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D State

Publications and source records attributed to D State.

27 records · Page 2Linked to original sources

Prediction of outcome and severity of illness by analysis of the frequency distributions of cardiorespiratory variables.

Despite the wide variety of illnesses and operations, we observed a common cardiorespiratory pattern of shock that was differenf for the survivors and nonsurvivors, although no one variable was capable of predicting outcome. Differences between the patterns of survivors and nonsurvivors were defined by range criteria and by cut-points operationally obtained from the frequency distributions of cardiorespiratory variables. The values of each of the 33 variables obtained, at times remote from therapy during each successive stage in the postoperative course, were used to predict survival and death in a series of 113 patients by the range and cut-point methods. An average of 13.5% of all the available variables gave a correct prediction by the range cirteria and 35% by the cut-point method. The mean percentage of Right--Wrong classifications throughout all stages for range and cut-point methods was 80 and 85%, respectively. Using the last available stage, the outcome was correctly predicted by the range criteria in 80% and by the cut point method in 88% of the patients. The high percentage of correct predictions suggests that these methods may provide a measure of the severity of acute illness as well as early warning of impending death.

Blood Gas Analysis

Rapid bedside computation of cardiorespiratory variables with a programmable calculator.

The value prompt assessment of hemodynamic cardiorespiratory function in critically ill medical and surgical patients is widely appreciated. We have presented a system for rapidly computing these variables on real time in the ICU, for a capital outlay of less than $250. In so doing, we hope to extend the benefits of this type of assessment to the smaller community hospital ICU and individual clinicians.

Computers

[The advantages of agglutination and precipitation tests used in the serological diagnosis of meningitis due to H. influenza type B].

During the period January 1985-July 1988, 532 purulent CSF taken from patients with meningitis, aged between 3 weeks and 91 years, were studied by microscopic examination, cultivation and for H. influenzae type B (HITB) also by coagglutination (COA), counterimmunoelectrophoresis (CIE) and double immunodiffusion (DID) in agarose gel. Positive CSFs were taken from the patients aged 1 month-24 years old, of which 76% from children under 5 years old, and 42% from children under one year. 65.9% of the patients were males; the disease was more frequent in the first and last 4 months of the year, with the highest incidence in April. 12 bacterial spectra were found: N. meningitidis--62.97%, Str. pneumoniae--9.77%, H. influenzae type B--8.27%, and also Salmonella, E. coli, Staphylococcus, Klebsiella, Acinetobacter, beta-hemolytic Streptococcus, Alcaligenes, Proteus and Enterobacter in 4.70; the rest of 14.28% had indefinite etiology. H. influenzae was evidenced in CSF by microscopic examination in 3.38%, by cultivation in 3.94%, and the soluble antigen of HITB by COA in 8.27%, by CIE in 8.08% and by DID in 7.33%. The sensibility order of the tests was: COA, CIE, DID, cultivation and microscopic examination. The COA and CIE techniques are recommended for the current use in examination of the purulent CSF due to their simplicity, rapidity, sensibility, specificity and possibility of establishing the diagnosis when the bacteriologic techniques are negative.

Agglutination Tests

Diagnosis of pneumococcal meningitis by coagglutination method.

It was tested the possibility to evidence the pneumococcal capsular antigen, by coagglutination, directly in CSF, using a specific coagglutinating reagent for all the 10 serological types of S. pneumoniae more frequently encountered in our country. Were investigated 134 CSF from purulent meningitis, out of which 37 were of probable pneumococcal etiology, on the basis of bacterioscopic examination, 26 of other etiology and 71 of unknown etiology. The results obtained showed 28 (75.7%) positive reactions in the fluids from probably pneumococcal meningitides on the basis of the positive bacterioscopic examination. The specificity of the reactions is demonstrated by the negative reactions with the fluids from meningitides of other etiology, as well as by the concordance between the antigen serotype from the liquid and that of the isolated S. pneumoniae strain. For a good test sensitivity could argue the positive reactions obtained with 6 CSF from meningitides of unknown etiology.

Agglutination Tests