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Biomedical subjects

L Manley

Publications and source records attributed to L Manley.

30 records · Page 2Linked to original sources
PubMed1991

Trauma in pregnancy: uterine rupture.

Trauma during pregnancy is a unique situation. Understanding injury patterns, anatomic and physiologic changes, and the initial approach to resuscitation is essential for all emergency nurses. Maternal resuscitation is the only means of fetal resuscitation. Meticulous attention must be given to the ABC's, with some minor modifications. Cervical spine immobilization is done in conjunction with positioning on the left side. Oxygen is used liberally, but may not benefit the fetus if hypovolemia exists. IV access and aggressive fluid resuscitation should proceed quickly. Diagnostic testing, including radiologic evaluation, is performed as necessary--the mother's life must not be jeopardized on the basis of fetal risk. Continuous fetal monitoring should be instituted, even with seemingly minor injuries. In the rare event of maternal arrest, a postmortem cesarean section may be lifesaving for the infant. Policies should be formulated jointly by ED, obstetric, and neonatal staffs in advance to speed this difficult decision-making process. The keys to survival, for both mother and infant, are an organized approach to resuscitation and teamwork among all professionals.

Adolescent↗
PubMed1990

Use of a monoclonal antibody to estrone-3-glucuronide in an enzyme-linked immunosorbent assay (ELISA).

A direct urinary ELISA for estrone-3-glucuronide has been produced following cloning and characterisation of a monoclonal antibody to the above estrogen metabolite. The ELISA follows our established pattern of absorbing a thyroglobulin conjugate, to which estrone-3-glucuronide has been coupled, to the wells of a microtitre plate using guanidine hydrochloride. A competition reaction between either standards/samples and the adsorbed hormone compete for antibody combining sites. The assay is completed by addition of an anti-mouse Ig-peroxidase complex and read at 492 nm following additions of O-phenylenediamine substrate in under 4 h. The correlation between urinary "total estradiol" and "total estrone and estradiol" is very good and, in conjunction with our ELISA for pregnanediol glucuronide, has allowed for the improved clinical management of infertile and subfertile women.

Animals↗
PubMed1990

Apnoeic heart rate responses in humans. A review.

Research examining the heart rate response of humans to apnoea and apnoeic immersion in water has tended to produce equivocal results. Controversy exists in relation to the existence and onset, course and ultimate extent of apnoeic bradycardia, either at rest or during exercise. The reduction in heart rate that has been observed in response to apnoea and apnoeic immersion is considered by some to be a component of an oxygen conserving mechanism termed the mammalian dive reflex. Doubt has been expressed, however, as to whether humans do possess the complex cardiovascular response evident in diving mammals. A bradycardial response to apnoea at rest is reasonably well established. Reports conflict with regard to apnoeic responses to exercise in both terrestrial and aquatic environments, and for the temporal onset of apnoeic bradycardia in general, and the time course required for the maximal development of the response. It is suggested that the existing discrepancies with regard to heart rate responses to apnoea are due in part to the large variety of research protocols employed, with, in many cases, a lack of control of those factors said to modify apnoeic heart rates, and in part to a lack of uniformity in the interpretation of the obtained results. Conflicting evidence exists for almost all of the factors said to modify the apnoeic heart rate response in humans. Factors implicated in the phenomenon of apnoeic bradycardia include the influence of temperature and the physical condition of the individual, varying lung volumes, the depth of immersion in water, the body position during the apnoeic episode, and the psychological state of the individual. The influence of the sex and age of the subjects is equally contentious. Finally, the role of breath-holding capacity as it influences the extent of bradycardia remains to be examined further. Additional research requires the adoption of an integrative, holistic approach if a comprehensive understanding of apnoeic heart rate responses is to be achieved.

Adolescent↗
PubMedDate not supplied

Easing pain in children.

The assessment and management of pain in children has been essentially ignored until recently. Thankfully, these "dark ages of pain" are ending. The trauma nurse is an integral part of the pain management team and can have a positive impact on outcome by using a combination of relatively simple strategies. These include using multiple types of assessment to measure the severity of pain; providing adequate pain relief with a combination of pharmacologic and nonpharmacologic interventions; and carefully monitoring and documenting the efficacy of all pain management approaches.

Analgesics↗
PubMedDate not supplied

Essentials of airway management for the injured child.

The anatomy of a child's airway presents multiple challenges for health care providers who must maintain adequate ventilation and oxygenation. The care giver must be knowledgeable about the anatomic differences between children and adults and skilled in the use of pediatric airway adjuncts to provide safe, effective airway management.

Adult↗
PubMedDate not supplied

Milestones in medical management of trauma.

Trauma care appears to be a relatively young science because of the major strides made after World War II. A historical foundation of today's practice is provided, with interesting anecdotes concerning some of the pioneers, their motivations, and the reactions of their medical peers. A chronology of trauma care highlights the growth of multiple fields of science that eventually blended to become the basis for modern care.

Europe↗
PubMedDate not supplied

Co-localization of choline acetyltransferase and tyrosine hydroxylase within neurons of the dorsal motor nucleus of the vagus.

In the present study, we employed a dual-immunofluorescent labeling procedure to determine if the biosynthetic enzymes tyrosine hydroxylase (TH) and choline acetyltransferase (ChAT) are co-localized within neurons in the dorsal medulla of rat. Within this region TH-labeled neurons are distributed within the nuclei of the solitary tracts and medial aspect of the dorsal motor nucleus of the vagus. The absence of dopamine-beta-hydroxylase immunoreactivity within TH-labeled cells in the medial portion of the dorsal motor nucleus of the vagus suggests that these neurons are dopaminergic. Cholinergic perikarya also are present in the dorsal medulla and are distributed throughout the dorsal motor nucleus of the vagus and hypoglossal nucleus. Of these ChAT-positive perikarya, a small percentage limited to the medial aspect of the dorsal motor nucleus of the vagus (i.e., corresponding to the location of dopamine neurons) also contain TH. The existence of TH within ChAT-positive neurons in the dorsal motor nucleus of the vagus provides an anatomical substrate with which to suggest that catecholaminergic and cholinergic fibers contribute to the vagus nerve and may serve to explain some of the cardiac and gastric effects resulting from systemic administration of catecholamine agents.

Adrenergic Fibers↗