PubMed HealthSearch

Biomedical subjects

S Kingston

Publications and source records attributed to S Kingston.

10 recordsLinked to original sources

A provincial hospital C.C.U. after ISIS 2.

A prospective study of admissions to an Irish provincial coronary care unit in the light of reported benefits of streptokinase and oral aspirin as reported in the Isis study was carried out. Of 115 patients admitted with suspected myocardial infarction (M.I.), the diagnosis was confirmed in 41. The average delay from onset of chest pain to admission to C.C.U. was 6.65 hours (0.3-18 hours, median 6 hours). Twenty-six of the 41 patients were given streptokinase after a median time lapse of six hours from the onset of pain. 88% of the M.I. patients were on oral aspirin at discharge but only 12% were on oral beta blockers. These findings are compared with the findings of the Isis 2 study worldwide and in Ireland. The presence of risk factors in the patients with M.I. is analysed, 16 of the 41 had serum cholesterol levels greater than 6 mmols/l. As an index of community risk factor screening, an enquiry was made of the patients and of their family doctor as to whether serum cholesterol had previously been checked, this had been done in only 12 of 41 and in only 2 had it been carried out by the family doctor. Pre-hospital analgesic use was also examined and 36 of the 41 patients had chest pain and were seen by their G.P.s but only 18 were given analgesics of whom 13 received morphine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists

Implementing a philosophy of care on a children's ward using action research.

This paper charts the progress of an action research project initially implemented to assist the staff of a pediatric ward in the development of primary nursing. The use of ward meetings to identify needs and clarify objectives is discussed; from this emerged a broader remit to implement the ward's philosophy of care. Five areas of clinical practice development were identified for work: development of a staff development strategy, identification of resource people, movement to primary nursing, development of standards of care, and development of the ward environment. Progress in these five areas is explored, and the use of evaluation strategies such as visual analogue scales, unstructured interviews and personal diaries are discussed. Description and discussion of some of the difficulties associated with this project are given. In conclusion, the authors address the issue of whether action research is in fact a specific methodology or a philosophy.

Clinical Nursing Research

Magnetic resonance imaging of foot and ankle trauma.

MRI is a useful diagnostic tool in the assessment of traumatic lesions of the foot and ankle. It is especially useful in demonstrating acute and chronic tendon and ligament injuries. Subtle fractures, including osteochondral, nondisplaced, and stress fractures, are well shown with MRI but may be difficult to detect on radiographs. A bone scan may also be used to detect these fractures; however, with MRI the fracture extent may be determined. MRI is also useful in diagnosing complication of trauma, such as ischemic necrosis and bone and soft-tissue infections.

Ankle Injuries

Comparison of MRI to contrast CT in the diagnosis of spinal stenosis.

Retrospectively, the MR (magnetic resonance) and contrast CT (computed tomography examinations of 41 patients (123 segments) were objectively scored to evaluate spinal stenosis and disc degeneration. Five categories to evaluate stenosis included the facet joint, foramina, central canal, disc on sagittal section, and disc on axial section. In addition, the ability to demonstrate spondylolysis was compared. The examinations were interpreted by a single observer blinded to the results. Comparisons show 96.6% agreement between MR and contrast CT in the diagnosis of spinal stenosis. Magnetic resonance showed disc degeneration in 74 of 123 segments, while CT showed disc degeneration disease in 27 of 123 segments. Spondylolysis was recognized at three segments on both MR and CT. In conclusion, MR and contrast CT are comparable in their abilities to demonstrate spinal stenosis, and MR is more sensitive in demonstrating disc degeneration.

Adult

Magnetic resonance imaging of the ankle and foot.

MRI has gained wide acceptance in evaluating the musculoskeletal system because of its wide array of advantages, including its superior soft-tissue contrast, noninvasiveness, direct multiplanar imaging, and lack of ionizing radiation. Its high-resolution images allow excellent visualization of bones, muscles, ligaments, tendons, and cartilaginous elements. MRI's greater sensitivity in detecting effusions and focal areas of pathology over other currently available imaging modalities make it the method of choice in many instances when imaging the foot and ankle.

Ankle

Magnetic resonance imaging in the diagnosis of disc degeneration: correlation with discography.

One hundred and one disc levels in 36 patients with low-back pain were studied with magnetic resonance imaging (MRI) (T2-weighted) sagittal images and conventional roentgenographic discography to detect early disc degeneration. Thirty-nine discs also were evaluated after discography with roentgenographic CT MRI findings were compared with discography results. MRI was 99% accurate in predicting normality or abnormality as determined by discography. Changes in disc signal on MRI accurately reflected the presence or absence of degenerative changes seen on discography in patients with low-back pain. Clinically, MRI is a useful technique for detecting early disc degeneration and for assessing the affected disc level and adjacent levels in patients with low-back pain and spondylolithesis.

Adolescent