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Biomedical subjects

S Russell

Publications and source records attributed to S Russell.

134 records · Page 8Linked to original sources
PubMedDate not supplied

Reducing readmissions to the intensive care unit.

OBJECTIVE: To determine factors that contributed to readmissions to the intensive care unit (ICU) from the general wards. DESIGN: Prospective, descriptive, qualitative, and quantitative. SETTING: The Royal Melbourne Hospital, which is a large, metropolitan, university-affiliated tertiary hospital with specialist and general wards. The ICU is a 14-bed medical and surgical adult unit. PATIENTS: 572 patients admitted to ICU between July 1 and December 31, 1993. RESULTS: There were 639 admissions, with 67 (10.5%) being readmissions. This study showed that 63% of all readmissions came from the general wards. The study identified three main factors that contributed to readmissions from the ward: progression of the patient's illness, postoperative care requirements, and inadequate follow-up care on the general wards. Identifying inadequate continuity of care on the general wards as a cause of readmissions to the ICU led to the appointment of an ICU follow-up nurse to facilitate the transition from the ICU to the general ward. CONCLUSION: Preliminary results indicate that the appointment of the follow-up nurse has not only reduced the rate of readmissions to the ICU but also decreased the acuity levels of those readmitted.

Continuity of Patient Care↗
PubMedDate not supplied

Chemokine and chemokine receptor expression in keloid and normal fibroblasts.

Keloids are benign collagenous tumors that occur during dermal wound healing in genetically predisposed individuals. The lesions are characterized by over-proliferation of fibroblasts, some leukocyte infiltration, and prolonged high rates of collagen synthesis. To determine whether leukocyte chemoattractants or chemokines are participating in this disease process, immunohistochemical staining for the CXC chemokine, MGSA/GROalpha, and its receptor, CXCR2, was performed on tissue from keloids, hypertrophic scars and normal skin. Immunoreactive MGSA/GROalpha was not observed in hypertrophic scars or normal dermis, but was present in some myofibroblasts and lymphocytes in nodular areas of the keloid samples. This staining positively correlated with the degree of inflammatory infiltrate in the lesions. Keloids, but not hypertrophic scars or normal dermis, also exhibited intensive immunoreactivity for the CXCR2 receptor in endothelial cells and inflammatory infiltrates with occasional staining of myofibroblasts. In contrast, cultured fibroblasts from either keloids or normal skin did not express detectable amounts of mRNA for MGSA/GRO or CXCR2, although interleukin-1 strongly induced MGSA/GRO mRNA in both cell types. Interleukin-1 induction of MGSA/GRO was inhibited by glucocorticoid in normal and keloid fibroblasts, and the effect was more pronounced in keloid fibroblasts. This event was not correlated with inhibition of nuclear activation of NF-kappaB, AP-1 or Sp1, and might therefore be mediated by another mechanism such as decreased mRNA stability or transcriptional repression through the glucocorticoid response element in the MGSA/GRO promoter. Data from in vitro wounding experiments with cultured normal and keloid fibroblasts indicate that there were no significant differences in MGSA/GRO or CXCR2 receptor levels between normal and keloid fibroblasts. We also show that cultured keloid fibroblasts exhibit a delayed wound healing response. We postulate that the inflammatory component is important in development of keloid lesions and chemotactic cytokines may participate in this process.

Blotting, Northern↗
PubMedDate not supplied

Outcome in prenatally diagnosed fetal agenesis of the corpus callosum.

This study of the outcome and prognostic factors in prenatally diagnosed agenesis of the corpus callosum (ACC) was undertaken to see if there are any differences between subgroups, what relationship they have to neurodevelopmental outcome and whether this information aids the counselling of parents of fetuses with the condition. The outcome of 14 prenatally diagnosed fetuses with ACC and 61 postnatally diagnosed patients was assessed in terms of clinical problems, developmental milestones and neurological signs; each patient was then given a score out of 10, 0 being a normal outcome and 10 being the worst outcome, i.e. death or termination of pregnancy. Comparing patients diagnosed pre- and postnatally, several similarities were found indicating that the postnatal group can provide useful information about the prenatal group. There was a higher incidence of ACC in males than females. In the prenatally diagnosed patients complete ACC was more common than partial ACC, although this might be because partial ACC was easily missed. Complete ACC has a worse prognosis than partial ACC (p = 0.001), and when associated with other anomalies, especially of the central nervous system, the outcome is very bad (p < 0.01). The only neurodevelopmentally normal patients were in the isolated partial ACC group. This study highlights the need to perform a detailed review of fetal anatomy and the desirability of determining the karyotype of the fetus in all newly diagnosed cases of ACC so that as much information as possible is available before parents are counselled about the likely outcome.

Agenesis of Corpus Callosum↗
PubMedDate not supplied

Explaining demographic trends in teenage fertility, 1980-1995.

CONTEXT: The teenage birthrate rose sharply in the late 1980s and early 1990s, and then declined in the 1990s. Attempts to explain these changes have failed to account for the changing environment in which adolescents live. METHODS: Data from the 1995 cycle of the National Survey of Family Growth are used to compare the experiences of three cohorts of teenage females in the 1980s and 1990s. A life-course framework is used to examine trends in characteristics of adolescents and adolescent mothers over time, and event-history analyses are conducted to determine which characteristics are associated with the risk of a teenage birth in each cohort. A comparison of the predicted probabilities from hazard analyses shows how changes in the context of adolescence across the cohorts help explain changes in the probability of a teenage birth over time. RESULTS: Factors associated with the increase in the teenage birthrate in the 1980s include negative changes in family environments (such as increases in family disruption) and an increase in the proportion of teenagers having sex at an early age. Factors associated with the recent decline in the teenage birthrate include positive changes in family environments (such as improvements in maternal education), formal sex education programs and discussions with parents about sex, stabilization in the proportion of teenagers having sex at an early age and improved contraceptive use at first sex. Sexually experienced teenagers in the mid- 1990s were younger, on average, at first sex than were their counterparts in the 1980s, and thus are at an increased risk of a teenage birth. Partner factors, including nonvoluntary first sexual experiences, were not associated with the risk of a adolescent birth in any cohort. CONCLUSIONS: Programs to further reduce the teenage birthrate should take into account the role of family stability, parent-child communication, sex education programs and engagement in school, as well as attempt to reduce the proportion of adolescents having sex at an early age and to improve contraceptive use. The increasing risk levels among sexually experienced teenagers suggest that current programs may be reducing sexual activity among adolescents already at a low risk of a teenage birth, without addressing the needs of those at highest risk.

Adolescent↗
PubMedDate not supplied

Nurses who become the parent of the patient.

How often have you received a nursing report on a pediatrics unit and heard or overheard, "The Mom (Dad) is a nurse and drove me crazy all day?" Or perhaps your own child has been hospitalized and you remember feeling frustration and anger when you think about the experience. What are the dynamics involved in these two situations? What do we as caring professionals really understand about the emotions involved? What emotions might we feel if our own child needs hospitalization? The following anecdotal dialogue was written by two professional nurses whose lives were unexpectedly disrupted when their babies each needed hospitalization. Together, involved in the care of one child they found their emotions and professional beliefs interwoven in such a manner as to make this article possible.

Adult↗
PubMedDate not supplied

Dignity to the end.

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Community Health Nursing↗