STUDY OF ADRENOCORTICAL PHYSIOLOGY IN JET FLYING

1956 ◽  
Vol 34 (3) ◽  
pp. 534-542 ◽  
Author(s):  
C. W. Murphy ◽  
R. A. Cleghorn

A statistically significant eosinopenia occurred on days on which jet aircraft were flown in the mornings. The difference between experimental and control days was more marked in the early part of the afternoon than in the later part. The absolute values for urinary corticoid excretion were not shown to be significantly different on experimental days by comparison with control days, but when expressed in terms of corticoid excretion/body surface area they were seen to be significantly greater on the mornings of experimental days by comparison with control days. Corticoid/body surface area was not constant for different individuals. Salivary electrolyte concentration did not differ significantly on experimental days as compared with control days, but the late afternoon hour at which the single specimen was collected may have missed any change occurring earlier.

1956 ◽  
Vol 34 (1) ◽  
pp. 534-542
Author(s):  
C. W. Murphy ◽  
R. A. Cleghorn

A statistically significant eosinopenia occurred on days on which jet aircraft were flown in the mornings. The difference between experimental and control days was more marked in the early part of the afternoon than in the later part. The absolute values for urinary corticoid excretion were not shown to be significantly different on experimental days by comparison with control days, but when expressed in terms of corticoid excretion/body surface area they were seen to be significantly greater on the mornings of experimental days by comparison with control days. Corticoid/body surface area was not constant for different individuals. Salivary electrolyte concentration did not differ significantly on experimental days as compared with control days, but the late afternoon hour at which the single specimen was collected may have missed any change occurring earlier.


1998 ◽  
Vol 21 (2) ◽  
pp. 91-94
Author(s):  
M. Hatoko ◽  
S. Hirai ◽  
T. Muramatsu ◽  
M. Kuwahara ◽  
A. Shiba ◽  
...  

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S39-S40
Author(s):  
Taylor Schoenborn ◽  
Mini Thomas ◽  
Kelsey Miller-Willis ◽  
Rita Frerk ◽  
Nicole O Bernal

Abstract Introduction Accurate determination of the total body surface area (TBSA) burned is an essential element for the clinical management of burn care. The Lund and Browder (LB) is a tool that allows practitioners to calculate the TBSA burned, which is used to determine fluid needs, nutritional requirements, and graft site availability. Studies have shown that individuals with a body mass index (BMI) greater than 30 have an increase in surface area in the trunk and lower extremities, making the applicability of the traditional LB less accurate. The objective of this study was to develop and implement an electronic obese LB and compare it to the traditional LB. Methods Using the paper by Williams et al. as a guide, an obese LB was constructed for each body type: android, gynecoid and mixed (Table 1). Based on the patients BMI, the hospital’s Electronic Medical Record (EMR) would direct staff to the appropriate LB. All providers were formally trained on the obese LB, body types and changes in body surface area measurements. A retrospective chart review of adult patients admitted from January 2020 to September 2020 with a BMI≥30 was conducted. The BMI, body type, and location of burn was analyzed for each patient. The TBSA burned was recalculated for each patient using the traditional LB and compared to the obese LB completed at admission. Results A total of nineteen patients had a BMI≥30 and an admission obese LB completed. The TBSA burned ranged from 0.25–78.5%. The difference in TBSA burned calculated by the traditional and obese LB was 4.2±8.8 % (Figure 1). In patients with burns to the trunk or lower extremities (n=7) a difference of 12±10.5% was observed. Conclusions Limited research exists demonstrating the use of a standardized obese LB in clinical practice. No patient complications were identified with the use of the developed obese LB. Evaluation of the data revealed that the traditional LB often underestimated the TBSA burned in obese patients with burns to the trunk and/or lower extremities. This could lead to under-resuscitation and complications related to hypovolemia. In addition, expectations on patient survival and outcomes become inaccurate. As obesity grows in prevalence having a LB that recognizes the difference in surface area observed in the trunk and lower extremities can improve patient outcomes. Further research with a larger sample size is needed to gain a greater understanding of the clinical impact of an obese LB. We have shown that accurate determination of the burn area in obese patients can be done in a standardized fashion within the EMR.


1996 ◽  
Vol 76 (05) ◽  
pp. 682-688 ◽  
Author(s):  
Jos P J Wester ◽  
Harold W de Valk ◽  
Karel H Nieuwenhuis ◽  
Catherine B Brouwer ◽  
Yolanda van der Graaf ◽  
...  

Summary Objective: Identification of risk factors for bleeding and prospective evaluation of two bleeding risk scores in the treatment of acute venous thromboembolism. Design: Secondary analysis of a prospective, randomized, assessor-blind, multicenter clinical trial. Setting: One university and 2 regional teaching hospitals. Patients: 188 patients treated with heparin or danaparoid for acute venous thromboembolism. Measurements: The presenting clinical features, the doses of the drugs, and the anticoagulant responses were analyzed using univariate and multivariate logistic regression analysis in order to evaluate prognostic factors for bleeding. In addition, the recently developed Utrecht bleeding risk score and Landefeld bleeding risk index were evaluated prospectively. Results: Major bleeding occurred in 4 patients (2.1%) and minor bleeding in 101 patients (53.7%). For all (major and minor combined) bleeding, body surface area ≤2 m2 (odds ratio 2.3, 95% Cl 1.2-4.4; p = 0.01), and malignancy (odds ratio 2.4, 95% Cl 1.1-4.9; p = 0.02) were confirmed to be independent risk factors. An increased treatment-related risk of bleeding was observed in patients treated with high doses of heparin, independent of the concomitant activated partial thromboplastin time ratios. Both bleeding risk scores had low diagnostic value for bleeding in this sample of mainly minor bleeders. Conclusions: A small body surface area and malignancy were associated with a higher frequency of bleeding. The bleeding risk scores merely offer the clinician a general estimation of the risk of bleeding. In patients with a small body surface area or in patients with malignancy, it may be of interest to study whether limited dose reduction of the anticoagulant drug may cause less bleeding without affecting efficacy.


Author(s):  
Shirazu I. ◽  
Theophilus. A. Sackey ◽  
Elvis K. Tiburu ◽  
Mensah Y. B. ◽  
Forson A.

The relationship between body height and body weight has been described by using various terms. Notable among them is the body mass index, body surface area, body shape index and body surface index. In clinical setting the first descriptive parameter is the BMI scale, which provides information about whether an individual body weight is proportionate to the body height. Since the development of BMI, two other body parameters have been developed in an attempt to determine the relationship between body height and weight. These are the body surface area (BSA) and body surface index (BSI). Generally, these body parameters are described as clinical health indicators that described how healthy an individual body response to the other internal organs. The aim of the study is to discuss the use of BSI as a better clinical health indicator for preclinical assessment of body-organ/tissue relationship. Hence organ health condition as against other body composition. In addition the study is `also to determine the best body parameter the best predict other parameters for clinical application. The model parameters are presented as; modeled height and weight; modelled BSI and BSA, BSI and BMI and modeled BSA and BMI. The models are presented as clinical application software for comfortable working process and designed as GUI and CAD for use in clinical application.


2015 ◽  
Vol 18 (3) ◽  
pp. 098
Author(s):  
Cem Arıtürk ◽  
Serpil Ustalar Özgen ◽  
Behiç Danışan ◽  
Hasan Karabulut ◽  
Fevzi Toraman

<p class="p1"><span class="s1"><strong>Background:</strong> The inspiratory oxygen fraction (FiO<sub>2</sub>) is usually set between 60% and 100% during conventional extracorporeal circulation (ECC). However, this strategy causes partial oxygen pressure (PaO<sub>2</sub>) to reach hyperoxemic levels (&gt;180 mmHg). During anesthetic management of cardiothoracic surgery it is important to keep PaO<sub>2</sub> levels between 80-180 mmHg. The aim of this study was to assess whether adjusting FiO<sub>2</sub> levels in accordance with body temperature and body surface area (BSA) during ECC is an effective method for maintaining normoxemic PaO<sub>2</sub> during cardiac surgery.</span></p><p class="p1"><span class="s1"><strong>Methods:</strong> After approval from the Ethics Committee of the University of Acıbadem, informed consent was given from 60 patients. FiO<sub>2</sub> adjustment strategies applied to the patients in the groups were as follows: FiO<sub>2</sub> levels were set as 0.21 × BSA during hypothermia and 0.21 × BSA + 10 during rewarming in Group I; 0.18 × BSA during hypothermia and 0.18 × BSA + 15 during rewarming in Group II; and 0.18 × BSA during hypothermia and variable with body temperature during rewarming in Group III. Arterial blood gas values and hemodynamic parameters were recorded before ECC (T1); at the 10th minute of cross clamp (T2); when the esophageal temperature (OT) reached 34°C (T3); when OT reached 36°C (T4); and just before the cessation of ECC (T5).</span></p><p class="p1"><span class="s1"><strong>Results:</strong> Mean PaO<sub>2</sub> was significantly higher in Group I than in Group II at T2 and T3 (<em>P</em> = .0001 and <em>P</em> = .0001, respectively); in Group I than in Group III at T1 (<em>P</em> = .02); and in Group II than in Group III at T2, T3, and T4 <br /> (<em>P</em> = .0001 for all). </span></p><p class="p1"><span class="s1"><strong>Conclusion: </strong>Adjustment of FiO<sub>2</sub> according to BSA rather than keeping it at a constant level is more appropriate for keeping PaO<sub>2</sub> between safe level limits. However, since oxygen consumption of cells vary with body temperature, it would be appropriate to set FiO<sub>2</sub> levels in concordance with the body temperature in the <br /> rewarming period.</span></p>


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