Synergy of chymopapain and diatrizoate studied in an experimental model

The effect of diatrizoate on the chronic toxicity of chymopapain in the epidural space was studied. Chymopapain was injected epidurally into four monkeys; chymopapain plus diatrizoate meglumine, into four. In 3 months, neither group developed significantly more arachnoiditis than a control group of animals that had received epidural injections of physiologic saline. No synergistic effect of chymopapain and diatrizoate on the meninges was detected.     

The Bair Hugger patient warming system in prolonged vascular surgery: an infection risk?

Introduction  

Use of the Bair Hugger forced-air patient warming system during prolonged abdominal vascular surgery may lead to increased bacterial contamination of the surgical field by mobilization of the patient's skin flora.     

Ligamentum flavum: appearance on sagittal and coronal MR images

The appearance of the ligamentum flavum on sagittal and coronal magnetic resonance (MR) images has not been described in detail in the radiologic literature. The authors reviewed correlative MR images and anatomic sections obtained with a cryomicrotome in 20 cadavers in order to analyze anatomic relationships, variations, and progressive degenerative changes of the ligamentum flavum in the lumbar region. MR imaging showed the ligamentum flavum as an intermediate-signal-intensity structure on images obtained with short and long repetition times (TRs). Sagittal short TR images were effective for evaluating relationships between the ligamentum flavum, spinal canal, and nerve roots. Degenerative changes in the ligamentum flavum appeared as changes in shape or thickness of the ligaments on MR images. Calcification and fat infiltration, which were well depicted on anatomic sections, were not visualized on MR images.     

Guidelines for blood utilization review

Hospitals are required by accrediting agencies to perform blood utilization review. Specific areas that must be addressed are the ordering, distribution, handling, dispensing, and administration of blood components. Monitoring the effects of transfusion on patients is also required. The format of the review process and the criteria for appropriate blood utilization must be developed by each institution. This article provides examples of areas that can be reviewed and procedures that may be used. However, the suggested laboratory values must not be interpreted as defining indications or criteria for transfusion. Each transfusion committee, or its equivalent, is responsible for developing its own institutional blood utilization procedures and audit criteria. Review and approval by the medical staff prior to implementation are essential. The procedures must also be reviewed and revised on a regular basis.