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Biomedical subjects

D Gallagher

Publications and source records attributed to D Gallagher.

At least 19 recordsLinked to original sources
PubMed1992

Heart rate variability in smokers, sedentary and aerobically fit individuals.

To test the hypothesis that certain lifestyles may affect cardiovascular regulatory mechanisms, heart rate variability (HRV) among three age-matched groups with different lifestyles (smoking, sedentary and aerobically fit) were compared. Heart rate variability was defined as the difference in heart rate during inhalation vs. exhalation. Heart rate was obtained from normal RR intervals, using a continuous electrocardiogram recording, while subjects were seated and breathing at an augmented tidal volume, and also while subjects were standing and breathing at normal tidal volumes. In the physically active group, heart rate variability was significantly elevated at rest as well as during some of the autonomic tests, when compared to the sedentary and smoker groups (p < 0.05). A hypothesis to explain this finding is that smoking or a sedentary lifestyle reduces vagal tone, whereas a physically active lifestyle, resulting in enhanced aerobic fitness, increases vagal tone. These findings may have cardiovascular health implications.

Adult↗
PubMed1992

Accuracy of a portable interpretive ECG machine in diagnosis of acute evolving myocardial infarction.

From a study of 526 patients having automatic ECG analysis, criteria were established which diagnosed acute evolving Q wave myocardial infarction with 71% sensitivity and 98% specificity. Specificity was 100% when patients with known previous Q wave infarction were excluded. In pre-hospital practice the high sensitivity and specificity were maintained. This method appears appropriate, when other criteria are met, for paramedic-initiated pre-hospital thrombolysis with remote supervision of a cardiologist by telephone.

Adult↗
PubMed1990

Brachioradial delay.

Explore the source record for details and available documents.

Aortic Valve Stenosis↗
PubMed1990

Transfusion and alloimmunization in sickle cell disease. The Cooperative Study of Sickle Cell Disease.

In 1,814 patients with sickle cell disease who had been transfused, the overall rate of alloimmunization to erythrocyte antigens was 18.6%. The rate of alloimmunization in this group appears to be an explicit function of the number of transfusions received because it increases exponentially with increasing numbers of transfusions. Alloimmunization usually occurred with less than 15 transfusions, although the rate of alloimmunization continued to increase when more transfusions were given. The rate of alloimmunization was less in patients with hemoglobin SC disease and sickle-beta+ thalassemia because these patients had received fewer transfusions. Children less than 10 years old had a slightly lower rate of alloimmunization than patients in other age groups even after correction for the number of transfusions given. Women were more frequently alloimmunized than men; this was largely due to the fact that women received more transfusions than men, but in the age group 16 to 20 years the increase may have been due in part to alloimmunization owing to pregnancy. Forty-five percent of those alloimmunized made antibodies of only one specificity; 17% made four or more antibodies reacting with different antigens. Antibodies to the C and E antigens of the Rh group, the Kell antigen, and the Lewis antigens were most commonly made. These findings may be important in formulating a rational transfusion policy in sickle cell disease.

Adolescent↗
PubMed1990

Factor analysis and preliminary validation of the mini-mental state examination from a longitudinal perspective.

The Mini-Mental State Examination (MMSE) is a commonly used instrument for assessing mental impairment. Previous proposals for its underlying structure have focused on scores obtained from a single administration of the test. Because the MMSE is widely used in longitudinal studies, we examined the pattern of relations among the rates of chance of the items. Data were obtained from 63 subjects for 1.5 years or more. The relations among the rates of change of the MMSE items were described by a five-factor solution that accounted for 75% of the variance and comprised factors pertaining to orientation and concentration, obeying commands, learning and repetition, language, and recall. This was in contrast to the structure of the scores obtained from a single administration of the MMSE, which was best described by a two-factor solution. In order to provide a clinical validation, factor scores derived from the MMSE factors were used to predict scores on the Memory and Behavior Problems Checklist and the Brief Cognitive Rating Scale.

Aged↗
PubMed1990

Retrospective assessment of marital adjustment and depression during the first 2 years of spousal bereavement.

Two hundred twelve bereaved elders rated marital adjustment using items drawn from the Locke and Wallace (1959) Marital Adjustment Test and completed the Beck Depression Inventory 2 months, 12 months, and 30 months after the loss of their spouses. Their responses were compared with those of 162 nonbereaved individuals of comparable age who were tested at the same times. More positive ratings of marital adjustment were made by bereaved subjects than by nonbereaved subjects. Among nonbereaved elders, more severe ratings of depression were associated with lower ratings of marital adjustment. In the bereaved sample, however, the opposite was found: More severe ratings of depression were associated with higher ratings of marital adjustment. This pattern of results changed only slightly over the 2.5-year course of bereavement and was not influenced by gender. These results are discussed in terms of cognitive processes (e.g., idealization) that influence retrospective assessments of marital adjustment during bereavement.

Adaptation, Psychological↗
PubMed1989

Prevalence of depression in family caregivers.

Family caregivers who sought help to increase their coping skills (N = 158) and caregivers who volunteered for a longitudinal study of Alzheimer's disease (N = 58) were screened for depression. Among help-seekers, 46% had depression according to Research Diagnostic Criteria (RDC), but among non-help-seekers, only 18% met this criterion. In general, women were more depressed than men, but no major differences in the extent of depression were found in those who cared for more impaired persons.

Adaptation, Psychological↗
PubMed1989

Alliance and outcome in late-life depression.

Older adults who met criteria for major depressive disorder were randomly assigned to behavioral, cognitive, or brief dynamic therapy. Symptoms were equally reduced across the three treatment conditions. Early in treatment, alliance ratings were obtained from both therapists and patients and were related to outcome. We calculated one therapist alliance composite score and five patient alliance factor scores. In general, no agreement was found between therapists' and patients' judgments of alliance. Levels of alliance were found to be not significantly different across the three treatment conditions. For the sample as a whole, only the patient factor of Patient Commitment was found to be associated with depressive symptoms after treatment, with the strongest findings in the cognitive therapy condition. The Patient Commitment factor uniquely contributed to outcome over and above the contribution of initial symptomatology and symptomatic change at midpoint in therapy. Expected trends of association with outcome were observed for the therapist alliance composite score in brief dynamic therapy and for the patient factor of Patient Working Capacity in both cognitive and brief dynamic therapy. Findings are discussed in terms of their theoretical and clinical implications.

Aged↗
PubMed1989

Mortality in children and adolescents with sickle cell disease. Cooperative Study of Sickle Cell Disease.

A study of the natural history of sickle hemoglobinopathies was begun in March 1979. By August 1987, a total of 2824 patients less than 20 years of age were enrolled. There have been 14,670 person-years of follow-up. Seventy-three deaths have occurred. Most of the deaths were in patients with hemoglobin SS. The peak incidence of death was between 1 and 3 years of age, and the major cause in these young patients was infection. Cerebrovascular accidents and traumatic events exceeded infections as a cause of death in patients greater than 10 years of age. There was limited success in identifying risk factors for death. Comparison of this study's overall mortality of 2.6% (0.5 deaths per 100 person-years) with previous reports indicates improvement of survival in US patients less than 20 years of age with sickle hemoglobinopathies. This improvement is most likely due to parental education and counseling about the illness and the early institution of antibiotics in suspected infections.

Adolescent↗
PubMed1988

Autonomic arousal feedback and emotional experience: evidence from the spinal cord injured.

We interviewed spinal-cord-injured, other handicapped, and nonhandicapped subjects to investigate the relation between the perception of autonomic arousal and experienced emotion. The three groups differed significantly on only one measure of affect intensity, with the spinal-cord-injured subjects more often reporting stronger fear in their lives now compared with the past. In addition, spinal-cord-injured subjects often described intense emotional experiences. Spinal-cord-injured subjects who differed in their level of autonomic feedback differed in intensity on several measures. Subjects with greater autonomic feedback tended to report more intense levels of negative emotions. The findings indicate that the perception of autonomic arousal may not be necessary for emotional experience. There were weak trends in our data, however, suggesting that the perception of arousal may enhance the experience of emotional intensity. The subjective well-being reports of the handicapped groups were comparable to those of nonhandicapped subjects, indicating successful coping with their disability.

Adolescent↗
PubMed1988

Noninvasive measurement of retrograde conduction times in pacemaker patients.

Retrograde, or ventriculoatrial conduction (VAC) has been measured in 67% of pacemaker patients with SSS and 25% of patients with 3 degrees block. DDD pacers use the postventricular atrial refractory period (PVARP) to prevent sensing VAC. If the PVARP is too short, a pacer-mediated tachycardia (PMT) could occur. If too long, rapid atrial rates may not be sensed. To accurately set the PVARP, VAC must be measured. Five noninvasive methods are described: (1) Surface ECG during VVI pacing; (2) Atrial intracardiac electrograms during VVI pacing; (3) Initiating a PMT with long pacemaker AV interval; (4) Initiating a PMT at the maximum tracking rate; (5) DDI mode with electronic calipers. The description of these methods is intended to enable a physician to detect and measure VAC in patients with any manufacturer's DDD or VDD pacemaker.

Cardiac Pacing, Artificial↗