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Biomedical subjects

D Davis

Publications and source records attributed to D Davis.

341 records · Page 19Linked to original sources

Can minimum separation criteria ensure electromagnetic compatibility in hospitals? An experimental study.

Electromagnetic interference (EMI) from radiofrequency (RF) sources can cause medical device malfunction. It has been proposed that such EMI be minimized by only operating sources of given RF powers when sufficiently separated from medical devices of given immunities. Such minimum separation criteria are estimated assuming free-space propagation, which is only valid in the ideal case. Yet proposed medical device EMC standards will require that minimum-separation criteria be listed in equipment manuals accompanying all new medical devices. It is essential that the practical utility of such minimum-separation criteria be evaluated. Fields due to an 800-MHz-type cellphone were measured in various rooms and corridors within an urban hospital, having both new (gyprock) and old (clay-block) wings. Data obtained from a calibrated antenna attached to a spectrum analyzer were repeatedly measured and averaged. Results were compared to those predicted by free-space propagation. Free-space predictions tended to overestimate measured fields in gyprock rooms and along corridors of both gyprock and clay-block construction. However, the free-space model tended to underestimate field levels predicted in clay-block rooms and in below-ground corridors. Usage of separation criteria to ensure EMC appeared useful in gyprock rooms and hospital corridors, but less so in rooms with clay-block walls or in below-ground sections of the hospital. This suggested that the latter regions should be considered as being special zones where side-by-side operation of RF sources and medical devices would require more conservative management (e.g., restriction or special approval of particular source or medical device).

Electric Conductivity↗

[Interaction of proflavin with deoxytetraribonucleoside triphosphate 5'-d(ApGpCpT): thermodynamic analysis from (1)H NMR data].

Temperature relationships of chemical shifts of protons of proflavin mixed with deoxytetraribonucleoside triphosphate 5'-d(ApGpCpT) in water solution were investigated on impulse NMR spectrometer (500 MHz). Procedure is suggested for calculating values of mole fractions of various associates in solution as a function against temperature. Free energies of Gibbs, entalpy and entropy were determined in the reactions of complex formation 1:1, 1:2, 2:1 of proflavin with tetranucleotide. The results point to a significant role of hydrophobic interactions during the formation of dye--tetramere duplex complexes.

Magnetic Resonance Spectroscopy↗

Orthotopic heart transplantation with preoperative unsuspected left superior vena cava and absence of right superior vena cava.

We report the case history of a 47-year-old man who underwent orthotopic heart transplantation for ischemic cardiomyopathy. At the time of cardiectomy, the patient was found to have a persistent left superior vena cava draining into the coronary sinus and complete absence of his right superior vena cava. The donor heart had been removed without knowledge of this venous anomaly; consequently, the donor's superior vena cava and innominate vein were not harvested. The persistent left superior vena cava was cannulated for cardiopulmonary bypass. The recipient's heart was excised along the atrial ventricular groove, preserving the persistent left superior vena cava and coronary sinus. The atrial cuffs of the recipient and donor were fashioned for atrial-to-atrial anastomoses. Successful endomyocardial biopsies have been performed through the femoral veins after transplantation.

Anastomosis, Surgical↗

"Understanding AIDS"--the national AIDS mailer.

The Centers for Disease Control (CDC) of the Public Health Service made public health history in 1988 by mailing the pamphlet, "Understanding AIDS," to every household in the United States. Approximately 126 million copies were distributed, reaching at least 60 percent of the population according to several national polls. The pamphlet was produced and mailed at a cost of about 20 cents per copy. The impact of "Understanding AIDS" by itself on AIDS-related behavior was not fully assessed. Extensive message pretesting and other commercial marketing techniques to improve the effectiveness of the brochure, however, helped "Understanding AIDS" achieve an increase in awareness and concern about AIDS. A number of lessons were learned during the process. They included the importance in such an enterprise of setting a deadline, doing formative research, receiving active support from senior management, achieving a consensus on scientific knowledge, using communications experts, centralizing the final decision-making function, maximizing publicity surrounding the mailing, building a base of support among constituency groups, planning distribution logistics from the very start, and designing evaluation into the process from the beginning.

Acquired Immunodeficiency Syndrome↗

"America Responds to AIDS": its content, development process, and outcome.

During the 1987-90 period, five phases of new AIDS information materials were released to the general public in the ARTA campaign, including a national mailer. The five were "General Awareness: Humanizing AIDS" in October 1987, "Understanding AIDS," the national mailout, April 1988, "Women at Risk/Multiple Partner, Sexually Active Adults," October 1988, "Parents and Youth," May 1989, and "Preventing HIV Infection and AIDS: Taking The Next Steps," July 1990. From planning to implementation to evaluation, ARTA is based on well-established theory and practice. Initially, the campaign was a response to an immediate crisis. It has evolved into the deliberate and systematic development of objectives to combat a chronic problem. ARTA represents one of the most comprehensive formative research processes in the history of public service campaigns. The dynamic process of carefully developing each new phase to include such important entities as State and local health agencies and community-based organizations is at least as important as the quality of the end materials. The objectives of each new phase are based on the needs of the public and of specific audiences. Maximum input from all relevant constituencies is obtained to ensure that they support the campaign's objectives and implementation strategy.

Acquired Immunodeficiency Syndrome↗

[Study of complex formation of ethidium bromide with the self-complementary deoxytetranucleotide 5'-d(ApGpCpT) by unidimensional and two- dimensional 1H NMR spectroscopy].

Complex formation of ethidium bromide (3,8-diamino-6-phenyl-5-ethyl-phenanthridine) with the self-complementary desoxytetraribonucleosidetriphosphate d(ApGpCpT) was studied in aqueous solution by uni- and two-dimensional 1H NMR spectroscopy (500 and 600 MHz). The concentration dependence of the chemical shifts of protons of the complex at a fixed temperature (T = 308 K) were measured. The schemes of complexing of the dye with the tetranucleotide which take into account eventual molecular associates in solution are discussed. Equilibrium constants of the reactions and the limiting values for the chemical shifts of the protons of ethidium bromide incorporating into the complex were calculated. Relative contents of different complex types were analyzed. The relationship between the dynamic equilibrium and dye/tetranucleotide concentration ratio was examined. The conclusion is made that, as with the complex of proflavine with the d(AGCT) examined earlier, ethidium bromide is intercalated essentially into the G-C site of the tetranucleotide being in the duplex form. The difference in intercalation between ethidium bromide and proflavine lies in the fact that ethidium bromide incorporate on the side of the narrow groove, whereas proflavine is built in on the side of the large groove. Based on the calculated values of the induced chemical shift of ethidium bromide protons and 2-d NOE spectal data, an adequate model (1:2) of the complex of the dye with tetranucleotide in solution was constructed.

Ethidium↗

Bridging to transplant. Equal extended survival for patients undergoing LVAD support when compared with long-term medical management.

Implantation of ventricular assist devices (VADs) to support patients awaiting cardiac transplant has become an effective means of assuring that these critically ill patients survive to transplant. The authors undertook a retrospective analysis of 115 consecutive patients listed for cardiac transplant from January 1992 through June 1995. A VAD was implanted in 19 of these patients. Survival was calculated by intent to treat from the time of transplant listing through heart transplant, if it occurred. The analysis demonstrates that the patients who underwent implantation of a VAD as bridge to transplant had survival times similar to those of patients with medical management. These survival statistics demonstrate the utility of VADs as an effective means to bridge critically ill patients until a suitable donor organ becomes available. In addition, as previous studies have suggested for acute results, earlier implementation and better patient selection may lead to improved long-term survival.

Adult↗

Has your organization leveraged the benefits of a computerized patient record?

Health care organizations have responded to the shift to capitated payments by reengineering and streamlining their operations. Most are planning for the automation of health care delivery through the Implementation of clinical information systems. The cornerstone of these systems is the computerized patient record (CPR), which it is believed will increase productivity, cut costs, and provide improved clinical outcomes information. The promise of the CPR is instantaneous access to a patient's information when needed, with historical and current clinical information, from any location. However, not all organizations have realized the value the CPR can provide to manage the demand for health services that ultimately will be necessary for their success. As health systems have identified benefits of an automated patient record, not all are related directly to cost containment; many have either a direct correlation to cost-savings or a risk avoidance that would have been costly to the organization if the alerts, warnings, or access to complete information had not been available. The proactive nature of these tools embedded in the CPR can be one of the greatest long-term benefits to the case manager.

Appointments and Schedules↗