PubMed Health⌕ Search

Biomedical subjects

Daniel O'Connor

Publications and source records attributed to Daniel O'Connor.

11 recordsLinked to original sources
PubMed2006

A survey of publicly funded aged psychiatry services in Australia and New Zealand.

OBJECTIVE: To map the size and distribution of publicly funded aged psychiatry (psychogeriatric) services in Australia and New Zealand in 2003. METHOD: Services were tracked exhaustively through personal, professional and academic contacts, electronic searches and word-of-mouth. Directors or managers of services were asked to complete a brief questionnaire concerning their locality, services, staff profile and patient contacts. RESULTS: Services varied widely with respect to their numbers, size and community outreach. Victoria was the only Australian state to provide specialist, multidisciplinary aged psychiatry teams with community, acute inpatient and residential arms in all its major cities. New South Wales, the state with the largest aged population, performed relatively poorly on most indicators. New Zealand performed relatively well despite its small size and widely dispersed population. CONCLUSIONS: Publicly funded aged mental health services are effective and reach frail, multiply disabled old people who cannot access private psychiatrists and are often overlooked by services for younger adults. At the time of our survey, such services were distributed in Australia in a highly inequitable fashion.

Aged↗
PubMed2006

Psychotic symptoms in the elderly--assessment and management.

BACKGROUND: Psychotic symptoms in the elderly arise in mood disorders, schizophrenia, dementia, and delirium. OBJECTIVE: This article provides a brief overview of the presentation and management of each condition. DISCUSSION: Management follows logically from a thorough mental state examination, medical work up and accurate diagnosis. Depression and mania with psychotic symptoms respond best to an antidepressant and mood stabiliser respectively, usually in combination with antipsychotic medication. Severe cases require electroconvulsive therapy. Atypical antipsychotics are now the treatment of choice in late life schizophrenia. Psychotic symptoms are common in dementia but usually fade within 6-12 months. Doses of psychiatric medications should therefore be lowered every 3 months to check that continued treatment is necessary. Most cases of delirium do not require psychiatric medication.

Aged↗
PubMed2005

Effects of titanium particle size on osteoblast functions in vitro and in vivo.

The formation of titanium (Ti)-wear particles during the lifetime of an implant is believed to be a major component of loosening due to debris-induced changes in bone cell function. Radiographic evidence indicates a loss of fixation at the implant-bone interface, and we believe that the accumulation of Ti particles may act on the bone-remodeling process and impact both long- and short-term implant-fixation strengths. To determine the effects of various sizes of the Ti particles on osteoblast function in vivo, we measured the loss of integration strength around Ti-pin implants inserted into a rat tibia in conjunction with Ti particles from one of four size-groups. Implant integration is mediated primarily by osteoblast adhesion/focal contact pattern, viability, proliferation and differentiation, and osteoclast recruitment at the implant site in vivo. This study demonstrates the significant attenuation of osteoblast function concurrent with increased expression of receptor activator of nuclear factor kappaB ligand (RANKL), a dominant signal for osteoclast recruitment, which is regulated differentially, depending on the size of the Ti particle. Zymography studies have also demonstrated increased activities of matrix metalloproteinases (MMP) 2 and 9 in cells exposed to larger Ti particles. In summary, all particles have adverse effects on osteoblast function, resulting in decreased bone formation and integration, but different mechanisms are elicited by particles of different sizes.

Animals↗
PubMed2005

Tissue compression is not necessary for needle-localized lesion identification.

BACKGROUND: Tissue compression to enhance lesion visibility on radiography of needle-localized breast biopsy specimens is widely used. We hypothesized that compression is not necessary for detection of lesions on specimen radiography. METHODS: Forty-nine consecutive patients underwent needle-localization biopsies of 59 mammographic targets. All specimens were radiographed without and with compression. The films were later independently reviewed and compared with preoperative mammograms by 2 surgeons and a breast-imaging radiologist. The primary end point was identification of mammographic targets in noncompressed specimen radiographs. RESULTS: Twenty-nine targets were masses, 36 contained calcifications, and 14 contained previously placed clips. All mammographically localized lesions were identified on noncompressed views. Overall concordance for the 2 images was 100% for all 3 reviewers and 98% among reviewers. CONCLUSIONS: Tissue compression before specimen radiography is not routinely necessary for target lesion identification.

Biopsy, Needle↗
PubMed2005

A survey of Australian and New Zealand old age psychiatrists' preferred medications to treat behavioral and psychological symptoms of dementia (BPSD).

BACKGROUND: People with behavioral and psychological symptoms of dementia (BPSD) are often prescribed psychotropic medications. There is little evidence that one class of medication is more effective and safer than another and so expert opinion plays an important role in shaping local practice. In an earlier U.S. survey of psychiatrists and neurologists, limited consensus emerged regarding the pharmacological management of BPSD. We repeated this study to check consensus levels in Australia and New Zealand, following the introduction of newer atypical neuroleptics, antidepressants and cholinesterase inhibitors, and to identify areas where drug trials will be of greatest benefit. METHODS: A brief structured survey, similar to one used in the U.S.A., was posted to a random sample of members of the Australian and New Zealand Faculty of Psychiatry of Old Age. RESULTS: We received 106 replies (71% response). Respondents, who had 14 years' experience on average, rated atypical neuroleptics as their treatment of choice for dementia complicated by psychosis, verbal aggression, physical aggression, sundowning and persistent yelling. Opinions varied widely regarding the management of other symptoms and the role of second-line treatments. CONCLUSION: Atypical neuroleptics were preferred by most respondents for treatment of most BPSD. These views, while based on considerable clinical experience, have only limited backing from published reports, and head-to-head studies of available treatments are required to ensure that clinical practice has scientific support.

Aged↗
PubMed2004

How well do Australian medical schools prepare general practitioners to care for patients with mental disorders?

OBJECTIVE: The purpose of the present paper was to map the mental health workloads of general practitioners (GPs) , and to determine GPs' views of the adequacy of their undergraduate training in psychiatry. METHODS: Twenty-nine GPs who had graduated since 1980 from an Australian medical school provided data on 339 consecutive adult patients with conspicuous psychological disorders. After listing their patients' problems and management plans, doctors rated the value of their undergraduate teaching in preparing them for this task. RESULTS: Depression, anxiety and substance abuse accounted for 71% of reported cases. Virtually all patients were given some psychologically orientated treatment. Only half were prescribed a psychotropic medication. Nineteen of the 29 doctors wished that they had received more training in counselling. CONCLUSIONS: In an earlier survey it was found that Australian and New Zealand medical school curricula focused largely on the diagnosis and pharmacological management of psychosis and depression. The GPs in the present study most commonly applied psychologically orientated treatments of anxiety, depression and substance abuse. It is proposed that medical schools provide tuition to medical students in counselling.

Adolescent↗
PubMed2003

Effect of radiation, heat, and aging on in vitro wear resistance of polyethylene.

Radiation cross-linking increases the wear resistance of polyethylene used in total hip replacement. Radiation also generates residual free radicals, which are detrimental to long-term properties of polyethylene. Two approaches are used to stabilize the residual free radicals and terminally sterilize the components. One is postirradiation annealing with gas sterilization and the other is postirradiation melting with gamma sterilization in nitrogen. The hypothesis of the current study is that postirradiation annealing followed by gamma sterilization in nitrogen will result in more free radicals in polyethylene than gamma sterilization either in air or in nitrogen alone. To test this hypothesis, concentration of residual free radicals was quantified in polyethylene that was annealed and gamma sterilized in nitrogen and control polyethylenes gamma sterilized in air versus in nitrogen. Three crosslinked polyethylenes that were melted and gas sterilized also were included in the study. The effects of residual free radicals were studied by accelerated aging. Oxidation levels and weight loss in bidirectional pin-on-disk tests were determined before and after aging. Polyethylene that was subjected to postirradiation annealing and gamma sterilization resulted in 58% more residual free radicals than control polyethylenes. Weight loss of the annealed polyethylene increased by 16-fold on accelerated aging and had three times higher oxidation levels than that measured in control polyethylenes after aging. In contrast, polyethylenes that were stabilized with postirradiation melting and terminally gas sterilized showed no detectable residual free radicals. Accelerated aging did not affect the weight loss and oxidation levels of melted polyethylenes.

Free Radicals↗
PubMed2002

Reimaging in pediatric neurotrauma: factors associated with progression of intracranial injury.

PURPOSE: The purpose of this study was to characterize the radiologic changes that are seen in the first 24 to 48 hours after head injury and to correlate those changes with clinical findings, to determine which children are at greatest risk for progression of their neurologic injury. METHODS: The authors identified 104 children (less-than-or-equal17 years of age) who had a second computed tomography (CT) scan of the head within 24 to 48 hours of admission. CT scans were evaluated systematically in a blinded fashion. Mechanism of injury, findings on physical examination, therapeutic measures, and changes in management were recorded from hospital medical records. The 50 children whose second CT scan showed progression of injury were compared with the 54 patients whose intracranial injuries were unchanged or improved on their second CT. RESULTS: Twenty-six percent of patients (13 of 50) with radiographic progression of injury had an admission Glasgow coma score of 15. Progression of injury was more common, however, in patients with lower Glasgow coma scores, averaging 9 on admission and 10 at the time of the second CT. Progression of injury also was more common if the initial head CT showed 3 or more intracranial injuries, mass effect, intraventricular hemorrhage, or an epidural hematoma. CONCLUSIONS: Children with an intracranial injury identified on their initial head CT scan should undergo a second scan 24 hours after injury, especially if the initial CT shows 3 or more intracranial injuries, mass effect, intraventricular hemorrhage, or an epidural hematoma. .

Adolescent↗