1,802 research outputs found
Hemodynamic consequences of chronic parasympathetic blockade with a peripheral muscarinic antagonist
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Alors que le système nerveux sympathique a un rôle bien établi dans la régulation de la pression artérielle, l'influence de la fonction ou dysfonction du système parasympathique sur la pression artérielle n'est pas évidente, en particulier à long terme. Nous avons testé l'hypothèse que l'inhibition chronique du système parasympathique a un effet persistant sur la pression artérielle (PA), la fréquence cardiaque (FC) et la variabilité de la pression artérielle (VPA). Des rats de type Sprague Dawley ont été instrumentés pour monitoring de la pression artérielle 22h par jour par télémétrie et abrités dans des cages métaboliques. Après guérison de l'intervention et après une période contrôle de référence, de la scopolamine methyl bromide (SMB), un antagoniste muscarinique périphérique, a été perfusé i.v. pendant 12 jours. Le tout fut suivi d'une période de récupération de 10 jours. La SMB a entraîné une augmentation rapide de la PA de 98±2 mmHg à un maximum de 108±2 mmHg le deuxième jour de perfusion de la SMB puis la PA s'est stabilisée à une valeur plateau de +3±1 mmHg au dessus de la valeur contrôle (P < 0.05). Après l'arrêt de la perfusion de SMB, la PA moyenne a diminué de 6±1 mmHg. La FC a augmenté immédiatement et est restée significativement au dessus de la valeur contrôle le dernier jour de 1a perfusion de SMB. La SMB a également induit une diminution de la variabilité à court terme de la FC (au sein d'intervalles de 30 minutes et une augmentation de la variabilité à court terme et à long terme (entre intervalles de 30 minutes) de la PA. Ces données suggèrent que l'inhibition muscarinique périphérique chronique conduit à une augmentation modeste mais persistante de la PA, FC et VPA, qui sont des facteurs de risque cardiovasculaires connus
The Impact of a Nursing Case Management Model on Quality of Care as Defined by Length of Stay, Health Outcomes, and Patient Satisfaction
Get PDFThe purpose of this research was to investigate the impact of a nursing case management model versus a traditional modified primary care model on quality of care. Quality of care in this study was defined (by the provider) as length of stay, (by the client) as patient satisfaction and (by the professional) as meeting outcomes of appropriate clinical standards of care.
The study used a quasi-experimental design on the experimental (case managed) and control (modified primary care) groups. A non-random sample was selected for the patient population due to existing hospital protocol. The sample consisted of 100 patients (641 total patient days) who had elective orthopedic surgery and were hospitalized in an acute care setting.
The objectives of this study were met by collection of demographic data, length of stay data, and related complications information. This information plus outcome measurement data was collected on an Outcomes Measurement form. Patient satisfaction data was obtained by telephone survey using the structured format of the Press Ganey Patient Satisfaction Survey.
Data was analyzed with descriptive and inferential statistics. Frequencies were run on the data, as well as a two-tailed t-test for independent samples at the .05 level of significance.
In the case managed group, a significant reduction in the mean length of stay over the Diagnosis Related Group (DRG) length of stay was realized (p \u3c .05). There was not a significant difference in the control group of patients receiving modified primary care. There was not a statistically significant difference between the groups in the patients\u27 perception of satisfaction. There were significant differences in health outcome being met in the case managed group.
This study found that case managed patients undergoing an elective orthopedic surgical procedure in an acute care setting had a higher level of outcomes met with a reduced length of stay than non-case managed patients. Several implications for nursing, health care services and the health care reform are suggested from this study
Dens Evaginatus: A Problem-Based Approach
Get PDFDens evaginatus is an uncommon developmental anomaly of human dentition characterized by the presence of tubercle on the occlusal surface of mandibular premolars and lingual surface of anterior teeth. Due to occlusal trauma this tubercle tends to fracture thus exposing the pathway to the pulp chamber of teeth. This case report is about the presentation of dens evaginatus in mandibular premolars bilaterally; among them tooth 44 was associated with chronic apical periodontitis. Fractured tubercle of three premolars was sealed with composite resin. Root canal treatment was performed with tooth 44. Routine endodontic treatment did not result in remission of infection. Therefore, culture and sensitivity tests were performed to identify the cause and modify treatment plan accordingly. Triple antibiotic paste was used as an intracanal medicament to disinfect the root canal that resulted in remission of infection
Moving day in Jungle Town /
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