Special focus theatre nursing. Facing the challenges in theatre nursing: NATN Congress focus.
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Biomedical subjects
Publications and source records attributed to G Hutt.
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With the increasing acceptance of various forms of alternative medicine as coping strategies for the stresses and strains of modern life, hypnotherapy is becoming more and more established as an adjunct to orthodox medical practice. Scientific research methods applied to hypnotism, as well as improved communication and education, have done much to raise the image of hypnotherapy generally.
January 1994 and the Control of Substances Hazardous to Health Regulations (COSHH) are being amended to include among others anaesthetic gases. For COSHH to be effective it has to be enforced. In order to see how this might be achieved one can perhaps look at the effectiveness of the Regulations since 1989.
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We report on 27 "high risk" patients out of 171 consecutive patients undergoing percutaneous transluminal coronary angioplasty from June 1984 to August 1985. The ages ranged from 31-80 years (mean 62.7 +/- 10) years. High risk percutaneous transluminal coronary angioplasty was defined as: salvage cases (3 patients) where the patients presented in cardiogenic shock or the vessels were not bypassable; multivessel coronary artery disease (22 patients) where a large area of jeopardized myocardium was dependent on the angioplasty vessel(s); left ventricular dysfunction (7 patients) as defined by two of the three criteria: left ventricular end-diastolic volume index greater than 100 ml/m2; ejection fraction less than 30%; and left ventricular end-diastolic pressure greater than 20 mm Hg. The initial success rate in the high risk patients was 85.2%. Emergency coronary artery bypass surgery in these patients was 7.4%. There was one death in the high risk group, as one of the salvage cases died 24 hours after successful percutaneous transluminal coronary angioplasty due to severe underlying myocardial disease. In conclusion percutaneous transluminal coronary angioplasty can be successfully performed in high risk patients with a low complication rate and should be considered as an alternative to coronary artery bypass graft surgery in selected high risk patients.
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