With doctors experiencing no more than a modest effect on their work lives, open notes seem worthy of widespread adoption.”
“Object. Follow-up head CT scans are important in neurocritical Selleckchem Nepicastat care but involve intrahospital transport that may be associated with potential hazards including a deleterious effect on brain tissue oxygen pressure (PbtO(2)). Portable head CT (pHCT) scans offer an alternative imaging technique without a need for patient transport. In this study, the investigators examined the effects of pHCT scans on intracranial pressure (ICP),

cerebral perfusion pressure (CPP), and PbtO(2) in patients with severe brain injury.\n\nMethods. Fifty-seven pHCT scans were obtained in 34 patients (mean age of 42 15 years) who underwent continuous ICP, CPP, and PbtO(2) monitoring in the neuro intensive care

unit at a university-based Level 1 trauma center. Patient ICU records were retrospectively reviewed and physiological data obtained during the 3 hours before Luminespib in vitro and after pHCT scans were examined.\n\nResults. Before pHCT, the mean ICP and CPP were 14.3 +/- 7.4 and 78.9 +/- 20.2 mm Hg, respectively. Portable HCT had little effect on ICP (mean ICP 14.1 +/- 6.6 Mill Hg, p = 0.84) and CPP (mean CPP 81.0 +/- 19.8 mm Hg, p = 0.59). The mean PbtO(2) was similar before and after pHCT (33.2 +/- 17.0 mm Hg and 31.6 +/- 15.9 mm Hg, respectively; p = 0.6). Ten episodes of brain hypoxia (PbtO(2) < 15 mm Hg) were observed before pHCT; these episodes prompted scans. Brain hypoxia persisted in 5 patients after pHCT despite treatment. No new episodes of brain hypoxia were observed during or after pHCT.\n\nConclusions. These data suggest that pHCT scans do not have a detectable effect on a critically ill patient’s ICP, CPP, or PbtO(2). (DOI: 10.3171/2010.11.JNS091148)”
“Background.

Fully human leukocyte antigens (HLA)-mismatched liver grafts are well accepted, but the HLA influence on acceptance or rejection is unclear and much less so the impact of HLA-C, which may be conditioned by the fact that HLA-C-encode molecules are the major ligands for killer cell immunoglobulin-like receptors (KIR).\n\nMethods. The HLA-C allele compatibility and the effect of donor and recipient HLA-C genotype check details on early liver graft acceptance and on CD8+KIR+ T-cells recuperation were analyzed in a series of 431 primary liver transplants. Standard polymerase chain reaction PCR-SSO was used for HLA-C typing and flow cytometry to identify T cells KIR positives. Transplants were classified into two groups: acute rejection and nonacute rejection, and individual HLA-C genotypes as C1/C1, C2/C2, and C1/C2.\n\nResults. A favorable effect of HLA-C allelic compatibility on early liver graft acceptance was found because acute rejection significantly increased in transplants performed with 2 HLA-C allele mismatches (P=0.02).