Biomedical subjects

A Driscoll

Publications and source records attributed to A Driscoll.

8 recordsLinked to original sources

PubMed2001

How do patients with interstitial cystitis present?

PURPOSE: We determined how interstitial cystitis progresses from initial symptoms to diagnosis. MATERIALS AND METHODS: We retrospectively analyzed the records of 45 patients to determine the dates of symptom onset and diagnosis, and sequence of urgency/frequency, nocturia and pain. We also documented alternate and previous diagnoses, and previous surgical treatments. RESULTS: Of the patients 89% presented with only 1 symptom. Median time from the initial symptom to all symptoms was 2 years (mean 5.5). The most common previous diagnoses were urinary infection in 19 cases, a gynecologic diagnosis in 14 and urethral diagnoses in 6. A previous urinary infection was documented in only 1 of 19 patients, while 11 had undergone hysterectomy and 5 diagnosed with endometriosis had no pathological documentation available. CONCLUSIONS: Early interstitial cystitis presents variably and usually with only a single symptom of urgency/frequency, nocturia or pain. Clinicians may fail to appreciate the symptoms of early interstitial cystitis, which leads to delayed diagnosis until the patient is more symptomatic. With time multiple symptoms manifest. Bacterial cystitis, prostatitis, endometriosis and chronic pelvic pain are common initial misdiagnoses. Interstitial cystitis should be considered when laboratory documentation of alternate diagnoses is lacking or when patients fail to respond to therapy for alternate diagnoses.

Adolescent↗

PubMed2000

Managing post-discharge care at home: an analysis of patients' and their carers' perceptions of information received during their stay in hospital.

This small-scale study carried out in a Melbourne metropolitan hospital explored patients' and their carers' perceptions of information, adequacy of information, and their utilization of information concerning post-discharge care received from health professionals during their stay in hospital. The research design consisted of two stages. Stage one involved a qualitative approach using focused interviews of five pairs of patients and their carers, 2 weeks after discharge from hospital. Five main themes emerged from the content analysis of the interview transcripts: information given by health professionals to patients and carers, patients' and carers' psychological well-being, activities of daily living, caring tasks of the patients, and community linkages. A quantitative approach was used for stage two involving two sets of questionnaires, one for the patient and one for the carer, developed from the themes identified in stage one. A pilot study was conducted on three pairs of patients and their carers, 2 weeks after discharge from hospital. The main study consisted of a convenience sample of 40 pairs of patients and their carers who completed the questionnaires 2 weeks post-discharge. Data analysis of stage two of the study consisted of descriptive statistics and cross-tabulations. The main findings suggested that carers received very little information from health professionals concerning their patients' health problems and care at home. The carers' health and employment states were often not considered in their patients' discharge plan. Carers who were present with their patients when they received information concerning post-discharge care experienced a decrease in anxiety during their patients' convalescence at home, greater satisfaction with the information they received, and their patients experienced fewer medical problems post-discharge. The implications for nursing practice and research include recommendations for a more effective system of discharge planning, and further research to include a larger population with a more varied group of participants.

Adult↗

PubMed1997

The Dietary Variety Score: assessing diet quality in healthy young and older adults.

OBJECTIVE: To develop a new dietary variety score (DVS) and link it to other measures of diet quality, including a modified diet quality index (DQI). SUBJECTS: The subjects were 24 healthy young (ages 20 to 30 years) and 24 healthy older (ages 60 to 75 years) adults, including 24 men and 24 women. Their dietary intake assessments were based on one 24-hour food recall interview and 14 consecutive days of food records. DESIGN AND MEASURES: Energy and nutrient intakes were estimated using Nutritionist IV software. DVS was based on the cumulative number of different foods consumed over the 15-day period. DQI was a 5-point scale based on conformity with the key US dietary recommendations. Full score was awarded for diets deriving 30% or less of energy from fat, 10% or less of energy from saturated fat, more than 50% of energy from carbohydrate, and containing less than 300 mg cholesterol and 2,400 mg sodium per day. Analytic measures included analyses of variance, correlation analyses, and chi 2 tests. RESULTS: Older subjects consumed more varied diets than did young subjects. Higher DVS values were linked positively to vitamin C intakes and negatively to the consumption of salt, sugar, and saturated fat. However, a high DVS was not linked to a high score on the DQI in this subject sample. DISCUSSION/CONCLUSIONS: Few studies have addressed the issue of how many different foods constitute a varied diet. The present classification scheme offers a new way of assessing dietary variety at the individual or group level. Measures of dietary variety may represent an additional facet of diet quality and their relationship to selected health outcomes should be examined further.

Adult↗

PubMed1996

Salt taste perceptions and preferences are unrelated to sodium consumption in healthy older adults.

OBJECTIVE: Age-related deficits in salt taste perception are said to increase preferences for salty foods, thereby leading potentially to greater sodium consumption. This study examined the link between salt taste perceptions and preferences and sodium intakes as a function of age and gender. DESIGN: We studied 24 young adults (aged 20 to 30 years) and 24 healthy older adults (aged 60 to 75 years). The subjects tasted and rated five sodium chloride solutions and eight samples of salted chicken broth containing from 0.04 to 0.64 mol/L sodium. Food intakes were assessed using a 24-hour food recall and 14 consecutive days of diet records. RESULTS: Older and younger subjects did not differ in their sensory evaluations of chicken broth, including ratings of the intensity of saltiness. Older subjects preferred less salty soups than did young adults. Hedonic response profiles for salt in soup were not related to daily sodium intakes as assessed by diet records. APPLICATIONS: Salt taste perceptions and preferences were unrelated to sodium intakes in young adults and in older respondents. Factors other than taste may influence dietary sodium consumption.

Adult↗

PubMed1993

Neuroleptic prescriptions for acutely ill geriatric patients.

BACKGROUND: Use of neuroleptic medication by the general population of acute care hospitals and in geriatric populations in long-term care has been described. This study examines the use of neuroleptics in acutely ill medical/surgical geriatric patients. METHODS: Chart review was performed for geriatric patients prescribed a neuroleptic drug during a 2-month study period. Patient characteristics, indications for drug use, and evaluations of cognitive or behavioral dysfunction were noted. For the patients who received only haloperidol, the type of order was described and prescription strategies were identified. RESULTS: Ninety-one (10.7%) of 848 patients received a neuroleptic order. They were older and stayed longer than the rest of the geriatric population. Fifty-eight percent were demented or delirious but 31.9% were simply described as agitated or had no reason identified for drug use. Haloperidol was the sole neuroleptic prescribed for 91.2% of patients. The rationale behind the strategies for drug prescription (loading, maintenance, sporadic) was not clear. CONCLUSION: This study raises concerns about the quality of documentation around drug use and the adequacy of diagnostic evaluation prior to drug prescription. The strategies of drug treatment do not consistently reflect a working knowledge of the pharmacology of the drug or a diagnosis-based plan of treatment. Future research should focus on physician education and the efficacy of diagnosis and management of the agitated elder.

Acute Disease↗

PubMed1982

l-Tyrosine as an immunological adjuvant.

A series of experiments has been carried out to investigate the adjuvant properties of the amino acid L-tyrosine in laboratory animals. Adsorption of various allergenic materials to L-tyrosine was found to enhance the induction of IgG antibodies, but no unusual propensity to stimulate IgE antibody or delayed hypersensitivity was observed. Administration of the amino acid at a site remote from the allergen was found not to augment antibody production. This, together with evidence of reduced bioavailability of the tyrosine-adsorbed allergen, suggested that the adjuvant activity observed resulted from a short-term depot effect.

Adjuvants, Immunologic↗

PubMedDate not supplied

The effect of patient position on the reproducibility of cardiac output measurements.

OBJECTIVE: To determine the effect of patient position on the reproducibility of cardiac output measurements. DESIGN: Prospective, two-group quasi-experimental design. Convenience sample. SETTING: The study involved two intensive care units in two adult acute care hospitals. PATIENTS: Thirty patients admitted to the intensive care unit who had a thermodilution pulmonary artery catheter in place. Ages ranged from 39 to 80 years (mean of 66.4 +/- 11.3 years). OUTCOME MEASURES: Thermodilution cardiac output measurements. INTERVENTION: The subjects were placed in one of two groups, initially by flipping a coin then into alternate groups. Group A subjects were placed supine, and after 5 minutes had cardiac output measurements performed. They were then placed in the 45-degree upright position, and after an additional 5 minutes had cardiac output measurements performed. Group B subjects were first placed in the 45-degree upright position, and after 5 minutes had cardiac output measurements performed. They were then placed in the supine flat position, and after an additional 5 minutes had cardiac output measurements performed. RESULTS: Seventy percent (n = 30) of the sample population displayed a lower cardiac output in the 45-degree upright position than that obtained in the supine position, with the decrease ranging from 1% to 32% (mean decrease 11%). Forty percent (n = 30) of cardiac output measurements obtained in the 45-degree upright were greater than or equal to 10% less than those obtained in the supine flat position. The differences in cardiac output were analyzed with the paired t test. which produced a 95% confidence interval from -0.539 to -0.083. The two-group Wilcoxon test was used to analyze the mean cardiac output with the patient in the supine, flat position and in the 45-degree upright position. The mean cardiac output at 0 degrees was found to be statistically significant higher (p = 0.0083) than the mean cardiac output at 45 degrees. The effect of coexisting variables was analyzed with the Kruskal-Wallis. The use of vasoconstrictors was the only variable that had a statistically significant change in cardiac output associated with a change in position. CONCLUSIONS: These results indicate that cardiac output measurements are affected by alterations in patient position. To ensure accurate comparisons between consecutive cardiac output measurements, the researchers recommend that the position in which the cardiac output measurements are performed be documented and the cardiac output measurements be conducted in a uniform position.

Adult↗

PubMedDate not supplied

Young women's degree of control over first intercourse: an exploratory analysis.

CONTEXT: While policymakers and researchers alike often seem to believe that young women's decision to initiate sexual intercourse is conscious and free of ambiguity, the actual degree of control that such young women exert over first intercourse has rarely been explicitly examined. METHODS: The 1995 National Survey of Family Growth asked all women who had experienced intercourse to rate, on a 1-10 scale, the wantedness of their first intercourse; they were then asked whether the experience was voluntary. Logistic regression analysis of data for women aged 15-24 who had experienced first premarital intercourse was performed to test the effect of background factors and wantedness scores on contraceptive use at voluntary first intercourse. RESULTS: Twenty-four percent of women aged 13 or younger at the time of their first premarital intercourse report the experience to have been nonvoluntary, compared with 10% of those aged 19-24 at first premarital intercourse. About one-quarter of respondents who reported their first intercourse as voluntary chose a low value (1-4) on the wantedness scale. Women whose first partner was seven or more years older than themselves were more than twice as likely as those whose first partner was the same age or younger to choose a low value (36% vs. 17%). Women whose partner had been seven or more years older were also less likely than other women to have used contraceptives at first intercourse. After the introduction of controls for demographic and background factors, partner age discrepancy and relationship status, wantedness of voluntary first intercourse was not independently related to the odds of contraceptive use at that intercourse. CONCLUSION: Characterizing women's first intercourse as simply voluntary or nonvoluntary is inadequate. Measures that take into account degrees of wantedness may help elucidate relationships between sexual initiation, contraceptive use and teenage pregnancy. The fact that substantial numbers of young women voluntarily participated in a first sexual experience about which they felt ambivalent or negative deserves the attention of program planners and service providers.

Adolescent↗