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1.
Nature ; 622(7981): 33-34, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37848632
3.
Am J Nurs ; 123(9): 53-56, 2023 09 01.
Article in English | MEDLINE | ID: mdl-37615471

ABSTRACT

Editor's note: This is the next installment in a series on electrocardiogram (ECG) interpretation. Nurses in all settings should know the basics, as medications and physiological changes can cause cardiac arrhythmias. Each article will start with a brief case scenario and an ECG strip and then take you step by step through analyzing the heart rhythm.


Subject(s)
Arrhythmias, Cardiac , Electrocardiography , Humans , Arrhythmias, Cardiac/diagnosis
4.
Am J Nurs ; 123(2): 43-45, 2023 02 01.
Article in English | MEDLINE | ID: mdl-36698361

ABSTRACT

Editor's note: This is the next installment in a series on electrocardiogram (ECG) interpretation. Nurses in all settings should know the basics, as medications and physiological changes can cause cardiac arrhythmias. Each article will start with a brief case scenario and an ECG strip and then take you step by step through analyzing the heart rhythm.


Subject(s)
Arrhythmias, Cardiac , Bradycardia , Humans , Bradycardia/diagnosis , Bradycardia/etiology , Arrhythmias, Cardiac/diagnosis , Electrocardiography
5.
Am J Nurs ; 122(11): 49-51, 2022 11 01.
Article in English | MEDLINE | ID: mdl-36261906

ABSTRACT

Editor's note: This is the next installment in a series on electrocardiogram (ECG) interpretation. Nurses in all settings should know the basics, as medications and physiological changes can cause cardiac arrhythmias. Each article will start with a brief case scenario and an ECG strip and then take you step by step through analyzing the heart rhythm.


Subject(s)
Physical Exertion , Syncope , Male , Humans , Syncope/etiology , Electrocardiography , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/etiology
6.
Am J Nurs ; 122(7): 53-55, 2022 07 01.
Article in English | MEDLINE | ID: mdl-35736604

ABSTRACT

Editor's note: This is the next installment in a series on electrocardiogram (ECG) interpretation. Nurses in all settings should know the basics, as medications and physiological changes can cause cardiac arrhythmias. Each article will start with a brief case scenario and an ECG strip and then take you step by step through analyzing the heart rhythm.


Subject(s)
Arrhythmias, Cardiac , Electrocardiography , Female , Humans
7.
Am J Nurs ; 122(2): 57-59, 2022 02 01.
Article in English | MEDLINE | ID: mdl-35085155

ABSTRACT

Editor's note: This is the next installment in a series on electrocardiogram (ECG) interpretation. Nurses in all settings should know the basics, as medications and physiological changes can cause cardiac arrhythmias. Each article will start with a brief case scenario and an ECG strip and then take you step by step through analyzing the heart rhythm.

8.
Am J Nurs ; 121(8): 51-54, 2021 08 01.
Article in English | MEDLINE | ID: mdl-34819474

ABSTRACT

Editor's note: This article is one in a series on electrocardiogram (ECG) interpretation. Nurses in all settings should know the basics, as medications and physiological changes can cause cardiac arrhythmias. Each article will start with a brief case scenario and an ECG strip and then take you step by step through analyzing the heart rhythm. To see all the articles in the series, go to http://links.lww.com/AJN/A207.


Subject(s)
Arrhythmias, Cardiac/complications , Tachycardia/complications , Arrhythmias, Cardiac/physiopathology , Electrocardiography/methods , Humans , Male , Tachycardia/physiopathology , Young Adult
9.
Am J Nurs ; 121(10): 63-66, 2021 10 01.
Article in English | MEDLINE | ID: mdl-34554992

ABSTRACT

Editor's note: This is the next installment in a series on electrocardiogram (ECG) interpretation. Nurses in all settings should know the basics, as medications and physiological changes can cause cardiac arrhythmias. Each article will start with a brief case scenario and an ECG strip and then take you step by step through analyzing the heart rhythm.


Subject(s)
Death, Sudden, Cardiac , Electrocardiography , Electrolytes/administration & dosage , Nurse's Role , Torsades de Pointes/diagnosis , Bipolar Disorder/drug therapy , Emergency Service, Hospital , Female , Humans , Intensive Care Units , Middle Aged , Out-of-Hospital Cardiac Arrest , Quetiapine Fumarate/adverse effects , Quetiapine Fumarate/therapeutic use , Return of Spontaneous Circulation , Unconsciousness/etiology
10.
Am J Nurs ; 121(6): 61-64, 2021 06 01.
Article in English | MEDLINE | ID: mdl-34009167

ABSTRACT

Editor's note: This is the next installment in a series on electrocardiogram (ECG) interpretation. Nurses in all settings should know the basics, as medications and physiological changes can cause cardiac arrhythmias. Each article will start with a brief case scenario and an ECG strip and then take you step by step through analyzing the heart rhythm.


Subject(s)
Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/nursing , Dyspnea/diagnosis , Dyspnea/nursing , Electrocardiography/nursing , Emergency Nursing/methods , Electrocardiography/methods , Humans
11.
Case Rep Surg ; 2020: 8816931, 2020.
Article in English | MEDLINE | ID: mdl-33101753

ABSTRACT

Primary carcinosarcoma of the spleen is a rare, aggressive splenic malignancy. To date, seven cases have been reported in the literature. We report a first case of primary carcinosarcoma of the spleen in France. A 75-year-old woman with a medical history of hysterectomy for uterine adenocarcinoma presented with left hypochondrium pain following blunt abdominal trauma. A splenic mass was noted on computed tomography (CT) scan. A splenectomy was performed by laparotomy. Histology revealed a malignant mixed Mullerian tumor. The PET scan allowed us to confirm that it was a primary lesion of the spleen. She is currently undergoing adjuvant chemotherapy despite the tumor progression. The interest of this case lies in the rarity of primary carcinosarcomas of the spleen and the circumstances of its diagnosis.

12.
Am J Nurs ; 120(10): 47-49, 2020 10.
Article in English | MEDLINE | ID: mdl-32976156

ABSTRACT

Editor's note: This is the second installment in a new series on electrocardiogram (ECG) interpretation. Nurses in all settings should know the basics, as medications and physiological changes can cause cardiac arrhythmias. Each article will start with a brief case scenario and an ECG strip and then take you step by step through analyzing the heart rhythm.


Subject(s)
Dyspnea/etiology , Tachycardia, Sinus/diagnosis , Anti-Bacterial Agents/administration & dosage , Cough/etiology , Electrocardiography , Female , Humans , Middle Aged , Tachycardia, Sinus/therapy
13.
Am J Nurs ; 120(5): 45-47, 2020 05.
Article in English | MEDLINE | ID: mdl-32332366

ABSTRACT

Editor's note: This is the first in a new series on electrocardiography (ECG) interpretation. Nurses in all settings should know the basics, as medications and physiological changes can cause cardiac arrhythmias. Each article will start with a brief case scenario and an ECG strip and then take you step by step through analyzing the heart rhythm.


Subject(s)
Bradycardia , Electrocardiography , Fatigue/etiology , Thyroxine/therapeutic use , Bradycardia/diagnosis , Bradycardia/drug therapy , Heart Rate , Humans , Male , Middle Aged
14.
J Surg Case Rep ; 2014(5)2014 May 19.
Article in English | MEDLINE | ID: mdl-24876517

ABSTRACT

Intercostal incisional hernias are rarely encountered post-operative complications. Bone sequestra of the ribs are similarly rare. We report a very rare case of a left sided rib bone sequestrum mimicking an incisional hernia after a nephrectomy, splenectomy, and distal pancreatectomy.

15.
Nature ; 493(7434): 644-6, 2013 Jan 31.
Article in English | MEDLINE | ID: mdl-23364742

ABSTRACT

From the masses of the planets orbiting the Sun, and the abundance of elements relative to hydrogen, it is estimated that when the Solar System formed, the circumstellar disk must have had a minimum mass of around 0.01 solar masses within about 100 astronomical units of the star. (One astronomical unit is the Earth-Sun distance.) The main constituent of the disk, gaseous molecular hydrogen, does not efficiently emit radiation from the disk mass reservoir, and so the most common measure of the disk mass is dust thermal emission and lines of gaseous carbon monoxide. Carbon monoxide emission generally indicates properties of the disk surface, and the conversion from dust emission to gas mass requires knowledge of the grain properties and the gas-to-dust mass ratio, which probably differ from their interstellar values. As a result, mass estimates vary by orders of magnitude, as exemplified by the relatively old (3-10 million years) star TW Hydrae, for which the range is 0.0005-0.06 solar masses. Here we report the detection of the fundamental rotational transition of hydrogen deuteride from the direction of TW Hydrae. Hydrogen deuteride is a good tracer of disk gas because it follows the distribution of molecular hydrogen and its emission is sensitive to the total mass. The detection of hydrogen deuteride, combined with existing observations and detailed models, implies a disk mass of more than 0.05 solar masses, which is enough to form a planetary system like our own.

16.
Neurocrit Care ; 18(1): 20-5, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23138547

ABSTRACT

BACKGROUND: Brain tissue oxygen monitoring (pBtO2) has been advocated in the treatment of patients with severe traumatic brain injuries (TBI); however, controversy exists regarding the improvements that pBtO2 monitoring provides. The objective of our study was to evaluate our experience and effect on mortality with goal directed pBtO2 monitoring for severe TBI compared to traditional ICP/CPP monitoring. METHODS: All patients admitted with severe TBI (GCS < 8) to our Level 1 trauma center from June 2007 through June 2009 were retrospectively analyzed. All patients had ICP monitoring and pBtO2 monitors were placed based on the current practices of the attending neurosurgeon producing two temporally matched cohorts of patients with and without pBtO2 monitors. Exclusion criteria were age <18 years and survival <24 h. Goal-directed therapy was utilized in all patients to maintain ICP <20 mmHg and CPP >60 mmHg. Patients with pBtO2 monitors were managed to maintain a level >20 mmHg. RESULTS: 74 patients were treated for severe TBI over the 2-year study period with 37 patients in each group. Both groups were similar in age, sex, and admission Glascow Coma Score(GCS).The pBtO2-monitored group did, however, have significantly lower injury severity score [26 (25-30) vs. 30 (26-36), p = 0.03] and AIS Chest [0 (0-0) vs. 2 (0-3), p = 0.02]. There was no survival difference found (64.9 vs. 54.1 %, p = 0.34). No difference with respect to discharge GCS or discharge Functional Independence Measure score was identified. CONCLUSIONS: Compared with ICP/CPP-directed therapy alone, the addition of pBtO2 monitoring did not provide a survival or functional status improvement at discharge. The true clinical benefit of pBtO2 monitoring will require further study.


Subject(s)
Brain Injuries/diagnosis , Brain/metabolism , Intracranial Pressure , Oximetry/methods , Oxygen/metabolism , Adult , Brain/blood supply , Female , Humans , Male , Middle Aged , Monitoring, Physiologic/methods , Oxygen/analysis , Retrospective Studies , Trauma Centers , Treatment Outcome , Young Adult
17.
J Surg Educ ; 69(3): 311-9, 2012.
Article in English | MEDLINE | ID: mdl-22483130

ABSTRACT

OBJECTIVE: Interest in international surgery among general surgery residents in the United States has been shown in several publications. Several general surgery residency programs have reported their experiences with international surgery rotations (ISRs). Learning to use limited resources more efficiently is often cited as a benefit of such rotations. We hypothesized that general surgery residents become more resource efficient after they have completed an ISR. STUDY DESIGN: Laboratory, radiologic, and diagnostic studies ordered on 2900 patients by 21 general surgery residents over 65 months at a single institution were analyzed retrospectively. The patient populations they wrote orders on were assessed for similarity in age, gender, and diagnoses. The outcomes in those patient populations were assessed by duration of stay and in-hospital mortality. Six (29%) of these residents (ISR residents) completed a 1-month ISR during their third year of residency. Their orders were compared with their classmates who did not participate in an ISR (NISR residents). The results were compared between the 2 cohorts from both before and after their international rotations. An analysis focused on comparing the changes from pre-ISR to post-ISR. A survey was also sent after objective data were collected to all residents and alumni involved in the study to assess their subjective perception of changes in their resource efficiency and to characterize their ISRs. RESULTS: Patient populations were similar in terms of demographics and diagnoses. ISR residents generated an average of $122 less in orders per patient per month after their ISR compared with before. NISR residents generated an average of $338 more in orders per patient per month after the ISRs compared with before (p = 0.04). Pre-ISR order charges were statistically similar. Similar results were observed when radiologic/diagnostic study orders were analyzed independently. Differences in outcomes were statistically insignificant. The survey revealed that most of the ISR residents perceived that their attitude toward ordering tests and laboratories was influenced greatly by their ISR, and all the ISR residents perceived that they became more resource efficient than their peers after their ISRs. CONCLUSION: These preliminary findings seem to indicate increased resource efficiency among general surgery residents who completed an ISR. However, the sample size of residents was small, and we could not establish conclusively a causal relationship to their ISRs. A more extensive study is needed if reliable conclusions are to be drawn regarding the effect of ISRs on the resource efficiency of residents.


Subject(s)
Clinical Competence , Education, Medical, Graduate/economics , General Surgery/education , International Educational Exchange/economics , Internship and Residency/economics , Adult , Attitude of Health Personnel , Competency-Based Education , Confidence Intervals , Cost Savings , Cross-Sectional Studies , Education, Medical, Graduate/methods , Female , General Surgery/economics , Humans , International Cooperation , International Educational Exchange/statistics & numerical data , Male , Middle Aged , Odds Ratio , Resource Allocation , Retrospective Studies , United States
18.
Adv Urol ; : 960490, 2009.
Article in English | MEDLINE | ID: mdl-19255628

ABSTRACT

Purpose. We seek to correlate conventional hydronephrosis (HN) grade and hydronephrosis index (HI). Methods. We examined 1207 hydronephrotic kidneys by ultrasound. HN was classified by Society of Fetal Urology guidelines. HN was then gauged using HI, a reproducible, standardized, and dimensionless measurement of renal area. We then calculated average HI for each HN grade. Results. Comparing HI to standard SFU HN grade, average HI is 89.3 for grade I; average HI is 83.9 for grade II; average HI is 73.0 for grade III; average HI is 54.6 for SFU grade IV. Conclusions. HI correlates well with SFU HN grade. The HI serves as a quantitative measure of HN. HI can be used to track HN over time. Versus conventional grading, HI may be more sensitive in defining severe (grades III and IV) HN, and in indicating resolving, stable, or worsening HN, thus providing more information for clinical decision-making and HN management.

19.
Nature ; 448(7157): 1026-8, 2007 Aug 30.
Article in English | MEDLINE | ID: mdl-17728752

ABSTRACT

Class 0 protostars, the youngest type of young stellar objects, show many signs of rapid development from their initial, spheroidal configurations, and therefore are studied intensively for details of the formation of protoplanetary disks within protostellar envelopes. At millimetre wavelengths, kinematic signatures of collapse have been observed in several such protostars, through observations of molecular lines that probe their outer envelopes. It has been suggested that one or more components of the proto-multiple system NGC 1333-IRAS 4 (refs 1, 2) may display signs of an embedded region that is warmer and denser than the bulk of the envelope. Here we report observations that reveal details of the core on Solar System dimensions. We detect in NGC 1333-IRAS 4B a rich emission spectrum of H2O, at wavelengths 20-37 microm, which indicates an origin in extremely dense, warm gas. We can model the emission as infall from a protostellar envelope onto the surface of a deeply embedded, dense disk, and therefore see the development of a protoplanetary disk. This is the only example of mid-infrared water emission from a sample of 30 class 0 objects, perhaps arising from a favourable orientation; alternatively, this may be an early and short-lived stage in the evolution of a protoplanetary disk.

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