PubMed Health⌕ Search

Biomedical subjects

H Evers

Publications and source records attributed to H Evers.

At least 19 recordsLinked to original sources
PubMed1992

Screening of pulmonary hypertension in chronic obstructive pulmonary disease and silicosis by discriminant functions.

The aim of our prospective multicentric study was to develop a screening method for pulmonary hypertension in patients with chronic lung diseases. We investigated 710 patients in 10 hospitals: 315 males and 109 females with chronic obstructive pulmonary disease, and 286 males with silicosis. Manifest pulmonary hypertension was defined as pulmonary artery pressure greater than 20 mmHg (2.7 kPa) at rest. The multivariate statistical method used was a stepwise discriminant analysis. In males with chronic obstructive pulmonary disease, the diameter of the right descending pulmonary artery, forced expiratory volume in one second (FEV1) arterial oxygen tension (PaO2) at rest, and age turned out to be relevant for discrimination of groups with and without manifest pulmonary hypertension. For females the FEV1/FVC (forced vital capacity) ratio replaced the absolute value of FEV1 in the calculated discriminant function. In females, sensitivity and specificity were below 80%. In males, both were distinctly above 80%. In silicosis, the diameter of the right descending pulmonary artery was much less important, since it could frequently not be measured precisely. In these cases, precision of the prediction of about 80% could only be obtained by combined evaluation of spirometry, PaO2 during exercise, and body plethysmography. The calculated discriminant functions are appropriate for screening patients with risk of pulmonary hypertension. For different chronic lung diseases, and for both sexes, different combinations of parameters are relevant. The method is recommended to select patients who should undergo an invasive examination of pulmonary haemodynamics.

Discriminant Analysis↗
PubMed1991

Effect of intradermal injection of saline or a local anaesthetic agent on skin blood flow--a methodological study in man.

The influence of intradermal needle insertion and fluid injection on skin blood flow was investigated using laser Doppler flowmetry. Seventeen healthy, young male volunteers participated. Four test sites on each forearm (volar surface) were used in a randomized, double-blind study. Recordings were made at 20, 40, 60 and in Group III also at 90 min after needle insertion or intradermal injection. In Group I (n = 6) different volumes of saline (0.05, 0.1, 0.2, 0.3 and 0.5 ml) were injected, producing an increase in flow, there being no differences between the various volumes. In Group II (n = 4) needle insertions were made using different needle sizes (20 G, 23 G and 30 G), the larger ones being impractical to use. Increases in flow were seen, and were somewhat higher for the larger needles. Group III (n = 12) was studied regarding the effects of three local anaesthetic agents on skin blood flow (0.1 ml, 30 G needle). Injection of bupivacaine 0.75% produced a marked increase in flow, similar to lidocaine 1% but apparently longer lasting. Bupivacaine 0.25% caused less increase in flow, similar to the flow seen with saline. Injections of ropivacaine 0.75% and 0.25%, i.e. in clinical concentrations, caused a decrease in blood flow, this being most marked after 0.25%, indicating a unique flow-decreasing effect of this new local anaesthetic drug.

Adult↗
PubMed1991

[Reference values for spirometry exemplified by FVC and FEV1 parameters--comparison of normal values of the Pathophysiology of Respiration Section and the European Society for Coal and Steel].

Reference values published by the Section Pathophysiology of Breathing in the Society for Pulmology and Tuberculosis of the GDR and reference values of European Community for Coal and Steel (EGKS) were compared on example of FVC and FEV1. It was found a relative well accordance of reference values of FVC and FEV1 in younger and middle-aged men of a height from 160-200 cm (between -5 to +15%). In women with a body height of 150 to 200 cm a well correlation for FVC and FEV1 is also given (-10 to +10%). Reference values are showing a more important difference with increasing age and independent of sex. There are problems concerning the reference values in male and female lower than 155 cm body height.

Adult↗
PubMed1990

The concentration of lidocaine in follicular fluid when used for paracervical block in a human IVF-ET programme.

Lidocaine is a well-documented local anaesthetic often used for paracervical block (PCB) in pregnant women. For this reason, the substance was used early on for PCB in connection with transvaginal follicle aspiration. However, the concentration reached in follicular fluid after PCB or local infiltration of the vaginal wall has not been previously determined. Furthermore, if lidocaine reaches the follicle, it seems important to determine if the concentration reached influences fertilization and early cleavage of the embryo and the pregnancy rate. The study included 46 women who had PCB with lidocaine (50 mg) and 46 women who had no PCB in connection with follicle aspiration. The mean concentration in follicular fluid was 0.36 +/- 1.1 micrograms/ml. There was no significant difference in lidocaine concentration between follicles containing oocytes that were fertilized and those that were not. Furthermore, the fertilization and cleavage rates did not differ significantly in women with and without PCB with lidocaine. The pregnancy rate did not differ between the two groups. It thus seems that the concentration of lidocaine found in the follicular fluid after PCB with 50 mg lidocaine does not negatively affect fertilization of the human oocyte or early cleavage of the human embryo.

Adult↗
PubMed1990

The influence of nifedipine (Corinfar) on pulmonary hypertension in chronic obstructive lung disease.

Calcium antagonists may provide an effective approach to the treatment of pulmonary hypertension disorders. Under this aspect we examined 44 patients by right heart catheterisation at rest and at exercise before and after sublingual application of a single dose of 20 mg nifedipine (Corinfar) as well as under continuous dosage of 30-60 mg daily. In patients with latent pulmonary hypertension we ascertained an efficient significant decrease of PAP, 15 of 18 patients were responders. This protective effect persists in the longterm studies after 1 year as well as after 2 years at equal magnitude. In patients with manifest pulmonary hypertension the influence on pulmonary hemodynamics was not so efficient. This behaviour is caused by morphological fixation of pulmonary hypertension. Therefore the determination of magnitude of pulmonary hypertension by right heart catheterisation is necessary for evaluation of nifedipine therapy.

Adolescent↗
PubMed1990

EMLA: a new topical anesthetic.

Eutectic Mixture of Local Anesthetics (EMLA) containing 5% lidocaine and prilocaine in a cream was found to give effective topical analgesia in normal and diseased skin, making it useful for superficial surgery and various other clinical procedures. To be effective, an adequate amount must be applied under occlusion and at the right time before the intervention.

Administration, Topical↗
PubMed1989

Who gets a bath?

Explore the source record for details and available documents.

Aged↗
PubMed1989

District nursing, the disabled and the elderly: who are the black patients?

Community care research in central Birmingham has shown that disabled and old black people are under-represented on the caseloads of district nurses compared to their white counterparts. Whilst factors suggested as contributing to this (service ethnocentrism and general practitioners as 'gate-keepers') are discussed elsewhere, this paper focuses on those few old and disabled black people who are district nurse patients. Following comparisons between these black and white patient groups, the differing perspectives of black patient and district nurse are explored. Stereotypes and myths, knowledge about each other and language/communication are discussed as important areas which may disadvantage black patients in their interaction with district nurses. Attention is drawn to the urgent need for district nursing to address the issue of black disabled and old people in the community and the accompanying central role of research.

Black or African American↗
PubMed1989

The nursing auxiliary service and the care of elderly patients.

Although nurse auxiliaries comprise a large and rapidly expanding part of the district nursing service, nursing research has largely neglected this group of nurses and the people they see. Using a patient-centred approach, which is a key element of the research, we studied the characteristics of patients who were either physically handicapped, frail elderly or elderly mentally infirm, who make up a large majority of the patients. We found that auxiliaries' patients fell into a typical 'at risk' group; they were older and more likely to be living alone than qualified nurses' patients, and yet they received less frequent visits. Motives for providing and continuing the service to patients were not always related to nursing need, and while recipients were grateful for the service, both they and auxiliaries themselves identified areas of potential improvement. The need to continue to monitor and improve the overall quality, effectiveness and efficiency of the service to patients and potential patients, demands that practitioners, managers and researchers systematically review referral to the service and the work of the nurse auxiliary using a patient-focused approach.

Activities of Daily Living↗
PubMed1989

District nurses' patients--issues of caseload management.

Current pressures on all community services mean that practitioners must give more detailed attention to evaluation of patient outcomes and caseload review. District nursing caseloads in one health authority have been examined using a patient-focused approach. Random samples of patients who were either physically disabled, frail elderly, or elderly mentally infirm (n = 202) were examined for the distinctive and differing characteristics, if any, of recently referred and long-stay patients. Recently referred patients in our sample were either terminally ill, or had more chronic physical disorders. Patients who stayed on the books received either injections, general care from qualified staff or baths from nurse auxiliaries. Although covering similar areas of the health authority, nursing teams varied in the proportions of recently referred and long-stay patients, suggesting that individual nurses' caseload management is a crucial determinant of length of time on the books. In particular, nursing and medical review of all patients receiving vitamin B12 injections is urgently called for. In order for caseload monitoring to be facilitated, practitioners need relevant local and patient based data in order to make inter-team comparisons. The findings also have training and management support implications.

Aged↗
PubMed1989

Absorption of lidocaine and prilocaine after application of a eutectic mixture of local anesthetics (EMLA) on normal and diseased skin.

A eutectic mixture of 5% lidocaine and prilocaine was applied under occlusion for 1 or 2 hours on 25-100 cm2 areas of normal and diseased skin, and the absorption was followed by measuring the concentrations of the drugs in the draining vein and the general circulation at different time intervals after the application. The analgesic and vascular effects in the skin were also recorded. When the mixture was applied on normal skin the absorption was more rapid from the face than from the forearm. The absorption from diseased skin was faster than that from normal skin, with higher plasma concentrations, and a more rapid but shorter anesthetic effect was noted. With the doses used the plasma levels in the general circulation were 100 times lower than those associated with toxicity. The drug concentrations in the draining vein were highest after treatment of diseased skin and were 2-90 times higher than in the general circulation. The plasma concentrations of lidocaine and prilocaine ran parallel to each other, but the prilocaine level was 10-50% lower than that of lidocaine in the draining vein and 200-300% lower in the general circulation.

Anesthetics, Local↗
PubMed1989

[Clinical studies of the effect of physical training therapy on oxygen absorption and pulmonary artery pressure in persons with chronic obstructive lung diseases].

Twenty patients with chronic obstructive bronchitis were submitted to a 6-week rehabilitation program including bicycle training, breathing exercise, inhalation, massage, short wave therapy and others. Before and after 6-week training we investigated ventilatory and blood gas parameters and pulmonary artery pressure at rest and during exercise. There was no change in the oxygen uptake on the same exercise stage. We found an insignificant decrease of the pulmonary artery pressure at rest and during exercise. The physical training has no negative influence on the behaviour of pulmonary pressure. We stated a good effect of physical conditioning on the systemic circulation. The working capacity of all patients improved at the end of the training period.

Adult↗
PubMed1988

Present research in local analgesics.

A brief overview of current research into local anaesthesia which outlines the potential developments in this field is given as seen from work in one specialised research centre. This is a précis of a paper given as the second Goldman Lecture.

Anesthetics, Local↗
PubMed1987

Local anaesthetics modifying the dermal response of irradiation. An experimental study.

In a series of experiments in rabbits the dermal reaction, provoked by a single dose or intermittent doses of irradiation, was prevented or modified by topical or parenteral administration of local anaesthetics, compared to irradiated control animals. The topical application of a eutectic lidocaine/prilocaine cream, EMLA 5%, was found to be more effective than intravenously injected lidocaine (Xylocain 1%).

Anesthetics, Local↗
PubMed1986

Long-acting local anaesthetics in oral surgery. Clinical evaluation of bupivacaine and etidocaine for mandibular nerve block.

2 long-acting local anaesthetics, bupivacaine and etidocaine, have been compared to lidocaine with regard to effect during surgical removal of impacted mandibular third molars and effect upon the immediate postoperative pain. It can be concluded from this study that both bupivacaine and etidocaine as well as lidocaine were highly effective and without significant difference with regard to pain blocking during surgery. Both long-acting solutions were significantly superior to lidocaine in providing an extended duration of postoperative pain control. Comparing the 2 long-acting solutions, patients in the bupivacaine group had a significantly longer pain-free period than patients in the etidocaine group.

Acetanilides↗
PubMed1979

Local effects produced on intact skin by epicutaneously applied anaesthetic formulations. An experimental study in man.

By means of experiments involving pin-pricking, compositions containing 10% ketocaine base in a mixture of 2-propanol, glycerol and water were found to produce a high frequency of block to cutaneous pain following application to volunteers under an occlusive dressing. The local analgesic efficacy was found to be directly related to the degree of saturation of ketocaine in the vehicle and time of application. The degree of hyperaemia observed in the treated skin areas was found to be related to the degree of local analgesia produced.

Adult↗
PubMed1979

Inhibition of hyperhidrosis by topical application of a local anesthetic composition.

An eutectic mixture of 5% lidocaine and 5% prilocaine applied locally to the skin inhibited epinephrine-induced sweating in healthy subjects. It also inhibited palmar and axillary hyperhidrosis from 1 to 6 hours after application to 15 of 17 patients tested. A placebo lotion was without effect. When used daily for 3--4 weeks, only 25% of the patients were very pleased with the treatment. The reason for the decrease of efficacy is uncertain.

Administration, Topical↗