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Biomedical subjects

C M Dougherty

Publications and source records attributed to C M Dougherty.

At least 19 recordsLinked to original sources
PubMed2001

Testing the effectiveness of converting patients to long-acting antianginal medications: The Quality of Life in Angina Research Trial (QUART).

OBJECTIVE: Our purpose was to test the hypothesis that converting patients with stable angina to long-acting antianginal medications would improve their functional status, symptom control, treatment satisfaction, and quality of life. METHODS AND RESULTS: A single-blind randomized trial of 100 patients with stable coronary artery disease was performed in the outpatient clinic of a Veterans Affairs Health System. Outpatients with chronic stable angina taking at least 2 antianginal medications were studied. Patients were randomized to one of two treatments: optimal adjustment of their usual antianginal medications or conversion to solely long-acting medications (long-acting diltiazem +/- nitroglycerin patches +/- atenolol) with subsequent optimization. The primary outcome was the 3-month change in Seattle Angina Questionnaire scores. Although no differences in physical limitation scores were noted, patients randomized to receive long-acting medications had improved symptom control (3-month improvement in anginal stability [19.1 vs 5.6, P =.02] and anginal frequency [17.8 vs 5.5, P =.006]), more treatment satisfaction (3-month improvement of 8.2 vs 3.0, P =.057), and better quality of life (3-month improvement of 11.2 vs 5.6, P =.09) compared with patients whose pretrial medications were optimized. The improvement in symptom control was statistically significant. CONCLUSION: Converting patients with chronic, stable angina to long-acting antianginal medications resulted in substantial improvements in symptom control with a trend toward better treatment satisfaction and quality of life.

Adrenergic beta-Antagonists↗
PubMed2001

Theoretical development of nursing interventions for sudden cardiac arrest survivors using social cognitive theory.

This article discusses the theoretical development of a nursing intervention program to enhance recovery over the first year following sudden cardiac arrest. Concepts from social cognitive theory and domains of concern following sudden cardiac arrest underpin a tailored and standardized nursing intervention. The nursing intervention program is designed for delivery by means of telephone and through the mail. Testing of the nursing intervention program is underway using a clinical trial design.

Defibrillators, Implantable↗
PubMed2001

The natural history of recovery following sudden cardiac arrest and internal cardioverter-defibrillator implantation.

The purposes of this review are to 1) summarize current knowledge regarding the "natural history of recovery" (physical functioning, psychological adjustment, and neurologic impairments) following sudden cardiac arrest and internal cardioverter-defibrillator implantation over the first year; and 2) discuss the implications for the development of nursing intervention programs based on the natural history of recovery. The natural history serves as a basis for understanding the recovery experiences of sudden cardiac arrest survivors as well as determining how intervention programs might help the most.

Activities of Daily Living↗
PubMed2000

Outpatient nursing case management for cardiovascular disease.

Case management has been an effective treatment model for maintaining costs while preserving quality of care for vulnerable populations who are frequent care users. Nursing case management has been effective in improving health outcomes in chronically ill populations. Specifically, nurse practitioner care has been as effective, and in some areas, more effective in managing chronic health problems of patients than care provided by physicians. Cardiovascular disease is a chronic condition, often accompanied by long-term symptoms and disability, that is prevalent in the United States population. Outpatient nursing case management for chronic health problems associated with cardiovascular disease is posited as a model for a heavily used system that maintains quality of care in this group.

Ambulatory Care↗
PubMed1998

Comparison of three quality of life instruments in stable angina pectoris: Seattle Angina Questionnaire, Short Form Health Survey (SF-36), and Quality of Life Index-Cardiac Version III.

Three instruments for the assessment of quality of life, the Seattle Angina Questionnaire (SAQ), the Short Form Health Survey (SF-36), and the Quality of Life Index-Cardiac Version III (QLI) were administered to 107 patients with stable angina pectoris in a longitudinal randomized trial comparing the use of alternative anginal medications in the management of chronic stable angina pectoris. This study demonstrated that differences in angina severity as measured by the Canadian Cardiovascular Society Classification (CCSC) were related to each of the SAQ subscales, to selected subscales of the SF-36, but not to the QLI. All quality of life (QOL) instruments demonstrated acceptable test-retest reliability when administered over a 2-week interval. Neither the SF-36 nor the QLI were discriminative of angina severity or sensitive to changes in CCSC angina classification. Both the SAQ and QLI detected changes in heart disease related QOL over time.

Aged↗
PubMed1997

Family-focused interventions for survivors of sudden cardiac arrest.

This paper 1) describes what is known about recovery for families of patients who survive sudden cardiac arrest (SCA) and undergo internal cardioverter defibrillator (ICD) implantation, 2) discusses empirical evidence for interventions aimed at affecting recovery following SCA and ICD implantation, 3) presents additional data that suggest interventions for cardiac arrest survivors and their families, and 4) makes recommendations for the development of future intervention programs for SCA survivors and their families. Research supporting the use of educational and support interventions designed for SCA survivors and families is reviewed. Recommendations are made for future design and testing of interventions in the population.

Adaptation, Psychological↗
PubMed1995

Psychophysiological responses after sudden cardiac arrest during hospitalization.

A sample of 21 sudden cardiac arrest (SCA) survivors were interviewed every 48 hours during hospitalization to determine emotional, cognitive, and physiological parameters of recovery. On the average, SCA survivors were not excessively anxious, depressed, angry, or confused during hospitalization, but they did report high levels of denial and uncertainty. The two most predominant cognitive impairments at the time of hospital discharge were loss of short-term memory and construction ability. Both the number of cardiac arrhythmias and the types of interventions used to manage them decreased as hospital discharge approached.

Acute Disease↗
PubMed1994

Longitudinal recovery following sudden cardiac arrest and internal cardioverter defibrillator implantation: survivors and their families.

OBJECTIVE: To describe psychological reactions, neurological sequelae, and family adjustment following sudden cardiac arrest during the first year of recovery. METHODS: 15 sudden cardiac arrest survivors and 1 member of each family were interviewed and completed questionnaires five times within the first year following sudden cardiac arrest (hospital discharge, 1, 3, 6, and 12 months). Psychological reactions assessed included anxiety, depression, anger, denial, and global stress. Neurological sequelae assessed included confusion and neurocognitive functioning. Family adjustment assessed included marital adjustment and family coping. All sudden cardiac arrest survivors suffered primary ventricular fibrillation outside the hospital and had an internal cardioverter defibrillator implanted during hospitalization. RESULTS: Anxiety, depression, anger, stress, and confusion were highest at hospital discharge and decreased over 1 year, with survivors reporting higher levels than spouses. Denial was high throughout the entire year in survivors. Memory and construction ability were impaired throughout the entire year in survivors. Family coping and dyadic satisfaction were highest at hospital discharge and decreased throughout 1 year. Spouses reported fewer coping strategies and lower dyadic satisfaction than survivors. Family social support was lower than previously established norms at all periods during the first year of recovery. CONCLUSION: To develop intervention programs to aid adjustment, healthcare providers need to take into account psychological reactions, neurological deficits, and family coping of sudden cardiac arrest survivors and their family members.

Adaptation, Psychological↗
PubMed1992

Comparison of heart rate variability in survivors and nonsurvivors of sudden cardiac arrest.

Imbalances in autonomic nervous system function have been posed as a possible mechanism that produces ventricular fibrillation and sudden cardiac arrest in patients with cardiovascular disease. Heart rate (HR) variability is described in survivors and nonsurvivors of sudden cardiac arrest within 48 hours after resuscitation using time and frequency domain analytic approaches. HR data were collected using 24-hour ambulatory electro-cardiograms in 16 survivors and 5 nonsurvivors of sudden cardiac arrest, and 5 control subjects. Survivors of sudden cardiac arrest were followed for 1 year, with recurrent cardiac events occurring in 4 patients who died within that year. Analysis of 24-hour electrocardiograms demonstrated that control subjects had the highest HR variability (standard deviation of all RR intervals = 155.2 +/- 54 ms), with nonsurvivors demonstrating the lowest HR variability (standard deviation of all RR intervals = 52.3 +/- 6.1 ms) and survivors of sudden cardiac arrest falling between the other 2 groups (standard deviation of all RR intervals = 78 +/- 25.5 ms, p less than or equal to 0.0000). Two other indexes of HR variability (mean number of beat to beat differences in RR intervals greater than 50 ms/hour and root-mean-square of successive differences in RR intervals) did not demonstrate the expected pattern in this sample, indicating that perhaps patterns of HR variability differ between groups of patients with cardiovascular disorders. Spectral analytic methods demonstrated that survivors of sudden cardiac arrest had reduced low- and high-frequency spectral power, whereas nonsurvivors demonstrated a loss of both low- and high-frequency spectral power.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

Isolation of a yeast artificial chromosome clone that spans the (12;16) translocation breakpoint characteristic of myxoid liposarcoma.

Cytogenetic analysis of liposarcomas has demonstrated that translocation (12;16) (q13.3;p11.2) is characteristic of the myxoid subtype of this adipose tissue tumor. Our previous results suggested that the GLI gene is close to the translocation breakpoint on chromosome 12. We now describe a yeast artificial chromosome (YAC) that contains GLI and spans the chromosome 12 region involved in the t(12;16) breakpoint. This clone will permit rapid definition of the genetic region surrounding the breakpoint and allow isolation of the gene presumably affected by the translocation.

Chromosomes, Fungal↗
PubMed1985

The nursing diagnosis of decreased cardiac output.

This descriptive study validated the nursing diagnosis of decreased cardiac output in a critical-care population. A cardiac output assessment tool was developed. Nursing interventions associated with decreased cardiac output were identified and classified as independent, collaborative, and dependent.

Adult↗
PubMed1976

Severe atypical endometrial changes and sequential contraceptive use.

Of eight young women, seven had a diagnosis of well-differentiated endometrial adenocarcinoma and one had atypical endometrial hyperplasia. The average age was 40.1 years, with 6.04 years of dimethisterone-ethinyl estradiol (Oracon) sequential contraceptive use. The patients were not typical of those in whom endometrial carcinoma develops. Although these cases do not prove that long-term administration of dimethisterone-ethinyl estradiol causes endometrial adenocarcinoma or atypia, they indicate that it may do so.

Adenocarcinoma↗
PubMed1975

Puerperal myocardiopathy complicating stimulataneous uterine and tubal pregnancies.

The authors point out the difficulty in recognizing puerperal myocardiopathy and the necessity for standardizing the diagnostic features. The patient described here was all the more unusual because of the coincidental occurrence of a second rare condition-simultaneous uterine and tubal pregnancies. Our data may add support to the theory that all ill-defined myocardial lesion resblts from an autoimmune response.

Adult↗