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Biomedical subjects

E O'Malley

Publications and source records attributed to E O'Malley.

At least 19 recordsLinked to original sources
PubMed1995

Professed religious affiliation and the practice of euthanasia.

Attitudes towards active voluntary euthanasia (AVE) and physician-assisted suicide (PAS) among 1,238 doctors on the medical register of New South Wales varied significantly with self-identified religious affiliation. More doctors without formal religious affiliation ('non-theists') were sympathetic to AVE, and acknowledged that they had practised AVE, than were doctors who gave any religious affiliation ('theists'). Of those identifying with a religion, those who reported a Protestant affiliation were intermediate in their attitudes and practices between the agnostic/atheist and the Catholic groups. Catholics recorded attitudes most opposed to AVE, but even so, 18 per cent of Catholic medical respondents who had been so requested, recorded that they had taken active steps to bring about the death of patients.

Attitude of Health Personnel↗
PubMed1994

Euthanasia: attitudes and practices of medical practitioners.

OBJECTIVE: To record doctors' attitudes towards, and practice of, active voluntary euthanasia (AVE) and physician-assisted suicide (PAS) in New South Wales and the Australian Capital Territory. METHODS: A postal survey was sent to a random sample of 2000 practitioners on the Medical Register of NSW (which includes medical practitioners in the ACT). RESULTS: Almost half the practitioners had been asked to perform euthanasia, of whom 28% had complied. Of practitioners asked to assist with suicide, 7% had complied. There was majority support for changes to the law concerning euthanasia. CONCLUSIONS: There are relatively high levels of support for, and practice of, AVE and PAS by medical practitioners in New South Wales and the ACT, suggesting that the current legislation should be reviewed.

Adult↗
PubMed1987

Differential ontogeny of alpha 1-adrenergic and cholinergic receptor sites in the atria and ventricles of the inbred Dahl hypertension-sensitive (S/JR) and -resistant (R/JR) rat.

The ontogeny of atrial and ventricular alpha 1-adrenergic and muscarinic cholinergic receptor sites was investigated in inbred Dahl hypertension-sensitive (S/JR) and -resistant (R/JR) rats between 5 and 150 days of age. The density of sites in both cardiac regions was generally greater in the neonate than mature rat. A marked proliferation of sites was observed in neonatal and young adult rats that occurred in the following order: ventricular cholinoceptors----ventricular adrenoceptors----atrial cholinoceptors----atrial adrenoceptors. The density of ventricular adrenoceptors was greater in the S/JR rat than the R/JR rat at 5 days of age. At 150 days of age, the density of sites was less in the S/JR rat than the age-matched R/JR rat or the normotensive 50-day-old S/JR rat. The development of atrial adrenoceptors was similar between the strains, regardless of the blood pressure. The density of ventricular cholinergic receptors was greater in the S/JR strain at 5 and 15 days of age. However, the density of atrial cholinergic sites was consistently greater in the S/JR strain throughout development. The results of this study suggest that: (1) significant prenatal receptor development occurs in the heart; (2) receptor development may precede the functional maturation of postganglionic autonomic efferents; and (3) distinguishing differences in the regional density of alpha 1-adrenergic and muscarinic cholinergic binding sites are present between S/JR and R/JR rats at much earlier points in development than previously shown.

Animals↗
PubMed1987

To tunnel or not to tunnel catheters for parenteral nutrition.

The effect of subcutaneous catheter tunnelling on the incidence of catheter sepsis and on catheter life span in the absence of a nutrition team was determined in a prospective controlled clinical trial. Eighty one patients who received 92 courses of parenteral nutrition had 110 catheters inserted. Alternate catheters were tunnelled. Four patients who received parentheral nutrition for less than 48 hours were excluded from the study. Catheter related sepsis occurred in one tunnelled (1.8%) and 4 non-tunnelled catheters (7.6%) (P greater than 0.05 NS). Mean life span of tunnelled catheters was 21 days (range 5-37 days) compared to 12.6 days for non-tunnelled (range 3-19 days) (P less than 0.05). Six non-tunnelled catheters became displaced, a complication which did not occur with tunnelled catheters (P less than 0.01). In conclusion subcutaneous tunnelling of silicone catheters prolongs catheter life span but does not significantly influence catheter sepsis.

Bacterial Infections↗
PubMed1987

The role of CT in the management of carcinoma of the oesophagus and cardia.

The role of computed tomography in assessing tumour spread and tumour resectability was evaluated in 50 patients with oesophageal carcinoma (17 middle third, 33 lower third). CT accurately identified all patients with tumour confined to the oesophagus (Stage I or II) but was limited in its ability to assess direct organ invasion (Stage III) with an overall accuracy for evaluating middle third lesions of 82% (aorta 70%, tracheobronchial tree 94%, other mediastinal structures 82%) compared to an overall accuracy for lower third lesions of 97% (aorta 97%, pancreas 100%, diaphragm 97%). Tumours deemed resectable on CT were always resectable at operation but two of seven middle third tumours and one of twelve lower third lesions deemed unresectable underwent curative resection. Preoperative CT evaluation of oesophageal tumours is useful in that it may reliably identify tumour lesions confined to the oesophagus and reliably identify distant metastases. Because of its limitations however in the assessment of organ invasion, particularly by middle third lesions, this study suggests that patients with oesophageal tumours with no evidence of distant metastases, who are otherwise fit to undergo tumour resection, should not be denied surgery on the sole basis of positive organ invasion on CT particularly if that organ is the aorta.

Adult↗
PubMed1986

Lymphadenopathy due to fatal histiocytic proliferative disorder containing Michaelis-Gutmann bodies.

A 59-year-old white man had generalized lymphadenopathy, fever, weight loss, and hypercalcemia. Histologic examination of seven lymph nodes from three different anatomic sites revealed a diffuse histiocytic infiltrate containing numerous typical Michaelis-Gutmann (MG) bodies. Histochemical and immunohistochemical results confirmed the histiocytic nature of the predominant cell within the infiltrate. Approximately equal numbers of residual normal B-cells, T-helper, and T-suppressor cells were present. Electron microscopy revealed extracellular and intracellular MG bodies, many of which were membrane-bound. Special stains, electron microscopy, and lymph node culture did not demonstrate microorganisms. The histologic features of the infiltrate were those of malacoplakia. However, the disease behaved like a lymphoma, with the occurrence of lymphadenopathy and a fatal outcome.

B-Lymphocytes↗
PubMed1986

The ontogeny of renal alpha 1- and alpha 2-adrenoceptors in the Dahl rat model of experimental hypertension.

[3H]prazosin (PRAZ) and [3H]rauwolscine (RAUW) were used to examine the ontogeny of renal alpha 1- and alpha 2-adrenoceptors in the inbred Dahl hypertension-sensitive (S/JR) and -resistant (R/JR) rat. PRAZ and RAUW each bound to a single population of non-interacting sites. The binding of each ligand was saturable and reversible. The greatest proliferation of each receptor subtype occurred between 5 and 25 days of age. During this period, a 4 to 5-fold increase in the density of each was observed. Adult levels of each were reached by 50 days of age. The alpha 2-adrenoceptor was the predominant subtype present in renal tissue. However, its ratio to the alpha 1 subtype was influenced by strain and age: the ratio was greatest in the S/JR strain and decreased with age in both strains. The profile of alpha 1-adrenoceptor development was similar in S/JR and R/JR rats. In contrast, the density of alpha 2-adrenoceptors was similar in S/JR and R/JR rats at 5 and 15 days of age but significantly greater in the S/JR rat between 25 and 150 days of age. The elevated density of alpha 2-adrenoceptors could not be explained by strain-related differences in blood pressure or alterations in the affinity of the receptor. The results suggest that a relationship may exist between elevated renal alpha 2-adrenoceptor density and the genetic predisposition to hypertension in the S/JR rat. However, because this relationship is not apparent during the neonatal period of development, the possibility that the elevated density of sites may be secondary to some other event should also be considered.

Age Factors↗
PubMed1983

Long term follow-up of hyperthyroid patients treated by subtotal thyroidectomy.

The early and long term complications of subtotal thyroidectomy in 306 hyperthyroid patients (multinodular goitre and diffuse hyperplasia) followed for up to 30 yr are reviewed. There were no perioperative deaths. Sixteen patients (5.2 per cent) had transient symptomatic hypocalcaemia, while 9 (2.9 per cent) had permanent hypocalcaemia. Permanent unilateral vocal cord paralysis occurred in 11 (3.6 per cent) patients (1.8 per cent of nerves at risk). Cumulative per cent (+/- s.e.m.) relapse and hypothyroid rates at 30 yr (life-table analysis) were 15.6 +/- 2.4 per cent and 20.5 +/- 2.1 per cent, respectively. Lifelong follow-up of post-thyroidectomy patients is mandatory because of the risk of relapse of hypothyroidism.

Adolescent↗