Biomedical subjects

C Westlake

Publications and source records attributed to C Westlake.

3 recordsLinked to original sources

PubMed1991

Commitment to function: microsurgical flaps.

Microsurgical procedures facilitate the optimal function of patients and provide for an enhanced quality of life. The contribution of this procedure to the eventual positive outcome of multiple patient populations is clear. Therefore, competence in the care of this emerging patient population is essential for the plastic surgical nurse. This article has outlined the history of free flaps, flap anatomy and physiology, evaluation of flap vascularity, and postoperative nursing care. Further work needs to be performed in order to definitively describe nursing and medical interventions, delineate effective wound management techniques, and develop monitoring devices that will augment the success of the free flap procedure.

Education, Nursing, Continuing↗

PubMed1990

Cardiovascular effects of recreational cocaine abuse.

Deaths related to the recreational use of cocaine in the United States have increased to epidemic proportions within the last decade. Frequently, persons with cocaine toxicity present to the emergency room, require critical care nursing, and are admitted to the intensive care unit. This article outlines the cardiovascular effects of recreational cocaine abuse. Initially, the historical perspective of the drug is outlined. The mechanism of action, administration, absorption, and excretion are discussed. Details regarding the cardiovascular effects of cocaine are described. Although no uniform treatment plan has been developed for every complication of cocaine overdose, the current therapeutic modalities are outlined. Finally, the clinical implications for clinical practice are addressed. The recreational abuse of cocaine presents new patient care challenges for the critical care nurse. With increased knowledge, the health care provider may assist in meeting the clinical needs of this emerging patient population.

Cardiovascular System↗

PubMedDate not supplied

Randomized study of high dose oral cyclosporine therapy for mild acute cardiac rejection.

Mild acute rejection progresses to moderate rejection in approximately one third of the cases. Standard rejection therapy would then be instituted with the attendant risk of infection and other side effects. We randomized 40 episodes of mild acute rejection (20 episodes in each group) to receive no additional therapy or to have the oral cyclosporine dose increased for 7 to 10 days with repeat endomyocardial biopsy performed. In the group with no additional therapy 30% progressed to moderate rejection, whereas in the group with increased doses of oral cyclosporine, 10% progressed to moderate rejection (p = 0.10). As the purpose of our study was to assess the efficacy of increased cyclosporine levels for preventing progression from mild to moderate rejection, the treated group was redefined according to whether the cyclosporine level increased by greater than or equal to 50% during the study. In this treated group average cyclosporine levels increased from 169 +/- 78 to 413 +/- 267 ng/ml. Progression to moderate rejection occurred in one of 21 cases (5%) compared with seven of 19 cases (37%) in the group without an increase in cyclosporine level (p less than 0.05). The transient increase in cyclosporine levels was well tolerated. This study demonstrates that the use of high dose oral cyclosporine to treat mild acute rejection is well tolerated and may reduce progression to moderate rejection when a significant increase in cyclosporine level is achieved.

Acute Disease↗