PubMed Health⌕ Search

Biomedical subjects

E Keane

Publications and source records attributed to E Keane.

At least 19 recordsLinked to original sources
PubMed2004

Brain death and organ donation: an audit in the Irish National Transplantation and Neurosurgical Centre.

We set out to identify the reasons why potential organ donors (PODs) fail to become actual donors and the causes of under-utilization of organs offered for donation. We audited 354 patients who died in the intensive Care Unit over 18 months. Of 155 PODs, 78 (50%) did not undergo brain stem testing (BST) because of (i) unavoidable death from non-CNS causes before BST (n = 50), (ii) treatment withdrawal without BST (n = 17) and (iii) preconditions for BST were not fulfilled (n = 11). Brain death was confirmed in 75 patients. Relatives refused consent for donation in 25 patients organ donation was not discussed with the family in 6, and medical contraindications to organ donation prevented donation in 5. Thirty seven (24% of all PODs) became organ donors who provided a total of 216 organ. All donated kidneys were utilized but unsuitability and logistic issues prevented utilization of 20% and 13% of all donated organs respectively. The commonest reason for failure to utilise potential organ donors was failure to perform BST. In most cases this was because BSTs were not possible but more aggressive management of and the routine performance of BST in all PODs could increase the number of donors. Not approaching relatives to ask consent for organ donation and a high rate of refusal by relatives also led to loss of organ donors.

Brain Death↗
PubMed2003

Immunisation: the views of parents and health professionals in Ireland.

A knowledge, attitude and practice study on vaccinations was undertaken among Irish parents and healthcare professionals between May and August 2001. Parents expressed fear of vaccine side effects, mistrust of health services, and felt poorly informed on the vaccination issues. According to group discussions, health professionals felt they lack time and user-friendly materials to properly inform the parents.

Health Knowledge, Attitudes, Practice↗
PubMed2001

Local delivery of c-myc neutrally charged antisense oligonucleotides with transport catheter inhibits myointimal hyperplasia and positively affects vascular remodeling in the rabbit balloon injury model.

Myointimal hyperplasia after percutaneous transluminal coronary angioplasty (PTCA) is a key component of the process of restenosis. The c-myc is a critical cell-cycle division protein involved in the formation of neointima. We evaluated the long-term impact of local delivery of c-myc neutrally charged antisense oligonucleotides (Resten-NG) on myointimal hyperplasia after PTCA in a rabbit model. PTCA was performed in the iliac arteries of 25 New Zealand white rabbits, using a Transport catheter at 8 atm for 30 sec, three times; 500 microg Resten-NG (n = 11) or saline (n = 14) was delivered to the PTCA site at 2 atm with the outer balloon for 2 min. The diet was supplemented with 0.25% cholesterol for 10 days before and 60 days after PTCA. Angiography was performed at harvest, and vessels were fixed in formalin, processed, and stained with hematoxylin and eosin (H&E) and Movat. Quantitative angiography showed that local delivery of antisense c-myc at PTCA reduced late luminal loss from 1.8 +/- 0.30 mm in control animals to 0.90 +/- 0.30 mm in the treatment group (P = 0.001). Histological analysis by planimetry showed that intimal areas were 1.67 +/- 0.44 mm(2) and 0.82 +/- 0.32 mm(2) in the control and antisense delivery groups, respectively (P < 0.05). We conclude that local delivery of Resten-NG inhibited myointimal hyperplasia after PTCA in cholesterol-fed rabbits for up to 60 days.

Angioplasty, Balloon, Coronary↗
PubMed2000

Trend analysis and socio-economic differentials in infant mortality in the Southern Health Board, Ireland (1988-1997).

The objective of this paper is to examine trends in infant mortality (IMR) and low-birth weight (LBW) in the Southern Health Board (SHB) area and to investigate the relationship between IMR and social and economic factors. IMR data were obtained from the Central Statistics Office (CSO) over a 10-year period (1988-1997). Social deprivation was measured using the Small Area Health Research Unit (SAHRU) Deprivation Index, which consists of five census-based indicators; unemployment, low social class, car ownership, rented accommodation and overcrowding. During the 10 years, 556 infants died, 380 deaths (68%) occurring in the neonatal period and 176 (32%) in the post-neonatal period. There was a downward trend in IMR throughout the study period, from 11.3 in 1988 to 4.0 in 1997 (p < 0.001). The IMR in Cork City was higher than the rate in the SHB area as a whole (p = 0.0001). Congenital anomalies accounted for 34% of neonatal deaths. Sudden infant death syndrome (SIDS) and congenital anomalies accounted for 45% (79/176) and 22% (39/176) of postnatal deaths, respectively. Only 7% of all district electoral division (DED's) in the SHB were classed in the most deprived SAHRU Deprivation Index category (level 5). Yet, almost half (43%) of the DED's in Cork City were level 5 compared to only 1% in Cork County and 2% in Kerry. Despite significant overall improvements in infant mortality in the SHB, infants born into the lower socio-economic area (Cork City) continue to experience higher relative risks of mortality in comparison with those born in the higher socio-economic areas. Further investigation into the apparently divergent socio-economic patterns of infant mortality within the SHB is necessary.

Cause of Death↗
PubMed1999

Micronutrient supplementation in the AIDS diarrhoea-wasting syndrome in Zambia: a randomized controlled trial.

OBJECTIVE: As HIV has spread through sub-Saharan Africa, persistent diarrhoea has emerged as a major problem in hospitals and in the community in severely affected areas. We have previously demonstrated that antiprotozoal therapy with albendazole reduces diarrhoea in AIDS patients in urban Zambia. This trial was designed to test the hypothesis that the clinical response to albendazole might be improved by oral micronutrient supplementation. DESIGN: Randomized, placebo-controlled trial. SETTING: Home care service of Ndola Central Hospital, Zambia. PATIENTS: HIV-seropositive patients with persistent diarrhoea. INTERVENTION: Patients were randomized to albendazole plus vitamins A, C and E, selenium and zinc orally or albendazole plus placebo, for 2 weeks. MAIN OUTCOME MEASURES: Time with diarrhoea following completion of treatment; mortality; adverse events. RESULTS: Serum vitamin A and E concentrations before treatment were powerful predictors of early mortality, but supplementation did not reduce time with diarrhoea or mortality during the first month, even after taking into account initial vitamin A or E concentrations, CD4 cell count or clinical markers of illness severity. Serum concentrations of vitamins A and E did not increase significantly in supplemented patients compared with those given placebo, and there were no changes in CD4 cell count or haematological parameters. No adverse events were detected except those attributable to underlying disease. CONCLUSIONS: Although micronutrient deficiency is predictive of early death in Zambian patients with the diarrhoea-wasting syndrome, short-term oral supplementation does not overcome it nor influence morbidity or mortality.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Melting of a DNA hairpin without hyperchromism.

UV absorbance spectroscopy is the most common method for detecting nucleic acid structural transitions and obtaining thermodynamic parameters. UV-detected melting has been used to determine stabilities of nucleic acid hairpins, duplexes, triplexes, and higher order structures and to determine thermodynamic effects of unusual or modified bases and mismatched base-pairs. We report that in some cases UV absorbance spectroscopy is an inadequate analytical technique for these purposes. Some critical transitions are invisible to UV absorbance spectroscopy. For example, the conversion of dodecamer d(CGCAAATTCGCG) from hairpin to random coil is not accompanied by hyperchromism. Circular dichroism (CD) spectroscopy (263 nm) clearly detects two transitions for this dodecamer, each giving a pronounced change in ellipiticity. The concentration dependence of the low-temperature transition and the concentration independence of the high-temperature transition indicate that the predominant state converts from duplex to hairpin to random coil as the temperature increases. These assignments are confirmed by comparison to oligonucleotides of similar sequence that undergo a hairpin to coil transition only. In contrast to CD spectroscopy, UV absorbance spectroscopy shows only a single transition. The transition detected by UV absorbance spectroscopy corresponds to the low-temperature transition detected by CD. UV absorbance spectroscopy does not detect the second transition at any wavelength (from 218 to 310 nm) (by changes) in either absorbance or its derivative with temperature.

Circular Dichroism↗
PubMed1997

Psychiatric disorder among American Indian adolescents: prevalence in Northern Plains youth.

UNLABELLED: This article presents data on the prevalence of psychiatric disorders among American Indian adolescents, using DSM-III-R criteria. OBJECTIVE: To generate current prevalence data using a structured diagnostic instrument, the Diagnostic Interview Schedule for Children, Version 2.1C (DISC-2.1C). METHODS: Youths from a Northern Plains tribe who had participated in an earlier study comprised the sample. At reinterview, respondents were between 14 and 16 years of age, when Indian adolescents are thought to be at particularly high risk for manifesting emotional disorders. One hundred nine of the original sample of 251 were still in schools on the reservation. Trained indigenous lay interviewers administered the DISC-2.1C to respondents in a private setting within the school. RESULTS: The findings indicate that rates of some psychiatric problems (e.g., disruptive behavior disorders, substance-related disorders, and their comorbidity) are high among these high school students. CONCLUSIONS: These data, as well as national statistics, suggest that, compared with non-Indian populations, a greater percentage of Northern Plains adolescents manifest significant psychiatric symptoms which warrant treatment.

Adolescent↗
PubMed1996

Survey of immunity to measles in schoolchildren in Cork.

Surveillance of measles in the Republic of Ireland has relied until now on notifications of clinically diagnosed infections and a manual system for monitoring coverage. In the light of a measles epidemic predicted in the United Kingdom in 1995, it was considered timely to review the epidemiology of measles and obtain baseline seroepidemiological data on measles immunity in Cork City in the Republic of Ireland. The age specific prevalence of measles IgG in saliva from 2000 schoolchildren aged 5 to 15 years was determined. The study also compared susceptibility rates in children with and without a history of measles vaccination or infection. Histories provided by parents were found to be unreliable in informing vaccination practice, as 79 of the 102 seronegative children would have been classified as immune. The proportion of children immune to measles, as gauged by seropositivity, was 91.9% in children aged 5 to 10 years and 95.8% in 11 to 15 year olds. The implications of the study results are discussed in relation to future prevention and control strategies.

Adolescent↗
PubMed1996

Albendazole chemotherapy for treatment of diarrhoea in patients with AIDS in Zambia: a randomised double blind controlled trial.

OBJECTIVE: To determine the value of short course, high dose albendazole chemotherapy in the treatment of persistent diarrhoea related to HIV in unselected patients in urban Zambia. DESIGN: A randomised double blind placebo controlled trial of albendazole 800 mg twice daily for two weeks. Patients were monitored intensively for one month and followed for up to six months. SETTING: Home care. AIDS services in Lusaka and Ndola. PATIENTS: 174 HIV seropositive patients with persistent diarrhoea (defined as loose but not bloody stools three or more times a day for three weeks or longer). No investigations were undertaken except HIV testing after counselling. MAIN OUTCOME MEASURES: Proportion of time periods during which diarrhoea was experienced after completion of treatment; proportion of patients with full remission after completion of treatment; mortality. RESULTS: The patients taking albendazole had diarrhoea on 29% fewer days than those taking placebo (P < 0.0001) in the two weeks after treatment. The benefit of albendazole was maintained over six months. In patients with a Karnofsky score of 50 to 70 (needing help with activities of daily living and unable to work, but not needing admission to hospital) diarrhoea was reduced by 50%. Remission was obtained in 26% of all patients who received albendazole (P = 0.004 against 9% receiving placebo), and this difference was maintained over six months (log rank test, P = 0.003). Albendazole had no effect on mortality. Minimal adverse effects were noted. CONCLUSIONS: For HIV infected Zambians with diarrhoea of more than three weeks' duration albendazole offers substantial relief from symptoms and may be used empirically, without prior investigation.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Back to basics.

Explore the source record for details and available documents.

Humans↗
PubMedDate not supplied

Kill or cure?

Explore the source record for details and available documents.

Aged↗
PubMedDate not supplied

Who's holding the baby?--women's experience of their postnatal care.

This paper examines women's experience of their postnatal care in hospital and at home. It found that over a third of women surveyed had problems caring for themselves and the baby. Breastfeeding mothers were more likely to have problems than bottle-feeding mothers. There was no relationship between having such problems and parity. Women were particularly dissatisfied with postnatal services at home, 45% describing them as inadequate. Satisfaction with services was significantly associated with having sufficient advice from health professionals in hospital and at home. In view of the findings of this paper, it is clear that a strategy is required to identify those most in need of postnatal care and target services accordingly.

Adolescent↗