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Biomedical subjects

K Holm

Publications and source records attributed to K Holm.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

A comparison of intravascular pressure monitoring system contamination and patient bacteremia with use of 48- and 72-hour system change intervals.

OBJECTIVE: To determine the incidence of culture positivity in intravascular monitoring systems by comparing 48- versus 72-hour intervals for flush solution, stopcocks, and catheters on removal. DESIGN: Prospective, quasi-experimental, random assignment. SETTING: Intensive care units of a midwestern university medical center and a community hospital. PATIENTS: Seventy-six critically ill adult patients, ranging in age from 24 to 96 years (X = 61.6), requiring arterial or pulmonary artery catheters. OUTCOME MEASURE: Culture positivity of flush solution, stopcocks, or catheter tips. INTERVENTION: Data collection was initiated at designated change intervals of 48- or 72-hours; cultures were taken of flush solution and stopcocks; catheter tip cultures were obtained on catheter removal. RESULTS: Chi-square analyses indicated that increasing the change interval to 72 hours resulted in no significant difference in culture positivity of catheter tips. However, the difference between the 48- and 72-hour groups in culture-positivity rates of stopcocks from arterial catheters was significant (1, N = 82) = 6.86, p less than 0.01. CONCLUSIONS: Our results showed that increasing the change interval to 72 hours did not increase the risk of catheter-associated infection or catheter-associated bacteremia. Chi-square analysis did not show an association between culture-positive stopcocks, the incidence of culture-positive catheter tips, entries into the system, or catheter-related bacteremia and a change interval that was increased to 72 hours. Thus, increasing the change interval to 72 hours does not increase the risk of infection.

Adult↗
PubMedDate not supplied

Perimenopause: the transition into menopause.

With an ever-accumulating body of knowledge about menopause has come the realization that the transition into menopause, specifically the perimenopausal period, is a process occurring over a period of years. We now know that the majority of women do not move from a time of regular menses to an abrupt cessation of menses. Rather, they experience perimenopause, a time of menstrual irregularity defined by changes in the length of the menstrual cycle and/or changes in level of discomfort associated with menses. We also know now that hormonal levels during the perimenopausal period may fluctuate more intensely, precipitating vasomotor and other symptoms. There is a tremendous need to educate women and their health care providers about the stages of the menopausal process. Such education will foster understanding of when women can expect the onset of perimenopausal symptoms. Health care providers should assist women with their questions and concerns as they move through this time of transition.

Adult↗
PubMedDate not supplied

An analysis of menopause in the popular press.

With the increased interest in menopause, it is imperative that midlife women be given reliable information. An analysis of the lay literature on menopause over the past ten years in the United States was conducted in order to determine the content of the articles, their source, and their credibility. Most articles were found to blend opinion with fact, and many of the authors of these articles did not have any stated qualifications in midlife women's health. Physicians, particularly those espousing the medicalization of menopause, were the most often quoted experts, and few nurses or other health care workers were cited as experts. It is suggested that nurses become more involved in health education for midlife women.

Attitude to Health↗
PubMedDate not supplied

The relationship between physical activity and perimenopause.

Our purpose in conducting this study was to examine the relationship between physical activity and symptoms associated with perimenopause. A group of 214 perimenopausal women aged 40-55 years (mean = 47 years) completed the Women's Health Assessment Scale (assesses symptoms associated with perimenopause: vasomotor, psychosomatic, menstrual, and sexual symptoms) and the physical activity questionnaire. These women were categorized into three groups based on their levels of physical activity: inactive, relatively active, and active. Analyses of covariance (ANCOVA) revealed significant differences between groups in frequency and distress of overall symptoms associated with perimenopause (F = 8.86, p = .00, F = 6.25, p = .00, respectively). Further analyses indicated that relatively active and active women had significantly fewer and less distressful psychosomatic symptoms (F = 8.05, p = .00, F = 5.80, p = .00, respectively), such as irritability, forgetfulness, and headache as well as fewer and less distressful sexual symptoms (F = 3.42, p = .03, F = 3.73, p = .03, respectively), such as vaginal dryness and decreased sexual desire than inactive women. No significant differences were found among groups on vasomotor and menstrual symptoms. In conclusion, physical activity may be an important alternative/adjunct to hormone therapy particularly for psychosomatic and sexual symptom management at perimenopause.

Adaptation, Psychological↗
PubMedDate not supplied

Insulin-like growth factor-I and insulin-like growth factor binding protein-3 during maintenance chemotherapy of acute lymphoblastic leukemia in children.

PURPOSE: To assess the effect of maintenance chemotherapy (MT) on growth factors and growth in children with acute lymphoblastic leukemia (ALL). PATIENTS AND METHODS: Twenty-one children (10 girls, 11 boys) with standard risk pre-B ALL treated with chemotherapy had serum insulin-like growth factor-I (IGF-I), serum IGF binding protein-3 (IGFBP-3) levels, and linear growth and weight data measured every 3 months during MT. The levels of the cytotoxic metabolites of methotrexate (MTX) and 6-mercaptopurine (6MP) (i.e., erythrocyte MTX polyglutamates [E-MTX], and erythrocyte 6-thioguanine nucleotides [E-6TGN]), s-aminotransferases, and white blood counts (WBC) were measured at least monthly. RESULTS: At the beginning of MT, the median IGF-I standard deviation scores (SDS) and IGFBP-3 SDS were -0.52 and -0.09, respectively, which declined during MT to -1.67 (P < 0.001) and -1.82 (P < 0.001), respectively. At the time of diagnosis, the median height SDS was -0.4, which declined during MT to a median height SDS of -0.9 at cessation of therapy. No significant correlations were found between growth factor levels, growth and body mass index (BMI) versus the doses of MTX, and 6MP, E-MTX, E-6TGN, s-aminotransferases, or WBC. CONCLUSIONS: A significant decline in IGF-I, IGFBP-3, and growth retardation may not be directly related to the treatment intensity during MT.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Information Centre: responding to needs of older people and carers.

This article is the fourth in the series focusing on recent developments in the Elderly West Research Centre in western Sweden. It describes an innovative research, development and evaluation project, the Aldre Vast Information Centre (AV IC), which was developed in direct response to the local needs of Swedish older people and their family carers who participated in the EU ACTION project (Assisting Carers using Telematics Interventions to meet Older persons' Needs) outlined in the first article in this series (Vol 11(11): 759-763). Families requested easier access to information, education and support from professional carers. They also valued the informal support network from other family carers who listened and shared experiences together. In response to these needs, the AV IC project was established to provide telephone, videophone and internet support to older citizens and their families living in the Sjuharad area of west Sweden. The Information Centre is run by professionals and volunteers with the aim of empowering and supporting older people and their families to make informed choices and decisions regarding health and social care matters of importance to them. The project provides an innovative example of how the Aldre Vast Sjuharad user-focused philosophy (Magnusson et al, 2001) can be applied in practice to provide an appropriate evaluation model - namely, one that enables all those stakeholders in the IC to have a voice in its shape and direction.

Age Factors↗
PubMedDate not supplied

Resumption of home activities following cardiac events.

Patients resume home activities at different paces after uncomplicated cardiac events, and respond to education in a variety of ways. Forty patients recovering from either myocardial infarction (MI) and coronary artery bypass surgery, or MI with coronary angioplasty who were enrolled in a randomized clinical study were interviewed and completed questionnaires regarding their experience resuming home activities. Responses indicated that uncomplicated patients can easily resume those activities important to them. Based on these findings, a Home Activity Assessment Tool was finalized to provide the practicing nurse with practical ways to guide discharge teaching. Use of this tool may facilitate patient's resumption of home, social and work activities.

Activities of Daily Living↗
PubMedDate not supplied

Analysis of cervical smears obtained within three years of the diagnosis of invasive cervical cancer.

The cytologic histories of 376 women presenting with invasive carcinoma of the cervix were analyzed. In total, 202 (53.7%) of these women had had 355 smears taken during the three years preceding presentation. All 320 smears with an original cytologic diagnosis of less than cancer were reviewed. The original cytologic diagnosis was low in 95 (30.6%) of 310 adequate smears. Originally, 96 (30.9%) of the adequate smears were evaluated as negative; at review, only 55 (17.5%) of the adequate smears were evaluated as negative. Comparing the review diagnoses to the 355 total smears, the rates of negative smears were 13.5% (42 of 310) for squamous-cell carcinoma, 30.0% (12 of 40) for adenocarcinoma and 20.0% (1 of 5) for adenosquamous carcinoma (P less than .05). The cellular composition of the smear was significantly related to the cytologic detection of abnormalities: endocervical cylindrical and/or metaplastic cells were seen in only 45.5% of smears diagnosed as negative, but in 84.4% and 97.8% of smears diagnosed as atypia and cervical intraepithelial neoplasia, respectively P less than .00001). Smears without endocervical cells should be considered inadequate and should be repeated.

Adenocarcinoma↗