Operative variables are better predictors of postdischarge infections and unplanned readmissions in vascular surgery patients than patient characteristics

Objective

Although postoperative readmissions are frequent in vascular surgery patients, the reasons for these readmissions are not well characterized, and effective approaches to their reduction are unknown. Our aim was to analyze the reasons for vascular surgery readmissions and to report potential areas for focused efforts aimed at readmission reduction.

Effect of beta blockade and beta stimulation on stage fright

Stage fright, physiologically the "fight or flight" reaction, is a disabling condition to the professional musician. Because it is mediated by the sympathetic nervous system, we have investigated the effects of beta blockade on musical performance with propranolol in a double blind fashion and the effects of beta stimulation using terbutaline. Stage fright symptoms were evaluated in two trials, which included a total of 29 subjects, by questionnaire and by the State Trai Anxiety Inventory. Quality of musical performance was evaluated by experienced music critics. Beta blockade eliminates the physical impediments to performance caused by stage fright and even eliminates the dry mouth so frequently encountered. The quality of musical performance as judged by experienced music critics is significantly improved. This effect is achieved without tranquilization. Beta stimulating drugs increase stage fright problems, and should be used in performing musicians only after consideration of the detrimental effects which they may have on musical performance.     

Surveillance for West Nile virus in clinic-admitted raptors, Colorado

In 2005, 13.5% of clinic-admitted raptors in northern Colorado tested positive for West Nile virus (WNV). Clinic-admitted-raptor surveillance detected WNV activity nearly 14 weeks earlier than other surveillance systems. WNV surveillance using live raptor admissions to rehabilitation clinics may offer a novel surveillance method and should be considered along with other techniques already in use.     

Relationship of plasma anti-heparin activity and platelet survival time in coronary disease

Platelet-endothelial interaction probably plays a role in the development of atherosclerotic vascular disease and its complications. Platelet survival time has been found to be shortened and plasma anti-heparin activity has been shown to be increased in patients with coronary atherosclerosis. Platelet survival (autologous labelling with ⁵¹Chromium) and plasma anti-heparin activity (heparin-thrombin clotting time of platelet poor plasma) were measured in 75 men with coronary artery disease. Platelet survival was shortened (< 3.3 days) in 60 men (80%) and averaged 2.6 ± 0.06 days (AVE $\text{t}\text{1}\text{2}\text{± SEM}$; normal $\text{t}\text{1}\text{2}$ 3.7 ± 0.03 days; N = 28; P < 0.001). Anti-heparin activity was abnormal (< 0.96) in 26 men (35%) and averaged 1.04 ± 0.02 (ratio patient to blank; seconds/seconds; normal ratio 1.10 ± 0.01; N = 25; P < 0.01). Platelet survival time correlated with anti-heparin activity (r = 0.68). Sulfinpyrazone (800 mg. daily) and indomethacin (100 mg. per day) increased platelet survival and decreased heparin neutralizing activity. Dipyridamole (100 mg. orally per day) in combination with aspirin (1,200 mg. per day) increased platelet survival and decreased anti-heparin activity, but aspirin alone had a comparatively weak effect on these tests. Results suggest that plasma heparin neutralizing activity correlates with platelet survival time in men with coronary artery disease. Sulfinpyrazone, indomethacin, and dipyridamole in combination with aspirin alter platelet survival and heparin neutralizing activity, but aspirin alone has a comparatively weaker effect.