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Biomedical subjects

P Liehr

Publications and source records attributed to P Liehr.

At least 19 recordsLinked to original sources
PubMed2003

Effect of periurethral denervation on function of the female urethra.

OBJECTIVE: The purpose of this study was to determine the effect of periurethral denervation on contractile function of the female rat urethra. STUDY DESIGN: Periurethral nerve transection or sham operation was performed in 16 young female rats. After 2 weeks, contractile function of the external urethra sphincter (EUS) and longitudinal smooth muscle was determined. Inhibitors of nitric oxide (NO) signaling were used to evaluate the role of nitric oxide in nerve-mediated relaxation. Statistical comparisons were conducted by Student t test. RESULTS: Periurethral nerve transection resulted in gross evidence of urinary retention and bladder distention. In normal and sham-operated rats, nerve-mediated relaxation of urethral smooth muscle was inhibited by L-nitroarginine and oxadiazolo quinoxalin-1-one (ODQ), and this relaxation response was impaired significantly after periurethral nerve injury. Relaxation responses to the NO donor sodium nitroprusside remained intact. Contractile function of the EUS was not altered by periurethral nerve injury. CONCLUSION: Neurons surrounding the urethra contain NO and innervate smooth muscle of the inner urethra. Periurethral denervation results in impaired urethral smooth muscle relaxation with no appreciable effect on contractility of the external striated sphincter.

Animals↗
PubMed1999

Middle range theory: spinning research and practice to create knowledge for the new millennium.

The foundation of middle range theory reported during the past decade was described and analyzed. A CINAHL search revealed 22 middle range theories that met selected criteria. This foundation is a firm base for new millennium theorizing. Recommendations for future theorizing include: clear articulation of theory names and approaches for generating theories; clarification of concept linkages with inclusion of diagrammed models; deliberate attention to research-practice connections of theories; creation of theories in concert with the disciplinary perspective; and, movement of middle range theories to the front lines of nursing research and practice for further analysis, critique, and development.

Humans↗
PubMed1999

Attentively Embracing Story: a middle-range theory with practice and research implications.

This paper describes the middle-range theory of attentively embracing story. Attentively embracing story is connecting with self-in-relation through intentional dialogue to create ease. The theory emerged in the context of the neomodernist and simultaneity paradigms as the authors shared situations in practice and research and linked these encounters to the story literature. Practice implications with a client who has hypertension and research implications with a pregnant adolescent are presented. The proposed middle-range theory is offered for critical examination by the nursing community as a guide for practice and research aimed at the promotion of human growth and change.

Adaptation, Psychological↗
PubMed1998

Predictors of ambulatory blood pressure: identification of high-risk adolescents.

Within a life span perspective on prevention, adolescence was conceptualized as a pivotal transition in the evolution of risk for hypertension and other cardiovascular morbidity. Resting blood pressure (BP), BP reactivity, and 24-hour ambulatory BP were measured in a multiethnic sample of 41 male and female adolescents aged 15 to 16 years old. Results were consistent with the hypothesis that BP levels during reactivity testing would be better predictors of ambulatory BP than levels of BP measured at rest using a standard protocol. Ethnic group differences in ambulatory BP were statistically significant. The findings warrant further study and may provide a means for early identification of adolescents at risk for developing high BP.

Adolescent↗
PubMed1997

Blood pressure reactivity in urban youth during angry and normal talking.

Distinctions between male and female adult patterns of cardiovascular disease are well established. Although risk for cardiovascular disease begins early in life, little research has been focused on the beginning of gender difference patterns. This pilot study examined blood pressure reactivity, gender, and biologic maturity in adolescents talking about angry life circumstances and the usual progression of their day. Systolic and diastolic blood pressure increased during talking, and the addition of biologic maturity to the analysis distinguished males from females. Males had higher systolic blood pressures than did females throughout the protocol, and, generally, mature subjects had higher systolic and diastolic blood pressures than did less mature subjects. These pilot data confirm the effects of talking on blood pressure. The data suggest that biologic maturity enhances understanding of gender differences in adolescent blood pressure reactivity and continued study of the gender-blood pressure reactivity distinctions in adolescents may further understanding of adult patterns of gender differences in cardiovascular disease.

Adolescent↗
PubMed1997

The effect of turning and backrub on mixed venous oxygen saturation in critically ill patients.

OBJECTIVE: To examine the effect of a change in body position (right or left lateral) and timing of backrub (immediate or delayed) on mixed venous oxygen saturation in surgical ICU patients. METHODS: A repeated-measures design was used to study 57 critically ill men. Mixed venous oxygen saturation was recorded at 1-minute intervals for 5 minutes in each of three periods: baseline, after turning, and after backrub. Subjects were randomly assigned to body position and timing of backrub. Subjects in the immediate-backrub group were turned and given a 1-minute backrub. Mixed venous oxygen saturation was measured at 1-minute intervals for 5 minutes at two points: after the backrub and then with the patient lying on his side. For subjects in the delayed-backrub group, saturation was measured at 1-minute intervals for 5 minutes at two different points: after the subject was turned to his side and after the backrub. RESULTS: Both position and timing of backrub had significant effects on mixed venous oxygen saturation across conditions over time. Subjects positioned on their left side had a significantly greater decrease in saturation when the backrub was started. At the end of the backrub, saturation was significantly lower in subjects lying on their left side than in subjects lying on their right side. The pattern of change differed according to the timing of the backrub, and return to baseline levels of saturation after intervention differed according to body position. CONCLUSIONS: Two consecutive interventions (change in body position and backrub) cause a greater decrease in mixed venous oxygen saturation than the two interventions separated by a 5-minute equilibration period. Turning to the left side decreases oxygen saturation more than turning to the ride side does. Oxygen saturation returns to clinically acceptable ranges within 5 minutes of an intervention. In patients with stable hemodynamic conditions, the standard practice of turning the patient and immediately giving a backrub is recommended. However, it is prudent to closely monitor individual patterns of mixed venous oxygen saturation, particularly in patients with unstable hemodynamic conditions.

Adult↗
PubMed1997

Guidelines for selecting outcome measures: lifestyle modification for stage 1 hypertension.

Lifestyle modification is the recommended intervention for stage 1 hypertension. Advanced practice nurses are well positioned to guide lifestyle modification, and they are well prepared to measure outcomes related to the intervention. Selection of an appropriate outcome measure begins with matching the measure to the intervention. Matching is reliant on identification of the system of ideas and the research database guiding the intervention. This article proposes guidelines for selecting an outcome measure for use with individuals in practice settings. The guidelines are then applied in the selection of an outcome measure for lifestyle modification in stage 1 hypertension.

Guidelines as Topic↗
PubMed1995

Effects of intraoperative manual descending compressions on saphenous vein incision healing.

Many patients who undergo saphenous vein harvesting during aortocoronary bypass procedures experience saphenous vein incision site complications, such as hematoma formation. Twelve percent of the patients in this descriptive, comparative study developed hematomas in their saphenous vein incision sites. Contributing factors were age, smoking, diabetes, and intraoperative heparinization. An intraoperative nursing intervention (ie, manual descending compressions) did not decrease hematoma formation but warrants further investigation.

Adult↗
PubMed1995

Cardiovascular reactivity during verbal communication: an emerging risk factor.

Cardiovascular reactivity (CR), the abrupt increase in blood pressure and heart rate that occurs during stress, is emerging as a potential risk factor for hypertension and coronary heart disease. This article reviews the research on CR to verbal communication, an everyday stressor. A case study is presented to illustrate the usefulness of this research to clinical practice. Strategies to decrease CR during talking are presented.

Adult↗
PubMed1993

Nursing blood pressure research, 1980-1990: a bio-psycho-social perspective.

The purpose of this review is to examine nursing research on blood pressure (BP) from 1980 to 1990 from a bio-psycho-social perspective. Nursing research articles (N = 50) from three journals were reviewed. The inclusion of subject descriptions, environmental factors, dynamic and interpersonal aspects were tabulated. This review provides a basis for designing nursing research on BP with a broader perspective.

Adult↗
PubMed1993

Critiquing and using nursing research: guidelines for the critical care nurse.

This article focuses on a concern that practicing nurses are expected to use nursing research but are not thoroughly prepared to meet this expectation. This concern is addressed by proposing: (1) a guideline for research critique that is designed to bridge baccalaureate education and nursing practice and (2) a unique description of research utilization that may be realistically accomplished by practicing nurses.

Clinical Competence↗
PubMed1992

Uncovering a hidden language: the effects of listening and talking on blood pressure and heart rate.

Listening and talking are essential to everyday life and especially to successful nursing interventions. Whereas the cardiovascular changes that occur during talking have been extensively documented, those that occur during listening have not been studied. Blood pressure (BP) and heart rate (HR) were measured in healthy men (N = 54) and women (N = 55) while they listened and talked. Talking resulted in significant increases in both BP and HR; although also significant, increases during listening were of a lesser magnitude. These cardiovascular changes were affected by the order of the dialogue activities (talking or listening first) and by gender.

Adult↗
PubMed1992

The effect of two intraoperative heat-conserving methods on orthopedic patients receiving regional and general anesthesia.

Postoperative hypothermia is a serious complication of surgery. The best way to prevent postoperative hypothermia is to prevent perioperative heat loss. The purpose of this study was to compare the efficacy of Thermadrape (O.R. Concepts, Inc., Roanoke, TX), a heat-retaining surgical covering, with cotton blankets in maintaining core body temperature for patients receiving general or regional anesthesia. One hundred seventeen patients having hand, wrist, or elbow surgery were covered with either cotton blankets or Thermadrape covering throughout the perioperative period. Core body temperature was measured using a tympanic membrane device (FirstTemp, Intelligent Medical Systems, Carlsbad, CA) preoperatively, on PACU admission, and at discharge. Thermadrape covering and cotton blankets were equally effective in conserving body heat. Patients receiving general anesthesia were cooler on PACU admission than those receiving regional anesthesia, regardless of the type of covering. Hospital decisions regarding choice of perioperative heat conservation interventions will be guided by the cost of the intervention as well as efficacy. If overall hospital cost of cotton blankets is greater than that associated with Thermadrape covering, a decision to use Thermadrape covering may be warranted. Important factors for consideration in future research are presented and discussed.

Anesthesia, Conduction↗
PubMed1992

Effect of venous support on edema and leg pain in patients after coronary artery bypass graft surgery.

The purpose of this study was to assess the effect of external venous support on edema and pain in the saphenous graft leg of patients who had coronary artery bypass graft surgery (CABG) 5 days and 1 month after surgery. Fifty-six patients who had CABG surgery were randomly assigned to the experimental (n = 24) or control (n = 32) group. Subjects in the experimental group wore graded compression support hose. Edema was assessed by using ankle, calf, and thigh circumference measurements. Pain was measured on a visual analog scale. Hose were effective in preventing edema during hospitalization, but results at 1 month were inconclusive. There was no difference in leg pain for experimental and control subjects. That a number of patients in the experimental group were unable to complete the study suggests that off-the-shelf, thigh-high support hose may not be useful for individuals with disproportionately large thighs. Further investigation of the long-term effects of support hose is warranted.

Adult↗
PubMedDate not supplied

Blood pressure and sexual maturity in adolescents: the Heartfelt Study.

This study investigates sexual maturity as a predictor of resting blood pressures independent of other known predictors, in 179 boys and 204 girls 11-16 years of age from the Heartfelt Study. The sample included youth of African (n = 140), Mexican (n = 117), and European and "other" (n = 126) backgrounds. Sexual maturity was assessed during clinical examination of three standard indicators for each sex. Systolic and diastolic blood pressures were higher in children of maturity stages IV and V, compared to stages I-III, in each gender/ethnic group (P < 0.01 in almost all groups). Boys and girls advanced in sexual maturity for their age group, had significantly higher systolic blood pressures (but not diastolic) than the less advanced in linear models that included height, body mass index (BMI), ethnicity, and age as co-predictors. Diastolic blood pressures were predicted by height in boys and by age and the BMI in girls. This analysis, using a very conservative approach, suggests that sexual maturity provides important and independent information on systolic blood pressure in adolescents. Further investigation of its role in 24-hr blood pressures and in blood pressures taken during physical and emotional stress, is recommended.

Adolescent↗