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Biomedical subjects

S Heard

Publications and source records attributed to S Heard.

29 records · Page 2Linked to original sources
PubMed1989

Ocular manifestations of the congenital varicella syndrome.

Three children developed the congenital varicella syndrome following a maternal varicella infection during the second trimester of pregnancy. Systemic findings included a bulbar palsy, mild hemiparesis, cicatricial skin lesions, developmental delay, and learning difficulties. Ocular findings included chorioretinitis, atrophy and hypoplasia of the optic discs, a congenital cataract, and Horner's syndrome. Electroretinograms and pattern-reversal visual-evoked potentials recorded from the four eyes with chorioretinitis were attenuated and degraded. Two of the children had been misdiagnosed as having congenital toxoplasmosis. Chorioretinal scars probably occur more frequently with the congenital varicella syndrome than has been previously recognized and should be included in the differential diagnosis of congenital chorioretinal scars. Hypoplasia of the optic disc may develop after an intrauterine varicella infection during the 16th week of gestation. Children with the congenital varicella syndrome should be examined by an ophthalmologist to exclude ocular abnormalities. These abnormalities are often subtle and difficult to diagnose correctly.

Chickenpox↗
PubMed1988

Efficacy of pulse oximetry and capnometry in postoperative ventilatory weaning.

We examined the ability of capnometry and pulse oximetry to identify potential respiratory problems by comparing oxyhemoglobin saturation (O2Sat) as measured by pulse oximetry and end-tidal CO2 (PetCO2) with arterial blood gas (ABG) determinations in 40 mechanically ventilated ICU patients. Hemoglobin saturation as measured by pulse oximetry correlated significantly with PaO2 (r = .65, p less than .0001); more importantly, an oximeter O2 Sat less than 95% showed 100% sensitivity in identifying hypoxemia (i.e., PaO2 less than 70 torr). PetCO2 tended to correlate strongly with PaCO2 for individual patients, but not when evaluated as a screening tool for identifying ventilatory abnormalities in the overall group (r = .52, p less than .0001). A PetCO2 less than 26 torr identified hypocarbia (defined as PaCO2 less than 30 torr) with a sensitivity of 85%. However, a PetCO2 of greater than 40 torr predicted hypercarbia (PaCO2 greater than 45 torr) with a sensitivity of only 28%. The efficacy of pulse oximetry and capnometry in monitoring respiratory status during postoperative ventilatory weaning was examined in a subset of 24 patients who had undergone elective cardiac surgery. All patients were weaned by intermittent mandatory ventilation, but each was assigned randomly to either a control group monitored with periodic ABG sampling or to an experimental group, monitored by following PetCO2 and O2 Sat via pulse oximetry. In the experimental group, ABG values were obtained on ICU admission, but thereafter only if a) O2 Sat less than 95%, b) PetCO2 less than 26 or greater than 40 torr, or c) felt to be clinically indicated by ICU staff.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

Evaluating nurse-led inpatient units.

This article highlights findings from three studies into nurse-led inpatient units. The results are not the same in each case, particularly with regard to length of stay, and the authors discuss the possible reasons for this. Further work is needed to develop NLIUs and identify cost savings.

Cost Savings↗
PubMedDate not supplied

Predicting future long-term-care needs in a community.

Under current financial restraints, planning for the future long-term-care needs of older Canadians is coming under increasing scrutiny. Even though health care is moving to a community-based system (i.e., deinstitutionalization), this is not necessarily the most cost-effective strategy for severely disabled older adults. Three models are used in the present paper to estimate the number of severely disabled (two or more ADL disabilities abilities) older adults expected in the next 5 to 10 years in a small community in Northern Ontario. While mortality and disability rates are the main predictors, it was also necessary to consider additional factors particular to the community in question. It is suggested that for long-term-care planning to be effective and economically sound, similar strategies will be needed throughout Canada.

Activities of Daily Living↗
PubMedDate not supplied

Zzz ... wake up to management.

It is now 2 years and some 50 articles later since this lexicon on management and finance in the NHS began. At this start the NHS forms were 5 years old, the Tomlinson Report on the state and organization of London's health care had been published 18 months earlier and clinicians were warily but increasingly willing to consider that participation in management might be both interesting and necessary to survive the changes.

Decision Making↗