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Biomedical subjects

M Segatore

Publications and source records attributed to M Segatore.

30 records · Page 2Linked to original sources
PubMed1992

Fever after traumatic brain injury.

Fever or pyrexia is a common clinical phenomenon. Among survivors of traumatic brain injury, it may appear immediately after injury, signal the presence of infection or reflect dysfunction of the thermoregulatory system. Management of pyrexia must be distinguished from measures that seek to identify and remove the putative cause of fever. Guidelines for decision making regarding the nursing management of patients with fever are presented. Given the potential benefit of fever, the ability of most patients to tolerate temperature elevations and the adverse effects, costs and discomforts associated with therapy, our habit of automatically reducing temperature should be examined.

Adult↗
PubMed1992

Vasospasm after aneurysmal subarachnoid hemorrhage: a review of pathophysiology.

Ischemic brain injury, including infarction, continues to cause major morbidity among operated and non-operated survivors of aneurysmal subarachnoid hemorrhage. Following an introductory description of cerebral vessel pathology, the relationship between angiographic vessel narrowing, or "spasm", and focal clinical deficits attributed to the resulting ischemia is explored. The role of nimodipine is presented with respect to its impact on survival quality. The session concludes with an outline of directions for future research.

Humans↗
PubMed1992

Deafferentation pain after spinal cord injury. Part I. theoretical aspects.

Pain which persists long after spinal cord injury can become the most disabling sequela for the survivor. In extreme cases, it may lead to chemical dependency, severe depression and even suicide. Following definition and description of deafferentation pain, the risks and benefits of current pharmacologic, surgical and other therapies are presented. Part I (in this issue) presents theoretical aspects and Part II (in Vol. 9 No. 3) will present management aspects of deafferentation pain. This two-part review is intended to facilitate informed decision-making by both consumers and caregivers.

Afferent Pathways↗
PubMed1991

Determining the interrater reliability of motor power assessments using a spinal cord testing record.

Instruments developed for use in any clinical setting must be tested for validity and reliability. The interrater reliability of neuroscience nurses' assessments for motor power using the Sunnybrook Health Science Centre Spinal Cord Testing record was determined using eleven patients with spinal cord lesions. Percentage of agreement between raters exceeded the predetermined acceptable level of 80%, and Kappa coefficient of agreement indicated excellent interrater agreement (K = .90, p less than .001). Study limitations are identified, and indications for further research discussed.

Adult↗
PubMed1988

Spinal cord testing: development of a screening tool.

The Acute Spinal Cord Injury Program at Sunnybrook Medical Centre has treated more than 950 patients in the 13 years since development of the program. Ongoing assessment is essential in the care and rehabilitation of these patients. Nurses at Sunnybrook developed a screening tool which specifies muscle groups and dermatomes to be tested, and a means to quantify muscle power. The tool also addresses evaluation of vital capacity, bowel and bladder function. This article describes tool development and illustrates its use.

Adult↗
PubMed1988

Endometrial carcinoma. Clinical and pathological correlations with survival and surgical treatment.

From 1978 to 1985 a total of 151 patients were treated for endometrial carcinoma. Of these, 25 patients underwent extrafascial abdominal hysterectomy and pelvic lymphadenectomy, 25 were treated according to Wertheim procedure and pelvic lymphadenectomy and 32 underwent intrafascial abdominal hysterectomy; 62 women underwent vaginal surgery, 7 of whom according to Shauta. A correlation between the degree of myometrial invasion, histological grading, hystological type and stage of the tumor showed no statistically significant difference. The 5-year actuarial survival rate was found to be 76.5%. A comparison between survival and age of patients showed a significant difference in the survival (p less than .01) of the group less than 55 years as compared to the older age group. As far as the surgical treatment instituted is concerned, no statistical difference in survival was found between patients operated vaginally and those operated abdominally (p greater than .05). The site of recurrences were then analyzed in 22 patients, 50% were local recurrences, and the remaining distant metastases. Of these only one patient was cured and is still free of disease 5 years after recurrence. The criteria used to select patients for vaginal surgery are also indicated.

Adult↗
PubMedDate not supplied

Managing the surgical orthopaedic patient with Parkinson's disease.

Parkinson's disease is a chronic, progressive, disabling, neurologic disorder that can complicate the diagnosis, clinical course, and recovery from comorbid conditions, such as traumatic fractures. Attention to specific aspects of management ought to minimize morbidity and facilitate orthopaedic recovery, notably medication titration and airway protection, hemodynamic stability, and surveillance proportional to mental capacity. Classical orthopaedic management may have to be altered, especially if the patient has advanced neurologic disease. Optimal management of patients with combined surgical orthopaedic and neurologic disease offers the treatment team an unusual opportunity to collaborate and coordinate multiple facets of care.

Antiparkinson Agents↗
PubMedDate not supplied

The Glasgow Coma Scale: time for change.

OBJECTIVE: To summarize and evaluate evidence on the psychometric properties of the Glasgow Coma Scale (GCS). RESULTS: This instrument attempts to capture the phenomenon of consciousness with three gross indicators of nervous system function. Although the GCS does capture consciousness to a limited extent and has pragmatic utility for practitioners, it suffers serious limitations for clinical monitoring and prediction and is being eclipsed by a variety of other instruments. CONCLUSION: In spite of its acknowledged shortcomings and the emergence of parallel instruments with greater reliability and validity, the GCS continues to enjoy a privileged, but unwarranted, position in clinical and investigational contexts.

Consciousness Disorders↗
PubMedDate not supplied

Midclavicular catheters in the antepartum population. A continuous quality improvement review.

After a catheter-induced subclavian thrombosis, a continuous quality improvement (CQI) study was undertaken to answer the question: Are midclavicular lines appropriate in high-risk obstetric patients? This article reports the findings of a retrospective chart audit that described 32 consecutively placed midclavicular lines in a high-risk obstetric population. Study variables included maternal and catheter characteristics, as well as dwell time and rationales for line discontinuance. Therapy was completed in 68%. There were no episodes of noncompliance, catheter malfunction, or bleeding. Episodes of phlebitis and occlusion were relatively uncommon; positive cultures occurred in six catheter tips but were unaccompanied by any clinical evidence indicative of bacteremia or catheter sepsis. However, given the growing recognition of the risks of subclinical and clinical thrombosis endemic to the midclavicular position, increasing reports of malposition that are logistically unable to address, and the growing number of osmotically active solutions being used that are not suited to anything other than superior vena cava dilution, the authors have stopped placing midclavicular catheters in the high-risk obstetric population.

Adult↗