A self-contained plasmapheresis device based on Starling flow has been proposed. A computer model was developed to describe the device performance, and a device using conventional cellulose tri-acetate (CTA) fibers was modeled. Predicted pressure drops and ultrafiltration flow agreed well with measurements using bovine blood in prototype devices made with CTA fibers. The model predicted the expected Starling flow and predicted the observed high hematocrit region near the fiber wall and a layer of packed red cells on the wall. Typically, 15% of the ultrafiltration flow occurred in the first 2-3% of the fiber length where no packed cell layer was present. The entrance header was predicted to cause lower blood pressures in the peripheral fibers, producing a net plasma migration from the central to the peripheral fibers. As an example application for this device, the computer model was used to assess the feasibility of reducing LDL-cholesterol in patients. The use of sequential 1 hour treatments by a modified device was predicted to reduce the cholesterol in a standard man from 200 mg% to 150 mg% in less than 3 hours.

Animals↗

PubMedDate not supplied

Information needs of health care professionals in an AIDS outpatient clinic as determined by chart review.

OBJECTIVE: To examine the information needs of health care professionals in HIV-related clinical encounters, and to determine the suitability of existing information sources to address those needs. SETTING: HIV outpatient clinic. PARTICIPANTS: Seven health care professionals with diverse training and patient care involvement. METHODS: Based on patient charts describing 120 patient encounters, participants generated 266 clinical questions. Printed and on-line information sources were used to answer questions in two phases: using commonly available sources and using all available medical library sources. MEASUREMENTS: The questions were divided into 16 categories by subject. The number of questions answered, their categories, the information source(s) providing answers, and the time required to answer questions were recorded for each phase. RESULTS: Each participant generated an average of 3.8 clinical questions per chart. Five categories accounted for almost 75% of all questions; the treatment protocols/regimens category was most frequent (24%). A total of 245 questions (92%) were answered, requiring an average of 15 minutes per question. Most (87%) of the questions were answered via electronic sources, even though paper sources were consulted first. CONCLUSIONS: The participating professionals showed considerable information needs. A combination of on-line and paper sources was necessary to provide the answers. The study suggests that present-day information sources are not entirely satisfactory for answering clinical questions generated by examining charts of HIV-infected patients.

Ambulatory Care↗

PubMedDate not supplied

Clinical and/or biochemical pancreatitis in diabetic ketoacidosis.

The association between diabetic ketoacidosis and acute pancreatitis is examined with reference to four patients. Hypertriglyceridemia was noted in only one of the patients. The pancreatitis was relatively mild and resolved rapidly.

Acute Disease↗