Rupture of the pregnant uterus.
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Biomedical subjects
Publications and source records attributed to B Barnes.
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Twenty-six patients with clinically documented acute cerebral infarction were evaluated by computed tomography within the first 24 hr. In 21 patients, subtle mass effects and/or focal areas of decreased attenuation corresponding to areas of clinical deficit were demonstrated. Enhancement occurred in only five of 15 infarctions rescanned after contrast administration. In three of these, the region of infarction became isodense after contrast administration. In a patient with multifocal infarcts, enhancement was the only clue to infarction in one focus. The improved spatial and contrast resolution of current generation scanners appears to have significantly increased the sensitivity of computed tomography in demonstrating acute cerebral infarction and has important clinical application.
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Medical personnel in a pediatric center were tested for their ability to correctly compute drug doses for sick newborns. One of every 12 doses computed by 95 registered nurses contained an error that would result in the administration of an amount that was ten times higher or lower than the dose ordered. The error rate was no different for experienced or inexperienced nurses. The test also included an evaluation of the nurse's ability to judge the appropriateness of the drug dose ordered for a specified infant. Experienced nurses tended to be more certain, although wrong, in their judgment when compared to inexperienced nurses. Eleven pediatricians, when given the same test, scored higher than the nurses but still made errors at the rate of one of every 26 computations attempted. Five registered pharmacists who were tested demonstrated far better computational skills than either the nursing or physician group.
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The results of a 1974 survey of albumin measurements as performed by more than 1,300 laboratories are presented. The most widely used methods are the dye-binding technics: bromcresol green (BCG) and 2-(4'-hydroxyazobenzene) benzoic acid (HABA). These are followed by electrophoresis and salt fractionation. All methods yielded comparable albumin concentrations except electrophoresis, which manifested a consistent low bias. This close agreement is attributed, in part, to the normal-range concentration of albumin in the test specimen. Type of standardization, i.e., commercial serum, bovine serum albumin, human serum albumin, or pooled serum, did not appear to be a factor in the estimation of albumin in the normal serum submitted for analysis. Surprisingly, interlaboratory variation, from method means, was the lowest for salt fractionation and electrophoretic technics.
Six juvenile Macaca fascicularis relatively unfamiliar with one another were placed together in a large play apparatus. The Boelkins' water test was used to establish dominance. After one hour of social interaction the animals formed a stable hierarchy. Following six days of observation of this group, the dominant male and female were removed. This removal drastically altered the behavior of the remaining animals (19 of 40 behavior categories changed significantly). A replication indicated that behavior in one group allowed predictions of future behavior in that group, but did not allow predictions to an autonomous segment of the original group.
The authors review 47 patients with closed-head injuries requiring treatment for acute subdural hematoma and report that 21 (45%) survived for 5 days or more. Follow-up study of these 21 survivors led to the following observations: that clinical evaluation of these patients is the most reliable index of their postoperative progress; that the diagnostic usefulness of postoperative cerebral arteriograms is limited because immediate postoperative changes tend to persist; that craniotomy is preferable to burr holes for removal of an acute hematoma; and that the value of cisternography, unless done serially, is limited since posttraumatic hydrocephalus develops rapidly and may persist indefinitely.
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A new method utilizing computer subtraction allows 2 separate radionuclide angiograms to be performed during a single laboratory visit. Two separate intravenous injections of the radionuclide are given so that the patient's head can be imaged in 2 different projections. Background activity from the first injection is subtracted by the computer to allow good resolution of blood flow following the second injection. A static brain scan is performed after the second injection. Although single-view radionuclide angiography is widely used in the diagnostic evaluation of the brain, the addition of a second projection provides additonal important diagnostic information. The views obtained, however, must be determined individually for each patient on the basis of the clinical history and neurologic signs. The selection of appropriate views, the diagnostic quality of the studies, and the practical clinical application of this technique are illustrated by 2 case reports.
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