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Biomedical subjects

M E Walsh

Publications and source records attributed to M E Walsh.

54 records · Page 3Linked to original sources
PubMedDate not supplied

Minimizing venous thromboembolic complications in the orthopaedic patient.

Venous thromboembolic events (VTE), which include deep venous thrombosis (DVT) and pulmonary embolus (PE), are the most common life-threatening complications associated with orthopaedic surgical procedures. DVT is particularly prevalent in patients undergoing total knee and hip arthroplasty, occurring at a rate of 50 to 60%. In addition, up to 2% of orthopaedic patients receiving pharmacologic prophylaxis still develop PE. Because the majority of candidates for these procedures are older adults with a multitude of comorbid conditions, standard prophylactic practices may not always result in optimal clinical outcomes. Thus, it is important for nurses to have a general understanding of appropriate thromboprophylaxis. This article will provide an overview of the current recommended guidelines and explore the risks and benefits of both pharmacologic agents and adjunctive treatment modalities.

Anticoagulants↗
PubMedDate not supplied

RDX loss in a surface soil under saturated and well drained conditions.

On military training ranges, low-order, incomplete detonations deposit RDX (hexahydro-1,3,5-trinitro-1,3,5-triazine) into surface soils. In this study, we evaluated RDX biodegradation in surface soils obtained from a military training range in Alaska. Two factors were compared: (i) soil water potential during the incubations; and (ii) the use of acetonitrile (ACN) as an RDX carrier to spike samples. Organic solvents have been used in laboratory studies to dissolve slightly water-soluble contaminants before addition to soil. We added ACN to obtain final soil ACN concentrations of 0 mg kg(-1) (0%), 1000 mg kg(-1) (0.1%) and 10 000 mg kg(-1) (1%). We then compared RDX attenuation in the soil under saturated and unsaturated conditions. RDX fell below the limit of detection within 3 wk of study initiation under the saturated condition. A maximum degradation rate of 0.15 mg RDX L(-1) d(-1) was measured. Under the unsaturated condition, 42% of the original RDX was still present at study termination (5 wk). The addition of acetonitrile at 0.1 or 1.0% had no affect on RDX loss in the saturated soil. In the unsaturated soil, however, ACN at 1.0% inhibited RDX loss by as much as 25%. These findings indicate that soil water potential and carrier solvent concentrations can impact the rate and extent to which RDX is attenuated in a surface soil.

Acetonitriles↗
PubMedDate not supplied

Preparing to perform an awake fiberoptic intubation.

Fiberoptically guided tracheal intubation represents one of the most important advances in airway management to occur in the past thirty years. Perhaps its most important role is in management of the anticipated difficult airway. This is a situation in which the dangers of encountering the life-threatening "can't intubate, can't ventilate" situation can be avoided by placement of an endotracheal tube while the patient is awake. Although skill at the procedure of endoscopy is obviously necessary in this setting, these authors hold that success or failure of the technique frequently depends on the adequacy of preparation. These measures include 1) pre-operative assessment of the patient; 2) careful explanation of what lies in store; 3) "setting the stage"; 4) preparing the equipment to be used; and 5) preparing the patient (antisialogue, sedation, application of topical anesthesia to the upper airway). If these preparatory measures are carried out meticulously, the likelihood of performing a successful and comfortable awake fiberoptic tracheal intubation is greatly increased.

Anesthesia, Local↗