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Biomedical subjects

A Timoney

Publications and source records attributed to A Timoney.

9 recordsLinked to original sources
PubMed2004

Cost analysis of flexible ureterorenoscopy.

OBJECTIVE: To assess the costs of flexible ureterorenoscopy. MATERIALS AND METHODS: Data were collected prospectively for 100 cases using a new flexible ureteroscope (DUR8, Circon ACMI, Stamford, USA), including the indications for flexible ureterorenoscopy, use of laser probes, disposable instrumentation, and the cost and timing of ureteroscope repair. RESULTS: Of the 100 procedures 68 were for stone disease, 21 for known or suspected transitional cell carcinoma (TCC), six were diagnostic only and five were for pelvi-ureteric junction obstruction. The ureteroscope was repaired after the 29th and 88th cases. The ability of the ureteroscope to deflect was maintained throughout. At the time of purchase the ureteroscope was listed at pound 15 000 and each repair/exchange currently costs pound 4200, thus the total expenditure on the ureteroscope was pound 23 400. Total expenditure on ancillary equipment was pound 28 727, of which pound 22 927 was on disposables and pound 5800 on 10 laser probes. CONCLUSION: In this series the costs of the ancillary equipment exceeded the purchase and maintenance of the ureteroscope, and we expect this trend to continue in the long term. The advent of more durable ureteroscopes may ultimately reduce the frequency of costly repairs. The cost of disposables should be considered in planning the budget.

Carcinoma, Transitional Cell↗
PubMed2002

Indicators of deprivation, voting patterns, and health status at area level in the Republic of Ireland.

STUDY OBJECTIVE: To determine what relation, if any, exists between mortality patterns, indicators of deprivation, general lifestyle and social attitudes, as exemplified by general election voting pattern, in the Republic of Ireland. A relation has been demonstrated previously between voting and mortality patterns in the United Kingdom. DESIGN: Cross sectional ecological study using three data sources. Standardised mortality ratios (SMR) were based on mortality rates at county level and 1996 census data from the Central Statistics Office, 1997 general election first preference voting data in all 41 constituencies were aggregated to county level. Selected reported measures of health status, lifestyle and social circumstances are from the first ever National survey on lifestyles, attitudes and nutrition (SLAN). This study comprised adults over 18 years sampled by post using the electoral register from 273 representative district electoral divisions. Univariate inter-relations were examined at individual level for the dataset as a whole, adjusting for age and at aggregated level for 26 county borough areas, which included the two largest cities and for 22 county areas, which afforded correlation with voting pattern, using the method of Pearson's correlation coefficient. PARTICIPANTS: 1,806,932 votes were cast nationally at the 1997 general election, representing a voter turnout of 65.92 %. There was an overall response rate of 62% to SLAN comprising 6539 adults (47% male). The demographic pattern of survey respondents was consistent with that of the general population over 18 years. MAIN RESULTS: At individual level there was a large number of highly significant inter-relations between indicators of deprivation, various measures of self rated health status and lifestyle factors. Aggregated at 26 county level percentage unemployed (r=0.408, p=0.038), and level of education (r=0.475, p=0.014) related significantly to SMR and inversely to both fruit and vegetable consumption (r= -0.672, p=0.001) and excess alcohol consumption among men (r= -595, p=0.003). Those rating their health as fair or poor were more likely to report a poor quality of life (r=0.487, p=0.022), to have none or primary school education only (r=0.428, p=0.047), or to have a means tested medical services card (r=0.428, p=0.047). There was no significant relation between SMR and voting pattern for the two main political parties (67.28% first preferences) but a significant relation with left wing voting (r=0.446, p=0.037). Fianna Fail voting pattern was inversely related to level of dissatisfaction with health (r= -0.59, p<0.05). There was a positive significant relation between left wing voting and dissatisfaction with health (r=0.51, p<0.02) and rate of smoking (r=0.47, p=0.03). Smoking pattern also related positively to rates of voter abstention (r=0.526, p=0.12). CONCLUSIONS: These data are consistent with those in other countries in showing a relation between deprivation indicators and lifestyle, but differ in that no relation with SMR and the votes cast for the main parties was seen in a country with a mainly centre right voting pattern. The relation between left wing voting pattern and some indicators of deprivation and lifestyle suggest that party political voting patterns and affiliations could be a useful indicator of vertical social capital. However, its variability as a measure across countries suggests that the inter-relation between sociocultural and economic factors and the consequent influence on health status is not straightforward.

Adolescent↗
PubMed2000

Transurethral water-induced thermotherapy for the treatment of benign prostatic hyperplasia: a prospective multicenter clinical trial.

PURPOSE: We evaluate the effectiveness and safety of transurethral water-induced thermotherapy for the treatment of lower urinary tract symptoms of benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A total of 125 patients with lower urinary tract symptoms due to BPH were enrolled at 8 study centers. Pretreatment evaluation included determination of International Prostate Symptom Score (I-PSS), peak urinary flow rate and quality of life score. Patients also completed a sexual function questionnaire. Patients were evaluated 3, 6 and 12 months after water-induced thermotherapy. RESULTS: Significant improvements in I-PSS, peak urinary flow rate and quality of life score were observed as early as 3 months after water-induced thermotherapy. At 12 months I-PSS had improved by a median of 12.5 (95% confidence interval 11.5 to 13.5) versus baseline, peak urinary flow rate by 6.4 ml. per second (5.6 to 7.5) and quality of life score by 2.5 (2.0 to 2.5). I-PSS, peak urinary flow rate and quality of life score improved by 50% or more at 12 months in 61.5%, 71.3% and 71.6% of patients, respectively. No adverse impact of water-induced thermotherapy on sexual function was noted, and preexisting discomfort during ejaculation and interference in sexual function due to lower urinary tract symptoms were significantly ameliorated after treatment. Serious adverse events were infrequent and manageable. CONCLUSIONS: Water-induced thermotherapy significantly alleviates lower urinary tract symptoms of BPH, increases peak urinary flow rate and enhances patient quality of life. This novel catheter based, minimally invasive treatment is easily administered in the outpatient setting. Water-induced thermotherapy holds promise as a useful and cost-effective option for the clinical management of BPH.

Aged↗
PubMed1997

Do general practitioners and community pharmacists want information on the reasons for drug therapy changes implemented by secondary care?

BACKGROUND: The content of discharge prescriptions/summaries to improve communication about medication provided at discharge has been the subject of recent studies. To date, the authors are not aware of any literature that assesses the need for primary care health professionals to receive information on reasons for drug therapy changes incurred during hospital admission. Owing to increased emphasis on seamless care, patient education, and increased accountability for drug costs, general practitioners (GPs) and community pharmacists may consider the receipt of information on the reasons for drug therapy changes incurred during hospital admission to be an essential requirement. AIM: To determine whether GPs and community pharmacists want, and receive, information on the reasons for drug therapy changes implemented by secondary care. The preferred method of acquiring this information is also investigated. METHOD: A questionnaire was posted to all GPs and community pharmacists within the catchment area of Glasgow Royal Infirmary University NHS Trust. Data were collected between June 1995 and July 1995. RESULTS: Replies were received from 71 (64%) GPs and 33 (80%) community pharmacists. Of the respondents, 96% of GPs and 94% of community pharmacists would like information on one or more reason types for drug therapy changes, but the majority do not receive the desired information. Ninety per cent of GPs and 85% of community pharmacists seek this information of facilitate continuity of patient care. The preferred method of receiving the information is by postal delivery via a modified hospital discharge prescription. CONCLUSION: The existing hospital discharge prescription requires modification to facilitate the completion of the reasons for drug therapy changes. The issue of patient-held cards requires consideration. These factors may facilitate continuity of patient care on hospital discharge.

Attitude of Health Personnel↗
PubMedDate not supplied

The development and application of a new surgical device--the Endoscopic Liquidiser and Surgical Aspirator (ELSA).

Modern surgery is looking for ways to carry out procedures which limit unnecessary damage to the patient. This means, in practice, using smaller incisions and special tools. An instrument for removing tissue through a small cross-section has been developed. It is suitable for both endoscopy and laparoscopy. The instrument and its development is described, and its performance evaluated in vitro and for a range of clinical procedures. Experiments aimed at uncovering the mechanism of cutting are discussed as to their relevance for practical instrument development.

Aged↗