open Access Journals (Sweden)

Thein Swe

2016-01-01

Full Text Available To our knowledge and literature search, concurrent cryptococcal meningitis and neurosyphilis in a patient have rarely been reported. Here, we report a 37-year-old male with HIV infection presented with headache and dizziness for 5 days along with memory difficulty and personality changes for about 1 week. During the hospital stay, cryptococcal meningitis was confirmed with positive cerebral spinal fluid (CSF cryptococcal antigen titer (1:320 and positive CSF culture. Diagnosis of neurosyphilis was made based upon CSF white blood cell count of 85 cells/mL, with CSF total protein of 87 mg/dL, reactive CSF treponemal antibody, and fluorescent treponemal antibody. The patient was treated with amphotericin B, flucytosine, fluconazole, and benzathine penicillin G, and the patient was recovered and discharged. HIV patients are at high risk of developing severe infections of the central nervous system. Awareness should be made not only to single infection but also for dual pathology for a better and life-saving management.

Facilitating a More Efficient Commercial Review Process for Pediatric Drugs and Biologics

Directory of Open Access Journals (Sweden)

Ryan D. Rykhus

2017-12-01

Full Text Available Over the past two decades, the biopharmaceutical industry has seen unprecedented expansion and innovation in concert with significant technological advancements. While the industry has experienced marked growth, the regulatory system in the United States still operates at a capacity much lower than the influx of new drug and biologic candidates. As a result, it has become standard for months or even years of waiting for commercial approval by the U.S. Food and Drug Administration. These regulatory delays have generated a system that stifles growth and innovation due to the exorbitant costs associated with awaiting approval from the nation’s sole regulatory agency. The recent re-emergence of diseases that impact pediatric demographics represents one particularly acute reason for developing a regulatory system that facilitates a more efficient commercial review process. Herein, we present a range of initiatives that could represent early steps toward alleviating the delays in approving life-saving therapeutics.

Feminist psychodynamic psychotherapy of eating disorders. Theoretic integration informing clinical practice.

Science.gov (United States)

Zerbe, K J

1996-12-01

Ideas derived from feminism and psychoanalytic theory can be combined for the integrated treatment of eating disorder patients. For a large subgroup of patients who continue to have a poor quality of life or inadequate symptom control (despite customary psychopharmacologic and cognitive behavioral interventions), feminist psychodynamic psychotherapy may prove lifesaving. This article explores how the patient may come to grasp more deeply the multiple roles her symptom has played in her psychological survival. Practical suggestions to enrich the psychotherapy as the patient traverses the natural struggles of adult life are emphasized. The importance of understanding and working with transference and countertransference issues while helping the patient accept life's paradoxes, ambiguities, and potential avenues for growth are underscored. The author reviews eight specific areas that warrant attention in psychotherapeutic exploration from a feminist psychoanalytic perspective (Culture as Bedrock Issue; Gender as Organizer of Behavior, Ownership of Body; Moral Development; Development of Personal Voice; Emphasis on Adult Development; Sexual Concerns; and Aggressive Conflicts).

International cooperation to improve access to and sustain effectiveness of antimicrobials.

Science.gov (United States)

Årdal, Christine; Outterson, Kevin; Hoffman, Steven J; Ghafur, Abdul; Sharland, Mike; Ranganathan, Nisha; Smith, Richard; Zorzet, Anna; Cohn, Jennifer; Pittet, Didier; Daulaire, Nils; Morel, Chantal; Rizvi, Zain; Balasegaram, Manica; Dar, Osman A; Heymann, David L; Holmes, Alison H; Moore, Luke S P; Laxminarayan, Ramanan; Mendelson, Marc; Røttingen, John-Arne

2016-01-16

Securing access to effective antimicrobials is one of the greatest challenges today. Until now, efforts to address this issue have been isolated and uncoordinated, with little focus on sustainable and international solutions. Global collective action is necessary to improve access to life-saving antimicrobials, conserving them, and ensuring continued innovation. Access, conservation, and innovation are beneficial when achieved independently, but much more effective and sustainable if implemented in concert within and across countries. WHO alone will not be able to drive these actions. It will require a multisector response (including the health, agriculture, and veterinary sectors), global coordination, and financing mechanisms with sufficient mandates, authority, resources, and power. Fortunately, securing access to effective antimicrobials has finally gained a place on the global political agenda, and we call on policy makers to develop, endorse, and finance new global institutional arrangements that can ensure robust implementation and bold collective action. Copyright © 2016 Elsevier Ltd. All rights reserved.

Latest discoveries and trends in translational cancer research: highlights of the 2008 Annual Meeting of the American Association for Cancer Research.

Science.gov (United States)

Cho, William C S

2008-08-01

The Annual Meeting of the American Association for Cancer Research (AACR) is the world's largest and most comprehensive gathering of cancer researchers. At the 2008 AACR Annual Meeting, innovative research approaches, novel technologies, potentially life-saving therapies in the pipeline, late-breaking clinical trial findings, and new approaches to cancer prevention were presented by top scientists. Reflecting the global state of cancer research with an eye toward future trends, several areas of great science and discovery in the cancer field were shared in this report, which include cancer biomarkers, the role of microRNAs in cancer research, cancer stem cells, tumor microenvironment, targeted therapy, and cancer prevention. This article presents an overview of hot topics discussed at the 2008 AACR Annual Meeting and recapitulates some scientific sessions geared toward new technologies, recent progress, and current challenges reported by cancer researchers. For those who did not attend the meeting, this report may serve as a highlight of this important international cancer research meeting.