PubMed Health⌕ Search

Biomedical subjects

E O'Shaughnessy

Publications and source records attributed to E O'Shaughnessy.

15 recordsLinked to original sources
PubMed1999

Development of a PCR assay for diagnosis of Pneumocystis carinii pneumonia based on amplification of the multicopy major surface glycoprotein gene family.

We have evaluated a PCR technique using primers based on Pneumocystis carinii major surface glycoprotein (MSG) genes, a multicopy gene family, for utility in detection of P. carinii in BAL and oropharyngeal samples obtained from immunosuppressed patients. These primers were able to detect P. carinii DNA in as little as 16 fg of genomic DNA. PCR using MSG primers detected P. carinii DNA in 7 smear-positive BAL samples (100% sensitivity), and found no P. carinii DNA in 12 smear-negative BAL samples (100% specificity). Mitochondrial ribosomal RNA (mrRNA) primers, commonly used in PCR studies of PCP, detected P. carinii in six of seven positive samples (85.7% sensitivity) and none of 12 were negative samples (100% specificity). Diagnosis of PCP by amplification of 81 oropharyngeal samples using MSG primers had a 50% sensitivity (4/8) and 96% specificity (70/73). PCR with mrRNA primers was 37.5% sensitive (3/8) and 100% specific (73/73). All three false-positive MSG results showed a very low intensity on Southern hybridization. PCR using MSG gene primers should prove valuable in the diagnosis of PCP.

Fungal Proteins↗
PubMed1996

Comparison of 99mTc infecton imaging with radiolabelled white-cell imaging in the evaluation of bacterial infection.

BACKGROUND: Bacterial infection can pose a substantial diagnostic dilemma. Techniques involving radiolabelled leucocytes can pinpoint the site of inflammation. However, previous radiolabelling techniques have failed to distinguish between bacterial-mediated infection and non-bacterial inflammation. To overcome this difficulty, we have studied a radiopharmaceutical, technetium-99m (99mTc) Infecton, which is based on the antibiotic ciprofloxacin. METHODS: We used this agent to image bacterial infection in 56 patients (one twice) with known or suspected sites of infection. We then compared the imaging results of these patients with those from a radiolabelled leucocyte study. FINDINGS: The concordance rate was 68% (39 out of 57 images). In 18 discordant results 99mTc Infecton was correctly positive in 8 out of 9 positive studies and correctly negative in 4 out of 9 negative studies. 4 out of 5 of the falsely negative studies were in patients who had taken antibiotics for over 7 days. We found that 99mTc Infecton gave better imaging results than radiolabelled leucocytes. Comparison between 99mTc Infecton and leucocyte imaging gave sensitivities of 84% and 81%, and specificities of 96% and 77%, respectively. INTERPRETATION: We believe that the specificity 99mTc Infecton confers for bacterial infection and its ease of administration are the main advantages of this new agent.

Adolescent↗
PubMed1996

Tuberculosis due to Mycobacterium bovis in humans in the south-west region of Ireland: is there a relationship with infection prevalence in cattle?

OBJECTIVE: To compare the incidence of tuberculosis due to Mycobacterium bovis in humans to the prevalence of M. bovis infection in cattle in south-west Ireland and discuss possible links between them. SETTING: In the south-west region of Ireland, a mixed urban and rural community (pop. 536,000), there is a residuum of human tuberculosis caused by M. bovis. METHODS: A retrospective analysis of the incidence of culture-positive M. bovis disease in humans in south-west Ireland from 1983 to 1994 and of the results of tuberculin testing in cattle from 1978 to 1994 for the same region. RESULTS: One to five cases of human tuberculosis due to M. bovis were recorded per year while the overall prevalence of bovine infection fell gradually during the period of study from 467 tuberculin-positive animals per 100,000 cattle tested in 1983 to 158 per 100,000 in 1994. CONCLUSION: The low incidence plateau of human tuberculosis due to M. bovis together with the decline in prevalence of animal infection in the overall period studied suggest a cut-off in the animal to human chain of infection at two points; the animal source and the ingestion of (now pasteurized) milk. This would suggest that disease in humans is now due to reactivation of previous foci of infection which were acquired when milk pasteurization was not compulsory. Based on this, we would anticipate a further reduction and possible elimination of human tuberculosis due to M. bovis in this region in the next 10-15 years.

Animals↗
PubMed1995

Colorimetric detection of heat-labile toxin-encoding gene of enterotoxigenic Escherichia coli by PCR.

In the developing world, enterotoxigenic Escherichia coli (ETEC) strains which produce enterotoxins are a significant cause of morbidity and mortality. Heat-labile (LT) toxin PCR detection methods have been described, but they have limited applications in a routine laboratory setting. A colorimetric DNA method for the rapid amplification and detection of the LT toxin gene in ETEC strains is described. Target amplification together with colorimetric detection would overcome many of the limitations of conventional PCR. This paper describes a colorimetric PCR detection method specific for LT-gene-encoding ETEC strains. DNA was extracted from two representative colonies from each bacterial isolate and amplified by PCR. Digoxigenin was incorporated into the amplification product, permitting a one-step direct detection using anti-digoxigenin alkaline phosphatase-conjugated antibody. This technique was applied to the investigation of 70 E. coli isolates derived from clinical fecal samples obtained from an Irish population. Eleven percent of the samples were LT positive, confirming the applicability of this method. All LT-positive ETEC strains (controls and clinical isolates) were detected, and no false-positive results occurred.

Bacterial Toxins↗
PubMed1994

What is a clinical fact?

As a preliminary to the question, 'What is a clinical fact?', the author asks the wider question, 'What is a fact?', answering that facts are double in aspect: they both say how the world is, and they also depend on our species, our language, theory, etc. A claim of fact in any empirical discipline--in the natural sciences or in human studies with their different methods--is a truth claim which is not infallible or unique to the fact, and also a claim that must offer itself for verification. Using the clinical record of three sessions, she then tries to answer the question, 'What is a clinical fact?', offering the starting formulation that clinical facts, under the unusual conditions of an analytic hour which give an analyst access to a patient's inner world, manifests themselves in the form of immediate psychological realities between patient and analyst. On the way, the author discusses the analyst's anxieties about making a claim of clinical fact; further striking features emerge about clinical facts in the three sessions, and some unsolved problems, i.e. the variety of analytic theories, subjectivity and objectivity, are noted. Even while they bear the perplexities of their problems, clinical facts are of great significance to the study of the mind. They extend the domain of psychology to the area of the mind's interiority, with its human experiences of subjective meaning, conscious, and especially unconscious.

Adolescent↗
PubMed1992

Enclaves and excursions.

This paper describes and names as 'enclaves' and 'excursions' two deteriorations of the psychoanalytic situation, which occur when an analyst exceeds the limited, partial acting out inevitable in clinical work. Under pressure from his patient an analyst may unwittingly turn the analysis into a refuge from disturbance, i.e. an enclave. If he succumbs to pressures to move away from, instead of towards, knowing what is psychically urgent, an analyst may turn the analysis into a series of flights, i.e. an excursion. Unrecognized, these deformations interfere with or even halt the therapeutic process, which requires that the analyst find a way of working which accommodates both the patient's communication of, and need for, a refuge or flight with the analyst, while at the same time analysing it.

Adult↗
PubMed1990

Can a liar be psychoanalysed?

At first glance a liar is an inauspicious patient for a psychoanalysis, a treatment based on truthfulness. Because it presents in speech, lying may seem a mature difficulty, but analysis reveals that it is primitive, linked to the habitual liar's doubts and anxieties about communication with primary objects which, from several causes, have become for him lying objects. As expected, lying makes for a series of problems which handicap the analytic process. Even so, the paper illustrates clinically the view that if the fundamental level of the lying that emerges in the analysis is addressed by understanding it as the liar's communication that he is a liar in identification with, and acutely anxious about, his lying object--in the transference the analyst--a genuine analytic process can be set in train.

Deception↗
PubMed1983

Words and working through.

The paper discusses communication--its modes and its changes--between analyst and patient, and, more particularly, within the patient himself in the course of a psychoanalysis. Clinical material from two cases illustrates how patients may need to communicate to the analyst both in words and also--in order to bring their less developed self--by more primitive modes, which can be understood and conceptualized by Melanie Klein's notion of projective identification. As the patient feels understood by the analyst's words (the mutative interpretations) he may slowly become more aware of his primitive modes of relating, until, ultimately, his method of communication changes and he is himself able to express his understanding of himself in his own words. This brings structural change and a resumption of ego development, and is a mutative moment. In brief: mutative interpretations are not by themselves the agency of change. They put the patient in a position to change. He himself must do the active, mutative working through in his own words.

Communication↗
PubMedDate not supplied

Human Mycobacterium bovis infection in the south-west of Ireland 1983-1992: a comparison with M. tuberculosis.

Epidemiological and bacteriological aspects of human Mycobacterium bovis disease were investigated in south-west Ireland (counties Cork & Kerry, population 536,000) over the years 1983-92 inclusive and compared to M. tuberculosis. Results showed a small, stable incidence of culture positive M. bovis human disease, mean annual incidence 0.56 per 100,000 population compared to a higher but declining incidence of culture positive M. tuberculosis (15.3 per 100,000 in 1983, 9.0 per 100,000 in 1992). Male patients were the majority, 63.4 per cent of M. bovis; 62.4% of M. tuberculosis (p = 0.03). Fifty three per cent of M. bovis cases (n = 30) were pulmonary, compared to 85% of M. tuberculosis (n = 626; p = 0.0001). M. bovis patients were older (p = 0.02), mean age 58.4 years (SD 18.9) compared to 48.5 (SD 22.2). The mycobacterial smear positive rate was similar in both groups taken as a whole. No rural-urban difference in incidence was found in either disease, suggesting in the case of M. bovis initial infection in childhood via contaminated milk in the pre-pasteurisation era.

Animals↗