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Biomedical subjects

J Ker

Publications and source records attributed to J Ker.

16 recordsLinked to original sources
PubMed2006

The challenges of initiating a multi-professional clinical skills project.

Health care professionals are required to work collaboratively to prevent fragmented care and improve the quality of the patient's journey. The drive for multi-professional and inter-professional education is aimed at nurturing collaboration by engaging in joint educational initiatives. Although many United Kingdom (UK) policy documents endorse multi-professional and inter-professional initiatives, few seek to address the significant challenges inherent within these ventures. This paper uses force field analysis to make explicit the challenges experienced by two National Health Service (NHS) organizations on the east coast of Scotland during the initiation phase of a multi-professional clinical skills project. An action research methodology is employed to highlight the strategies adopted by the project team. The authors suggest that gaining insight into the cultural, logistical and educational challenges inherent in such initiatives provides valuable data to plan appropriate strategies to aid project success.

Clinical Competence↗
PubMed2005

Electrocardiographic surrogates of structural myocardial alterations in the Dorper sheep heart.

In this study we evaluated the validity of well-known human electrocardiographic markers of myocardial pathology in Dorper sheep. These markers include: the duration of the QRS complex of premature ventricular complexes (PVCs), the presence of notching of the QRS complex of PVCs and change of the ST-segment of PVCs. It was shown that these three electrocardiographic phenomena correlate with myocardial pathology in the hearts of Dorper sheep. We also describe a new electrocardiographic indicator of myocardial pathology, namely an increase in the frequency of cardiac memory T waves as a new electrocardiographic surrogate for myocardial pathology in the hearts of Dorper sheep.

Animals↗
PubMed2004

Ventricular dyssynchrony as a cause of structural disease in the heart of Dorper sheep.

Ventricular dyssynchrony is a disturbance of the normal, organized electromechanical coupling of the two ventricles. This condition has many causes, such as left bundle branch block, ventricular preexcitation, right ventricular pacing and right ventricular premature ventricular complexes (PVCs). Ventricular dyssynchrony has many adverse haemodynamic effects on the left ventricle and we wanted to know whether these adverse haemodynamic effects might have any structural consequences on the left ventricles of such hearts. Six healthy Dorper wethers were subjected to numerous right ventricular PVCs to induce ventricular dyssynchrony in order to determine whether any structural consequences will occur in the left ventricles of these hearts. Myocarditis in the musculature of the left ventricles of all six these hearts was seen.

Animals↗
PubMed2003

The heart remembers: observations of cardiac memory in the Dorper sheep heart.

Memory is a property common to a diverse range of tissues. Cardiac memory has been demonstrated in the human, dog, rat and rabbit. This is a peculiar phenomenon, reflected in the T wave of the electrocardiogram. The heart is able to remember periods of alterations in the sequence of ventricular activation and once there is a return to a normal sequence of ventricular activation the T waves may manifest memory. Cardiac memory is noted when the T wave during normal ventricular activation retains the vector of the previous abnormal QRS complex, caused by a period of altered ventricular activation. Possible mechanisms of memory in the heart are alterations of the transient outward potassium current (I10) in ventricular myocytes and new protein synthesis inside myocytes. These two mechanisms operate in short- and long-term cardiac memory respectively. Currently, it is unknown whether memory may have adverse structural consequences in the heart. We were able to demonstrate memory in the hearts of Dorper wethers and this is the first report of cardiac memory in Dorper sheep.

Animals↗
PubMed2003

Ventriculo-atrial conduction in the ovine heart, caused by premature ventricular complexes.

In humans, and certain animals, the atrioventricular conduction system is capable of bidirectional conduction. Depolarization impulses, originating in the ventricle itself, may thus be conducted in a retrograde direction towards the atria. Two common causes for this phenomenon of ventriculo-atrial (retrograde) conduction are premature ventricular complexes and ventricular pacing. The surface electrocardiogram can be used for the detection of such retrogradely conducted beats. The purpose of this study was to investigate the possibility of ventriculo-atrial conduction in Dorper sheep. Premature ventricular complexes in eight healthy Dorper wethers were induced and it was possible to document retrogradely conducted beats on the surface electrocardiogram in all of them. It is concluded that the Dorper sheep heart is capable of ventriculo-atrial conduction.

Animals↗
PubMed1998

Respiratory muscle endurance in heart failure--the effect of clinical severity.

UNLABELLED: In chronic heart failure there is no single explanation for reduced effort tolerance. Recently, abnormalities of skeletal muscles, which include respiratory muscles, have been described in cases of chronic heart failure. The aim of this study was to investigate the effect of clinical severity of heart failure, measured by means of the Boston score, on respiratory muscle performance (strength and endurance). METHODS: Using the Boston score, we compared 20 patients with chronic heart failure and low ejection fraction to 20 normal people, measuring maximal inspiratory mouth pressures (MIPs), maximal expiratory mouth pressures (MEPs) and endurance. Endurance was measured by repeated maximal static contractions of MIP and MEP as well as maximal voluntary ventilation (MVV). RESULTS: Inspiratory strength (MIP 75 +/- 34 cmH2O) but not expiratory strength (MEP 116.9 +/- 43.7 cmH2O) were reduced in heart failure patients, compared with controls (MIP 96.2 +/- 29.2, MEP 120.4 +/- 31 cmH2O). Endurance of inspiratory muscles was significantly reduced (P < 0.007) but not of expiratory muscles (P > 0.25). Clinical severity did not correlate with reduced endurance. CONCLUSION: Endurance of the inspiratory muscles was reduced in chronic heart failure unrelated to clinical severity.

Adult↗
PubMed1978

Comparison of carbuterol and hexoprenaline aerosol in bronchial asthma.

A new beta 2-adrenergic bronchodilator, carbuterol, was compared with hexoprenaline and placebo, by double-blind crossover technique in 10 adult asthmatic patients. Carbuterol 200 microgram was compared with hexoprenaline 200 microgram, corresponding to 2 inhalations from a standard aerosol in each case. The carbuterol effect, in terms of vital capacity and forced expiratory volume in 1 second (FEV1) was significantly longer than that of hexoprenaline. Its effect on airways resistance also appeared to be longer, although this difference was not statistically significant. The difference in duration of action may be due to greater potency of carbuterol, or to a longer elimination half-life of carbuterol. No significant effects on heart rate or blood pressure were noted with either drug.

Adolescent↗
PubMedDate not supplied

Diaphragmatic hernia mimicking an atrial mass: a two-dimensional echocardiographic pitfall and a cause of postprandial syncope.

A large hiatal hernia constitutes a form of posterior mediastinal mass that can encroach on the posterior aspects of the heart. During two-dimensional echocardiography this phenomenon may be confused with an intra-atrial mass or various other posterior mediastinal masses. Furthermore, such a large hiatal hernia encroaching on the heart may cause syncope. We present such a case and the various possible mechanisms of syncope, as well as review the two-dimensional echocardiographic pitfalls in these patients.

Diagnosis, Differential↗
PubMedDate not supplied

Isolated left ventricular non-compaction as a cause of thrombo-embolic stroke: a case report and review.

Isolated left ventricular non-compaction is the result of incomplete myocardial morphogenesis, leading to persistence of the embryonic myocardium. The condition is recognised by an excessively prominent trabecular meshwork and deep intertrabecular recesses of the left ventricle. These intertrabecular recesses are prone to thrombus formation, with resultant embolic sequelae. We describe a case of cerebral thrombo-embolism in a young woman due to isolated left ventricular non-compaction.

Adult↗