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Biomedical subjects

B Doran

Publications and source records attributed to B Doran.

9 recordsLinked to original sources
PubMed1996

International travel preparedness: a guideline for occupational health professionals.

1. With businesses becoming more global, occupational health nurse are often confronted with the challenge of assessing health risks and providing preventive measures and counseling for expatriates. 2. In assessing health risks for the expatriate, consider the entire itinerary, length of stay, and living accommodations; the occupation or lifestyle of the individual; whether the expatriate is pregnant or relocating with children; chronic health conditions; age; allergies; immunocompromised conditions; psychological health; and medications. 3. Update all travelers on routine immunizations including: tetanus/diphtheria; polio vaccine; measles/mumps/rubella vaccine; influenza and pneumococcal vaccines. Other immunizations are based on geographic risk. 4. Predeparture education and counseling based on risk assessment also is essential.

Female↗
PubMed1995

The use of propofol for sedation of critically ill patients undergoing haemodiafiltration.

OBJECTIVE: To assess the requirement for propofol to provide sedation in critically ill patients in established renal failure during the commencement of haemodiafiltration. DESIGN: Prospective clinical study. SETTING: ICU, University Hospital. PATIENTS: 10 adult patients. All were mechanically ventilated, had acute oliguric renal failure which necessitated continuous veno-venous haemodiafiltration and were receiving a continuous intravenous infusion of propofol for sedation. Sedation was assessed using a scoring system. INTERVENTION: Veno-venous haemodiafiltration. MEASUREMENTS AND RESULTS: Connection of the extracorporeal circuit produced a reduction in plasma propofol concentration in 7 out of 9 patients (one sample misplaced) with subsequent awakening in 3 of these 7 patients. The commencement of haemodiafiltration itself did not significantly influence the requirement for propofol (8 out of 10 patients). CONCLUSION: Haemodiafiltration does not substantially influence the requirement for propofol but the initial introduction of the extracorporeal circuit will reduce plasma concentrations in the majority of patients. This may be due to haemodilution alone or absorption of plasma albumin (with propofol) onto the membrane.

APACHE↗
PubMed1995

Determinants of early and late mortality in patients with end-stage renal disease undergoing cardiac surgery.

To determine factors influencing early and late mortality associated with cardiovascular surgery in end-stage renal disease, 48 consecutive patients (mean age 56.3 years) were reviewed: 30 underwent coronary and 18 valvular surgery. There were eight early deaths, three in the former and five in the latter group. Factors significantly related to early mortality in univariate testing included infective valvular disease, emergency vs elective surgery (both p = 0.02) poor left ventricular function and prolonged clamping and bypass times (all p = 0.001). When these factors were included in a stepwise logistic regression analysis, infective valvular disease (p = 0.02), poor left ventricular function (p = 0.01) and long cross-clamping (p = 0.01) were independently associated with early mortality. There were six late deaths. Survival for the whole cohort at 1, 5 and 7 years was 95%, 60.4% and 42.6%, respectively. Related to late mortality at univariate testing were age (p = 0.03), smoking (p = 0.04), diabetes (p = 0.03) and poor left ventricular function (p = 0.02), and stepwise logistic regression analysis showed independent association with age, diabetes and impaired left ventricular function. Mortality associated with cardiac surgery in patients with end-stage nephropathy can be reduced by better patient selection, early operation in patients with infective endocarditis, and minimized cross-clamping and bypass times.

Adult↗
PubMed1992

A nasal CPAP system. Description and comparison with facemask CPAP.

Nasopharyngeal pressures were compared in eight subjects breathing through either a nasal CPAP system or facemask CPAP system at a fresh gas flow of 50, 75 and 100 l.min-1. During nose breathing there was no significant difference in nasopharyngeal pressure between the two systems. During mouth breathing pressures were significantly lower with nasal CPAP. During nose breathing at 75 l.min-1 the mean inspiratory and expiratory pressures in cmH2O (SD) were 3.4 (0.68) and 5.9 (0.55) for nasal CPAP and 3.3 (0.71) and 6.3 (0.73) for facemask CPAP. The respective pressures during mouth breathing were 0.3 (0.73) and 2.9 (1.74) for nasal CPAP and 3.9 (0.73) and 5.8 (0.82) for facemask CPAP.

Adult↗