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Biomedical subjects

M Kinney

Publications and source records attributed to M Kinney.

At least 19 recordsLinked to original sources
PubMed1991

Inflow atherosclerotic disease localized to the common femoral artery: treatment and outcome.

Severe occlusive disease of the common femoral artery without significant aortoiliac disease is not common in our experience. Since 1978 we have operated upon 29 limbs in 22 patients (mean age 60) with localized common femoral artery disease. Indications for operation were claudication in 31% and impending limb loss in 69%. Operations included common femoral artery endarterectomy with patch angioplasty (19 limbs), patch angioplasty alone (two limbs), and common femoral artery endarterectomy without a patch (three limbs). Operative mortality was zero; there were nine wound complications, one patient had a myocardial infarction with early thrombosis. Symptomatic relief was obtained in 20 of 22 patients. All minor amputations healed. The mean postoperative ankle/brachial index increased to 0.67 from 0.49. Mean follow-up is 37 months (one-118 months); there have been 10 late deaths. Cumulative two and five year patency rates are 82% and 74%, limb salvage is 80% and 80%, respectively. Major amputations were required in five patients at two, two, 12, 23, and 68 months. Further inflow procedures were required in four patients: three aortobifemoral bypasses and one axillofemoral bypass. Although this disease has an uncommon inflow level, it is amenable to safe, durable, local procedures.

Aged↗
PubMed1990

Altered level of consciousness: validity of a nursing diagnosis.

The purpose of this three-phase study was to examine the validity of the nursing diagnosis altered level of consciousness (ALC). The conceptual framework was diagnostic reasoning. In Phase I, 26 content experts certified in neuroscience nursing completed four rounds of a Delphi survey to identify defining characteristics and operational definitions for the nursing diagnosis. The diagnosis was divided into ALC: arousal and ALC: content. In Phase II, 30 staff nurses from two neuroscience intensive care units (NICUs) used the magnitude estimation scaling technique in judging the importance and frequency of occurrence of defining characteristics chosen in Phase I. In Phase III, 60 patients in two NICUs were assessed for frequency of occurrence of the defining characteristics for ALC: arousal and ALC: content. In Phase I, there was greater than or equal to 70% agreement on the appropriateness and clarity of 28 and 24 defining characteristics and operational definitions for ALC: arousal and ALC: content, respectively. In Phase II, there were 7 major defining characteristics identified for ALC: arousal and 6 major defining characteristics identified for ALC: content. In Phase III, there were 13 defining characteristics that occurred with significantly greater frequency in patients with an ALC: arousal and 17 defining characteristics that occurred with significantly greater frequency in patients with an ALC: content.

Attitude of Health Personnel↗
PubMed1990

A methodology for validating nursing diagnoses.

A methodologic approach consisting of four phases is proposed for validating nursing diagnoses. The sequential phases include use of the Delphi technique, magnitude estimation scaling, patient observation, and testing nursing interventions through clinical trials. The proposed methodologic approach is a strategy for researching the diagnosis and treatment of human responses to actual or potential health problems--the foundation for nursing practice.

Clinical Nursing Research↗
PubMed1990

Publicity.

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Advertising↗
PubMed1989

Identifying critical defining characteristics of nursing diagnoses using magnitude estimation scaling.

The question addressed in this study was: Can the critical defining characteristics (CDCs) of nursing diagnoses be determined by magnitude estimation scaling (MES)? MES was used by having 32 nurse subjects numerically estimate the magnitude of each characteristic of anxiety and of sleep pattern disturbance on each of three concept dimensions: importance, frequency, and competency. Geometric means of the stimuli for each of the concept dimensions were computed and correlated with each other. Strong correlations between the characteristics and the concept dimensions were obtained. It was concluded that MES is a useful technique for identifying the CDCs and operational definitions of nursing diagnoses.

Anxiety↗
PubMed1988

What if?

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Humans↗
PubMed1979

Ascites: its correction by peritoneovenous shunting.

Patients with refractory ascites and HRS should be considered to present an urgent indication for peritoneovenous shunting. The shunt offers a method of continuous reinfusion of ascitic fluid which corrects avid sodium retention, oliguria and azotemia. Severe encephalopathy, jaundice or peritoneal sepsis--common complications of cirrhosis--contraindicate installation of the shunt before improvement occurs. Associated cardiac disease does not contraindicate the use of the shunt provided that ascitic fluid is removed at the time of operation and large amounts of diuretics are used. This operation has also proved useful in ascites attributed to causes other than cirrhosis. The main complications include disseminated intravascular coagulopathy, hepatic coma and sepsis in a few patients. Results of a randomized prospective study indicate that the shunt should probably be considered in patients with diet-resistant massive ascites even before they prove to be refractory to diuretic therapy.

Aged↗
PubMed1978

Renal failure in ascites secondary to hepatic, renal, and pancreatic disease. Treatment with a LeVeen peritoneovenous shunt.

Renal failure occurs in ascites of diverse causes. Functional renal failure (the hepatorenal syndrome) in cirrhotic patients is usually progressive and rapidly fatal. Insertion of a LeVeen shunt significantly reduces weight, as well as abdominal girth, and improves preoperative urine flow (488 vs 2,318 ml/24 hr; P less than .001) and natriuresis (12 +/- 15 vs 45 +/- 33 mEq/liter; P less than .003). The shunt should not be inserted in patients with alcoholic hepatitis (bilirubin level greater than 8 mg/100 ml). Ascitic fluid should be discarded at the time of surgery in patients with impaired cardiac function, a bleeding diathesis, and when liver function is more severely deranged.

Acute Kidney Injury↗