PubMed Health⌕ Search

Biomedical subjects

L Hawthorne

Publications and source records attributed to L Hawthorne.

12 recordsLinked to original sources
PubMed2001

Endothelial cell apoptotic genes associated with the pathogenesis of thrombotic microangiopathies: an application of oligonucleotide genechip technology.

Idiopathic thrombotic thrombocytopenic purpura (TTP) is a disease characterized by the apoptotic injury of all microvascular endothelial cells (MVEC) except those of pulmonary origin. It notably also spares EC of large vessel origin. It is fatal unless treated with plasma exchange. The EC lineage restriction of the apoptotic lesions in vivo is reproduced in vitro following exposure of primary human MVEC derived from various tissues to TTP plasma. Oligonucleotide genechip technology was used to identify genes that may contribute to the resistance of lung MVEC to apoptosis induced by TTP plasma and to explore the intrinsic genotypic heterogeneity between MVEC of TTP-sensitive (skin) versus resistant (lung) lineage. Exposure of cells to TTP or normal plasma yielded 157 genes that were differentially expressed in primary human lung MVEC. A global change in expression of pro- and anti-apoptotic genes was seen, including increases in caspase 1, Fas, and Bcl-xl, already shown by experimental means to be involved in TTP pathogenesis. Additional differences suggest the importance of pathways related to the death receptor ligand TRAIL, as well as a role for disruption of EC-extracellular matrix interactions in the initiation of apoptosis. Maintenance of specific prosurvival signals at baseline may be a feature of lung MVEC resistance in TTP as suggested by higher expression than skin EC of the TRAIL antagonist, osteoprotegerin, and the vascular endothelial growth factors, VEGF/VPF and VEGF-C, and their receptors, VEGFR-2 (KDR) and VEGFR-3 (Flt4).

Apoptosis↗
PubMed2001

The globalisation of the nursing workforce: barriers confronting overseas qualified nurses in Australia.

Recent decades have coincided with the rapid globalisation of the nursing profession. Within Australia there has been rising dependence on overseas qualified nurses (OQNs) to compensate for chronic nurse shortages related to the continued exodus of Australian nurses overseas and to emerging opportunities in other professions. Between 1983/4 and 1994/5, 30 544 OQNs entered Australia on either a permanent or temporary basis, counter-balancing the departure overseas of 23 613 locally trained and 6519 migrant nurses (producing a net gain of just 412 nurses in all). The period 1995/6--1999/2000 saw an additional 11 757 permanent or long-term OQN arrivals, with nursing currently ranked third target profession in Australia's skill migration program, in the context of continuing attrition among local nurses. This pattern of reliance on OQNs is a phenomenon simultaneously occurring in the UK, the US, Canada and the Middle East --- the globalisation of nursing reflecting not merely Western demand but the growing agency and participation of women in skilled migration, their desire for improved quality of life, enhanced professional opportunity and remuneration, family reunion and adventure.

Attitude of Health Personnel↗
PubMed2001

Effect of fluid preload on maternal haemodynamics for low-dose epidural analgesia in labour.

We prospectively studied 30 women in labour who requested epidural analgesia. They were randomly allocated into two groups; one received a preload of 7 mL/kg normal saline and the other no preload. All patients had a standard epidural solution consisting of 0.1% bupivacaine 20 mL containing fentanyl 2 microg/mL. Mean arterial blood pressure and cardiac index were measured serially for 20 min after epidural drug administration. Cardiac index was measured using transthoracic electrical bioimpedance (BOMED). Power calculation showed that a sample size of 30 had 80% power to detect a difference of more than 20% in cardiac index using a two-sided test at a significance level of <0.05. No significant changes in cardiac index or mean arterial pressure occurred at any time in either group. These results suggest that routine fluid preloading is not necessary for 0.1% bupivacaine 20 mL with fentanyl 2 microg/mL as epidural bolus in labour.

Clinical Trial↗
PubMed1997

Cardiac arrest complicating spinal anaesthesia for caesarean section.

We present a 36-year-old multiparous woman who developed intractable hypotension and cardiac arrest during spinal anaesthesia for elective caesarean section. Cardiopulmonary resuscitation was successful and both mother and baby made a good recovery. Postoperative investigation revealed a dilated cardiomyopathy related to pregnancy. This case highlights the importance of expediting delivery of the neonate during maternal cardiopulmonary resuscitation, the prompt use of adrenaline as inotropic support, and preoperative assessment in apparently healthy parturients.

Journal Article↗
PubMed1997

Extradural pain relief in labour: bupivacaine sparing by extradural fentanyl is dose dependent.

The minimum local analgesic concentration (MLAC) of bupivacaine in labour is defined as the effective concentration in 50% of subjects (EC50). We have used the technique of double-blinded sequential allocation to quantify the bupivacaine sparing effect of the addition of four different doses of extradural fentanyl in 223 labouring women. There were five groups: (1) plain bupivacaine (control); (2) bupivacaine with fentanyl 1 microgram ml-1; (3) bupivacaine with fentanyl 2 micrograms ml-1; (4) bupivacaine with fentanyl 3 micrograms ml-1; and (5) bupivacaine with fentanyl 4 micrograms ml-1. The MLAC of bupivacaine were 0.069% w/v, 0.057% w/v, 0.048% w/v, 0.031% w/v and 0.015% w/v, respectively. We observed a reduction in MLAC of 18%, 31% (P = 0.03%), 55% (P < 0.0001) and 72% (P < 0.0001) with fentanyl 1, 2, 3 and 4 micrograms ml-1, respectively, demonstrating a significant negative linear trend (P < 0.0001) with increasing fentanyl dose. The incidence of pruritus was increased significantly with fentanyl 4 micrograms ml-1 (P = 0.0015). Because of this, fentanyl 3 micrograms ml-1 may be the optimal dose when the aim is bupivacaine sparing extradural analgesia during labour.

Adolescent↗
PubMed1996

Failed intubation revisited: 17-yr experience in a teaching maternity unit.

We have reviewed 5802 Caesarean sections performed during general anaesthesia. Our use of general anaesthesia had decreased from 83% in 1981 to 23% in 1994. Despite this, the incidence of failed intubation has increased from 1 in 1984 to 1 in 250 in 1994. The problems associated with general anaesthesia in the obstetric population are increasing. Asians and African/Afrocaribbeans were represented disproportionately because of the increased use of general anaesthesia in these patients. Exposure of trainees to obstetric general anaesthetics has decreased by one-third.

Adult↗
PubMed1996

Asian student migration to Australia.

"This paper presents an overview of Asian student migration to Australia, together with an analysis of political and educational aspects of the overseas student programme. It focuses on some significant consequences of this flow for Australia. The characteristics of key student groups are contrasted to provide some perspective of the diversity of historical and cultural backgrounds, with the source countries of Malaysia, Indonesia and PRC [China] selected as case studies. Since the issue of PRC students in Australia has attracted considerable public attention and policy consideration, particular focus is placed on their experience." (SUMMARY IN FRE AND SPA)

Asia↗
PubMed1996

Immigrants and the professions.

"The extent to which migrants holding professional qualifications have been able to put these qualifications to productive use in Australia has long been a contentious issue. This article provides some answers which we hope will allow the debate on the extent and causes of migrant professional progress in Australia to proceed on a firmer foundation." The authors find that "migrants have made a major contribution to Australia's professionally-qualified workforce. Those arriving pre-1980s and early 1980s have largely been able to convert their qualifications into professional level employment. However, later arriving migrants have been far less successful."

Australia↗
PubMed1995

Asian female students in Australia: temporary movements and student migration.

"The most significant population movement affecting Australia in recent years has been a dramatic growth in the number of short term arrivals.... While a substantial literature has evolved concerning overseas students' temporary migration and settlement, there has been only limited demographic analysis undertaken to date, including minimal attempt to explore the participation and specific student experience of women. This paper seeks to address this omission through presentation of a detailed analysis of the characteristics of Asian female students within the overall student movement, together with a preliminary exploration of issues related to their personal and academic transition."

Australia↗