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排序方式: 共有139条查询结果,搜索用时 31 毫秒
1.
Insulin infusion protocol for critical care units. 总被引:2,自引:0,他引:2
Dimple Dilkhush Jeffry Lannigan Tressa Pedroff Anthie Riddle Mary Tittle 《American journal of health-system pharmacy》2005,62(21):2260-2264
PURPOSE: An insulin infusion protocol for critical care units is described. SUMMARY: Evidence that aggressive glycemic control improves outcomes led physicians, nurses, dietitians, and pharmacists at a trauma center to develop an insulin infusion protocol. Before the protocol, elevated blood glucose concentrations were often not treated until they reached 200 mg/dL or higher. Insulin infusions were underutilized and were often not started until capillary blood glucose concentrations were greater than 350 mg/dL for 12 or more hours. When orders for an insulin infusion were written, they did not include directions for dosage adjustment, and the goal blood glucose range varied. A preliminary protocol was drafted allowing adjustments in insulin administration to be based on changes in capillary blood glucose values since the previous blood glucose measurement. The protocol was presented to a multidisciplinary team and further refined. The targeted blood glucose concentration range was 80-130 mg/dL. After the targeted range was achieved for a patient, if the blood glucose level continued to decrease over three consecutive measurements, the infusion rate was decreased by 0.5 or 1 unit/hr, depending on the capillary blood glucose level. Data for the first 30 patients were collected from September 2003 to August 2004. It took 2-36 hours (mean, 12.6 hours) to bring the capillary blood glucose concentration to less than 130 mg/dL. Among 2,845 capillary blood glucose measurements, there were 15 cases of hypoglycemia (0.4%) requiring treatment with 50% dextrose injection. CONCLUSION: A multidisciplinary effort resulted in the development of an insulin infusion protocol for use in critical care units. 相似文献
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John Hicks Anthony Dilley Dimple Patel James Barrish Shen-Hua Zhu Mary Brandt 《Ultrastructural pathology》2013,37(4):321-333
Lipoblastoma is a relatively rare tumor that occurs in infancy and early childhood and arises from embryonic white fat. Although a benign tumor, lipoblastomas tend to recur and may resemble myxoid liposarcoma. The authors report 26 cases over a 15-year period at Texas Children's Hospital. There was a slight female predilection (14F:12M). The most common symptom was a painless mass with or without increasing size. The trunk, extremities, head and neck, retroperitoneum, inguinal canal, peritoneal cavity, and lung were the tumor sites. Most tumors were circumscribed lipoblastomas and the minority were diffuse infiltrative lipoblastomatosis. Reexcision for residual or recurrent tumor was necessary more frequently in patients with lipoblastomatosis. Histopathologic examination and ultrastructural examination revealed cellular neoplasms composed of immature adipocytes with relatively well-defined septa, frequent lipoblasts, a fine vascular network, and often a myxoid appearance resembling myxoid liposarcoma. Cytogenetics was performed in 4 cases with chromosome 8q abnormality being most common. The major concern with lipoblastoma in children is to completely excise the tumor to avoid leaving residual tumor and to prevent recurrences. Confusion with myxoid liposarcoma, well-differentiated liposarcoma, and typical lipomas may occur. Although asymptomatic, lipoblastomas may cause dysfunction of other organ systems due to mass effect. Complete surgical excision with at least 2 years of follow-up is the preferred therapy. 相似文献
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Demichelis F Setlur SR Banerjee S Chakravarty D Chen JY Chen CX Huang J Beltran H Oldridge DA Kitabayashi N Stenzel B Schaefer G Horninger W Bektic J Chinnaiyan AM Goldenberg S Siddiqui J Regan MM Kearney M Soong TD Rickman DS Elemento O Wei JT Scherr DS Sanda MA Bartsch G Lee C Klocker H Rubin MA 《Proceedings of the National Academy of Sciences of the United States of America》2012,109(17):6686-6691
5.
P. G. Paul Talwar Prathap Harneet Kaur Khan Shabnam Dimple Kandhari Gaurav Chopade 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2014,18(3)
Background and Objectives:
The purpose of this study is to estimate the cumulative incidence, patient characteristics, and potential risk factors for secondary hemorrhage after total laparoscopic hysterectomy.Methods:
All women who underwent total laparoscopic hysterectomy at Paul''s Hospital between January 2004 and April 2012 were included in the study. Patients who had bleeding per vaginam between 24 hours and 6 weeks after primary surgery were included in the analysis.Results:
A total of 1613 patients underwent total laparoscopic hysterectomy during the study period, and 21 patients had secondary hemorrhage after hysterectomy. The overall cumulative incidence of secondary hemorrhage after total laparoscopic hysterectomy was 1.3%. The mean size of the uterus was 541.4 g in the secondary hemorrhage group and 318.9 g in patients without hemorrhage, which was statistically significant. The median time interval between hysterectomy and secondary hemorrhage was 13 days. Packing was sufficient to control the bleeding in 13 patients, and 6 patients required vault suturing. Laparoscopic coagulation of the uterine artery was performed in 1 patient. Uterine artery embolization was performed twice in 1 patient to control the bleeding.Conclusions:
Our data suggest that secondary hemorrhage is rare but may occur more often after total laparoscopic hysterectomy than after other hysterectomy approaches. Whether it is related to the application of thermal energy to tissues, which causes more tissue necrosis and devascularization than sharp culdotomy in abdominal and vaginal hysterectomies, is not clear. A large uterus size, excessive use of an energy source for the uterine artery, and culdotomy may play a role. 相似文献6.
Metal sulfides are gaining prominence as conversion anode materials for lithium/sodium ion batteries due to their higher specific capacities but suffers from low stability and reversibility issues. In this work, the electrochemical properties of CuS anode material has been successfully enhanced by its composite formation using graphitic carbon nitride (g-C3N4). The CuS nanoparticles are distributed evenly in the exfoliated g-C3N4 matrix rendering higher electronic conductivity and space for volume alterations during the repeated discharge/charge cycles. The 0.8CuS:0.2g-C3N4 composite when used as an anode for lithium ion coin cell exhibits a reversible capacity of 478.4 mA h g−1 at a current rate of 2.0 A g−1 after a run of 1000 cycles which is better than that reported for CuS composites with any other carbon-based matrix. The performance is equally impressive when 0.8CuS:0.2g-C3N4 composite is used as an anode in a sodium ion coin cell and a reversible capacity of 408 mA h g−1 is obtained at a current rate of 2.0 A g−1 after a run of 800 cycles. A sodium ion full cell with NVP cathode and 0.8CuS:0.2g-C3N4 composite anode has been fabricated and cycled for 100 runs at a current rate of 0.1 A g−1. It can be inferred that the g-C3N4 matrix improves the ion transfer properties, alleviates the volume alteration happening in the anode during the discharge/charge process and also helps in preventing the leaching of polysulfides generated during the electrochemical process.Metal sulfides are gaining prominence as conversion anode materials for lithium/sodium ion batteries due to their higher specific capacities but suffers from low stability and reversibility issues. 相似文献
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Somnath Saha Dibyakanti Mondal Dimple Khetawat Atanu Roy Sekhar Chakrabarti Basudev Bhattacharya 《Indian journal of otolaryngology and head and neck surgery》2002,54(4):264-267
A New multiplex PCR have been developed in our laboratory using primer sets, aiming amplification of both D.N.A target fragments obtained in 18S RNA of commonly encountered fungi in human being and in Rhinosporidium seeberi using F1-fw/F2-rev (500 bp target) and Rhino-fw/ Rhino-rev (.177 bp target). This multiplex PCR has been found to be able to delect R. seeberi from clinical samples and differentiate it from other fungi. Furthermore, by this multiplex PCR, R. seeberi, phylogenitically appears to belong to a member of so called DRIPs clade of fish parasite not a cyanobacterium as claimed previously, by some workers. 相似文献
9.
Somnath Saha Dibyakanti Mondal Dimple Khetawat Atanu Roy Sekhar Chakrabarti Basudev Bhattacharya 《Indian journal of otolaryngology and head and neck surgery》2002,54(4):264-267
A New multiplex PCR have been developed in our laboratory using primer sets, aiming amplification of both D.N.A target fragments
obtained in 18S RNA of commonly encountered fungi in human being and in Rhinosporidium seeberi using F1-fw/F2-rev (500 bp
target) and Rhino-fw/ Rhino-rev (.177 bp target). This multiplex PCR has been found to be able to delect R. seeberi from clinical
samples and differentiate it from other fungi. Furthermore, by this multiplex PCR, R. seeberi, phylogenitically appears to
belong to a member of so called DRIPs clade of fish parasite not a cyanobacterium as claimed previously, by some workers. 相似文献
10.