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Biomedical subjects

M W Beal

Publications and source records attributed to M W Beal.

At least 19 recordsLinked to original sources
PubMed2001

Ventilatory failure, ventilator management, and outcome in dogs with cervical spinal disorders: 14 cases (1991-1999).

OBJECTIVE: To determine the incidence of and risk factors for ventilatory failure in dogs undergoing surgery for treatment of cervical spinal disorders and to document ventilator management, clinical course, and long-term outcome of dogs that experienced ventilatory failure in association with cervical spinal disorders or their management. DESIGN: Retrospective study. ANIMALS: 14 dogs. PROCEDURE: Dogs with cervical spinal disorders that required positive-pressure ventilation (PPV) were identified, and signalment, concurrent diseases, neurologic status at initial examination, clinical course, pulmonary function before, during, and after PPV, management techniques, complications, and outcome were recorded. Dogs that underwent surgery and required PPV were compared with dogs that underwent cervical spinal surgery during the same period that did not require PPV. RESULTS: 14 dogs with cervical spinal disorders required PPV to treat hypoventilation, including 13 of 263 (4.9%) dogs that underwent surgery for cervical spinal disorders. Lesions between the second and fourth cervical vertebrae and treatment by means of a dorsal decompressive laminectomy were associated with a significantly increased risk of perioperative hypoventilation. Pulmonary gas exchange function was normal or nearly normal throughout the course of PPV in dogs that survived. Ten dogs survived, and 9 of the 10 regained neurologic function. All 9 dogs that regained neurologic function had deep pain perception on initial examination at the veterinary teaching hospital. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a small percentage of dogs with cervical spinal disorders may require perioperative ventilatory support. With prolonged PPV and aggressive management, a good outcome may be achieved in dogs similar to those described in the present study.

Animals↗
PubMed2000

Emergency vascular access.

Establishing and maintaining vascular access is often vital to the preoperative, intraoperative, and postoperative management of the small animal emergency surgical patient. Vascular access may be used for the delivery of crystalloids, colloids, blood components, medications, and anesthetic or sedative agents. It can also facilitate venous and arterial blood sampling and allow direct measurement of arterial and venous pressures. The small animal emergency and critical care veterinarian should have a thorough knowledge of vascular access techniques, including peripheral and central venous catheterization, intraosseous, and arterial access. Competence in percutaneous, percutaneous facilitative, and surgical cutdown approaches should ensure that vascular access can always be established in the critically ill patient.

Animals↗
PubMed2000

Vascular access: theory and techniques in the small animal emergency patient.

Acquisition of vascular access in the emergent small animal patient is one of the keys to successful management of a population of patients that are often unstable with regard to their major body systems. Venous and intraosseus cannulation allow for the administration of a variety of fluids and potentially life-saving medications. In addition, central venous and arterial access also serve as conduits for atraumatic blood sampling and intravascular pressure monitoring. A thorough knowledge of vascular access theory, the dynamics of fluid flow, vascular anatomy, catheter selection criteria, and placement techniques are critical to the proper and safe use of the vascular access options available today to the small animal clinician.

Animals↗
PubMed2000

Acupuncture and Oriental body work: traditional and biomedical concepts in holistic care: history and basic concepts.

Acupuncture and related forms of Oriental body work, such as shiatsu and acupressure, have become increasingly part of the complementary and alternative health care in the last twenty years in the United States. Yet most consumers and professionals, nurses included, know little or nothing about the philosophical and diagnostic underpinnings of these forms of treatment. The frameworks underlying these modalities are intrinsically holistic, and provide an interesting model for nurses and others who are looking for different ways to think about data from patient care. Part I of two articles presents descriptions of practices, and an introduction to the history and basic concepts underlying Chinese acupuncture and related forms of Oriental body work.

Acupressure↗
PubMed2000

Acupuncture and oriental body work: traditional and modern biomedical concepts in holistic care--conceptual frameworks and biomedical developments.

An introduction to the history and basic concepts underlying acupuncture and Oriental body work was presented in the April 2000 (14:3) issue of Holistic Nursing Practice. The functioning of Yin and Yang organs and meridians are addressed in this article, along with the diagnostic frameworks of Five Elements or Phases and Eight Principle Patterns. Contemporary biomedical developments in the use of acupuncture are discussed, along with research on the endorphin system as a biomediary of acupuncture. Possible applications to nursing are discussed.

Acupuncture Therapy↗
PubMed2000

Acupuncture for symptom relief in HIV-positive adults: lessons learned from a pilot study.

CONTEXT: Although acupuncture is used by many people with HIV disease as a complementary treatment to Western medicine, there is a lack of scientifically sound research on patient responses and outcomes. OBJECTIVE: To explore the feasibility of conducting a larger study investigating the efficacy of acupuncture on symptom distress, psychological distress, and quality of life in HIV-infected individuals. DESIGN: This pilot study used a block randomization, single-blinded design. SETTING: Yale University General Clinical Research Center. PARTICIPANTS: Eleven HIV-positive participants. INTERVENTION: Patients were grouped by CD4 cell counts and received acupuncture treatments twice each week for 3 weeks. The experimental group received a protocol with 2 components: one tailored to the individual's symptoms and a second standardized component treatment designed to promote health and immune function. The control-needling group received a standardized treatment involving stimulation of acupuncture points identified as "clinically irrelevant" in treating the conditions under investigation (i.e., acupuncture points that have consistently not been cited as helpful for symptoms of relevant conditions or immune disorders). MAIN OUTCOME MEASURES: The HIV-Symptom List was administered to gather data on symptom distress, the Brief Symptom Inventory was used to gather data on psychological distress, and the Functional Assessment of HIV Infection was administered to collect data on quality of life. RESULTS: Preliminary data from small numbers of participants showed trends toward improvement in symptoms and quality of life. CONCLUSIONS: A follow-up pilot study will focus on the use of acupuncture to relieve gastrointestinal symptoms in people with HIV.

Acupuncture Therapy↗
PubMed1999

Respiratory failure attributable to moxidectin intoxication in a dog.

A 5-month-old 22-kg (48.4-lb) sexually intact male Collie was examined after ingesting a moxidectin-containing deworming medication. The dog was comatose and had respiratory arrest after progressively worsening lethargy, ataxia, and seizures. Exposure was confirmed by isolation of moxidectin from a biopsy specimen of adipose tissue, using liquid chromatography-mass spectroscopy methods. Treatment included use of intermittent positive-pressure ventilation, activated charcoal and cathartic administered enterally, nutrients administered via nasogastric tube, and intensive supportive care. The dog was weaned from a ventilator on day 6 after ingestion and was discharged on day 10. The dog was considered clinically normal during examination 24 days after ingestion. On the basis of the dog reported here and toxicologic data provided by the manufacturer of the deworming product, some Collies may have increased susceptibility to products containing high doses of moxidectin.

Adipose Tissue↗
PubMed1990

Cervical cytology.

The Pap smear has been used for detection of precancerous and early lesions of the cervix for almost 50 years. This article reviews current risk factors of cervical cancer and cytologic and histologic cervical changes to increase the practitioner's understanding of Pap smear screening. Information also is provided on how to obtain a quality sample as well as nursing implications in obtaining samples.

Female↗
PubMed1987

Understanding cervical cytology.

Nurse practitioners and nurse midwives perform Pap smears routinely as a part of well-woman health care. However, the clinician may not understand the terminology used to express the results of the test or the rationale for strict adherence to correct technique. Information on basic histology and cytology is presented with the goal of helping the clinician understand what the cytologist is looking for and what the results from a Pap smear mean. Two sets of nomenclature for results are presented. Risk factors for development of cancerous and precancerous conditions of the cervix and the controversy regarding frequency of Pap smear sampling are discussed, as are guidelines for treatment and referral of women with class II Pap smears.

Female↗
PubMedDate not supplied

Acupuncture and related treatment modalities. Part I: Theoretical background.

An introduction to the therapeutic applications, history, and theory of acupuncture and several related treatment modalities is presented. The practices of acupuncture, moxibustion, acupressure, and shiatsu are described. The underlying concept of treatment of imbalances of ch'i, or life energy, is presented along with the flow of ch'i in meridians (pathways), and the theories of yin and yang, Five Elements, and Eight Principle Patterns.

Acupuncture Therapy↗
PubMedDate not supplied

Acupuncture and related treatment modalities. Part II: Applications to antepartal and intrapartal care.

The application of acupuncture, moxibustion, acupressure, and shiatsu to antepartal and intrapartal care are discussed. Information on therapeutic interventions as described in textbooks is presented and compared with specific treatments evaluated in research studies. Specific clinical indications addressed include nausea during pregnancy, repositioning of the fetus in breech position, stimulation of contractions and true labor, and pain relief in labor. Qualifications for practitioners and recommendations for certified nurse-midwives caring for clients seeking referral for these services are discussed.

Acupuncture Therapy↗
PubMedDate not supplied

Chlamydia infection in a nurse-midwifery caseload.

The purpose of this study was to determine whether antepartum treatment of chlamydia infection resulted in a change in incidence of maternal infection in the intrapartum and postpartum periods as indicated by the incidence of maternal febrile morbidity or antibiotic therapy. In June of 1986, an inner-city tertiary-care center nurse-midwifery service began including diagnosis and treatment of chlamydia infection in routine antepartum care. In this retrospective chart review, the incidence of intrapartum and postpartum infection among women who delivered in this caseload between May 1985 and May 1986 (the last year prior to the routine chlamydia diagnosis and treatment) was compared with that of women who delivered between July 1986 and July 1987 (the first year after initiation of the testing). No significant differences were found. Implications for the development of research projects within nurse-midwifery clinical services are discussed, along with methodologic problems that may ensue when attempting to study changes in outcome in ones' own service.

Chlamydia Infections↗
PubMedDate not supplied

Use of Norplant in women with or at-risk for noninsulin-dependent diabetes.

This review addresses the use of Norplant in women with or at-risk for noninsulin-dependent diabetes mellitus (NIDDM). Background information on NIDDM is given, including pathogenesis, effect on glucose and lipid metabolism, and management. The effect of exogenous estrogen and progestogens on glucose tolerance is briefly discussed. In reviewing the effects of Norplant on glucose metabolism, studies on women with normal glucose tolerance were reviewed, along with the one study of Norplant use in women with a past history of gestational diabetes. Norplant does have a minor effect on glucose metabolism. Studies are contradictory regarding lipid metabolism but most suggest that Norplant does not have a negative effect on the high density lipoprotein/total cholesterol ratio. Factors influencing contraceptive choice are reviewed. Protocols for management of Norplant in women with or at-risk for NIDDM are then presented, followed by a case study and a brief discussion.

Adult↗
PubMedDate not supplied

Women's use of complementary and alternative therapies in reproductive health care.

Numerous studies have documented that health care consumers all over the world are spending money out of pocket for alternative therapies and that billions of dollars are spent in the United States alone. In this article, the use of complementary and alternative therapies by women health care consumers is discussed, particularly as this phenomenon relates to women's reproductive health in the United States. Women use conventional health care services more frequently than men; thus, it is not surprising that women account for approximately two thirds of health care appointments for complementary and alternative therapies. The traditional conceptual frameworks of herbal medicine, homeopathy, acupuncture, and acupressure are presented, and common clinical applications to women's reproductive care are discussed.

Acupressure↗
PubMedDate not supplied

Acupuncture and acupressure. Applications to women's reproductive health care.

An introduction to the therapeutic applications, history, and theory of acupuncture and acupressure is presented. The traditional concepts that underlie treatment of imbalances of ch'i, or vital energy, are presented, along with the theories of yin and yang, meridians, vital substances, pathogenic factors, five phases, and the eight principle patterns. Contemporary Western research findings on the biochemical mediaries and effects of acupuncture are reviewed. Clinical applications to women's reproductive care that are presented include treatment for dysmenorrhea, infertility, and childbearing. Data on clinical trials are reviewed, and licensure and educational preparation for practice of these modalities are discussed.

Acupressure↗
PubMedDate not supplied

Preventing perinatal transmission of HIV: an evidence-based update for midwives.

This article presents an update on human immunodeficiency virus care in the United States, with an emphasis on care during pregnancy and strategies to prevent perinatal transmission. Common drug regimens are reviewed. Obstetric factors related to transmission, such as mode of delivery, also are discussed. Guidelines for collaboration between midwives and human immunodeficiency virus specialists are outlined.

Adult↗