Background 
Many animal models have been developed to study bronchopulmonary dysplasia (BPD). The preterm rabbit is a low-cost, easy-to-handle model, but it has a high mortality rate in response to the high oxygen concentrations used to induce lung injury. The aim of this study was to compare the mortality rates of two models of hyperoxia-induced lung injury in preterm rabbits.


Methods 
Pregnant New Zealand white rabbits were subjected to caesarean section on gestational day 28 or 29 (full term = 31 days). The premature rabbits in the 28-day gestation group were exposed to room air or FiO2 ≥95%, and the rabbits in the 29-day gestation group were exposed to room air or FiO2 = 80% for 11 days. The mean linear intercept (Lm), internal surface area (ISA), number of alveoli, septal thickness and proportion of elastic and collagen fibers were quantified.


Results 
The survival rates in the 29-day groups were improved compared with the 28-day groups. Hyperoxia impaired the normal development of the lung, as demonstrated by an increase in the Lm, the septal thickness and the proportion of elastic fibers. Hyperoxia also decreased the ISA, the number of alveoli and the proportion of collagen fibers in the 28-day oxygen-exposed group compared with the control 28-day group. A reduced number of alveoli was found in the 29-day oxygen exposed animals compared with the control 29-day group.


Conclusions 
The 29-day preterm rabbits had a reduced mortality rate compared with the 28-day preterm rabbits and maintained a reduction in the alveoli number, which is comparable to BPD in humans.

/pdf/a-hyperoxic-lung-injury-model-in-premature-rabbits-the-478ss5nzom.pdf

A hyperoxic lung injury model in premature rabbits: the influence of different gestational ages and oxygen concentrations.

Medical professionals are presented with numerous ethical questions that need answering on an almost daily basis. In this paper, the story of Baby Fae is used as a vehicle to discuss ethical issues. This case highlights the core ethical question regarding the taking of an innocent animal’s life to attempt to save the life of an innocent human. It has been more than twenty-six years since Baby Fae lived and died with a baboon heart keeping her blood flowing and her body alive. Presented in this paper are the facts, simply stated, regarding an historical event that had a profound effect upon medical history. Nurses played a role in it that other nurses can emulate: working professionally in the face of great opposition, retaining patient privacy rights, realizing that we cannot always have a vote about which side of a case we would like to be on, and functioning non-judgmentally as a patient advocate. It can be easy to laud or criticize an historical event; but, we do not live in history – we only hope to learn from it. This article is available in JCCC Honors Journal: http://scholarspace.jccc.edu/honors_journal/vol2/iss2/2 “Those who know what’s best for us must rise and save us from ourselves.” One evening in late 1984 in the high-desert city of Barstow, California a twentyfour-year-old woman, pregnant with her second child began to bleed vaginally. Still about two weeks short of her baby’s due date, she hurried to the local community hospital. Three hours later her baby daughter was born. Soon after delivery they knew something was wrong. The baby’s mother, Teresa Beauclair, was granted only a minute with her daughter before the nurses took the newborn out of the delivery room. A few hours later the baby was rushed by ambulance to Loma Linda University Medical Center But, who knows what is best for us when the definition of right and wrong is blurred? What is right and wrong when the meaning has yet to be defined and who gives one the authority to establish what is right and what is wrong? What if there are two perceived rights (or wrongs) and a decision must be made between the two? Now give this a moment of thought: is it right to do wrong in order to do right? Life can, and usually does, present us with problems that need more than a cursory inspection of a rule book or even an indepth appraisal of a terrestrial guru’s faculties. Given a scenario already recorded in history, one may be glad he or she was not the person that had to come up with a decision that now is too easy to laud or criticize. Not everything that can be thought of has been thought of already. There are moments in time that create reasons for each of us to look inwardly and outwardly in order to determine that, perhaps, something needs to change – now how do we collectively move toward that end? The purpose of this work is to look back at such an event in recent history that did just that and learn about making ethical decisions. It is now time to take off the nursing shoes and, non-judgmentally, “walk a mile” in the shoes of others. 1 Moore: Ethical Issues in the Case of Baby Fae Published by ScholarSpace @ JCCC, 2011 in Loma Linda, California. Soon after Ms. Beauclair’s discharge from the Barstow hospital she drove to there to be with her daughter. “When I got there I never, ever, dreamed that I would be told that there was nothing that they could do to help her and that she was going to die,” Ms. Beauclair recalled. “I remember being really upset and I said, ‘You mean you can put a man on the moon; but, there’s nothing you can do to help her,’ and he (the Dr.) said ‘no.’” The newborn was diagnosed with hypo-plastic leftheart syndrome (HLHS). This congenital condition results in left side of the heart being physically under-developed in its entirety. The left atrium, mitral valve, left ventricle, and aortic valve are all too small to pump sufficient blood to the brain, organs, and rest of the body. The body not only is deprived of oxygen and nutrients; but, the lungs and right-side of the heart become congested and begin to fail as well. Until the early 1980s, this diagnosis was fatal 100% of the time. The young mother was given a choice: 1) Let her baby die in the Loma Linda hospital, 2) let her die at the hospital in Barstow, or 3) let her die at home. After she “went outside and cried, and screamed, and threw a temper tantrum, basically,” Ms. Beauclair chose the last option. Not wanting to have the memory of her daughter’s passing where she lived, she checked into a motel in Barstow. There, for a couple of days, mother and baby bonded; Ms. Beauclair came to the conclusion that her daughter had the right to die at home. 2 JCCC Honors Journal, Vol. 2 [2011], Iss. 2, Art. 2 http://scholarspace.jccc.edu/honors_journal/vol2/iss2/2 A few days later, Ms. Beauclair called Loma Linda University Medical Center to report that the infant was becoming jaundiced. Dr. Dougals Deming, the perinatologist/neonatologist that diagnosed the baby with HLHS, surprised that the girl was even still alive, spoke with the mother about the unexpected early return of Dr. Leonard Bailey who also had experience at the Hospital for Sick Children in Toronto, Canada. There, for seven years, he was involved in studies related to the treatment of infants with HLHS and a large number of experimental surgeries. Dr. Bailey informed a press conference held that same month, “...what those babies needed, really, was heart replacement.” At the hospital in Toronto there had been studies of heart transplantations from animal donors. Newborn goats were receiving hearts from other subspecies of goats with Cyclosporine to prevent rejection; the life expectancy of the recipients was indefinite. If the donor was either a piglet or lamb, the life expectancy, with treatment by Cyclosporine and Azathioprine, was a little over thirty days and one hundred sixty-five days, respectively. With human xenograft transplantation the picture was a bit grim. “We were a little stymied about how we were going to find donors for human babies. No one was volunteering dead babies’ hearts for transplantation, and so we began to actually study the possibility of cross-species transplantation using baby baboons. We had a number, a litany really, of babies that came and were diagnosed and died. And for whatever reasons along came this baby, Stephanie Fae.” Dr. Bailey asked to speak directly with Ms. Beauclair in a conference at the medical center – a communication commonly called “informed consent”; so she traveled back to Loma Linda and discussed the experimental surgery with Dr. Bailey for more than seven hours. Ms. Beauclair said, “We went over all of the seven years of research that he had done.” vi An alternative procedure to transplantation that was relatively new at 3 Moore: Ethical Issues in the Case of Baby Fae Published by ScholarSpace @ JCCC, 2011 the time had been developed by Dr. William Norwood in Philadelphia. This method, with variations to accommodate the individual patient’s need, is to reroute the systemic deoxygenated blood directly to the lungs and have the right side of the heart perform the work that the left side is originally designed to do, pump the oxygenated blood throughout the body. At that time, the success rate for the first stage of Dr. Norwood’s procedure was forty percent; the oldest living child was four-years-old. Four of those children had undergone the second stage by this time and two of those children survived. No child had yet been given the third, and final, stage of the Norwood procedure. Dr. Gegory Pence, of the School of Medicine and Department of Philosophy at the University of Alabama at Birmingham, commented on the case: “A third ethical issue concerned informed consent. Did Bailey carefully describe the alternative Norwood procedure, with a 40 percent success rate...to Fae’s parents? Or that it might be used until a human heart was found? ...An old saying always evokes knowing smiles among physicians: ‘Beware the surgeon with one case.’ William DeVries suffered criticisms that he only demonstrated the ‘clinical feasibility’ of the artificial heart, not its ‘clinical usefulness.’ Did Baby Fae’s parents understand that their child’s operation might merely demonstrate the former?” Ms. Beauclair said that Dr. Bailey had informed her about the Norwood procedure that day; but, would not perform the operation on her daughter because he had not had reasonable confidence that he would be very successful with it. He directed her to the Philadelphia hospital if that was the option she felt she would take. Xenografting was not completely unheard of in 1984. The first recorded crossspecies transplantation occurred in 1682 when part of a dog’s bone was used in a Russian aristocrat’s injured skull. In 1963 and 1964, there were kidney transplantations from chimpanzees and baboons to adult humans in Denver and New Orleans. Most of these patients died within three weeks. One patient in Denver survived a little over three 4 JCCC Honors Journal, Vol. 2 [2011], Iss. 2, Art. 2 http://scholarspace.jccc.edu/honors_journal/vol2/iss2/2 months; one other, in New Orleans, lived for nine months. In 1964 a chimpanzee heart was transplanted by Dr. James D. Hardy in Jackson, Mississippi. This patient lived less than two hours. There is also a reference to a British cardiologist named Yocoub who connected the veins and arteries of a one-year-old dying boy to those of a living baboon in 1975. Until Baby Fae, he was the youngest xenograft patient on record; neither the boy nor the baboon survived the operation. After the long talk with Dr. Bailey, Ms. Beauclair gave the surgeon the written authorization to perform the testing on her daughter to determine which of the twelve baboons that the medical center had in the facility would be the best match. Loma Linda’s Institutional Review Board (IRB) had investigated Dr. Bailey’s plan over fourteen months and offered its approval in December of

/pdf/a-discussion-of-ethical-issues-in-the-case-of-baby-fae-5bg2vink85.pdf

A Discussion of Ethical Issues in the Case of Baby Fae

Humanitarian organizations, like the humans that operate or benefit from them, are filled with challenges, successes, and failures. As the largest non-governmental organization on the planet today, Doctors Without Borders has its own interesting history that falls short of the glory most people ascribe to it when they hear the westernized version of its French name, Médecins Sans Frontières (MSF). In researching this organization, the author studied several books, reviewed dozens of articles and web-sites, listened to the full recruitment pitch while watching the concurrent online presentation, and watched the movie “Living in Emergency: Stories of Doctors Without Borders”. The reader has approximately fifty hours of research condensed into about twenty minutes of reading. The final product attempts a neutral presentation of the positive and negative of MSF’s history, a description of their current locations and specific work in those areas, and information on what the prospective candidate (specifically the nursing applicant) needs to consider before engaging in a personal affiliation with the organization. MSF is rooted deeply in its French heritage. It isn’t a place for the glory-seeker, the casual traveler, or the average American. Is it worth the time to pursue? That is up for the reader to determine. This article is available in JCCC Honors Journal: http://scholarspace.jccc.edu/honors_journal/vol2/iss1/2 “There are two main levels. One level is the attachment anybody would have to the place in which you‟ve been; and, the other is the nonsense of...of not doing something once you know something needs to be done.” So states the Italian ex-patriot Doctor Chiara Lepora in the movie Living in Emergency: Stories of Doctors Without Borders. “You‟re driving somewhere and you have a car crash happening in front of you, you have the duty of doing something. And, Liberia is a huge car crash...it‟s not about Liberia, it‟s about Congo, Sudan, Pakistan, Darfur, wherever, lots of places. Car crashes everywhere.”i There are stories that we, as servants in the field of nursing, like to remember whether they involve us or not. There are also stories that we would rather forget. Then, there are the stories that we, usually, don‟t know or wouldn‟t want to know. Those are the stories that call to us to make a decision to get involved in one way or another, much like a sermon in our house of worship does. The stories about and within Doctors Without Borders are too numerous to cover in brief, too troubling for a compassionate person‟s soul, and too graphic for most people‟s stomachs. Today, Doctors Without Borders/Médecins Sans Frontières (MSF) is the world‟s largest non-governmental organization providing medical and humanitarian assistance. MSF sends teams to locations of conflict, disease, and disaster in over sixty countries to assist tens of thousands annually.ii They are not a religious organization; they are people who see the need of others who cannot care for themselves in locations that we in the developed world can only imagine truly exist in our world of relative luxury. Are others needed? Yes. Can you get involved? Yes. Will you be utilized if you try? Maybe. The onset of an organization is normally quite heroic; the early attempts at living are normally fraught with chaos. The story of MSF is no different. The roots of MSF start in the late 1960‟s in a country far away from its birthplace, in an environment not unlike what the streets of Paris have seen so many times in its own past. Civil war erupted in Nigeria in May, 1967, when the eastern part of the country, Biafra, declared itself to be independent. The International Red Cross (IRC) sent a number of medical aid workers in to Biafra to tend to the 1 Moore: Introduction to Doctors Without Borders Published by ScholarSpace @ JCCC, 2011 injured and refugees of the conflict. Before entering the theater, the IRC required that its volunteers sign a promise of discretion. Doctor Bernard Kouchner, a gastroenterologist from France, went in to work at Biafra after reluctantly signing the agreement with the IRC. When he returned to France, he broke the agreement in order to bring to light the inhumane suffering that was entirely too prolific within the confines of the breakaway region of Nigeria. “The sights appalled Kouchner, who 35 years later could still recall the hungry children „like dry plants finally withered.‟ But the French doctors soon realized that these Biafran civilians were not simply caught in the crossfire. They were being deliberately starved by the Nigerian Forces who had created a food blockade ensuring that „all would perish, so light, so frail in our hands.‟ The doctors believed they were witnessing a genocide.”iii The Nigerian military forces would not budge on their hardline stance, even going so far as to murder a number of ex-patriot and national hospital staff who were attempting to help. Upon his return to France, Kouchner and a number of his colleagues tried multiple ways to raise awareness about the plight of the Biafran people. The neutrality exhibited by the International Red Cross, even at the death of its own people, could not be tolerated any longer. In the mind of Kouchner, the IRC was allowing the genocide to continue. “„To give medical care and keep quiet, to give medical care and let children die, for me it was clearly complicity,‟ he told students at the Harvard school of Public Health in 2003. „Neutrality led to complicity. The duty to interfere was born.‟”iv The French word Frontieres, where “Borders” comes from in Doctors Without Borders, loosely correlates to “Repression.” The trick in establishing an effective medical organization that operated outside the boundaries of colonialism was quite a task. The first hurdle was finding like-minded people. Bernard Kouchner developed that like-minded group that met, informally, in his home. The stand of this group of “Biafrans”, as they came to be known from their ties to the region in Nigeria, was that the rights of those oppressed must trump the borderlines established in the international vision of sovereignty. By the early 1970s another group, spurred on by the editor of the medical journal Tonus, came to the same conclusion as the 2 JCCC Honors Journal, Vol. 2 [2011], Iss. 1, Art. 2 http://scholarspace.jccc.edu/honors_journal/vol2/iss1/2 Biafrans. Raymond Borel, that editor, put out the call for French doctors to aid those in need as a resultof the natural disasters in Iran, Yugoslavia, and Eastern Pakistan.v The editor argued that aid was under-expedited and overloaded with bureaucracy and political meddling. It didn‟t take too long before the two groups found each other. Though the two groups had much in common, there was a major sticking point that was later to become a cause of division within the fledgling organization. Trying to put a charter together that all could agree upon was a challenge for the assembly that met in the office of Tonus in December of 1971. The whole “neutral vs. active” contention was revived in the fourth article of MSF‟s charter: They maintain professional discretion and refrain from making judgments or expressing public opinions – favorable or hostile – with regard to the events, forces, and leaders who accepted their aid.vi The reader can guess whether or not Bernard Kouchner was in favor of this article being in the charter. There were thirteen men at the table when the final charter was approved – perhaps it was an omen of the trouble soon to come. Early on in the history of MSF, there were only about 140 volunteers that were all too busy to really help where they were needed and there was little money in the coffers to send them anywhere with supplies. The goal of MSF was to be first on the field when needed; that part fell short as well. The first major test for them came a little after their first anniversary and involved deployment of people and supplies to Managua, Nicaragua in response to a major earthquake there. When they finally arrived, they were three days late. Again, in 1974, they were not quite the first in response to the area of Honduras that had been ravaged by Hurricane Fifi. As referred to earlier, the “honeymoon” ended soon after the “marriage.” In 1974 a Kurdish envoy met with Bernard Kouchner about supporting the Kurdish revolt against the government of Iraq and to solicit support from MSF. Kouchner agreed and Borel countered. Kouchner sent the team, according to his side of the story, only as a source of medical service. 3 Moore: Introduction to Doctors Without Borders Published by ScholarSpace @ JCCC, 2011 Apparently the disagreement worked in Kouchner‟s favor because he and a friend were elected to the two highest posts within MSF at the 1975 annual meeting and one of Borel‟s allies was given the boot from the board of directors. It was now up to the Biafrans to lead the organization in the direction that it ought to go. Along came 1976 and MSF‟s first real successes. The budget was still puny due to a lack of marketing strategy on the board‟s part. Direct mailing was not yet used in France. But, in the troubled nation of Lebanon MSF was alive and well. It was the first war mission opportunity for Doctors Without Borders and they took it. A group of fifty-six volunteers rotated through a Beirut hospital and the world began to take notice. MSF was given its first free advertising: Dans leur sale d’attente 2 milliards d’hommes (There are two billion people in their waiting room). Time magazine wrote an article about MSF‟s work in Lebanon and called it “an extraordinary...medical organization.”viii A young doctor with experience in the Cambodian refugee camps of Thailand took charge of MSF‟s Paris office in 1977, after receiving high praise from Bernard Kouchner. His name was Claude Malhuret. It was short-lived agreement between Kouchner and Malhuret. The younger man had a new vision for MSF: longer mission times and logis

/pdf/an-introduction-to-the-organization-commonly-known-as-3sd1gr8s3y.pdf

An Introduction to the Organization Commonly Known as Doctors Without Borders

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Sean Moore

Author Tools

Chat about Author

Papers

A Discussion of Ethical Issues in the Case of Baby Fae

An Introduction to the Organization Commonly Known as Doctors Without Borders