20 research outputs found
Acute Respiratory Distress Syndrome in Patients with Cardiovascular Disease
No full textHeart and lung interaction within the thoracic cavity is well known during inhalation and exhalation, both spontaneously and during mechanical ventilation. Disease and dysfunction of one organ affect the function of the other. A review of the cause-and-effect relationship between cardiovascular disease and acute respiratory distress syndrome (ARDS) is of significance, as the disease burden of both conditions has both a national and global impact on health care. This literature review examines the relationship between cardiovascular disease and ARDS over the past 25 years
Immediate Postoperative Management of Cardiac Surgery Patients
No full textCardiac surgery is quite common in the United States. Outcomes after cardiac surgery are not only dependent on how the surgery went and how the anesthesia care was provided intraoperatively but also on the optimal management in the postoperative critical care setting. It is of paramount importance that the cardiac intensivist has a comprehensive understanding of cardiopulmonary physiology and the sequelae of cardiopulmonary bypass. Most preventable deaths after cardiac surgery have been linked to postoperative problems in the intensive care unit (ICU).1,2 Failure to recognize and rescue a patient from potentially reversible complications is a cause of perioperative morbidity and mortality. Patients who undergo cardiac surgery often present with multiple rapidly changing clinical problems; they are initially unstable with extremely fluid and dynamic clinical status. Postoperative care of these patients requires knowledge of general fundamental concepts of patient care as well as concepts unique to this set of patients. The initial management of these patients as they return from the operating room is critical, because clinical errors at this time can have far-reaching implications. The initial management should begin even before the patient arrives in the cardiovascular intensive care unit (CVICU). It is vital that the cardiac intensivist reviews the chart and notes the type of surgery, indications, preoperative hemodynamic data, comorbid conditions, medications, and allergies. Upon the patient’s arrival in the CVICU, a careful systematic assessment of the patient begins with obtaining a comprehensive handoff from the surgical and anesthesia team. The cardiac intensivist should ascertain what procedure was done in the operating room and inquire as to any intraoperative events that might impact the patient’s postoperative course. Then, they should physically examine the patient as part of this initial evaluation. During the initial assessment, the intensivist should avoid focusing on any one issue and attempt to get a global picture of the patient’s clinical status. A thorough knowledge of the specific monitoring and drug delivery lines is imperative, as is knowledge of where the drains are placed. Once the initial assessment is complete, specific issues can be identified, prioritized, and addressed.3,
pH<sub>i</sub>responses to osmotic cell shrinkage in the presence of open-system buffers
No full textChanges in plasma volume in vivo cause rapid changes in extracellular pH by altering the plasma bicarbonate concentration at a constant Pco2(Garella S, Chang BS, and Kahn SI. Kidney Int 8: 279, 1975). Few studies have examined the possibility that changes in cell volume produce comparable changes in intracellular pH (pHi). In the present study, alveolar macrophages were exposed to hyperosmotic medium in the absence or presence of the open-system buffers CO2-HCO3−, propionic acid-propionate, or NH3-NH4+. In the absence of open-system buffers, exposure to twice-normal osmolarity (2T) produced a slow cellular alkalinization [change in pHi(ΔpHi) ≈ 0.38; exponential time constant (τ) ≈ 120 s]. In the presence of 5% CO2, 2T caused a biphasic pHiresponse: a rapid increase (ΔpHi≈ 0.10, τ ≈ 15 s) followed by a slower pHiincrease. Identical rapid pHiincreases were produced by 2T in the presence of propionic acid (20 mM). Conversely, 2T caused a rapid pHidecrease (ΔpHi≈ −0.21, τ ≈ 10 s) in the presence of NH3(20 mM). Thus osmotic cell shrinkage caused rapid pHichanges of opposite direction in the presence of a weak acid buffer (contraction alkalosis with CO2or propionic acid) vs. a weak base buffer (contraction acidosis with NH3). Graded ΔpHiwere produced by varying extracellular osmolarity in the presence of open-system buffers; osmolarity increases of as little as 5–10% produced significant ΔpHi. The rapid pHiresponses to 2T were insensitive to inhibitors of membrane H+transport (ethylisopropylamiloride and bafilomycin A1). The results are consistent with shrinkage-induced disequilibria in the total cellular buffer system (i.e., intrinsic buffers plus added weak acid-base buffer).</jats:p
THE NORMAL MODES OF CYCLOPROPENONE
No full textAuthor Institution: Department of Chemistry, University of PittsburghThe C = C stretching frequencies of cyclopropenone and cyclopropenone- present [FIGURE] a puzzling problem. They are presumably the very intense and strongly polarized Raman bands at 1480 and 1409 , respectively. These unusually low values are in sharp contrast to those observed when the substituents are methyl, chloro, of phenyl, for then the C = C frequencies are in the ``normal” range of . The low values for H and D raise a question about the proper description of the normal mode involved in these cases. A normal coordinate analysis of cyclopropenone- and has been carried out, and the potential energy distribution has been determined for each of the twelve normal modes of each molecule. The discussion will concentrate on the answer to the above problem
Frequency of Nasal Colonization by Staphylococus Aureus and Some Effective Factors in Intravenous Drug Abusers in Three Hospitals of Tehran in 2005-2006
No full textBackground & Objectives: This study was prepared to determine the frequency ofStaphylococus aureus nasal colonization among intravenous drug abusers with respect to thisfact that the rate of colonization is dependent on various factor including addictionbehaviours. There wasn't any native study on this subject. The purpose of thisstudy was toprepare the basic data of S.aureus nasal olonization among intervenous drug abusers, inorder to reducing the incidence and nasal carriage rates of S.aureus infections.
Methods: This was a prospective cross sectional study that included all of intravenous drugabusers who referred to three hospitals of Tehran from 2005 to 2006. Specimens for culture were obtained by swabbing anterior nares. Swabs were inoculated into nasal chapman broth and incubated at 35 °C for 48 hours. Isolated colonies were urthersubjected to identificationand antimicrobial susceptibility testing. The related data were collected using patients`medical files and analyzed with using SPSS 11.
Results: Staphylococcus aureus was grown in 38 cultures (26.2%). We did not find any
significant relationship between variables such as, economic condition, methods of using
drugs, frequency of drug use, infection with different viruses, gender and colonization by
Staphylococcus aureus.
Conclusion: We observed lower nasal colonization with Staphylococcus aureus among
patients. We suggest preparing similar study in order to clarify the role of different factors
that have effect on the rate of nasal colonization with Staphylococcus aureus
144: EVALUATION OF NEUROMUSCULAR BLOCKADE REVERSAL ON POSTOPERATIVE OUTCOMES IN CARDIOVASCULAR SURGERY
No full textPicking the President: Understanding the Electoral College. Revised and Expanded Edition
No full textDuring the latter half of 2024, with the United States amid unchartered waters, the Revised and Expanded Edition of Picking the President was assembled (like the first edition had been in 2017) to promote understanding of the Electoral College. To this end, Part I (“The First Edition of Picking the President”) consists of the first edition’s Preface, Introduction, and fourteen essays. Part II (“New Perspectives on the Electoral College”) unveils a new Prelude, a new Introduction, and fifteen new essays. Part III (“Resources”) features fifty items, including the complete debate on the subject at the Constitutional Convention, which illuminate the creation, ratification, and early evolution of the United States’ presidential election system. In providing an expansive view of the Electoral College, the Revised and Expanded Edition of Picking the President aims to promote understanding of this system as the United States heads still further into the unknown.
With new contributions by Robert M. Alexander, Kathleen Bartoloni-Tuazon, Gary Bugh, Eric Burin, Jane E. Calvert, Wilfred U. Codrington III, Heather Cox Richardson, George C. Edwards III, Mark Stephen Jendrysik, John P. Kaminski, Randall M. Miller, Jack N. Rakove, Michael T. Rogers, Paul Schumaker, Michael H. Taylor, and Rosemarie Zagarri.
Eric Burin is Professor of History at the University of North Dakota, author of Slavery and the Peculiar Solution: A History of the American Colonization Society, and editor of the open-access anthology, Protesting on Bended Knee: Race, Dissent, and Patriotism in 21st Century America (2018).https://commons.und.edu/press-books/1031/thumbnail.jp
Gay men's narratives of pregnancy in the context of commercial surrogacy
No full textAuthor version of the chapter reproduced here with permission from the publisher.Historically, gay men have primarily become fathers in the context of heterosexual relationships, or for some men through foster care, adoption, or co‐parenting arrangements as sperm donors (Riggs and Due). Since the beginning of the 21st
century, however, gay men living in western countries have increasingly made use of commercial surrogacy services (Everingham, Stafford‐Bell, and Hammarberg). The increased use of these services has become possible as a result of legislative change in countries such as the US (in which many states now allow for the contracting of surrogacy services), in addition to the provision of services in countries where the regulation of commercial surrogacy has not occurred until relatively recently (such as India and Thailand). The rapid growth in the use of commercial surrogacy services by gay men has been shaped by factors such as 1) a desire for genetic relatedness between children and at least one of their fathers (in a couple), 2) the perception that commercial surrogacy allows men to have greater control over the process of having a child, and 3) the perception that commercial surrogacy arrangements offer greater legal security to gay men (Murphy; Tuazon‐McCheyne).The research reported in this chapter was supported by an Australian Research Council Discovery Grant, DP110101893
Effects of extracellular pH on tumour necrosis factor-α production by resident alveolar macrophages
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