https://www.annalsthoracicsurgery.org/article/0003-4975(89)90381-0/pdf

Apparent coagulopathy caused by infusion of shed mediastinal blood and its prevention by washing of the infusate

Intraoperative blood salvage: medical controversies.

Self-efficacy is one’s perceived confidence to perform a specific behaviour. Self-efficacy theory is briefly outlined and applications of self-efficacy theory in research on exercise, diet, alcohol use, smoking, and illicit drug use are reviewed. These represent a selection of behaviours that need to be initiated or maintained (diet, exercise). controlled (alcohol use, diet) or avoided (smoking, illicit drug use) to promote or maintain health. To date most research has investigated individual health behaviours in isolation from others and it is suggested that the role of self-efficacy in changing or maintaining multiple health behaviours needs to be further investigated. The assessment of self-efficacy is discussed and the relationship between self-efficacy and other social psychological models is examined. Some constraints on self-efficacy theory in relation to health behaviours are considered. Available research evidence suggests that self-efficacy is a fundamental variable in understanding and predicti...

Self-efficacy and health behaviour: A review

Pleural complications in the intensive care unit.

Acute coagulopathy in pregnancy.

The coagulation system was investigated in five dogs undergoing autotransfusion from experimental hemothorax. One fourth of the blood volume was bled into the pleural space, drained, and autotransfused. The hemothorax blood showed: very prolonged PT and PTT; very low platelets and fibrinogen; midly elevated FDP; very low coagulation factors VIII, and V; reduced XII, prothrombin, X, XI, and VII. Partial clotting, mild fibrinolysis, and fibrin deposition over the pulmonary pleura seemed to cause incoagulability of hemothorax blood. Post autotransfusion arterial blood showed: normal PT and PTT; 25% decrease in platelets, and 31% decrease in fibrinogen from baseline values. There was also an overall 20% reduction of fibrinogen from baseline values. There was also an overall 20% reduction of all clotting factors, but their levels remained above 50% activity. It was concluded that autotransfusion from a hemothorax of 25% the blood volume in dogs causes a mild loss of hemostatic components, but does not significantly compromise the clotting mechanism.

Autotransfusion from experimental hemothorax: levels of coagulation factors.

The authors assessed the diagnostic value of the plasma anti-thrombin III (AT III) assay in 112 adult hospitalized patients with abnormal hemostatic parameters, using the Protopath procedure. In 100 patients tested only once, low AT III was observed in 25 of 29 cases of acute disseminated intravascular coagulation (DIC); 7 of 10 with infections; 8 of 11 with acute liver disease; 19 of 20 with chronic liver disease; and 16 of 30 with other illnesses. The authors conclude that the assay cannot distinguish among disease categories, although it is a sensitive index of DIC. AT III was also repeatedly measured at various time intervals in 12 additional patients. The results suggest enhancement of the diagnostic and prognostic value of the assay with serial testing.

Fluorometric Assay of Antithrombin III: Diagnostic Value in 112 Patients with Abnormal Hemostasis

To the Editor.— Dr Pate1pointed out that the "continuing debate in regard to the magnitude of risks to health care workers involved in treating patients with acquired immunodeficiency syndrome frequently generates dogmatic opinions unsupported by fact." The same can be said for some human immunnodeficiency virus-releated govenmental regulations that are directed at phlebotomists. The major risk for transmission of blood-borne infections during blooddrawing procedures is due to needle sticks, which glove use cannot prevent.2,3Despite this, proposed Occupational Safety and Health Aministration guidelines require gloves for all phlebotomists for all procedures whereexposure to blood is possible.4This proposal ignores recommendations from the Centers for Disease Control that skilled phlebotomists be given the choice of whether or not to wear gloves.5Phlebotomy rarely involves worker contact with body fluids, except when the employee is inexperienced or has sores or dermatologic conditions of the hands; in

Needle Sticks in Phlebotomists: Too Much Ado About a Rare Event

A rib injury in an athlete may not always require several weeks of enforced rest, as may be seen in the present case report of an elite‐level distance runner who fell onto his chest while cycling. Essential primary treatment is to determine accurately the presence or absence of any underlying injury such as pneumothorax. If such injury is absent, aggressive initial rehabilitative therapy and appropriate medication, followed by a steady transition back to normal training as comfort permits, can safely minimize loss of physical fitness and competitive down time. Because the athlete described here had been part of a long‐term cardiopulmonary fitness monitoring program, additional physiological and physical data, collected during an 8‐year period, provided a unique opportunity to understand better the effect of temporary debilitation from both a clinical and athletic perspective.

David H. Vroon

Papers

Autotransfusion from experimental hemothorax: levels of coagulation factors.

Fluorometric Assay of Antithrombin III: Diagnostic Value in 112 Patients with Abnormal Hemostasis

Needle Sticks in Phlebotomists: Too Much Ado About a Rare Event

Effects of rib injury on race performance in an elite endurance athlete: Rehabilitation can minimize loss of fitness