Biomedical subjects

D Rudolphi

Publications and source records attributed to D Rudolphi.

5 recordsLinked to original sources

PubMed1993

An update on the peripheral pseudoaneurysm.

A false aneurysm, or pseudoaneurysm, is a hematoma that occurs after injury of all layers of the arterial wall and that may occur secondary to trauma or to infection or as a complication of arterial bypass reconstruction. The presence of a pulsatile mass is usually the initial finding on physical examination that leads to more definitive testing and diagnosis. Treatment traditionally has been surgical repair. Recently, observation of stable false aneurysms and ultrasound-guided compression have proved to be effective and less invasive in a select group of patients. This article focuses on the incidence, causes, diagnosis, and various treatment modalities used today. The role of the nurse in caring for these patients is also addressed.

Aneurysm, False↗

PubMed1992

Limb loss in the elderly peripheral vascular disease patient.

Limb loss in the elderly is a significant problem for a number of reasons. One of the primary problems this patient population experiences is rehabilitation. Regaining independence following amputation is often a slow and painful process. In addition, studies reveal a high incidence of depression as well as increased mortality rates in the elderly population following amputation. Nurses can play a key role in assisting the patient in attaining the highest level of function possible following limb loss. Nursing interventions should focus on coordinating a team approach to care of the amputee, educating both patient and family, as well as encouraging patient participation in support groups.

Aged↗

PubMed1990

Laser angioplasty in the lower extremities: an early surgical experience.

From July 1988 through December 1988 laser "hot tip" angioplasties coupled with balloon dilations were performed on 95 patients at the Union Memorial and University of Maryland hospitals. The patients ranged in age from 42 to 84 years (mean, 66.4 years), and there were 61 men and 34 women in the study. Indications for the procedure included claudication in 70 (74%) and severe ischemia in 25 (26%). Noninvasive studies were performed on all patients before and after the procedure. One hundred seventeen segments were treated in 28 iliac arteries and 89 superficial femoral/popliteal arteries. No tibial arteries were treated. Fifty-two stenoses and 65 occlusions occurred. The procedures were performed percutaneously in 52 patients (55%), and open surgical technique was used in 43 patients (45%). Nine immediate failures (9.5%) and 86 successes (90.5%) were noted within 24 hours of the procedure. Follow-up ranged from 1 to 6 months with a mean of 3.2 months. Late failures within this time period occurred in 21 patients (22%). The total failure rate was 30/95 or 31.5%. Only one of the patients was made worse by a failed laser-assisted balloon angioplasty. Immediate complications consisted of formation of subcutaneous hematoma in 20 of the 52 patients having percutaneous procedures (38%) and healing difficulty in 3 of the 43 patients having open surgical procedures (7%). Hospital stay was usually 1 day longer in the latter group. No patient required surgical intervention for bleeding as a result of a vessel perforation. However, this phenomenon was noted during the course of three superficial femoral artery laser-assisted balloon angioplasties.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

The role of sclerotherapy as an adjunct to Unna's boot for treating venous ulcers: a prospective study.

Ankle ulcers associated with venous disease have been traditionally treated by Unna's compressive bandages. However, successful healing of an ulcer with this therapeutic modality is slow and tedious. The purpose of this study is to investigate whether adjunctive sclerotherapy of large venous channels near the ulcers enhances healing. Twenty-eight patients with perimalleolar venous ulceration were entered into this study. Ulcer size ranged from 6.0 to 25 cm2. All were examined for the presence of large venous channels adjacent to the ulcer bed. A portable continuous-wave Doppler supplemented digital examination of the area. Twenty-five out of 28 patients had easily detectable venous channels, and these were randomized into two groups: group I, treated by weekly changes of Unna's compressive boots; group II, treated by weekly change of Unna's compressive boots and sclerotherapy with 3% sodium tetradecyl sulfate (Sotradecol). All patients had the size of the ulcer measured during their weekly visits. Patients in group II took a mean of 2.1 weeks to exhibit 50% healing and 4.3 weeks to fully heal. Conversely patients in group I took a mean of 3.2 weeks to achieve 50% healing and 6.1 weeks to fully heal. Thus, healing was significantly faster (p less than 0.05) in group II. In conclusion, the therapeutic efficiency of Unna's compressive bandaging is significantly enhanced by the adjunctive sclerotherapy of adjacent venous channels.

Adult↗

PubMed1990

The nursing shortage and specialty practice.

This paper has reviewed numerous factors contributing to the nursing shortage. These factors include changes in medical practice and the patient population, professional beliefs and objectives, and economic factors. Although many articles reviewed focus on the reasons for and solutions to the shortage, few note specifics regarding how the shortage may or may not impact on the quality of patient care. The impact of the shortage on specialty areas of nursing practice and specifically the area of peripheral vascular nursing was also reviewed. Although no recommendations were made for alleviating the shortage, recommendations for the preparation of the specialty nurse were discussed. The author agrees with Hoeffer and Murphy who state that the future of specialization is at the masters degree level. Also important is that the various nursing groups support professional credentialing and certification as a means of regulating specialty practice. Only through cooperation will nursing "specialization" be consistent in its definition as well as be recognized by nursing, other health care providers and the public as a meaningful credential.

Education, Nursing, Graduate↗