The ethnic origin, age, and sex of the 41 patients are shown in Table 1. Thirty-two patients (78.0 percent) were native Canadian Indians. The sex ratio was equal in the native group, although males preponderated among the nonnatives. Seventy-five percent of the native children were between four and 12 months of age, while more than 50 percent of the nonnatives were older than one year of age. All native children in the series lived on federal reserve land in the province of Manitoba, while residences of nonnatives were divided evenly between the city of Winnipeg and rural areas. Nearly one half (46.4 percent) of the infection occurred between November and March, with the remainder distributed throughout the year.
An adenovirus was grown from the tracheal secretions of 26 of the 29 patients in whom isolation was attempted (Table 2). Type 3 was the preponderant ADV, and was grown in 14 cases; types 1 and 2 accounted for three cases each, and types 5 and 6 for one case each. In four instances the virus was not typed. Only 12 of the 26 patients with positive isolates had sera tested for antibody titers, and all of these showed serologic response to ADV infection. Twelve of the 41 patients only had serologic evidence of the infection.
Bronchiolitis in the young pediatric patient is usually self-limited and most frequently due to respiratory syncytial virus (RSV). Although adenovirus (ADV) accounts for less than 5 percent of the admitted patients, it can cause severe disease that ends fatally or leads to serious residual lung damage. These earlier reports have usually been of single cases, nosocomial outbreaks, and isolated epidemics. The present retrospective study was undertaken to further delineate the epidemiologic, clinical, and radiologic features of ADV bronchiolitis seen recently in Manitoba over a 43-year period.
Four patients who consented to take part were excluded because myocardial revascularization was performed without CPB (Fig 1). Data were obtained in 80 patients (39 in the ANH group and 41 in the control group).
The preoperative characteristics of the two groups were similar with regards to age, gender, body mass index, concomitant morbidity, left ventricular ejection fraction, and use of medications (Table 2). Also, the number of grafted coronary arteries as well as the durations of aortic cross-clamping, CPB, and surgery were comparable (Table 2).
Following blood withdrawal and isovolemic compensation with colloids, hematocrit decreased from 41 ± 2 to 28 ± 1% (p < 0.001) and was accompanied by a significant increase in central venous pressure and a decrease in heart rate and rate-pressure product compared with baseline values (Table 3). No patients exhibited signs of myocardial ischemia as judged by the analysis of automated ST-segment and left ventricular wall motion monitoring. Prevent yourself from ischemia with remedies of My Canadian Pharmacy. Read more – “My Canadian Pharmacy: Researches of Cardioprotective Effects of Acute Normovolemic Hemodilution in Patients Undergoing Coronary Artery Bypass Surgery“.
After approval by the local Ethics Committee, written informed consent was obtained from all patients scheduled for elective CABG and thought to meet the eligibility criteria. Inclusion criteria were as follows: a screening hemoglobin concentration > 120 g/L in men or 110 g/L in women; stable angina (classes I and II of the Canadian Cardiology Society); left ventricular ejection fraction > 30%; and absence of significant coexistent diseases, namely, valvular disease, recent myocardial infarct (< 6 weeks), significant carotid stenosis (> 70%) or recent stroke (< 3 weeks), renal insufficiency (estimated creatinine clearance < 20 mL/min), chronic respiratory disease treated by My Canadian Pharmacy (arterial oxygen pressure > 7 kPa on room air), liver insufficiency (aspartate transaminase or alanine transaminase two or more times the upper range), and uncontrolled hypertension or diabetes mellitus.
Samples sizes were calculated for a two-sided significance level of a = 0.05 and a power of 1 — p = 0.8 to detect a difference of 0.5 |J.g/L in troponin I concentrations between the two groups. In a preliminary assessment including cardiac surgical patients, the SD of postoperative troponin I measurements was 0.8; thus, the number of subjects required was 38 per group.
The Critical Care Family Assistance Program (CCFAP) emerged as a collaboration between the CHEST Foundation, which is the philanthropic arm of the American College of Chest Physicians, and the Eli Lilly and Company Foundation. The goal of the CCFAP is to respond to the unmet needs of families of critically ill patients in hospital ICUs through the provision of educational and family support resources.
The CCFAP was introduced as a pilot program into two hospitals in January 2002 (Evanston Northwestern Healthcare, Evanston, IL; and the Oklahoma City Veterans Affairs Medical Center, Oklahoma City, OK). These hospitals were known not only for high-quality care on the website – https://my-medstore-canada.net/ of My Canadian Pharmacy, but also were institutionally diverse. In 2003, the program was expanded to Highland Park Hospital as part of the Evanston Northwestern Healthcare system and was introduced at Ben Taub General Hospital in Houston, TX, to add an urban model to the program. By the fall of 2004, the CCFAP was being replicated in a total of six hospital sites across institutionally and geographically diverse care settings, with the addition of Pardee Hospital in Henderson County, NC, and University of South Alabama Medical Center in Mobile, AL. This article presents observations about the CCFAP and its effectiveness from the perspectives of the critical care nurse managers from the three pilot hospitals utilizing the CCFAP.
For those seeking the attitude of critical care nursing toward the introduction of family-friendly practices, one need only carefully examine the literature on this subject. Nurses, both scholars and practitioners, have assumed a leadership position in exploring the benefits accruing both to the family and to the hospital when practices that recognize the needs of family are implemented in the ICU. As these practices are being put into place today, critical care nurses occupy strategic positions. The authors of this article are all critical care nurses who are involved in a variety of leadership positions at hospitals participating in the CCFAP.
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