Radiographic assessment of pulmonary fluid clearance and lung aeration in newborn calves delivered by elective Caesarean section.

The aim of this study was to develop a radiographic standard for the assessment of pulmonary fluid clearance and lung aeration in newborn calves. Caesarean-delivered mature calves (n = 9) underwent lung assessment by thoracic radiography as well as arterial and venous blood gas analysis within the first 30 min, 1, 2, 3, 6, 12 and 24 hr after birth. The results indicated that newborn calves delivered by elective Caesarean section suffered from a physiological combined respiratory and metabolic acidosis with the dominance of respiratory acidosis, and an improvement in these conditions was recorded within 24 hr after birth. Concerning the radiographic results, clear lung fields, improvement in lung expansion, air content of the lung and absence of lung opacification occurred within 24 hr of birth. Furthermore, the ventral lung quadrant showed an improvement in radiographic opacification and lung expansion earlier than the dorsal lung regions. The findings of this study support the potential role of thoracic radiography in the assessment of pulmonary fluid clearance and lung aeration in newborn calves.

Assessment of cerebral tissue oxygen saturation in septic patients during acetazolamide provocation - a near infrared spectroscopy study.

UNLABELLED: Sepsis-associated encephalopathy is a multifactorially determined process of the brain parenchyma. Among other factors, vasogenic causes have been shown to play a role in its development. The aim of the present work was to assess whether cerebral tissue oxygen saturation is influenced by administration of acetazolamide in septic patients compared to controls. PATIENTS AND METHODS: 15 patients with severe sepsis and 10 healthy controls were studied. Cerebral oxygen saturation was assessed by INVOS 51 OOC Cerebral Oxymeter (NIRS) before and after administration of 15 mg/kg BW acetazolamide in both groups. RESULTS: The maximal rise that has been found in the partial pressure of CO(2) in the arterial blood of septic patients after administration of acetazolamide was from 35 ± 5 mmHg to 41.1 ± 6.3 mmHg. For the partial pressure of O(2) the observed increase was from 123.7 ± 47.1 mmHg to 139.9 ± 49 mmHg. Vasodilatory stimulus resulted in a similar maximal increase in cerebral oxygen saturation in septic patients and in controls (8.9 ± 6.5% for septic patients and 9.2 ± 4.6% for healthy persons, respectively). CONCLUSIONS: Cerebral vasoreactivity to acetazolamide is preserved in patients with severe sepsis.

A prospective comparison of Doppler echocardiography and postoperative angiography in the assessment of left internal thoracic artery graft in 72 patients submitted to minimally invasive direct coronary artery bypass.

BACKGROUND: Concerns have been raised regarding the accuracy of the left internal thoracic artery (LITA) anastomosis performed during minimally invasive direct coronary artery bypass (MIDCAB). In a prospective study, we tested the hypothesis that transthoracic Doppler echocardiography is an adequate technique to determine LITA patency when compared to "gold standard" postoperative angiography. METHODS: Seventy-two consecutive patients with single left anterior descending (LAD) coronary artery stenosis were submitted to MIDCAB performed on a beating heart using the LITA. All patients underwent transthoracic Doppler Echocardiography and angiography before discharge. LITA was considered patent when diastolic fraction (DF) of time-velocity integral was equal or greater than 0.5. FitzGibbon grading system was used to evaluate LITA patency by angiography (A=excellent; B=stenosis reducing caliber of anastomosis or trunk to < 50% of grafted coronary artery; O=occlusion). RESULTS: Angiography showed that LITA was patent in 70 (97.2%) patients, 69 of them been graded A. Adequate image and flow signal of the LITA was achieved in 65 (90.3%) patients, been considered patent in 61 (93.8%) of them. Comparison between echocardiography and angiography in these 65 patients showed a specificity of 96.8% and a sensitivity of 50%. In 7 (9.7%) patients in whom no adequate echocardiography signal was obtained, the LITA graft was normal in six and occluded in one. CONCLUSIONS: For patients whose LITA graft can be imaged, transthoracic Doppler echocardiography is highly specific and is a valuable method for noninvasive evaluation of LITA graft patency after MIDCAB.

[Regional frequency of lung cancer and COLD-mortality]. / A tudorak-es a KALB-mortalitas teruleti gyakorisaga.

"The study analyses regional differences of lung cancer and chronic obstructive lung disease [COLD] mortality in 61 Hungarian towns between 1980 and 1989. The result of regional clustering with [the] Monte-Carlo method shows that regional distribution of lung cancer and chronic obstructive lung disease mortality is not random. Whereas the mortality rates by age group and sex hardly show correlation with air pollution data between 1980 and 1989, they are much higher in more industrialised areas than elsewhere." (SUMMARY IN ENG AND RUS)

[Dental status of 14-18-year old secondary school students in Budapest (VIII. District) in 1991. (Implications of a dental-sociological study)]. / 14-18 éves budapesti (VIII. kerületi) középiskolások fogazati állapota 1991-ben (Egy fogászati-szociológiai vizsgálat fogorvosi vonatkozásai).

In this dento-sociological examination the dental status of 1623 secondary-school-students living in the capital of Hungary, was found better than that of the same-aged students examined previously. The number of decayed teeth was higher than the number of filled teeth. The average level of oral hygiene was found between "good" and "middle" levels. Among the three types of secondary schools the best oral hygiene status was found in the secondary grammar school.

Increasing safety belt use in a secondary enforcement state: evaluation of a three-county special enforcement program.

Special enforcement programs to increase belt use present a unique challenge in states with secondary enforcement laws. This paper reports findings from an evaluation of a combined public information and education/enforcement program to increase restraint use along a highly traveled corridor in three Michigan counties. This program (US-31 SAVE) was successful in increasing belt use at least temporarily along the special enforcement corridor. Observed belt use increased from a baseline rate of 56.7% to 65.1% during the program before slipping slightly to 62.7% after the intensive enforcement and PI&E declined (all differences significant at p less than .05). This paper details program and evaluation activities and suggests future research needs to better understand the most effective mix of public information and enforcement efforts in states with secondary belt use laws.

Use and misuse of automobile child restraint devices.

OBJECTIVE: To determine demographic, social, and behavioral characteristics that are associated with correct child restraint device (CRD) use. DESIGN: Cross-sectional. SETTING: Fast-food restaurant parking lots in southeastern Michigan. PARTICIPANTS: Children younger than age 4 years and their drivers. SELECTION PROCEDURES: Consecutive sample. INTERVENTION: None. MEASUREMENTS/MAIN RESULTS: Seven hundred seventeen child passengers were observed for 11 dimensions of CRD use and 661 of their drivers were interviewed. Three hundred ninety-four (55%) of the children were in CRDs, but 248 (63%) of those children were incorrectly restrained. A 43-point misuse index was constructed based on scores assigned for different types of misuse. Seven variables (ie, age of child, race of parent, driver as a parent, days driving, number of occupants, perceived comfort of CRDs, and belief that the social norm supports CRD use) were highly predictive of CRD use. In contrast, only three factors (ie, age of child, education of the driver, and knowledge of the CRD law) were minimally predictive of correct use. CONCLUSIONS: Since correct use of CRDs represents such a complex behavior, the best strategy to address the widespread problem of CRD use may be through the design of less complicated CRDs.

Estimating costs of traffic crashes and crime: tools for informed decision making.

Traffic crashes and crime both impose significant economic and social burdens through injury and loss of life, as well as property damage and loss. Efforts to reduce crashes and crime often result in competing demands on limited public resources. Comparable and up-to-date cost data on crashes and crime contribute to informed decisions about allocation of these resources in important ways. As a first step, cost data provide information about the magnitude of the problems of crashes and crime by allowing us to estimate associated dollar losses to society. More importantly, cost data on crashes and crime are essential to evaluating costs and benefits of various policy alternatives that compete for resources. This paper presents the first comparable comprehensive cost estimates for crashes and crime and applies them to crash and crime incidence data for Michigan to generate dollar losses for the state. An example illustrates how cost estimates can be used to evaluate costs and benefits of crash-reduction and crime-reduction policies in making resource allocation decisions. Traffic crash and selected index crime incidence data from the calendar year 1988 were obtained from the Michigan State Police. Costs for crashes and index crimes were generated and applied to incidence data to estimate dollar losses from crashes and index crimes for the state of Michigan. In 1988, index crimes in Michigan resulted in $0.8 billion in monetary costs and $2.4 billion in total monetary and nonmonetary quality-of-life costs (using the willingness-to-pay approach). Traffic crashes in Michigan resulted in $2.3 billion in monetary costs and $7.1 billion in total monetary and nonmonetary quality-of-life costs, nearly three times the costs of index crimes. Based on dollar losses to the state, the magnitude of the problem of traffic crashes clearly exceeded that of index crimes in Michigan in 1988. From a policy perspective, summing the total dollar losses from crashes or crime is of less importance than understanding the costs and benefits of various policy alternatives. This paper therefore concludes with an example of how our cost estimates can be used to compare the costs and benefits of competing policies.

Converting an acute care unit into a skilled nursing facility: a methodology.

To combat the problem of excess capacity and to meet the needs of its elder community. Highland Park Hospital (HPH) in Highland Park, Illinois decided to convert an unused acute care unit into a skilled nursing facility (SNF). Detailed here is the methodology used to determine the number of SNF beds needed by HPH, the options for development available, and the factors considered when choosing the type of facility to be designed.