Now showing items 14083-14102 of 14815

    • Tumescent Infusion for Split Thickness Skin Grafting

      Wong, Raymond K.; Huynh, Thanh; French, Edward; Dotson, Victoria (The University of Arizona., 2018)
      Current literature indicates a significant decrease in operative blood loss with the usage of a hemostatic agent for auto-graft sites.11, 12 Tumescence, the localized infiltration of subcutaneous solution to prepare auto-graft donor site, builds counter pressure under the dermatome, which is a mechanical device that allows for harvest of a uniform thickness split thickness skin graft. Tumescent infusion can be done manually or by a device. The process of manual injection through a syringe is operator dependent and divides the total volume of the infusate into several aliquots, which limits delivery efficiency. Additionally, when manually injected through a syringe, limitations exists for temperature management and infusate distribution. Recently our group modified a roller pump setup for tumescent infusion upon request by our hospital’s trauma and burns surgeon. A novel aspect of our setup over existing machine-operated tumescent infusion systems was the incorporation of a heat exchanger to warm the infusate. This alternative method of using Roller pump – heat exchanger device delivers a constant rate of infusate without any pauses, and simultaneously warms the infusate to assist with intra-operative thermoregulation. After conducting a retrospective chart review for patients at Banner University Medical Center, for patients who underwent split thickness skin grafting from September 2016 to May 2017 we found that mean post-operative temperatures in the machine aided tumescence (MAT) n = 43 group with surgeon 1 (MD1) was 36.6, which represents a mean -0.18 degree C decrease from pre-operative temperatures. Comparatively, the manual tumescence (MT) group with surgeon 2 (MD2) (n = 19) post-operative temperature was 35.6 degrees and represent a mean -1.36 degrees C change. (p ≤ 0.0001) For calculated blood loss and transfusions, MAT/MD1 (n = 20) was found to have significantly higher blood loss and transfusion requirements than the MT/MD2 (n = 13) group with a mean of 1.1 ± 0.98 mL/cm2 and 276 ± 316 mL pRBC transfusion requirement, whereas the MT/MD2 group demonstrated a mean 0.55 ± 0.54 mL/cm2 CBL and 43.5 ± 94.3 mL pRBC transfusion requirement. (p=0.08) In a prospective in-vitro analysis, it was determined that mean infusion duration for 0.7 L of tumescent solution at an average infusion rate of 150 mL/min, was 1156 seconds with MT. (n=15) Comparatively MAT (n=15) accomplishes the same volume infusion in 280 seconds, which was a 76% decrease in infusion duration. (p ≤ 0.0001) Results indicated that infusion duration was significantly lower for MAT compared to MT. Intraoperative temperature change was significantly less for MAT/MD1 than MT/MD2. Calculated blood loss and transfusion requirements were significantly higher for MAT/MD1 compared to MT MT/MD2. Overall, infusion duration and intraoperative temperature management favored MAT/MD1, while blood loss and transfusion requirements favored MT/MD2. Negative outcomes for increased blood loss and transfusion requirements may suggest that tumescence with MAT/MD1 was not suitable for all patients. However, decreased infusion duration and superior temperature management may outweigh adverse effects in blood loss for patients that are more susceptible to clinical hypothermia.

      Randall, Debra Jean, 1955- (The University of Arizona., 1986)
    • A tunnel diode logic network with artibrary fan-in and fan-out capability

      Bell, Lynn Stephen, 1938- (The University of Arizona., 1964)
    • The tunnel diode monostable multivabrator

      Morgan, Max Joseph, 1037- (The University of Arizona., 1961)
    • Turkey's asbestos: Trends and development

      Garcia, Meliton M.; Karul, Saban Ali, 1951- (The University of Arizona., 1987)
      The asbestos resources in Turkey should be exploited in a carefully planned manner for two reasons: (1) to minimize the health hazards associated with the mining and processing of asbestos, and (2) to avoid wasteful exploitation for the sake of making profit. Its consumption should be optimized by using it for the critical applications only, where its unique properties are essential. Turkey's asbestos resources and alternative minerals to asbestos should be exploited to assist in its economic development. However Turkey must control the environmental and occupational hazards associated with the production of these commodities if it is to avoid the loss experience of other developed countries. The hazards associated with the use of asbestos in many noncritical applications have raised the demands for substitute materials which are less hazardous. Turkey is in a position of developing and marketing many of the substitute materials by exploiting some of its industrial minerals.
    • Turn of the century metropolitan park systems

      Zube, Ervin H.; Lyon, Roberta Lee, 1944- (The University of Arizona., 1988)
      More than twenty metropolitan park systems in the United States were designed and constructed during a period of intense urbanization in the late nineteenth century. Similar conditions of rapid growth in "Sunbelt" cities today, and continued recognition of the need for urban parks, makes understanding of factors significant to the longevity of the historic systems useful. Park systems of Washington, DC, Cleveland, Ohio, Kansas City, Missouri and Minneapolis, Minnesota are compared in the literature and by direct observation. Settings, goals, forms, siting, and activities of these systems are examined. Impacts of suburbanization, changes in transportation, increased leisure, and development of planning bureaucracies are discussed and compared. Findings suggest: graphic plans exhibiting bold images were most likely to be implemented; intent of the design is preserved by careful definition of goals and objectives; and systems organized on the basis of natural topography and drainageways have better maintained their usefulness and identity.
    • Turning Black into White: The Agents of Persuasion and the News Media

      Bayless, Linda Elisabeth (The University of Arizona., 1997)
    • Turnus as a tragic character

      Ricketts, Leila Eleanor, 1907- (The University of Arizona., 1933)
    • Turquoise: its history and significance in the Southwest

      Muir, Gertrude Hill (The University of Arizona., 1938)

      RHODIUS, ALEJANDRO A. (The University of Arizona., 1989)
    • Two and four choice object discrimination by gerbils

      Goodman, Roy R., 1943- (The University of Arizona., 1969)
    • Two approaches to patient preparation for transfer from an intensive care unit

      MacMacken, Peggy Sue, 1948- (The University of Arizona., 1978)
    • Two aspects of two works by Yü Ta-Fu

      Lanford, Conway Bristol, 1943- (The University of Arizona., 1975)
    • A two channel photographic plate guiding control system

      Reed, Michael Allan Handy, 1940- (The University of Arizona., 1967)
    • The two dimensional treatment of an original problem in landscape painting

      Stanley, William Clinton, 1927- (The University of Arizona., 1957)
    • Two Essays on Perceived Climate Change and Adaptation of Rural Livelihoods

      Rahman, Tauhidur; Kishore, Siddharth; Aradhyula, Satheesh; Scheitrum, Daniel; Tronstad, Russell (The University of Arizona., 2018)
      For my thesis, I am going to present two essays on perceived climate change and livelihood adaptation. Using a survey data on 3,300 representative rural households from each drought as well as flood-prone regions of India, we examine the links between the households’ livelihood adaption choices and perceived climate change. The livelihoods adaptation choices are jointly modeled as the multivariate probit regression, estimated by the simulated likelihoods procedure of Cappellari and Jenkins (2003). We find that households who chose one adaptation strategy were more likely to choose another one. The adaptation choices of the households are strongly determined by their perceived climate change and the results are robust to multicollinearity among the measures of the perceptions of climate change. Among the control variables, access to information on onset of monsoon and amount of rainfall influences adaption choices.
    • Two great kivas at Point of Pines ruin

      Gerald, Mary Virginia Gould, 1924- (The University of Arizona., 1957)
    • Two instructional methods in contour drawing

      Weckesser, Jane Kathryn, 1941- (The University of Arizona., 1978)