Articles: adult.
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The present overview describes recent contributions to the literature with regard to choice of anesthetic techniques, approaches to anesthetic management of elderly outpatients undergoing arthroscopy and other procedures, reconsideration of the problem of postoperative delirium in the elderly patient, and a general summary of perioperative management and assessment of anesthetic risk in older adults. ⋯ The efficiency and speed with which outpatient surgery and anesthetic recovery can be conducted in older adults continue to improve. Monitors of depth of anesthesia, ultra-short-acting agents, and combined techniques have minimized minor complications such as nausea and vomiting, and have improved the speed with which these patients recover from anesthesia. A small proportion of elderly surgical outpatients remain at risk for residual postoperative cognitive dysfunction.
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Tissue ice content and post-freeze survival were documented for caterpillars of the arctiid moth Pyrrharctia isabella. Tissue ice content was inversely dependent on freeze temperature (-3 degrees C=24.4%, -6 degrees C=40.2%, -10 degrees C=48.7%) but values were substantially less than expected given hemolymph osmolality. Accumulation of glycerol (200-300 mM) in the hemolymph helped to colligatively reduce the amount of freezable water. ⋯ Pupation rates ranged between 45.7 to 52.4% of caterpillars in a test group. Adult emergence exceeded 60% of the pupae in the -3 and -6 degrees C test groups. Hence, P. isabella caterpillars survived ecologically relevant freezes and continued their life cycles to adulthood.
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Jornal de pediatria · Nov 2002
[Clinical practice parameters for hemodynamic support of pediatric and neonatal patients in septic shock].
The Institute of Medicine has called for the development of clinical guidelines and practice parameters to develop "best practice" and potentially improve patient outcome. ⋯ American College of Critical Care Medicine adult guide lines for hemodynamic support of septic shock have little application to the management of pediatric or neonatal septic shock. Studies are required to determine whether American College of Critical Care Medicine guidelines for hemodynamic support of pediatric and neonatal septic shock will be implemented and associated with improved outcome.
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BACKGROUNG AND OBJECTIVES: Double lumen tubes may determine different flow resistances. This disparity may result in non-homogeneous ventilation. This study aimed at comparing the resistive pressure of 37 FR double lumen tubes to distinct flows as compared to conventional adult tracheal tubes. ⋯ Resistive patterns of 37 FR and 7,5 mm tubes were very similar. Any double lumen branch occlusion significantly increases resistance, however in a similar way for both branches for flows below 0.5 L.s-1. These results suggest the use of low inspiratory flow to minimize ventilatory system resistive pressure when any branch of a double-lumen tube is occluded.
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The emergency department (ED) is a unique potential location for recruitment into studies of complementary and alternative medicine (CAM) therapies. We sought to determine the stated willingness of ED patients with musculoskeletal complaints to participate in CAM research for their presenting problem, and to determine the characteristics of this population. ⋯ ED patients with musculoskeletal complaints have a high stated willingness to participate in CAM research, even if this involves outpatient follow-up or a placebo-controlled design. ED-based CAM research appears feasible and should be pursued.