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P Wicker

Publications and source records attributed to P Wicker.

At least 55 records · Page 3Linked to original sources
PubMed1997

Emerging infections.

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Bacterial Infections↗
PubMed1995

Pre-operative visiting--making it work.

Several key features are emerging about the management situation in the NHS which has an effect, in part, on the way a pre-operative visiting scheme must be introduced. Fewer nurses are being employed Technicians (ODP's) are being trained in ever greater numbers to take over the non-nursing duties of theatre nurses. Managers, even at theatre manager level, are increasingly coming from non nursing, non-medical or non-healthcare backgrounds. Budgets are being devolved down to theatre sister level. Theatre sisters are being downgraded to what was once a senior staff nurse grade. Two of the more significant concerns of managers are 'value for money' and 'quality at a given price'. It is very likely that clinical based nurses will be the ones who are trying to implement a pre-operative visiting system. If so, then they must take these factors into account in order to be successful. This requires an understanding of the management process and how to 'speak the same language' as a manager. The following paper is based on my experiences both in this country and abroad, and upon my perception of how the role of a clinical nurse interacts with the role of manager.

Humans↗
PubMed1993

Effects of hypertension and aging on coronary arteriolar density.

Coronary reserve has been shown repeatedly to be depressed in hypertension and aging. The underlying mechanisms remain elusive, but structural alterations of the coronary vasculature have been implicated. In this study, we measured maximal coronary dilator capacity and structural characteristics relevant to coronary resistance in aging normotensive (Wistar-Kyoto, n = 22) and spontaneously hypertensive rat (SHR) strains (n = 25) at 1.5, 4, 11, 16, and 22 months of age. Coronary flow measurements, using radiolabeled microspheres, demonstrated a significant (p < 0.01) hypertension- and age-related decline in maximal coronary dilator capacity. After flow measurements, vascular dimensions and arteriolar density were obtained from 1-micron sections prepared from perfusion-fixed hearts. A total of 10,012 arterioles were analyzed, 4,820 in hypertensive and 5,192 in normotensive rats. There was an 18-28% reduction in arteriolar density in hypertensive rats that specifically affected the terminal arteriolar bed at 1.5-11 months. However, the decrement in arteriolar density stabilized at 10% and 6% in 16- and 22-month-old hypertensive rats, respectively. Arteriolar density was not affected by aging. In both strains, there was a significant (p < 0.01) age-related decrease in the ratio of lumen diameter to wall thickness in arterioles > 50 microns. In addition, there was an overall 30% decrease (p < 0.01) in the ratio of lumen diameter to wall thickness in hypertensive compared with normotensive rats. These data indicate that both hypertension and aging are accompanied by structural alterations of the coronary resistance vasculature. These structural alterations may contribute to the depression in coronary reserve that complicates hypertension and aging.

Aging↗
PubMed1992

Differences in left ventricular structural and functional changes between pheochromocytoma and essential hypertension. Role of elevated circulating catecholamines.

Experimental findings suggest that catecholamines increase protein synthesis and play a role in cardiac hypertrophy. We hypothesize that elevated circulating plasma catecholamines in pheochromocytoma influence cardiac structural and functional remodeling. We compared 15 patients with surgically proven pheochromocytoma and 15 with untreated essential hypertension; we matched the patients for age, sex, body surface area, and blood pressure (BP) levels. Left ventricular hypertrophy (LVH) was identified by M-mode echocardiography in six patients with pheochromocytoma and in four with essential hypertension. Among both groups there were no differences in cardiac structure, no correlation between left ventricular mass and BP, no significant differences in mitral E-F slope, no correlation between either plasma norepinephrine or plasma epinephrine levels, and no differences in the left ventricular structural indices measured. In the pheochromocytoma group, left ventricular end systolic stress and end systolic diameter were significantly lower and left ventricular percent fractional shortening was higher. Plasma norepinephrine levels were higher in the pheochromocytoma group, but did not differ among patients of that group with and without LVH. We conclude that in both pheochromocytoma and essential hypertension, only a subset of patients develop evidence of LVH, and that in pheochromocytoma, the elevation of circulating plasma catecholamines is not necessarily associated with LVH. These results indicate that factors other than catecholamines and BP determine the development of LVH in pheochromocytoma.

Adolescent↗
PubMed1992

Wound dressings.

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Bandages↗
PubMed1991

Theatre nursing in Australia.

A herniorraphy is the same wherever it is carried out, in any part of the world. If that was all our job was about, as some would have us believe, then life would be simple indeed. However, it never ceased to amaze me how many different ways there were to carry out the same job. In Adelaide we 'wet-set' our instruments, in Darwin we had small pre-packed trays which were set on trolleys sideways, and in Perth we had pre-sterilised boxes of instruments which we laid out on trolleys ourselves.

Australia↗
PubMed1991

Buyers and sellers.

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Economic Competition↗