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Biomedical subjects

C Downey

Publications and source records attributed to C Downey.

12 recordsLinked to original sources
PubMed2000

Epidural cooling for spinal cord protection during thoracoabdominal aortic aneurysm repair (a case study).

Aneurysms result from damage to artery walls as a result of underlying athrosclerotic and/or thromboembolic disorders. A thoracoabdominal aortic aneurysm involves vessel damage and wall weakening in the thoracic and abdominal segments of the aorta. Thoracoabdominal aortic aneurysm repair is considered to be high risk due to the nature of the intervention that requires an extensive incision with clamping of the thoracic aorta above the renal arteries. Clamping of the aorta renders all areas distal to the clamp at high risk for ischemic trauma especially to the spinal cord where the risk of neurological deficits postoperatively is 7-16% (Cambria, et al., 1997; Davison, et al., 1997). Several adjunct interventions have been tried to reduce the risk of spinal cord injury associated with the ischemia of cross clamping. Epidural cooling has been successful as an adjunct in reducing the neurological deficits. A preoperative nursing assessment indicating the appropriate nursing diagnoses and nursing care required for this patient, allowed for individualization of the plan needed to include this new procedure and plan for best patient outcomes and practices.

Aged↗
PubMed1999

The spies who....

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Hospital Administration↗
PubMed1998

Early identification and prognostic implications in disseminated intravascular coagulation through transmittance waveform analysis.

Efforts to improve the prognosis in disseminated intravascular coagulation (DIC) have been hampered by the lack of an early, useful and rapidly available diagnostic marker. More recently, a characteristic bi-phasic change in the light transmittance waveform profile of the APTT assay has been associated with DIC. In this prospective study, we have assessed the utility of this assay in the routine clinical setting. 1,470 samples were analysed from 747 patients and 41 patients had DIC. The sensitivity and specificity of the bi-phasic waveform pattern for DIC was 97.6% and 98% respectively. The appearance of a bi-phasic waveform preceded the development of abnormalities in the standard laboratory tests for DIC and waveform changes correlated closely with clinical events. In conclusion, transmittance waveform analysis is not only useful as an early diagnostic and single monitoring marker of DIC but the quantifiable and standardisable changes also allow for prognostic applicability in clinical management.

Biomarkers↗
PubMed1997

Novel and diagnostically applicable information from optical waveform analysis of blood coagulation in disseminated intravascular coagulation.

Transmittance waveform is the term applied to the optical profile generated from the process of clot formation on standard coagulation tests run on the MDA-180, a new-generation automated coagulation analyser. In patients with disseminated intravascular coagulation, a characteristically abnormal 'biphasic change' is seen on both the activated partial thromboplastin time and thrombin time waveforms. Increasing steepness of the initial slope on the waveform correlates with clinical deterioration and fulminant progression. Although the mechanism underlying the biphasic appearance remains to be elucidated, its identification provides the diagnostic laboratory with a simple, rapid and robust assay for disseminated intravascular coagulation that can help the clinician with urgent and appropriate therapeutic interventions.

Blood Coagulation↗
PubMed1988

Increase in levels of serum keratan sulfate following cartilage proteoglycan degradation in the rabbit knee joint.

Following injection of chymopapain into a single knee joint in rabbits, serum keratan sulfate levels rose sharply and remained elevated for at least 48 hours before returning to preinjection levels. These changes were accompanied by depletion of proteoglycans from articular cartilage in the injected joint. We conclude that serum keratan sulfate levels rise predictably following acute loss of proteoglycan from a single joint.

Animals↗
PubMed1982

Pattern of follicular development during the estrous cycle of aged rats.

The pattern of follicular development during the estrous cycles of aged rats was examined and compared with that of mature rats. In both, preovulatory follicles are derived from a select group of small pre-Graafian follicles which begin to develop at estrus and reach the preovulatory size by the morning of proestrus, but the rate of growth, as judged by an increase in the percentage of granulosa cells incorporating 3H-thymidine, is accelerated in the follicles of aged rats. A second mechanism, which accounts for preovulatory follicles in aged rats, involves the rescue from atresia of pre-Graafian and preovulatory follicles. The existence of this mechanism is supported by the observation that at metestrus in aged rats virtually all follicles, regardless of their state of atresia, possess a high percentage of granulosa cells incorporating 3H-thymidine, indicating that the follicles are growing rapidly. However, some of these rapidly growing follicles show signs of atresia such as pyknotic nuclei within their granulosa cell layers. Since follicles in the initial stage of atresia contain defective oocytes (Peluso et al. 1979b), their rescue and development into preovulatory follicles would result in the ovulation of defective oocytes, a fact which accounts in part of the lower fertility in these older animals.

Aging↗