Biomedical subjects

D Hickey

Publications and source records attributed to D Hickey.

27 records · Page 2Linked to original sources

PubMed1988

Urethral and prostatic colonization and infection in patients undergoing prostatectomy.

We conducted a prospective trial to identify organisms colonizing the urethra and prostate and their role in the aetiology of infection after prostatectomy. Twenty-five patients were studied of whom six developed postoperative infection. The causative organisms were previously recovered from the urethra but not the prostate. There was a high rate of urethral colonization by streptococci (14/25) and a low incidence of prostatic colonization. We describe a novel method of sampling the prostate.

Bacteriological Techniques↗

PubMed1987

Radical cystectomy in presence of fused "cake" kidney.

Radical cystectomy is the optimal treatment for patients with invasive bladder cancer. The presence of a fused pelvic kidney is an uncommon congenital abnormality and when found in a patient with bladder cancer may alter the operative procedure. Herein we report on a patient presenting with invasive bladder cancer and a pelvic "cake" kidney.

Angiography↗

PubMed1987

Amylase gene duplication: an ancestral trait in the Drosophila melanogaster species subgroup.

Electrophoretic polymorphism of amylases was studied in 45 geographic populations of the two cosmopolitan sibling species, D. melanogaster and D. simulans, and in one to three populations or strains of six other species in the D. melanogaster subgroup. Two species, D. erecta and D. orena, for which only a few strains were available were monomorphic. In the other species 2 or 3 amylase variants were identified while in D. melanogaster, 12 electrophoretic variants were characterized. Altogether 17 different amylase isozymes have been observed. The contrast in the level of polymorphism between D. melanogaster and the other species cannot be explained simply by the occurrence of a duplication in the former species. Genetic analysis demonstrated the existence of a duplication in at least 4 other species, namely D. simulans, D. mauritiana, D. yakuba, and D. teissieri. It is therefore suggested that the duplication occurred in a common ancestor and the phylogenetic implications of these observations are discussed.

Amylases↗

PubMed1986

Pre-treatment testosterone levels: significance in androgen deprivation therapy.

From June 1982 to February 1985, 53 patients with stage D2 carcinoma of the prostate confirmed by tissue biopsy, elevated prostatic acid phosphatase and a positive bone scan were initiated on androgen deprivation therapy. Before commencement of treatment all patients underwent determination of serum testosterone levels at 8 a.m. Of the patients 23 received 200 mcg. buserelin per day, 17 received 1 mg. diethylstilbestrol 3 times daily, 6 received 40 mg. megestrol acetate 4 times daily, 2 received 1 mg. leuprolide per day and 5 underwent bilateral orchiectomy. Evaluation of the best response in each patient revealed 3 (6 per cent) complete and 17 (32 per cent) partial responses, while 22 patients (41 per cent) remained stable and 11 (21 per cent) had progression. Pre-treatment serum testosterone levels ranged from 150 to 879 ng. per dl. The mean serum testosterone level in patients having a complete response was 524 +/- 18.04 ng. per dl. The mean in the progression group was 279.4 +/- 110.1 ng. per dl. This difference was not statistically significant owing to the large standard deviation in the progression group. However, of the 15 patients who had a pre-treatment serum testosterone level of more than 500 ng. per dl. only 1 (7 per cent) had progression. None of the patients whose pre-treatment testosterone level was less than 200 ng. per dl. had objective tumor regression. Our study suggests that pre-treatment serum testosterone levels may predict the probability of a satisfactory response to androgen deprivation therapy.

Aged↗

PubMedDate not supplied

Impaired renal allograft, but not patient survival, in patients with antibodies to hepatitis C virus.

BACKGROUND: The impact of hepatitis C virus (HCV) infection in renal transplant patients is controversial and there are no data on the outcome of renal transplantation in this sub-group of Irish patients. AIM: To examine the outcome of renal transplantation in patients with hepatitis C. METHODS: We examined the outcome of first grafts from renal transplant patients with hepatitis C antibody positive and compared them to a control group. During this period, 24 HCV positive patients received 33 grafts. All were treated with standard immunosuppression. RESULTS: Graft survival rate was less in the HCV positive cases (p=0.0087). Graft survival at 1 year was 75% in the HCV positive group versus 85% in the HCV negative group, 40% versus 62% at 5 years and 14% compared with 40% at 10 years. Patient survival was similar in both groups (p=0.78). Patient survival at 1 year was 96% versus 94%, 87% versus 80% at 5 years and 70% in both groups at 10 years. CONCLUSION: In the Irish renal transplant population, the presence of hepatitis C antibodies, before or after transplantation is associated with worse long-term graft, but not patient survival.

Adult↗

PubMedDate not supplied

Radiologic evaluation of simultaneous pancreas-kidney transplantation.

We describe the radiographic imaging modalities that were used in the first twelve consecutive patients who have undergone simultaneous pancreas and kidney transplantation (SPK) at our institution. The total number of examinations undertaken in this study included ultrasound (n = 22), radionucleide scanning (n = 19), cystography (n = 14), computed tomography (n = 2) and magnetic resonance imaging (n = 1). Eighteen percent (5/22) ultrasound examinations were abnormal (perirenal collection [n = 4], peri-pancreatic collection [n = 1]. Two collections required aspiration and were confirmed as lymphocoeles. Cystography showed ureteric reflux in two patients and radionucleide DTPA scanning revealed a delay in the excretory phase in 20% of patients. CT was used in two patients with SPK and demonstrated large peri-pancreatic collections. No episodes of rejection or late graft pancreatitis were noted in this series. We discuss the role of radiographic imaging in detecting early graft failure and also in defining the surgical complications that may arise following transplantation. We also outline the merits and disadvantages of each imaging modality. We conclude that the most useful initial imaging techniques in the evaluation of patients following SPK are ultrasound including Doppler and nuclear medicine.

Adult↗

PubMedDate not supplied

Renal transplantation performed across a positive crossmatch: a single centre experience.

UNLABELLED: The importance of certain positive crossmatches (CM+) in kidney transplantation remains controversial. Fifty consecutive kidney transplants were performed across a CM+ between Jan. 1990-April 1994. In 19 cases there was an isolated B-cell CM+ (Group I), in 24 an historic T-cell IgM CM+ (Group II) and in 7 an historic T-cell IgG CM+ (Group III). Comparing groups I:II:III: early acute rejection affected 32%, 42%, 57% of grafts; mean serum creatinine at 3 months was 166, 150, 229 umol/l (p < 0.05); 1 yr graft survival was 95 per cent, 96 per cent, 71 per cent (p = 0.09). In group III both graft losses were in the setting of an additional current B-cell CM+. CONCLUSIONS: Transplantation performed in either the presence of an isolated B-cell CM+ or in the presence of an historic T-cell IgM CM+ was associated with acceptable outcomes at 1 yr. An historic T-cell IgG CM+ was confirmed as a contraindication to transplantation in most circumstances, especially when coupled with a current B-cell CM+.

Adult↗

PubMedDate not supplied

Outcomes of adult cadaveric renal transplantation in ireland 1986 to 2001.

BACKGROUND: Since the introduction of renal transplantation in the Republic of Ireland in 1964, the number of transplants performed annually has increased from single figures in the 1960s to the current rate of approximately 130 renal transplants per year. Improvements in graft and patient outcomes have been associated with the introduction of the immunosuppressive agent Cyclosporin (CSA) in the mid 1980s. AIMS: The aim of this study was to examine trends in outcomes and factors that influence outcomes for adult kidney transplantation from 1986 to 2001. METHODS: All adult cadaveric kidney transplantations carried out between 1986 and 2001 were included. We separated the transplanted grafts and patients into four time periods; 1986-1989, 1990-1993, 1994-1997, 1998-2001. Graft and patient survival outcomes were compared for the different periods. RESULTS: The one-year kidney graft survival rate increased from 82% during 1986-1989 to 86% during 1998-2001. Patient survival over the four time periods studied has remained stable at approximately 95% at one year. CONCLUSION: We report a significant improvement in kidney graft outcomes over the past 16 years. Patient survival has remained relatively stable during this period.

Adult↗

PubMedDate not supplied

Renal transplantation in the elderly--the Irish experience.

BACKGROUND: The aim of this paper was to evaluate patient and kidney graft survival rates in renal transplant recipients and compare the outcomes between the different patient age groups. METHODS: A retrospective review of all adult renal transplants performed at Beaumont Hospital between the years 1986-2001 was carried out. Patients were defined as 'elderly' if they were 65 years of age or older and 'younger' if less than 65 years at the time of transplantation. Patient and transplant graft survival rates were analysed for each age group. RESULTS: Data were analysed on 1462 'younger' patients and 105 'elderly' renal transplant recipients. Estimated patient survival at 1, 5 and 10 years were 96%, 87% and 74% in the younger patient group compared to 85%, 59% and 33% in the elderly group. The adjusted graft survival rates (adjusted for death due to other causes and with a functioning graft in situ) for the younger group were 89%, 77% and 64% at one, five and ten years respectively, while for the elderly group, adjusted one, five and ten year survival rates were 89%, 83% and 70% respectively. CONCLUSIONS: Although the elderly have a shorter life expectancy than the younger population they do benefit from renal transplantation similar to the younger recipients.

Age Factors↗