Search PubMed⌕ Search

Biomedical subjects

S Hunter

Publications and source records attributed to S Hunter.

At least 235 records · Page 13Linked to original sources

HPRT-deficient (Lesch-Nyhan) mouse embryos derived from germline colonization by cultured cells.

Embryonal stem (ES) cell lines, established in culture from peri-implantation mouse blastocysts, can colonize both the somatic and germ-cell lineages of chimaeric mice following injection into host blastocysts. Recently, ES cells with multiple integrations of retroviral sequences have been used to introduce these sequences into the germ-line of chimaeric mice, demonstrating an alternative to the microinjection of fertilized eggs for the production of transgenic mice. However, the properties of ES cells raise a unique possibility: that of using the techniques of somatic cell genetics to select cells with genetic modifications such as recessive mutations, and of introducing these mutations into the mouse germ line. Here we report the realization of this possibility by the selection in vitro of variant ES cells deficient in hypoxanthine guanine phosphoribosyl transferase (HPRT; EC 2.4.2.8), their use to produce germline chimaeras resulting in female offspring heterozygous for HPRT-deficiency, and the generation of HPRT-deficient preimplantation embryos from these females. In human males, HPRT deficiency causes Lesch-Nyhan syndrome, which is characterized by mental retardation and self-mutilation.

Adenine Phosphoribosyltransferase↗

Comparison of 2 wound volume measurement methods.

OBJECTIVE: To compare 2 wound volume measurement techniques, the Kundin device and stereophotogrammetry, on 2 wound shapes. DESIGN: Using 2 wound measurement techniques, the interrater and intrarater reliability and the bias and standard error of measurement of an L-shaped and a pear-shaped plaster of paris wound model were assessed. SETTING: A clinical laboratory of a school of nursing. PARTICIPANTS: Twenty-four raters, all but 2 being registered nurses, measured each of the wounds using both techniques. INTERVENTIONS: Each rater measured each wound twice using each method in a randomly assigned order defined on a card that was drawn from a box. Measurements were recorded on a researcher-designed data collection form, which included some demographic data related to each participant. MAIN OUTCOME MEASURES: The study hypothesis was that there would be no significant difference in accuracy between the 2 wound volume measurement methods. RESULTS: The least biased and most accurate technique was stereophotogrammetry, with the smallest standard of error of measurement. Interrater reliability of average ratings was identical for both methods at 0.98. For single ratings, stereophotogrammetry was slightly higher than the Kundin device. Intrarater reliability was higher on the pear-shaped wound for the Kundin device, which had lower interrater reliability, suggesting that nurses were consistent in the direction and size of personal error. Intrarater reliability for stereophotogrammetry was identical to that of the Kundin device for the L-shaped wound and lower for the pear-shaped wound. CONCLUSIONS: Although both techniques have acceptable accuracy, stereophotogrammetry is more accurate and has more clinical applications.

Adult↗

The prevalence and incidence of pressure ulcers in the hospice setting: analysis of two methodologies.

Hospice patients may be at greater risk of pressure ulcer development than most patients. This descriptive study explored the prevalence and incidence of pressure ulcers in the hospice setting, utilizing both a prospective and retrospective methodological approach. Levine's theory of the four principles of conservation formed the theoretical basis for the study, and the Braden Scale for Predicting Pressure Ulcer Risk was used for data collection. Prevalence of pressure ulcers was noted to be 13 percent in the study. Incidence of pressure ulcers was found to be zero percent using prospective methodology and 13 percent using retrospective methodology. Five of eight ulcers (62 percent) occurred within two weeks of patient death. Factors related to pressure ulcer development are presented, as well as a discussion of using research methodologies in the hospice setting. The article suggests the need for preventive protocols for skin care for patients who are at risk for pressure ulcer development.

Female↗

Evaluation of pressure ulcer prevalence rates for hospice patients post-implementation of pressure ulcer protocols.

Hospice patients may be particularly at risk for pressure ulcer development due to several factors. Identifying populations at risk for pressure ulcer development, such as hospice patients, and providing prevention and risk protocols for these populations can substantially reduce the prevalence and incidence of pressure ulcers. However, are hospice patients prone for skin breakdown despite prevention and treatment efforts? This study examines the prevalence of pressure ulcers in hospice patients following the implementation of pressure ulcer prevention and treatment protocols. Levine's theory of conservation of structural integrity formed the theoretical framework for this descriptive study. A midwestern hospital-based hospice agency was the site for this study. All patients 18 years of age and older were included in the study. Pressure ulcer prevalence audits were done at four, eight, 12, and 18 months after protocols were outlined by the hospice staff. Results of the audits revealed prevalence rates of 14.8 percent, 8.5 percent, 13.6 percent, and 23.8 percent, at each of the aforementioned audits. 10 of 15 patients who were pressure ulcer positive were males; the sacral location was most common (seven of 19 ulcers occurred sacrally) with the ischial location being the next common (six of 19 ulcers were ischially located). No ulcers occurred above the waist or in patients below 51 years of age. Recommendations from this study urge that particular prevention attention be given to protocols which address "sitting," due to the predominance of ulcers located in the sacral and ischial regions. In addition, the author concludes that perhaps, pressure ulcers may occur in this population despite the best of efforts to prevent them.

Aged↗

Mixed acid-base abnormalities in diabetes.

This study is a description of a patient who exhibited diabetic ketosis associated with an alkalosis rather than acidosis and a review of eight previously reported cases. Precipitating factors for this syndrome are severe vomiting with loss of hydrogen, potassium, and chloride ions, and dehydration. The ingestion of alkali may also result in this mixed acid-base disturbance. Treatment consists primarily of replacement of potassium and chloride. All reported patients had received large doses of insulin for initial therapy; however, limited insulin (20 U) therapy in this patient almost completely reversed the metabolic abnormality with 12 hours.

Acid-Base Equilibrium↗

Risk factors for cardiovascular disease among exercising versus non-exercising women.

As expected, overall, women who exercised had lower body weights, BMIs, and lower risk blood profiles than did those who did not exercise, with exceptions occurring only in the 40 to 49 age group for total cholesterol and LDL cholesterol. Systolic and diastolic blood pressure differences were small between exercisers and nonexercisers, but significant overall. Women who exercised perceived their health, feelings of well-being, and energy to accomplish daily tasks as higher and they missed fewer days of work than did their nonexercising counterparts.

Adolescent↗

Preceptorship in practice.

Following a review of preceptorship practices within the children's services directorate of the Newcastle upon Tyne Hospitals NHS Trust, a working party was established to produce a directorate-wide preceptorship package. This article reviews the literature, provides a summary of the preceptorship guidelines, and critically analyses the process of implementing the programme.

England↗

Two-dimensional wound measurement: comparison of 4 techniques.

Two- and three-dimensional wound measurement techniques are documented in the literature and used clinically, as well as in research. The purpose of this study was to compare 4 two-dimensional wound measurement techniques: linear length and width using a ruler, planimetry, computerized stereophotogrammetry (SPG) length and width, and computerized SPG area. Three plaster of Paris wound models were developed and baseline measurements of outer wound perimeters obtained via a Coordinate Measuring Machine. The convenience sample of raters included 66 upper-division baccalaureate nursing students, graduate nursing students, nursing staff, and wound care nurses. Each rater measured each wound twice in a randomly assigned order of methods written on a card drawn from an envelope. The least biased technique was the computer area, followed in order by the computer length and width, planimetry, and ruler length and width. The most accurate technique, given multiple raters, was determined by the standard error of measurement. The smallest standard error of measurement, thus the most accurate, was the computer area technique, followed in order by the ruler length and width, computer length and width, and planimetry. Interrater reliability of average ratings was high; only the SPG area measurements for single ratings were reliable enough for clinical or research purposes. Intrarater reliability was high for methods with low interrater reliability, suggesting that nurses are consistent in the direction of personal error.

Adult↗

Your infection control program.

Training is essential in order to avoid being infected by a bloodborne disease, says the author. This training must be a cooperative effort by the employer and the safety and/or emergency response employee. The bloodborne pathogens plan must include education, vaccination, and follow-up.

HIV Infections↗

Congenital heart disease in adolescence.

Adolescents and young adults with congenital heart disease are increasingly commonly seen in cardiological practice. Their problems are particular and often unique. Their management requires training and experience in the management of congenital heart disease by the attending cardiologist. In these days of clinical governance, management of ACHD patients must be supervised by clinicians specifically trained in handling congenital cardiac malformation.

Adolescent↗

Clinical evaluation of an automated turning bed.

PURPOSE: The purposes of this study were to assess client comfort and sleep quality, client physiologic response (skin and respiratory status), the effect on the need for caregiver assistance, and cost when using an automated turning bed. DESIGN: Nonexperimental, evaluative study. SAMPLE: Twenty-four adult home or long-term care resident subjects who had a degenerative disease, spinal cord injury, stroke, cerebral palsy, or back surgery. METHODS: Each subject agreed to use the automated turning bed for four weeks. Researchers completed a demographic survey and skin assessment, and assessed each subject for pressure ulcer risk and for the need of assistance of a care giver for turning before and after the four weeks of using the turning bed. Subjects rated the turning bed in terms of comfort and sleep quality. FINDINGS: Subjects rated the turning bed as more comfortable than their own bed and expressed satisfaction at the pain relief attained when on the turning bed. While using the turning bed, there was a significant improvement in sleep quality. No skin breakdown or deterioration in respiratory status occurred. Fewer subjects required the assistance of a caregiver for turning when on the turning bed. CONCLUSION: This automated turning bed shows great promise in meeting a need for patients with limited mobility whether they are homebound or in a residential community. IMPLICATIONS FOR NURSING RESEARCH: Future studies that further investigate use of the turning bed for postoperative back patients while still in the acute care setting are indicated. Replicative studies with a larger sample size are also indicated.

Adult↗

The lived experience of having a pressure ulcer: a qualitative analysis.

In this descriptive, qualitative, phenomenological study, the researchers explored the phenomena of the lived experience of having a pressure ulcer to determine the essential structure of the experience. The sample included 8 respondents: 4 individuals who currently had a pressure ulcer and 4 who previously had a pressure ulcer that had healed. Four respondents also had a spinal cord injury and 5 had surgical flap reconstruction. Respondents were asked to reflect and reply to the following statements: "Please describe your experience of having a pressure ulcer. Share all the thoughts, perceptions, and feelings you can recall until you have no more to say about this experience." From verbatim transcriptions of interviews, 7 themes evolved with related sub-themes. The themes that emerged were (1) perceived etiology of the pressure ulcer; (2) life impact and changes; (3) psychospiritual impact; (4) extreme painfulness associated with the pressure ulcer; (5) need for knowledge and understanding; (6) need for and effect of numerous, stressful treatments; and (7) the grieving process. In this paper, the essential nature of the experience of living with a pressure ulcer is presented. Pressure ulcers had a profound impact upon the subjects' lives, including physical, social, and financial status; change of body image; and/or loss of independence and control. Those with a Stage IV pressure ulcer and flap repair and/or those with a spinal cord injury experienced the grieving process in some form. Although the experience of having a pressure ulcer has similarities for each individual, each experiences it in a unique manner. Patients with a pressure ulcer with or without a spinal cord injury have significant needs in learning to cope and live with their condition.

Adaptation, Psychological↗

The long-term clinical outcome of patients with tricuspid atresia. II. Influence of surgical procedures.

One-hundred and eleven patients with tricuspid atresia were seen during 1972-1982 and thirteen of these were not operated upon. The remaining 98 patients have undergone at least one operation. Those with low pulmonary blood flow had 1-4 shunt procedures; in 15 patients with high pulmonary blood flow the pulmonary artery was banded. The mortality rate after the first shunt was 10% (8/82), 9% after the second shunt (3/32) and 12% after the third and fourth shunts. Three out of 15 (20%) patients died after pulmonary artery banding. Twenty three patients underwent a Fontan operation and five died (22%); eighteen survivors are clinically well (after 1-7 years). One patient required a pacemaker implantation and revision of his Fontan procedure. The survivors of the palliative operations and the unoperated patients were more restricted, the older ones having developed pulmonary vascular obstructive disease, chronic heart failure or arrhythmias.

Anastomosis, Surgical↗

Value of echocardiographic determination of isovolumic relaxation time in the detection of heart transplant rejection.

The reproducibility of the measurement of isovolumic relaxation time in heart transplant recipients was assessed in eight heart transplant recipients. The value of routine measurement of isovolumic relaxation time and fractional shortening by echocardiography in the diagnosis of rejection was assessed by comparison with endomyocardial biopsy results in 12 patients. Despite a large, unexplained variability that will limit the application of the test in the individual patient, there was a significant fall in isovolumic relaxation time with moderate to severe rejection.

Echocardiography↗