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Biomedical subjects

N Hughes

Publications and source records attributed to N Hughes.

27 records · Page 2Linked to original sources
PubMed1991

Maternal temperature regulation during extradural analgesia for labour.

We have studied the effect of analgesia on maternal temperature (oral and tympanic membrane) progression in 53 women during normal spontaneous labour. Three groups were studied: two received extradural analgesia with a continuous infusion of 0.25% bupivacaine with or without the addition of fentanyl; the third group received only parenteral opioid analgesia. All patients were afebrile and without clinical evidence of infection at the beginning of the study. Both groups of patients receiving extradural analgesia had a consistent and significant increase in temperature after approximately 5 h of analgesia; no such trend was observed in the parenteral opioid group. Alterations in mechanisms of heat dissipation may explain these findings.

Adolescent↗
PubMed1991

Obstetric outcome in women after multiple spontaneous abortions.

Obstetric outcome in 88 women with a past history of three or more consecutive pregnancy losses was studied. The results were compared to those in our total obstetric population for the same period (control group). The incidence of small-for-gestational-age infants, prematurity, low-birth-weight infants and toxemia in the study group was not significantly different from that in the control group. Gestational diabetes and chronic hypertension, however, occurred more frequently in the study group than in the control group (P less than .001). These data could be helpful in counseling women with repeated pregnancy loss.

Abortion, Habitual↗
PubMed1991

Teaching psychology to student radiographers: a survey of current methods and attitudes.

A number of schools of diagnostic radiography were surveyed by questionnaire to establish current trends and status of psychology teaching. The results show that methods used are split fairly equally between experiential and nonexperiential techniques. Reasons for the utilisation of role play methods are explored, and several comments are reproduced concerning the future of psychology teaching and aspirations for the future.

Attitude↗
PubMedDate not supplied

Effects of alkalinization of lidocaine on the pain of skin infiltration and intravenous catheterization.

STUDY OBJECTIVE: To test the hypothesis that alkalinization of lidocaine decreases the pain of skin infiltration in surgical patients. DESIGN: Double-blind, randomized, prospective study. SETTING: Preoperative holding units, Brigham and Women's Hospital. PATIENTS: 184 adult surgical patients. INTERVENTIONS: We compared the efficacy of 1% lidocaine with and without 0.1 mEq/ml of sodium bicarbonate (NaHCO3) for relief of pain of (1) skin infiltration and (2) intravenous (i.v.) catheterization prior to surgery. MEASUREMENTS AND MAIN RESULTS: Patients evaluated the intensity of pain using a 100 mm visual analog scale (VAS). There were no differences between study groups (lidocaine with NaHCO3, n = 89; lidocaine alone, n = 95) with respect to site of catheterization or catheter gauge used. Lidocaine plus NaHCO3 caused significantly less pain on skin infiltration (median VAS = 4; range = 0 to 51) than did lidocaine alone (VAS = 8; range = 0 to 48; p < 0.008). Pain of i.v. catheterization also did not differ between groups. There was a weak correlation between catheter gauge and pain of i.v. catheterization (r = -0.19; p = 0.01). CONCLUSIONS: Pain resulting from skin infiltration of lidocaine solutions can be diminished by adding NaHCO3. However, catheter size is more important than the presence or absence of NaHCO3 in determining the pain of i.v. catheterization.

Adult↗
PubMedDate not supplied

Continuous pump pressures cannot be used to identify catheter tip migration into the subarachnoid space.

BACKGROUND AND OBJECTIVES: Migration of an epidural catheter into the subarachnoid space is a potentially lethal complication of continuous epidural anesthesia. We evaluated the use of pump pressure measurement during infusion in detecting such an occurrence. METHODS: Pump pressures at two flow rates (P1 and P10) and epidural space pressure (P0) were measured hourly in eight consecutive ASA Physical Status I parturients receiving continuous epidural anesthesia and compared to those of a patient whose catheter migrated into the subarachnoid space. In addition, total resistance to infusion (Rtot) was calculated as the slope of the least squares regression line linking pressure and flow. Epidural resistance (Repi) was computed as the difference between total resistance and catheter resistance; Repi = Rtot - Rcath. RESULTS: In epidural catheters, average P0 and P10 were 13 +/- 4 mmHg and 23 +/- 4 mm Hg, respectively, and did not change over time. Rtot and Repi averaged 960 +/- 180 RU and 980 +/- 120 RU, respectively. Pump pressures in the subarachnoid catheter were 10 mmHg for P0 and 20 mmHg for P10, while Rtot was 1000 RU. CONCLUSIONS: We conclude that epidural and subarachnoid space resistance is essentially zero and the pump pressure in the system is used to overcome the catheter resistance. Both spaces offer the same total resistance to infusion and, therefore, pump pressure will not change when a catheter migrates into the subarachnoid space.

Anesthesia, Epidural↗
PubMedDate not supplied

The role of physician assistants in the delivery of medical care.

Although the physician assistant (PA) profession is slightly more than 30 years old, in its short history, it has had a significant impact on the delivery of quality medical care in the United States. There are approximately 34,000 PAs currently in clinical practice. The purpose of this article is to describe the role physician assistants play in the delivery of medical care and the benefits they bring to the health system and to patients.

Credentialing↗