Given an abstract, generate a keyword (a noun phrase) that best describes the focus or contribution of the paper. Such keywords can be directly from the given abstract or outside it.

Q: Abstract: A retrospective review of the cases of fifteen patients with a three-part fracture of the proximal part of the humerus is presented. Fourteen of the fractures were treated with tension-band wiring and one, with an AO buttress plate. The patients were evaluated for pain, range of motion, strength, and function of the involved shoulder and the radiographic result at an average of fifty-four months after the injury. At follow-up, the shoulders had an average of 126 degrees of active elevation, 29 degrees of active external rotation, 81 degrees of active abduction, and internal rotation to the second lumbar vertebra. The only early complication was failure of fixation in the patient who had been treated with a buttress plate. In two patients, radiographic evidence of avascular necrosis of the humeral head later developed, and one of them required revision to a hemiarthroplasty. In conclusion, we recommend operative treatment for the healthy, active individual who has a three-part fracture of the proximal part of the humerus. We found that the best results with these difficult fractures are obtained using tension-band wiring.

A: Aged
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Q: Abstract: As the use of helicopters for air transport of critically ill patients increases, the availability of monitoring devices for physiological parameters during flight becomes important. It has long been known that arterial PO2 (PaO2) decreases during unsupplemented, non-pressurized flight. In this study, the authors examined the use of the transconjunctival oxygen (cjO2) monitor for assessing the adequacy of arterial oxygenation during helicopter flight in four healthy volunteers. Arterial PaO2 as measured by conventional blood gas analysis was compared with cjO2 at ground level, 5,000 feet, and 10,000 feet altitude. Mean PaO2 dropped significantly from 93.5 to 81.5 to 58.5 mm Hg, respectively (P less than 0.001, analysis of variance with repeated measures). Mean cjO2 also decreased significantly from 63.8 to 52.0 to 34.8 mm Hg, respectively (P less than 0.001, analysis of variance with repeated measures). Within individual subjects, cjO2 was an accurate predictor of PaO2 (P less than 0.001, multiple regression analysis). The relationship between cjO2 and PaO2 was linear with a regression coefficient of 1.147. The authors conclude that the transconjunctival O2 monitor may be useful for monitoring the adequacy of arterial oxygenation during helicopter flight in hemodynamically stable patients. The results of study also support the use of supplemental oxygen in all patients subjected to helicopter transport.

A: Adult
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Q: Abstract: The effectiveness of neostigmine 0.07 mg kg-1 and edrophonium 0.8 mg kg-1 as antagonists of profound neuromuscular blockade induced by vecuronium 0.1 mg kg-1 or atracurium 0.5 mg kg-1 was studied in 59 healthy patients. The antagonists were administered 5 min after total ablation of the twitch response and the end-point of recovery was a train-of-four ratio of 70%. In 30 patients given vecuronium the mean time to reach this point (duration TOF70) was 66.7 min in the control group (no antagonist), 43.5 min in the group given neostigmine and 59.8 min in the group given edrophonium. The duration TOF70 was shorter in the neostigmine group than in the control (P less than 0.01) and edrophonium (P less than 0.01) groups. The duration TOF70 did not differ from control in the edrophonium group. In 29 patients given atracurium, the durations TOF70 were 66.4, 44.1 and 54.9 min in the control, neostigmine and edrophonium groups, respectively. The durations TOF70 in the neostigmine (P less than 0.01) and edrophonium (P less than 0.01), groups were shorter than control. The duration TOF70 of the neostigmine group was shorter than in the edrophonium group (P less than 0.01). These results show that profound neuromuscular blockade cannot be rapidly antagonized by either of these two agents, but if reversal is required under these circumstances, neostigmine would be the more effective drug.

A:
Adult
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