Biomedical subjects
Publications and source records attributed to S Hart.
The well-publicised dangers of contracting infection from blood-borne viruses make an awareness of comprehensive protective measures for self and others an imperative for nurses. Sarah Hart reviews the precautions nurses should take when dealing with contaminated blood and other body fluids, and lays emphasis on the need for all nurses, regardless of the particular area in which they work, to adopt and promote safe practices.
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Recent press attention on HIV infected health care workers has brought the issue of nurses' and hospitals' responsibility for notifying patients of their HIV status to the fore. In the first of two consecutive articles, the author outlines the Department of Health's guidance on the issue of nurses' responsibility.
This second article on the importance of notifying patients of the HIV status of health care workers focuses on the responsibility of hospitals and health authority personnel. The author discusses the recent Department of Health guidelines on the subject and highlights the need for nurses to be aware of them.
Diagnostic radiology and sealed and unsealed sources of radiotherapy are valuable in the treatment of cancer. However, unwanted consequences can result from excessive exposure to ionising radiation. Therefore, its administration requires great care not only to protect the patient but also the nurses involved in patient care. Nurses should be aware of the safety issues in the diagnostic and therapeutic use of ionising radiation so that they can work safely and confidently.
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This study investigated the influences of pin type (stainless steel or titanium), number of pins (0, 2, or 4), and pin orientation (parallel or perpendicular to tensile forces) on the fracture resistance of four core materials: amalgam, composite resin, and two alloy-reinforced glass-ionomer cements. Analysis of variance revealed significant differences among materials, number of pins, and pin orientation. The fracture resistance of amalgam was reduced most by pins, followed by composite resin. The least strength reduction was found in alloy-reinforced glass ionomers, and in some pin orientations, fracture resistance was doubled compared to the controls. The most favorable pin orientation was parallel to tensile stresses. As the number of pins incorporated in amalgam was increased, fracture resistance decreased.
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The alpha 2-selective adrenergic agonist xylazine has a long lasting antinociceptive effect (> 4 hours) after lumbosacral injection in dogs (Rector, 1996). The present study was performed to find out if epidurally administered xylazine acts locally as well as systemically. In a clinical investigation 30 dogs anesthetized with isoflurane in oxygen (1.9 Vol.% ET) were examined before and after epidural and intramuscular injection of xylazine (0.25 mg/kg) during surgery and over a 240-minute postoperative period. All dogs underwent surgery caudal the costal arch. The surgical patients were divided into three groups: group I: xylazine (0.25 mg/kg) epidural and aqua pro injectione i.m. (n = 10 dogs); group II: aqua pro injectione epidural and xylazine (0.25 mg/kg) i.m. (n = 10 dogs); group III: aqua pro injectione epidural and aqua pro injectione i.m. (n = 10 dogs). The division of xylazine epidural or i.m. or aqua pro injectione only was randomized. Prior to surgery, in all three groups somatic stimuli were exerted by pressure on the nailbed of a hind- and a forelimb before and after the epidural injection under general anesthesia. Heart rate, mean arterial pressure and rate of ventilation were used to determine the analgesic effect. During surgery, heart rate and mean arterial pressure were measured every 15 minutes. At the end of the operation, all patients were treated with the (alpha 2-selective adrenergic-antagonist atipamezole. During a 240 minute post operative examination heart rate, mean arterial pressure, rate of ventilation and reaction to pressure on the surgery site were used to determine the analgesic properties of xylazine. In this study it could be shown, that the concurrent epidural (group I) or intramuscular injection (group II) of xylazine in isoflurane anesthetized dogs leads to a better analgesic effect than isoflurane alone (group III) after somatic stimulation of a hind- and forelimb. From the antinociceptive effect in the forelimb after epidural administration of xylazine it was concluded that xylazine acts both locally as well as systemically. This was also confirmed by the hemodynamic changes, which were similar in group I (xylazine epidurally) and group II (xylazine i.m.). In the two groups treated with xylazine (group I and II), bradycardia and AV-blocks I and II were observed in three dogs during the first 30 minutes after epidural and intramuscular injection of xylazine. Hemodynamic changes were seen at the time of maximal plasma xylazine concentrations. One dog in the control group also had a bradycardia in connection with an AV-block II. During surgery no hemodynamic differences could be observed between the three groups. Heart rate was within normal limits and mean arterial pressure showed a slight hypotension. In agreement with the investigation of Rector (1996) it was shown in this study that xylazine has a long lasting (> 4 hours) antinociceptive effect after lumbosacral injection in the epidural space (group I). This analgesic effect is of local, spinal cord origin, as it was impossible to antagonize the analgesia by systemic application of atipamezole. In contrast to this, atipamezole reversed all analgesic properties totally after systemically administered xylazine in group II. However, sufficient analgesic plasma xylazine concentrations could only be detected in group II up to 180 minutes after injection. After this time period, an analgesic effect could not be expected anyway, even without antagonization. It can be concluded that the epidural administration of xylazine offers advantages in contrast to a systemic administration, as a longer lasting analgesic effect can be observed (after the epidural application), and systemic side effects can be reversed without effecting spinal analgesia.