Prevention of bleeding after cardiopulmonary bypass with high-dose tranexamic acid. Double-blind, randomized clinical trial

This prospective, double-blind, randomized trial assessed the effectiveness of high-dose tranexamic acid given in the preoperative period on blood loss in patients undergoing cardiopulmonary bypass. One hundred fifty patients scheduled to undergo cardiac operations with cardiopulmonary bypass were randomized into three groups of equal size. The first group received 10 gm of tranexamic acid intravenously over 20 minutes before sternotomy and a placebo infusion over 5 hours. The second group received 10 gm of tranexamic acid over 20 minutes and then another 10 gm infused intravenously over 5 hours. The control group received a placebo bolus and a placebo infusion over 5 hours (0.9% normal saline solution). The blood loss after the operation was measured at 6 hours and 24 hours. The homologous blood and blood products given during and up to 48 hours after operation were recorded. Eighteen percent of the control group patients shed more than 750 ml blood in 6 hours compared with only 2% in both tranexamic acid groups. Patients who shed more than 750 ml blood required 93% more red blood cell transfusions than patients without excessive bleeding. Tranexamic acid (10 gm) given intravenously in the period before cardiopulmonary bypass reduced blood loss over 6 hours by 50% and over 24 hours by 35%. Continued tranexamic acid infusion (10 gm over 5 hours) did not reduce bleeding further. There was no difference in the coagulation profile before operation between patients with and without excessive bleeding. However, coagulation tests done in the postoperative period indicated ongoing fibrinolysis and platelet dysfunction in patients with excessive bleeding.     

Gain characteristics of 1.55-μm high-speed multiple-quantum-welllasers

We describe the important characteristics of high-speed p-doped compressively strained MQW lasers obtained from comprehensive below-threshold DC measurements. Results of gain and differential gain versus wavelength and carrier density are verified by above-threshold resonance measurements. Measurement-derived design curves of gain, differential gain, and linewidth enhancement factor allow device optimization for high speed and low chirp     

Lingual ischemia following tongue entrapment in a glass bottle

A 10-year-old, previously healthy female presented to the emergency department via emergency medical service transport, with her tongue tightly entrapped inside a glass bottle (9 oz, Yoohoo brand of chocolate drink). The tongue was massively edematous and ecchymotic due to impaired venous return from constriction by the neck of the bottle. After repeated attempts at mechanically reducing the tongue out of the bottle, a professional glazier was contacted, who was able to remove the bottle in the operating room with a steel glass cutter. Needle evacuation of a small hematoma was then performed to decrease the pressure ischemia to the tongue, which began to improve quickly.     

Typical intellectual engagement and personality: Reply to Rocklin (1994).

T. Rocklin (see record 1994-29650-001) examined the relations between M. Goff and P. L. Ackerman's (see record 1993-13529-001) measure of typical intellectual engagement (TIE) and a personality test measure of Openness. Rocklin's arguments are examined in the context of 3 themes: philosophical issues, TIE and Openness from a facet perspective, and the bandwidth-fidelity dilemma. Although Rocklin raised important issues about these constructs, it is demonstrated that measures of TIE and Openness, although significantly related, are theoretically and empirically distinguishable. (PsycINFO Database Record (c) 2010 APA, all rights reserved)