Search PubMed⌕ Search

Biomedical subjects

D K Newman

Publications and source records attributed to D K Newman.

At least 55 records · Page 3Linked to original sources
PubMed1997

Is hyaluronidase helpful for peribulbar anaesthesia?

A prospective, randomised controlled study was performed to investigate whether hyaluronidase improved the efficacy of peribulbar anaesthesia. Ninety-two patients undergoing peribulbar anaesthesia for intraocular surgery all received 10 ml of an anaesthetic solution consisting of a 50:50 mixture of 2% lignocaine with 1 in 200,000 adrenaline and 0.5% bupivacaine. Patients were randomised to a hyaluronidase group which received 150 IU/ml hyaluronidase in this anaesthetic solution (a higher concentration than previous studies) or a control group which received no hyaluronidase. There were 44 patients in the hyaluronidase group and 48 patients in the control group. All anaesthetic injections were administered by an experienced ophthalmologist and no supplementary injections were required in any case. The mean time interval between administration of the block and commencement of surgery was 22 minutes. No statistically significant difference was found between the two groups for pre-operative akinesia (p = 0.16), intraoperative akinesia (p = 0.25), eyelid paralysis (p = 0.72), objective analgesia (p = 0.23) or subjective analgesia (p = 0.60). The majority of patients in both groups achieved excellent akinesia, eyelid paralysis and analgesia. The reasons for these findings in the light of previously conflicting reports on the value of hyaluronidase in peribulbar anaesthesia are discussed.

Adjuvants, Anesthesia↗
PubMed1997

Precipitation of Arsenic Trisulfide by Desulfotomaculum auripigmentum.

A newly discovered bacterium, Desulfotomaculum auripigmentum, precipitates arsenic trisulfide (As(inf2)S(inf3)). Precipitation of As(inf2)S(inf3) by this organism results from its reduction of As(V) to As(III) and S(VI) to S(-II). At the As(III) concentration range of interest (0.1 to 1 mM), the stability of As(inf2)S(inf3) is highly sensitive to pH and [S(-II)]. Thus, the relative rates at which D. auripigmentum reduces As(V) and S(VI) are critical to its formation of As(inf2)S(inf3). Other As(V)- or S(VI)-reducing bacteria are unable to precipitate As(inf2)S(inf3) either due to their inability to reduce both As(V) and S(VI) or because they reduce S(VI) too rapidly. Electron microscopy of thin sections showed that the precipitate forms both intra- and extracellularly. Microbial As(inf2)S(inf3) formation nucleates precipitation of the mineral in the bulk milieu, whereas heat-killed cells alone do not serve as templates for its formation. Precipitation of As(inf2)S(inf3) by D. auripigmentum suggests that As(inf2)S(inf3) formation may be important in the biogeochemical cycle of arsenic.

Journal Article↗
PubMed1997

Urinary outcomes in older adults: research and clinical perspectives.

There is a need for continued collaboration between clinicians and researchers to further improve urinary continence outcomes. This article presents the perspectives of four nurses who conduct continence research or who have independent continence services practices. Each discusses continence outcomes used in long-term care facilities or the community as a researcher or clinician and suggests implications for future nursing development.

Aged↗
PubMed1996

Preschool vision screening: outcome of children referred to the hospital eye service.

AIMS: To assess the outcome of children referred to the hospital eye service (HES) from an orthoptist based preschool vision screening programme. METHODS: A retrospective study was conducted of children referred from screening during a 2 year period. Children were screened by community orthoptists at 3 1/2 years of age. The main outcome measures were (1) HES findings for children referred from screening, and (2) visual outcome for amblyopic children after completion of treatment. RESULTS: The attendance rate at screening was 79.3% (6794 children): 348 children (5.1% of those screened) were referred to the HES. The HES findings were refractive error (32.9%), amblyopia (29.9%), false positive referral (20.1%), strabismus (13.2%), and other ocular disorders (3.9%). The positive predictive value of screening was 79.9%. Screening detected 48 children with straight eyed amblyopia and 43 children with strabismic amblyopia. A visual acuity of 6/9 or better in the amblyopic eye was achieved by 87.2% of straight eyed amblyopes and 64.3% of strabismic amblyopes (chi 2 = 5.27, p = 0.02). Residual amblyopia of 6/24 or worse occurred in only 5.6% of amblyopic children. CONCLUSION: Most amblyopic children detected by preschool vision screening achieve a good visual outcome with treatment. While treatment earlier in the sensitive period might be expected to give improved results, it remains to be demonstrated that preschool screening results in a better outcome than screening at school entry. Preschool vision screening also detects a significant number of children without amblyopia who have reduced vision due to refractive errors. This group of children must be included in any analysis of the cost effectiveness of preschool vision screening.

Amblyopia↗
PubMed1995

Prevention of immune-mediated corneal graft destruction with the anti-lymphocyte monoclonal antibody, CAMPATH-1H.

We report a patient with peripheral rheumatoid corneal melting who developed a corneal perforation in one eye requiring tectonic keratoplasty. Nine consecutive corneal grafts were rapidly destroyed despite systemic immunosuppression with corticosteroid, cyclophosphamide, azathioprine and cyclosporin A. A rejection episode was observed in one graft before it melted and allograft rejection may have contributed to the destruction of other grafts. Corneal graft survival was ultimately achieved by systemic immunosuppression with the anti-lymphocyte monoclonal antibody, CAMPATH-1H. A single episode of rejection developed in the early post-operative period which was easily reversed by topical corticosteroid. Corneal melting has not recurred and the graft has now remained intact and clear for 24 months. Anti-lymphocyte monoclonal antibodies may therefore provide effective immunosuppression in the treatment of refractory ocular disorders.

Aged↗
PubMed1994

Significance and impact of urinary incontinence.

All nurses can play an important role in the detection of urinary incontinence (UI) in both community as well as institutional populations. With their advanced practice assessment and patient management skills, NPs are assuming a major role in the diagnosis and treatment of UI in primary and acute care settings, in home care, and in the management of chronic incontinence in long-term care. A strong commitment by the nursing community to emerge as a leading health care provider of incontinence assessment and management will be a major contribution to providing long awaited assistance for the 10 million incontinence sufferers in the United States. This article reviews the significance and impact of UI across all settings.

Adult↗
PubMed1994

Planning an independent nursing practice for continence services.

Nurses are assuming greater leadership in the field of continence care. Many of the services necessary to assess and manage incontinence can be provided through an independent nurse practice. With advanced practice NP skills and a desire to be an entrepreneur, this article provides a guideline for conceptualizing and organizing an independent practice for managing urinary incontinence.

Humans↗
PubMed1993

Establishing a continence service using AHCPR guidelines.

The Agency for Health Care Policy and Research (AHCPR) has recently released practice guidelines for the management of adult urinary incontinence. The guidelines are designed to enhance the quality, effectiveness and appropriateness of health care in the area of incontinence. The purpose of this article is to describe assessment and management strategies as used in a continence clinic that incorporate AHCPR guidelines. This continence clinic exists within an established gynecology practice, however, continence services can be provided in nursing homes and/or home care agencies.

Female↗
PubMed1992

Pelvic muscle reeducation as a nursing treatment for incontinence.

Pelvic muscle reeducation is a safe, effective, conservative therapy for patients with UI. The success of the method depends on the proper selection of patients and the active participation of a cooperative patient. However, it is of limited use in patients with cognitive impairment. Methods exist to assist the nurse in pelvic muscle reeducation.

Exercise Therapy↗
PubMed1991

A portable bladder scanner.

Nurse practitioners are the primary care providers in a variety of health care settings. Often the NP is the first health care provider to suspect a problem based on history, observations, diagnosis, and patient comfort. In making a diagnosis, the NP must be cognizant of all available diagnostic techniques and procedures. A simple and easy method for ultrasonic bladder scanning has developed over the past several years. NPs can utilize this technique in their clinical practices.

Humans↗
PubMed1989

Managing urinary incontinence in community-residing elderly persons.

This two-year project demonstrated a significant decrease over time in urinary accidents after instruction in Kegel exercises augmented by the use of biofeedback, habit training, and relaxation techniques in 54 cognitively intact volunteers aged 60 years and over who had stress, urge or complex types of incontinence. This decrease in urinary accidents per week was maintained from the end of focused treatment through 6-month and 1-year follow-up, despite the age of the participants, previous urinary-related surgeries, or duration of incontinence.

Aged↗