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Biomedical subjects

J Dunning

Publications and source records attributed to J Dunning.

46 records · Page 3Linked to original sources
PubMed1992

Apparent obstruction of the superior vena cava and a continuous murmur: signs of a fistula between a vein graft aneurysm and the right atrium.

A previously undescribed complication of a saphenous vein aortocoronary bypass graft, namely formation of a fistula between a vein graft aneurysm and the right atrium is reported. A patient presented with a continuous murmur and a combination of signs suggesting superior vena cava obstruction. This pathology was shown by both echocardiography and angiography. Surgical treatment was attempted.

Aged↗
PubMed1991

Clinical factors and the size of the external callus in tibial shaft fractures.

The influence of clinical factors on external callus formation was investigated by prospectively studying 50 closed adult unilateral tibial shaft fractures. The fractures were treated by closed methods and all united normally within 20 weeks of injury. The callus volume and a quantitative index of size, calculated from roentgenograms, did not correlate with clinical factors such as severity of trauma, interval from fracture to weight bearing, fracture morphology, presence or absence of a fracture gap, or fracture displacement.

Adult↗
PubMedDate not supplied

Family assessment tools: a review of the literature from 1978-1997.

Traditionally, nursing practice in critical care settings has been focused on recognizing and addressing the needs of the patient with an acute and serious health problem and individual family members. Little progress has been made in understanding how families manage this hospitalization experience; however, family health has been reported to be a significant factor in the patient's recovery. The purpose of this article is to review the literature from 1978 to 1997 that has examined family assessment tools in a variety of clinical settings. The ultimate goal of the review is to determine their usefulness for critical care environments and their congruence with family systems nursing, which is aimed at the cognitive, behavioral, and affective domains of family functioning. The following characteristics are used to review each of the selected instruments: theoretical framework; purpose; description; the unit of analysis; ease of administration and scoring; reading level; psychometric evaluation; and utility to guide clinical practice and research. Although the instruments have a variety of strengths, none of them are congruent with the philosophy of family systems nursing. Therefore instruments need to be developed that would guide assessment and interventions for nurses in critical care settings.

Critical Care↗
PubMedDate not supplied

The use of exercise technetium-99m 2-methoxy-isobutyl-isonitrile (99mTc-Sestamibi) perfusion scanning in the detection of acute rejection after cardiac transplantation.

Acute cardiac rejection remains an important cause of death during the first year following cardiac transplantation. Right ventricular biopsies at regular intervals are the main method of detecting rejection, although it is invasive. Unfortunately, non-invasive methods of detecting rejection have not proved reliable enough to replace cardiac biopsies. We assessed the usefulness of technetium-99m 2-methoxy-isobutyl-isonitrile (99mTc-Sestamibi) perfusion scanning in detecting acute rejection in 12 human orthotopic cardiac transplant recipients. Rest and exercise studies and right ventricular biopsies were performed on two occasions. Isotopic evidence of rejection was defined as a perfusion abnormality on either the resting or exercise studies. 99mTc-Sestamibi studies successfully identified acute rejection in 8 of 11 rejection episodes (p less than 0.04). The calculated sensitivity and specificity of 99mTc-Sestamibi scanning were both 72%. Perfusion scanning with 99mTc-Sestamibi may be useful in the diagnosis of acute rejection in cardiac transplant recipients.

Adult↗
PubMedDate not supplied

Influence of recipient and donor gender on outcome after heart transplantation.

To investigate the effect of recipient and donor genders on the outcome after heart transplantation, a retrospective survey was undertaken of 356 patients (366 transplants: 316 males, 40 females) undergoing transplantation between January 1979 and December 31, 1989, at Papworth Hospital. Ninety-three organs came from female donors; 263 organs came from males. Twelve females (30%; 95% confidence interval 16% to 44%) and 51 males (16%; 95% confidence interval 12% to 20%) died in the early postoperative period (within 90 days of operation). To date, two females (5%) and 51 males (16%) have died in the late postoperative period. Comparison between recipient genders showed no statistically significant difference in early mortality rates from any cause or in actuarial survival overall, although fatal acute rejection was significantly more common in female recipients (7 of 40 female recipients versus 19 of 316 male recipients). The higher incidence of fatal rejection among female recipients was related to the higher proportion of female donors in this group, because recipients of female donor grafts had significantly higher mortality rates, particularly in the early postoperative period and as a result of acute rejection, than did recipients of organs from male donors. Death from rejection after the first 3 months and death from infection were not gender-related. Recipients of grafts from female donors did not suffer significantly more early morbidity, such as rejection and infection, or late morbidity in the form of coronary artery disease. Acute rejection episodes were more common in female recipients.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗