Respiratory acid-base disorders.

Respiratory acid-base disorders, although infrequently diagnosed in veterinary medicine, can cause or contribute to adverse clinical outcomes. Recognition of the mechanisms and causes of respiratory acidosis and alkalosis can prompt clinical detection of the acid-base derangement, allowing for appropriate intervention.

Respiratory complications in the critically ill animal.

Respiratory dysfunction in a critically ill animal is a life-threatening complication that often presents a challenge to patient management. In the critical care setting, the most severe respiratory complications include nosocomial pneumonia, pulmonary thromboembolism (PTE), and acute respiratory distress syndrome (ARDS). Successful treatment of acute respiratory failure, although difficult, can be enhanced by recognition of predisposing factors, knowledge of underlying pathophysiologic mechanisms, and early prophylactic and therapeutic intervention.

Fetal monitoring in perinatal sepsis.

To evaluate the utility of conventional electronic fetal monitoring in detection of established perinatal sepsis, we conducted a case-controlled study of fetal monitor results in 18 patients delivering newborns with sepsis. Eleven of the 18 newborns (61%) demonstrated clinically reassuring fetal heart rate patterns, not significantly different from controls (p = 0.80). No pattern predictive of presumed perinatal sepsis could be identified. Obstetric factors traditionally associated with increased risk of perinatal infection, such as long duration of labor, use of internal fetal monitoring, and increased number of vaginal examinations were not significantly different from controls. Preterm rupture of membranes greater than 24 hours occurred in less than 50% of the cases. Clinical diagnosis of chorioamnionitis was established in only one third of the patients who delivered newborns with sepsis. In this study, use of conventional electronic fetal monitoring did not accurately identify newborns with presumed intrauterine infection.

Psychometric characteristics of the multidimensional health locus of control scales among psychiatric patients.

In a sample of 60 psychiatric patients recently discharged from inpatient or day hospital psychiatric facilities, we evaluated the psychometric characteristics of the Multidimensional Health Locus of Control (MHLC) scales. The scales demonstrated alpha reliabilities and intercorrelations similar to those reported by Wallston, Wallston, and DeVellis (1978). Factor analysis and a confirmatory LISREL analysis provided more qualified support for the hypothesized three-factor structure of the scales. The findings suggest, however, that the MHLC appears suitable for use among psychiatric patients, particularly in the combined forms (A and B) version.

Management of obstetric and gynecologic office emergencies.

Careful telephone triage of women with significant obstetric and gynecologic emergencies is the optimal way to avoid devastating complications in the office. With practical knowledge and some specialized office equipment and medications, most obstetric and gynecologic emergencies can be managed effectively in the office or stabilized while arranging transport to a hospital. Management of the most common complications likely to be encountered is outlined in this article.

A digital timing and display unit for intraoperative mapping of cardiac arrhythmias.

An inexpensive display and timing unit incorporating a multichannel signal delay has been developed for mapping the heart during electrophysiological surgery. It provides a continuous digital readout of the time relationships between 3 intracardiac electrograms and the surface electrocardiogram. The electrograms are displayed on a storage oscilloscope with an automatic erase facility. This unit is used to locate accessory atrioventricular connections in the Wolff-Parkinson-White syndrome, to map ventricular tachycardias and to locate the bundle of His. The design has been refined during 5 years of use in over 200 operative procedures.