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Biomedical subjects

J Hawkins

Publications and source records attributed to J Hawkins.

100 records · Page 6Linked to original sources
PubMedDate not supplied

Comparative evaluation of four different infusion rates of ropivacaine (2 mg/mL) for epidural labor analgesia.

BACKGROUND AND OBJECTIVES: Previous studies have reported comparable efficacy for ropivacaine and bupivacaine when used for labor analgesia at concentrations of 2.5 mg/mL. In this multicenter study, we assessed ropivacaine at the commercially available concentration of 2 mg/mL (0.2%) for labor pain management. METHODS: After Institutional Review Board approval and informed consent, 128 women at term were randomly assigned to receive ropivacaine at one of the four infusion rates via a lumbar epidural catheter. Analgesia was initiated with a 5-mL test dose, followed by injections of 5-15 mL of 2 mg/mL ropivacaine. The continuous infusion was then started at 4, 6, 8, or 10 rmL/hour. Rescue analgesia was provided with 5-mL "top-up" injections as necessary to provide maternal comfort. Pain relief was assessed by using a visual analog pain scale (VAPS) and motor block was assessed by using a modified Bromage scale. RESULTS: All infusion regimens effectively decreased VAPS, and most patients in all groups had minimal or no motor block at the end of the first stage of labor. Mean total number of the top-up injections required per patient were 3, 2, 1.5, and 1.4, respectively, in the 4, 6, 8, and 10-mL/hour groups (P < .05, 4 mL/hour vs. all other groups). Despite receiving more total bolus dosages, the 4-mL/hour group had less motor block in the lower extremities (P < .05). Apgar scores and neurological adaptive capacity scores were similar for all groups. CONCLUSIONS: The 2 mg/mL of ropivacaine produces satisfactory labor analgesia at epidural infusion rates of 4, 6, 8, and 10 mL/hour, provided supplemental bolus dosages are available. Clinically, a rate of 6 mL/hour may be the lowest effective rate that provides the best combination of pain relief, motor block, and rebolusing, although rates of 8 and 10 mL/hour produced similar results.

Adult↗
PubMedDate not supplied

A new cohesive short-stretch bandage and its application.

The undisputed optimum treatment for venous leg ulcers is compression therapy, where an external appliance (multilayer, short-stretch bandaging and compression hosiery) promotes venous return through graduated compression of the tissues and capillaries. However, this is not always acceptable to the patient, particularly when the patient's social life is affected with malodour and pain associated with venous leg ulcers, thereby reducing quality of life. There is a psychosocial consideration when the bandaging system is bulky, hot and difficulty is found with the fitting of shoes. An alternative and clinically effective solution is essential if the wound is to heal. In this case study, the patient was provided with a cohesive and short-stretch compression bandage (Actico), which allowed her to continue her social life while effectively treating her ulcer.

Aged↗
PubMedDate not supplied

Pregnant women's perceptions of abuse.

OBJECTIVE: To determine whether pregnant women's perceptions of abuse severity and danger, and their ability to control the abuse, are significantly correlated with the acts of abuse they experience, and to find out whether relationships exist among women's appraisals of abuse severity, danger, and their perceived ability to stop the abuse. DESIGN: A correlational design was used to compare the abusive acts experienced by the women and their perceptions of that abuse. SETTING: Nine prenatal clinics in urban areas of the northeastern United States. PARTICIPANTS: Sixty-one ethnically diverse, pregnant abused women were interviewed. MAIN OUTCOME MEASURE: Pearson's product-moment correlations were used to examine relationships between abusive experiences and women's perceptions of abuse. RESULTS: Women's perceptions of abuse severity were modestly correlated with threatened (r = .25) and actual violence (r = .36). Perceptions of abuse severity and danger were correlated (r = .41). CONCLUSIONS: Women's beliefs about abuse severity, danger, and their ability to control abuse cannot be fully comprehended by exploring the discrete acts they experience. Further research is needed to identify additional factors that influence those beliefs.

Adolescent↗
PubMedDate not supplied

Addressing the shortage of radiologists.

In a survey of 254 hospital radiology departments conducted last year, Dallas-based U.S. Radiology Partners (USRP), a radiology management firm, found that 45 percent of hospitals are understaffed in radiology. Fifty-six percent of hospital radiology department heads surveyed by USRP indicated that staffing shortages were diminishing the quality of care their departments are able to provide. Moreover, staffing shortages are occurring at a time when radiology volume generally is increasing. There are various underlying reasons why the supply of radiologists and other physicians is insufficient to meet demand in many areas, including institutional misdiagnosis, graduate medical education, patient preferences, the economy, restrictions on international medical graduates, practice patterns, patient and physician demographics and new technology. Given current physician supply and demand trends, a strategic radiology staffing plan is needed. Such a plan would include the following elements: retention, candidate parameters, contracts and incentives, sourcing, screening, interviewing, responsiveness and decisiveness.

Data Collection↗
PubMedDate not supplied

Perioperative management of adrenal cortical suppression.

Two questions asked prior to podiatric surgery for patients with a history of steroid therapy are: what are the risks involved with surgery and what specific measures should be taken in perioperative management for these patients? Studies identifying normal adrenal response to surgery in patients with a long-term history of steroid use have been noted. This paper discusses use of the metyrapone test to identify patients with adrenal suppression who may require additional steroid coverage perioperatively and empirical steroid dosing regimens.

Adrenal Cortex↗
PubMedDate not supplied

Comparing nursing costs for preterm infants receiving conventional vs. developmental care.

The incremental costs incurred by VLBW (less than 1,500 grams) infants during the first year of life accounted for one-third of the $11.4 billion spent in the U.S. on health care. Developmental care for VLBW infants focuses on light and noise management, coordination of interventions to minimize sleep interruptions and positioning/bundling the infant to prevent disorganizaiton and promote self-regulation. When compared to 60 VLBW infants receiving conventional NICU care, improved physiologic stability measures and fewer days in the NICU were recorded for the 60 VLBW infants cared for by nurses and trained developmental care specialists. Because the move from the NICU to the transitional unit occurred earlier for the developmental group of VLBW infants, and their nursing intensity needs were lower, the average cost savings achieved for this group was $4,340 per infant during the first 35 days of life or less if discharged.

Child Development↗