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Biomedical subjects

F Sheehan

Publications and source records attributed to F Sheehan.

8 recordsLinked to original sources
PubMed1994

A phase II study of delta-9-tetrahydrocannabinol for appetite stimulation in cancer-associated anorexia.

PURPOSE: To evaluate the appetite-stimulating properties of delta-9-tetrahydrocannabinol (THC) in patients with anorexia due to advanced cancer. PATIENTS AND METHODS: Nineteen patients with various malignancies were entered. All had cancer-associated anorexia and a life expectancy greater than four weeks. Patients were started on THC 2.5 mg p.o. t.i.d. one hour after meals for four weeks. Evaluations for side effects, efficacy, acceptability and satisfaction were conducted at two and four weeks. RESULTS: 18 patients were evaluable. Ten patients completed the entire 28-day study. Four patients experienced grade I toxicity and three withdrew at their request. Thirteen patients reported an improved appetite. CONCLUSION: THC is an effective appetite stimulant in patients with advanced cancer. It is well tolerated at low doses. Further studies are needed to determine the most appropriate dose and the specific population most likely to respond.

Administration, Oral↗
PubMed1994

Significance of defect severity in technetium-99m-MIBI SPECT at rest to assess myocardial viability: comparison with fluorine-18-FDG PET.

UNLABELLED: The pathophysiological significance of 99mTc-MIBI uptake at rest for assessing myocardial viability in patients with coronary artery disease (CAD) is still controversial. Therefore, we studied the relationship of 99mTc-MIBI uptake at rest and preserved or absent uptake of 18FDG as assessed with PET in 111 consecutive patients after overnight withdrawal of their antianginal medication. METHODS: Each ventricle was evaluated in 13 segments derived from 25 regions of interest (ROIs) in short-axis cuts and 18FDG uptake was normalized to the intraindividual normal reference ROI (ROI with maximal = 100% 99mTc-MIBI uptake). Segments with a normalized 18FDG uptake > 70% were defined as viable while segments with a 18FDG uptake < 50% were defined as nonviable. RESULTS: Five to 11% of segments with 99mTc-MIBI uptake at rest < or = 30% of peak activity were viable and 80%-84% nonviable. Of moderate to severe 99mTc-MIBI defects at rest (31%-70% of peak), 13%-61% were viable. Segmental 99mTc-MIBI uptake and normalized 18FDG uptake were linearly correlated (r = 0.61, n = 1443, p < 0.001). In segments revealing severely reduced 99mTc-MIBI uptake (< or = 50% of peak) the correlation was considerably lower (r = 0.44, n = 295, p < 0.001). CONCLUSIONS: In patients with CAD, 99mTc-MIBI uptake underestimates myocardial viability in comparison to 18FDG-PET. Myocardial 99mTc-MIBI uptake therefore appears to reflect myocardial blood flow rather than myocardial viability. Patients with moderate and severe 99mTc-MIBI defects at rest may benefit from additional metabolic PET imaging prior to final therapeutic decisions.

Adult↗
PubMed1986

Scintigraphic quantification of myocardial necrosis in patients after intravenous injection of myosin-specific antibody.

The Fab fragments of antimyosin antibodies, labeled with 99mTc, were used in the scintigraphic examination of 30 patients with myocardial infarction. The ability to detect necrosis and determine its extent from the antimyosin scan were compared with the results of quantitative regional wall motion analysis by contrast ventriculography at 10 to 14 days and 99mTc-pyrophosphate imaging. Antimyosin images recorded by planar and single photon-emission computed tomography (SPECT) delineated areas of myocardial necrosis in 27 of 30 patients (90%) compared with a 91% sensitivity of pyrophosphate in 21 of 23 patients. Infarct size was determined by both antimyosin and pyrophosphate SPECT images. Results by both techniques showed a significant correlation with computer-derived hypokinetic segment length (r = .79 for both, p = .002) and peak creatine kinase (r = .9 for both, p less than .01). Although sensitivity for and correlations with markers of necrosis were similar with both techniques, infarct size by pyrophosphate SPECT was 1.7 times larger than infarct size by antimyosin SPECT (p less than .01). Certain zones in the infarct area were differentially labeled; the nature and irreversibility of injury within these zones remains to be clarified.

Antibodies↗
PubMed1985

Coronary anatomy and left ventricular function in the first 12 hours of acute myocardial infarction: the Western Washington Randomized Intracoronary Streptokinase Trial.

The relationships among clinical variables, coronary anatomy, and left ventricular function during the early hours of acute myocardial infarction (AMI) were evaluated from data acquired in the Western Washington Intracoronary Streptokinase Trial. All patients had symptoms and electrocardiographic changes typical of AMI. All data were obtained before treatment with streptokinase. Mean time to catheterization was 4.1 hr after onset of symptoms. Coronary angiograms (n = 245) were analyzed for location of infarct-related occlusion and collateral flow to the infarct bed. Left ventricular ejection fraction and regional left ventricular function were quantitated in 227. Sixty-two percent of occlusions were in the most proximal segment of the involved coronary artery. Collateral circulation was seen in 42% overall, in 31% with left anterior descending artery (LAD) occlusion, and in 52% with right coronary artery (RCA) occlusion (p less than .005). Left ventricular ejection fraction was lowest and regional function was most abnormal in the group with proximal LAD occlusion. Hyperkinesis was present in 32%; in those with hyperkinesis, hyperkinetic segment length was longest in those with RCA or circumflex occlusion. Multivariate analysis identified proximal LAD occlusion as the factor most closely associated with left ventricular ejection fraction and with measures of left ventricular regional hypofunction. We conclude that (1) AMI is usually caused by occlusion or subtotal occlusion in the most proximal portion of the involved coronary artery, (2) collateral circulation is more frequent with RCA than with LAD occlusion, and (3) location of the infarct-related occlusion is the most important determinant of global and regional left ventricular function in the early hours of AMI.

Aged↗
PubMed1983

Descending venography.

Patients with chronic venous insufficiency may have a combination of problems. The veins in the lower extremity can be affected by post phlebitic changes, obstruction, venous valvular incompetence or any mixture of these. Correct medical and/or surgical treatment hinges on the accurate assessment of the venous system. Complete studies of the lower extremity should incorporate ascending and descending venography as well as the clinical presentation. The methods described above easily enable one to achieve this accuracy with a minimal of time and discomfort to the patient. The incidence of primary venous valvular incompetence, may be higher than first anticipated and only by performing descending venography will this cause chronic, venous insufficiency to be unmasked. When employed in the appropriate patient, descending venography is an invaluable asset to diagnosis and ultimate treatment.

Adult↗
PubMedDate not supplied

Assessing postpartum adjustment. A pilot study.

Utilizing crisis theory, the stages of growth and development, and a theory of role transition and enactment, a series of questionnaires was developed as a clinical tool to study women's adaptation to motherhood during six weeks postpartum. The tool was tested on six women. Results suggest that the postpartum is indeed a critical period of identity reformation and role transition. Theories are developed for a framework, and a timetable for nursing intervention is given.

Adaptation, Psychological↗