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PubMed2005

Is albumin administration in the acutely ill associated with increased mortality? Results of the SOAP study.

INTRODUCTION: Albumin administration in the critically ill has been the subject of some controversy. We investigated the use of albumin solutions in European intensive care units (ICUs) and its relationship to outcome. METHODS: In a cohort, multicenter, observational study, all patients admitted to one of the participating ICUs between 1 May and 15 May 2002 were followed up until death, hospital discharge, or for 60 days. Patients were classified according to whether or not they received albumin at any time during their ICU stay. RESULTS: Of 3,147 admitted patients, 354 (11.2%) received albumin and 2,793 (88.8%) did not. Patients who received albumin were more likely to have cancer or liver cirrhosis, to be surgical admissions, and to have sepsis. They had a longer length of ICU stay and a higher mortality rate, but were also more severely ill, as manifested by higher simplified acute physiology score (SAPS) II and sequential organ failure assessment (SOFA) scores than the other patients. A Cox proportional hazard model indicated that albumin administration was significantly associated with decreased 30-day survival. Moreover, in 339 pairs matched according to a propensity score, ICU and hospital mortality rates were higher in the patients who had received albumin than in those who had not (34.8 versus 20.9% and 41.3 versus 27.7%, respectively, both p < 0.001). CONCLUSION: Albumin administration was associated with decreased survival in this population of acutely ill patients. Further prospective randomized controlled trials are needed to examine the effects of albumin administration in sub-groups of acutely ill patients.

Age Distribution↗
PubMed2005

From soap opera to science: towards gaining access to the psychopaths who live amongst us.

This idiographic and essentially exploratory study examined the unique experiences of 20 women who had been victimized within the context of heterosexual relationships with a male partner who was rated as having the characteristics associated with psychopathy. An integrated approach, using questionnaires, and biographical and narrative data, was utilized. The experimental group consisted of 20 women who had partnered males rated by the women on the Hare P-SCAN (Hare & Herve, 1999) as having many or most of the features of psychopathy. As this was the first reported use of the Hare P-SCAN to provide partner ratings, norms for scorings on this assessment tool were obtained from ratings provided by a control group of a random sample of 100 women who had completed the Hare P-SCAN and provided ratings for their last male partner. Four two-tailed independent samples t tests were conducted to test for significant differences in scorings between the two groups. Following screening, semi-structured interviews were conducted with the experimental group, that is, 20 women who had partnered males with psychopathic traits. The four independent samples t test showed that significant differences occurred between the ratings of male partners by women in the experimental group and ratings provided by the control group. Narrative data, generated from written accounts and interviews with women in the experimental group, was successful in clarifying the manner in which males with the personality traits which define psychopathy managed the heterosexual relationship and the nature and patterns of the abusive behaviours which occurred in this context.

Adult↗
PubMed1991

Effect of feeding calcium soaps to early postpartum dairy cows on plasma prostaglandin F2 alpha, luteinizing hormone, and follicular growth.

Multiparous Holstein cows (n = 18) were fed a total mixed ration containing corn silage, corn grain, whole cottonseed, soybean meal, dried distillers grains, and chopped bermudagrass hay (control) or same diet plus Ca salts of long-chain fatty acids (2.2% of diet DM) for the first 60 d postpartum. Predicted energy balance was calculated from DM intake, milk yield and composition, and BW. On d 25 postpartum, cows were injected with 25 mg of prostaglandin F2 alpha and treated for 15 d with an intravaginal device containing 1.9 g progesterone. Profiles of 15-keto-13,14-dihydro-prostaglandin F2 alpha (d 1 to 21) and plasma triglycerides (d 7 to 60) were similar between groups. Average number of follicles, determined by ultrasonography prior to d 25, tended to differ between groups; controls had more 3- to 5-mm and fewer 6- to 9-mm follicles than the group of fat-fed cows. Basal, smoothed mean concentration, and average luteinizing hormone amplitude, determined by 10-min samples for 8 h on d 10, were not significantly different between groups. Increasing predicted energy balance was associated with increased pulse amplitude and diameter of the largest follicle on d 10. During the progesterone treatment period and the postprogesterone treatment estrous cycle, cows fed fat had greater numbers of 3- to 5-mm and greater than 15-mm follicles. In conclusion, feeding fat did not influence 15-keto-13,14-dihydro-prostaglandin F2 alpha or luteinizing hormone dynamics but did alter the average number of follicles within different size classes and the diameter of largest and second largest follicle after progesterone treatment.

Animal Feed↗
PubMed1992

Energy balance and lactation response in Holstein cows supplemented with cottonseed with or without calcium soap.

Holstein cows (n = 58, 21 primiparous), fed corn and wilted grass silages (63:37, DM basis) for free choice consumption, were assigned to control concentrate or supplemented concentrate during wk 1 to 16 postpartum with linted whole cottonseed (15% of projected DMI) alone or with Megalac (.54 kg/d). Our objective was to examine the effects of fatty acids on energy and N balances, total tract digestibility, and milk fatty acids in wk 7 and 16 and to assess total lactation responses. During balance measurements, fatty acids constituted 4.1, 6.8, and 8.6% of DM in control, oilseed, and oilseed plus protected fatty acid diets. Fat additions reduced fiber digestion (attributed to oilseed) and, to some degree, DMI and milk yield, but enhanced fat test without affecting protein percentage. Supplementary fat increased the proportion of C18:0 in milk at the expense of short-chain fatty acids. Supplemental oilseed with or without protected fatty acids reduced total heat production by 6% and reduced heat in excess of maintenance by 8%. Best estimates of NEL in linted whole cottonseed and of fat in Megalac were 1.81 and 5.69 Mcal/kg of DM. In total lactation, primiparous cows yielded more milk and FCM when fed oilseed plus Megalac and less of each when fed oilseed alone than controls. In pluriparous cows, milk yield was reduced by 2.7 kg/d relative to other treatments when oilseed plus Megalac was fed; FCM yield increased about 2 kg/d only when oilseed was supplemented alone. Overall, data suggest that basal ration fat and oilseed supplementation were too high or that supplementation should have been delayed until feed intake was higher.

Animal Feed↗
PubMed1984

What does a bar of soap have to do with health care marketing?

In today's competitive health care market, product/service marketing will become the key to survival. This article introduces a new way of using an established marketing concept. Product/service marketing is based on promoting services that fulfill a number of requirements, including being highly visible and a foundation for the later development of an overall marketing plan. Choosing the products/services to be marketed and developing the marketing program are discussed.

Economic Competition↗