Asunto(s)
Garantía de la Calidad de Atención de Salud , Medicina Estatal/normas , Financiación Gubernamental , Humanos , Relaciones Interprofesionales , Auditoría Médica , Ejecutivos Médicos , Médicos , Garantía de la Calidad de Atención de Salud/economía , Garantía de la Calidad de Atención de Salud/legislación & jurisprudencia , Calidad de la Atención de Salud/legislación & jurisprudencia , Gestión de Riesgos , Medicina Estatal/economía , Medicina Estatal/legislación & jurisprudencia , Medicina Estatal/organización & administración , Factores de Tiempo , Gestión de la Calidad Total/legislación & jurisprudencia , Reino UnidoRESUMEN
The effects of three calcium channel-blocking agents, verapamil, nifedipine and diltiazem, given intravenously, have been studied on the cardiovascular and sympathetic responses to acute haemorrhagic shock in anaesthetized dogs. Following acute haemorrhage, cardiac output, mean pulmonary artery pressure, mean right atrial pressure, and pulmonary capillary wedge pressure all fell, and adrenaline, noradrenaline and plasma renin activity rose. In the presence of each calcium antagonist the fall in cardiac output, mean pulmonary artery pressure, central venous pressure and pulmonary capillary wedge pressure was similar, and the rise in catecholamine levels unaffected. The rise in plasma renin activity following diltiazem 0.02 mg kg-1 or 0.1 mg kg-1 or nifedipine 0.01 mg kg-1 was similar to values in a control group, whereas in those receiving verapamil 0.15 mg kg-1 or 0.6 mg kg-1, or nifedipine 0.05 mg kg-1, the rise was greater.
Asunto(s)
Bloqueadores de los Canales de Calcio/farmacología , Hemodinámica/efectos de los fármacos , Choque Hemorrágico/fisiopatología , Sistema Nervioso Simpático/efectos de los fármacos , Animales , Diltiazem/farmacología , Perros , Femenino , Masculino , Nifedipino/farmacología , Renina/sangre , Choque Hemorrágico/sangre , Verapamilo/farmacologíaRESUMEN
The Carden ventilator is described and assessed when used in adult and paediatric modes against test lungs with varying compliance and airways resistance. The ventilator proved to have limited ability to compensate for changes in test lung compliance and resistance. Repeated confirmation of tidal volume is mandatory, but the Carden combines simplicity with flexibility of design and may prove useful as a theatre ventilator.
Asunto(s)
Ventiladores Mecánicos , Adulto , Resistencia de las Vías Respiratorias , Niño , Diseño de Equipo , Humanos , Rendimiento Pulmonar , Volumen de Ventilación PulmonarRESUMEN
The duration of impairment of mental functioning after anaesthesia was studied in 55 patients undergoing hernia repair who were divided into three groups in which the method of induction of anaesthesia (intravenous or inhalational) and ventilation (spontaneous or controlled) was varied. Performance in a five minute serial reaction time test and subjective estimates of coordination were assessed four times a day for two complete postoperative days and were compared with those in a control group of orthopaedic patients in hospital. After considerable impairment initially, reaction times in all groups gradually returned towards control values, but in patients breathing spontaneously during anaesthesia impairment recurred during the second postoperative day. These results suggest that such patients should be advised not to undertake hazardous tasks such as driving a car for at least 48 hours after a general anaesthetic. Discrepancies between subjective and objective assessments of impairment also suggest that patients should not rely on their own assessments of fitness to drive.
Asunto(s)
Anestesia General , Herniorrafia , Humanos , Masculino , Procesos Mentales , Persona de Mediana Edad , Periodo Posoperatorio , Distribución Aleatoria , Tiempo de Reacción , Respiración Artificial , Factores de TiempoRESUMEN
The Blease 5300 ventilator is described. A laboratory assessment of its performance gave satisfactory results and confirmed the favourable impressions formed by medical and nursing staff, in the intensive therapy unit during a trial lasting 3 months.
Asunto(s)
Ventiladores Mecánicos , Estudios de Evaluación como Asunto , Humanos , Presión , Volumen de Ventilación PulmonarRESUMEN
Lead isotopic compositions of 12 galenas from five late Archaic-initial Woodland grave and habitation sites in southern Ontario have made it possible to determine the "most likely" source areas for the galenas. For one of the oldest sites (Finlan), the most likely source is in the southwestern Upper Mississippi Valley (Wisconsin-Illinois-Iowa) mineral district. The seven Finlan galenas exhibit a range of isotopic ratios; three of the largest specimens have substantial isotopic variations (up to 1.8 percent in the ratio of lead-207 to lead-206) on a scale of a few centimeters. This suggests that the lead isotopic zoning ascribed to the Upper Mississippi Valley area is not sufficiently well defined to enable us to determine if all the Finlan samples were derived from a single mineral deposit. Galenas from the other sites (Constance Bay, Hind, Bruce Boyd, and Picton) most probably originated in the southeastern Ontario-northwestern New York area. Isotopic differences among the Constance Bay, Hind, and Bruce Boyd galenas, on the one hand, and the Picton galena, on the other, suggest that at least two distinct sources in that region were exploited.