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Biomedical subjects

K Greaves

Publications and source records attributed to K Greaves.

6 recordsLinked to original sources
PubMed1998

Cardiac troponin T does not increase after electrical cardioversion for atrial fibrillation or atrial flutter.

OBJECTIVE: To determine whether cardiac troponin T increases after electrical cardioversion in patients with atrial fibrillation or atrial flutter. DESIGN: Serum creatine kinase (CK), creatine kinase-MB (CKMB), and cardiac troponin T were measured before, 24 hours, and 48 hours after cardioversion in 15 patients with atrial fibrillation or atrial flutter. RESULTS: 12 of the 15 patients (80%) were successfully cardioverted to sinus rhythm. The median number of shocks was three (range one to six), the median cumulative energy 710 J (50 to 1430 J), and the median peak energy 300 J (50 to 360 J). Total CK increased from a baseline median concentration of 92 (45 to 259) to 1324 (96 to 6660) U/l at 24 hours and 1529 (120 to 4774) U/l at 48 hours after cardioversion. There was a small increase in CKMB but the ratio of CKMB to CK did not increase. There was no increase in cardiac troponin T in any patient. CONCLUSIONS: Following electrical cardioversion of atrial fibrillation or atrial flutter, cardiac troponin T remains unchanged despite a large rise in total CK, indicating that the CK is derived from skeletal muscle and that myocardial injury does not occur. If cardiac troponin T is increased after cardioversion for atrial arrhythmias then other causes of myocardial damage should be sought.

Aged↗
PubMed1993

TLAs and beyond.

National Vocational Qualifications (NVQs) are a truly exciting new concept in training which match the development and assessment of knowledge and skills to service needs. They are non-prejudicial and have a flexibility which can make them an attractive option in any forum and to any grade of staff. Please do not discount this as mere propaganda--it may not quote the official doctrines to the letter, but it does describe the basis of the NVQ philosophy which matches service requirements with specific skills training and, after two years' involvement with these qualifications, I have to agree. In this first article, the 'backbone' of the structures relating to an NVQ strategy will be described, both at a national and a local level.

Clinical Competence↗
PubMed1993

Exploring the issues.

In the previous article, I gave an overview of National Vocational Qualifications and the structures which give support on a national and local basis, an understanding of which is essential before informed judgements can be made and implementation successfully achieved. This second article will address some of the issues which have raised concern within operating departments throughout the country, but which must be resolved if the needs to ensure effective staffing levels in the future are to be met. It is inevitable that there will be no easy answers and equally true that each and every operating departments and ODP assessment centre will address the issues in a different way. Our joint and ultimate aim is that of providing a high standard of patient care and, for once, there is a flexibility within the training system to facilitate just that!

Accreditation↗
PubMed1992

Actinic reticuloid: action spectra and UVA protection factor sunscreens.

This study compares the action spectra on two new patients with actinic reticuloid (AR), with one previously reported patient. All three patients had exquisite photosensitivity in the UVB range being up to 27 times more sensitive than controls. Sensitivity also increased into the UVA Range, all up to 335 nm and, one into the visible. Their photosensitivity made evaluation of the Sun Protection Factor (SPF) of selected, more recent, high-numbered sunscreens easier to compare, because of the shorter time of the minimal erythema dose when tested with a solar simulator. A sunscreen containing butyl methoxydibenzoylmethane (Parsol 1789) with an overall SPF of 16 was not as effective at protecting the actinic reticuloid patients as a higher SPF numbered sunscreen containing a benzophenone (SPF of 40). The Parsol 1789 gave a protection value of 5 in the UVA Range, compared to one of 3 given by the sunscreen containing benzophenone. The SPFs of seven of these commerically available high-numbered sunscreens were compared with controls.

Aged↗
PubMed1990

Children's Activity Rating Scale (CARS): description and calibration.

A five-level Children's Activity Rating Scale (CARS) was designed to categorize the intensity of physical activities and discriminate between levels of energy expenditure in young children. The CARS was used by trained observers over a 12-month period to assess physical activities of 3-4 year-old children during field observations. Agreement among observers using the CARS was 84.1% for 389 paired observation periods. The energy expenditure for each level was assessed by measuring VO2s and heart rates of 5-6 year-old children (12 boys, 13 girls) while they performed eight activities representing the CARS levels. Mean VO2s for the eight activities in Levels 1-5 ranged from 7.1 to 37.5 ml.kg BW-1.min-1 (1 to 5.42 METS; 14.5% to 80.6% of VO2max). Mean heart rates ranged from 89 to 183 b.min-1 for activities in Levels 1-5. VO2s and heart rates at each level were significantly different from all other levels. These data demonstrate that the CARS encompasses a wide range of energy expenditures, discriminates between levels of energy expenditure, and can be used by trained observers to reliably evaluate physical activity and estimate energy expenditure of young children.

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