Biomedical subjects

W J Hanna

Publications and source records attributed to W J Hanna.

At least 19 recordsLinked to original sources

PubMed1998

Knowledge and fears of anaesthesia and surgery. The Jamaican perspective.

This study was undertaken to assess patients' knowledge and perceptions, fears and concerns regarding perioperative management. 300 patients were interviewed consecutively and a questionnaire was completed for each patient. 25% admitted to having anxiety about their upcoming operation. The prevalence of preoperative fear was significantly higher in younger patients (age < 40 years, p < 0.05) and in more educated patients (secondary and tertiary levels, p < 0.001). The commonest fears were those of a morbid nature (e.g. death on the operating table). 34% of the patients did not realize that anaesthetists were qualified doctors, and only 10% recognized the central role played by anaesthetists in the monitoring of vital signs throughout an operation. There is continuing need for public education on the role of the anaesthetists in health care, and anaesthetists must ensure that preoperative concerns of their patients are adequately addressed.

Adolescent↗

PubMed1996

The equine periodic paralysis Na+ channel mutation alters molecular transitions between the open and inactivated states.

1. The Na+ channel mutation associated with equine hyperkalaemic periodic paralysis (HPP) affects a highly conserved phenylalanine residue in an unexplored region of the alpha-subunit. This mutation was introduced into the rat skeletal muscle Na+ channel gene at the corresponding location (i.e. F1412L) for functional expression and characterization in Xenopus oocytes. 2. In comparison with wild-type (WT) channels, equine HPP channels showed clear evidence for disruption of inactivation: increased time-to-peak current, slowed rates of whole-cell current decay, significant increases in sustained current, rightward shifts in the steady-state inactivation curve by 9.5 mV, a 6-fold acceleration in the rate of recovery from inactivation at -80 mV, decreased number of blank single-channel sweeps, repetitive opening of single channels throughout depolarizing steps, increased open probability per sweep, and an increased mean open time. 3. The observed disruption of inactivation in HPP occurred without measurable changes in steady-state activation and first latency kinetics of channel opening. 4. Kinetic modelling demonstrates that the equine HPP phenotype can be simulated by altering the rate constants for transitions entering and leaving the inactivated states resulting from an energetic destabilization of the inactivated state. 5. These results suggest that the highly conserved cytoplasmic end of the third transmembrane segment (S3) in the fourth internal repeat domain (domain IV) plays a critical role in Na+ channel inactivation.

Animals↗

PubMed1995

Tetanus: a recurring intensive care problem.

A fifteen-year retrospective study of 108 cases of tetanus admitted to the Intensive Care Unit (ICU) at the University Hospital of the West Indies is presented. Males predominated (70%), with peak incidence occurring amongst the young and the elderly. In 57% the disease was severe enough to require neuromuscular blockade and controlled ventilation. Respiratory complications occurred most commonly (80%), predominantly as a result of infection. Dysautonomia, exhibited by 55% of patients, presented the greatest difficulty in management. Mortality was high (20%), with sudden cardiac arrest being the most common cause of death. The average duration of stay in the ICU was long (27 days). As Jamaica is a Third World country with limited resources, the continued occurrence of this preventable disease represents a drain on existing intensive care funds. This must be brought to the attention of institutions responsible for planning health care programmes for developing countries.

Adolescent↗

PubMed1994

Nasal non-invasive positive pressure ventilation. A new method of ventilatory support for patients with chronic respiratory failure.

This case report is presented to illustrate the advantages of Nasal Non-invasive Positive Pressure Ventilation (NNIPPV). It is relatively simple, practical, easy to use, and has been proven to be an efficient means of treatment for patients with chronic respiratory failure (CRF), especially hypercapnic respiratory failure. The availability of NNIPPV has increased in recent years and has made the concept of domiciliary ventilatory support a practical reality. It has resulted in decreased frequency and duration of hospital admission and hence minimised certain demands on the health service. The use of NNIPPV should be encouraged in developing countries where a shortage of health personnel (especially nurses) and limited health care budgets exist.

Aged↗

PubMed1994