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ITEM OB17. Date and Time of Admission to the NICU Note: The date and time of admission to the NICU are protected health care data items. These items will not be exported to the Vermont Oxford Network. They will be stored on your local computer. a. Date of Admission to the NICU mm dd yyyy ; : Enter the date of admission to the NICU as recorded in the maternal or infant medical record. Use the mm dd yyyy format for example 05 07 2006 for May 7, 2006 ; . b. Time of Admission to the NICU hh: mm AM PM ; Enter the time of admission to the NICU as recorded in the maternal or infant medical record. Use or and hh: mm format for example 10: 15 for 10: 15 in the morning ; . ITEM OB18. APGAR Score at 10 Minutes Enter the 10 minute APGAR score if the score was recorded in either the maternal or infant medical record. Enter "Unknown" if the APGAR score at 10 minutes was not recorded in either the maternal or infant medical record. ITEM OB19. Arterial Blood Gas a. Arterial Blood Gas Obtained during First 24 Hours? Select "Yes" if it is documented in the infant record that an arterial blood gas was obtained within 24 hours of birth. Select "No" if it is not documented in the infant record that an arterial blood gas was obtained within 24 hours of birth. Select "Unknown" if the infant record is missing and not available for review, or if it is not known whether an arterial blood gas was obtained. Note: If multiple arterial blood gases were obtained, the lowest pH and worst base deficit values, defined below, may be from different blood gases. b. pH from Arterial Blood Gas. Enter the lowest pH from an arterial blood gas obtained during the first 24 hours after birth. c. Base Deficit from Arterial Blood Gas. Enter the worst base deficit in mmoles liter from an arterial blood gas obtained during the first 24 hours after birth.
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Control treatment was replicated five times. Growth of C. vulgaris was inhibited by all doses in both experiments, but inhibition was 22% greater when the extract was added on day 0. Growth Gleocapsa sp. was slightly inhibited by all doses when the extract was added on day 0, but not when it was added on day 6. No other species were inhibited, regardless of dose or timing of dose. The results of this study and other bioassay studies suggest that differential susceptibility to barley straw among algae is common and may reduce the effectiveness of barley straw as an algal control technique. 61 BIOGEOGRAPHY OF MARINE RED ALGAE: MYTHS AND REALITIES Hommersand, M. H. Department of Biology, Coker Hall, University of North Carolina, Chapel Hill, NC 27599-3280 USA Theories about the geographical distribution of marine algae fall roughly into two categories: 1 ; a concept of biogeographical regions in which algal distribution is determined primarily by growth, reproductive and lethal temp erature boundaries Setchell, van den Hoek, Breeman, Lning ; and 2 ; an historical perspective in which distribution is determined primarily by patterns of dispersal and the establishment of barriers to dispersal vicariance biogeography ; Svedelius, Garbary, Lindstrom, Hommersand ; . Setchell proposed the 5 isotherm rule in 1920, and in 1924 Svedelius advocated a worldwide distribution for tropical and subtropical groups followed by discontinuous distribution upon closure of the connection between the Indian Ocean and Mediterranean Sea and, later, between North and South America Wegener's theory ; . Transarctic dispersal routes have received special attention in recent years Lindstrom, Lning, van Oppen, Olsen, Stam ; , as have special relationships between Australasia, South Africa and South America Hommersand ; . Less well understood are the climatic changes that have taken place in the Cenozoic which are strategic to an understanding vicariant biogeography. The advent of molecular methods combined with the tools of phylogenetic systematics now make it possible to identify ancestral taxa, test the consistency of tree topologies, and calculate mean branch lengths between sister lineages diverging from an interior node of a tree. With such methods it may be possible to infer ancestral areas, identify dispersal pathways, determine the chronology of isolating events, assess the impact of multiple invasions, and generally relate dispersal and vicariance models to phylogenetic hypotheses for red, brown and green a lgal taxa.
As the only drug in its class that is specific to one receptor subtype, Flomax is much more uroselective than Hytrin and Cardura, and physicians prefer the agent because of its much lower associated incidence of postural hypotension. Alfuzosin Uroxatral; Sanofi-Synthelabo Inc., New York, NY ; is a newer alpha-1 blocker that is also not subtype specific. We reviewed the pharmacologic literature to find which alpha-1 receptor subtype mediates contraction of the iris dilator's smooth muscle. Based upon a number of animal studies, it appears that alpha-1A is the predominant receptor subtype in the iris dilator muscle as well.2 Although systemic alpha 1-antagonists differ in their receptor subtype affinities, it is not clear why IFIS was not seen in our patients taking Hytrin and Cardura. Recently, urologists have begun to treat urinary retention symptoms in women with Flomax, 3 and, predictably, anecdotal reports are emerging that these women demonstrate IFIS as well. CLINICAL FEATURES Based upon features common to all of our cases, we defined the IFIS according to a triad of signs: a floppy iris that billows in response to normal irrigation currents in the anterior chamber Figure 2 a marked propensity for the iris to prolapse to the phaco and sideport incisions; and progressive pupillary constriction during surgery Figure 3 ; . Although there are other possible causes of either iris prolapse or intraoperative miosis, it is the combined presence of all three aforementioned features that defines and characterizes the IFIS. The pupil frequently dilates poorly or suboptimally, but this feature was not uniform to all cases in our study. Because mechanical pupillary stretching or partial-thickness sphincterotomies are among the most and ceftin.
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Cash Flow Cash generated from operating activities before exceptional items was $6, 069 million compared with $4, 617 million in 2003. The increase in cash is due to higher profits and minimal working capital outflows of $9 million compared to $1, 101 million in 2003. In 2003 all three components of working capital led to substantial cash outflows whereas in 2004 there were inflows on inventories $129 million ; and creditors $71 million ; offset by an outflow on debtors $209 million ; . The reduction in inventory was due partly to tight operational management and high sales in the second half of 2004 but also in part to the ExantaTM and IressaTM provisions. The increase in creditors was seen mainly in trade creditors. Debtors increased over the year as sales in the fourth quarter, and particularly December, were substantially higher than in the same period in 2003. Cash flow from working capital in the fourth quarter was notably strong due mainly to inventories which, when compared with September 2004, fell for the reasons above and debtors, which also fell because sales in December were lower than in September. Cash expenditure on exceptional items was $8 million compared with $391 million in 2003, which included $355 million settlement in respect of the ZoladexTM investigation. Tax paid was $1, 246 million, which is $360 million higher than last year. This was due to larger tax credits in relation to prior year foreign currency losses arising from inter-company balances and other deductions arising in 2003. Capital expenditure of $1, 296 million is $301 million lower than last year. Proceeds from the sale of the joint venture interest in the Advanta seeds business and the Durascan divestment totalled $355 million compared with $80 million in 2003 from the sale of Marlow Foods. Accordingly, free cash flow being cash flow before returns to shareholders and financing ; for the year was $3, 932 million compared with $1, 899 million in 2003. Share repurchases totalled $2, 212 million and external dividends paid of $1, 378 million were $156 million higher than in 2003. After the $862 million increase in short term investments and $727 million financing inflows which includes $746 million new financing in the form of a US bond, net cash funds have increased by $478 million from the beginning of the year to stand at $3, 974 million at 31 December 2004 and celebrex.
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Telephone records confirmed the relationship between Schenker and Student A. The girl's cell phone records show that she began calling the teacher on April 8, 2004, at 9: 08 p.m. Student A registered 1, 163 minutes in 316 calls to Schenker. Schenker also called Student A's phone 24 times for a total of 416 minutes. Most calls were after school hours or on weekends and the records also revealed that, despite her assertion to the contrary, Student A had contact with the teacher even after the complaint was made against him. Schenker's telephone records showed that he called Student A at her home and on her cell phone during non-school hours, on weekends, and during summer recess. Schenker telephoned Student A 93 times for a total of 527 minutes. The information provided by the students who had no motive to fabricate details and the documentary evidence clearly establish Barry Schenker's inappropriate behavior, including his relationship with Student A. Despite Student A's change of heart regarding her complaint against Schenker, it is likely that she and the teacher were involved sexually as indicated in the disclosure to her guidance counselor and her account to the NYPD. It is the recommendation of this office that Schenker's employment be terminated and that this matter be considered should he apply for any position with the New York City school system in the future. We are sending a copy of this letter and of our report concerning this investigation to the Office of Legal Services. We also are forwarding our findings to the New York State Education Department for whatever action it deems appropriate. Should you have any inquiries regarding the above, please contact First Deputy Commissioner Regina Loughran, the attorney assigned to the case. She can be reached at 212 ; 510-1426. Please notify First Deputy Commissioner Loughran within thirty days of receipt of this letter of what, if any, action has been taken or is contemplated concerning Barry Schenker. Thank you for your attention to this matter. Sincerely, RICHARD J. CONDON Special Commissioner of Investigation for the New York City School District.
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E.g., number of follow-ups, discharge location, amount of supervision, length of hospital stay ; . Stepwise logistic regression was used to determine how sets of predictors could distinguish between suicidal and nonsuicidal patients. Results: Of the 658 cases that were referred for suicidality 13.2% ; , 192 29.2% ; were not confirmed by the psychiatric consultant. Also, of those referred for other reasons, 91 2.1% ; were identified as suicidal by the consultant but not by the consultee. Patients identified as suicidal by the consultants differed in demographics from patients not identified as suicidal by either the consultant or the consultee, by being below age 45 P 0.001 ; , unemployed P 0.001 ; , not presently married P 0.001 ; , not black P 0.006 ; , unskilled P 0.018 ; , less educated P 0.001 ; , and living alone P 0.004 ; . Analyses of the other three domains in Methods ; are in progress. For example, inclusion of problems identified by the consultee improved distinction between the two patient groups. Conclusion: Distinguishing referred patients with suicidal problems will lead to the construction of an algorithm for screening general-hospital inpatients for suicidal risk. DSM-IV would be more complete if it had a provision for the coding of suicidal behavior so this important and potentially fatal symptom would be recorded and researched in the acute-care medical setting. 45. Predictive Characteristics of CL Patients Diagnosed as Substance Abusers: Development of a Screening Tool at the Bedside J.J. Strain, MD, FAPM; S. Gilman, MD; A.M. Cartagena, MA; K. Kelliher, MA; J. Schmeidler, PhD ntroduction: Our inability to differentiate the medically surgically ill patients who have polysubstance abuse disorders PSUD ; near admission or in their inpatient acute hospitalization stage, has impeded early identification, evaluation, diagnosis, and establishment of referral for treatment. This report characterizes the demographic variables, reasons for referral, interventions, and hospital process variables for this important group of psychiatric disorders. It is the intent, from examining large CL databases in multiple institutional settings, to understand the nature of this cohort sufficiently enough to develop an algorithm, based on significant odds ratios, that would reveal important early predictors. Method: All 4, 999 inpatient psychiatric referrals from 1988 through December 1997 were evaluated, and the findings recorded on the MICROCARES computerized database system, by psychiatric consultants and reviewed by senior CL attendings. Data were and clonazepam.
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Immunotherapy The rationale of immunotherapy for cancer is based on observations that immune factors called T-cells attack specific molecular targets known as antigens, foreign substances that the immune system identifies and attacks. One tactic employs genetically designed vaccines that inject factors in prostate cancer cells to serve as antigens so that the immune system is tricked into attacking the real cancer cells. Some vaccines have had modest effects in reducing PSA levels in a few patients. Another study used prostate cancer cells from patients that were then treated with radiation. After the cells were reintroduced into patients, they triggered a widespread immune response against the cancer. Other immune factors are being tested are monoclonal antibodies, immune factors that are genetically designed to target specific prostate cancer cells. Bisphosphonates Bisphosphonates are proving to be very helpful for reducing bone pain in metastasized cancers. These drugs actually help reduce cancer spread in breast cancer patients, although it is not clear whether they have the same benefits for prostate cancer patients. ; Other Investigative Agents A number of non-hormonal drugs are under investigation. COX-2 Inhibitors. COX-2 is a protein that appears to cause prostate cancer cell growth. Animal studies are suggesting that agents that suppress COX-2, including experimental agents as well as aspirin and similar so-called NSAIDs, should be tested for treating prostate cancer. Vitamin-Derived Treatments. Some studies are reporting that vitamin-D derived agents, such as calcitriol, may eventually be beneficial for prostate cancer patients. Liarozole blocks the break down of retinoid acid a vitamin A derivative important in maintaining normal cell growth and structure ; and is showing promise for reducing PSA levels and improving symptoms in early trials. Angiogenesis Inhibitors. Thalidomide, linomide Roquinimex ; , and AE-941 Neovastat ; are three investigative agents that inhibit angiogenesis, the formation of new blood vessels that are critical for spreading cancer. These agents literally turn off the cancer's life blood. They appear to have very few side effects, although thalidomide was notorious in the 1950s for causing birth defects in women. Matrix Metalloproteinases Inhibitors. Drugs are being tested in clinical trials that inhibit matrix metalloproteinases, which are enzymes that may degrade cell structure allowing cancers to grow and metastasize. Doxazosin. Doxazosin Carduea ; , a drug commonly used to treat benign prostatic hyperplasia, has been shown to kill prostate cancer cells in lab experiments. The effects are amplified when doxazosin is combined with adriamycin or etoposide, chemotherapy drugs. More research is needed to determine if this effect has significance fpr patients. Herbal Based Agents. An extract from eight Chinese herbs referred to as PC-SPES is showing promise in reducing PSA levels by up to 80% in some men. Side effects include breast swelling, leg cramps, nausea and vomiting, and blood clots due to the estrogenic activity of these herbs.
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Were used. ELISA kits from Immunotech Marseille, France ; were used for four patients. The upper limit for the TNF- serum concentration as measured using these kits in healthy subjects was 15 pg ml. The upper limit for IL-1 was 5 pg ml, and for IL-6 it was 10 pg ml. ELISA kits from R&D Systems Minneapolis, MN ; were used for the last patient. TNF- , IL-1 , and IL-6 were undetectable in healthy subjects using these kits. Measurement of VEGF. Levels of VEGF were determined in serum samples n 3 ; or plasma samples n 2 ; , using ELISA kits from R&D Systems. The normal concentration of VEGF as measured by these kits in healthy subject serum was 224 pg ml range, 62 to 707 ; , and VEGF was undetectable in plasma from most healthy subjects range, 0 to 115 ; . Levels of proinflammatory cytokines and VEGF were compared with those found in 11 patients with POEMS syndrome who had no evidence of PH by echocardiography. Concentrations are expressed as the median value. Statistical analysis was performed using the MannWhitney U test. A p value less than 0.05 was considered significant.
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Intravenous fluids or vasopressor therapy may be used. A transient hypoteosive response is not a contraindication In turther doses ol CAR DURA. 2. ImpaIred liver function: CARDURA should be administered with caution to patients with evidence ot Impaired hepatic tunction onto patients receiving drugs lsnowrsto influence hepetic metabolism. There Is no controlled clinIcal enperience with CARDURA In patients with those conditions. 3. Leukopenla Neutropenia: Analysis at hematologlc data from patients receiving CARDURA in controlled clInIcal trials showed that the mean WBC IN 474 ; and mean neutrophil counts N 419 ; were decreased by 2.4% and 1.0% respectively, compared to placebo, a phenomenon seen with other.
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Human hair growth is cyclic, with each follicle producing many distinct hairs during a lifetime. There are approximately 5 million hair follicles on the body, of which, on average, only 100, 000 are on the scalp. There is some variation in the number of scalp follicles, ranging from about 70, 000 to 150, 000 for brunettes, with blondes having 10% more and redheads 10% less.1 Most of the follicles on the body produce vellus hairs that are cosmetically insignificant, and many do not even protrude from the skin's surface. Hair follicles develop as epidermal down growths that invaginate the dermis and subcutaneous fat and enclose at their base a small stud of highly specialized dermis known as the dermal papilla. Follicles exist as pilosebaceous units that also give rise to the sebaceous glands, arrector pili muscles, and, in certain areas, apocrine glands. The hair growth rate is relatively constant at about 1 cm mo, and hairs appear on the skin's surface in groups of three, known as Meijeres trio group. The hair follicles first form on the eyebrow, upper lip, and chin at between 9 and 12 weeks gestation, and at birth the full complement of hair follicles is present. Hair follicle formation occurs in a frontal to occipital wave on the scalp and a cephalocaudal wave on the body, reaching the feet at about 22 weeks. The first hair grows from the follicle between weeks 16 and 22. The hair grows for about 10 12 weeks to a length of 23 cm and covers the entire body from head to toe. These fine and nonpigmented hairs are known as lanugo hairs. The growth then terminates in similar frontooccipital and cephalocaudal waves, with the follicles entering telogen via the involutional catagen phase. Telogen terminates with the development of the second hair bud forming at the base of the bulb. New anagen hair growth results in the commencement of shedding of the first coat of hair between weeks 32 and 36. At full term, there are two consecutive waves of hair on the scalp, each of which is running from the forehead to the.
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