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Biomedical subjects

L D Watson

Publications and source records attributed to L D Watson.

8 recordsLinked to original sources
PubMed2001

A prospective trial of inhaled nitric oxide in clinical lung transplantation.

BACKGROUND: Reperfusion injury (RI) is a major cause of mortality and morbidity among lung transplant recipients. We sought to determine if prophylactic administration of inhaled nitric oxide (NO) to lung transplant recipients at reperfusion would prevent RI. We also hypothesized that if prophylactic NO proves ineffective in preventing RI then it may improve pulmonary hemodynamics and gas exchange in the subset of patients who develop RI. METHODS: After informed consent, 28 consecutive, adult lung transplant recipients received NO at 20 ppm at reperfusion. NO was withdrawn for 15 min at 6 and 12 hr after reperfusion, and gas exchange and hemodynamics were measured. RESULTS: Five of the 28 lung transplant recipients (18%) developed RI. Withdrawal of NO for 15 min in this subset of patients resulted in a significant rise in mean pulmonary artery pressure and a reduction in oxygenation index. All five patients with RI were kept on inhaled NO until full functional recovery of the allograft and were then weaned from mechanical ventilation. None required extracorporeal membrane oxygenation support; the early mortality in this group was 20% (1/5). The remaining 23 patients without RI had uneventful early postoperative course and were weaned from NO and mechanical ventilation within 36 hr of transplantation. CONCLUSIONS: Prophylactic-inhaled NO does not prevent RI in human lung transplantation. However, inhaled NO, started at reperfusion, improves gas exchange and reduces pulmonary artery pressure in those patients who develop RI.

Administration, Inhalation↗
PubMed1997

Cardiovascular and hormonal responses to food ingestion in humans with spinal cord transection.

In sympathetic denervation due to primary autonomic failure, ingestion of food causes a fall in blood pressure (BP) and exacerbates postural hypotension. It is not known whether these responses occur in tetraplegics with physiologically complete cervical spinal cord transection, who also have sympathetic dysfunction because of disruption of descending spinal sympathetic pathways. We, therefore, studied the effect of a liquid meal on BP, heart rate (HR) and neurohormonal levels in tetraplegics. Paraplegics with low lesions and without sympathetic dysfunction served as controls. After food ingestion, there was no fall in BP in tetraplegics or in controls. HR did not change in either group. After fund, plasma noradrenaline was unchanged in tetraplegics, but rose in controls, while plasma renin activity (PRA) rose in tetraplegics but not in controls. The fall in BP and rise in HR on head-up tilt after the meal in tetraplegics was similar to that before the meal. There was no change in PRA following pre-prandial tilt in either group; post-prandial tilt raised levels in the tetraplegics, unlike in controls. Thus there is considerable variance in the responses to food between tetraplegics and paraplegic controls, and even greater differences when compared with published data in other autonomic disorders with sympathetic dysfunction; this may relate to the site and the nature of the sympathetic lesion and the ability to activate compensatory mechanisms.

Adult↗
PubMed1994

Clinical staff and the new student nurse: anticipating change.

This article focuses on the feelings and perceptions of clinical staff who are about to encounter Project 2000 students. It makes use of selected findings from a small exploratory study in which interviews were used to gather qualitative data from such staff. There is a brief consideration of the historical context of nurse education from which Project 2000 has arisen and the legislation that has been instrumental in its development. Embodied within this change is the expectation that clinical staff will continue to contribute to the education of student nurses on clinical placements. The target population for this study was identified as clinical staff who would be working with Project 2000 students within a large general teaching hospital. Through means of taped informal interviews, the study explored the world of the clinical staff in relation to their expectations of Project 2000 students. It identified feelings of threat, lack of communication and issues of change and its implementation. For successful implementation and wide acceptance of such a radical change in nurse education, consistency of knowledge and communication was shown to be essential.

Attitude of Health Personnel↗
PubMedDate not supplied

A microelectronic conductimetric biosensor.

The fabrication and operation of a microelectronic conductimetric biosensor is described. The device monitors the change in solution conductance occasioned by the catalytic action of enzymes immobilised over a planar conductance cell comprising serpentined and interdigitated metal conductor tracks. The output of the instrument was linear over a 3 min period on addition of urea to a sample cell overlaid with immobilised urease. The responses to any given urea concentration were reproducible to within approximately +/- 1%. The device responds to urea present in serum samples.

Electrochemistry↗
PubMedDate not supplied

Stages of stroke: a model for stroke rehabilitation.

This article offers a model for stroke rehabilitation in both community and hospital settings which was developed as a result of observations made by staff working in both areas. It examines the effects of using more traditional models of stroke and neurological rehabilitation, where professional practice is more isolated, together with the effects of models for acquired brain injury that have identified positive outcomes. It was recognized by staff that a pragmatic model for stroke rehabilitation does not appear to be available. The Stages of Stroke model provides a 'map' with different routes to effective outcomes, helping those within stroke rehabilitation to recognize where they are and where they are going. It encourages a client-centred, not a service-centred programme.

Activities of Daily Living↗
PubMedDate not supplied

Developments in surgical oncology--past, present, and future trends.

The historical development of integrated treatment programs for locally advanced or aggressive cancers, for which the results of surgical excision or radiotherapy are unsatisfactory, is reviewed. Chemotherapy should be used first (induction chemotherapy), while tumour vasculature is intact; intra-arterial infusion gives a greater regional effect. Central residual tumour may be eradicated by subsequent radiotherapy and/or surgery. Regional induction chemotherapy is particularly useful in treating locally advanced stage III breast cancer, locally advanced head and neck cancer, gastric cancer, and locally advanced sarcomas and melanomas of the limbs. A team approach, involving surgical and medical oncologists, radiotherapists, immunologists, and others should improve the results in these patients.

Combined Modality Therapy↗
PubMedDate not supplied

Stages of stroke: a model for stroke rehabilitation.

This article offers a model for stroke rehabilitation in both community and hospital settings which was developed as a result of observations made by staff working in both areas. It examines the effects of using more traditional models of stroke and neurological rehabilitation, where professional practice is more isolated, together with the effects of models for acquired brain injury that have identified positive outcomes. It was recognized by staff that a pragmatic model for stroke rehabilitation does not appear to be available. The Stages of Stroke model provides a 'map' with different routes to effective outcomes, helping those within stroke rehabilitation to recognize where they are and where they are going. It encourages a client-centred, not a service-centred programme.

Cerebrovascular Disorders↗