Search PubMed⌕ Search

Biomedical subjects

K Jordan

Publications and source records attributed to K Jordan.

139 records · Page 8Linked to original sources
PubMedDate not supplied

Assessment of published reliability studies for cervical spine range-of-motion measurement tools.

OBJECTIVE: To assess the reliability of tools to measure cervical spine range of motion in clinical settings and discuss the necessary components for reliability studies. DATA SOURCES: Database searches included Bandolier, Bath Information and Data Services including Index of Scientific and Technical Proceedings, British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, English National Health Care Database, MEDLINE, Occupational Therapy Index, Physiotherapy Index, and Rehabilitation index for English language articles from 1966. In addition, citations were searched. STUDY SELECTION: Studies were selected that assessed the tool for intraobserver or interobserver reliability, evaluated it on movements of flexion/extension, lateral flexion, or rotation, and measured range of motion of the whole cervical spine. DATA EXTRACTION: All papers were read by one nonclinical researcher with a data extraction sheet. A consultant rheumatologist and a physiotherapist were each asked to read a sample of the papers to give a clinical viewpoint. DATA SYNTHESIS: Evidence for the reliability of measurement tools was assessed qualitatively based on the quality of the study designs, appropriateness of analysis, and strength of the reliability based on reported intraclass correlation coefficients (the most appropriate analysis technique for reliability studies of this nature). Measurement tools were found to have not been fully tested for reliability, particularly in terms of adequate sample size and appropriate analysis techniques. There were also wide variations in the research design, including the protocol for movement, the characteristics of observers and study population, whether warm-ups were allowed, whether the movement was active or passive, and time intervals between repeated measurements. CONCLUSION: Although a range-of-motion device has shown promise in reliability and has many advocates, its practicality for clinical use is questionable. Further work must be performed on all measurement tools. Researchers need to produce more rigorous studies and consider the issues discussed here.

Cervical Vertebrae↗
PubMedDate not supplied

Retinal haemorrhages and papilloedema due to benign intracranial hypertension in a pregnant diabetic.

A case of benign intracranial hypertension associated with generalized oedema is reported in a normotensive pregnant patient with long-standing insulin-treated diabetes mellitus. Following treatment with bed rest, chlorthalidone and dexamethasone the condition resolved and a healthy infant was delivered. This condition, not previously reported in a diabetic pregnancy, must be differentiated from other causes of bilateral optic nerve abnormalities associated with retinal haemorrhages and oedema, including diabetic retinopathy, diabetic optic neuropathy, accelerated hypertension and cerebral mass lesions. Treatment is required to prevent permanent visual impairment due to pressure on the susceptible optic nerve of the diabetic patient and to avoid the metabolic consequences to both mother and fetus of poor nutritional intake due to nausea.

Adult↗
PubMedDate not supplied

Ketorolac vs meperidine for the management of pain in the emergency department.

OBJECTIVE: To compare the pain relief, sedation, and common side effect profiles of ketorolac tromethamine and meperidine for the management of acute pain in the emergency department (ED). METHODS: A prospective, double-blind, randomized clinical trial was conducted over a 12-month period using consecutive adult patients presenting to a university teaching hospital ED (annual census: 32,000), who required IM analgesia for acute pain. Adult patients with acute pain of various etiologies were randomly assigned to receive a single fixed IM dose of ketorolac (60 mg) or meperidine (100 mg). RESULTS: Ninety-three patients were enrolled in the study; 46 were randomized to meperidine and 47 to ketorolac. Using a visual analog scale, there was no difference in pain relief between the ketorolac and meperidine groups even after adjusting for baseline pain level. Ketorolac caused significantly (p < 0.005) less sedation than did meperidine at one hour. Rescue analgesia was required for seven of the 46 (15.2%) patients receiving meperidine and five of the 47 (10.6%) patients receiving ketorolac (p = NS). Seventeen of 45 (38%) patients receiving meperidine experienced side effects compared with eight of the 47 (17%) patients receiving ketorolac (p = 0.0452). CONCLUSIONS: When used to treat patients who had acute pain states, 60 mg of IM ketorolac produced analgesia similar to that produced by 100 mg of IM meperidine; however, the ketorolac produced fewer subjective side effects and less sedation than did the meperidine.

Adolescent↗
PubMedDate not supplied

Interferon. Clinical uses and nursing implications.

Interferon is a biological response modifier that regulates immune functions, slows cell proliferation, and inhibits virus replication. Interferon has produced promising results in the treatment of certain viral diseases and various tumors. It is rapidly becoming a part of conventional treatment regimes. Its various types, lots, and batches as well as its appropriate dilutions and doses must be familiar to nurse clinicians to assure safe administration and patient management. This article discusses the historical evolution of interferon, its clinical uses, and patient management issues.

Humans↗