Connecticut medicine
-
Connecticut medicine · Jun 2008
Informed consent for procedures in the Neonatal Intensive Care Unit.
Establishing those procedures that require documentation of specific informed consent in a Neonatal Intensive Care Unit (NICU) setting remains controversial. Although documentation of specific informed consent for blood transfusions is universally mandated, consent for other procedures such as umbilical catheterizations may or may not be obtained and/or documented. In a retrospective study, medical charts of 116 neonates were reviewed to determine if consent for umbilicalvein and arterial catheterizations, blood transfusions, and procedures that require documentation of consent at Connecticut Children's Medical Center (CCMC), had been obtained. ⋯ Variables contributing to decreased consent rates for catheterizations were explored as were alternatives that would increase the consent rate. National Neonatal Intensive Care Unit consent policies from eight children's hospitals were reviewed to further evaluate current practice. Future research investigating expectations of families would be useful to create policy revisions.
-
Connecticut medicine · May 2008
Biography Historical ArticleJourney through World War II with Captain Gioacchino Parrella, MD U.S. Army.
-
Connecticut medicine · Apr 2008
Case ReportsAcquired deficiency of vitamin K-dependent clotting factors due to brodifacoum ingestion.
Brodifacoum, also known as a superwarfarin, is a four-hydroxycoumarin derivative. It exerts an anticoagulant effect by inhibiting the reduction of vitamin K-2,3 epoxide, thereby decreasing the production of vitamin K-dependent clotting factors. It is a readily available rodenticide that has been associated with accidental ingestions in children. ⋯ We followed the brodifacoum level, which decreased to 31 ng/ml approximately six weeks after initial presentation. The exact length of treatment required to prevent recurrence of the coagulopathy was not determined because the patient did not return for follow-up. Superwarfarin ingestion must be suspected and quickly identified in patients with depletion of vitamin K-dependent clotting factors resulting in potentially catastrophic bleeding.
-
We reviewed medical examiner, law enforcement, crime laboratory data, and death certificates on all 1,530 violent deaths (homicide, suicide, undetermined firearm) in Connecticut occurring from 2001-2004. There was an average of 383 deaths (rate = 11.2 deaths per 100,000 persons annually). Overall, males aged 20 to 29 were at the greatest risk of violent death (rate = 30.5/100,000). ⋯ Firearms were used in 33% of suicides and 58% of homicides. The rate of violent death is lower than most other states in the country. In Connecticut suicide is the leading cause of violent death overall; however, in areas characterized by the highest levels of poverty and lowest levels of education, homicide is the leading cause of violent death.