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Biomedical subjects

S Hunter

Publications and source records attributed to S Hunter.

At least 127 records · Page 7Linked to original sources
PubMed1992

Adaptation of the maternal heart in pregnancy.

The first haemodynamic change during pregnancy seems to be a rise in heart rate. Starting between two and five weeks this continues well into the third trimester. Stroke volume increases slightly later than the heart rate and continues throughout the second trimester after an augmentation of venous return and a fall of systemic vascular resistance and afterload. Myocardial contractility is probably slightly increased. During the third trimester there is relatively little change in these cardiac indices. After delivery there is a very early and dramatic reduction in volume loading followed by a return towards normal cardiac output. Structural changes within the heart reflect the volume loading of pregnancy and include dilatation of the valve ring and increase in myocardial thickness. Post partum resolution of the ventricular hypertrophy seems to take longer than the rest of the post partum changes. The resemblance to the cardiovascular changes associated with training and exercise are fascinating and worthy of further study.

Adaptation, Physiological↗
PubMed1992

The 24/25-kDa serum insulin-like growth factor-binding protein is increased in elderly women with hip and spine fractures.

Fractures of the hip in elderly women represent a clinical syndrome (age-related osteoporosis) often marked by decreased calcium absorption and secondary hyperparathyroidism. We studied 13 elderly women with fractures of the hip and spine and 18 healthy similarly aged control women to determine whether serum insulin-like growth factor-I (IGF-I) or its carrier binding proteins (IGFBPs) were altered in this syndrome. Serum IGF-I concentrations were not different in the two groups (P = 0.50), but immunoreactive PTH was significantly higher in the fracture group (58.50 +/- 8.20 vs. 13.50 +/- 2.70 ng/L; P less than 0.003). Binding of [125I]IGF-I to IGFBP-3, IGFBP-2, and IGFBP-1, measured by ligand blotting, was not statistically different in the 2 groups, but binding intensities for the serum 24/25-kDa IGFBP were approximately 2.5 times greater in fracture women than control women (P less than 0.0005). In data pooled from both groups, PTH correlated strongly (r = 0.70; P less than 0.0001) with the relative binding intensities for the 24/25-kDa IGFBP. Based on previous work, we speculate that production of the 24/25-kDa IGFBP, which in vitro is known to inhibit IGF-I- and IGF-II-mediated osteoblast function, may be stimulated by PTH in patients with the syndrome of age-related osteoporosis.

Aged↗
PubMed1992

Adult day care: promoting quality of life for the elderly.

1. Adult day care allows elderly clients to continue to be a part of their family. The program promotes maintenance of joint mobility, challenges the mind, and allows the client to be a productive part of the community. 2. As director of an adult day care center, it is the RN's responsibility to ensure quality of care for all clients. This includes providing inservice education, establishing quality assurance monitoring, and individualizing care plans for each client. 3. For appropriate placement in day care, the client must be oriented, cooperative, and able to comprehend communication. Physical endurance must allow the client to remain out of bed during the day, and the staff must be able to manage physical handicaps.

Aged↗
PubMed1992

Skin problems: epidemiology of pressure ulcers in a skilled care facility.

The majority of nursing home residents have conditions that place them at risk for the development of pressure ulcers. Reported pressure ulcer prevalence rates range from 16% to 35%. Pressure ulcers are multifactorial in origin and necessitate ongoing vigilance by the entire health-care team. Associated risk factors include impairments of circulation, sensation, physical condition, nutrition, mobility, and activity. Stage I pressure ulcers frequently go unrecognized, yet their recognition is essential to prevent further damage. Comprehensive initial assessments of the skin and risk factors of pressure ulcer development at admission will allow for easier reassessment and comparison.

Aged↗
PubMed1992

Standing up to the big squeeze.

Consumer confidence is at its lowest ebb since 1980. Economic growth is at a standstill & unemployment & inflation are both rising. Here's a front-line report from more than three dozen operators who are fending off the recession's dual pressures of slow sales & rising costs. They are using discount pricing, partnering with vendors, setting pay for performance standards & a variety of other recession-beating practices.

Cost Control↗
PubMed1992

The effect of hypovolaemia on healing of the right and the left colon. An experimental study.

An experimental study was carried out to investigate the effect of a period of hypovolaemia prior to surgery on healing of the right and left colon of the baboon. Colonic healing was assessed in three ways: in terms of (i) anastomotic leakage, (ii) hydroxyproline concentrations and (iii) breaking strength. The results suggest that hypovolaemia before surgery affects the right and left colon similarly.

Anastomosis, Surgical↗
PubMed1991

Doctors in the making.

Explore the source record for details and available documents.

Education, Medical, Graduate↗
PubMed1991

Hypoplastic left heart syndrome: more potential transplant recipients than suitable donors.

Neonatal cardiac transplantation offers the prospect of survival for babies with hypoplastic left heart syndrome--but only if suitable donors are available. In a retrospective survey in the Northern health region of England and Wales, the likely need for neonatal cardiac transplantation far outweighed the potential availability of donors. Over 8 years (1983-90) hypoplastic left heart syndrome was identified in 38 newborn babies and in 9 fetuses in utero. Of 41 live births (including 3 diagnosed prenatally) 31 would have been candidates for a cardiac transplant, but only 4 suitable donors could be identified (3 with anencephaly born alive during the same period and 1 who died between 1979 and 1986 after a head injury). Analysis of all infant deaths in 1987-89 revealed only 3 potential donors from 426 deaths in the 3 years. Although more widespread antenatal diagnosis may lead to fewer liveborn babies with hypoplastic left heart syndrome, these findings indicate that an alternative source of donors needs to be identified before neonatal cardiac transplantation can be widely used in the treatment of this disorder.

Abortion, Induced↗
PubMed1991

Serial changes in pulmonary haemodynamics during human pregnancy: a non-invasive study using Doppler echocardiography.

1. Serial pulmonary haemodynamic investigations were performed in 13 women before conception, at monthly intervals throughout pregnancy, and then at 6 months after delivery. 2. Mean pulmonary artery pressure was calculated from pulsed Doppler pulmonary velocities. Pulmonary flow was measured by Doppler and cross-sectional echocardiography. These two measurements were used to calculate pulmonary vascular resistance. 3. Mean non-pregnant pulmonary artery pressure was 13.8 mmHg and no significant change was demonstrated during pregnancy. 4. Pulmonary flow increased from 4.88 to 7.19 litres/min during pregnancy. 5. Pulmonary vascular resistance decreased from 2.85 resistance units before pregnancy to 2.17 resistance units at 8 weeks gestation. Thereafter there was no further significant change, values returning to pre-pregnant levels by 6 months after delivery.

Adult↗
PubMed1991

Reproducibility of ultrasonic measurement of fetal cardiac haemodynamics.

Two observers made independent estimates of volume flow across all four heart valves in 27 fetuses using a combination of cross-sectional and Doppler echocardiography. There were considerable discrepancies between observers in volume flow estimation arising from inconsistency both in cross-sectional and in Doppler measurements. One observer also produced a second estimate by making new measurements from the original recordings. There was considerable within-observer variability which was mainly due to errors in cross-sectional measurements. The problems of applying this technique to fetal cardiac haemodynamics are discussed.

Adult↗
PubMed1991

Cardiovascular effects of acute bronchiolitis.

Twenty-one children with normal hearts were studied during acute bronchiolitis. Doppler echocardiography showed tricuspid valve regurgitation in 11 patients, many of whom had evidence of raised pulmonary artery systolic pressure. Serial studies in those with severe infection showed that tricuspid regurgitation disappears with clinical improvement.

Acute Disease↗
PubMed1991

Non-invasive assessment of pulmonary arterial pressure in healthy neonates.

Doppler echocardiograms were carried out on 51 healthy babies three times during the first 72 hours of life to estimate pulmonary arterial systolic pressure by measuring regurgitant tricuspid jet velocity and applying the Bernoulli equation. Tricuspid regurgitation was detected at some stage in all preterm babies and most of those born at full term. Pulmonary arterial pressure could be measured from peak regurgitant velocity in babies with pansystolic regurgitation. The incidence of pansystolic regurgitation among 34 term babies at 0-12, 13-36, and 32-72 hours of age was 22, 27, and 19%, and in 17 preterm babies (within the same age groups) was 53, 50, and 31%, respectively. Estimates of pulmonary artery pressure in the term babies were in accord with known catheter values. Pressure fell rapidly during the first day in all 51 babies. The ratio of pulmonary:systemic arterial pressure was comparable between the two groups throughout. Ductal flow patterns mirrored the fall in this ratio with age--bidirectional flow was associated with a ratio of between 0.88:1 and 1.22:1 and high velocity left to right flow with a ratio of between 0.49:1 and 0.66:1. Both these techniques are noninvasive ways of assessing neonatal pulmonary arterial pressure.

Blood Pressure↗
PubMed1991

Incidence and prediction of pressure ulcers in five patient care settings.

Pressure ulcers (PU), one example of an alteration in skin integrity, remain a prominent healthcare concern in all patient care settings. Incidence refers to the number of "new cases occurring over a given time period" (NPUAP, 1989, p. 26). Adult patients (n = 190) in five patient care settings who were assessed to be free of PUs on admission were followed over a specified period of time to assess the incidence of pressure ulcer development for each setting. Subjects each had a skin assessment, along with a risk assessment utilizing the Braden Scale. A demographic data form was also completed on each subject. Pressure ulcers developed post-admission in 18 (9%) patients, 11 of whom were acute care patients and eight of whom were patients in skilled care. No patients developed pressure ulcers in the rehabilitation, home care, or hospice settings. Incidence for acute care was 15% and 28% in skilled care. Braden predictor scores were also recommended for each setting and factors associated with pressure ulcer development were discussed.

Adult↗
PubMed1990

Primary pulmonary alpha-fetoprotein-producing malignant germ cell tumor.

We are reporting the clinical and pathologic features of a primary, pulmonary, malignant germ cell tumor associated with a marked elevation of serum alpha-fetoprotein (38,427 ng/mL) and lactate dehydrogenase activity (756 U/L), in a 26-year-old female. This controversial, rare neoplasm has not been extensively discussed in the pathology literature. We emphasize the clinical importance of establishing this diagnosis in view of the favorable response to chemotherapy shown by malignant germ cell tumors.

Adult↗