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Biomedical subjects

D Edwards

Publications and source records attributed to D Edwards.

225 records · Page 13Linked to original sources
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Autonomic reflexes in preterm infants.

Some autonomic nervous reflexes often tested in adult medicine have been studied in 21 preterm infants (25-37 gestational weeks). The aim was to develop such tests for preterm infants and see if there were any differences in babies with recurrent apnea and bradycardia and babies who had been exposed to sympathicolytic drugs before birth. To test sympathetic nervous activity the peripheral vascular resistance was measured before and during 45 degrees of head-up tilting. To test parasympathetic nervous activity the degree of bradycardia was measured in response to cold face test (application of an ice-cube on the fore-head) and laryngeal stimulation with saline. Finally the heart rate changes after a sudden noise (85 dB) were studied as an indicator of both sympathetic and vagal activity. The peripheral resistance was found to be relatively low in these preterm infants, particularly in some infants tested at the postnatal age of about two months. Heart rate and mean blood pressure did not change during tilting, while the peripheral resistance increased significantly mainly due to lowered limb blood flow. The median decrease of the heart rate during the cold face test was 20.0% and during laryngeal receptor stimulation 23.7%. The sudden noise usually caused a biphasic heart rate response. An autonomic nervous reflex score was calculated and found to be negative (parasympathetic) in infants with recurrent prolonged apnea and bradycardia and positive in infants with clinical signs of increased sympathetic nervous activity.

Apnea↗
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Pulmonic stenosis in dogs: balloon dilation improves clinical outcome.

Medical records of 81 dogs with severe pulmonic stenosis from 2 referral centers were examined retrospectively. Forty dogs underwent balloon valvuloplasty (BV), which was performed by 1 operator, whereas 41 did not. The mean age at latest follow-up was 41.5 months. A statistical comparison of the clinical outcome and survival was performed. Dogs revealing clinical signs at presentation showed a 16-fold increase in risk of death compared with asymptomatic dogs (P < .001). Statistical analyses demonstrated that an increase of 1 mm Hg in transstenotic pressure gradient (PG) at presentation was associated with a 3% increase in hazard rate (P < .001). Thirty-seven dogs survived BV with a median reduction in PG of 46%. The median preoperative PG was 120 mm Hg, and median PG 24 hours postoperatively was 55 mm Hg with a median of 55 mm Hg 6 months post-BV. Twenty (49%) of the non-BV (NBV) dogs remained asymptomatic at last follow-up. Fourteen (34%) of the NBV dogs died or were euthanized because of heart disease related to pulmonic stenosis. Twelve of these dogs died suddenly, whereas only 1 of the BV dogs died suddenly. After adjusting for PG, clinical signs at presentation, and age, BV or dilation was associated with a 53% reduction in hazard rate (P = .005). This study indicates that BV, when performed by an experienced operator, appears to be successful both in alleviating clinical signs and in prolonging survival in dogs with severe pulmonic stenosis.

Animals↗
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Comparison of oscillometric and intra-arterial blood pressure and pulse measurement.

Non-invasive oscillometric blood pressure and pulse measured by an Omron HEM-703CP monitor were compared with arterial values obtained from direct measurements of the radial artery. An excellent correlation and agreement was found between the two methods (systolic r = 0.99; diastolic r = 0.97; pulse r = 0.99), although there was some variability among individual subjects. The range of difference between them was 0 to 10 mmHg for systolic and -6 to +5 mmHg for diastolic pressures. When tested on the bench using the Metron QA-1280 non-invasive blood pressure analyser the HEM-703CP monitor rarely exhibited errors exceeding 2-3 mmHg over a measurement range of 50-200 mmHg.

Adult↗
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Attention, learning, and personality during ketamine emergence: a pilot study.

To analyze the memory, learning, attention, and personality effects associated with emergence from partial ketamine induction, 11 resident physicians were tested. Ketamine was found to be truly dissociative in that it seemed to impair learning of and memory for unusual word associations, at least in young physicians.

Adult↗
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Evaluation of a self-directed smoking prevention and cessation program.

This study evaluates a youth subject-directed smoking prevention and cessation program titled Breathe Easy! The program was delivered at two sites and a control group was recruited from two additional sites. Surveys were administered prior to the program and either 1 month or 6 months after completion at the exposure sites. The same survey administration procedure was used as the control. After controlling for invalid responses and including only those that completed both surveys, 251 exposure subjects and 159 control subjects remained for analysis. At sites with 1-month follow-up, no significant difference was noted between intervention and control groups. At the sites with 6-month follow-up, prevalence dropped from 18.7% to 8.9%, which is statistically significant, while at the control site prevalence changed from 14.1% to 9.4%, which is not significant. Additional outcomes examined in the exposed group showed trends toward smoking cessation and prevention at higher rates than those of the unexposed group.

Adolescent↗
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Evaluating the impact of a continuing education program on change in gerontologic nursing practice.

In this article, the authors describe behavior changes reported by nurses after attending a continuing education program that addressed nursing care of the gerontologic client in the acute hospital setting. Although participants reflected positively upon knowledge gained at the conference and described themselves as amenable to change, they associated environmental and administrative factors negatively with implementation of practice changes. Conclusions from descriptive analysis of responses yielded suggestions for strategies to enhance the impact of continuing education programs on nursing care of the aged client.

Adult↗