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Biomedical subjects

K Dunne

Publications and source records attributed to K Dunne.

14 recordsLinked to original sources
PubMed2001

Intussusception associated with bacterial meningitis.

Despite its common association with viral illnesses, intussusception has only rarely been found in the presence of bacterial infections. Two infants are described, both of whom were admitted to hospital with bilious vomiting, drowsiness, and dehydration. Both infants required urgent intravenous volume expansion. Intussusception was confirmed, and reduction was achieved by enema in both cases. Recovery was slow, and one infant developed a seizure. Evidence of meningococcal meningitis was found in both, with septicaemia in one. Neurological outcome is normal to date, and there has been no recurrence of intussusception in either case.

Enema↗
PubMed2000

Family experiences of palliative care in the acute hospital setting.

The study described in this article sought to gain understanding and insights into the lived experience of families who journeyed with their loved one through the palliative phase of illness as inpatients in the acute hospital setting. The study was carried out in a district general hospital which did not have the services of a palliative care team. A descriptive phenomenological approach was used as the researcher wanted the participants to describe their experience of palliative care in the acute hospital setting as they experienced it. This approach is described in detail. A purposive sample of eight family members was interviewed and data were analysed using Colaizzi's (1978) seven stages of data analysis. The results showed that the acute hospital environment had many shortcomings as a place to deliver palliative care and family members were at times left feeling isolated and helpless. The limitations of the study are discussed along with recommendations that could enhance outcomes of care for family members during this difficult period in their loved one's illness.

Family Health↗
PubMed2000

An audit of subcutaneous syringe drivers in a non-specialist hospital.

The use of syringe drivers as a method of drug delivery to control symptoms in palliative care is a common and accepted practice, but one which has evolved rather than been subject to close multiprofessional scrutiny and guideline formation. There is evidence that adverse incidents may arise as a result of syringe driver use (Medical Devices Agency (MDA), 1998), for example, errors in drug calculations, drug stability, equipment failure (including disconnection) and the wrong rate of infusion. Inadequate user training, poor servicing of equipment and inadequate documentation and record keeping are all thought to be contributing factors (MDA, 1998). In the hospital where this audit was carried out, syringe drivers are used to administer drugs to patients with cancer during the palliative phase of illness. The purpose of this clinical audit was to establish the standard of current practice in wards where syringe drivers were being used. A retrospective study of 13 cases of syringe driver use is presented. The results highlight many areas of unregulated practice with regard to setting up, monitoring and maintenance of syringe drivers. The choice of drugs and doses prescribed, evaluation of treatment responses and review of treatment regimens were also areas of concern. Guidelines for the use of syringe drivers in non-specialist hospitals are put forward.

Adult↗
PubMed2000

Pregnancy outcome and complications in women with spina bifida.

OBJECTIVE: To describe the antenatal complications, mode of delivery and outcome of pregnancy in women with spina bifida. STUDY DESIGN: Case series of women known to have attended the spina bifida clinic at the Royal Children's Hospital. Medical records, postal questionnaire and telephone interview were utilized to collect data on the effect of pregnancy on the health of women and the effect of spina bifida on pregnancy outcome. RESULTS: Of 207 women born between 1945 and 1975, 23 reported having a pregnancy, and 17 who had completed pregnancies agreed to participate. The 17 women had a total of 29 pregnancies, with 23 pregnancies progressing to births. Fourteen of 17 women had antenatal admissions, with wheelchair-dependent women requiring more-frequent and longer admissions. Recurrent urinary infections in pregnancy occurred in women with a prior history of urinary infections; stomal problems occurred but were not serious; mobility was reduced for two women during pregnancy, with full recovery afterwards; and preexisting pressure sores worsened during pregnancy. Vaginal deliveries occurred in one in five pregnancies of women who were wheelchair dependent and in ten of eighteen pregnancies in independently mobile women, including seven of eight pregnancies of independently mobile women without ileal conduits. Cesarean sections were accompanied by postoperative complications in 10 women. CONCLUSION: Women with spina bifida who become pregnant generally have a positive outcome, with relatively low complication rates.

Adult↗
PubMed1993

Characterization of the quaternary structure and conformational properties of the human stem cell inhibitor protein LD78 in solution.

The human LD78 protein (sometimes referred to as human macrophage inflammatory protein-1 alpha) has been shown to protect multipotential hemopoietic stem cells from the effects of cytotoxic agents. Administration of the recombinant stem cell inhibitor molecule LD78 as an adjunct to chemotherapy has potential clinical benefit in reducing or preventing the neutropenia associated with this treatment. At physiological ionic strength, the 8-kDa LD78 molecule exists as soluble, heterogeneous, multimeric complexes of mass ranging from 100 to > 250 kDa. The hydrodynamic and structural properties of LD78 have been determined in various buffer solutions using analytical ultracentrifugation, circular dichroism, and fluorescence spectroscopy. The results demonstrate that defined, homogeneous monomer and tetramer forms of LD78 can be prepared which display distinct conformational properties. The combined use of hydrodynamic and spectroscopic analysis provides an insight into the pathway and molecular mechanics of LD78 self-association.

Acetates↗
PubMed1987

Near-miss sudden infant death syndrome: clinical findings and management.

The clinical findings for 73 infants with near-miss sudden infant death syndrome (SIDS) diagnosed from 1980 to 1984 are presented. Infants who were found apparently dead and who required vigorous stimulation or mouth-to-mouth resuscitation to revive them were said to have near-miss SIDS. The most common finding was apnea, often with pallor. A repeat episode requiring resuscitation occurred in 30 (41%) infants. Six (8%) had multiple episodes requiring resuscitation. Two infants (3%) died. Prediction of subsequent attacks or outcome was impossible on clinical grounds. The controversy of definition, relationship to SIDS, and treatment is discussed.

Apnea↗
PubMed1986

Acute transverse myelopathy in childhood.

The clinical features and outcome of idiopathic acute transverse myelopathy were reviewed for 21 children aged between seven months and 14 years. Pain, most commonly in the back, was the initial symptom for 12 patients; for another six it was weakness and for two urinary retention. All patients had weakness of the legs, and 11 had arm weakness as well. Five patients had very acute onset of severe weakness and were unable to walk within three hours of onset of symptoms. Two children made no significant recovery; for the remainder onset of recovery was evident within two to 17 days. 12 patients later were normal or had only minimal neurological deficit, but nine had a poor outcome with major disturbance of motor or sphincter function. Only one of the five with very acute onset had a good outcome. Over-all, the prognosis after acute transverse myelopathy in childhood is a little better than that reported for adults.

Adolescent↗
PubMedDate not supplied

Care study: providing effective care in palliative nursing.

Currently, nurses are under great pressure to demonstrate effective, evidence-based patient care. In this article a single case study will be used to demonstrate that care can be based on recent research within a palliative care setting to produce effective outcomes. Research-based interventions, which were used to provide care for a patient who will be referred to as Maria, will be discussed and evaluated to illustrate the contribution that evidence-based practice made to her nursing care. Although it is a single case study and the findings cannot be generalized, it is suggested that this article can be used to demonstrate the need for accurate interpretation of assessment data, illustrate the use of research to support nursing interventions in pain management, constipation and skin pressure damage, and show that empirical evidence alone may not be a sufficient basis for care and that moral issues must be taken into account.

Adult↗
PubMedDate not supplied

Effective communication in palliative care.

This article focuses on the definitions of communication and an examination of their relationship to palliative care nursing. The underpinning theory is analysed as a means of understanding the communication process. The communication process in nursing is considered in the context of nurse/patient/family communication. While the focus of the article is on palliative care, the principles of communication as outlined also have relevance and applicability to nurses working in a variety of other clinical settings.

Attitude to Death↗