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Six-month Period (six-month + period)
Selected AbstractsA Prospective Comparison of Ultrasound-guided and Blindly Placed Radial Arterial CathetersACADEMIC EMERGENCY MEDICINE, Issue 12 2006Stephen Shiver MD Abstract Background Arterial cannulation for continuous blood-pressure measurement and frequent arterial-blood sampling commonly are required in critically ill patients. Objectives To compare ultrasound (US)-guided versus traditional palpation placement of arterial lines for time to placement, number of attempts, sites used, and complications. Methods This was a prospective, randomized interventional study at a Level 1 academic urban emergency department with an annual census of 78,000 patients. Patients were randomized to either palpation or US-guided groups. Inclusion criteria were any adult patient who required an arterial line according to the treating attending. Patients who had previous attempts at an arterial line during the visit, or who could not be randomized because of time constraints, were excluded. Enrollment was on a convenience basis, during hours worked by researchers over a six-month period. Patients in either group who had three failed attempts were rescued with the other technique for patient comfort. Statistical analysis included Fisher's exact, Mann-Whitney, and Student's t-tests. Results Sixty patients were enrolled, with 30 patients randomized to each group. Patients randomized to the US group had a shorter time required for arterial line placement (107 vs. 314 seconds; difference, 207 seconds; p = 0.0004), fewer placement attempts (1.2 vs. 2.2; difference, 1; p = 0.001), and fewer sites required for successful line placement (1.1 vs. 1.6; difference, 0.5; p = 0.001), as compared with the palpation group. Conclusions In this study, US guidance for arterial cannulation was successful more frequently and it took less time to establish the arterial line as compared with the palpation method. [source] Randomized controlled trial of physiotherapy in 56 children with cerebral palsy followed for 18 monthsDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 1 2001E Bower PhD MCSP Senior Research Fellow This study aimed to determine whether motor function and performance is better enhanced by intensive physiotherapy or collaborative goal-setting in children with cerebral palsy (CP). Participants were a convenience sample of 56 children with bilateral CP classified at level III or below on the Gross Motor Function Classification System (GMFCS), aged between 3 and 12 years. A 2 × 2 factorial design was used to compare the effects of routine amounts of physiotherapy with intensive amounts, and to compare the use of generalized aims set by the child's physiotherapist with the use of specific, measurable goals negotiated by the child's physiotherapist with each child, carer, and teacher. Following the six-month treatment period there was a further six-month period of observation. Changes in motor function and performance were assessed by a masked assessor using the Gross Motor Function Measure (GMFM) and the Gross Motor Performance Measure (GMPM) at three-month intervals. There was no statistically significant difference in the scores achieved between intensive and routine amounts of therapy or between aim-directed and goal-directed therapy in either function or performance. Inclusion of additional covariates of age and severity levels showed a trend towards a statistically significant difference in children receiving intensive therapy during the treatment period. This advantage declined over the subsequent six months during which therapy had reverted to its usual amount. Differences in goal-setting procedures did not produce any detectable effect on the acquisition of gross motor function or performance. [source] Monogenic diabetes: information seeking and genetic testing access via e-mailEUROPEAN DIABETES NURSING, Issue 2 2010M Shepherd RGN, PhD Honorary Clinical Senior Lecturer Abstract Background: Confirmation of monogenic diabetes by molecular genetic testing has allowed many patients, often previously assumed to have type 1 diabetes, to transfer from insulin injections to sulphonylurea tablets, with improvements in glycaemic control and quality of life: www.diabetesgenes.org provides information about monogenic diabetes and genetic testing. Aim: To investigate key issues raised by individuals who e-mailed the monogenic diabetes team about genetic testing and monogenic diabetes management. Methods: Sixty e-mail enquiries, received over a six-month period from patients and professionals worldwide, were analysed using a qualitative thematic content approach. Results: Five themes emerged: 1. Accessing genetic technology: patients and professionals both enquired about access to testing; 2. Presentation of evidence: medical facts presented by patients and professionals included characteristics specifically relevant to diagnosing monogenic diabetes; 3. Experiences of healthcare: patients often researched their condition online and some felt dissatisfied with routine consultations; 4. Seeking specialist advice regarding treatment: specific information was sought relating to management of neonatal diabetes or monogenic diabetes and pregnancy; 5. Searching for a cure through genetic technology: patients questioned whether genetic advances would lead to a cure for diabetes. Conclusion: This project offers the first insights into use of e-mail as a means of gaining access to a specialist monogenic team and information about genetic testing. Although providing advice via e-mail can prove complicated, particularly when received from patients under the care of other clinicians, it is an efficient means of communicating specialist knowledge. Study findings will aid development of a ,frequently asked questions' section of www.diabetesgenes.org. Copyright © 2010 FEND [source] Does aversive behavior during toddlerhood matter?INFANT MENTAL HEALTH JOURNAL, Issue 4 2002The effects of difficult temperament on maternal perceptions, behavior Seventy-three mothers and their toddlers were observed when the children were 18 and 24 months of age in a series of laboratory procedures designed to assess relations among frustration distress, aggression/venting, and defiance, as indicators of aversive behavior, and their relations to maternal interactive style concurrently and over time. A second goal was to identify the predictors of aversive behavior at 24 months of age. Child aversive behavior as a predictor of increases in maternal negativity over time was also examined. Results indicated that distress, venting, and defiance were related to one another at 18 months of age. For boys, venting at 24 months of age, but not distress or defiance, was associated with greater maternal report of stress and higher incidence of behavior problems at 24 months of age. Venting behavior at 24 months of age was predicted by the interaction of early aversive behavior and low maternal positive guiding behavior. Increases in maternal negative behavior over the six-month period were predicted by the interaction of earlier negative maternal behavior and child sex, with negative mothers of boys displaying greater increases in negative behavior at the later age. These findings are discussed in terms of the significance of early aversive behavior, in the context of mother,child interaction, for later problematic behavior. ©2002 Michigan Association for Infant Mental Health. [source] Use of the internet and of the NHS direct telephone helpline for medical information by a cognitive function clinic populationINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2003A. J. Larner Abstract Background Internet websites and medical telephone helplines are relatively new and huge resources of medical information (,cybermedicine' and ,telemedicine', respectively) accessible to the general public without prior recourse to a doctor. Study Objectives To measure use of internet websites and of the NHS Direct telephone helpline as sources of medical information by patients and their families and/or carers attending a cognitive function clinic. Design and Setting Consecutive patients seen by one consultant neurologist over a six-month period in the Cognitive Function Clinic at the Walton Centre for Neurology and Neurosurgery, a regional neuroscience centre in Liverpool, UK. Results More than 50% of patients and families/carers had internet access; 27% had accessed relevant information, but none volunteered this. 82% expressed interest in, or willingness to access, websites with relevant medical information if these were suggested by the clinic doctor. Although 61% had heard of the NHS Direct telephone helpline, only 10% of all patients had used this service and few calls related to the reason for attendance at the Cognitive Function Clinic. Conclusions Internet access and use is common in a cognitive function clinic population. Since information from internet websites may shape health beliefs and expectations of patients and families/carers, appropriately or inappropriately, it may be important for the clinic doctor to inquire about these searches. Since most would use websites suggested by the doctor, a readiness to provide addresses for appropriate sites may prove helpful. Copyright © 2003 John Wiley & Sons, Ltd. [source] Rehabilitation and guidance as reported by women and men who had undergone coronary bypass surgeryJOURNAL OF CLINICAL NURSING, Issue 4 2007Kirsi Koivunen RN Aims and objectives., The purpose of this study was to describe the experience of rehabilitation reported by coronary artery disease patients who had undergone coronary artery bypass surgery. A further purpose was to describe the kind of guidance on rehabilitation that they were given during this period. Methods., The data consisted of thematic questionnaires completed by six women and eight men who had undergone coronary artery bypass surgery. They had recorded their experiences on these questionnaires at one-month intervals for a year after the surgery. The data were analysed using the method of content analysis. Results., On the basis of the results, women had experienced the most balanced period of physical, mental and social rehabilitation during the six months following surgery. Their recovery, however, suffered a setback after the first six months. On the basis of the results, men attained a better balance of physical, mental and social rehabilitation only after the six-month period following surgery. Even men had various problems in their rehabilitation, but their recovery proceeded more smoothly than that of women. Women hoped for more guidance throughout the process of rehabilitation. The support and help from wives had a positive impact on the process of men's recovery. Peer support was another significant source support. Conclusions., A person undergoing rehabilitation needs special guidance from health care professionals, especially when his/her rehabilitation does not proceed optimally. The findings suggest that, especially, the guidance of women should be improved because women seemed to suffer from many problems during their process of rehabilitation, including loneliness, insecurity, uncertainty, fears, depression and anxiety. Relevance to clinical practice., Expanding the role of practical nurses to provide both preventive and rehabilitation guidance should be seen as an important strategy in health care. Individual needs, gender differences and support from families and peers should be taken into consideration when planning and implementing guidance. [source] Evaluation of a falls prevention programme in an acute tertiary care hospitalJOURNAL OF CLINICAL NURSING, Issue 2 2007M Hth Sci, PG Dip Clin Epi, Teresa A Williams BN Aims and objectives., To evaluate a systematic, coordinated approach to limit the severity and minimize the number of falls in an acute care hospital. Background., Patient falls are a significant cause of preventable injury and death, particularly in older patients. Best practice principles mandate that hospitals identify those patients at risk of falling and implement interventions to prevent or minimize them. Methods., A before and after design was used for the study. All patients admitted to three medical wards and a geriatric evaluation management unit were enrolled over a six-month period. Patients' risk of falling was assessed using a falls risk assessment tool and appropriate interventions implemented using a falls care plan. Data related to the number and severity of falls were obtained from the Australian Incident Monitoring System database used at the study site. Results., In this study, 1357 patient admissions were included. According to their risk category, 37% of patients (n = 496) were grouped as low risk (score = 1,10), 58% (n = 774) medium risk (score = 11,20) and 5% (n = 63) high risk (score = 21,33) for falls. The incidence of falls (per average occupied bed day) was eight per 1000 bed days for the study period. Compared with the same months in 2002/2003, there was a significant reduction in falls from 0·95 to 0·80 (95% CI for the difference ,0·14 to ,0·16, P < 0·001). Conclusion., We evaluated a systematic, coordinated approach to falls management that included a falls risk assessment tool and falls care plan in the acute care setting. Although a significant reduction in falls was found in this study, it could not be attributed to any specific interventions. Relevance to clinical practice., Preventing falls where possible is essential. Assessment of risk and use of appropriate interventions can reduce the incidence of falls. [source] Central venous access for haemodialysis: prospective evaluation of possible complicationsJOURNAL OF CLINICAL NURSING, Issue 2 2007Denise De Andrade PhD Aims and objectives., The combination of chronic renal insufficiency and haemodialysis represents a challenge for health professionals. Chronic renal insufficiency patients undergoing haemodialysis treatment through a temporary double-lumen catheter were prospectively studied in order to identify the type and frequency of local and systemic complications. Methods., A six-month period was established with a view to the inclusion of new cases. Data were acquired through interviews, clinical assessment and patient records, and entered into a Microsoft Excel database through a double entry system and exported to the Statistical Package Social Sciences software. Sixty-four patients were evaluated prospectively, of which thirty-eight (59.4%) were men and 35 (54.7%) required catheter insertion for immediate treatment. During the study period, 145 catheters were inserted, ranging from 1 to 7 implants per patient, 29 (45.3%) were single insertions and 127 (87.6%) catheters were inserted into the jugular vein. The catheters were left in place for an average of 30 days. Results., Forty-one (64%) presented inadequate functioning, after about 26 days. A febrile state occurred in 24 (37.5%) patients after 34 days, secretion at the catheter entry site in 27 (42.2% after 26 days and bloodstream infection was encountered in 34(53%) after 34 days. Of the 61 blood culture samples, thirty (49%) were positive for Staphylococcus aureus that was the microorganism most frequently isolated. Conclusion., The findings indicate worrying aspects such as the catheters permanence time, exposing patients to different complications, including infection. Furthermore, inadequate catheter functioning leads to inefficient haemodialysis treatment. Relevance to clinical practice., Knowledge about complications allows for systematic care planning, prevention and control actions. [source] Development of a Lyophilization Formulation that Preserves the Biological Activity of the Platelet-inducing Cytokine Interleukin-11 at Low ConcentrationsJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 1 2000CHRISTOPHER PAGE Recombinant human interleukin-11 (rhIL-11) is a licensed biological therapeutic product in at least one country and is used to combat thrombocytopenia during chemotherapeutic regimens, as well as undergoing clinical trials for a range of other disorders. Following attempts to lyophilize IL-11 at low concentrations, it was clear that a significant loss of recoverable biological activity occurred. Investigation of a variety of factors, including the type of container in which the rhIL-11 was lyophilized, revealed that surface adsorption to glass was a major factor resulting in loss of activity of rhIL-11 in solution (> 40% reduction after 3 h at room temperature), in addition to losses of activity post-lyophilization. To overcome this problem, different formulations containing combinations of human serum albumin (HSA), trehalose and Tween-20 have been investigated. Two formulations were successful in entirely preserving the biological activity of rhIL-11 through lyophilization and subsequent reconstitution (potency estimates of formulated relative to original material being ,0.97). Accelerated degradation studies, performed at intervals over a six-month period, demonstrated the stability of freeze-dried rhIL-11 using these formulations (predicted annual reduction in potency after storage at ,20°C ,1.4%). In conclusion, we have developed a working combination of excipients (0.5% HSA, 0.1% trehalose and 0.02% Tween-20 in potassium phosphate buffer (pH 7.4)) to formulate a stable rhIL-11 freeze-dried product in glass containers, with no loss in potency. These findings should facilitate development of low dose rhIL-11 products and be an indicator of caution to those using this and other material with similar physical properties, without taking appropriate precautions to avoid losses through adsorption. [source] THE EFFICACY OF SHORT DAILY DIALYSIS,A SINGLE-CENTRE EXPERIENCEJOURNAL OF RENAL CARE, Issue 3 2010Glenda Rayment M Nursing (Renal) SUMMARY Studies have shown that patients converted to short daily haemodialysis (SDHD) have reported many clinical benefits, decreased complications during dialysis and a better quality of life. A six-month prospective cohort study was conducted to examine the efficacy of SDHD to patients previously receiving three times per week haemodialysis therapy. Following informed consent, participants received haemodialysis daily, Monday,Saturday, between 2 and 2.5 hours for each treatment and followed-up for a six-month period. The participants continued to experience hypotension, cramping and headache and were noncompliant with fluid intake. There was a gradual reduction in blood pressure, cessation of antihypertensives and reduction of erythropoietin therapy (ERT). There were no hospital admissions or reports of access complications. The nursing staff reported an increase in activity levels and nursing interventions with the participants following conversion to SDHD. However, the participants reported a better quality of life. [source] Efficacy and safety of pimobendan in canine heart failure caused by myxomatous mitral valve diseaseJOURNAL OF SMALL ANIMAL PRACTICE, Issue 3 2005P. J. Smith Objectives: To evaluate the clinical efficacy and safety of pimobendan by comparing it with ramipril over a six-month period in dogs with mild to moderate heart failure (HF) caused by myxomatous mitral valve disease (MMVD). Methods: This was a prospective randomised, single-blind, parallel-group trial. Client-owned dogs (n=43) with mild to moderate HF caused by MMVD were randomly assigned to one of two groups, which received either pimobendan (P dogs) or ramipril (R dogs) for six months. The outcome measures studied were: adverse HF outcome, defined as failure to complete the trial as a direct consequence of HF; maximum furosemide dose (mg/kg/day) administered during the study period; and any requirement for additional visits to the clinic as a direct consequence of HF. Results: Treatment with pimobendan was well tolerated compared with treatment with ramipril. P dogs were 25 per cent as likely as R dogs to have an adverse HF outcome (odds ratio 4.09, 95 per cent confidence interval 1.03 to 16.3, P=0.046). Clinical Significance: R dogs had a higher overall score and thus may have had more advanced disease than P dogs at baseline (P=0.04). These results should be interpreted cautiously but such a high odds ratio warrants further investigation. [source] A survey of tracheal intubation difficulty in the operating room: a prospective observational studyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2001F. Adnet Background: The purpose of this study is to describe all degrees of endotracheal intubation difficulty among patients attended by eight anesthesiologists during routine surgery over a six-month period. Airway characteristics were routinely assessed preoperatively, according to the anesthesiologists' usual practice. Methods: Difficult tracheal intubation was evaluated by the Intubation Difficulty Scale (IDS), a quantitative score based on seven variables. An IDS value of 0 is consistent with a procedure without difficulty, and an IDS > 5 with a procedure involving moderate to major difficulty. Results: For 1171 patients undergoing tracheal intubation, IDS was 0 in 55%, and greater than 5 in 8% of cases. External laryngeal pressure, repositioning the patient and added use of a stylet were the most frequent methods chosen to facilitate tracheal intubation. Conclusion: There was a high incidence (37%) of minor difficulties encountered during routine surgery. [source] Clustering of Device-Related Concerns and Type D Personality Predicts Increased Distress in ICD Patients Independent of Shocks,PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 1 2008SUSANNE S PEDERSEN Ph.D. Background: This study examined the impact of clustering of device-related concerns and Type D personality on anxiety and depressive symptoms during a six-month period and the clinical relevance of shocks, implantable cardioverter defibrillator (ICD) concerns, and Type D. Methods: Consecutively implanted ICD patients (n = 176) completed questionnaires at baseline and six months and were divided into four risk groups: (1) No risk factors (neither ICD concerns nor Type D); (2) ICD concerns only; (3) Type D only; (4) Clustering (both ICD concerns and Type D). Results: The prevalence of Type D and concerns were 21.6% and 34.7%. Analysis of variance for repeated measures showed a reduction in anxiety over time (P < 0.001), with the risk groups exerting a stable (P = 0.14) but differential effect (P < 0.001); the highest level was seen in the clustering group. Similar results were found for depression, although depressive symptoms did not decrease (P = 0.08) and the impact of clustering was less clear. These results were confirmed in adjusted analysis, with shocks (P = 0.024) also being associated with anxiety but not depression. The impact of ICD concerns and Type D personality on anxiety and depression at baseline and six months was large (,0.8) compared to negligible to moderate for shocks (0.0,0.6). Conclusions: ICD patients with psychosocial risk factor clustering had the highest level of anxiety, whereas the pattern for depression was less consistent. Shocks influenced outcomes, but the impact was smaller compared to ICD concerns and Type D personality. It may be timely to expand the focus beyond shocks when seeking to identify ICD patients at risk for adverse clinical outcome due to their psychological profile. [source] Leaf nest use and construction in the golden-brown mouse lemur (Microcebus ravelobensis) in the Ankarafantsika National ParkAMERICAN JOURNAL OF PRIMATOLOGY, Issue 1 2010Sandra Thorén Abstract The use of leaf nests has been documented in several mouse lemur species over the last few decades, including the golden-brown mouse lemur. Nest construction, however, has only rarely been observed and detailed descriptions of this process are lacking so far. We aim to determine the relative importance of leaf nests as shelters for the golden-brown mouse lemur, and to test predictions concerning the role of thermoregulation, safety (i.e., protection of infants), and of interspecific competition with the sympatric gray mouse lemurs in regulating nest use. Finally, we intend to clarify whether and how Microcebus ravelobensis constructs the nests, and we provide physical descriptions of seven leaf nests. Nocturnal focal observations were carried out from May 2007 to January 2008 on 18 females, and sleeping sites were regularly monitored during a six-month period. Data were collected from two study sites, one with exclusive presence of M. ravelobensis, and one with co-existence of the two mouse lemur species. Sixty-five out of 379 identified daily sleeping sites were leaf nests. These represented a total of 35 different leaf nests, used by 15 out of 18 females. The relative leaf nest use differed between sites during five out of six months, but without a consistent pattern. Interspecific competition can therefore not explain leaf nest use. Leaf nest use differed seasonally and may be partly explained by thermoregulatory advantages in the site with lower minimum temperatures. Nest use was furthermore higher than expected in both sites during the rearing season that indicates the role of nests in infant protection. For the first time, we could confirm that golden-brown mouse lemurs build leaf nests themselves. Nest building lasted between 46 and 68,min, which shows that this task is time consuming and therefore probably costly. Am. J. Primatol. 72:48,55, 2010. © 2009 Wiley-Liss, Inc. [source] Plugging the Prisoner Finance Gap: A Critical Analysis of Financial Support for Newly-Released PrisonersTHE HOWARD JOURNAL OF CRIMINAL JUSTICE, Issue 1 2010YVETTE HARTFREE Senior Research Associate Abstract: The prison discharge grant is intended to meet prisoners' immediate needs on release and assist with living costs prior to their receiving their first benefit payment. It has been widely criticised for providing inadequate financial support, leaving prisoners with a gap in their finances on release. This article discusses the extent to which recent policy developments have been effective in closing this gap. The analysis is based on data from a longitudinal qualitative study of 40 prisoners who were tracked over a six-month period following their release from prison. This research shows that despite new policy initiatives the prisoner finance gap remains. [source] Studies on triploid oysters in Australia: farming potential of all-triploid Pacific oysters, Crassostrea gigas (Thunberg), in Port Stephens, New South Wales, AustraliaAQUACULTURE RESEARCH, Issue 6 2005J A Nell Abstract Triploid Pacific oysters Crassostrea gigas farmed in Port Stephens, NSW had an exceptionally fast growth rate and reached a whole weight of 55 g in 13 months versus 20 months for diploids. Mortality of the triploids (24.5±2.94%) was significantly lower (P<0.05) than that of the diploids (40.0±2.26%) over the duration of the experiment (July 2002,February 2004). Unfortunately, this advantage was offset by discoloration of the meats of the triploids when they were in better condition than the diploids over summer (October 2003,March 2004). However, discoloration of meat of triploids had cleared up by April 2004 and neither did they suffer this problem from April,September 2003. The triploids also had a lower peak condition than the diploids. Oysters in peak meat condition, i.e. spawning condition, are preferred for the half shell trade in Australia and in this study, there was at least a six-month period prior to discoloration, when the triploids were large enough and had sufficient meat condition for marketing on the half shell. [source] An audit of the prevalence of recorded nicotine dependence treatment in an Australian psychiatric hospitalAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2010Paula Wye Abstract Objectives: To investigate the prevalence of recorded smoking status, nicotine dependence assessment, and nicotine dependence treatment provision; and to examine the patient characteristics associated with the recording of smoking status. Method: A retrospective systematic medical record audit was conducted of all psychiatric inpatient discharges over a six-month period (1 September 2005 to 28 February 2006), at a large Australian psychiatric hospital, with approximately 2,000 patient discharges per year. A one-page audit tool identifying patient characteristics and prevalence of recorded nicotine dependence treatment, and requiring ICD-10-AM diagnoses coding was used. Results: From 1,012 identified discharges, 1,000 medical records were available for audit (99%). Documentation of smoking status most frequently occurred on the admission form (28.8%) and diagnoses summary (41.6%). Documentation of nicotine dependence was not found in any record, and recording of any nicotine dependence treatment was negligible (0-0.5%). The rate of recorded smoking status on discharge summaries was 6%. Patients with a diagnosis of alcohol, cannabis, sedative use disorders or asthma were twice as likely to have their smoking status recorded compared to those who did not have these diagnoses. Conclusions: Mental health services, by failing to diagnose and document treatment for nicotine dependence, do not conform to current clinical practice guidelines, despite nicotine dependence being the most commonly diagnosed psychiatric disorder. Implications: Considerable system change and staff support is required to provide an environment where a primary prevention approach such as smoking care can be sustained. [source] Investigation of febrile passengers detected by infrared thermal scanning at an international airportAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2010William J. H. McBride Abstract Objective: To determine the best approach for the evaluation of fever, detected by infrared thermal scanning, at an international airport. Methods: Arriving passengers with fever were divided into three groups: community evaluation by a GP, with or without cost compensation, or evaluation at the airport by a health practitioner. Uptake of offered evaluations was measured, diagnoses were recorded, and region-specific rates of fever measured. Observations were made on practical aspects of thermal screening. Results: Over a six-month period, 181,759 passengers were screened for fever at the Cairns international airport, Queensland, Australia. Fever was identified in 118 (0.06%) of the arriving passengers and 76 were enrolled in the study. Only 19 of these passengers (25%) voluntarily underwent further evaluation. No differences were observed in the three approaches. Conclusions: Public health surveillance of febrile passengers arriving at an international airport should not rely on voluntary passenger participation for the detection of imported contagious diseases. [source] Characteristics of Heart Rate Variability Can Predict Impending Septic Shock in Emergency Department Patients with SepsisACADEMIC EMERGENCY MEDICINE, Issue 5 2007Wei-Lung Chen MD ObjectivesTo determine whether heart rate variability (HRV) measures can be used to predict which septic patients in the emergency department (ED) will progress to septic shock. MethodsThe authors prospectively enrolled consecutive patients who met the 2001 International Sepsis Definitions Conference criteria of sepsis and visited the ED of a university teaching hospital over a six-month period. In addition to the septic workup, a continuous 10-minute electrocardiogram recording was performed at the same time. The HRV measures were calculated off-line and correlated with the outcome of the patients. ResultsEighty-one patients aged 30,84 years who met the inclusion criteria were enrolled. The patients were classified as those with no septic shock (n= 60) and those with septic shock (n= 21), according to their outcome within six hours. The baseline root mean square successive difference, high-frequency power, and normalized high-frequency power of the septic shock group were significantly higher than those of the no septic shock group. The low-frequency power, normalized low-frequency power, and low-/high-frequency power ratio of the septic shock group were significantly lower than those of the no septic shock group. Multiple logistic regression analysis identified root mean square successive difference as the best predictor of impending septic shock for septic ED patients. ConclusionsHRV measures may be used to identify septic ED patients with impending septic shock. Among those HRV measures, root mean square successive difference seems to be the best indicator to predict the occurrence of septic shock. [source] | |||||||||||||