Trace element concentrations in wintering waterfowl from the Great Salt Lake, Utah.

The Great Salt Lake (GSL) is an important region for millions of migratory waterbirds. However, high concentrations of some trace elements, including Hg and Se, have been detected within the GSL, and baseline ecotoxicological data are lacking for avian species in this system. We collected common goldeneye (Bucephala clangula), northern shoveler (Anas clypeata), and green-winged teal (A. crecca) from the GSL during the winters of 2004-2005 and 2005-2006 to evaluate sources of variation in liver trace element concentrations. Hg concentrations were among or exceeded the highest values reported in the published literature for common goldeneye, northern shoveler, and green-winged teal. Average Hg (total) concentrations of common goldeneye peaked in midwinter, whereas average Se concentrations peaked during late winter. During late winter, 100% and 88% of female goldeneye contained elevated concentrations of Hg [>or=1.0 microg/g wet weight (ww)] and Se (>or=3.0 microg/g ww), respectively, and 5% and 14% contained potentially harmful amounts of Hg (>or=30.0 microg/g ww) and Se (>10.0 microg/g ww), respectively. Similarly, 30% and 16% of male goldeneye contained potentially harmful concentrations of Hg and Se, respectively. Concentrations of Hg and Se were elevated in 100% and 79%, respectively, of northern shoveler samples (sexes combined) collected during February. We suggest that waterfowl contain biologically concerning amounts of Hg and Se during winter while on the GSL and further research is needed to evaluate the effect of these elements on GSL waterbirds.

Trichomoniasis as a factor in mourning dove population decline in Fillmore, Utah.

We examined whether trichomoniasis had been a factor in a dramatic mourning dove (Zenaida macroura) population decline in Fillmore, Utah (USA). We reasoned that if we could not find a high proportion of doves showing clinical signs of disease then the population was not being affected. Prevalences of Trichomonas gallinae in doves were 21% for 1992 and 14% for 1993. We also examined 230 birds and found only one with oral lesions. These prevalences were similar to those observed at the same study site in the 1950's, or reported elsewhere. Based on our results, we believe that trichomoniasis was not affecting the Fillmore mourning dove population at the time of our study.

Diagnosis and management of arrhythmias associated with Wolff-Parkinson-White syndrome.

Because of the emergency nature of the arrhythmias associated with WPW syndrome, nurses are often called upon for diagnosis and intervention in critical settings. In such cases the nurse's understanding of mechanisms, ECG recognition, and emergency treatment guarantees the patient the best possible outcome, not only in the critical setting, but in the long term as well. The most common arrhythmias of WPW syndrome are PSVT and atrial fibrillation. In PSVT a differential diagnosis is made on the ECG between (1) CMT using the AV node anterogradely and an accessory pathway retrogradely and (2) AV nodal reentry tachycardia. Helpful clues are location of the P' wave, presence of QRS alternans, the initiating P'R interval, and presence of aberrancy. Atrial fibrillation with an accessory pathway has the morphology of VT but is differentiated because the rhythm is irregular and the rate is more than 200 beats per minute. Emergency treatment consists of blocking the accessory pathway with procainamide. Emergency treatment for both types of PSVT consists of breaking the reentry circuit at the AV node (eg, vagal maneuver, adenosine, or verapamil). Procainamide can also be used to block the retrograde fast pathway in the AV node and to terminate CMT by blocking the accessory pathway. Symptomatic patients with accessory pathways are referred for evaluation and possible radio-frequency ablation.

Computer-assisted orthognathic treatment planning.

Computers are being integrated into all aspects of the dental office. This article uses a patient study to demonstrate the capabilities of new software systems to aid the orthodontist and surgeon in orthognathic treatment planning.

Verongamine, a novel bromotyrosine-derived histamine H3-antagonist from the marine sponge Verongula gigantea.

The novel bromotyrosine derivative verongamine [1] has been isolated from the marine sponge Verongula gigantea. The isolation of verongamine was facilitated by employing histamine-H3 bioassay-guided fractionation. Verongamine is a specific histamine-H3 antagonist at concentrations as low as 1 microgram/ml.

Evaluation of a forced-air system for warming hypothermic postoperative patients.

Thirty adult surgical patients admitted to the recovery room with an oral temperature less than or equal to 35.0 degrees C were randomized into two groups. Group 1 patients were covered with cotton blankets warmed to 37.0 degrees C, and group 2 patients were treated with a forced-air warming system. Mean oral temperature on admission to the recovery room was the same in both groups (34.3 degrees C). Oral temperature and the presence or absence of shivering were recorded at 15-min intervals. After application of the selected warming method, patients in group 2 were warmer at all time intervals. Mean temperatures in the forced-air heating group and in group 1 were, respectively, 34.8 degrees C and 34.3 degrees C (P less than 0.05) at 15 min; 35.0 degrees C and 34.2 degrees C (P less than 0.01) at 30 min; 35.2 degrees C and 34.5 degrees C (P less than 0.05) at 45 min; 35.8 degrees C and 34.7 degrees C (P less than 0.001) at 60 min; 36.0 degrees C and 35.0 degrees C (P less than 0.01) at 75 min; and 36.0 degrees C and 35.0 degrees C (P less than 0.01) at 90 min. The incidence of shivering was significantly greater in group 1 at 15 and 45 min. In addition, time spent in the recovery room was significantly greater in group 1 than in group 2, 156.0 min versus 99.7 min (P less than 0.003).

Wellens' syndrome: identification of critical proximal left anterior descending stenosis.

By understanding and recognizing the signs of Wellens' syndrome: 1) unstable angina; 2) little or no enzyme elevation; 3) little or no ST elevation; 4) no loss of precordial R waves; 5) progressive, symmetrical, deep T wave inversion in V2 and V3, the informed critical care nurse can make an important nursing diagnosis and, with the life-saving interventions now available, can save many individuals from massive anterior wall MI.

Role of preoperative cessation of smoking and other factors in postoperative pulmonary complications: a blinded prospective study of coronary artery bypass patients.

The association between preoperative smoking cessation and postoperative pulmonary morbidity was studied prospectively in 200 consecutive patients undergoing an elective coronary artery bypass surgical procedure. Detailed respiratory, cardiovascular, and smoking histories were elicited. Preoperative arterial blood gas analyses and bedside spirometry were performed. Urinary cotinine levels were measured to verify smoking histories. During spirometry, severe angina developed in seven patients, who were hence excluded from the study; one patient died of hemorrhage intraoperatively. An observer unaware of patients' preoperative histories assessed the remaining 192 patients throughout the intraoperative and postoperative periods for pulmonary complications. Postoperative pulmonary complications occurred in a third of the current smokers. Patients who had stopped smoking for 2 months or less had a pulmonary complication rate almost 4 times that of patients who had stopped for more than 2 months (57.1% versus 14.5%). Patients who had stopped smoking for more than 6 months had rates similar to those who had never smoked (11.1% and 11.9%, respectively). Preoperative pulmonary dysfunction, increased pack-years of smoking, prolonged surgical time, and the use of enflurane were independently associated with postoperative pulmonary morbidity (P less than 0.05). We concluded that smoking cessation should occur at least 2 months preoperatively to maximize the reduction of postoperative respiratory complications.