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Biomedical subjects

F Perry

Publications and source records attributed to F Perry.

At least 19 recordsLinked to original sources
PubMed1994

Role of psychological factors in postoperative pain control and recovery with patient-controlled analgesia.

OBJECTIVE: We examined the extent to which preoperative state and trait anxiety, general need to control, need to control analgesia, expectations regarding postoperative pain, and demographic variables predict the severity of postoperative pain, discomfort, anxiety, duration of recovery, and patient-controlled analgesia (PCA) behaviors. DESIGN: Preoperative and outcome variables were analyzed using Pearson product-moment correlations and forward stepwise multiple linear regression. SETTING: This study was conducted at a university hospital in preoperative and postoperative settings. PATIENTS: Ninety-nine consecutively consenting ASA physical status I-II women (age 46 +/- 11 years, 70% caucasian, 28% Afro-American, 2% Hispanic) undergoing simple hysterectomy procedures with no known cancer were included in the study. INTERVENTIONS: Standardized general anesthesia, surgery, and PCA therapy was conducted. OUTCOME MEASURES: The McGill Pain Questionnaire (MPQ), patient requests and delivered analgesic medication, visual analog scales (VAS) for pain and anxiety, time to oral medications and hospital discharge, and Likert scale measurements of overall pain and discomfort were utilized. RESULTS: Older patients generally reported less pain, but used the same amount of analgesic medication as younger patients. Preoperative trait anxiety correlated with increased PCA requests, but not with postoperative pain. In contrast, preoperative state anxiety correlated positively with postoperative pain and with shorter time to hospital discharge. The patients' need for control was positively correlated with the Present Plan Index scale of the MPQ, with morphine requirement, and with PCA requests. CONCLUSIONS: Psychological factors do influence postoperative recovery and pain control in women receiving PCA therapy after abdominal hysterectomy, and attention to individual patient differences may lead to improved postoperative outcomes.

Adult↗
PubMed1991

Shared governance: a Canadian experience.

Control over practice, nursing shortages and better utilization of personnel are serious problems facing nurses in hospitals today. Shared governance models are one way to enhance professionalism, thus making the practice of nursing appealing. Effects of moving toward a shared governance model are described with examples derived from a rural hospital in British Columbia. Practical recommendations are given which support nursing leaders who dare to risk deep structural change.

British Columbia↗
PubMed1990

Autonomic components of the human pupillary light reflex.

To investigate the autonomic components of the pupillary light reflex in humans, we used infrared pupillometry combined with a partial local cholinergic (tropicamide) or alpha-adrenergic (thymoxamine) blockade. The pupillary response curve was analyzed using parameters identical or similar to those employed previously to study the autonomic components of the pupillary light reflex. Tropicamide increased baseline pupil area and affected five of the eight measured parameters. Thymoxamine lowered baseline pupil area but did not affect any of the parameters. We found the expected cholinergic contribution to the constrictive phase of the pupillary light reflex but no evidence for peripheral alpha-adrenergic activity during redilation. We propose that redilation primarily involves parasympathetic relaxation, modulated by cholinergic inhibition of the dilator muscle and central sympathetic inhibition of the Edinger-Westphal nucleus.

Adult↗
PubMed1989

Paradoxical analgesia produced by low doses of the opiate-antagonist naloxone is mediated by interaction at a site with characteristics of the delta opioid receptor.

This study addressed the opiate receptor subclass which underlies the paradoxical analgesic action of intrathecal administration of low doses of the stereospecific opiate receptor antagonist, naloxone. The analgesic effect of low dose naloxone was abolished in rats that had been pretreated 24 hr earlier with a large intrathecal dose of naloxone or 20 min previously with the delta receptor specific antagonist, ICI-174,864. A large intrathecal dose of naloxone administered 24 hr previously also abolished the analgesic effects of the delta-specific ligands [D-Pen2,5]-enkephalin and [D-Ser2]-Leu enkephalin-Thr but not those produced by mu-ligands Tyr-D-Ala-Gly-NMe-Phe-Gly-ol and beta-Casomorphin(1-4) amide or by the kappa-specific ligand, U50,488H. Furthermore, the analgesic action of low dose naloxone (on thermal and mechanical nociceptive threshold tests) persisted in rats made tolerant to mu-opioid receptor specific ligands. We conclude that the analgesic action of a low dose of naloxone is mediated via interaction with a stereospecific binding site with the characteristics of the delta-opioid receptor.

Analgesia↗
PubMed1988

Comparison of local tumor recurrence following excision with the CO2 laser, Nd:YAG laser, and Argon Beam Coagulator.

This study compares the incidence of local tumor recurrence following primary excision with the CO2 laser, Nd:YAG laser (contact), Argon Beam Coagulator, or electrocautery. One hundred eight Fisher 344 rats with R3230AC mammary tumors (1.6 +/- 0.04 [SD] cm diameter) were used. All animals were randomized into groups of similar tumor size. In groups C and CS, excision was performed with a Sharplan 1060 CO2 laser (TEMoo, 25 W, continuous wave [CW], 0.2-mm spot size). Wounds in group CS were "sterilized" (0.5-mm spot size, 25 W, CW) by gently heating the wound without causing blanching or charring. In group N, a 0.4-mm contact Laser Blade and a Cooper 8000 Nd:YAG laser at 20 W CW was used. In groups SA1 and SA2, tumors were excised with the scalpel, and hemostasis and wound "sterilization" were accomplished with the Bard System 6000 Argon Beam Coagulator (ABC) at 40 W and 4 liters/min argon gas flow in SA1 and 12 liters/min in SA2. In group E, excision was accomplished at 40 W blend mode, 10 W spray mode. In group EA, excision was accomplished at 60 W cutting current, and hemostasis was achieved with the ABC. The animals were examined for evidence of recurrence for 34 days postoperatively. Mortalities were excluded from analysis. The incidence of recurrence was 11/14 (79%) in C, 6/16 (38%) in CS, 10/14 (71%) in SA1, 6/13 (46%) in SA2, 6/15 (40%) in N, 7/10 (70%) in EA, and 3/15 (20%) in E. Group E is statistically different (P less than .01) from groups EA, C, and SA1. Group C was different (P less than .01) from groups E, CS, and N. These results demonstrate an inverse relationship between tumor recurrence and local thermal effects at the surgical site. The ABC did not increase tumor recurrence. Contact YAG surgery was similar to CO2 laser excision and "sterilization." An attempt to study the influence of gas flow and pressure on local tumor recurrence and metastases should be made.

Adenocarcinoma↗
PubMed1982

Discrimination of sleep onset stages: behavioral responses and verbal reports.

In a descriptive experiment on discrimination five human subjects were studied during the transitional period of sleep onset. Subjects were aroused by an abrupt auditory stimulus, attempted to discriminate the pre-arousal stage by a behavioral response, and answered a series of standardized questions. These questions focused on specific characteristics of private experience associated with sleep onset. Of 180 awakenings, subjects correctly identified 109 sleep-onset stages. Subjects' answers were analyzed to determine what criteria were used to make the discrimination among sleep-onset stages and to examine their self-awareness of changes in private experience. It was established that there are stage-related changes in mental processes and content and that these may aid subjects in making such discriminations. Implications of the methodological approach used in this study are discussed.

Adult↗
PubMed1981

Discrimination of early sleep stages: behavioral indicators.

Six subjects participated in a one-night sleep-onset experiment. They were aroused from stage 1 and stage 2 as defined by standard electroencephalographic criteria. Subjects pressed a button upon arousal to indicate which of two subjective states they were in just before awakening. Performance accuracy from stage 1 awakenings appeared to remain relatively constant at approximately 83%; performance from stage 2 awakenings showed increasing accuracy. Response latencies increased between stage 1 and stage 2 awakenings.

Adult↗
PubMed1980

Patient advocacy program links board and patient.

The patient advocacy program at Hurley Medical Center, Flint, MI, was developed as part of an administrative effort to make the institution more responsive to the human needs of patients. The program acts as a direct link between the patient and the trustee by bringing to the board's attention specific information on patient problems along with corrective actions that have been implemented.

Governing Board↗
PubMed1979

Medical center supports patient advocacy.

At Hurley Medical Center, patient advocates enjoy an amiable relationship with administrators and are considered a valuable management information resource.

Consumer Behavior↗
PubMedDate not supplied

Ethics and impaired healthcare executives.

Healthcare executives are not expected to poorly manage their own health. When they do, they do more than diminish their own public image: They can also damage the public image of their organizations of employment.

Ethics, Professional↗