Biomedical subjects

J Sheehan

Publications and source records attributed to J Sheehan.

At least 37 records · Page 2Linked to original sources

PubMed1990

The use of cyclosporin A in adult nephrotic syndrome: nine cases and literature review.

Nine adult patients with resistant nephrotic syndrome were treated with cyclosporin A (CyA). All had failed to respond to high dose corticosteroids with or without cyclophosphamide. Three patients had minimal change disease, 3 had focal sclerosing glomerulosclerosis (FSGS), 2 had mesangiocapillary GN, and one had membranous nephropathy. The mean age of the patients was 26.4 years (range 16 to 39 years). CyA was given orally twice daily at a mean dose of 6.7 mg/kg/24 hours (range 6-10 mg/kg/24 hours). Four patients achieved full remission, two patients went into partial remission and three failed to respond. Two patients developed clinical nephrotoxicity, which reversed on dose reduction or cessation of CyA. All 3 patients with minimal change disease who responded subsequently relapsed after stopping CyA, but remitted rapidly on reintroduction of the drug. We suggest that the mode of action of CyA in nephrotic syndrome may be related to intra-renal vasoconstriction in addition to its direct immunosuppressive effect. In this limited series, we found that CyA can be an effective therapy for otherwise refractory nephrotic syndrome, although relapse on withdrawal of CyA may well be a significant clinical problem.

Adult↗

PubMed1990

Investigating change in a nursing context.

This paper focuses on 'why', 'what' and 'how' issues as they relate to the investigation of change in a nursing context. The why issues revolve around the need for change, and evolutionary and revolutionary change are discussed. Next the what issues are discussed and some variables involved in the change process are identified, and the role of change agents is outlined. Change strategies such as the power-coercive, the rational-empirical and the normative-re-education are discussed. Finally, the potential of action research in the context of bringing about change is advanced.

Delivery of Health Care↗

PubMed1989

Importance of magnesium chloride repletion after myocardial infarction.

Data pertinent to the role of magnesium deficits in coronary artery disease and myocardial infarction are reviewed. Results of clinical, laboratory and epidemiologic studies indicate an association between magnesium deficiency and a poor prognostic outcome in patients who have had myocardial infarction. It therefore appears to be a reasonable prophylactic measure to monitor closely magnesium status in patients with coronary heart disease and other patients at risk of acute myocardial infarction, and to supplement with magnesium chloride when clinically necessary. In addition, recent studies provide supportive evidence that supplementation of magnesium chloride may reduce the incidence of fatal and nonfatal arrhythmias after an infarct.

Arrhythmias, Cardiac↗

PubMed1989

Progression from enrolled to registered general nurse (1): Charting the conversion.

This is a report of part of an empirical evaluation of a conversion course for Enrolled Nurses. The focus of the study was the changes, if any, which might take place in the students. A five faceted approach was used to collect data including three value exercises designed to identify those characteristics and values deemed by the Nurse to be important elements of his/her self image, diary keeping and meetings with the students. This part of the paper deals with the methodological aspects of the study and reports on the diary keeping and the meetings with the students. Part two will relate to the value exercises used. The study provides evidence of some of the difficulties experienced by students in the transition from Enrolled Nurse to Registered General Nurse status. It also provides evidence of 'desirable' changes in the students which occurred during the course.

Education, Nursing, Continuing↗

PubMed1989

Progression from enrolled to registered nurse (2): Charting the conversion.

Part 2 of the study focuses on the three value instruments mentioned in part 1 (Hembrough & Sheehan 1989). The students were asked to complete the three value-oriented tasks on seven occasions throughout the duration of the course. The data obtained provided some evidence regarding the stability of the students' values. The study also identifies and comments upon the most persistently and popularly chosen value descriptors. Cameos relating to the professional and personal self-perceptions of each student are also presented.

Career Mobility↗

PubMed1989

Reinforcement of bone cement using metal meshes.

Following on from previous work reported in this journal, a practical system has been developed for in situ fibre reinforcement of bone cement in the hip joint prosthesis. A fibre preform is inserted during the operation, surrounding the metal stem of the prosthesis, forming a composite with the cement. Tests performed on full-scale models of the joint show improvements in fatigue life by more than an order of magnitude when a preform of metal fibres is used; this significantly delays the onset of cement cracking and stem loosening. Initial results reported previously suggest that other fibre materials such as carbon may give even greater improvements. Clinical trials have begun, using a form of the metal mesh.

Bone Cements↗

PubMed1988