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Biomedical subjects

K Holm

Publications and source records attributed to K Holm.

176 records · Page 10Linked to original sources
PubMedDate not supplied

Coronary heart disease: requisite knowledge for developing prevention strategies for the aging adult.

More people than ever before are reaching old age, with the latest statistics indicating that life expectancy for a man of 45 years has increased from 70.4 to 77.3 years and from 77.0 to 82.8 years for a woman. One of the primary factors associated with this increase in longevity is the decrease in mortality from cardiovascular disease. Since the mid 1960's, there has been a decline in cardiovascular mortality of about three percent per year. Recent technological advances and healthier lifestyles are among the reasons contributing to this trend, supporting the notion that the decrease in cardiovascular mortality and morbidity is due to more than just aging and genetic predisposition. Our challenge as health care professionals, is to be aware not only of the cardiovascular changes that occur as a result of aging, but to identify when and how much intervention is appropriate (i.e. risk factor modification) for selected age groups, particularly the older adult.

Age Factors↗
PubMedDate not supplied

Women undergoing coronary artery bypass surgery: physiological and psychosocial perspectives.

Men and women have similar mortality and long-term survival after coronary artery bypass surgery. When compared with men, however, women have less favorable outcomes in graft patency, perioperative infarction, relief of symptoms, and physical activity levels. Finally, little information is available about women's employment and psychosocial outcomes, making comparisons between genders speculative at best. We suggest that prospective studies of bypass surgery in women include a thorough assessment of key variables such as symptoms, activity, and return to employment, housework, or both, before and after surgery. It is essential to examine the immediate postoperative activity level of female bypass surgery patients for information on resumption of household activities. This information is critical for successful rehabilitation. Whether the term "return to work" includes household activities must be addressed. This will allow researchers to use the same outcome when discussing "gainfully employed or active." For comparisons between the sexes, women of all age groups must be studied, since age clearly affects outcome. The effect of repeated surgeries must also be examined. As more women survive the first bypass, how they fare in subsequent operations will require study. The need to examine benefits of surgical versus medical treatment is critical. A primary issue is whether women are referred for surgical intervention later than men, and if so, is this a reason for their relatively poor outcome after this procedure? Furthermore, we predict that the multiple roles now assumed by women will influence incidence of heart disease and how women fare after surgical intervention.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Artery Bypass↗
PubMedDate not supplied

Management of cervical root perforation: report of a case.

The case reported here demonstrates, in the planning and treatment of this patient, a good example of teamwork among different dental specialities. The clinical examination of a healthy, sixteen-year- old Swedish boy produced the diagnoses of osteitis periapicalis resorptiva chronica and root perforation, after unsuccessful treatment by the school dentist who had referred the patient. Orthodontic extrusion was preferred to a surgical approach. The prosthetic treatment was completed immediately after finishing the endodontic procedures.

Adolescent↗
PubMedDate not supplied

An evaluation of two indirect methods of blood pressure measurement in ill patients.

Direct (intraarterial) and two indirect (using a mercury sphygmomanometer [MS] and an automatic [auscultatory] device) methods of blood pressure measurement were compared in intensive care patients (N = 32). One trained observer blind to both automatic and direct measurements obtained all indirect MS measurements. All direct and indirect measurements were made on the same arm. Direct measurements were obtained from 10-second strip chart recordings. In normotensive patients both indirect measurements of systolic blood pressure (SBP) underestimated the direct SBP; however, only the SBP value obtained with the automatic device (106 mm Hg) was significantly different, p less than .05, from the direct SBP value (120 mm Hg). No significant difference was noted between methods in measurement of normotensive diastolic blood pressure. In hypertensive patients direct SBP was significantly greater, p less than .05, from both values obtained by indirect measurement. In patients without hypotension the automatic device may be substituted for the MS and direct blood pressure methods. The automatic device may offer the advantage of decreasing observer bias and variability in blood pressure measurement.

Adult↗
PubMedDate not supplied

Can hairspray be used as a smear fixative? A comparison between two types of coating fixatives.

Pairs of smears from 25 consecutive women undergoing routine screening and 30 consecutive colposcopy patients suspected of having cervical intraepithelial neoplasia were randomized and fixed with either Merckofix or a hairspray to compare their use as coating fixatives. Vacuolated cells from the cervical transformation zone were present in 9 of 25 and 24 of 30 smears fixed with hairspray against 2 of 25 and 2 of 30 of smears fixed with Merckofix in the two series, respectively. These findings indicate that the fixative effect of commercial hairsprays always should be tested before such hairsprays are introduced into routine procedures.

False Negative Reactions↗
PubMedDate not supplied

The value of provoked expectoration in obtaining sputum samples for cytologic investigation. A prospective, consecutive and controlled investigation of 134 patients.

A prospective controlled investigation in 134 consecutive outpatients compared the cytologic adequacy of sputum samples obtained by spontaneous and provoked expectoration. Inhalation of nebulized 10% sodium chloride was used for provoked expectoration. A significantly higher number of adequate samples was produced after provocation, as judged by the presence of alveolar macrophages (X2 = 5.63; p less than 0.02). The improvement in sample adequacy was limited to the nonsmokers and ex-smokers in the study. This result, together with the relatively high cost of cytologic sputum examinations, indicates that provoked expectoration should at least be applied to the collection of sputum samples from nonsmokers and ex-smokers.

Humans↗
PubMedDate not supplied

Early appraisal of coronary revascularization on quality of life.

Information available for nurses on counseling cardiac patients about the outcomes of bypass surgery has focused on the time following the first postoperative year. In order to assess earlier impact, two groups of bypass patients--alike in terms of preoperative physical activity, angina level, and type of revascularization--were compared in terms of quality of life and related areas. Seventeen patients were 3 to 5 months (88-141 days) postoperative and 17 patients were 6 to 8 months (161-222 days) post-operative. They were asked to rate themselves on Cantril's Self-Anchoring Scale in relation to past, present, and future life satisfaction. An analysis of variance (ANOVA) indicated that both groups of patients viewed their future life satisfaction to be better than their life satisfaction prior to open heart surgery. Furthermore, the patients 6 to 8 months postoperative viewed their present life satisfaction to be significantly better than their past (p less than .05). Both groups reported a decrease in the level of angina and an increase in the level of physical activity after surgery (p less than .001). They also reported greater satisfaction with family life (p less than .05), social life (p less than .001), and sexual life (p less than .01) following surgery. Overall, there were significant improvements in the quality of life early in the recovery period following surgery. Residual incisional pain may have contributed to any differences between groups.

Adult↗
PubMedDate not supplied

The role of catecholamines, age, and fitness on blood pressure reactivity to dynamic exercise in patients with essential hypertension.

OBJECTIVE: To determine the relationship between exercise blood pressure (BP) and catecholamine levels in hypertensive subjects and, secondarily, to evaluate the influence of age and fitness level. DESIGN: Descriptive correlational. SETTING: Midwestern, university-affiliated medical center. SUBJECTS: 27 hypertensive subjects, mean age 45 years, who were free of antihypertensive medications. OUTCOME MEASURES: BP and plasma catecholamines (norepinephrine and epinephrine). INTERVENTION: Subjects were given an incremental maximal exercise test on a cycle ergometer beginning at 25 watts with workloads increasing by 25 watts every 2 minutes until exhaustion. Plasma catecholamines were measured at rest, at 100 watts, and at maximal exercise. BP, heart rate, and oxygen consumption (VO2) were measured at rest and at the end of each workload. RESULTS: Systolic and diastolic BP were unrelated to catecholamines at rest and during exercise. When subjects were evaluated according to fitness level (VO2max), resting BP was not significantly different among groups (low fitness = VO2max < or = 25 ml/kg/min; moderate fitness = VO2max 26 to 39 ml/kg/min; high fitness = VO2max > or = 40 ml/kg/min). However, an inverse relationship was observed between fitness level and rate of rise of systolic and diastolic BP during submaximal work. Multiple regression showed that fitness predicted diastolic BP response (p = 0.02) at 100 watts. Age, however, predicted systolic BP response (p = 0.015). CONCLUSIONS: Neither the level of resting nor the magnitude of BP response to exercise in hypertensive subjects was directly related to level of plasma catecholamines. The magnitude of change in BP during exercise was modulated by age and fitness level.

Adult↗
PubMedDate not supplied

Gender differences in exercise determinants.

To determine whether gender differences existed in the relationships among potential predictors of leisure-time physical activity (LTPA), a heuristic model of nine explanatory variables was tested with the responses of 146 men and 158 women randomly selected from middle- and upper-income census tracts of a midwestern city. The models for men and women did not differ significantly. The findings suggest interventions to increase LTPA participation that enhance health self-determinism and social influences on exercise and influence the negative attitudes toward exercise held by those who have poorer perceived health status, smoke, or are overweight.

Adult↗