The maximum surgical blood order schedule and surgical blood use in the United States

The outdating of units of blood can be reduced by decreasing the amount of time they spend in an assigned or crossmatched status. This reduction can be achieved in a hospital by establishing a maximum surgical blood order schedule (MSBOS) which reduces the excessive number of units of blood crossmatched preoperatively for patients undergoing elective surgery. The various steps which occurred in the development of a MSBOS in a large general hospital are detailed and the projected reduction in the number of crossmatched units which can be achieved with the MSBOS is illustrated. illustrated. The projected number of units of blood transfused to patients during their hospitalization for 50 common primary surgical procedures in the United States during 1974 is presented as a basis for defining maximum blood orders for each procedure.     

Anomalous double blood supply to the lung

We report an unusual case in which an apparently normal upper lobe of the right lung was supplied by major systemic arterial and pulmonary arterial vessels. The anomalous artery arose from the descending aorta. Following interruption of this vessel, the machinery-like murmur previously present disappeared.     

Efficiency in water quality control for the Wilamette River

The Federal Water Pollution Control Act of 1972, P.L. 92-500, requires tertiary treatment of all effluent by 1983; Oregon State policy focuses on maintaining future effluent discharges at a level no greater than current levels. The Federal and State policies are combined in planning for the future management of the quality of the Willamette River. As a consequence, the Willamette will be clean-too clean- and the economic inefficiency inherent in the water quality control plan will cause misallocation of public resources. This misallocation could be avoided by incorporating economic principles, especially cost comparisons and the consideration of alternative procedures, into the water quality plan.     

Antimicrobial-resistant Salmonella serovars isolated from imported foods

A total of 187 Salmonella isolates representing 82 serotypes recovered from 4072 imported foods in the year 2000 by the U.S. Food and Drug Administration field laboratories were tested for their susceptibility to 17 antimicrobials of human and veterinary importance. Fifteen (8%) isolates were resistant to at least one antimicrobial, and five (2.7%) were resistant to three or more antimicrobials. Most of the isolates (n=9) exhibited resistance to tetracycline. Four isolates from catfish or tilapia from Taiwan or Thailand also demonstrated resistance to nalidixic acid. These nalidixic acid-resistant Salmonella isolates possessed a point mutation at the Ser83 or Asp87 position in DNA gryase, resulting in amino acid substitutions to phenylalanine, tyrosine, or asparagine. One Salmonella Derby isolated from frozen anchovies imported from Cambodia was resistant to six antimicrobials including ampicillin, amoxicillin/clavulanic acid, chloramphenicol, sulfamethoxazole, tetracycline, and trimethoprim/sulfamethoxazole. Of seven isolates displaying resistance to sulfonamides, only one S. Derby and one Salmonella Agona contained class 1 integrons that were further shown to possess the aadA and pse-1 genes conferring resistance to streptomycin and ampicillin, respectively. This study indicates that antimicrobial-resistant Salmonella are present in imported foods, primarily of seafood origin, and stresses the need for continued surveillance of foodborne zoonotic bacterial pathogens from imported foods entering the United States.     

Personality and mortality risk across the life span: The importance of conscientiousness as a biopsychosocial attribute.

Objective: This study addressed whether personality in childhood and personality in adulthood are independent predictors of mortality risk and the extent to which behavioral and other psychosocial factors can explain observed relationships between personality and mortality risk. Design: This was a prospective longitudinal cohort study of 1,253 male and female Californians over 7 decades (1930-2000). Proportional hazards regressions were the principal analyses. Main Outcome Measures: Mortality risk (in the form of relative hazards) was the primary outcome. Additional tests of mediators and moderators ascertained whether associations between personality and mortality risk remained significant when psychosocial and behavioral variables were statistically controlled. Results: The findings, including a new 14-year additional follow-up in old age, revealed that conscientiousness, measured independently in childhood and adulthood, predicted mortality risk across the full life span. The link from childhood remained robust when adult conscientiousness and certain behavioral variables were controlled. Psychosocial and behavioral variables partly explained the adult conscientiousness-longevity association. Conclusion: The findings demonstrate the utility and complexity of modern personality concepts in understanding health and point to conscientiousness as a key underexplored area for future biopsychosocial studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Human brain metabolic response to caffeine and the effects of tolerance

OBJECTIVE: Since there is limited information concerning caffeine's metabolic effects on the human brain, the authors applied a rapid proton echo-planar spectroscopic imaging technique to dynamically measure regional brain metabolic responses to caffeine ingestion. They specifically measured changes in brain lactate due to the combined effects of caffeine's stimulation of glycolysis and reduction of cerebral blood flow. METHOD: Nine heavy caffeine users and nine caffeine-intolerant individuals, who had previously discontinued or substantially curtailed use of caffeinated products because of associated anxiety and discomforting physiological arousal, were studied at baseline and then during 1 hour following ingestion of caffeine citrate (10 mg/kg). To assess state-trait contributions and the effects of caffeine tolerance, five of the caffeine users were restudied after a 1- to 2-month caffeine holiday. RESULTS: The caffeine-intolerant individuals, but not the regular caffeine users, experienced substantial psychological and physiological distress in response to caffeine ingestion. Significant increases in global and regionally specific brain lactate were observed only among the caffeine-intolerant subjects. Reexposure of the regular caffeine users to caffeine after a caffeine holiday resulted in little or no adverse clinical reaction but significant rises in brain lactate which were of a magnitude similar to that observed for the caffeine-intolerant group. CONCLUSIONS: These results provide direct evidence for the loss of caffeine tolerance in the human brain subsequent to caffeine discontinuation and suggest mechanisms for the phenomenon of caffeine intolerance other than its metabolic effects on elevating brain lactate.