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Ewenstein B, Wong WY, Casey K, Alai M. FVIII administration in surgery. Haemophilia 2011; 17:828-9. [PMID: 21682821 DOI: 10.1111/j.1365-2516.2011.02594.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lang S, Kääb A, Pechstädt J, Flügel WA, Zeil P, Lanz E, Kahuda D, Frauenfelder R, Casey K, Füreder P, Sossna I, Wagner I, Janauer G, Exler N, Boukalova Z, Tapa R, Lui J, Sharma N. Assessing components of the natural environment of the Upper Danube and Upper Brahmaputra river basins. ADVANCES IN SCIENCE AND RESEARCH 2011. [DOI: 10.5194/asr-7-21-2011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract. A comprehensive understanding of the interplay between the natural environment and the human dimension is one of the prerequisites to successful and sustaining IWRM practises in large river basins such as the Upper Brahmaputra river basin or the Upper Danube river basin. These interactions, their dynamics and changes, and the likely future scenarios were investigated in the BRAHMATWINN project with a series of tools from remote sensing and geoinformatics. An integrated assessment of main components of the natural environment in the two river basins as well as in five reference catchments within those basins, has led to the delineation of hydrological response units (HRUs). HRUs are spatial units bearing a uniform behaviour in terms of the hydrological response regime, as a function of physical parameters land use, soil type, water, vegetation cover and climate. Besides the delineated HRUs which are available in a spatially exhaustive manner for all reference catchments, the following information were provided as spatial layers: (1) uniform digital surface models of both the twinned basins and the reference catchments; (2) glacier areas and the magnitude of glacier loss; (3) mountain permafrost distribution and identification of areas particularly affected by permafrost thaw; (4) a consistent land use/land cover information in all reference catchments; and (5) the vulnerabilities of wetlands and groundwater in terms of anthropogenic impact and climate change.
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Faller RV, Casey K, Amburgey J. Anticaries potential of commercial fluoride rinses as determined by fluoridation and remineralization efficiency. THE JOURNAL OF CLINICAL DENTISTRY 2011; 22:29-35. [PMID: 21702322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE The objective of this work was to compare the anticaries potential of several currently marketed fluoride-containing mouthrinse products using two in vitro approaches: 1) fluoride uptake studies of demineralized human enamel samples after exposure to rinse products; and 2) microhardness studies of sound enamel samples after exposure to the rinse products and demineralizing agents. METHODS Four currently marketed rinse products, formulated at 100 ppm F, were evaluated in fluoride uptake studies relative to a negative (water) rinse control (Study 1). The same rinse products were evaluated in microhardness studies (Study 2) against a positive control, ACT Anticavity rinse, which is formulated with 225 ppm F and carries the ADA Seal of Acceptance as an effective anticavity mouthrinse. Test products included ACT Total Care rinse (pH = 6.34), Listerine Total Care rinse (pH = 3.57), Crest Pro-Health for Me rinse (pH = 3.33), and Crest Pro-Health Complete rinse (pH = 3.43). RESULTS Study 1-Samples treated with any of the fluoride-containing rinses showed significantly higher (p < 0.05) levels of fluoride uptake than the negative (water) control. Two of the products (Crest Pro-Health for Me and Crest Pro-Health Complete) showed significantly higher (p < 0.05) levels of fluoride uptake into demineralized enamel than the other marketed rinses (Listerine Total Care and ACT Total Care). Study 2-Samples treated with the same two rinse products (Crest Pro-Health For Me and Crest Pro-Health Complete) showed significantly lower mineral loss than the other rinse products, as well as the positive control. CONCLUSION Results of these in vitro studies indicate that the Crest mouthrinse products evaluated here are capable of providing significantly better fluoridation of demineralized enamel, as well as significantly better protection against the initiation and progression of demineralization, compared to the other marketed fluoride-containing mouthrinse products tested.
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Collins PW, Björkman S, Fischer K, Blanchette V, Oh M, Schroth P, Fritsch S, Casey K, Spotts G, Ewenstein BM. Factor VIII requirement to maintain a target plasma level in the prophylactic treatment of severe hemophilia A: influences of variance in pharmacokinetics and treatment regimens. J Thromb Haemost 2010; 8:269-75. [PMID: 19943875 DOI: 10.1111/j.1538-7836.2009.03703.x] [Citation(s) in RCA: 144] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Prophylactic factor (F)VIII has been shown to reduce bleeds and arthropathy in patients with severe hemophilia A. OBJECTIVES Assuming that the trough FVIII level is an important determinant of the efficacy of prophylaxis, this paper addresses the effect of the inter-patient variability in pharmacokinetics and different dosing regimens on trough levels. METHODS Simulations used FVIII half-lives and in vivo recoveries (IVR), observed during clinical trials with Advate [Antihemophilic Factor (Recombinant), Plasma/Albumin-Free Method], and commonly used prophylactic regimens to calculate their effect on FVIII levels during prophylaxis. RESULTS AND CONCLUSIONS Half-life and dose frequency had a larger effect on trough FVIII and time per week with FVIII<1 IU dL(-1) than IVR and infused dose per kg. The combined effect of these parameters resulted in substantial inter-patient variability in the amount of FVIII required to sustain a desired trough level. Prophylactic regimens based on Monday, Wednesday, Friday dosing were less cost effective in maintaining a desired trough level throughout the week. Dose escalation on Friday to cover the weekend would require potentially harmful doses of FVIII in many patients, especially in young children where more than 50% would require a Friday dose of over 100 IU kg(-1) and some would require more than 400 IU kg(-1). Knowledge of individual patients' half-lives and alteration of frequency of infusions may allow the more cost-effective use of FVIII and potentially expand access to prophylaxis to a greater number of patients, especially in regions where healthcare resources are scarce.
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Hudson N, Bell K, McGahan E, Lowe S, Galvin G, Casey K. Odour emissions from anaerobic piggery ponds. 2: improving estimates of emission rate through recognition of spatial variability. BIORESOURCE TECHNOLOGY 2007; 98:1888-97. [PMID: 16962321 DOI: 10.1016/j.biortech.2006.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Revised: 05/31/2006] [Accepted: 06/15/2006] [Indexed: 05/11/2023]
Abstract
Odour emission rates were measured for seven different anaerobic ponds treating piggery wastes at six to nine discrete locations across the surface of each pond on each sampling occasion over a thirteen month period. Significant variability in emission rates were observed for each pond. Measurement of a number of water quality variables in pond liquor samples collected at the same time and from the same locations as the odour samples indicated that the composition of the pond liquor was also variable. The results indicated that spatial variability was a real phenomenon and could have a significant impact on odour assessment practices. Considerably more odour samples would be required to characterise pond emissions than currently recommended by most practitioners, or regulatory agencies.
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Hudson N, McGahan E, Casey K, Lowe S, Galvin G, Jeston P, Dunlop M. Odour emissions from anaerobic piggery ponds. 1. Results of a three season, 14-month survey. BIORESOURCE TECHNOLOGY 2007; 98:1877-87. [PMID: 16962322 DOI: 10.1016/j.biortech.2006.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Revised: 05/31/2006] [Accepted: 06/15/2006] [Indexed: 05/11/2023]
Abstract
Odour emission rates were measured for seven different anaerobic ponds treating piggery wastes at six to nine discrete locations across the surface of each pond on each sampling occasion over a 14-month period. Emission rate values varied between ponds, between seasons for the same pond and even for the same pond on different days of a sampling week. Average seasonal emission rates ranged from 7.9 to 46.5OU/m(2)s, while average emission rates ranged from 16.0 to 29.0OU/m(2)s. Factors potentially responsible for the variability in emission rates were investigated, including air and pond liquor temperatures, time of day of sample collection, season and the impact of a prolonged drought.
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Lane VM, Liu IKM, Casey K, vanLeeuwen EMG, Flanagan DR, Murata K, Munro C. Inoculation of female American black bears (Ursus americanus) with partially purified porcine zona pellucidae limits cub production. Reprod Fertil Dev 2007; 19:617-25. [PMID: 17601409 DOI: 10.1071/rd06154] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2006] [Accepted: 04/09/2007] [Indexed: 11/23/2022] Open
Abstract
The present 2-year study investigated the feasibility of using porcine zona pellucidae (pZP) as antigen for immunocontraception in American black bears. Sows, 3–6 years of age, were administered either two doses of 250 µg pZP with Freund’s adjuvant (n = 10) or adjuvant alone (n = 5), one in April and one in May, and were kept away from the boars until June. Serum samples were collected before injections and before denning (November). The presence of sows with cubs at side was observed during premature emergence from denning. First-year results indicated that anti-pZP antibody titres in vaccinated sows were 2.5–9.0-fold (range) higher compared with non-vaccinated sows and that the vaccinated sows were threefold less likely to become pregnant (P = 0.167). Control and vaccinated bears produced 1.6 and 0.2 cubs per sow, respectively (P = 0.06). The second-year study investigated the feasibility of using pZP sequestered in a controlled-release pellet and a water-soluble adjuvant (QS-21) to avoid regulatory problems associated with Freund’s adjuvant. Sows in the treatment group (n = 22) were administered a single dose of an emulsion of 250 µg pZP and 150 μg QS-21 plus a pellet containing 70–90 µg pZP for delayed release as booster dose. Control sows (n = 5) received the QS-21 adjuvant in pellet alone. Serum samples were collected before inoculations (April) and before denning (November). Seven cubs were born to the five control sows, but none was born to the 22 vaccinated sows (P < 0.001). Anti-pZP antibody mean absorbance ratios in control sows remained at background levels, whereas vaccinated sows had ratios fourfold higher than controls. Two-dimensional polyacrylamide gel electrophoresis and immunohistochemical localisation confirmed immunoreactivity of sera from inoculated bears. We conclude that cub production in the American black bear can be effectively limited with either two injections of 250 μg pZP or a single inoculation of partially purified pZP sequestered in controlled-release pellets.
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Wilson F, Caffrey S, King E, Casey K, Gissane C. A 6-month prospective study of injury in Gaelic football. Br J Sports Med 2006; 41:317-21. [PMID: 17138631 PMCID: PMC2659076 DOI: 10.1136/bjsm.2006.033167] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To describe the injury incidence in Gaelic football. METHODS A total of 83 players from three counties were interviewed monthly about their injury experience, during the 6 months of the playing season. RESULTS The injury rate was 13.5/1000 h exposure to Gaelic football (95% CI, 10.9 to 16.6). There were nearly twice as many injuries during matches (64.4%, 95% CI, 54.1 to 73.6) as in training (35.6%, 95% CI, 26.4 to 49.5). The ankle was found to be the most commonly injured site (13.3%, 95% CI, 7.8 to 21.9). The musculotendinous unit accounted for nearly 1/3 of all injuries (31.1%). The tackle accounted for 27.8% of the injuries sustained (tackler 10%, 95% CI, 5.4 to 17.9; player being tackled 17.9%, 95% CI, 11.2 to 26.9). Of total match injuries, 56.9% (95% CI, 46.1 to 67.1) were experienced in the second half as opposed to 39.7% (95% CI, 29.8 to 50.5) in the first half. CONCLUSIONS Gaelic footballers are under considerable risk of injury. Greater efforts must be made to reduce this risk so that players miss less time from sport due to injury. Risk factors for injury in Gaelic football must now be investigated so that specific interventions may be established to reduce them.
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Wagner KR, Beiler S, Beiler C, Kirkman J, Casey K, Robinson T, Larnard D, de Courten-Myers GM, Linke MJ, Zuccarello M. Delayed profound local brain hypothermia markedly reduces interleukin-1beta gene expression and vasogenic edema development in a porcine model of intracerebral hemorrhage. ACTA NEUROCHIRURGICA. SUPPLEMENT 2006; 96:177-82. [PMID: 16671450 DOI: 10.1007/3-211-30714-1_39] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
White matter (lobar) intracerebral hemorrhage (ICH) can cause edema-related deaths and life-long morbidity. In our porcine model, ICH induces oxidative stress, acute interstitial and delayed vasogenic edema, and up-regulates interleukin-1beta (IL-1beta), a proinflammatory cytokine-linked to blood-brain barrier (BBB) opening. In brain injury models, hypothermia reduces inflammatory cytokine production and protects the BBB. Clinically, however, hypothermia for stroke treatment using surface and systemic approaches can be challenging. We tested the hypothesis that an alternative approach, i.e., local brain cooling using the ChillerPad System, would reduce IL-1beta gene expression and vasogenic edema development even if initiated several hours after ICH. We infused autologous whole blood (3.0 mL) into the frontal hemispheric white matter of 20 kg pentobarbital-anesthetized pigs. At 3 hours post-ICH, we performed a craniotomy for epidural placement of the ChillerPad. Chilled saline was then circulated through the pad for 12 hours to induce profound local hypothermia (14 degrees C brain surface temperature). We froze brains in situ at 16 hours after ICH induction, sampled perihematomal white matter, extracted RNA, and performed real-time RT-PCR. Local brain cooling markedly reduced both IL-1beta RNA levels and vasogenic edema. These robust results support the potential for local brain cooling to protect the BBB and reduce injury after ICH.
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Vilensky JA, Gilman S, Casey K. Sir Victor Horsley, Mr John Marshall, the Nervi Nervorum, and Pain. ACTA ACUST UNITED AC 2005; 62:499-501. [PMID: 15767520 DOI: 10.1001/archneur.62.3.499] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Chinivasagam HN, Thomas RJ, Casey K, McGahan E, Gardner EA, Rafiee M, Blackall PJ. Microbiological status of piggery effluent from 13 piggeries in the south east Queensland region of Australia. J Appl Microbiol 2004; 97:883-91. [PMID: 15479402 DOI: 10.1111/j.1365-2672.2004.02382.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To assist in the development of safe piggery effluent re-use guidelines by determining the level of selected pathogens and indicator organisms in the effluent ponds of 13 south-east Queensland piggeries. METHODS AND RESULTS The numbers of thermotolerant coliforms, Campylobacter jejuni/coli, Erysipelothrix rhusiopathiae, Escherichia coli, Salmonella and rotavirus were determined in 29 samples derived from the 13 piggeries. The study demonstrated that the 13 final effluent ponds contained an average of 1.2 x 10(5) colony-forming units (CFU) 100 ml(-1) of thermotolerant coliforms and 1.03 x 10(5) CFU 100 ml(-1) of E. coli. The Campylobacter level varied from none detectable (two of 13 piggeries) to a maximum of 930 most probable number (MPN) 100 ml(-1) (two of 13 piggeries). Salmonella was detected in the final ponds of only four of the 13 piggeries and then only at a low level (highest level being 51 MPN 100 ml(-1)). No rotavirus and no Erysip. rhusiopathiae were detected. The average log10 reductions across the ponding systems to the final irrigation pond were 1.77 for thermotolerant coliforms, 1.71 for E. coli and 1.04 for Campylobacter. CONCLUSIONS This study has provided a baseline knowledge on the levels of indicator organisms and selected pathogens in piggery effluent. SIGNIFICANCE AND IMPACT OF THE STUDY The knowledge gained in this study will assist in the development of guidelines to ensure the safe and sustainable re-use of piggery effluent.
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Arzberger P, Schroeder P, Beaulieu A, Bowker G, Casey K, Laaksonen L, Moorman D, Uhlir P, Wouters P. Promoting Access to Public Research Data for Scientific, Economic, and Social Development. DATA SCIENCE JOURNAL 2004. [DOI: 10.2481/dsj.3.135] [Citation(s) in RCA: 153] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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File SE, Jarrett N, Fluck E, Duffy R, Casey K, Wiseman H. Eating soya improves human memory. Psychopharmacology (Berl) 2001; 157:430-6. [PMID: 11605103 DOI: 10.1007/s002130100845] [Citation(s) in RCA: 146] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2001] [Accepted: 05/14/2001] [Indexed: 11/27/2022]
Abstract
RATIONALE Soya foods are rich in isoflavone phytoestrogens with weak agonist activity at oestrogen receptors. Oestrogen treatment has been found to improve memory in men awaiting gender reassignment and in post-menopausal women. OBJECTIVE To examine the effects of supervised high versus low soya diets on attention, memory and frontal lobe function in young healthy adults of both sexes. METHODS Student volunteers were randomly allocated to receive, under supervision, a high soya (100 mg total isoflavones/day) or a low soya (0.5 mg total isoflavones/day) diet for 10 weeks. They received a battery of cognitive tests at baseline and then after 10 weeks of diet. RESULTS Those receiving the high soya diet showed significant improvements in short-term (immediate recall of prose and 4-s delayed matching to sample of patterns) and long-term memory (picture recall after 20 min) and in mental flexibility (rule shifting and reversal). These improvements were found in males and females. In a letter fluency test and in a test of planning (Stockings of Cambridge), the high soya diet improved performance only in females. There was no effect of diet on tests of attention or in a category generation task. Those on the high soya diet rated themselves as more restrained and, after the tests of memory and attention, they became less tense than did those on the control diet. CONCLUSIONS Significant cognitive improvements can arise from a relatively brief dietary intervention, and the improvements from a high soya diet are not restricted to women or to verbal tasks.
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Hudson N, Casey K, Melvin S, Nicholas P. Laboratory investigation of supported permeable organic covers for the management of odour emissions from anaerobic piggery waste ponds. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2001; 44:317-326. [PMID: 11762479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Australian research has linked much of the odour arising from intensive livestock operations to pond treatment systems. A reduction in emissions from treatment ponds would therefore generally reduce odour emissions from intensive livestock operations. Published data indicates that the application of straw and other biological materials to effluent pond surfaces as a continuous cover reduces odour emissions. The effectiveness of these covers has not, however, been researched under controlled conditions. Using locally available materials, the efficacy of supported covers has been investigated using a series of laboratory anaerobic digesters treating typical piggery effluent. Research to date has focused on: identifying effective cover and cover support materials; quantifying odour reduction; identifying the impact use these covers may have on greenhouse gas emissions; devising practical and effective methods for constructing these covers. Results have confirmed that a variety of cover materials are effective in reducing pond odour emissions. Supporting the pond cover appears to extend the cover life expectancy. While greenhouse gas emissions appear to vary according to cover type, the overall significance of these emissions is not yet clear. The impact of permeable pond covers on overall pond performance requires additional research.
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Yarnitsky D, Sprecher E, Zaslansky R, Baron R, Bowsher D, Boivie J, Casey K, Claus D, Hanson P, Lindblom U, Marchettini P, Parry GJ, Verdugo R. Limitations of quantitative sensory testing when patients are biased toward a bad outcome. Neurology 1999; 52:894; author reply 894-5. [PMID: 10078760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
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Katims JJ, Yarnitsky D, Sprecher E, Zaslansky R, Baron R, Bowsher D, Boivie J, Casey K, Claus D, Hanson P, Lindblom U, Marchettini P, Parry GJ, Verdugo R, Ochoa J, Dyck PJ, Kesserwani H, Stevens JC, Dyck PJB, Melanson M, Suarez GA, Kennedy WR, Shy M, O'Brien PC. Limitations of quantitative sensory testing when patients are biased toward a bad outcome. Neurology 1999. [DOI: 10.1212/wnl.52.4.894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Casey K, Bedker DL, Roussel-McElmeel PL. Myocardial infarction: review of clinical trials and treatment strategies. Crit Care Nurse 1998. [DOI: 10.4037/ccn1998.18.2.39] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Casey K, Bedker DL, Roussel-McElmeel PL. Myocardial infarction: review of clinical trials and treatment strategies. Crit Care Nurse 1998; 18:39-52; quiz 53-4. [PMID: 9708119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Abstract
It has been proposed that females use the symmetry of secondary sexual traits to differentiate between potential mates. The vertical bars on male swordtail fish function as a signal that attracts females and deters rival males in one swordtail species. In addition, male courtship behaviour of most Xiphophorus species incorporates serial lateral presentations, which provide females with a clear opportunity to assess males for bilateral symmetry. We tested the hypothesis that X. cortezi females prefer males with a symmetrical bar number by determining whether females switched their preference between two males when we switched which male had a symmetrical number of bars. The ability to manipulate the bars without influencing other male traits allowed us to control for male characters correlated with bar symmetry that females might prefer. The degree of asymmetry in bar number we used was within the degree of asymmetry found for this trait in nature. Females switched their preference between a pair of males when we switched which male was symmetrical for bar number. We discuss the possibility that females prefer a symmetrical bar number as well as an alternative hypothesis. Copyright 1998 The Association for the Study of Animal Behaviour.
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Zimmer PW, Hill M, Casey K, Harvey E, Low DE. Prospective randomized trial of talc slurry vs bleomycin in pleurodesis for symptomatic malignant pleural effusions. Chest 1997; 112:430-4. [PMID: 9266880 DOI: 10.1378/chest.112.2.430] [Citation(s) in RCA: 116] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Symptomatic malignant pleural effusions are common sequelae in patients with certain malignancies. Pleurodesis via bedside thoracostomy is the current treatment option most commonly used. To our knowledge, this is the first prospective randomized trial to examine which agent, bleomycin or talc slurry, is superior in terms of effectiveness, safety, and cost. PATIENTS AND METHODS Between July 1992 and March 1995, 35 patients presenting to our medical center with symptomatic malignant pleural effusions were prospectively randomized to undergo chemical pleurodesis with either bleomycin or talc slurry via bedside thoracostomy. The conditions of patients were assessed and graded before and after treatment concerning pain, dyspnea, and chest radiographs. RESULTS Twenty-nine patients who underwent 33 treatments (14 with bleomycin and 19 with talc) were available for follow-up. Follow-up ranged from 2 weeks to 8 months (mean, 1.7 months). Both groups demonstrated notable improvement in both pain and dyspnea following treatment, but there were no statistically significant differences between groups in the amount of improvement (two-tailed Student's t test). Permanent control of effusions, defined objectively on chest radiograph, was achieved with 11 bleomycin treatments (79%) and 17 talc treatments (90%) (p=0.388). The procedures were well tolerated and no significant adverse effects were observed. Talc is a much less costly agent than bleomycin ($12.36 cost to our medical center per treatment for talc vs $955.83 for bleomycin). CONCLUSION Given the similar efficacy and significant cost advantage, we conclude that talc is the agent of choice when utilizing pleurodesis for control of symptomatic malignant pleural effusions.
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Coolican MB, Politoski G, Casey K. Programs for families of organ and tissue donors. EDTNA/ERCA JOURNAL (ENGLISH ED.) 1997; 23:5-8. [PMID: 9663985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Until recently, the families of patients who have given the gift of life have been the invisible group in the transplant circle. They donated the organs and tissues of their loved ones to unknown transplant recipients and then were to grieve alone. As transplantation has matured and become the treatment of choice for end stage organ failure and for other life-enhancing procedures, the importance of the donor and the donor family is being recognised and their needs and expectations identified.
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Treacy E, Arbour L, Chessex P, Graham G, Kasprzak L, Casey K, Bell L, Mamer O, Scriver CR. Glutathione deficiency as a complication of methylmalonic acidemia: response to high doses of ascorbate. J Pediatr 1996; 129:445-8. [PMID: 8804337 DOI: 10.1016/s0022-3476(96)70080-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A 7-year-old boy with deficient activity of methylmalonyl coenzyme A mutase (mut-methylmalonic acidemia) was seen in severe metabolic crisis. After hemodialysis and clearance of toxic metabolites, severe lactic acidosis persisted with multiorgan failure. Glutathione deficiency was noted and high-dose ascorbate therapy (120 mg/kg) commenced. Glutathione deficiency may contribute to the lactic acidosis observed during decompensation in patients with methylmalonic acidemia.
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Politoski G, Coolican M, Casey K. Perspectives on communication issues among transplant and procurement professionals, transplant recipients, and donor families. JOURNAL OF TRANSPLANT COORDINATION : OFFICIAL PUBLICATION OF THE NORTH AMERICAN TRANSPLANT COORDINATORS ORGANIZATION (NATCO) 1996; 6:78-83. [PMID: 9188363 DOI: 10.7182/prtr.1.6.2.g487230152800076] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Communication among professionals, donor families, and transplant recipients is a controversial topic. Traditionally, transplant and procurement professionals have made the decision about the type and frequency of information that a donor family and transplant recipient receive regarding one another, and relationships that might develop as a result. Information obtained through questionnaires demonstrated inconsistency in addressing donor family and transplant recipient needs for initial and follow-up information and communication-not only between clinical transplant and procurement donation coordinators, but within organizations involved in the care and support of these people. This wide variance regarding communication among all disciplines demonstrated a need for standardization of practice guidelines. Guidelines are being developed through collaboration of the major organizations involved in the care of donor families and transplant recipients to standardize communication practices throughout the United States.
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Heffner JE, Barbieri C, Casey K. Procedure-specific do-not-resuscitate orders. Effect on communication of treatment limitations. ARCHIVES OF INTERNAL MEDICINE 1996; 156:793-7. [PMID: 8615713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Do-not-resuscitate (DNR) orders are often inaccurately communicated between physicians and nurses or residents. Structured, procedure-specific DNR order forms have been suggested to improve communication, but no data exist to support this impression. METHODS The level of agreement between attending physicians and nurses or residents in their understanding of the DNR orders of critically ill patients was measured before and after instituting a structured DNR order form. Caregivers were asked (1) about the clinical events to which the DNR order applied, (2) whether the DNR order withheld all elements of cardiopulmonary resuscitation, and (3) whether other treatments were to be withheld. Results were reported as kappa +/- SE. RESULTS Nurses (n=41) and residents (n=34) showed only fair to moderate agreement with attending physicians (n=53) for the 76 evaluable patients before initiation of the DNR order form. After initiation of the structured DNR order form, nurses showed higher levels of agreement for the second (0.67 +/- 0.14) and third (0.69 +/- 0.13) components but not the first (0.39 +/- 0.15) component of the DNR order. Residents showed higher levels of agreement for the second (0.90 +/- 0.10) and third components (0.81 +/- 0.13) but not the first (0.57 +/- 0.17) component. Nurses compared with residents had lower levels of agreement with attending physicians for most aspects of the DNR order. CONCLUSION A structured DNR order form improves agreement in understanding of some but not all components of the DNR order.
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Kambin P, Casey K, O'Brien E, Zhou L. Transforaminal arthroscopic decompression of lateral recess stenosis. J Neurosurg 1996; 84:462-7. [PMID: 8609559 DOI: 10.3171/jns.1996.84.3.0462] [Citation(s) in RCA: 116] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The purpose of this study was to evaluate the feasibility and efficacy of arthroscopic decompression of lateral recess stenosis, determine potential associated complications, and present an alternative method to access the lateral recess of the lumbar spine. Forty patients were selected in whom the authors found clinical and computerized tomography evidence of lateral recess stenosis and sequestered foraminal herniations. All 40 were treated with a posterolateral arthroscopic technique, and 38 were available for this follow-up evaluation. A satisfactory result was obtained in 31 patients (82%). No neurovascular complications were encountered; however, other complications included an infection of the disc space in one patient and a causalgic-type pain in the involved extremity in four patients. The associated postoperative morbidity in this group of patients was minimal and resulted in rapid rehabilitation and return of patients to preoperative functioning level.
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