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Biomedical subjects

E Hanley

Publications and source records attributed to E Hanley.

10 recordsLinked to original sources
PubMed1998

Multicenter study of contaminated percutaneous injuries in anesthesia personnel.

BACKGROUND: Anesthesia personnel are at risk for occupational infection with bloodborne pathogens from contaminated percutaneous injuries (CPIs). Additional information is needed to formulate methods to reduce risk. METHODS: The authors analyzed CPIs collected during a 2-yr period at 11 hospitals, assessed CPI underreporting, and estimated risks of infection with human immunodeficiency virus and hepatitis C virus. RESULTS: Data regarding 138 CPIs were collected: 74% were associated with blood-contaminated hollow-bore needles, 74% were potentially preventable, 30% were considered high-risk injuries from devices used for intravascular catheter insertion or obtaining blood, and 45% were reported to hospital health services. Corrected for injury underreporting, the CPI rate was 0.27 CPIs per yr per person; per full-time equivalent worker, there were 0.42 CPIs/yr. The estimated average 30-yr risks of human immunodeficiency virus or hepatitis C virus infection per full-time equivalent are 0.049% and 0.45%, respectively. Projecting these findings to all anesthesia personnel in the United States, the authors estimate that there will be 17 human immunodeficiency virus infections and 155 hepatitis C virus infections in 30 yr. CONCLUSIONS: Performance of anesthesia tasks is associated with CPIs from blood-contaminated hollow-bore needles. Thirty percent of all CPIs would have been high-risk for bloodborne pathogen transmission if the source patients were infected. Most CPIs were potentially preventable, and fewer than half were reported to hospital health services. The results identify devices and mechanisms responsible for CPIs, provide estimates of risk levels, and permit formulation of strategies to reduce risks.

Anesthesiology↗
PubMed1992

Changing etiology of iliopsoas abscess.

Over a 5-year period, iliopsoas abscesses were found in 11 patients. Although the most common underlying condition was Crohn's disease (3 of 11 patients), 5 abscesses resulted from hematogenous spread from a distant site. Each of these five patients was elderly, severely malnourished, or had an underlying chronic disease. Fever was a presenting sign in 8 of 11 patients, whereas all 4 patients who presented with back pain had nontuberculous lumbar osteomyelitis or disk space infections. No patient presented with the classic triad of fever, back pain, and anterior thigh or groin pain. Computed tomographic (CT) scans accurately established the clinical diagnosis in 10 of 11 patients. Two of the patients died. One patient was an intravenous drug abuser, whereas the other patient was being treated with steroids for systemic lupus erythematosus. Elderly patients, diabetics, and patients with chronic disease are susceptible to this kind of occult infection and may present with minimal clinical findings. Aggressive diagnosis using CT scanning and treatment with resection of involved bowel, complete drainage of the abscess, and prolonged antibiotics are required to salvage these patients.

Abscess↗
PubMed1992

HIV infection in women. Implications for nursing practice.

Much remains to be explained regarding women with HIV infection or AIDS. Interest in determining whether the natural history of the disease or the clinical manifestations are gender specific is leading to more research focused on women. The female roles of childbearer and caretaker evoke ethical issues that are unique to this epidemic and that can impact on the development and delivery of health care services. Women at the greatest risk for HIV disease are not likely to form coalitions to advocate for services, research dollars, and education. They need advocates and assistance in becoming united to advocate for themselves. Nurses have a critical role in the provision of services to women with HIV disease. As educators, direct service providers, and administrators, nurses contribute to the development of services that are holistic and family centered. As advocates, nurses can ensure that women are accurately and well informed about the disease and the resources available to them. Because AIDS no longer affects only those persons living in large metropolitan areas, it is imperative that all nurses become experts in the care of women with AIDS and advocates for a better outcome.

Ethics, Nursing↗
PubMed1991

Herniated L4-L5 disc after placement of Harrington instrumentation for a fracture of the thoracolumbar spine.

The authors report a case in which L5 radiculopathy developed acutely after surgery for placement of Harrington rod instrumentation for an L1 body fracture. Computed tomographic myelography demonstrated a large L4-L5 herniated disc that had not been present in preoperative studies. An emergency laminectomy was performed, and a large, free, subligamentous disc fragment was removed. The patient subsequently regained L5 sensorimotor function. The postoperative development of lumbar radiculopathy is an uncommon complication of Harrington rod instrumentation that may result from several biomechanical features of the instrumentation. These injuries may not be detected by intraoperative monitoring of somatosensory evoked potentials, and therefore, the postoperative neurological examination assumes a crucial role in the early diagnosis of these lesions. As our case demonstrates, these radicular deficits may be reversible if their cause is promptly recognized and treated.

Aged↗
PubMed1990

The effects of freezing or freeze-drying on the biomechanical properties of the canine intervertebral disc.

The transplantation of spinal allografts to correct defects that include disc, body, or segments of both is currently under experimental investigation. A method of graft preservation that will least compromise the biomechanical integrity of the bodies or discs is required. Using a five-mode biomechanical analysis, the authors compared the change in stiffness of ten preserved canine spines. The freeze-dried specimens lost a significantly greater amount of stiffness in compression, flexion, extension, and torsion than did the frozen specimens. Therefore, from a biomechanical viewpoint, deep-freezing is superior to freeze-drying for spinal allograft preservation.

Animals↗
PubMed1978

Disc excision and spine fusion in the management of lumbar disc disease. A minimum ten-year followup.

Seventy-nine percent of 312 patients who underwent lumbar disc surgery were evaluated at least 10 years postoperatively (mean equal to 13.7 years). Residual back and nerve root symptoms and functional impairment were equally as common among the 143 patients who underwent fusion as they were among the 64 patients who did not. Thirty percent of the patients whose spines were fused and 37.7% of those patients whose spines were not fused were considered long-term failures because of persistent symptoms or the need for reoperation. Thirty-seven percent of the fusion patients had persistent graft donor site symptoms. Examined patients showed a high percentage of residual neurologic defects. An unexplained positive Trendelenburg sign was present in 14.8% of the fusion patients and in 18.2% of the patients whose spines were not fused. Although retrospective studies often have problems of accuracy, this analysis confirms other observations that midline spinal fusion offers few benefits in the management of lumbar disc disease.

Adult↗
PubMedDate not supplied

Injuries to pitchers in women's collegiate fast-pitch softball.

An injury survey of eight college softball teams ranked among the top 15 during the 1989 women's NCAA tournament championship by their athletic trainers found 26 injuries and complaints in 20 of 24 players. There were 15 grade I (nontime-loss) injuries, all musculotendinous except for a leg contusion and an ankle sprain. The 6 grade II injuries (altered play) were also musculotendinous except for 2 sprains to the hand and wrist. The 5 grade III (stopped play) injuries were somewhat more varied in type and resulted in an average of almost 7 weeks of time lost per injured player. Eighty-two percent of the time-loss injuries (grades II and III) involved the upper extremity. This survey suggests that there are likely to be a significant number of injuries involving loss of time from practice or games among elite women's fast-pitch softball pitchers.

Adolescent↗