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S L Dooley

Publications and source records attributed to S L Dooley.

60 records · Page 4Linked to original sources
PubMed1982

The effect of gestational age on amniotic fluid glucose in pregnancy complicated by diabetes mellitus.

Amniotic fluid glucose was measured in 189 amniotic fluid samples from 117 well-controlled Class A to F diabetic pregnant women from 32 to 40 weeks' gestation. A simultaneous maternal plasma glucose level was determined at each amniocentesis. Samples were obtained with the mother in the fasting or nonfasting (3.8 hours after breakfast) state. Amniotic fluid glucose correlated significantly with simultaneous maternal glucose (r = 0.562; p = 0.001). A significant downward linear trend of mean amniotic fluid glucose with advancing gestational age was demonstrated (p less than 0.01). No trend of mean simultaneous maternal glucose with gestational age was seen. These results were not affected by maternal prandial status at the time of amniocentesis. It is concluded that amniotic fluid glucose decreases with advancing gestational age in well-controlled diabetic pregnant women independent of maternal glycemic levels. Studies of amniotic fluid glucose and/or its relationship to other metabolic hormones must take this into account.

Amniocentesis↗
PubMed1980

Antenatal corticosteroids to prevent neonatal respiratory distress syndrome: risk versus benefit considerations.

The clinician considering administration of steroids to prevent respiratory distress syndrome (RDS) should attempt to identify patients who do not have criteria previously shown to increase the likelihood of benefit in the prevention of RDS. It is possible to accurately predict the interval to delivery in most cases. Four hundred thirty-nine patients at risk to deliver prior to 37 weeks have been screened for factors known to decrease the likelihood of benefit. Only 47 (10.7%) screened candidates have no exclusion criteria. Twenty-seven (6.9%) of 392 excluded neonates developed RDS; 20 of the 27 were predicted to and did deliver in less than 24 hours after initial screening. Only one case was inappropriately excluded. Fetal surfactant assessment is crucial; pulmonary maturity excludes 19% at 28 to 33 weeks and 35% at 34 to 37 weeks. Careful screening for exclusion factors known to decrease the likelihood of steroid derived benefit is essential when use of a drug with potential long-term consequences (risk) is considered.

Adrenal Cortex Hormones↗
PubMed1979

From staff nurse to head nurse: a trying transition.

The new head nurse is often unprepared for the role transition required by this new position. In this retrospective analysis of their first six months as head nurses, the authors, with a sense of humor, define a transition process consisting of three maturational stages. If nursing administrators and new head nurses anticipate and recognize these stages and their effects on nursing staff and care delivery, some of the resulting problems may be alleviated.

Adaptation, Psychological↗
PubMedDate not supplied

Reversal of diurnal cortisol rhythm and suppression of plasma testosterone in obstetric residents on call.

OBJECTIVE: The study was undertaken to quantify the psychologic and physiologic responses to the stresses of an obstetrics/gynecology residency program. METHODS: Six male residents were studied on four occasions: one day during the first 2 weeks of their residency, one day immediately following a vacation period, one day after a night on call in obstetrics, and one day while in the gynecology clinic. Stress was evaluated by validated psychologic instruments and by levels of plasma testosterone, luteinizing hormone (LH), cortisol, and prolactin in morning and afternoon blood samples. RESULTS: Self-reported stress was significantly elevated during the first 2 weeks of the residency after a night on call. Anxiety scores were significantly elevated after a night on call as were depression subscores for some residents. Plasma testosterone was highly significantly suppressed after the obstetrics night on call and during the first 2 weeks of the residency in comparison with the vacation period. Luteinizing hormone levels were also significantly lower after the obstetrics on-call experience. Plasma cortisol levels after a night on call were suppressed in the morning and normal or elevated in the afternoon. In comparison, the gynecology rotation was associated with normal levels of testosterone and lower levels of cortisol. CONCLUSION: In this small sample of residents, we observed an inverse relationship between self-reported stress levels and the concentrations of plasma testosterone and LH. The high levels of stress and anxiety expressed after a night on call also disrupted the normal pattern of plasma cortisol levels.

Anxiety↗