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3 results on '"S. P. Clifford"'

1. Hemodynamic changes associated with neuraxial anesthesia in pregnant women with covid 19 disease: a retrospective case-control study

Author

D. Sangroula, B. Maggard, A. Abdelhaleem, S. Furmanek, V. Clemons, B. Marsili, R. Stikes, M. Hill, A. Sigdel, S. P. Clifford, J. Huang, O. Akca, and M. C. Logsdon

Subjects
COVID-19, Parturient, Neuraxial Anesthesia, Hemodynamic, Anesthesiology, RD78.3-87.3
Abstract

Abstract Background Neuraxial blocks is the recommended mode of analgesia and anesthesia in parturients with Coronavirus 19 (COVID-19). There is limited data on the hemodynamic responses to neuraxial blocks in COVID-19 patients. We aim to compare the hemodynamic responses to neuraxial blocks in COVID-19 positive and propensity-matched COVID-19 negative parturients. Methods We conducted retrospective, cross-sectional case–control study of hemodynamic changes associated with neuraxial blocks in COVID-19 positive parturients in a Tertiary care academic medical center. Fifty-one COVID-19 positive women confirmed by nasopharyngeal reverse transcription–polymerase chain reaction (RT-PCR), were compared with propensity-matched COVID negative controls (n = 51). Hemodynamic changes after neuraxial block were recorded by electronic medical recording system and analyzed using paired and unpaired T- test and Wilcoxon-Mann–Whitney Rank Sum tests. The primary outcome was ≥ 20% change in MAP and HR after neuraxial block placement. Results In the epidural group, 7% COVID-19 positive parturients had > 20% decrease in mean arterial pressure (MAP) from baseline compared to 15% COVID-19 negative parturients (P = 0.66). In the spinal group, 83% of COVID-19 positive parturients had a decrease in MAP more than 20% from baseline compared to 71% in control (P = 0.49). MAP drop of more than 40% occurred in 29% COVID positive parturients in the spinal group versus 17% in COVID-19 negative parturients (P = 0.5465). In COVID-19 positive spinal group, 54% required vasopressors whereas 38% in COVID-19 negative spinal group required vasopressors (P = 0.387). We found a significant correlation between body mass index (BMI) > 30 and hypotension in COVID ( +) parturient with odds ratio (8.63; 95% CI-1.93 – 37.21) (P = 0.007). Conclusion Incidence and severity of hypotension after neuraxial blocks were similar between COVID-19 positive and COVID-19 negative parturients. BMI > 30 was a significant risk factor for hypotension as described in preexisting literature, this correlation was seen in COVID-19 positive parturients. The likely reason for parturients with BMI > 30 in COVID negative patients not showing similar correlation, is that the sample size was small.

Published
2022
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2. Hand hygiene behaviours monitored by an electronic system in the intensive care unit – a prospective observational study

Author

Q, Xu, Y, Liu, D, Cepulis, A, Jerde, R A, Sheppard, W, Reichle, L, Scott, L, Oppy, G, Stevenson, S, Bishop, S P, Clifford, P, Liu, M, Kong, and J, Huang

Subjects
Microbiology (medical), Cross Infection, Infection Control, Intensive Care Units, Infectious Diseases, Health Personnel, Humans, Hand Hygiene, Guideline Adherence, General Medicine, Electronics, Article
Abstract

BACKGROUND: It is difficult to improve compliance with hand hygiene (HH), and underlying behaviours are not clearly understood among healthcare workers. AIM: To study HH behaviours among healthcare workers. METHODS: This was a prospective observational study. A Sanibit electronic HH system was installed in a 10-bed surgical intensive care unit (ICU) that detected HH opportunities automatically when healthcare workers entered or exited a patient room, and tracked the HH compliance of healthcare workers. The HH compliance rate and patient contact time were calculated and analysed at both ICU level and individual level over time. FINDINGS: In total, 27,692 HH opportunities were recorded over this 6-month trial period. The HH compliance rate was significantly higher when healthcare workers exited patient rooms than when they entered patient rooms (37.3% vs 26.1%; P30 s) events (23.45% vs 32.77%, 21.44% vs 35.03% and 44.88% vs 67.81%, respectively; P

Published
2022

3. Additions to the Flora of the Cayman Islands

Author

Gerald F. Guala, F. J. Burton, G. R. Proctor, and S. P. Clifford

Subjects
Flora, biology, Ecology, Pennisetum setaceum, Biodiversity, Tripsacum floridanum, Plant Science, Hydrocotyle umbellata, biology.organism_classification, Geography, Botany, Tripsacum dactyloides, Cayman Islands, Melaleuca quinquenervia, Ecology, Evolution, Behavior and Systematics
Abstract

Summary. Recent biodiversity surveys in the Cayman Islands have generated several new records for the reasonably be attributed to recent introduction. Exotics not clearly spreading, but known to be weedy elsewhere, were often seen in planted lawns and in landscape situations. Notable among these were Hydrocotyle umbellata L. and Polypremum procumbens L. found apparently as accidental introductions in recent landscaping at the Queen Elizabeth II Botanic Park and several large fruiting specimens of Melaleuca quinquenervia (Cav.) S. T. Blake in a landscape planting on Cayman Brac. Also, several grasses previously unknown in the Cayman Islands were observed in cultivation in Georgetown and environs. The species observed included Cymbopogon citratus (DC.) Stapf, Pennisetum setaceum (Forssk.) Chiov., Pennisetum macrostachyum (Brogn.) Trin., Phyllostachys sp., Pogonatherum paniceum (Lam.) Hack., Tripsacum floridanum Porter ex Vasey, and Tripsacum dactyloides (L.) L. The flora of the Cayman Islands is dynamic and work continues on cataloguing and conserving the biodiversity of the islands. There will certainly be more species found (e.g. an as yet undetermined Drypetes found recently in the Mastic area) and some will certainly disappear. We will continue to report on the developments. Photographs of most (and eventually all) collections at CAYM and FTG can be seen

Published
2002

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