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Biomedical subjects

K Doerksen

Publications and source records attributed to K Doerksen.

4 recordsLinked to original sources
PubMed1999

Herpes zoster and multiple sclerosis.

BACKGROUND: Clinical experience suggests that young multiple sclerosis patients may have herpes zoster (HZ) earlier and more often than the general population. As there is evidence of a relationship between varicella zoster virus (VZV) and MS, a study of HZ and MS was undertaken. METHODS: Eight hundred and twenty-nine patient-members of the Manitoba Chapter of the Canadian Multiple Sclerosis Society were surveyed by mail. Six hundred and thirty-three (76%) responded. Questions included: age at diagnosis of MS, history of HZ (yes, no, probably), number of episodes of HZ and age at each occurrence, date of birth, and sex of respondent. The controls were consecutive patients with other neurological diseases (OND) attending local neurological or neurosurgical clinics, plus practice-based and population-based surveys of herpes zoster without reference to any other disease. The OND controls were assessed at the time of their outpatient visits. RESULTS: In the MS group with a positive/probable history of HZ, the HZ/MS rate was 106/633 (16.8%); in the practice-based survey the rate was 192/3534 (5.4%); and among the patients with OND it was 42/616 (6.8%). The HZ occurred at an earlier age in the MS group. The majority of male patients had HZ prior to the diagnosis of MS. The date of diagnosis is more likely to be a precise memory as opposed to the onset of symptoms. More than one attack of HZ was also more common in the MS group. CONCLUSIONS: This survey adds to the evidence that patients with MS have a unique relationship with the herpes zoster virus.

Adolescent↗
PubMed1998

Vagus nerve stimulation therapy: nurses role in a collaborative approach to a program.

Approximately 300,000 Canadians have epilepsy. Of those 30 percent fail to achieve satisfactory seizure control with current antiepileptic drug therapy (Vagus Nerve Stimulator Study Group, 1995). The development and availability of new therapeutic options cannot be overlooked for medically intractable patients. Chronic Vagus Nerve Stimulation (VNS) has demonstrated a 50 percent reduction in seizure frequency in 1/3 of patients with refractory partial onset seizures (Uthman, et al, 1993). Individuals undergoing this procedure require the attention of health care professionals from both the neurological and neurosurgical programs. This unique intervention demands that the patient's device be tested intra-operative, and programming begin during the immediate post-operative phase. Assessment of tolerance and side effects to vagus nerve stimulation therapy, as well as continued evaluation of the patients seizure control are necessary to direct staged programming of the device. This poster will demonstrate how the nurses from the neurology and neurosurgery clinics have been able to collaborate to ensure patients needs are met. Patient education is crucial to assisting the patient through this procedure, and key points will be identified. The implementation of coordinating the approach for programming the patient's device will be depicted. Future recommendations for long-term outcome measurement will be addressed.

Continuity of Patient Care↗
PubMed1994

A comparative study of systemized vs. random tracheostomy weaning.

The purpose of this study was to compare a systematic tracheostomy weaning procedure to a random weaning approach by asking the question: "What is the benefit to the patient of a systematic vs. random weaning process for tracheostomy removal as defined by the number of weaning attempts and post-weaning complications?" A tracheostomy weaning procedure was developed at St. Boniface General Hospital as a joint venture between the neuroscience nurses and neurosurgeons in response to a perceived clinical need. This project evaluated the systemic procedure in two neuroscience units in Manitoba on ten adult patients who met the assessment criteria for tracheostomy removal established in the procedure. The patients were monitored for thirty days post removal for complications. In addition, a retrospective chart review was completed on twenty charts of patients who had undergone random tracheostomy weaning from 1990-1992. Content analysis of the documentation immediately before, during and after each tracheostomy weaning procedure was undertaken. The results of the study indicate that there were fewer weaning attempts required for the patients with the systemized procedure than the random procedure, and although not statistically significant, there were fewer post-removal complications per patient in the systemized procedure than with the random procedure. Content analysis of the retrospective data indicates that the random tracheostomy weaning procedure was subject to the individual nurses' judgement. The systemized procedure was more standardized and conformed to the protocols in the procedure. Most importantly, the patient's comfort and safety were greatly enhanced through the use of standard tracheostomy weaning procedure.

Adult↗