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Simple Intervention (simple + intervention)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Ageing to arrhythmias: conundrums of connections in the ageing heart

JOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 12 2006
Sandra A. Jones
The proportion of the population that is elderly continues to increase, leading to an increasing need to address problems chiefly associated with old age. Progressive ageing of the heart is associated with an increasing incidence of arrhythmias and disorders of the normal origin of the heartbeat, the sinoatrial node. This intrinsic pacemaker of the heart has an increasing tendency with age to lose its dominant role in pacing the heart, and regulation of heart rate becomes erratic. This ,sick sinus syndrome' is associated with fainting, palpitations, shortness of breath and sudden death. Current treatment of this condition is by implantation of an artificial pacemaker, an intervention increasingly required with age. The current evidence suggests that the normal heartbeat fails due to changes in the expression of critical proteins that ensure the correct production and conduction of the cardiac action potential. Depletion of a protein directly responsible for providing electrical connections between the cells of the heart, connexin 43, appears to leave the normal cardiac pacemaker disconnected and unable to drive the heart. This process may be associated with age-dependent changes in stress-related signalling. Simple interventions such as exercise could impact on the processes hypothesized to be involved and may offer a means to preserve the stability of the electrical activity of the heart into old age without pharmacological manipulation. [source]

Using Distraction to Reduce Reported Pain, Fear, and Behavioral Distress in Children and Adolescents: A Multisite Study

JOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 2 2000
Karen L. Carlson
ISSUES AND PURPOSE. Distraction during painful procedures has been shown to be effective in previous studies, yet this simple intervention is not used routinely. This study examined the effectiveness and feasibility of distraction in reducing behavioral distress, pain, and fear during venipuncture or intravenous insertion. DESIGN AND METHODS. A two-group randomized design with 384 children in 13 children's hospitals. RESULTS. Age was a significant factor in observed behavioral distress, reports of fear, and self-reported pain. The use of a kaleidoscope, however, did not significantly reduce pain or distress during venipuncture or IV insertion. PRACTICE IMPLICATIONS. Failure of the distraction intervention to reach statistical significance in this study is puzzling, given anecdotal reports of clinical efficacy. Methodological issues may have obscured actual differences between experimental and control groups. [source]

A simple intervention to reduce the complication of prolonged percutaneous tracheostomy

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2009
A. Azim
No abstract is available for this article. [source]

Stress-inducing factors in ICUs: What liver transplant recipients experience and what caregivers perceive

LIVER TRANSPLANTATION, Issue 8 2005
Gianni Biancofiore
The aim of this study was to compare a number of potentially stress-generating factors related to an intensive care unit (ICU) stay from the points of view of patients undergoing liver transplantation or elective major abdominal surgery and their caregivers in order to identify differences and similarities that may help to optimize patient care. The ICU Environmental Stressor Scale questionnaire was administered to 104 liver transplant recipients, 103 major abdominal surgery patients, 35 nurses and 21 physicians. The ICU staff were asked to complete the questionnaire on the basis of their perception of patient stressors. Both patient groups identified Being unable to sleep, Being in pain, Having tubes in nose/mouth, Missing husband/wife, and Seeing family and friends only a few minutes a day as the major stressors; the healthcare providers correctly identified the most stressing factors for the patients, but gave them higher scores. The mean scores were 71.9 ± 18.7 for the transplant recipients, 66.3 ± 20.9 for the patients undergoing elective major abdominal surgery, 99.7 ± 19.2 for the nurses, and 92.7 ± 16.1 for the physicians (P < 0.001). The qualitative evaluations of potentially stress-inducing ICU situations were substantially the same in the 2 patient groups, but the transplant recipients seemed to feel them more acutely. Although the caregivers identified the most discomforting situations, they overestimated the degree of stress they cause. The staff of each ICU should therefore seek to understand and reduce (even by means of simple interventions) the particular causes of psychophysical stress felt by their patients. (Liver Transpl 2005;11:967,972.) [source]

Brain edema in liver failure: Basic physiologic principles and management

LIVER TRANSPLANTATION, Issue 11 2002
Fin Stolze Larsen MD
In patients with severe liver failure, brain edema is a frequent and serious complication that may result in high intracranial pressure and brain damage. This short article focuses on basic physiologic principles that determine water flux across the blood-brain barrier. Using the Starling equation, it is evident that both the osmotic and hydrostatic pressure gradients are imbalanced across the blood-brain barrier in patients with acute liver failure. This combination will tend to favor cerebral capillary water influx to the brain. In contrast, the disequilibration of the Starling forces seems to be less pronounced in patients with cirrhosis because the regulation of cerebral blood flow is preserved and the arterial ammonia concentration is lower compared with that of patients with acute liver failure. Treatments that are known to reverse high intracranial pressure tend to decrease the osmotic pressure gradients across the blood-brain barrier. Recent studies indicate that interventions that restrict cerebral blood flow, such as hyperventilation, hypothermia, and indomethacin, are also efficient in preventing edema and high intracranial pressure, probably by decreasing the transcapillary hydrostatic pressure gradient. In our opinion, it is important to recall that rational fluid therapy, adequate ventilation, and temperature control are of direct importance to controlling cerebral capillary water flux in patients with acute liver failure. These simple interventions should be secured before more advanced experimental technologies are instituted to treat these patients. [source]