Biomedical subjects
Publications and source records attributed to Lloyd H Ketchum.
A variety of agents can improve hemostasis and reduce blood loss caused or exacerbated by congenital or acquired defects in platelet number of function. This review discusses several available approaches for the practicing clinician to reduce bleeding (diffuse or localized) in this clinical setting.
The associated decrease of pH in slow sand filters, due to CO2 conversion and biological activity, may produce effluent that is slightly corrosive to downstream distribution pipe material. This pilot study examined the use of a 3-cm crushed dolomite limestone media layer placed within the filter column of a slow sand filter to enhance effluent corrosion control by the introduction of beneficial dolomite dissolution products, without impacting turbidity removal efficiencies. Turbidity removal, calcium concentration, pH, conductivity, total hardness and alkalinity changes were calculated for the filter during a 60-day pilot study, and water chemistry values were used to estimate the changes of the saturation index (SI) throughout the filter run. Total hardness change through the filter was compared to change calculated by a derived equation for hardness using calcium concentrations to determine if the media was dissolving in stoichiometric proportions, and mineral service life in the filter was estimated using an assumption of stoichiometric dissolution at a constant flow rate. Effluent SI was raised an average of 30%, alkalinity was increased by 19%, and effluent pH averaged 7.7. Filter effluent complied with current turbidity regulatory requirements for the provision of potable water, and mineral service life was estimated between 7.5 and 9.5 years.
A variety of agents are available to improve hemostasis and reduce blood loss in multiple clinical settings. These agents are most commonly used to reduce bleeding when an underlying hemostatic defect is present. Some new agents offer the potential to decrease blood loss even in the absence of an obvious underlying hemostatic defect. The authors discuss the use of a variety of products to reduce bleeding and minimize transfusion of blood products in the setting of clotting factor deficiency or inhibition, platelet deficiency and/or dysfunction, increased fibrinolysis, therapeutic anticoagulation, and coagulopathies caused by dilution and consumption in the setting of trauma and surgery. The authors primarily focus on the available pharmaceuticals.