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Biomedical subjects

C Delaney

Publications and source records attributed to C Delaney.

At least 19 recordsLinked to original sources
PubMed2007

Neurokinin-1 receptor antagonism in a human model of visceral hypersensitivity.

BACKGROUND: Substance P acting via the neurokinin-1 receptor is involved in the development of hyperalgesia, although studies using neurokinin-1 receptor antagonists (NK-1RA) in human somatic pain have been disappointing. AIM: To evaluate whether Substance P is involved in the development of human visceral pain/hyperalgesia using a selective NK-1RA. METHODS: Using a validated human model of acid-induced oesophageal allodynia, pain thresholds to electrical stimulation (mA) were measured in the proximal oesophagus and the foot (somatic control), pre- and for 4 h postdistal oesophageal acid in 14 healthy subjects, using a double-blind, randomized, two-period, crossover study. Measurements were taken on the third day of dosing with either an oral NK-1RA or matching placebo, with 2 weeks washout between periods. RESULTS: Baseline pain threshold did not differ between treatments (proximal oesophagus 37 +/- 7.4 mA NK-1RA vs. 38 +/- 10.1 placebo P = 0.81, foot 40 +/- 15 mA NK-1RA vs. 38 +/- 14 placebo P = 0.68). NK-1RA did not attenuate the reduction in pain threshold in the proximal oesophagus postacid infusion (AUC-394 +/- 279 NK-1RA vs. -262 +/- 397 placebo P = 0.54). CONCLUSIONS: The lack of effect of NK-1RA on oesophageal pain threshold in our model does not support a role for Substance P in the development of acid-induced oesophageal allodynia.

Adult↗
PubMed2004

Acute, local effects of iontophoresed insulin and C-peptide on cutaneous microvascular function in Type 1 diabetes mellitus.

AIM: The aim of the present study was to demonstrate acute, local vasodilatatory effects of insulin and C-peptide on cutaneous microvascular function in Type 1 diabetic subjects. There are no published data available examining physiological effects of C-peptide delivered in this way. METHODS: The study included 20 participants with C-peptide-deficient Type 1 diabetes mellitus. Cutaneous microvascular function was assessed on the forearm using laser Doppler velocimetry. Insulin, C-peptide, acetylcholine (ACh), sodium nitroprusside (SNP) and saline were delivered through the skin using iontophoresis. The response was measured as percentage increase in flux above baseline. RESULTS: C-peptide delivered by iontophoresis produced a vasodilatatory response greater than the response to saline (289.5 +/- 265.9% vs. 105.1 +/- 163.6%, P = 0.003). The response to C-peptide was also shown to be dose dependent. Further, the size of the response to C-peptide correlated well with the size of the response to the endothelium-dependent vasodilatator ACh (r = 0.666, P = 0.001) but not with the size of the response to the endothelium-independent vasodilator SNP (r = 0.345, P > 0.05). CONCLUSIONS: Physiological effects of C-peptide on cutaneous microvascular function could be demonstrated in individuals with Type 1 diabetes. The results support both physiological activity of C-peptide and an endothelium-dependent mechanism similar to that of ACh. The technique reported may be useful in investigating vasoactive actions of C-peptide in a safe and non-invasive way.

Adult↗
PubMed2003

Randomized, controlled trial of carbon dioxide insufflation during colonoscopy.

INTRODUCTION: Insufflation of air is a cause of discomfort during and after colonoscopy. Although this can be minimized by good technique, the use of carbon dioxide insufflation may provide further benefits. Carbon dioxide is rapidly absorbed and excreted through the lungs. We hypothesized that carbon dioxide would alleviate post-colonoscopy discomfort. METHODS: After they had provided informed consent, patients presenting for colonoscopy were randomized into two groups: those in whom air was used for colonoscopy and those in whom carbon dioxide was used. Pain during and ten minutes after colonoscopy was measured on a ten-point analog scale. Data are mean and 95 percent confidence limits. RESULTS: There were 124 patients in the air group and 123 in the carbon dioxide group. Age, body mass index, indication, diagnosis, and number of procedures were similar for the two groups. There were no differences between the groups in the amounts of sedation or analgesia used, the percentage of examinations that were complete (air, 98.4 percent; carbon dioxide, 95.2 percent), or patient satisfaction (on a scale of 1 to 10: air, 9.4; carbon dioxide, 9.5). Although there were more females in the carbon dioxide group (69 vs. 51), hysterectomy rates were the same. Pain scores (mean +/- 95 percent confidence interval; scale of 1 to 10) immediately after the examination were 4.3 +/- 0.3 for air and 3.6 +/- 0.3 for carbon dioxide (no significant difference). Pain scores 10 minutes later were 2.1 +/- 0.2 for air and 0.9 +/- 0.2 for carbon dioxide (P < 0.05, Student's t-test). CONCLUSION: Because there was significantly less abdominal pain ten minutes after colonoscopy in the group in whom carbon dioxide was used, carbon dioxide should be considered as an insufflating gas for colonoscopy.

Abdominal Pain↗
PubMed2001

Relationships among somatic cell count, California mastitis test, impedance and bacteriological status of milk in goats and sheep in early lactation.

The objectives of this trial were to evaluate and compare the test characteristics of a number of indirect tests of bacteriological status of the milk from goats and sheep and to assess the affect of varying levels of prevalence of infection on the performance of those tests.The somatic cell count, California mastitis test (CMT) score, electrical impedance and the bacteriological status of 220 and 262 milk samples from the glands of lactating dairy goats and sheep, respectively, were determined. The sensitivity and specificity of indirect tests in predicting the bacteriological status were compared by analyzing the areas under the receiver operating characteristic curve and calculating the likelihood ratio at various cut-off values.Bacteria were isolated from 17.7 and 4.6% of glands from goats and sheep, respectively. Somatic cell count was a better predictor of bacteriological status than either the CMT score or impedance in both goats and sheep. However, knowledge of the CMT score in both sheep and goats and the impedance in goats increases the likelihood of predicting the presence of a bacterial pathogen compared to no testing at all (P<0.05). Knowledge of the age and days postpartum of the animals at the time of testing did not increase the probability that infection status could be predicted. Variation in cut-off levels to predict infection status reported in the literature may be due to variation in the prevalence of infection in the populations studied. Use of likelihood ratio allows comparison of tests over a range of prevalence's as likelihood ratios are independent of prevalence. The prevalence of infection within a herd should be considered when selecting a cut-off value for indirect testing for the presence of bacteria in milk of small ruminants.

Journal Article↗
PubMed2001

Health informatics and oncology nursing.

OBJECTIVES: To provide an overview of the essential role of health and nursing informatics in meeting the 21st century call to provide state-of-the-art oncology care. DATA SOURCES: Published articles, research studies, and documents relating to informatics. CONCLUSIONS: Health and nursing informatics encompass the pivotal roles of data and information; identifying and documenting essential data using nursing vocabularies; ensuring adequate computer-based patient record systems; accessing and building knowledge; using telecommunications to support care delivery; empowering the consumer through health informatics; transforming education; and enhancing decision making in oncology nursing through national research agendas. IMPLICATIONS FOR NURSING PRACTICE: The information age calls us to explore digital and information technologies as extensions of human capacity. Oncology nursing practice is especially positioned to contribute to the health of our population.

Forecasting↗
PubMed2001

Pharmacodynamics and pharmacokinetics of omapatrilat in heart failure.

The purpose of this study was to determine the pharmacodynamics and pharmacokinetics of omapatrilat, administered orally (25 mg) or intravenously (10 mg) in 19 New York Heart Association class II and class III congestive heart failure (CHF) patients versus 17 healthy controls matched for age, race, gender, and weight. The plasma concentrations of atrial natriuretic peptide (ANP) increased by approximately 20% and 30% in CHF and control subjects, respectively, at 4 hours after intravenous or oral omapatrilat administration. Similar elevation in the cyclic guanosine monophosphate concentration (25% to 35%) and ANP urinary excretion (21 ng/24 h to 22 ng/24 h) was seen in all treatment groups after omapatrilat administration. Angiotensin-converting enzyme activity was > 90% inhibited at 4 hours after dosing and remained approximately 60% to 70% inhibited at 24 hours after dosing. The levels of endothelin-1 and endothelin-2 remained unchanged after oral or intravenous administration of omapatrilat. The maximal reduction in seated blood pressure compared with baseline was similarfor CHF and control subjects. Clinical pharmacokinetic parameters were similar in both groups after intravenous dosing, but maximum concentration and area under the concentration-time curve were elevated in CHF patients compared with controls after oral dosing. Omapatrilat was well tolerated; differences in systemic exposure and metabolism between CHF patients and controls did not appear to be clinically significant.

Administration, Oral↗
PubMed2001

Omapatrilat: neurohormonal and pharmacodynamic profile when administered with furosemide.

Pharmacodynamic effects of combination therapy with omapatrilat and furosemide were evaluated. Two groups of 13 healthy subjects each received furosemide 20 mg dailyfor 15 days coadministered with either placebo on days 6 to 15 or omapatrilat 10 mg on days 6 to 10 and 25 mg on days 11 to 15. In the omapatrilat group, urinary excretion of atrial natriuretic peptide increased, and greater blood pressure reductions were seen compared with placebo. Concomitant omapatrilat treatment did not affect the acute diuresis, natriuresis, and kaliuresis observed with chronic administration of furosemide. Neither effective renal plasma flow nor glomerularfiltration rate changed in either treatment group. No clinically significant safety issues were observed. Daily coadministration of omapatrilat 10 or 25 mg with furosemide 20 mg does not affect the pharmacodynamics offurosemide at steady state.

Adult↗
PubMed2001

Hip subluxation and dislocation in Duchenne muscular dystrophy.

Although hip subluxation and dislocation occur commonly in neuromuscular diseases such as cerebral palsy, spinal muscular atrophy and myelomeningocele, they are not known to commonly affect patients with Duchenne Muscular Dystrophy. In this study, 15 out of 54 patients whose hip radiographs were reviewed showed unilateral subluxation, one had bilateral subluxation and three had unilateral dislocation. Having established that hip subluxation and dislocation develop frequently in patients with Duchenne Muscular Dystrophy, serial hip radiographs should be taken as has been advocated for cerebral palsy. The possible relationship between subluxation and pelvic tilt also calls for better control of sitting posture to prevent pelvic tilt. Spinal stabilization should be carried out at an early age when any scoliosis and pelvic tilt are still mild, so that progressive subluxation of the hip may be delayed or prevented, in addition to maintaining sitting balance and comfort.

Adolescent↗
PubMed2000

An international methodology to describe clinical nursing phenomena: a team approach.

The development of a structured and standardized clinical language for nursing is of major importance to the profession for both practice and science. This paper describes a methodological approach which has been developed for the refinement and extension of the NANDA taxonomy in the Nursing Diagnosis Extension and Classification (NDEC) project. The paper proposes that this method could be used by nurses in all countries to facilitate the identification, development and validation of terms and labels which can be incorporated into each country's own emerging data systems, translated and cross mapped between systems, and eventually incorporated into international data sets.

Humans↗
PubMed2000

Describing patient problems & nursing treatment patterns using nursing minimum data sets (NMDS & NMMDS) & UHDDS repositories.

Dramatic changes in health care have intensified practitioners' efforts to access and use information to determine more efficacious approaches to patient outcomes. The overall goal of the study is to measure the influence of nursing informatics clinical reasoning decision support interventions on patient outcomes. This paper describes Phases I of the study: the methodology for establishing and testing the usefulness of large data repositories comprised of three minimum data sets, including the Nursing Minimum Data Set (NMDS), the Nursing Management Minimum Data Set (NMMDS), and the Uniform Hospital Discharge Data Set (UHDDS), and the American Nurses Association Quality Indicators to support effectiveness research. The use of generic data modeling to construct a clinical nursing repository of more than 477,000 electronic records is discussed. Patient problem and treatment profiles, patterns, and variations based on standardized analyzing classifications are described for inpatient adult samples, and nursing and medical diagnosis groups.

Databases, Factual↗
PubMed1998

Reducing recidivism: medication versus psychosocial rehabilitation.

1. Noncompliance with psychotropic medications is a primary reason for recidivism to inpatient hospitalization. It is a great contributor to the "Revolving door syndrome." 2. Psychosocial rehabilitation clubhouses can decrease inpatient hospitalization in patients with chronic mental illness. Their supportive, vocational, and educational functions are worth the investment in terms of improving quality of life and functioning skills. 3. Patients on oral psychotropic medications were more compliant in this study than those on injectable neuroleptic regimens if they attended the clubhouse program. It is presumed that the clubhouse atmosphere "normalizes" the routine of taking psychotropic medications and enhances compliance.

Administration, Oral↗
PubMed1998

Setting standards for nursing data sets in information systems.

The American Nurses Association (ANA) has established the Nursing Information and Data Set Evaluation Center (NIDSEC). The purpose of this Center is to develop and disseminate standards pertaining to information systems that support the documentation of nursing practice, and to evaluate voluntarily submitted information systems against these standards. The need for an evaluation center arises out of a long history of calls for standards pertaining to nursing data and to information systems. Standards have been developed to evaluate the completeness, accuracy and appropriateness of four dimensions of nursing data sets and the systems that contain them 1) nomenclature, 2) clinical content, 3) clinical data repository, and 4) general system characteristics. Once the standards and scoring mechanisms were established, they were tested for reliability and validity. A Content Validity Index (CVI) of 0.875 was established for the scoring tool.

American Nurses' Association↗
PubMed1997

Nursing Management Minimum Data Set (NMMDS).

The Nursing Management Minimum Data Set (NMMDS) is the research-based management data set that meets the nurse executives need for a specific nursing management data capture system that will produce accurate, reliable, and useful data for decision making. The authors update the development of the NMMDS and discuss the 17 NMMDS across-settings elements. Also discussed are the applications of the NMMDS to clinical practice and some ways in which the NMMDS can benefit both nurses and patient/client care.

Continuity of Patient Care↗
PubMed1997

Nursing Information and Data Set Evaluation Center.

The American Nurses Association (ANA) has established the Nursing Information and Data Set Evaluation Center (NIDSEC). The purpose of this Center is to develop and disseminate standards pertaining to information systems that support the documentation of nursing practice, and to evaluate voluntarily submitted information systems against these standards. The target audience for these standards includes both consumers and vendors of clinical information systems. The need for an evaluation center arises out of a long history of calls for standards pertaining to nursing data and to information systems. These calls have come from the Secretary of Health and Human Services Commission on Nursing, the National Commission on Nursing Implementation Project (NICNIP). Standards will be developed to evaluate the completeness, accuracy and appropriateness of four dimensions of nursing data sets and the systems that contain them: 1) Nomenclature; 2) Clinical Content; 3) Clinical Data Repository; and 4) General System Characteristics.

American Nurses' Association↗
PubMed1996

Use of nursing informatics in advanced nursing practice roles for building healthier populations.

Dynamic changes in health care delivery organization, financing, and role of the consumer present an unprecedented opportunity for advanced practice nurses (APNs) to provide quality care to individuals and aggregates that emphasize health promotion, disease prevention, and health care management at a reasonable cost. APNs can use nursing informatics to help build healthier populations. This article outlines the major information needs dictated by the complex changes in health care, the power of information, and the strategies for ensuring access to information by APNs to meet the goal of building healthier populations.

Databases, Factual↗