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Biomedical subjects

S Loftus

Publications and source records attributed to S Loftus.

9 recordsLinked to original sources
PubMed2001

A longitudinal, quality of life study comparing four layer bandaging and superficial venous surgery for the treatment of venous leg ulcers.

OBJECTIVE: To investigate and compare changes in quality of life of patients with venous ulcers undergoing treatment with either four layer bandaging or superficial venous surgery. DESIGN: Fifteen patients with venous ulcers were selected from two treatment groups--either four layer bandaging or superficial venous surgery. Each received a postal questionnaire at pretreatment, four weeks and twelve weeks post treatment. The EuroQol quality of life questionnaire was used along with a disease specific questionnaire devised by the author. Analysis of results was undertaken using validated statistical methods. SETTING: Department of Vascular Surgery Leicester Royal Infirmary and Fosse Health (NHS) Trust (now the Leicestershire and Rutland Healthcare NHS Trust). MAIN OUTCOME MEASURES: To measure changes in quality of life of patients undergoing superficial venous surgery or four layer bandaging. RESULTS: Treatment over the twelve week period resulted in improvements in quality of life for both treatment groups (P = 0.001 for surgery and P = 0.019 for bandaging). No statistical differences in quality of life between the two treatment modalities were found at four and twelve weeks. CONCLUSION: There was evidence of an improvement in quality of life for both groups following twelve weeks of treatment. Improvements in pain and general quality of life were more marked in the bandaging group. Systems of care that offer rapid improvement to the patient's quality of life and wellbeing must be considered when planning effective leg ulcer management.

Adult↗
PubMed2000

Developing skills in leg ulcer nursing: the lessons learned.

The high treatment costs of inappropriate leg ulcer management are well referenced. Wide variations in practice have also been reported. A training programme for community nurses has been in place in Leicestershire and Rutland NHS Trust for five years. Its objective is to promote evidence-based leg ulcer management. The aim of this prospective audit was to assess and compare the effectiveness of the compression bandage systems used in the trust: the original Charing Cross system (August 1996 to September 1997) and Robinson's Ultra Four kit (October 1997 to December 1998). All patients with leg ulceration were assessed using the Leicestershire leg ulcer assessment form. This was submitted along with an audit tool to the tissue viability service in exchange for a 12-week supply of compression bandages. The audit form was resubmitted after each subsequent 12-week period until the patient either had healed or was withdrawn from the audit. Differences between the two groups in mobility, previous deep vein thrombosis, fixed ankle deformity, the male to female ratio, duration of ulcer and ulcer surface area were noted. Patients using the Ultra Four kit had faster healing times than those given the Charing Cross system, but this was not statistically significant. Cost comparisons between the previous dressing regimen and compression bandaging showed a significance difference (p < 0.001). There was also a significant reduction in nurse time (p < 0.001). The audit results showed that compression bandaging therapy was an effective method of achieving healing in patients with venous leg ulcers and that significant cost savings were made in terms of dressing cost and nurse time. Furthermore, there were potential benefits in continuing compression therapy for the group of non-healers.

Adult↗
PubMed1999

Effect of inotrope withdrawal on morbidity and mortality in patients with chronic heart failure: results of the vesnarinone trial withdrawal substudy. Vest Withdrawal Substudy Group.

BACKGROUND: The use of inotropic agents in the therapy of patients with congestive heart failure (CHF) is controversial. One concern regarding inotropic therapy has been that drug withdrawal could be associated with a worsening of symptoms. METHODS AND RESULTS: We took advantage of the discontinuation of the recent trial of vesnarinone in the therapy of CHF to assess the effects of withdrawal of the inotropic agent, vesnarinone, in patients with chronic CHF who had been randomized to receive either placebo or 30 or 60 mg of vesnarinone. Contrary to our initial hypothesis, withdrawal of vesnarinone did not impact on either morbidity or mortality over a period of 6 months. CONCLUSION: Although these results suggest vesnarinone withdrawal is safe, the applicability of these results to other inotropic agents remains unclear.

Cardiotonic Agents↗
PubMed1996

Comparison of metabolic, ventilatory, and neurohumoral responses during light forearm isometric exercise and isotonic exercise in congestive heart failure.

Maximal treadmill exercise responses were compared with light forearm isometric exercise responses in patients with chronic, stable heart failure (n = 14), and normal sedentary controls (n = 11). Isometric exercise was performed to exhaustion with 25% of maximal voluntary contraction. Gas-exchange analysis was used to determine oxygen consumption (VO2), carbon dioxide production (VCO2), and minute ventilation (VE) during exercise. Significant correlations were observed in normal controls, but not in patients with heart failure, between peak isotonic exercise and peak isometric exercise for VO2 (r = 0.75, p = 0.001) and VCO2 (r = 0.67, p <0.03), and between submaximal isotonic exercise (50% of peak) and peak isometric exercise for VO2 (r = 0.75, p = 0.007), VCO2 (r = 0.67, p = 0.02), and VE (r = 0.71, p = 0.01). At 90 seconds after isometric exercise in both groups, significant correlations (p <0.05) were observed with peak isotonic exercise for VE (r = 0.62 normals, and r = 0.63 heart failure). Plasma norepinephrine increased significantly (p <0.01) after both isotonic and isometric exercise in patients with heart failure, although peak values were greater with isotonic than with isometric exercise (p = 0.01). Plasma atrial natriuretic peptide and renin activity did not change with either isotonic or isometric exercise. In conclusion, maximal isotonic exercise responses are not predictive of peak isometric VO2 or VCO2 in patients with heart failure. However, VE during maximal isotonic exercise predicts postisometric exercise ventilation in both normals and patients with heart failure; this may determine the extent of dyspnea that patients with heart failure experience with isometric activities of daily living.

Adult↗