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At least 433 records · Page 24Linked to original sources
PubMed1987

Intraoperative death during caesarian section in a patient with sickle-cell trait. The Anaesthesia Advisory Committee to the Chief Coroner of Ontario.

The case of a woman with sickle cell trait who sustained a cardiac arrest and died during a Caesarian section under general anaesthesia is reported. Because the common causes of intraoperative hypoxia and shock were ruled out in this case, we believe that death was due to severe concealed aorto-caval compression. After delivery, the release of a large volume of hypoxaemic, acidotic blood with sickled cells could cause cardiac depression and arrest. The fact that the patient's mucous membranes were pink and she was haemodynamically stable while her uterus was cyanotic prior to delivery provides some positive evidence for this hypothesis. We emphasize that while complications secondary to sickle cell trait during general anaesthesia are very rare, they can occur. We discuss methods of monitoring such patients.

Adult↗
PubMed1995

Recommendations for preventing the spread of vancomycin resistance: recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC).

A rapid increase in the incidence of infection and colonization with vancomycin-resistant enterococci (VRE) has been reported from U.S. hospitals in the last 5 years. This increase poses several problems, including a) the lack of available antimicrobials for therapy of infections due to VRE, since most VRE are also resistant to multiple other drugs, e.g., aminoglycosides and ampicillin, previously used for the treatment of infections due to these organisms, and b) the possibility that the vancomycin resistance genes present in VRE may be transferred to other gram-positive microorganisms such as Staphylococcus aureus. An increased risk of VRE infection and colonization has been associated with previous vancomycin and/or multi-antimicrobial therapy, severe underlying disease or immunosuppression, and intra-abdominal surgery. Because enterococci can be found in the normal gastrointestinal or female genital tract, most enterococcal infections have been attributed to endogenous sources within the individual patient. However, recent reports of outbreaks and endemic infections due to enterococci, including VRE, have shown that patient-to-patient transmission of the microorganisms can occur either via direct contact or indirectly via hands of personnel or contaminated patient-care equipment or environmental surfaces.(ABSTRACT TRUNCATED AT 250 WORDS)

Centers for Disease Control and Prevention, U.S.↗
PubMed1995

Prevent Blindness America visual field screening study. The Prevent Blindness America Glaucoma Advisory Committee.

PURPOSE: To assess the screening efficacy and practical use of two portable devices to detect moderate to severe visual field loss rapidly in population screening. METHODS: Henson visual field analysis and Damato campimetry for glaucoma were performed in a healthy adult population, to determine false-positive rates; in established glaucoma patients and suspects, to determine false-negative rates; and in a general adult population, to assess practical use in actual screenings. RESULTS: There were no false-positive test failures among the 82 normal subjects who completed the Henson two-step screening. Eighty of 83 normal subjects passed Damato campimetry, resulting in a false-positive rate of 3.6%. Among 83 glaucoma suspects and patients, the Henson test identified 49 (84%) of 58 subjects whose full-threshold fields from Humphrey perimetry were abnormal, 38 (97%) of 39 of whom had moderate to severe visual field loss. The Damato campimeter detected 55 (81%) of 68 subjects with any pathologic loss on full-threshold visual fields, 44 (92%) of 48 of whom had moderate to severe visual field loss. Among 1,278 subjects tested in general population screenings, 55 subjects (4.3%) failed either or both tests. CONCLUSIONS: The Henson visual field analyzer can discriminate moderately to severely diseased from normal visual fields with high sensitivity and specificity. The Damato campimeter can reliably detect moderate to severe visual field loss with a tolerably low false-positive rate. To overcome the weakness of glaucoma screening by tonometry alone, some forms of visual field testing may be acceptably brief (cost effective) and accurate (sensitive and specific).

Adolescent↗