ABSTRACT
Families of critically ill patients desire early information regarding the condition of their relative. The purpose of this study was to determine how long family members waited before someone from the trauma team met with them to discuss the condition of their relative. This was a prospective, single-blinded study of a convenience sample of 63 trauma patients conducted at a trauma center. Observers recorded the time of arrival of the patient, time of family arrival, and the time the family was first contacted by the trauma team. Families arrived 38 +/- 35 minutes after the patient. The mean time families waited before contact with the trauma team was 37 +/- 34 minutes. This study shows that the trauma team is often slow in communicating with the family of the victim. One member of the caregiving team should be designated to advise the family on the condition of the patient as soon as possible.
Subject(s)
Communication , Professional-Family Relations , Wounds and Injuries , Adolescent , Adult , Aged , Aged, 80 and over , Humans , Middle Aged , Patient Care Team , Prospective Studies , Time , Trauma CentersABSTRACT
OBJECTIVE: To determine: 1) the number of patients arriving at the ED who had executed an advance directive (AD), 2) how many of the patients who had an AD brought the AD with them, and 3) whether those patients who did not have an AD had ever discussed ADs with their primary care providers (PCPs) or had ever heard of an AD. METHODS: A cross-sectional, observational survey of a convenience sample of high-risk patients presenting to the ED of a university hospital was performed. Patients presenting to the ED for acute complaints who were elderly or had an underlying disease that suggested a risk of death in the near future were considered high risk. RESULTS: Of the 238 patients surveyed, 90% had PCPs. However, only 22% had ADs. Of these, only 23% brought the AD to the ED. Of the patients who did not have ADs, 95% had never discussed ADs with their PCPs, and 42% did not know what an AD was. Blacks were less likely than whites to have ADs (p < 0.0002) or to know about them (p < 0.004). CONCLUSION: The majority of high-risk patients presenting to this ED do not have ADs. Among those high-risk patients who did have ADs, fewer than 25% brought the ADs with them. The development of ADs for high-risk patients and the availability of ADs in the ED are woefully inadequate. Emergency physicians need to collaborate with PCPs to remedy these deficiencies.
Subject(s)
Advance Directives , Emergency Service, Hospital , Adolescent , Adult , Advance Directives/statistics & numerical data , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Male , Middle AgedABSTRACT
A cellulolytic wild-type strain of Penicillium purpurogenum was isolated from a soil sample in southern Chile. It grew best at 28°C from an inoculum of 4×10(7) spores/100 ml medium. Highest endoglucanase activity was with Sigmacell as carbon source and corn steep liquor as nitrogen source. Wheat bran enhanced the production of endoglucanase and ß-glucosidase. The enzymes in the crude supernatants were stable up to 50°C and between pH 4.4 and 5.6 for 48 h.
ABSTRACT
The forkhead gene (FKH) regulates morphogenesis in Drosophila. It is the prototype of a new family of transcriptional activators. Partially degenerate oligonucleotides to two conserved amino acid sequences of this family were used to prime a polymerase chain reaction (PCR) amplification of HEL cell cDNA. Two unique clones, designated H3 and H8, were isolated that contained homologies to FKH. A third novel clone, 5-3, was isolated by low stringency screening of a chronic myelogenous leukemia cDNA library using H8 as a probe. H3 and 5-3 are preferentially expressed in restricted hematopoietic lineages, while the expression of H8 was ubiquitous. Southern analysis showed that FKH 5-3 is conserved through yeast, which is rare among tissue-specific transcription factors. The H3 and 5-3 clones provide evidence that FKH family members are present in a tissue-restricted manner in humans.
Subject(s)
DNA-Binding Proteins/genetics , Hematopoietic Stem Cells/metabolism , Nuclear Proteins/genetics , Transcription Factors/genetics , Amino Acid Sequence , Base Sequence , Blotting, Southern , Cloning, Molecular , DNA-Binding Proteins/chemistry , Forkhead Transcription Factors , Gene Expression , Genes , Humans , Molecular Sequence Data , Morphogenesis , Nuclear Proteins/metabolism , Oligodeoxyribonucleotides/chemistry , Polymerase Chain Reaction , RNA, Messenger/genetics , Sequence Alignment , Sequence Homology, Amino Acid , Transcription Factors/chemistryABSTRACT
The influence of physical stress (bicycle ergometer and track) on 13 parameters of the plasmatic coagulation system was investigated in trained and untrained test persons. Shortenings of the coagulation times as well as distinct increases of the activity or concentration were observed in the partial thromboplastin time (PTT), the factor VIII activity (VIII:C) and the factor VIII-associated antigen (VIIIR:Ag). The results are discussed with regard to their causes and their clinical importance.
Subject(s)
Blood Coagulation Factors/metabolism , Blood Coagulation Tests , Physical Exertion , Adult , Antigens/metabolism , Factor IX/metabolism , Factor VIII/immunology , Factor VIII/metabolism , Female , Humans , Male , Partial Thromboplastin Time , von Willebrand FactorABSTRACT
The concentration of the fibrinogen in the plasmas was determined in the course of a day (circadian rhythm) as well as in different position of the body. During the night hours a concentration minimum existed at 24.00 o'clock or at 4.00 o'clock, which however, could not be explained by the position of the body alone, which had changed in comparison to day-time. The time of the blood-taking and the position of the body must be taken into consideration in the interpretation of the laboratory values.
