Case report. Propranolol-induced lupus syndrome?
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Humans↗
Biomedical subjects
T Harrison
Publications and source records attributed to T Harrison.
Catecholamine levels after ketamine anesthesia in man.
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Adult↗
Sixth National Burn Seminar. Adrenaline and noradrenaline excretion following burns.
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Blood Pressure↗
Analysis of patients discharged from receiving hospitals within 24 hours of air medical transport.
INTRODUCTION: Use review has become increasingly important in the current atmosphere of cost justification for air medical transport. One criterion for use review is patient discharge from receiving hospitals within 24 hours of transport. The objective of this study was to determine the frequency and characteristics of patients discharged within 24 hours of air transport; the goal was to identify particular patient types likely to be discharged soon after air transport. METHODS: Flight records from November 1994 to September 1995 were reviewed. Follow-up identified patients who were discharged within 24 hours of air medical transport; these were designated the "24-hour group." Other patients were designated the "overall group." Comparisons between groups were made using the t test, Wilcoxon rank sum, and chi-square analysis (alpha = 0.05) for the following factors: age, vital signs, Glasgow coma score, percentage of intubated patients, and percentage of trauma and scene transports. RESULTS: Of the 945 flights analyzed, 42 (4.4%) transported patients who were discharged within 24 hours of air transport. Patients in the 24-hour group were younger, less likely to be intubated, and more likely to be scene-trauma transports compared with the overall group. CONCLUSION: This study demonstrates that air medical transports meet currently accepted criteria for helicopter transport. This study suggests that inappropriate air medical transport is rare, even in patients discharged from receiving hospitals within 24 hours of air transport.
Air Ambulances↗
Helicopter emergency medical services roles in disaster operations.
Rotor-wing aircraft have previously proven utility in disaster operations, but recent expert reviewers have identified areas of potential improvement in integration of helicopter emergency medical services (HEMS) resources into disaster planning and management. This paper discusses salient points regarding helicopter operations in disaster management, using prior reports regarding rotor-wing aircraft utilization as a basis upon which to provide a concise review of HEMS operations in disasters.
Air Ambulances↗
Flight crew airway management in four settings: a six-year review.
OBJECTIVE: To analyze flight crew airway management in four different settings (in flight, at trauma scenes, in ambulance, and in referring hospitals) and in two different aircraft used by the same helicopter EMS (HEMS) service. The null hypothesis was that there was no association between practice setting, or aircraft, and airway practices or success rate. METHODS: This retrospective study analyzed all patients in whom advanced airway management was attempted by the HEMS service during the study period October 1991 through October 1997. Data used were from flight records of Boston MedFlight Critical Care Transport Service, which uses a nurse/paramedic crew and had a paralytic-assisted intubation protocol in place. Data were analyzed with chi-square and Fisher's exact testing, risk ratio analysis, and logistic regression. RESULTS: Advanced airway management was attempted in 722 patients, with an airway placed in 705 (97.8%). Intubation success was unrelated to site of airway management (p = 0.14), but patients were more likely to have intubation attempted prior to flight (as opposed to in flight) if the crew were in the AS365N2 Dauphin as compared with the BK-117 (p<0.0001). In addition, patients were 0.77 times as likely (95% confidence interval, 0.68-0.88) to receive paralytic-facilitated intubation if airway management occurred in the hospital setting as compared with other sites. CONCLUSIONS: While HEMS crew airway management success rates are equally high in all practice settings, airway management decision making and practice appear to be significantly influenced by practice setting and aircraft type. These data support contentions that nonphysician HEMS crews can effectively manage airways in a variety of circumstances.
Adult↗
Salivary sIgA concentrations and stimulated whole saliva flow rates among women undergoing chemotherapy for breast cancer: an exploratory study.
A study was conducted to evaluate the secretion of stimulated whole saliva (SWS) and secretory IgA (sIgA) among three groups of women. One group was a healthy control group, the second group consisted of women diagnosed with metastatic breast cancer before being placed on chemotherapy, while the third group consisted of women on chemotherapy taking CMF (cyclophosphamide, methotrexate, and fluorouracil) for at least one month. There were seven patients in each group. SWS was collected. Salivary sIgA concentrations were determined by enzyme-linked immunoabsorbant assay. The results of the study showed that the mean SWS flow rate for the chemotherapy group (x = 0.96 mL/min) was significantly lower (p > 0.03) than that of the control group (x = 2.33 mL/min) and lower than that of the group with cancer (x = 1.81 mL/min). Additionally, the results showed that the mean sIgA concentrations for the chemotherapy group (x = 10.9 ng/mg of protein) were slightly lower than those of the control group (x = 13.7 ng/mg of protein) and lower than those of the group with cancer (x = 12.6 ng/mg of protein). The results of this study suggest that women placed on CMF for treatment of carcinoma of the breast may have reduced stimulated salivary production.
Adult↗
Relationship among stimulated whole, glandular salivary flow rates, and root caries prevalence in an elderly population: a preliminary study.
A comparison of salivary flow rates was made between two groups of healthy, unmedicated, elderly, Caucasian men and women ranging in age from 60 to 90 years. One group was a control group, while the other group had both active and restored root caries. The control group consisted of 69 individuals with a mean age of 73 years. The root caries group consisted of 39 individuals with a mean age of 71 years. The groups were evaluated for unstimulated (UPAR) and stimulated parotid gland flow rates (SPAR), unstimulated (USUB) and stimulated submandibular/sublingual gland flow rates (SSUB), and stimulated whole saliva flow rates (SWhole). Parotid flow rates were determined with the use of a Carlson-Crittenden cup, while submandibular/sublingual flow rates were determined by means of the NIDR collector. A 2% citrate solution was used for stimulation in glandular collections. Subjects chewed a 1-cm3 cube of paraffin to stimulate whole saliva. The results showed that the control group had higher UPAR, SPAR, USUB, SSUB, and SWhole than the root caries group.
Age Factors↗
Creativity in nurse education.
Educationalists have been accused of suppressing, or at least not encouraging, creativity in nursing students. Is this still the case or are the changes in nurse education helping to reverse this trend?
Creativity↗
Paediatrics needs to consider HIV.
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Acquired Immunodeficiency Syndrome↗
Children with AIDS.
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Acquired Immunodeficiency Syndrome↗
VP-16-213 in the treatment of stage III and IV diffuse lymphocytic lymphoma of the large cell (histiocytic) variety: an interim report.
A pilot study has previously demonstrated antitumor activity for the epipodophyllotoxin VP-16-213 in patients with diffuse lymphocytic lymphoma of the large cell (histiocytic) variety. To define this observation further, a prospective randomized trial was undertaken in patients with stage III and IV disease, comparing this agent used alone (group 1, 41 patients) to the response obtained when the same schedule of VP-16-213 was combined with either cyclophosphamide (group 2, 36 patients) or doxorubicin (group 3, 41 patients). The quantity of VP-16-213 given to patients in the three groups was equivalent. Of these 118 patients, three were lost to followup and thus were excluded from further study. Specifically included were 12 patients who died within 1 month of diagnosis while still receiving induction chemotherapy. For the three groups, complete remission rates were 39%, 26%, and 54%, and additional partial remissions were obtained in 20%, 11%, and 10% of the patients, respectively. The lower remission rates obtained in patients receiving cyclophosphamide combined with VP-16-213 are statistically significant (P less than 0.05), but no explanation for this is evident since the distribution of poor prognostic factors among the three groups was uniform. The higher percent of complete remission and the greater number of patients remaining free from disease in group 3 demonstrate the superiority of the combination of VP-16-213 with the anthracycline antibiotic doxorubicin.
Alopecia↗
HIV/AIDS. Maintaining confidentiality when tracing contacts.
The extent to which a patient who has HIV can rely on information relating to his or her status remaining confidential has been the subject of furious debate within and outside the nursing profession. This paper explores the issues, with particular reference to partner notification.
Acquired Immunodeficiency Syndrome↗