Biomedical subjects

Conor O'Neill

Publications and source records attributed to Conor O'Neill.

3 recordsLinked to original sources

PubMed2005

Deprivation: different implications for forensic psychiatric need in urban and rural areas.

BACKGROUND: Ecological relationships between deprivation and forensic psychiatric admission rates may differ in urban and rural areas. AIMS: The aim of the study was to compare the relationship between material deprivation and forensic admission rates in rural and urban areas for a whole-national service in Ireland over a 3-year period. METHOD: All Irish forensic admissions from 1997 to 1999 were allocated to the appropriate small area. Material deprivation scores were calculated from census data. Mean annual admission rates and Bayesian standardised forensic admission ratios for small areas were aggregated by material deprivation score and population density. RESULTS: At small area level, there were significant non-linear increases in forensic admissions with increasing deprivation. The increases in urban areas (population density >10/hectare) were absent in less densely populated areas. CONCLUSIONS: Deprivation alone may not be the key factor in predicting forensic service utilisation. Factors associated with specifically urban deprived areas may be of greater relevance in planning services.

Adolescent↗

PubMed2004

Subgroups of positive discs on discography.

STUDY DESIGN: Retrospective study of pressure-controlled discography (PCD) in patients with chronic low back pain (CLBP). OBJECTIVES: Define the distribution of disc pain thresholds and determine, using an analytical model, if a false-positive subgroup could be identified. SUMMARY OF BACKGROUND DATA: The characteristics of the distribution of disc pain thresholds may allow identification of subgroups within a population. METHODS: Disc pain thresholds were determined using PCD in patients with CLBP referred for discography. An analytical model and previously published data from an asymptomatic group were used to determine the distribution of false-positive discs. RESULTS: A total of 838 discs from 253 patients were studied. Regression analysis demonstrated no significant association between levels from patients with CLBP with more than one positive disc. The distribution of discography pain thresholds from the patients with CLBP revealed two distinct groups: contact-sensitive (CS) and pressure-sensitive (PS). Discs in the CS group have a pain threshold of 0 psi, indicating that contact between the contrast and the disc provokes pain. Discs in the PS group have a pain threshold of > 0 psi, demonstrating that internal pressure must be generated to provoke pain. PS discs consist of moderately and minimally sensitive subgroups, with overlapping distributions. The minimally sensitive subgroup corresponds to false-positive discs. At 50 psi, the probability of a false-positive disc is 100%, at 25 psi 50%, at 19 psi 25%, and at 14 psi 10%. CONCLUSIONS: Discography should be performed under pressure control, as doing so allows the pain threshold of discs to be quantified, and the probability that a disc is false-positive estimated.

Adolescent↗

PubMedDate not supplied

Failed back surgery: etiology and diagnostic evaluation.

BACKGROUND CONTEXT: This is a synopsis of a symposium presented to the North American Spine Society Annual Meeting in Montreal, Canada, 2002. PURPOSE: To provide the reader with a distillation of the material presented regarding the diagnosis of failed back surgery syndrome (FBSS). METHODS: Panel presentation. RESULTS: The proper treatment of patients with FBSS depends on a precise and accurate diagnosis. With a careful history, examination, imaging studies, psychological evaluation and diagnostic injections, a diagnosis can be reached in over 90% of patients. The most common diagnoses are foraminal stenosis (25% to 29%), painful disc (20% to 22%), pseudarthrosis (14%), neuropathic pain (10%), recurrent disc herniation (7% to 12%), facet joint pain (3%) and sacroiliac joint (SIJ) pain (2%). Psychological factors are always present and may help or hinder. Common psychological diagnoses include depression, anxiety disorder and substance abuse disorder. Diagnostic injections are very useful for facet joint pain, SIJ pain and discogenic pain; they may also be used to confirm a putative neural compression as a cause of pain. CONCLUSIONS: Spine surgeons must be aware of the common causes of FBSS in order to be able to thoroughly evaluate their patients and to minimize the occurrence of this problem.

Back Pain↗