OBJECTIVE: The purpose of this study was to determine whether any preoperative variable had a significant effect on extubation time after coronary artery bypass graft surgery. DESIGN: The study design was retrospective. SETTING: The study was conducted in a cardiac center in the United Kingdom where 1700 cardiac surgical operations are performed per year. SUBJECTS: The study sample was composed of 89 patients who had coronary artery bypass graft surgery performed by the designated consultant cardiac surgeon in the first 6 months of 1998. OUTCOME MEASURES: The measures included preoperative variables (age, gender, body mass index, cardiac status, pulmonary status) and extubation time. RESULTS: Mean extubation time was found to be 4.97 hours. Left ventricular function was found to be statistically significant (P =.05) to extubation time. CONCLUSIONS: We found that cardiac status had an effect on extubation time and that this warranted further investigation. No other preoperative variable had a significant effect on extubation time, raising questions concerning the need for strict preoperative exclusion criteria.

Adult↗

PubMedDate not supplied

Target Cities as an effective solution to the special problems of treatment and recovery in the city of Laissez Le Bon Temps Roulle.

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Crack Cocaine↗

PubMedDate not supplied

Arthrokatadysis in trisomy 18.

Protrusio acetabuli may be characterized by an inward displacement of the femoral head into the pelvis. A 20-year-old patient with trisomy 18, who is also notable for her longevity, developed bilateral protrusio over a course of 2 years. We believe that trisomy 18 should be considered a cause of protrusio.

Acetabulum↗

PubMedDate not supplied

Tattooing and hepatitis B infection.

To determine the prevalence of HBV carrier status in tattooed persons, 200 healthy, tattooed volunteers and 200 non-tattooed volunteers to match the first group for age, sex and ethnic group were screened. Prevalence of HBsAg in tattooed and non-tattooed volunteers was 19.5 and 9% respectively, which was a statistically significant difference (P less than 0.01). There was no difference in the prevalence in various age groups, ethnic groups, or sex, between the two groups.

Adult↗

PubMedDate not supplied

Conservative management of a displaced medial clavicular physeal injury in an adolescent athlete. A case report and literature review.

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Adolescent↗

PubMedDate not supplied

Foot deformity in myotonic dystrophy.

Myotonic dystrophy is a progressive multisystem disorder that may be inherited from either parent, although only children with affected mothers usually show the more severe congenital form of the condition; others are classified as having adult myotonic dystrophy. Since 1940, 29 patients with myotonic dystrophy (10 adult, 17 congenital, two unclassified) have been followed at the Alfred I. duPont Institute. Treatment protocols have been established for the treatment of talipes equinovarus deformity commonly seen in the congenital form of myotonic dystrophy, as well as the progressive dropfoot gait more commonly seen in the adult form.

Adolescent↗

PubMedDate not supplied

Computer supported studies on design and evaluation of solid dispersions of carbamazepine.

The main advantages of solid dispersions (the drug could be maintained in a bioavailable form, dosage reduction and cleaner manufacturing conditions) provide scope for the continued interest in field. Additionally, their use in providing a sustained or controlled release of drugs has only been tentatively examined. In the present study, Carbamazepine has been used to develop a dosage form which will provide a booster amount followed by sustained release of the drug for effective control of epileptic seizures while keeping the serum level of the drug at minimum. Enteric polymers CAP and CAT have been used to retard the release till the formulation reaches the intestine. Either individually or combined fractions of the formulations may be used in the therapy of epilepsy.

Anticonvulsants↗

PubMedDate not supplied

Preparation and in vitro dissolution of isoniazid from ethylcellulose microcapsules.

Microcapsules of isoniazid were prepared by phase separation coacervation process induced by non-solvent addition and using ethylcellulose (EC) as coating polymer. When polyisobutylene (PIB)--a protective colloid was present at sufficient concentration, film coated drug particles were formed. At 0-6% PIB concentration, the microcapsules were aggregated. Increase of colloid concentration produced microcapsules of less aggregation and higher drug content because coating became progressively thinner. PIB concentration also controlled the particle size and the release rate of drug from microcapsules. Wall thickness and EC loss were calculated from drug content. Microcapsules coated with EC were prepared with 7-9% PIB. Scanning Electron Microscopy was used to study the nature of aggregation and coating behaviour. The in vitro dissolution study confirmed the first order release pattern and also the Higuchi Matrix model.

Antitubercular Agents↗

PubMedDate not supplied

Structural perturbation of proteins in low denaturant concentrations.

The presence of very low concentrations of the widely used chemical denaturants, guanidinium chloride and urea, induce changes in the tertiary structure of proteins. We have presented results on such changes in four structurally unrelated proteins to show that such structural perturbations are common irrespective of their origin. Data representative of such structural changes are shown for the monomeric globular proteins such as horseradish peroxidase (HRP) from a plant, human serum albumin (HSA) and prothrombin from ovine blood serum, and for the membrane-associated, worm-like elongated protein, spectrin, from ovine erythrocytes. Structural alterations in these proteins were reflected in quenching studies of tryptophan fluorescence using the widely used quencher acrylamide. Stern-Volmer quenching constants measured in presence of the denaturants, even at concentrations below 100 mM, were higher than those measured in absence of the denaturants. Both steady-state and time-resolved fluorescence emission properties of tryptophan and of the extrinsic probe PRODAN were used for monitoring conformational changes in the proteins in presence of different low concentrations of the denaturants. These results are consistent with earlier studies from our laboratory indicating structural perturbations in proteins at the tertiary level, keeping their native-like secondary structure and their biological activity more or less intact.

Acrylamide↗

PubMedDate not supplied

Acute and long-term safety evaluation of a novel IH636 grape seed proanthocyanidin extract.

Grape seed proanthocyanidins are known to possess a broad spectrum of pharmacological, medicinal and therapeutic properties. Previous studies in our laboratories have demonstrated the various protective abilities of a novel IH636 grape seed proanthocyanidin extract (GSPE) against various pathologic conditions. However no extensive safety studies have been conducted on grape seed proanthocyanidins to date. This study demonstrates the acute and chronic safety studies on GSPE. Acute oral toxicity, dermal toxicity, dermal irritation and eye irritation studies have been conducted. The LD50 of GSPE was found to be greater than 5000 mg/kg when administered once orally via gastric intubation to fasted male and female albino rats. The LD50 of GSPE was found to be greater than 2000 mg/kg when administered once for 24 hr to the clipped, intact skin of male and female albino rats. In addition, 2000 mg/kg was found to be the no-observed-effect level (NOEL) for systemic toxicity under the conditions of the study. In a dermal irritation study, GSPE received a descriptive rating classification of moderately irritating. Extensive chronic studies were also conducted. We have assessed the effects of chronic administration of 100 mg GSPE/kg/day for twelve months and its effect on seven vital target organs, namely, brain, heart, intestine, kidney, liver, lung and spleen, and on serum chemistry changes in male B6C3F1 mice. Furthermore, the dose-dependent chronic effects of GSPE in female B6C3F1 mice were evaluated. Mice were fed 0, 100, 250 or 500 mg GSPE/kg/day for six months and the effects of GSPE exposure were examined on brain, duodenum, heart, kidney, liver, lung, pancreas and spleen, and on serum chemistry changes in female mice. These acute studies demonstrated that GSPE is safe and did not cause any detrimental effects in vivo under the conditions investigated in this study.

Administration, Topical↗

PubMedDate not supplied

Effectiveness of training on infant feeding practices among community influencers in a rural area of west Bengal.

Total 34 Influencers were trained in a subcentre area of South 24-parganas district of West Bengal. Knowledge was imparted to community influencers on infant feeding practices through lecture, group discussion, question-answer session and hand-on-training by trained health workers. Pre-assessment was done before initiation of training. Repeat training was conducted at frequent intervals within a period of 3 months. Mean score of knowledge of influencers during pre-training assessment was 13.3 and improved thereafter-following training to 20.8 (1st assessment), 20.6 (2nd assessment), 23.7 (3rd assessment) and 25.2 (final-assessment). Repeat training had also desired impact.

Child Nutrition Sciences↗

PubMedDate not supplied

Massive upper gastrointestinal haemorrhage due to intragastric rupture of a splenic artery aneurysm.

Most cases of splenic artery aneurysm are asymptomatic, being found incidentally at the time of investigations (e.g. ultrasound, computed tomography, angiography) or laparotomy for other conditions. Rupture of a splenic artery aneurysm with erosion into the stomach is a rare cause of massive upper gastrointestinal haemorrhage. This case report is, to our knowledge, only the second case of splenic artery aneurysm presenting with massive upper gastrointestinal haemorrhage due to erosion into the stomach in a nulliparous woman.

Aneurysm, Ruptured↗

PubMedDate not supplied

Financing geriatric programs in community health centers.

There are approximately 600 Community and Migrant Health Centers (C/MHCs) providing preventive and primary health care services principally to medically underserved rural and urban areas across the United States. The need to develop geriatric programs within C/MHCs is clear. Less clear is how and under what circumstances a comprehensive geriatric program can be adequately financed. The Health Resources and Services Administration of the Public Health Service contracted with La Jolla Management Corporation and Duke University Center on Aging to identify successful techniques for obtaining funding by examining 10 "good practice" C/MHC geriatric programs. The results from this study indicated that effective techniques included using a variety of funding sources, maintaining accurate cost-per-user information, developing a marketing strategy and user incentives, collaborating with the area agency on aging and other community organizations, and developing special services for the elderly. Developing cost-per-user information allowed for identifying appropriate "drawing card" services, negotiating sound reimbursement rates and contracts with other providers, and assessing the financial impact of changing service mixes. A marketing strategy was used to enhance the ability of the centers to provide a comprehensive package of services. Collaboration with the area agency on aging and other community organizations and volunteers in the aging network was found to help establish referral networks and subsequently increase the number of elderly patients served. Finally, development of special services for the elderly, such as adult day care, case management, and health education, was found to increase program visibility, opportunities to work with the network of services for the aging, and clinical utilization.

Community Health Centers↗

PubMedDate not supplied

Spinal deformities in Larsen's syndrome.

Eight patients with Larsen's syndrome were investigated and found to have a characteristic pattern of spinal deformity consisting of vertebral anomalies, spondylolysis, and scoliosis. The cervical spine was the most severely involved, and dysraphism as well as hypoplasia represented the most consistent patterns of deformity. Scoliosis was the most common deformity seen in the thoracic spine, whereas dysraphism, scoliosis, and spondylolysis were common in the lumbar spine. Dysraphism again was the most common anomaly in the sacrum. In the young patient, the spine may be difficult to evaluate because major portions of the elements are cartilaginous, and serial roentgenographic evaluations may be required. Early treatment may minimize the severity of the deformities and prevent sequelae.

Abnormalities, Multiple↗