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PubMed · 8299105

The nurses are innocent.

G Hamilton
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Abstract

In 1980-81, the nursing and medical staff of Toronto's Hospital for Sick Children (HSC) were agonizing over an increased death rate on cardiac wards 4A and 4B and groping for the cause. The key to this diagnostic puzzle appeared to surface when hospital radioimmunoassay tests revealed very high autopsy readings of digoxin on four babies who died during this period, Janice Estrella, Justin Cook, Kevin Pacsai and Allana Miller. Since one nursing team was present during each of these infants' final hours, it was assumed that one or more of the nurses had intentionally poisoned the infants with digoxin. A web of circumstantial evidence entrapped team member Susan Nelles, who was charged with murder.

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DigoxinFalse Positive ReactionsHomicideHumansJurisprudenceNursing Staff, HospitalJournal Article

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G Hamilton. 1993. The nurses are innocent.. https://pubmed.ncbi.nlm.nih.gov/8299105/

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Effects of Kanlijian on exercise tolerance, quality of life, and frequency of heart failure aggravation in patients with chronic heart failure.

OBJECTIVE: To observe the effects of conventional therapy combined with Kanlijian (KLJ) on exercise tolerance, quality of life and frequency of heart failure aggravation in patients with chronic heart failure (CHF). METHODS: Sixty CHF patients differentiated as sufferring from the syndrome of Xin-Shen Yang deficiency were included in the study and randomly assigned at the ratio of 2:1 into the KLJ group (n = 39) and the control group (n = 21). All the patients were treated with conventional therapy of Western medicine, but to those in the KLJ group, KLJ was medicated additionally one dose daily with 24 wks as one therapeutic course. The efficacy on TCM syndrome and changes of scores on TCM syndrome were observed after treatment. The indexes, including 6-minute walking distance (6MWD), quality of life (QOL, accessed by LHFQ scoring), NYHA grade, hemodynamic indexes and reducing/withdrawal rate of diuretic and digoxin before and after treatment were recorded and compared. Also the frequency of re-admission due to aggravation of heart failure in one year's time were observed. RESULTS: (1) The efficacy on TCM syndrome, improvement on scores of TCM syndrome, therapeutic effects on 6MWD, QOL, and NYHA grade in the KLJ group were superior to those in the control group. (2) Hemodynamic indexes after treatment, left ventricular fractional shortening (LVFS) and E peak/A peak (E/A), between the two groups had no significant difference, while left ventricular ejection fraction (LVEF) was increased significantly in the KLJ group, but with no obvious change in the control group. (3) The reducing/withdrawal rate of diuretic and digoxin in the KLJ group was significantly higher than that in the control group. (4) The 1-year frequency of re-admission significantly decreased in the KLJ group. CONCLUSION: The adjuvant treatment of KLJ on the basis of Western conventional therapy can significantly improve CHF patients' exercise tolerance, quality of life and cardiac function, reduce the dosage of diuretic and digoxin needed, and decrease the re-admission frequency due to aggravation of heart failure.

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