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Linda Russell

Publications and source records attributed to Linda Russell.

9 recordsLinked to original sources
PubMed2006

The Kraske procedure: a critical analysis of a surgical approach for mid-rectal lesions.

BACKGROUND AND OBJECTIVES: To analyze the Kraske procedure as an approach to mid-rectal disease. METHODS: Twenty-two patients underwent a Kraske procedure at either Duke University Medical Center, the Durham Veterans Administration Medical Center, or the Durham Regional Hospital between 1992 and 1997. The clinical and pathologic characteristics of these patients were retrospectively analyzed and compared with previous published series. RESULTS: Of the 22 patients, 13 underwent resection of an adenocarcinoma and 9 underwent resection of a villous adenoma. Post-operative complications included four fecal fistulas (two of which required a temporary diverting colostomy), two wound infections, two cases of urinary retention, and one case of transient fecal incontinence. CONCLUSIONS: The Kraske procedure minimizes exposure of mid-rectal lesions without the morbidity of a major laparotomy. However, it does carry a moderate complication rate and thus should be utilized selectively in managing patients with mid-rectal tumors not amenable to other treatment options.

Adenocarcinoma↗
PubMed2006

Pott disease in the thoracolumbar spine with marked kyphosis and progressive paraplegia necessitating posterior vertebral column resection and anterior reconstruction with a cage.

STUDY DESIGN: Case report. OBJECTIVES: To report on a patient with Pott disease, progressive neurologic deficit, and severe kyphotic deformity, who had medical treatment fail and required posterior/anterior decompression with instrumented fusion. Treatment options will be discussed. SUMMARY OF BACKGROUND DATA: Tuberculous spondylitis is an increasingly common disease worldwide, with an estimated prevalence of 800,000 cases. METHODS: Surgical treatment consisting of extensive posterior decompression/instrumented fusion and 3-level posterior vertebral column resection, followed by anterior debridement/fusion with cage reconstruction. RESULTS: Neurologic improvement at 6-month follow-up (Frankel B to Frankel D), with evidence of radiographic fusion. CONCLUSIONS: A 70-year-old patient with progressive Pott paraplegia and severe kyphotic deformity, for whom medical treatment failed is presented. A posterior vertebral column resection, multiple level posterior decompression, and instrumented fusion, followed by an anterior interbody fusion with cage was used to decompress the spinal cord, restore sagittal alignment, and debride the infection. At 6-month follow-up, the patient obtained excellent pain relief, correction of deformity, elimination of the tuberculous foci, and significant recovery of neurologic function.

Aged↗
PubMed2004

Evaluation of a wound dressing using different research methods.

This article examines different methods of assessing wound progress in order to better inform future research designs and thus produce a more credible and valid bank of knowledge. Data collected in a study of Vacutex, a capillary action dressing, were reassessed using four different mechanisms: non-blind assessment by a research nurse; two different scoring systems based on wound size and appearance; and a blind randomized assessment using initial and final images of wounds.Non-blind assessment indicated that the Vacutex dressing was superior to standard dressings by +40.8% (P=0.022); assessment by wound area and overall appearance indicated +11.2% superiority (P is not significant); and the blind randomized image-based assessment indicated a +20.6% difference (P is not significant). Assessment by wound area and description did not allow a percentage superiority to be identified and the conclusion of this method was that there was no significant difference by rank sum testing. The different assessment techniques resulted in significantly different conclusions about the effectiveness of Vacutex. On balance, the blind, randomized, image-based assessment may miss some finer nuances of wound progress but is probably the most unbiased option because those assessing the wounds are not aware of which images are taken before or after wounds have been treated.

Bandages↗
PubMed2004

Dental anxiety, dental health attitudes, and bodily symptoms as correlates of asthma symptoms in adult dental patients with asthma.

PURPOSE: The purpose of this study was to examine the relationship between asthma symptoms and dental anxiety, dental health attitudes, and physical symptoms and sensations such as watery eyes, upset stomach, headaches, and nausea in a group of adult dental patients with asthma. These variables are believed to be highly related to stress levels, which can exacerbate asthma symptoms during dental treatment. METHODS: Four self-report questionnaires and a demographic information form were completed by 60 adults with asthma in a waiting room of a private dental practice prior to receiving treatment. These instruments assessed dental anxiety, dental health attitudes, bodily symptoms, and asthma symptoms. Bivariate correlations were computed and tested for significance. They were followed by multiple regression analysis to analyze the relationship between the predictor variables-dental anxiety, dental health attitudes, and bodily symptoms, to the dependent variable-asthma symptoms. RESULTS: Pearson product correlations between the study variables revealed a statistically significant relationship between dental anxiety and bodily symptoms (r = 0.23, p < 0.05), and asthma symptoms and bodily symptoms (r = 54, p < 0.01). The analysis of variance indicated that the overall regression model (R2 = 30) was statistically significant (F(3,56) = 7.92, p < 0.01). Bodily symptoms was the only significant variable in the model. CONCLUSION: Dentists and dental hygienist should be attuned to adult patients who have asthma and exhibit signs of anxiety and/or other physical symptoms, or indicators of stress that can exacerbate asthma during or prior to dental treatment.

Adolescent↗
PubMed2003

A regression analysis of the Waterlow score in pressure ulcer risk assessment.

OBJECTIVE: To explore the predictive value of the Waterlow score, and the subscores of age and gender. DESIGN: Logistic regression analysis was conducted on the two subscores of the Waterlow score, and the residual Waterlow score with gender and age removed. Receiver operating characteristic (ROC) analysis gave a quantitative measure of the classification ability of the Waterlow score. SETTING: Burton, UK. SUBJECTS: All admissions over a five-year period to the District General Hospital, a total of 150,015 admissions of 82,691 patients. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Area under the ROC curve for significant (as determined by logistic regression) variables. RESULTS: Data were inaccurate in at least 44.7% of the records, and analysis was conducted on the 43,735 records for which no errors were apparent. Nine hundred and fifty-four patients had a pressure ulcer on admission (2.1%); 277 developed a pressure ulcer (0.6%). The Waterlow score was predictive of pressure ulcers. Age was predictive, and gender was not found to be a significant predictor. CONCLUSIONS: The Waterlow score may be improved and simplified by removing gender from the scoring system.

Adolescent↗
PubMed2002

Ethnicity in pressure ulcer risk assessment, with specific relation to the Pakistani ethnic minority in Burton, England.

BACKGROUND: There has been little work on ethnicity related to pressure ulcers in general and little or nothing specific to South Asians, and the Pakistani ethnic group in particular. AIM: To explore the relevance of ethnicity in pressure ulcers. METHODS: All admissions over a 5-year period to a District General Hospital in Burton, United Kingdom (UK) were considered where data were present on Waterlow Score, ethnicity and pressure sore status. Logistic regression analysis was conducted using ethnicity and other variables to predict ulcer formation. RESULTS; Age is predictive, but ethnicity was not found to be a significant predictor. CONCLUSION: There is no evidence that members of the Pakistani ethnic minority are at higher risk than the majority White population in Burton, with respect to pressure ulcers.

Age Factors↗
PubMed2002

Pressure ulcer classification: the systems and the pitfalls.

The classification of pressure ulcers constitutes an essential part of patient assessment and forms a baseline on which to monitor patients' progress and measure the outcomes of care. Four classification systems - Torrance, National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Stirling - are discussed. Many classification systems have been adopted by trusts despite insufficient research in their use in clinical practice. Regardless of which classification system is implemented, nurses need to be familiar with the one they are using and how to stage accurately a pressure ulcer. This can only be attained through regular education.

Humans↗
PubMed2002

Pressure ulcer classification: defining early skin damage.

This article is the second of a two-part series. The first part (Russell, 2002) looked at various systems and pitfalls of pressure ulcer classification systems. This article focuses on the difficulties of defining early skin damage. Patients' quality of life suffers significantly with a pressure ulcer. The smell of the exudate may be an embarrassment to the patient. The pain and the distress the patient will experience will not easily be forgotten, i.e. the number of dressings required for a deep pressure ulcer, even after the pressure ulcer has healed, will be a memorable intrusion to the patient's daily routine. Early detection of pressure ulcers and timely intervention are essential in the management of patients with pressure ulcers. Controversy exists over the definition of the first three stages of pressure ulcers, but there is consensus on the definition of deep tissue damage. If the pressure ulcer is covered with black necrotic tissue it is difficult to establish depth of the tissue damage. Intact skin can cause problems, as a sacrum may be purple but intact. There is still considerable debate with regard to reactive hyperaemia, as the exact time parameters for persistent erythema to occur are unknown. Little is understood with regard to the exact pathophysiology of reactive hyperaemia and this area requires further investigation. Blistered skin and skin tone also cause confusion in grading of pressure ulcers. The problems associated with classification of pressure ulcers, using colour classification systems, are discussed and the implications for practice are considered. The confusion surrounding early classification of pressure ulcers is discussed and it is hoped that such confusion can be addressed by standardizing training using one national classification system.

Erythema↗