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Biomedical subjects

E Rooney

Publications and source records attributed to E Rooney.

15 recordsLinked to original sources
PubMed1999

Comparison of the short-term effects of candoxatril, an orally active neutral endopeptidase inhibitor, and frusemide in the treatment of patients with chronic heart failure.

BACKGROUND: Candoxatril is a novel neutral endopeptidase inhibitor that increases plasma concentrations of atrial natriuretic factor and thereby produces natriuresis, diuresis, and vasorelaxation. This profile of action offers theoretical advantages over standard diuretic therapy in the treatment of patients with heart failure. The aims of the study were to compare the effects of candoxatril with those of frusemide in the treatment of patients with mild heart failure. METHODS: Male patients with mild heart failure were randomly assigned to 9 days of therapy with 20 mg frusemide twice a day, 200 mg candoxatril twice a day, or 400 mg candoxatril twice a day (n = 10 per group) after a 14-day placebo washout phase. Systemic hemodynamic measurements, exercise tolerance, and urinary and plasma hormone concentrations were assessed during the placebo run-in and at the beginning and end of the double-blind therapy. RESULTS: Frusemide and candoxatril caused similar diuresis and natriuresis. Candoxatril caused a slight decrease in systolic blood pressure and a dose-dependent increase in plasma and urinary concentrations of atrial natriuretic factor without elevating plasma renin activity. Frusemide reduced plasma concentrations of atrial natriuretic factor and increased plasma renin activity. Treadmill exercise capacity decreased 30 +/- 26 seconds after use of frusemide, compared with increases of 12 +/- 35 seconds after use of 200 mg candoxatril twice a day and 35 +/- 31 seconds after use of 400 mg candoxatril twice a day (P =.13; frusemide versus 400 mg candoxatril twice a day). CONCLUSIONS: In the treatment of patients with mild heart failure, candoxatril has diuretic effects equivalent to those of 20 mg frusemide twice a day without the associated and potentially detrimental activation of the renin-angiotensin-aldosterone system. The trend for improved exercise capacity with candoxatril warrants further investigation.

Atrial Natriuretic Factor↗
PubMed1999

Echocardiography overestimates left ventricular mass in hemodialysis patients relative to magnetic resonance imaging.

UNLABELLED: Echocardiography overestimates left ventricular mass in hemodialysis patients relative to magnetic resonance imaging. BACKGROUND: Left ventricular hypertrophy (LVH) is a common finding and a strong adverse prognostic factor in patients with chronic renal failure. An accurate method of measuring left ventricular mass (LV mass) is therefore a prerequisite in the management of these patients. Recent evidence has suggested that echocardiography overestimates LV mass in patients with essential hypertension, and this error increases with increasing LV mass. METHODS: We studied 35 patients on maintenance hemodialysis within 24 hours of their last dialysis. LV mass was measured by both echocardiography and magnetic resonance imaging (MRI) performed less than three hours apart. Clinic and ambulatory blood pressure (ABPM), resting echocardiogram, and blood sampling were performed at the same visit. RESULTS: Thirty-two patients had results from both methods. Clinic blood pressure, ABPM, and QT dispersion all correlated with LV mass, with a stronger correlation observed for MRI values. Intraobserver and interobserver variability were significantly greater for echocardiography (although similar to other published data). Comparing the two methods, the difference in LV mass values (echo minus magnetic resonance) increased in a linear fashion with an increasing mean mass and chamber diameter. CONCLUSIONS: Echocardiography significantly overestimates LV mass relative to MRI in the presence of LVH and dilation. This overestimation is the result of assumptions made in the calculation of mass from echocardiography M-mode images, which are invalid when LV geometry is abnormal. This error is therefore amplified in dialysis patients, the majority of whom have LVH and in whom intravascular volume is constantly changing.

Adult↗
PubMed1999

Inappropriately low plasma leptin concentration in the cachexia associated with chronic heart failure.

BACKGROUND: Cardiac cachexia is a syndrome of generalised wasting which caries a poor prognosis and is associated with raised plasma concentrations of tumour necrosis factor alpha (TNFalpha). TNFalpha increases secretion of leptin, a hormone which decreases food intake and increases energy expenditure. OBJECTIVE: To determine whether an inappropriate increase in plasma leptin concentration contributes to the cachexia of chronic heart failure. DESIGN: Retrospective case-control study. SETTING: Tertiary referral cardiology unit. PATIENTS: 110 human subjects comprising 29 cachectic chronic heart failure patients, 22 non-cachectic chronic heart failure patients, 33 patients with ischaemic heart disease but normal ventricular function, and 26 healthy controls. INTERVENTIONS: Measurement of: body fat content by skinfold thickness (cachectic males < 27%, females < 29%); plasma leptin, TNFalpha, and noradrenaline (norepinephrine); central haemodynamics in chronic heart failure patients at right heart catheterisation. MAIN OUTCOME MEASURES: Plasma leptin concentration corrected for body fat content, plasma TNFalpha and noradrenaline concentration, and central haemodynamics. RESULTS: Mean (SEM) plasma leptin concentrations were: 6.2 (0.6) ng/ml (cachectic heart failure), 16.9 (3.6) ng/ml (non-cachectic heart failure), 16.8 (3.0) ng/ml (ischaemic heart disease), and 18.3 (3.5) ng/ml (control) (p < 0.001 for cachectic heart failure v all other groups). Plasma leptin concentration remained significantly lower in the cachectic heart failure group even after correcting for body fat content and in spite of significantly increased TNFalpha concentrations. Thus plasma leptin was inappropriately low in cachectic chronic heart failure in the face of a recognised stimulus to its secretion. There was no significant correlation between plasma leptin, New York Heart Association class, ejection fraction, or any haemodynamic indices. CONCLUSIONS: Leptin does not contribute to the cachexia of chronic heart failure. One or more leptin suppressing mechanisms may operate in this syndrome-for example, the sympathetic nervous system.

Adipose Tissue↗
PubMed1996

The endoplasmic reticulum in PC12 cells. Evidence for a mosaic of domains differently specialized in Ca2+ handling.

Velocity and isopycnic gradient centrifugation were employed to fractionate post-nuclear supernatants rapidly prepared from PC12 cells in order to characterize areas of the endoplasmic reticulum involved in various aspects of intracellular Ca2+ homeostasis. The endoplasmic reticulum Ca2+ pumping activity, defined by three properties studied in parallel in the isolated fractions; thapsigargin-sensitive uptake of 45Ca2+, Ca2+-dependent, thapsigargin-sensitive protein phosphorylation and Western blotting of sarcoplasmic reticulum calcium ATPase (SERCA) 2b and putative SERCA3 ATPases, was concentrated primarily in a few fractions located at the top and toward the bottom of velocity and isopycnic gradients, respectively. The endoplasmic reticulum Ca2+ release channel, the inositol 1,4,5-trisphosphate receptor, was concentrated in the same fractions as the Ca2+ pumps, and additionally in a few fractions distinctly poor in SERCAs. In contrast, two lumenal markers (protein disulfide isomerase and calreticulin, the major Ca2+ storage protein of non-muscle endoplasmic reticulum) were enriched in the middle fractions of the velocity gradients while calnexin, a Ca2+-binding membrane protein, was more widely distributed throughout the gradients. These results document a considerable degree of functional and compositional heterogeneity in the endoplasmic reticulum of neurosecretory PC12 cells. Even in the limited areas that appear specialized for rapid Ca2+ uptake and release the ratio between pumps and channels varies considerably. Within the rest of the system, insulated from short-term fluctuations of Ca2+ concentration, Ca2+-binding proteins appear to be extensively distributed, in agreement with the idea that the Ca2+ content of the endoplasmic reticulum serves multiple functions.

Animals↗
PubMed1995

Odors of individuality of germfree mice are not discriminated by rats in a habituation-dishabituation procedure.

This study investigates whether differences in urinary odors of two major histocompatibility complex (MHC) congenic strains of mice reared in germfree conditions could be detected by male Sprague-Dawley rats in a habituation-dishabituation procedure. Rats were tested for their ability to discriminate between urine odors from one of the following pairs: (a) MHC congenic mice (B6 and B6-H-2k) housed in conventional conditions; (b) MHC congenic mice (B6 and B6-H-2k) raised in a germfree environment; (c) genetically identical mice maintained in conventional housing; or (d) genetically identical mice raised in a germfree environment. The urine odors of mice from the two MHC congenic strains raised in conventional housing were discriminable, but the urine odors of MHC congenic mice raised in a germfree environment were not discriminable. The odors of genetically identical mice, whether housed conventionally or under germfree conditions, were not discriminable. These results indicate that germfree rearing influences the urinary odors of individuality in MHC congenic mice. We discuss the possibility that the disparate findings from previous studies are a result of the methodologies employed.

Animals↗
PubMed1992

TQM/CQI in business and health care. An overview.

TQM/CQI is increasingly being used by U.S. companies and the health care industry to improve their operations and profitability. TQM/CQI can be used by occupational health nurses to help focus efforts to improve their health services and demonstrate their value. TQM/CQI also is used by businesses to improve the quality and cost of external health services. Occupational health nurses who are knowledgeable in TQM/CQI can help assure the quality of external health services as businesses strive to reduce rising health care costs.

Delivery of Health Care↗
PubMed1992

Business coalitions on health care. An evolution from cost containment to quality improvement.

Business coalitions on health were unable to achieve community wide savings in health care costs in the 1980s. Some coalitions are using TQM/CQI to achieve high quality health care at a reduced cost. Although too recent to determine its success, the use of TQM/CQI in employer-provider partnerships built on trust and good data systems may be the best hope for private sector health care system reform. Health professionals knowledgeable about TQM/CQI can play an important role in helping their employers make new relationships with health care providers work.

Commerce↗
PubMed1990

Corporate attitudes and responses to rising health care costs.

Faced with eroding profitability from rising health care costs, corporations are beginning to aggressively implement cost containment strategies. Although few companies have coordinated long range plans in place, corporations' attempts to exert control over the health care system will affect insurers, providers, and consumers. Occupational health nurses need to be aware of how cost-containment pressures will affect the various aspects of the U.S. health care system if they want to influence the changes. Occupational health nurses have an opportunity to work with benefits personnel and others in their company to maximize employee health while helping to implement programs to contain health care costs.

Attitude to Health↗
PubMedDate not supplied

Laparoscopic cholecystectomy in adult cystic fibrosis.

Two female patients with Cystic Fibrosis, attending the Adult Regional Cystic Fibrosis centre at the Cork University Hospital, were investigated for upper abdominal pain and found to have gallstones at ultrasonography. Laparoscopic cholecystectomy was performed successfully and, without complication, in both patients.

Adult↗