Computerized calculation with osmolality and its automatic comparison with observed serum ethanol concentration

The need to obtain blood alcohol levels in the differential diagnosis of the acutely intoxicated or unconscious patient often presents an emergency situation. By simultaneously determining the measured osmolality, the calculated osmolality, and the enzymatically-assayed ethanol level, the presence of alcohols other than ethanol can be recognized rapidly. A computer program has been written in FORTRAN to perform the necessary calculations, check for internal consistency, and alert the technologist if a disparity occurs.     

Laparoscopic diagnosis of subcapsular splenic hematoma in a horse

A 5-year-old Quarter Horse was examined after it developed signs of abdominal discomfort as a result of a training accident. Oral mucous membranes were pale, and capillary refill time was > 3 seconds. Hematologically, the PCV was low, and abdominocentesis yielded a serosanguineous fluid. Abdominal ultrasonography was performed and revealed a large hypoechoic mass associated with the cranial margin of the spleen. Because differentiation between subcapsular hematoma and extracapsular hematoma could not be made with certainty, further evaluation of the spleen was indicated. Abdominal laparoscopy was performed, with the horse standing, to evaluate the extent, severity, and nature of the splenic hematoma. Laparoscopic examination revealed a 7.5-cm-diameter splenic hematoma contained within the splenic capsule, confirming the diagnosis of subcapsular splenic hematoma. Abdominal laparoscopy provided excellent observation of the spleen and allowed for thorough evaluation and determination of the extent of the lesion. This information aided the clinician in reaching a definitive diagnosis and choosing between splenectomy and medical treatment.     

Observations on the epidemiology of porcine parvovirus

Evidence presented suggests that porcine parvovirus is highly stable and infective. Introduction of virus to susceptible herds results in 100% infection rate within the following 3 months. Active immunity is associated with high persistent levels of haemagglutination-inhibitating (HI) antibody (greater than 256), piglets suckling immune sows acquiring HI titres between 10,000 and 40,000. Loss of passive immunity, measured by HI, occurs in a majority of pigs between 14 and 26 weeks of age (mean 21 weeks), whilst an average of 25% (2-47%) of pigs lose HI titres between 26 and 36 weeks of age. Susceptibility to challenge with virus does not occur until 3-5 weeks following loss of HI titres. In endemically infected herds 98-100% of adult pigs show serological evidence of active immunity. A significant proportion of gilts may not be actively immune to porcine parvovirus at the time of first service, and subsequent infection may occur while these gilts are pregnant.     

Relationship of AaDO2 TO AIRWAY PCO2 in dog lungs

We measured the arterial Po2 and AaDo2 in open-chest dogs respired with air and with 5% CO2 in air at various lung volumes using a constant hyperventilatory pattern. The AaDo2 was an inverse function of lung volume with both air and 5% CO2 and was also an inverse function of both alveolar and arterial Pco2 values except at quite high lung volumes. There were two series of closed-chest experiments. In the first series, ventilation was varied to produce alveolar Pco2 and Po2 changes. In the second series, the dogs were hyperventilated at a constant rate and Pco2 was varied by adding CO2 with alveolar Po2 levels kept relatively constant. In both series the AaDo2 was inversely related to Pco2. We conclude that, in dogs, the AaDo2 is independent upon the Pco2 and speculate that this may be related to the effect of CO2 on collateral ventilation, although the Bohr effect may account for some of the dependence.     

Upgrading services in the small extended care facility

The Extended Care Facility (ECF) has become an important part of the community's provision of health care for the aged. Appropriate services must be available for long-term, intermediate, skilled, and short-term medical care. This report describes a small ECF (180 patients) rendering these needed services for the elderly. A limited operating budget, a shortage of physicians, and demand for an increase in the patient-load are some of the typical problems. In order that the important services can be rendered properly to the aged patients, participation by all the medical disciplines is essential. (The role of the Physical Therapy Department is discussed.) To upgrade services effectively, the interdisciplinary approach must involve a dual responsibility, i.e., the individual effort of the single discipline plus the group cooperative effort of all areas concerned.