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Biomedical subjects

C Byrne

Publications and source records attributed to C Byrne.

At least 19 recordsLinked to original sources
PubMed1992

Is angiographic ventriculography necessary for the assessment of ischemic patients?

A total of 53 patients with a provisional diagnosis of ischemic heart disease and without any clinical evidence of valvular, congenital, or primary muscle heart disease were studied by echocardiography and biplane left ventricular cineangiography. For angiographic ejection fraction analysis, a program developed in our department for use on an Apple Macintosh computer interfaced to a digitizing tablet was employed. Echocardiographic outlines of systolic and diastolic images were traced with a digitizing system on the screen and ejection fractions were calculated by a program incorporated in the echo machine. Good echo windows allowing ejection fraction calculations were present in 35 patients. There was a good correlation between angiographic and echocardiographic ejection fraction (r = 0.7, SEE = 0.09), and wall motion assessment revealed no significant discrepancies between the two image modalities. The remaining 18 patients had poor echo windows, preventing accurate echocardiographic determination of the ejection fraction. However, limited assessment of left ventricular size and wall motion was possible in all patients and allowed the identification of those who had impaired left ventricular function as judged by angiography (angiographic ejection fraction < 35%). We conclude that even in patients with poor echo windows echocardiographic assessment of left ventricular function provides clinical information similar to angiography which should not be considered mandatory for the investigation of ordinary ischemic patients.

Cardiac Catheterization↗
PubMed1992

Outcome, prognosis, and risk in a longitudinal follow-up study.

This study reports the results of a 4-year follow-up of a community sample of children who were ages 4 to 12 in 1983 at the first wave of data collection. Results on outcomes revealed that conduct disorder showed the greatest stability especially from late childhood to early adolescence. In multivariate analyses, both family dysfunction and problems getting along with others significantly predicted the persistence of one or more psychiatric disorders 4 years later, and low income predicted one or more psychiatric disorders among children free of disorder 4 years earlier. The implications of the results for the child psychiatric field, especially prevention, are discussed.

Adolescent↗
PubMed1992

Journal keeping as an educational strategy in teaching psychiatric nursing.

Personal attitudes and self-awareness are key issues of which the psychiatric nursing student must be aware when establishing a therapeutic relationship. Facilitating awareness and growth in these areas are fundamental challenges for the nurse educator. One potential teaching strategy with which to address this issue is journal keeping. This paper describes a study evaluating the impact of journal keeping on student nurses' attitudes toward psychiatric clients and self-awareness in relations with others. Third-year nursing students completing a psychiatric rotation kept journals which were used to reflect on thoughts and feelings engendered by their clinical experience. Two student control groups were used: one completing a psychiatric rotation without keeping journals and the second completing a medical-surgical rotation. All students completed the Opinions About Mental Illness, the Fundamental Interpersonal Relations Orientation-Behaviour, and Comfort in Working with Psychiatric Clients Scales prior to and at the end of their clinical experience. Findings support the use of journals to assist students in exploring and changing their attitudes but not necessarily in changing their interpersonal style.

Adult↗
PubMed1992

Hypertrophic cardiomyopathy in systemic lupus erythematosus and "lupus-like" disease. Chance association? A report of 2 cases.

Two patients, both women, one with "lupus-like" disease, age 51 years, the other a 45-year-old with systemic lupus erythematosus (SLE), developed symptoms and echocardiographic signs of hypertrophic cardiomyopathy. One patient had a family history of sudden maternal death. Neither patient had a history of sustained hypertension and there were no significant valvular lesions detectable to account for the septal and ventricular hypertrophy. The association of SLE or any related condition with hypertrophic cardiomyopathy has not been recorded. In one patient the question of a hereditary cardiomyopathy remains a possibility. The diagnosis of the condition was based on clinical and echocardiographic grounds alone. No endomyocardial biopsies were performed.

Cardiomyopathy, Hypertrophic↗
PubMed1991

Transcription factor AP2 and its role in epidermal-specific gene expression.

The epidermis is a stratified squamous epithelium whose major differentiation-specific products are keratins. To elucidate factors controlling keratinocyte-specific gene expression, we previously identified proximal and distal regulatory elements that act synergistically to drive keratinocyte-specific expression of the gene encoding human epidermal keratin K14. Control by the proximal element is mediated by a transcription factor, KER1, which is more abundant in nuclear extracts of keratinocytes than in extracts of other cell types, including fibroblasts, lymphocytes, and simple epithelial cells. In this report, we identify this factor as transcription factor AP2, shown to be transcribed in cells of epidermal and neural crest lineages. Furthermore, we demonstrate functional AP2 binding sites upstream from three additional epidermal genes, suggesting that AP2 may be generally involved in epidermal gene regulation. Finally, although AP2 is necessary, it is not sufficient for epidermal gene expression: a distal element contributes to tissue-specific expression of the human keratin K14 gene as judged by its ability to enhance expression of a heterologous promoter in keratinocytes but not in hepatoma cells. These results imply that a combination of factors is likely to contribute to epidermal-specific expression of the human keratin K14 gene.

Base Sequence↗
PubMed1991

Validation of the cause of renal failure of patients in the Medicare end-stage renal disease program.

Studies addressing the epidemiological issues of end-stage renal disease (ESRD) and the implications for health resource allocations are valuable, especially because the Medicare ESRD program is expected to continue growing during the next decade. Studies on trends in the causes of renal failure have benefited from Medicare's extensive data files on ESRD patients. However, no studies have been published that validate the cause of renal failure field in the Medicare files. The primary disease causing renal failure for over 10,000 New York State patients in the Medicare ESRD program was compared with their hospital discharge diagnoses. Of these patients, 8,730 (83%) had a known cause of renal failure in the Health Care Financing Administration (HCFA) data files. Eighty-nine percent of these patients' primary cause of renal failure was matched with the same major hospital diagnostic code. Patients with diabetes and glomerulonephritis had the highest overall match rates (96% to 97%). Patients with polycystic kidney disease and causes of renal failure other than the four major causes had the lowest match rates (75% to 76%), but these match rates increased to 84% to 87% for patients hospitalized more than five times. Some differences in match rate by age and race were found. These findings suggest that HCFA data on the causes of renal failure of ESRD patients are reasonably accurate and can be used successfully to study a variety of issues related to the diseases leading to chronic renal failure.

Adult↗
PubMed1991

Cardiovascular effects of growth hormone treatment in growth-hormone-deficient adults: stimulation of the renin-aldosterone system.

1. In adult humans with growth hormone deficiency, treatment with growth hormone has recently been shown to have major anabolic effects and to improve exercise performance. The cardiovascular effects of growth hormone in adults with growth hormone deficiency were examined in 24 patients treated with recombinant human growth hormone (0.07 units/kg at night) in a double-blind, placebo-controlled trial lasting 6 months. 2. Compared with placebo, resting M-mode echocardiography showed increases in left ventricular end-diastolic dimension and stroke volume in the group treated with recombinant human growth hormone. No differences were noted between the groups with respect to left ventricular end-systolic dimension, fractional shortening, wall thicknesses or mean arterial blood pressure. Left ventricular myocardial mass increased in the group given recombinant human growth hormone. 3. The supine plasma renin activity was increased and remained elevated over the 6 months, whereas the plasma aldosterone concentration was unchanged, after treatment with recombinant human growth hormone. Clinical signs of sodium retention were evident during the first 3 months of treatment with recombinant human growth hormone. 4. We conclude that treatment with recombinant human growth hormone in adults with growth hormone deficiency resulted in small increases in left ventricular pre-load, due to the sodium-retaining action of growth hormone. Activation of the renin-aldosterone system was involved in such changes. Myocardial hypertrophy was observed without changes in mean arterial pressure, reflecting the anabolic action of growth hormone.

Adult↗
PubMed1991

Heterogeneity of the effect of family history on breast cancer risk.

We studied the effects of family history on breast cancer risk among 2,908 cases and 3,180 controls, selected from participants in a nationwide screening project. First-degree family history was associated with a twofold risk increase. Second-degree family history effects were minimal, after adjusting for effects of first-degree relatives. Family history effects were not confounded by age at menarche, age at first full-term birth, age at natural menopause, or previous benign breast disease. Risks from mother's and sister's history were independent. The odds ratio (OR) from a maternal history, 1.9 (95% confidence interval [CI]: 1.6-2.3), varied little by the subject's age at diagnosis, menopause status, or disease laterality. Interactions of maternal history effects with multiple breast biopsies and age at menopause were greater than additive, indicating common mechanistic pathways. The OR from a sister's history was 2.3 (95% CI: 1.9-2.8) and was increased among women who were less than 45 (OR = 6.9), had bilateral disease (OR = 4.7), or were premenopausal (OR = 4.4). The effects from a mother's history and a sister's history are modified in different directions by different factors, providing further indication of the separate roles of a mother's and sister's history in breast cancer etiology.

Adult↗
PubMed1991

A collaborative model for the clinical education of baccalaureate nursing students.

Quality clinical supervision is fundamental for the consolidation of knowledge and the development of a professional identity for baccalaureate nursing students. Problems in providing high-quality clinical supervision range from a lack of practitioner role models to inadequate or unsupportive learning environments. Collaboration between the education and service sectors allows for the development of enriched clinical learning experiences for students. This paper describes an innovative collaborative educational process developed by McMaster University School of Nursing and the Nursing and Education Departments at Hamilton Psychiatric Hospital, Hamilton, Ontario, Canada. Front-line nursing staff are the clinical supervisors, with support from clinical nurse specialists, the hospital educator and the university faculty member. When compared to more traditional approaches, this model ensures that the students receive more variety in placements and access to expert human resources.

Education Department, Hospital↗
PubMed1991

Prevalence of behavioral symptoms and the relationship of child, parent, and family variables in 4- and 5-year-olds: results from the Ontario Child Health Study.

This study presents the frequency of behavioral symptoms in 4- and 5-year-old children as reported by parents in the Ontario Child Health Study. It also examines the relationship of the presence of child, parent, and family variables with parent-reported total scale scores. Eight of the 135 items were reported to be present by the parents of 50% or more of the 437 children in the sample. For 18 items, the prevalence rates for boys were significantly higher than for girls. Multiple regression analysis resulted in slightly different child, parent, and family variables influencing scores when total scores and scores on severe items only were used as dependent variables. Two variables appeared in both models: general health of the child and family status. Some of the child, parent, and family variables found to be associated with behavior disorder in older children do not appear to have as strong an association with disorder in 4- and 5-year-olds.

Canada↗
PubMed1990

The pathogenicity of Mycobacterium tuberculosis during chemotherapy.

We used the guinea pig as an experimental model to investigate the pathogenicity of Mycobacterium tuberculosis. Sputum samples were injected subcutaneously into guinea pigs and the animals were killed and an autopsy performed after eight weeks. The likelihood of the sputum samples producing tuberculosis in the guinea pig was related to culture positivity rather than to duration of chemotherapy. This study does not support the belief that a change in pathogenicity occurs during treatment of pulmonary tuberculosis.

Animals↗
PubMed1989

Role of community pharmacies in prevention of AIDS among injecting drug misusers: findings of a survey in England and Wales.

OBJECTIVE: To determine the current and potential roles of community pharmacists in the prevention of AIDS among misusers of injected drugs. DESIGN: Cross sectional postal survey of a one in four random sample of registered pharmacies in England and Wales. SETTING: Project conducted in the addiction research unit of the Institute of Psychiatry, London. SUBJECTS: 2469 Community pharmacies in the 15 regional health authorities in England and Wales. MAIN OUTCOME MEASURES: Willingness of pharmacists to sell injecting equipment to known or suspected misusers of drugs; pharmacists' attitudes to syringe exchange schemes, keeping a "sharps" box for use by misusers of drugs, and offering face to face advice and leaflets; and opinions of community pharmacists on their role in AIDS prevention and drug misuse. RESULTS: 1946 Questionnaires were returned, representing a response rate of 79%. This fell short of the target of one in four pharmacies in each family practitioner committee area in England and Wales, and total numbers of respondents were therefore weighted in inverse proportion to the response rate in each area. The findings disclosed a substantial demand for injecting equipment by drug misusers. After weighting of numbers of respondents an estimated 676 of 2434 pharmacies were currently selling injecting equipment and 65 of 2415 (3%) were participating in local syringe exchange schemes; only 94 of 2410 pharmacies (4%) had a sharps box for used equipment. There was a high degree of concern among pharmacists about particular consequences of drug misusers visiting their premises, along with a widespread acceptance that the community pharmacist had an important part to play. CONCLUSIONS: Promoting the participation of community pharmacists in the prevention of AIDS among misusers of injected drugs is a viable policy, but several problems would need to be overcome before it was implemented.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Septic shock syndrome in the surgical wound care patient.

The occurrence of septic shock in lower extremity surgery is rare. Its early identification and treatment are vital to its outcome. The authors present a case history of septic shock occurring in the surgical wound care patient, discuss the pathophysiology of septic shock, and then consider diagnosis along with treatment options.

Debridement↗