Aerobic Capacity after Contracting lnfectious Mononucleosis

Infectious mononucleosis can be disabling to athletes of all ages. Traditionally, long periods of limited physical activity are prescribed. During this time period a significant level of detraining can occur. Sixteen cadets from USMA who were identified as having mononucleosis had their aerobic capacity determined immediately after becoming afebrile. Nine of these cadets then entered a 2-week exercise program while the others remained inactive. After this time period all cadets were allowed to exercise at their own discretion. After an additional 2-week period (4 weeks after becoming afebrile), aerobic capacity was again determined. There were no differences within the groups when comparing VO2 max, METS, or run time to exhaustion on the two aerobic tests. One individual served as a case study with aerobic tests every week for 4 weeks and then 6 months after becoming afebrile. Again, no differences were observed in any variables measured. Thus, prolonged bed rest does not seem to be indicated for the individual recovering from mononucleosis. Noncontact activities can be initiated as soon as the fever disappears. J Orthop Sports Phys Ther 1986;8(4):199-202.     

Determining technologist staffing requirements and productivity in an academic setting

The department of radiology at New England Deaconess Hospital, in response to the recently imposed legislative constraints on reimbursement for the care of hospitalized patients, has extended a method developed in 1977 to define staffing requirements and productivity and to track departmental operating efficiency.     

Variation in acute fluid resuscitation among pediatric burn centers

BackgroundAccurate resuscitation of pediatric patients with large thermal injury is critical to achieving optimal outcomes. The goal of this project was to describe the degree of variability in resuscitation guidelines among pediatric burn centers and the impact on fluid estimates.MethodsFive pediatric burn centers in the Pediatric Injury Quality Improvement Collaborative (PIQIC) contributed data from patients with ≥15% total body surface area (TBSA) burns treated from 2014 to 2018. Each center's resuscitation guidelines and guidelines from the American Burn Association were used to calculate estimated 24-h fluid requirements and compare these values to the actual fluid received.ResultsDifferences in the TBSA burn at which fluid resuscitation was initiated, coefficients related to the Parkland formula, criteria to initiate dextrose containing fluids, and urine output goals were observed. Three of the five centers’ resuscitation guidelines produced statistically significant lower mean fluid estimates when compared with the actual mean fluid received for all patients across centers (4.53 versus 6.35 ml/kg/% TBSA, p < 0.001), (4.90 versus 6.35 ml/kg/TBSA, p = 0.002) and (3.38 versus 6.35 ml/kg/TBSA, p < 0.0001).ConclusionsThis variation in practice patterns led to statistically significant differences in fluid estimates. One center chose to modify its resuscitation guidelines at the conclusion of this study.     

Emergency surgery comparison of right versus left acute colonic diverticulitis: A 10-year outcome analysis

IntroductionThe difference in outcome between right (RCD) and left colonic diverticulitis (LCD) is not well established. The aim of this study was to analyse the presentation and surgical outcome of RCD versus left-sided disease following emergency surgery.MethodWe conducted a retrospective review of patients presenting with acute diverticulitis over a 10-year period from 2004 to 2014 to a tertiary unit. Patient demographics, Hinchey classification, need for emergency surgery, perioperative outcome and recurrence were evaluated.ResultsIn total 360 patients presented with acute diverticulitis, 218 (61%) were right-sided and 142 (39%) were left-sided. The mean age (57 yrs vs 68 yrs) and median length of stay (4 days vs 5 days) were significantly less in RCD (p < 0.001). The need for emergency surgery was similar between RCD and LCD (30.7% vs 23.2%, p = 0.12). Sixty-seven (31%) patients with RCD required emergency surgery, 42 (62.7%) of these were based on a presumptive diagnosis of appendicitis and underwent laparoscopic appendicectomy only. Operative morbidity (10.4% vs 51.5%, p < 0.001) and mortality were significantly higher in LCD (1.5% v 15.2%, p = 0.007). Subgroup analysis of non-appendicectomy, RCD patients, showed LCD were more likely to require surgery (11.5% vs 23.2%, p = 0.003). There was no difference in recurrence (p = 0.6).ConclusionRight colonic diverticulitis patients are younger and disease course is more benign compared to LCD. Presentation can be confused with appendicitis without proper imaging. In the rare cases where emergency surgery is required, RCD is associated with a lower operative morbidity and mortality compared to left-sided disease.     

Culture and in vitro bromodeoxyuridine-labelling of mouse kidney explants

Summary A method is described for extended mouse renal organ culture and is evaluated for the study of cell proliferation in 1 mm³ explants of renal cortex. Explants were maintained for up to 14 days with cellular viability being sustained at 20% of the original tissue block from day 2. Labelling indices in tuft, capsular and tubular cells ranged from 0 to approximately 20% over the culture period, following in vitro bromodeoxyuridine uptake. This technique offers potential for the study of local effects of inhibitors of proliferation.     

Evaluation of the Heart To Heart Project: lessons from a community-based chronic disease prevention project

PURPOSE. To present an evaluation of a 5-year, community-based, chronic disease prevention project managed by a state health department to determine whether the department could replicate similar previous projects that had received more funding and other resources. DESIGN. The evaluation used a matched comparison design and a review of archive and interview data. SETTING. Florence, South Carolina (population: 56,240). SUBJECTS. A random sample of 1642 persons in Florence (and 1551 in the comparison) who responded to a risk factor questionnaire and underwent a physical assessment; 70.7% of baseline subjects participated in the postintervention. Forty key persons were interviewed concerning project effectiveness. INTERVENTIONS BY PROJECT. Walk-a-thons, a speakers' bureau, media messages, restaurant food labeling, and cooking seminars. More than 31,000 participants were involved in 585 activities. MEASURES. Questionnaires focused on hypertension, obesity, high cholesterol, smoking, and exercise. Physical assessments determined lipid, lipoprotein, apolipoprotein, and blood pressure levels. Analysis of covariance was used for baseline and postintervention comparisons. Content analysis was used on archive and interview data. RESULTS. The project had a slightly favorable intervention effect on cholesterol and smoking, but failed to have an effect on other risk factors for cardiovascular disease. The project influenced community awareness, enlisted influential community members, and fostered linkages among local health services. CONCLUSIONS. Health departments can be instrumental in community risk reduction programming; however, they may not replicate projects having greater resources.