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Biomedical subjects

P Kenny

Publications and source records attributed to P Kenny.

30 records · Page 2Linked to original sources

Satisfaction with postnatal care--the choice of home or hospital.

This paper reports the findings of a study of client satisfaction with postnatal midwifery care. Women could choose one of two forms of care; either domiciliary care following early discharge, or hospital care until discharge. Consumers' perceptions of their postnatal care were examined at the end of the period of care. Women assessed the midwives' interest and caring, education and information provided, their own progress with feeding and baby care, and their own physical and emotional health. They were also asked about their expectations of and gains from postnatal care. The findings indicated that women choosing domiciliary care and women choosing hospital care had different expectations of their postnatal care, but were largely satisfied with the quality of the care they chose. The women who chose domiciliary care rated their postnatal care more highly than the women who stayed in hospital. The findings reinforce the importance of providing women with choices for the maternity care which best suits their needs.

Adult↗

The role of the clinical nurse co-ordinator in the provision of cost-effective orthopaedic services for elderly people.

Positions for nurses as coordinators and case managers have developed in response to demands for increased efficiency in the provision of hospital care. The Fractured Hip Management Programme in Western Sydney is one example of this development. The programme was introduced in response to mounting concern about the demands on hospital resources from elderly patients with hip fracture. A central feature of the programme is the pivotal role given to the nurse coordinator working within a multi-disciplinary team. This is not a new nursing role; rather it explicitly recognizes skills developed as part of the traditional nursing role. Evaluation of the programme found that patients received surgery sooner and spent less time in hospital, without adverse affects on outcome. The results show that recognition of the role of the nurse as patient advocate and care manager can lead to more cost-effective and higher-quality care.

Aged↗

Analgesia following arthroscopic knee surgery. A controlled study of intra-articular morphine, bupivacaine or both combined.

In a double-blind, randomised controlled trial, we studied 40 patients who received one of four intra-articular injections at the end of arthroscopic surgery. Each group contained ten patients. The patients in Group 1 received normal saline 25 ml; those in Group 2 received bupivacaine 0.25% 25 ml; those in Group 3 received morphine 5 mg in normal saline 25 ml; and those in Group 4 received a combination of bupivacaine 0.5% 12.5 ml and 5 mg of morphine made up to 25 ml with normal saline to produce the same bupivacaine concentration as Group 2. At the time the patient awoke, and 30min, 1hr, 1hr 30min, 2hr, 4hr, 8hr, 12hr, and 24hr postoperatively, pain was assessed using a visual analogue scale. The need for supplementary analgesic agents in the first 24 hours was recorded. All pain scores were significantly lower (P < 0.05) in Groups 2, 3 and 4 compared with the control group with the exception of Group 2 at 24 hours. Pain scores were significantly lower (P < 0.05) for Group 2 compared with Group 3 for the first 90 minutes postoperatively. At 4, 8, 12 and 24 hours postoperatively the pain scores were significantly lower (P < 0.05%) for Group 3 compared with Group 2. Group 4 had the lowest pain scores over the recorded period compared with the other groups. The need for supplemental analgesia was significantly lower (P < 0.05) in the treatment Groups 2, 3 and 4 compared to the control Group 1. There was no significant difference in supplemental analgesic requirements between Groups 2, 3 and 4.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Superior calcium absorption from calcium citrate than calcium carbonate using external forearm counting.

Calcium absorption from calcium citrate was compared with that obtained from calcium carbonate in 20 normal women. It was measured by external forearm counting technique, where the ratio of forearm radioactivity after an oral dose of labeled calcium salt (containing 500 mg calcium) and after an intravenous injection of trace radiocalcium represented fractional calcium absorption. The fractional calcium absorption from calcium citrate was 39.2 +/- 8.6%, which was significantly higher than the 31.2 +/- 9.4% derived from calcium carbonate (p less than 0.001). Seventeen subjects displayed greater calcium absorption from calcium citrate. The remaining three patients, with a lower calcium absorption from the citrate salt, had high levels of calcium absorption from calcium carbonate. It is concluded that calcium is better absorbed from calcium citrate than calcium carbonate when these salts are taken on an empty stomach in most women. The exception might be those with optimum calcium absorption from calcium carbonate.

Absorption↗

Mouthpiece forces produced while playing the trumpet.

A transducer for measuring the force applied to the trumpet mouthpiece during performance is described. The device allowed the players to perform on their own instrument and in their usual manner. The results of tests on 60 subjects showed that during playing the force between the mouthpiece and instrument increased with increasing loudness and ascending pitch but that there was no significant correlation between mouthpiece force and proficiency or style. The maximum force which the players could tolerate was greater for high proficiency players than for medium.

Biomechanical Phenomena↗

Oral glucocorticoids and their complications. A review.

Glucocorticoid preparations form one of the cornerstones of the modern medical pharmacopeia. This class of medications has been especially useful to dermatologists, who are purported to be among its most prolific users. Oral glucocorticoids, available now for over 30 years, are prescribed to over 7% of hospitalized patients. Of this group, some 17% may experience adverse effects. It behooves any physician who uses these powerful agents to be aware of the potential complications and side effects. In this article we have undertaken to summarize and discuss selective examples of this rapidly growing segment of the literature.

Administration, Oral↗

Are elevated levels of the tumour marker CA19-9 of any clinical significance?--an evaluation.

CA 19-9 is a tumour marker which has been used widely in patients with pancreatic adenocarcinoma. Elevated levels are associated with advanced disease at presentation and disease progression during follow-up. CA19-9 levels may also be elevated in a variety of other malignant and benign conditions. This study examined the significance and implications of elevated CA19-9 levels. An analysis of all CA19-9 measurements performed over a 4 yr period was undertaken and 204 patients with elevated CA19-9 levels were identified. One hundred and thirty patients (63.7 per cent) had malignant conditions and 74 (36.3 per cent) had benign conditions or no definite cause was found. There was a significant correlation between CA19-9 levels and CEA (r = 0.3137; P < 0.001) as well as alkaline phosphatase, ALT, AST, bilirubin, gamma glutamyl transpeptidase and lactate dehydrogenase. CA19-9 levels were significantly lower in patients with benign pathology than those with malignant pathology. Similar differences were observed for CEA. CA19-9 levels were in fact highest in patients with pancreatic carcinoma (P < 0.05) while no significant differences were observed for CEA. In conclusion CA19-9 may be elevated in both benign as well as malignant conditions and interpretation of CA19-9 results must be made in light of the clinical condition of the patient.

Adenocarcinoma↗

The quantitation of arterial elasticity from Doppler flow measurements.

The pattern of phasic pressure and flow in an artery is related to the components of the impedance of that artery and hence to its compliance. Phasic patterns of velocity in peripheral arteries have been recorded by using continuous wave ultrasound Doppler flowmeters coupled to high-speed spectrum analysers; this has enabled display of the stored spectral ensembles as 'sonograms'. Simultaneous recordings at proximal and distal sites in each limb of a variety of subjects were made under standard resting conditions; characteristic patterns of change in the sonogram are recognized where gross abnormalities of arterial anatomy are present. A technique is under development whereby the mean values of velocity for each 7.4 ms time slice are derived, smoothed, and the pulse described by standard Fourier transform analysis. The change of the waveform occurring during passage through the relevant arterial segment is then described by comparing the amplitude/frequency and time-delay/frequency plots at proximal and distal sites. Although results are at present preliminary, changes relating to age and known vascular abnormality are becoming apparent. Further development is in progress to determine the significance of these findings.

Adult↗