Relevant bibliographies by topics / Blood air

Academic literature on the topic 'Blood air'

Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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Journal articles on the topic "Blood air"

1

Chute, John P. "Tet2 helps blood cells balance in air." Blood 140, no. 11 (September 15, 2022): 1186–87. http://dx.doi.org/10.1182/blood.2022017532.

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Wong, John. "Blood substitutes are gasping for air." Nature Medicine 3, no. 1 (January 1997): 10. http://dx.doi.org/10.1038/nm0197-10.

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Seaton, A., A. Soutar, V. Crawford, R. Elton, S. McNerlan, J. Cherrie, M. Watt, R. Agius, and R. Stout. "Particulate air pollution and the blood." Thorax 54, no. 11 (November 1, 1999): 1027–32. http://dx.doi.org/10.1136/thx.54.11.1027.

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Manley, Kate, Aman Coonar, Frank Wells, and Marco Scarci. "Blood patch for persistent air leak." Current Opinion in Pulmonary Medicine 18, no. 4 (July 2012): 333–38. http://dx.doi.org/10.1097/mcp.0b013e32835358ca.

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Kiessling, Arndt-H., Mahmud Khalil, Ohmed Assaf, Frank Isgro, Kai-U. Kretz, and Werner Saggau. "Blood-Air Interface during Cardiopulmonary Bypass." Asian Cardiovascular and Thoracic Annals 12, no. 3 (September 2004): 198–201. http://dx.doi.org/10.1177/021849230401200304.

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Kumawat, Vijay, and Anil Aribandi. "Air Bubbles Produced During Rapid Blood Warming with Inline Blood Warmer Leading to Panic of Air Embolism." Indian Journal of Hematology and Blood Transfusion 33, no. 2 (November 3, 2016): 281–82. http://dx.doi.org/10.1007/s12288-016-0741-4.

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Harrison, Greg J. "Infiltration of Blood Vessels into Air Sacs." AAV Today 2, no. 2 (1988): 99. http://dx.doi.org/10.2307/30134423.

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Linn, William S., and Henry Gong. "AIR POLLUTION, WEATHER STRESS, AND BLOOD PRESSURE." American Journal of Public Health 91, no. 9 (September 2001): 1345—b—1346. http://dx.doi.org/10.2105/ajph.91.9.1345-b.

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9

Athanassiadi, K., E. Bagaev, and A. Haverich. "Autologous Blood Pleurodesis for Persistent Air Leak." Thoracic and Cardiovascular Surgeon 57, no. 08 (December 2009): 476–79. http://dx.doi.org/10.1055/s-0029-1185913.

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Baumgartner, Jill, Yuanxun Zhang, James J. Schauer, Majid Ezzati, Jonathan A. Patz, and Leonelo E. Bautista. "Household Air Pollution and Childrenʼs Blood Pressure." Epidemiology 23, no. 4 (July 2012): 641–42. http://dx.doi.org/10.1097/ede.0b013e3182593fa9.

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Dissertations / Theses on the topic "Blood air"

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Foraster, Pulido Maria 1984. "Noise and air pollution from road traffic : understanding their role in blood pressure." Doctoral thesis, Universitat Pompeu Fabra, 2013. http://hdl.handle.net/10803/283470.

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Epidemiological evidence is limited regarding the effects of long-term exposure to traffic-related air pollution and to traffic noise on blood pressure (BP). This thesis aims at (a) assessing the long-term co-exposure to traffic-related air pollution and traffic noise and (b) evaluating and disentangling the associations of each of these trafficrelated environmental factors on hypertension, systolic and diastolic BP in the adult population of Girona city (Catalonia, Spain). We studied the spatial correlation between annual average levels of measured nitrogen dioxide (NO2) and modeled traffic noise levels (L24h and Lnight) at 83 outdoor residential locations in Girona city. We used data from the baseline examination (years 2003-2006) of a population-based cohort corresponding to 3836 participants aged 35-84. We assigned outdoor annual average levels of NO2 and traffic noise at the participants’ postal addresses with a land-use regression model and a traffic noise model, respectively. Indoor traffic Lnight levels at the bedrooms were estimated based on the noise protection elements at home. The correlation between NO2 and traffic noise was high and city area-dependent. NO2 and indoor traffic noise showed consistent and independent associations with both BP and hypertension. In contrast, the associations for NO2 could not be disentangled from those for outdoor traffic noise. We also identified potential susceptibility groups. This thesis adds to the limited evidence showing that long-term exposure to trafficrelated air pollution and to traffic noise are associated (and independently) with both BP and hypertension. Further studies are required to confirm these results.
L’evidència epidemiològica és limitada en relació als efectes de l’exposició prolongada a la contaminació atmosfèrica i al soroll provinents del trànsit amb la pressió arterial (PA). Aquesta tesi té com a objectiu (a) explorar l’exposició conjunta a la contaminació atmosfèrica i al soroll del trànsit a llarg termini i (b) avaluar i separar les associacions de cadascun d’aquests dos factors ambientals amb la hipertensió i la pressió sistòlica i diastòlica a la població adulta de la ciutat mediterrània de Girona (Catalunya, Espanya). Vam estudiar la correlació espacial entre els nivells anuals mitjans de diòxid de nitrogen (NO2) mesurat i del soroll de trànsit modelitzat (L24h and Lnit) a l’exterior de 83 localitzacions residencials. Vam utilitzar les dades de l’exploració basal (anys 2003- 2006) d’una cohort poblacional corresponents a 3836 participants de 35 a 84 anys. Vam assignar els nivells mitjans anuals exteriors de NO2 i de soroll de trànsit a les adreces postals residencials de cada participant amb un model de regressió de l’ús del sòl i un model de soroll de trànsit, respectivament. Els nivells interiors de Lnit de trànsit als dormitoris es van derivar en base a les proteccions contra el soroll a casa. La correlació entre l’NO2 i el soroll del trànsit era elevada i depenia de l’àrea de la ciutat. Ambdós l’NO2 i el soroll del trànsit s’associaven consistent i independentment amb la hipertensió i la PA. En canvi, les associacions per l’NO2 no es podien deslligar de les del soroll de trànsit exterior. També vam identificar factors de susceptibilitat potencials. Aquesta tesi incrementa l’evidència escassa sobre que l’exposició prolongada a la contaminació atmosfèrica i al soroll del trànsit s’associen, i independentment, tant amb la PA com amb la hipertensió. Es requereixen més estudis per confirmar aquests resultats.
La evidencia epidemiológica es limitada en relación a los efectos de la exposición prolongada a la contaminación atmosférica y al ruido procedentes del tráfico con la presión arterial (PA). Esta tesis tiene como objetivo (a) explorar la exposición conjunta a la contaminación atmosférica y al ruido del tráfico a largo plazo y (b) evaluar y separar las asociaciones de cada uno de estos dos factores ambientales con la hipertensión y la presión sistólica y diastólica en la población adulta de la ciudad mediterránea de Girona (Cataluña, España). Estudiamos la correlación espacial entre los niveles anuales medios de dióxido de nitrógeno (NO2) medido y de ruido de tráfico modelizado (L24h and Lnoche) en el exterior de 83 localizaciones residenciales. Utilizamos los datos de la exploración basal (años 2003-2006) de una cohorte poblacional correspondientes a 3836 participantes de 35 a 84 años. Asignamos los niveles medios anuales exteriores de NO2 y de ruido de tráfico a las direcciones postales residenciales de cada participante con un modelo de regresión del uso del suelo y un modelo de ruido de tráfico, respectivamente. Los niveles interiores de Lnoche de tráfico en los dormitorios se derivaron en base a las protecciones contra el ruido en casa. La correlación entre el NO2 y el ruido del tráfico era elevada y dependía del área de la ciudad. Ambos el NO2 y el ruido del tráfico se asociaban consistente e independientemente con la hipertensión y la PA. En cambio, las asociaciones para el NO2 no se podían desenredar de las del ruido de tráfico exterior. También identificamos factores de susceptibilidad potenciales. Esta tesis incrementa la evidencia escasa sobre que la exposición prolongada a la contaminación atmosférica y al ruido del tráfico se asocian, e independientemente, tanto con la PA como con la hipertensión. Se requieren más estudios para confirmar estos resultados.
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Hilliard, Michael Wayne. "Measuring Tibial Artery Blood Flow Following a Moderate Fire and Air Vacuum Cupping Treatment." Thesis, North Dakota State University, 2018. https://hdl.handle.net/10365/28782.

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Cupping therapy has become a popular method of alternative medicine. However, no quantitative measures on the effects of cupping therapy on blood flow and skin temperature have been examined. The purpose of this study was to determine the effects cupping therapy on skin temperature and blood flow of the tibial artery. A pre and posttest experimental design was used. Twenty healthy males (20.70 ? 2.83 years) participated. Blood flow and skin temperatures were measured prior to and following a cupping protocol. Blood flow from fire cupping decreased an average of -3%. The skin temperatures during fire cupping increased 0.14?C ? 0.30?C. Blood flow from air vacuum cupping increased an average of 5%. The skin temperatures during air vacuum cupping did not change. The results suggest that there is insufficient evidence for the use of cupping therapy for increasing blood flow and skin temperature.
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Curto, Tirado Ariadna 1987. "Exposure to air pollution and links with cardiometabolic health in low- and middle-income countries." Doctoral thesis, Universitat Pompeu Fabra, 2019. http://hdl.handle.net/10803/666202.

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The aims of this thesis are: 1) to evaluate the performance of low-cost air quality monitors to monitor long-term exposure in rural areas from low- and middle-income countries; 2) to identify the determinants of personal air pollution exposure among women from a semi-rural area in Mozambique; and 3) to evaluate the associations between long-term exposure to ambient air pollution and cardiometabolic health in adults from a peri-urban area in India. We used data from: an experimental study, an observational study, and a cross-sectional epidemiologic study (CHAI). Main results: 1) the performance of low-cost monitors is not reliable yet to replace more expensive research-grade monitors; 2) kerosene-based lighting increased personal air pollution exposure in women from Mozambique; 3) long-term air pollution is associated with elevated blood pressure in women from India; and 4) we found no evidence that long-term air pollution is associated with higher blood glucose levels in peri-urban India.
Els objectius d’aquesta tesi són: 1) avaluar el rendiment dels monitors de qualitat de l’aire de baix cost per monitoritzar l’exposició a llarg termini en àrees rurals en països de renda baixa o mitjana; 2) identificar els determinants de l’exposició personal a la contaminació de l’aire en dones d’una àrea semi-rural de Moçambic; i 3) avaluar les associacions a llarg termini entre l’exposició ambiental a la contaminació de l’aire i la salut cardiometabòlica en adults d’una àrea peri-urbana de la Índia. Hem utilitzat dades provinents de: un estudi experimental, un estudi observacional i un estudi epidemiològic transversal (CHAI). Resultats principals: 1) el rendiment de monitors de baix cost encara no és prou fiable per reemplaçar a monitors més cars i establerts en recerca; 2) la il·luminació amb querosè va incrementar l’exposició personal a la contaminació de l‘aire en dones de Moçambic; 3) l’exposició a llarg termini de la contaminació de l’aire està associada a una major pressió arterial en dones de la Índia; i 4) no hem trobat evidència que la exposició a la contaminació de l’aire estigui associada a nivells més alts de glucosa en sang a la Índia peri-urbana.
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Sandin, Emma. "Optimization of the In vitro Pyrogen Test (IPT) Regarding Detection of Pyrogens in Air Samples." Thesis, Linköpings universitet, Institutionen för fysik, kemi och biologi, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-54297.

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Pyrogens are substances that may induce fever in the human body. They can be parts of bacteria, virus or fungi and due to the reaction they may cause in the body, they are routinely looked for in the medical technology industries. A method called in vitro pyrogen test (IPT) has been developed to detect these pyrogens. It is based on the fever reaction in the human body and only requires blood in combination with a solution believed to contain pyrogens. If the result is positive, the production of cytokines is started. The cytokines of interest in the IPT method are those involved in the fever process and two of them are IL-1β and TNF-α, which are the cytokines used as markers of infection in this study. Since the production of cytokines is in proportion to the amount of pyrogens, the inflammation-inducing potential of the sample can be decided. Due to problems in standardizing the method, mainly because it handles with living blood cells, focus is still pointed at improving it. The aim of this study was to optimize parameters within the IPT method by analysing air samples taken in indoor surroundings believed to contain pyrogens. The different parameters included extraction of the filter from the air sampling, incubation of whole blood and sample extract and analysis of the incubation with ELISA (enzyme linked immunosorbent assay). More specific, some of the issues concerned extraction media, time and shaking intensity for the extraction, blood ratio for the whole blood incubation and cytokines suitable for the method. A possible approach for the IPT method, when analysing air samples containing pyrogens, was reached.
Pyrogener kallas ämnen som framkallar feber och de kan exempelvis bestå av hela eller delar av bakterier, virus eller svamp (fungi). En metod som kallas för in vitro pyrogen test (IPT) har utvecklats för att detektera dessa pyrogener. Metoden bygger på att en lösning som misstänks innehålla pyrogener får komma i kontakt med blod från en människa. Efter en inkubering på mellan 4-24 timmar har blodet reagerat på eventuella pyrogener och bildat cytokiner, där mängden cytokiner är proportionell mot mängden pyrogener. De intressanta cytokinerna i den här studien var IL-1β och TNF-α, som båda är involverade i feberprocessen. Det har varit svårigheter med att standardisera metoden, mycket beroende på att det är levande celler som hela metoden bygger på, så syftet med den här studien var att förbättra in vitro pyrogen test. Luftprover tagna i inomhusmiljöer som misstänks innehålla pyrogener har använts i försöken att optimera varje steg i processen. De olika stegen inkluderade extraktion av filter som använts vid luftprovtagningen, inkubering med helblod och provextrakt och analys av inkuberingen med ELISA (enzyme linked immunosorbent assay). Några av de parametrar som undersöktes gällde extraktionsmedium, skaktid och skakintensitet under extraktionen, blodförhållande under helblodsinkuberingen och lämpliga cytokiner för metoden. Studien resulterade i att en metodik, för att analysera luftprov innehållande pyrogener med in vitro pyrogen test, kunde tas fram.
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Margolis, Helene Genevieve. "Short-term fluctuations in community air pollution and changes in blood biomarkers and cardiovascular function in an elderly cohort /." For electronic version search Digital dissertations database. Restricted to UC campuses. Access is free to UC campus dissertations, 2003. http://uclibs.org/PID/11984.

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Kubesch, Nadine Janet. "Health effects of traffic-related air pollution and physical activity: A real-world exposure experimental study." Doctoral thesis, Universitat Pompeu Fabra, 2015. http://hdl.handle.net/10803/482053.

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Exposure to traffic-related air pollution (TRAP) has been associated with adverse health outcomes. Physical activity (PA) in polluted air may increase pollutant uptake and hence affect health. The main aim of this thesis is to determine the short-term health effects of TRAP in healthy participants and any possible modifying effect of PA. A crossover real-world exposure study was conducted which compared in 28 healthy participants lung, systemic, and blood pressure responses to four different exposure scenarios: two hours of exposure in a high and low TRAP environment, each at rest and in combination with intermittent moderate PA, that comprised alternating 15-minute rest and cycling intervals. The data was analysed by using mixed effect models for repeated measures. High levels of TRAP induced airway and systemic inflammatory responses, as well as increased blood pressure. Physical activity improved lung function and attenuated the blood pressure increase. Physical activity in high levels of TRAP also induced lung and systemic inflammation, and decreased the circulating levels of the brain-derived neurotrophic factor (BDNF). The short-term exposure to TRAP is associated with adverse health effects. Physical activity has beneficial effects on health, even when performed in high levels of TRAP. The clinical meaning of the decreases in BDNF as a response to the intermitted physical activity in the experimental setting and the more habitual physical activity in daily life remains unclear. This study also suggests that the health effects of traffic-related air pollution and physical activity are predominantly independent in high levels of TRAP.
L'exposició a la contaminació de l'aire relacionada amb el tràfic (CART) s'ha associate amb resultats adversos per a la salut. L'activitat física (AF) realitzada en ambients amb aire contaminat pot augmentar l'absorció de contaminants i amb això produir efectes en la salut. L'objectiu principal d'aquesta tesi va ser determinar els efectes en la salut de l’exposició a la CART a curt termini en participants sans així com qualsevol possible efecte modificador de l’AF. S’ha realitzat un estudi en disseny del creuament amb exposició del “món real” comparant en 28 participants sans les respostes pulmonars, sistèmics i de la pressió arterial en quatre escenaris diferents d'exposició: 2 hores d’exposició en un entorn d'alta i baixa CART, cadascun en repòs i en combinació amb AF moderada i intermitent, que consta de quatre intervals de 15 minuts de descans i ciclisme. Les dades es van analitzar utilitzant models d'efectes mixtes per a mesures repetides. Els nivells alts de CART van induïr una resposta inflamatòria sistèmica i de la via aèria, i un augment de la pressió arterial. L’AF va millorar la funció pulmonar i va atenuar l’augment de la pressió arterial. L’AF en alts nivells de CART també va induïr una inflamació pulmonar i sistèmica y una disminució dels nivells circulants del factor neurotròfic derivat del cervell (FNDC)1. L'exposició a curt termini a CART s'associa amb efectes adversos per a la salut. L’AF té efectes beneficiosos sobre la salut, encara quan es realitza en alts nivells de CART. El significat clínic de les disminucions en el FNDC com a resposta a l’AF intermitent en l'entorn experimental i l’AF més habitual de la vida quotidiana segueix essent poc clara. Aquest estudi també suggereix que els efectes sobre la salut de la CART i l’AF són predominantment independents dels nivells alts de CART. 1 també conegut com “BDNF”, de l'anglès “Brain-derived Neurotrophic Factor”.
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Åberg, Anna-Maja. "Carbon monoxide in biological systems : An experimental and clinical study." Doctoral thesis, Umeå universitet, Kirurgisk och perioperativ vetenskap, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1427.

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Background: Carbon monoxide (CO) is a toxic gas, but it is also produced endogenously when haem is degraded. When produced in vivo, CO is believed to have positive biological effects. For example it activates the production of cyclic guanosine mono-phosphate and causes vasodilatation. CO is also believed to have anti-inflammatory properties by binding to Mitogen activated protein (MAP) kinase. Several studies in cells, mice and rats support this opinion regarding both the circulatory as well as the anti-inflammatory properties. However, studies in larger animals regarding circulatory effects have demonstrated contradictory results. The only study in humans regarding anti-inflammatory properties of CO could not demonstrate such effects. Methods: This thesis consists of four different models. In paper I a method for analysis of CO in blood was developed using gas chromatography. In paper II a porcine model was used to investigate the elimination time for CO. The pigs in paper II had a high concentration of CO administered via blood, and CO concentrations were followed over time and kinetically parameters calculated. Circulatory parameters were also measured to evaluate if there were any circulatory changes after CO administration. In paper III CO´s anti-inflammatory properties were investigated in an endotoxin-induced systemic inflammatory model in pigs. Paper III was a randomized study where one group inhaled CO and the other group served as controls. Plasma cytokine concentrations were measured and followed over time as an indication of the inflammatory state. In paper IV, CO concentrations in blood from blood donors at the Blood Centre in Umeå were investigated. The blood donors also completed a questionnaire about age, smoking history and other possible sources for exogenous contamination of CO in the blood. Results and conclusions: In paper I we developed a method suitable for analysis of low concentrations of CO in blood. The half-life of CO at levels of 250 µM in pigs was found to be 60 minutes. CO did not show anti-inflammatory effects after an endotoxin-induced systemic inflammation in pigs. In banked blood CO was present at concentrations up to six times higher than normal concentrations. This could be a risk when transfusing such blood to susceptible patients.
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Kouremenos, Konstantinos A., Mikael Johansson, and Philip J. Marriott. "Advances in gas chromatographic methods for the identification of biomarkers in cancer." Umeå universitet, Institutionen för molekylärbiologi (Medicinska fakulteten), 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-61275.

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Screening complex biological specimens such as exhaled air, tissue, blood and urine to identify biomarkers in different forms of cancer has become increasingly popular over the last decade, mainly due to new instruments and improved bioinformatics. However, despite some progress, the identification of biomarkers has shown to be a difficult task with few new biomarkers (excluding recent genetic markers) being considered for introduction to clinical analysis. This review describes recent advances in gas chromatographic methods for the identification of biomarkers in the detection, diagnosis and treatment of cancer. It presents a general overview of cancer metabolism, the current biomarkers used for cancer diagnosis and treatment, a background to metabolic changes in tumors, an overview of current GC methods, and collectively presents the scope and outlook of GC methods in oncology.
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Suwannasual, Usa. "Investigating the Mechanisms involved in Traffic-Generated Air Pollution–Mediated Disruption of the Blood-Brain Barrier in a Wild Type Mouse Model using a Pharmaceutical Intervention Approach." Thesis, University of North Texas, 2020. https://digital.library.unt.edu/ark:/67531/metadc1707379/.

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This study investigated whether oxLDL and/or angiotensin (Ang) II signaling pathways mediate traffic-generated air pollution- exposure induced alterations in blood-brain barrier (BBB) integrity and permeability in a healthy wild type (C57Bl/6) mouse model; additionally, whether these outcomes are exacerbated by a high fat-diet investigated. An environmentally relevant concentration of a mixture of vehicle engine exhaust (MVE) was used. To investigate the hypotheses, 12 wk old male C57Bl/6 mice on either a high fat (HF) or low fat (LF) diet were randomly assigned to inhalational exposure of either filtered-air (FA) or 30 µg PM/m3 diesel exhaust + 70 µg PM/m3 gasoline exhaust (MVE) for 6 hr/day for 30 days. Additionally, we examined mechanisms involved in MVE-mediated alterations BBB integrity using a novel BBB co-culture in vitro model, consisting of mouse primary cerebral vascular endothelial cells on an apical transwell and astrocytes in the basal compartment, which was treated with plasma from the mice on our exposure study. Our in vivo exposure study results showed that MVE inhalation resulted in increased circulating plasma oxLDL and Ang II, compared to FA controls. Additionally, we observed increased cerebral microvascular expression of oxLDL receptors, LOX-1 and CD-36, and Ang II receptor subtype 1 (AT1) in MVE-exposed C57Bl/6 mice, which was further exacerbated with consumption of an HF diet. Increased signaling of both Ang II and oxLDL was associated with decreased BBB integrity, as evidenced by the concurrent reduction in expression of tight junction (TJ) protein claudin-5 and increased permeability of sodium fluorescein (Na-F) from the blood into the cerebral parenchyma. Our results suggest that possible mechanisms involved in oxLDL and/or Ang II-mediated alterations in BBB integrity include oxidative stress and upregulated expression and activity of matrix metalloproteinase (MMP)-9, which is associated with degradation of TJ proteins in the BBB. Our in vitro BBB co-culture results confirm our in vivo findings, as we observe increased BBB permeability (TEER) and decreased integrity (decreased expression of TJ proteins) in the endothelial (apical) layer when treated with plasma from MVE-exposed mice, which was further exacerbated when treated with plasma from MVE-exposed mice on an HF diet. Pre-treatment of the endothelial cells with the AT1 receptor antagonist, Losartan, prior to applying plasma, resulted in attenuation of the alterations observed in endothelial integrity in the BBB co-culture treated with plasma from either MVE+LF or MVE+HF animals. These results suggest Ang II – AT1 signaling mediate, at least in part, the alterations in the BBB integrity observed after exposure to MVE. Moreover, we observed that treatment of the endothelial (apical) layer with plasma from MVE-exposed animals resulted in increased production of inflammatory mediators interleukin-6 (IL-6) and transforming growth factor-β in the astrocyte media (basal compartment). Additionally, these same astrocytes also displayed increased production of angiotensin-converting enzyme (ACE) and also AT1 receptor mRNA expression, while showing decreased expression of the aryl hydrocarbon receptor (AhR) and glutathione peroxidase (GPx). Collectively, these results suggest that exposure to the ubiquitous environmental air pollutant, vehicle engine emissions, results in increased oxLDL and Ang II signaling in the cerebral microvasculature, which is associated with decreased vessel integrity and increased oxidative stress and inflammatory signaling in the CNS. The observed detrimental outcomes are even further exacerbated when coupled with the consumption of an HF diet.
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Kletting, Stephanie [Verfasser], and Claus-Michael [Akademischer Betreuer] Lehr. "A new cell line-based coculture model of the human air-blood barrier to evaluate the interaction with aerosolized drug carriers / Stephanie Kletting ; Betreuer: Claus-Michael Lehr." Saarbrücken : Saarländische Universitäts- und Landesbibliothek, 2016. http://d-nb.info/1114735035/34.

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Books on the topic "Blood air"

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Ryan, Chris. Blood Money. London: RHCB, 2009.

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Environment, Great Britain Department of the. Secretary of State's guidance - blood processing. London: H.M.S.O., 1992.

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Williams, Peter Stanley. Blood, white and blue. South Croydon: Herald, 2003.

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Demarco, Joseph. On the passage of air from the lungs into the blood system, Montpellier, 1746. Msida (Malta): Malta university press, 1999.

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Vella, Horatio C. R. 1952-, ed. On the passage of air from the lungs into the blood system, Montpellier, 1746. [Malta]: Malta University Press, 1999.

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Biology and regulation of blood-tissue barriers. New York, N.Y: Springer Science+Business Media, 2012.

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Coate, Douglas. Carbon monoxide in the ambient air and blood pressure: Evidence from Nhanes II and the Saroad system. Cambridge, MA: National Bureau of Economic Research, 1988.

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Cheng, C. Yan. Biology and regulation of blood-tissue barriers. New York, N.Y: Springer Science+Business Media, 2012.

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Confessions of an air ambulance doctor: My life in blood, guts and latex gloves. Rearsby, Leicester: W F Howes Ltd, 2014.

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1962-, Stergiopulos Nikos, and Noble Mark I. M, eds. Snapshots of hemodynamics: An aid for clinical research and graduate education. 2nd ed. New York: Springer Verlag, 2010.

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Book chapters on the topic "Blood air"

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Lam, Adam, and Mark K. Ferguson. "Does Blood Patch for Persistent Postoperative Air Leak Reduce Air Leak Duration." In Difficult Decisions in Surgery: An Evidence-Based Approach, 167–76. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-47404-1_14.

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Davis, T. R. C., and J. Pooley. "Changes in Femoral Head Blood Flow Associated with Exposure to Compressed Air." In Bone Circulation and Bone Necrosis, 134–36. Berlin, Heidelberg: Springer Berlin Heidelberg, 1990. http://dx.doi.org/10.1007/978-3-642-73644-5_28.

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Zwart, A., J. G. J. Lommen, and V. J. Feron. "Multi-Compartment Model to Study the Effect of Air-Blood and Blood-Tissue Partition Coefficients on Concentration-Time-Effect Relationships." In Archives of Toxicology, 249–52. Berlin, Heidelberg: Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-77260-3_32.

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Isgro, Frank, A. H. Kiessling, and W. Saggau. "SMARxT and blood air interface — a new concept to improve biocompatibility of extracorporeal circuits —." In Current Perspectives of the Extracorporeal Circulation, 77–82. Heidelberg: Steinkopff, 2000. http://dx.doi.org/10.1007/978-3-642-57721-5_8.

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Nikolić, Maja, and Dragana Nikić. "Effects of Chronic Exposure to Urban Air Pollution on Red Blood Cells in Children." In Global Environmental Change: Challenges to Science and Society in Southeastern Europe, 211–19. Dordrecht: Springer Netherlands, 2010. http://dx.doi.org/10.1007/978-90-481-8695-2_17.

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Pisano, Antonio. "Air Bubbles in the Blood Sample: Better or Worse Oxygenation? Dalton’s Law and Fick’s Law." In Physics for Anesthesiologists, 19–26. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-57330-4_3.

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Kochubovski, Mihail. "Blood-Lead Levels in Schoolchildren from Veles, Related to the Ambient Air Pollution by Lead." In Exposure and Risk Assessment of Chemical Pollution — Contemporary Methodology, 371–78. Dordrecht: Springer Netherlands, 2009. http://dx.doi.org/10.1007/978-90-481-2335-3_27.

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Schulz, Heribert. "Short communication: Some Remarks on the Sub-Microscopic Anatomy and Pathology of the Blood-Air Pathway in the Lung." In Ciba Foundation Symposium - Pulmonary Structure and Function, 205–14. Chichester, UK: John Wiley & Sons, Ltd., 2008. http://dx.doi.org/10.1002/9780470719282.ch12.

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Ewers, U., H. Hajimiragha, E. Jermann, I. Freier, and A. Brockhaus. "Breath and Blood Levels of Benzene and Other Volatile Aromatic Hydrocarbons — Effect of Urban Air Pollution and Cigarette Smoking." In Environmental Hygiene II, 153–56. Berlin, Heidelberg: Springer Berlin Heidelberg, 1990. http://dx.doi.org/10.1007/978-3-642-46712-7_35.

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Pisano, Antonio. "Dalton’s Law and Fick’s Law: Resorption Atelectasis, Membrane Oxygenators, and How an Air Bubble May Affect Blood Gas Analysis." In Physics for Anesthesiologists and Intensivists, 45–54. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-72047-6_4.

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Conference papers on the topic "Blood air"

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Safar, Z., and W. Lotfi. "Screening epidemiological study: blood lead levels in the vicinity of a lead smelter." In AIR POLLUTION 2006. Southampton, UK: WIT Press, 2006. http://dx.doi.org/10.2495/air06075.

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Kim, Y. H., H. S. Rhim, H. S. Uhm, and E. H. Choi. "Atmospheric pressure air plasma jet assisted blood coagulation." In 2011 IEEE 38th International Conference on Plasma Sciences (ICOPS). IEEE, 2011. http://dx.doi.org/10.1109/plasma.2011.5993283.

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Wu, C., L. Tam, J. Clark, and P. Rosenfeld. "Dioxin and furan blood lipid concentrations in populations living near four wood treatment facilities in the United States." In AIR POLLUTION 2009. Southampton, UK: WIT Press, 2009. http://dx.doi.org/10.2495/air090291.

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Edwards, B., M. Genter, P. Succop, and G. Talaska. "254. Effects of Alterations of Blood Lipids by Diet on Solvent Air: Blood Partition Coefficients." In AIHce 2004. AIHA, 2004. http://dx.doi.org/10.3320/1.2758185.

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Chiu, Sheng-Hung, and Cheng-Hsien Liu. "An air-bubble-actuated micropump for on-chip blood transportation." In TRANSDUCERS 2009 - 2009 International Solid-State Sensors, Actuators and Microsystems Conference. IEEE, 2009. http://dx.doi.org/10.1109/sensor.2009.5285863.

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da Costa and Machado. "Basic Considerations Of Ultrasonic Air-bubble Detectors For Blood Extracorporeal Circulation." In Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 1992. http://dx.doi.org/10.1109/iembs.1992.595605.

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Ding, S., J. Tu, C. P. Cheung, R. Beare, T. Phan, D. Reutens, and Frank Thien. "Geometric Model Generation for CFD Simulation of Blood and Air Flows." In 2007 1st International Conference on Bioinformatics and Biomedical Engineering. IEEE, 2007. http://dx.doi.org/10.1109/icbbe.2007.345.

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Fuks, Kateryna, Sabine Hertel, Anja Viehmann, Michael Nonnemacher, Susanne Moebus, Hermann Jakobs, Christoph Kessler, Raimund Erbel, Karl-Heinz Jöckel, and Barbara Hoffmann. "Long-term Urban Background Particulate Air Pollution Increases Arterial Blood Pressure." In American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans. American Thoracic Society, 2010. http://dx.doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a1712.

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da Costa, Luiz Eduardo G., and Joao C. Machado. "Basic considerations of ultrasonic air-bubble detectors for blood extracorporeal circulation." In 1992 14th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 1992. http://dx.doi.org/10.1109/iembs.1992.5761021.

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Tang, Jeat Thong`, Shan Min Lo, Muhammad Khairul Taufiq Rosli, Hema Yamini Ramarmuty, and Kunji Kannan Sivaraman Kannan. "Autologous Blood Patch Pleurodesis for Persistent Air Leak: A Case Series." In ERS International Congress 2021 abstracts. European Respiratory Society, 2021. http://dx.doi.org/10.1183/13993003.congress-2021.pa3139.

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Reports on the topic "Blood air"

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Coate, Douglas, and Michael Grossman. Carbon Monoxide in the Ambient Air and Blood Pressure: Evidence From NHANES II and the SAROAD System. Cambridge, MA: National Bureau of Economic Research, September 1988. http://dx.doi.org/10.3386/w2711.

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Claus, Ana, Borzooye Jafarizadeh, Azmal Huda Chowdhury, Neziah Pala, and Chunlei Wang. Testbed for Pressure Sensors. Florida International University, October 2021. http://dx.doi.org/10.25148/mmeurs.009771.

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Currently, several studies and experiments are being done to create a new generation of ultra-low-power wearable sensors. For instance, our group is currently working towards the development of a high-performance flexible pressure sensor. However, with the creation of new sensors, a need for a standard test method is necessary. Therefore, we opted to create a standardized testbed to evaluate the pressure applied to sensors. A pulse wave is generated when the heart pumps blood causing a change in the volume of the blood vessel. In order to eliminate the need of human subjects when testing pressure sensors, we utilized polymeric material, which mimics human flesh. The goal is to simulate human pulse by pumping air into a polymeric pocket which s deformed. The project is realized by stepper motor and controlled with an Arduino board. Furthermore, this device has the ability to simulate pulse wave form with different frequencies. This in turn allows us to simulate conditions such as bradycardia, tachycardia, systolic pressure, and diastolic pressure.
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Koo, Helen Sumin, and Seoha Min. Airy Bloom. Ames: Iowa State University, Digital Repository, 2017. http://dx.doi.org/10.31274/itaa_proceedings-180814-220.

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Paparazzoa, Ersilia, Vincenzo Lagani, Silvana Geracitano, Luigi Citrigno, Mirella Aurora Aceto, Antoinio Malvaso, Francesco Bruno, Giuseppe Passarino, and Alberto Montesanto. An ELOVL2 based epigenetic clock for forensic age prediction: a systematic review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, December 2022. http://dx.doi.org/10.37766/inplasy2022.12.0006.

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Review question / Objective: To develop an easy, robust and improved blood-based age prediction model using ELOVL2 promoter methylation data. Eligibility criteria: All studies with the aim of understanding the relationship between the ELOVL2 methylation levels and age written in English language, carried out in humans and providing a publicly available dataset will be included in the systematic review. Articles that did not include original research (e.g., review, opinion article or conference abstract) and for which methylation analysis will be carried out using a technology different from the pyrosequencing in tissues different form blood will be excluded from further analyses.
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Moridi, Mina, Parinaz Onikzeh, Aida Kazemi, and Hadi Zamanian. CABG versus myotomy in symptomatic myocardial bridge patients : A systematic Review and Meta-analysis protocol. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, November 2021. http://dx.doi.org/10.37766/inplasy2021.11.0088.

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Review question / Objective: The aim of this study is to find which surgical intervention in myocardial bridge ( myotomy or CABG) is more effective in reducing adverse outcomes in symptomatic patients resistant to optimal medical therapy ? Condition being studied: Myocardial bridge : A myocardial bridge (MB) is a congenital heart defect in which a bridge of muscle fibers (myocardium) overlying a section of a coronary artery and the artery is squeezed and normal blood flow is disrupted. Most bridges don't seem to cause symptoms. However, some people can experience angina, or chest pain. In patients with symptoms, first line treatment is medication and if they have symptoms despite optimal medical treatment , invasive measures like CABG or myotomy should be taken.
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Mao, Hui, YueHui Wei, Huimin Su, and Xun Li. Pediatric Tui Na for cough in children: A protocol for a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, February 2022. http://dx.doi.org/10.37766/inplasy2022.2.0076.

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Review question / Objective: The aim of this systematic review is to evaluate the effectiveness and safety of pediatric Tui Na in the treatment of cough in children under seven years of age. Condition being studied: Cough is essentially a protective reflex of respiratory tract to various stimuli, typically in order to clear the lung airways of fluids, mucus, or other material. Cough not only has a negative impact on children’s daily activities and sleep, but is associated with parental stress and worries. Pediatric Tui Na, a therapeutic massage based on the Chinese traditional theory of Yin and Yang, Qi and blood, acupoints and meridians, enjoys a long history and has been widely applied to the treatment of common diseases like fever, diarrhea, cough and asthma. This study aims to evaluate the effectiveness and safety of pediatric Tui Na in the treatment of cough in children.
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Yahav, Shlomo, John Brake, and Noam Meiri. Development of Strategic Pre-Natal Cycling Thermal Treatments to Improve Livability and Productivity of Heavy Broilers. United States Department of Agriculture, December 2013. http://dx.doi.org/10.32747/2013.7593395.bard.

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The necessity to improve broiler thermotolerance and live performance led to the following hypothesis: Appropriate comprehensive incubation treatments that include significant temperature management changes will promote angiogenesis and will improve acquisition of thermotolerance and carcass quality of heavy broilers through epigenetic adaptation. It was based on the following questions: 1. Can TM during embryogenesis of broilers induce a longer-lasting thermoregulatory memory (up to marketing age of 10 wk) that will improve acquisition of thermotolerance as well as increased breast meat yield in heavy broilers? 2. The improved sensible heat loss (SHL) suggests an improved peripheral vasodilation process. Does elevated temperature during incubation affect vasculogenesis and angiogenesis processes in the chick embryo? Will such create subsequent advantages for heavy broilers coping with adverse hot conditions? 3. What are the changes that occur in the PO/AH that induce the changes in the threshold response for heat production/heat loss based on the concept of epigenetic temperature adaptation? The original objectives of this study were as follow: a. to assess the improvement of thermotolerance efficiency and carcass quality of heavy broilers (~4 kg); b. toimproveperipheral vascularization and angiogenesis that improve sensible heat loss (SHL); c. to study the changes in the PO/AH thermoregulatory response for heat production/losscaused by modulating incubation temperature. To reach the goals: a. the effect of TM on performance and thermotolerance of broilers reared to 10 wk of age was studied. b. the effect of preincubation heating with an elevated temperature during the 1ˢᵗ 3 to 5 d of incubation in the presence of modified fresh air flow coupled with changes in turning frequency was elucidated; c.the effect of elevated temperature on vasculogenesis and angiogenesis was determined using in ovo and whole embryo chick culture as well as HIF-1α VEGF-α2 VEGF-R, FGF-2, and Gelatinase A (MMP2) gene expression. The effects on peripheral blood system of post-hatch chicks was determined with an infrared thermal imaging technique; c. the expression of BDNF was determined during the development of the thermal control set-point in the preoptic anterior hypothalamus (PO/AH). Background to the topic: Rapid growth rate has presented broiler chickens with seriousdifficulties when called upon to efficiently thermoregulate in hot environmental conditions. Being homeotherms, birds are able to maintain their body temperature (Tb) within a narrow range. An increase in Tb above the regulated range, as a result of exposure to environmental conditions and/or excessive metabolic heat production that often characterize broiler chickens, may lead to a potentially lethal cascade of irreversible thermoregulatory events. Exposure to temperature fluctuations during the perinatal period has been shown to lead to epigenetic temperature adaptation. The mechanism for this adaptation was based on the assumption that environmental factors, especially ambient temperature, have a strong influence on the determination of the “set-point” for physiological control systems during “critical developmental phases.” Recently, Piestunet al. (2008) demonstrated for the first time that TM (an elevated incubation temperature of 39.5°C for 12 h/d from E7 to E16) during the development/maturation of the hypothalamic-hypophyseal-thyroid axis (thermoregulation) and the hypothalamic-hypophyseal-adrenal axis (stress) significantly improved the thermotolerance and performance of broilers at 35 d of age. These phenomena raised two questions that were addressed in this project: 1. was it possible to detect changes leading to the determination of the “set point”; 2. Did TM have a similar long lasting effect (up to 70 d of age)? 3. Did other TM combinations (pre-heating and heating during the 1ˢᵗ 3 to 5 d of incubation) coupled with changes in turning frequency have any performance effect? The improved thermotolerance resulted mainly from an efficient capacity to reduce heat production and the level of stress that coincided with an increase in SHL (Piestunet al., 2008; 2009). The increase in SHL (Piestunet al., 2009) suggested an additional positive effect of TM on vasculogenesis and angiogensis. 4. In order to sustain or even improve broiler performance, TM during the period of the chorioallantoic membrane development was thought to increase vasculogenesis and angiogenesis providing better vasodilatation and by that SHL post-hatch.
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Malkinson, Mertyn, Irit Davidson, Moshe Kotler, and Richard L. Witter. Epidemiology of Avian Leukosis Virus-subtype J Infection in Broiler Breeder Flocks of Poultry and its Eradication from Pedigree Breeding Stock. United States Department of Agriculture, March 2003. http://dx.doi.org/10.32747/2003.7586459.bard.

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Objectives 1. Establish diagnostic procedures to identify tolerant carrier birds based on a) Isolation of ALV-J from blood, b) Detection of group-specific antigen in cloacal swabs and egg albumen. Application of these procedures to broiler breeder flocks with the purpose of removing virus positive birds from the breeding program. 2. Survey the AL V-J infection status of foundation lines to estimate the feasibility of the eradication program 3. Investigate virus transmission through the embryonated egg (vertical) and between chicks in the early post-hatch period (horizontal). Establish a model for limiting horizontal spread by analyzing parameters operative in the hatchery and brooder house. 4. Compare the pathogenicity of AL V-J isolates for broiler chickens. 5. Determine whether AL V-J poses a human health hazard by examining its replication in mammalian and human cells. Revisions. The: eradication objective had to be terminated in the second year following the closing down of the Poultry Breeders Union (PBU) in Israel. This meant that their foundation flocks ceased to be available for selection. Instead, the following topics were investigated: a) Comparison of commercial breeding flocks with and without myeloid leukosis (matched controls) for viremia and serum antibody levels. b) Pathogenicity of Israeli isolates for turkey poults. c) Improvement of a diagnostic ELISA kit for measuring ALV-J antibodies Background. ALV-J, a novel subgroup of the avian leukosis virus family, was first isolated in 1988 from broiler breeders presenting myeloid leukosis (ML). The extent of its spread among commercial breeding flocks was not appreciated until the disease appeared in the USA in 1994 when it affected several major breeding companies almost simultaneously. In Israel, ML was diagnosed in 1996 and was traced to grandparent flocks imported in 1994-5, and by 1997-8, ML was present in one third of the commercial breeding flocks It was then realized that ALV-J transmission was following a similar pattern to that of other exogenous ALVs but because of its unusual genetic composition, the virus was able to establish an extended tolerant state in infected birds. Although losses from ML in affected flocks were somewhat higher than normal, both immunosuppression and depressed growth rates were encountered in affected broiler flocks and affected their profitability. Conclusions. As a result of the contraction in the number of international primary broiler breeders and exchange of male and female lines among them, ALV-J contamination of broiler breeder flocks affected the broiler industry worldwide within a short time span. The Israeli national breeding company (PBU) played out this scenario and presented us with an opportunity to apply existing information to contain the virus. This BARD project, based on the Israeli experience and with the aid of the ADOL collaborative effort, has managed to offer solutions for identifying and eliminating infected birds based on exhaustive virological and serological tests. The analysis of factors that determine the efficiency of horizontal transmission of virus in the hatchery resulted in the workable solution of raising young chicks in small groups through the brooder period. These results were made available to primary breeders as a strategy for reducing viral transmission. Based on phylogenetic analysis of selected Israeli ALV-J isolates, these could be divided into two groups that reflected the countries of origin of the grandparent stock. Implications. The availability of a simple and reliable means of screening day old chicks for vertical transmission is highly desirable in countries that rely on imported breeding stock for their broiler industry. The possibility that AL V-J may be transmitted to human consumers of broiler meat was discounted experimentally.
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Treadwell, Jonathan R., James T. Reston, Benjamin Rouse, Joann Fontanarosa, Neha Patel, and Nikhil K. Mull. Automated-Entry Patient-Generated Health Data for Chronic Conditions: The Evidence on Health Outcomes. Agency for Healthcare Research and Quality (AHRQ), March 2021. http://dx.doi.org/10.23970/ahrqepctb38.

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Background. Automated-entry consumer devices that collect and transmit patient-generated health data (PGHD) are being evaluated as potential tools to aid in the management of chronic diseases. The need exists to evaluate the evidence regarding consumer PGHD technologies, particularly for devices that have not gone through Food and Drug Administration evaluation. Purpose. To summarize the research related to automated-entry consumer health technologies that provide PGHD for the prevention or management of 11 chronic diseases. Methods. The project scope was determined through discussions with Key Informants. We searched MEDLINE and EMBASE (via EMBASE.com), In-Process MEDLINE and PubMed unique content (via PubMed.gov), and the Cochrane Database of Systematic Reviews for systematic reviews or controlled trials. We also searched ClinicalTrials.gov for ongoing studies. We assessed risk of bias and extracted data on health outcomes, surrogate outcomes, usability, sustainability, cost-effectiveness outcomes (quantifying the tradeoffs between health effects and cost), process outcomes, and other characteristics related to PGHD technologies. For isolated effects on health outcomes, we classified the results in one of four categories: (1) likely no effect, (2) unclear, (3) possible positive effect, or (4) likely positive effect. When we categorized the data as “unclear” based solely on health outcomes, we then examined and classified surrogate outcomes for that particular clinical condition. Findings. We identified 114 unique studies that met inclusion criteria. The largest number of studies addressed patients with hypertension (51 studies) and obesity (43 studies). Eighty-four trials used a single PGHD device, 23 used 2 PGHD devices, and the other 7 used 3 or more PGHD devices. Pedometers, blood pressure (BP) monitors, and scales were commonly used in the same studies. Overall, we found a “possible positive effect” of PGHD interventions on health outcomes for coronary artery disease, heart failure, and asthma. For obesity, we rated the health outcomes as unclear, and the surrogate outcomes (body mass index/weight) as likely no effect. For hypertension, we rated the health outcomes as unclear, and the surrogate outcomes (systolic BP/diastolic BP) as possible positive effect. For cardiac arrhythmias or conduction abnormalities we rated the health outcomes as unclear and the surrogate outcome (time to arrhythmia detection) as likely positive effect. The findings were “unclear” regarding PGHD interventions for diabetes prevention, sleep apnea, stroke, Parkinson’s disease, and chronic obstructive pulmonary disease. Most studies did not report harms related to PGHD interventions; the relatively few harms reported were minor and transient, with event rates usually comparable to harms in the control groups. Few studies reported cost-effectiveness analyses, and only for PGHD interventions for hypertension, coronary artery disease, and chronic obstructive pulmonary disease; the findings were variable across different chronic conditions and devices. Patient adherence to PGHD interventions was highly variable across studies, but patient acceptance/satisfaction and usability was generally fair to good. However, device engineers independently evaluated consumer wearable and handheld BP monitors and considered the user experience to be poor, while their assessment of smartphone-based electrocardiogram monitors found the user experience to be good. Student volunteers involved in device usability testing of the Weight Watchers Online app found it well-designed and relatively easy to use. Implications. Multiple randomized controlled trials (RCTs) have evaluated some PGHD technologies (e.g., pedometers, scales, BP monitors), particularly for obesity and hypertension, but health outcomes were generally underreported. We found evidence suggesting a possible positive effect of PGHD interventions on health outcomes for four chronic conditions. Lack of reporting of health outcomes and insufficient statistical power to assess these outcomes were the main reasons for “unclear” ratings. The majority of studies on PGHD technologies still focus on non-health-related outcomes. Future RCTs should focus on measurement of health outcomes. Furthermore, future RCTs should be designed to isolate the effect of the PGHD intervention from other components in a multicomponent intervention.
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MacFarlane, Andrew. 2021 medical student essay prize winner - A case of grief. Society for Academic Primary Care, July 2021. http://dx.doi.org/10.37361/medstudessay.2021.1.1.

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As a student undertaking a Longitudinal Integrated Clerkship (LIC)1 based in a GP practice in a rural community in the North of Scotland, I have been lucky to be given responsibility and my own clinic lists. Every day I conduct consultations that change my practice: the challenge of clinically applying the theory I have studied, controlling a consultation and efficiently exploring a patient's problems, empathising with and empowering them to play a part in their own care2 – and most difficult I feel – dealing with the vast amount of uncertainty that medicine, and particularly primary care, presents to both clinician and patient. I initially consulted with a lady in her 60s who attended with her husband, complaining of severe lower back pain who was very difficult to assess due to her pain level. Her husband was understandably concerned about the degree of pain she was in. After assessment and discussion with one of the GPs, we agreed some pain relief and a physio assessment in the next few days would be a practical plan. The patient had one red flag, some leg weakness and numbness, which was her ‘normal’ on account of her multiple sclerosis. At the physio assessment a few days later, the physio felt things were worse and some urgent bloods were ordered, unfortunately finding raised cancer and inflammatory markers. A CT scan of the lung found widespread cancer, a later CT of the head after some developing some acute confusion found brain metastases, and a week and a half after presenting to me, the patient sadly died in hospital. While that was all impactful enough on me, it was the follow-up appointment with the husband who attended on the last triage slot of the evening two weeks later that I found completely altered my understanding of grief and the mourning of a loved one. The husband had asked to speak to a Andrew MacFarlane Year 3 ScotGEM Medical Student 2 doctor just to talk about what had happened to his wife. The GP decided that it would be better if he came into the practice - strictly he probably should have been consulted with over the phone due to coronavirus restrictions - but he was asked what he would prefer and he opted to come in. I sat in on the consultation, I had been helping with any examinations the triage doctor needed and I recognised that this was the husband of the lady I had seen a few weeks earlier. He came in and sat down, head lowered, hands fiddling with the zip on his jacket, trying to find what to say. The GP sat, turned so that they were opposite each other with no desk between them - I was seated off to the side, an onlooker, but acknowledged by the patient with a kind nod when he entered the room. The GP asked gently, “How are you doing?” and roughly 30 seconds passed (a long time in a conversation) before the patient spoke. “I just really miss her…” he whispered with great effort, “I don’t understand how this all happened.” Over the next 45 minutes, he spoke about his wife, how much pain she had been in, the rapid deterioration he witnessed, the cancer being found, and cruelly how she had passed away after he had gone home to get some rest after being by her bedside all day in the hospital. He talked about how they had met, how much he missed her, how empty the house felt without her, and asking himself and us how he was meant to move forward with his life. He had a lot of questions for us, and for himself. Had we missed anything – had he missed anything? The GP really just listened for almost the whole consultation, speaking to him gently, reassuring him that this wasn’t his or anyone’s fault. She stated that this was an awful time for him and that what he was feeling was entirely normal and something we will all universally go through. She emphasised that while it wasn’t helpful at the moment, that things would get better over time.3 He was really glad I was there – having shared a consultation with his wife and I – he thanked me emphatically even though I felt like I hadn’t really helped at all. After some tears, frequent moments of silence and a lot of questions, he left having gotten a lot off his chest. “You just have to listen to people, be there for them as they go through things, and answer their questions as best you can” urged my GP as we discussed the case when the patient left. Almost all family caregivers contact their GP with regards to grief and this consultation really made me realise how important an aspect of my practice it will be in the future.4 It has also made me reflect on the emphasis on undergraduate teaching around ‘breaking bad news’ to patients, but nothing taught about when patients are in the process of grieving further down the line.5 The skill Andrew MacFarlane Year 3 ScotGEM Medical Student 3 required to manage a grieving patient is not one limited to general practice. Patients may grieve the loss of function from acute trauma through to chronic illness in all specialties of medicine - in addition to ‘traditional’ grief from loss of family or friends.6 There wasn’t anything ‘medical’ in the consultation, but I came away from it with a real sense of purpose as to why this career is such a privilege. We look after patients so they can spend as much quality time as they are given with their loved ones, and their loved ones are the ones we care for after they are gone. We as doctors are the constant, and we have to meet patients with compassion at their most difficult times – because it is as much a part of the job as the knowledge and the science – and it is the part of us that patients will remember long after they leave our clinic room. Word Count: 993 words References 1. ScotGEM MBChB - Subjects - University of St Andrews [Internet]. [cited 2021 Mar 27]. Available from: https://www.st-andrews.ac.uk/subjects/medicine/scotgem-mbchb/ 2. Shared decision making in realistic medicine: what works - gov.scot [Internet]. [cited 2021 Mar 27]. Available from: https://www.gov.scot/publications/works-support-promote-shared-decisionmaking-synthesis-recent-evidence/pages/1/ 3. Ghesquiere AR, Patel SR, Kaplan DB, Bruce ML. Primary care providers’ bereavement care practices: Recommendations for research directions. Int J Geriatr Psychiatry. 2014 Dec;29(12):1221–9. 4. Nielsen MK, Christensen K, Neergaard MA, Bidstrup PE, Guldin M-B. Grief symptoms and primary care use: a prospective study of family caregivers. BJGP Open [Internet]. 2020 Aug 1 [cited 2021 Mar 27];4(3). Available from: https://bjgpopen.org/content/4/3/bjgpopen20X101063 5. O’Connor M, Breen LJ. General Practitioners’ experiences of bereavement care and their educational support needs: a qualitative study. BMC Medical Education. 2014 Mar 27;14(1):59. 6. Sikstrom L, Saikaly R, Ferguson G, Mosher PJ, Bonato S, Soklaridis S. Being there: A scoping review of grief support training in medical education. PLOS ONE. 2019 Nov 27;14(11):e0224325.
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