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Biomedical subjects

H Ryan

Publications and source records attributed to H Ryan.

At least 19 recordsLinked to original sources
PubMed2005

How to recognize and manage psychological distress in cancer patients.

Psychological distress is common in cancer patients, however, it is often unrecognized and untreated. We aimed to identify barriers to cancer patients expressing their psychological concerns, and to recommend strategies to assist oncologists to elicit, recognize, and manage psychological distress in their patients. Medline, Psychlit, and the Cochrane databases were searched for articles relating to the detection of emotional distress in patients. Patients can provide verbal and non-verbal information about their emotional state. However, many patients may not reveal emotional issues as they believe it is not a doctor's role to help with their emotional concerns. Moreover, patients may normalize or somatize their feelings. Anxiety and depression can mimic physical symptoms of cancer or treatments, and consequently emotional distress may not be detected. Techniques such as active listening, using open questions and emotional words, responding appropriately to patients' emotional cues, and a patient-centred consulting style can assist in detection. Screening tools for psychological distress and patient question prompt sheets administered prior to the consultation can also be useful. In conclusion, the application of basic communication techniques enhances detection of patients' emotional concerns. Training oncologists in these techniques should improve the psychosocial care of cancer patients.

Anxiety↗
PubMed2001

Smoking among lesbians, gays, and bisexuals: a review of the literature.

OBJECTIVES: To collect estimates of smoking prevalence among lesbian, gay, and bisexual people from the published literature and to compare with general population estimates. METHODS: Databases were searched for all studies published in English on tobacco use among lesbians, gays, and bisexuals. From 1987 through 2000, twelve studies were identified (four youth, eight adult): seven were based on convenience samples; one on a population-based probability sample; one involved random sampling within selected census tracts; one was based on a large multicenter clinical trial; and two were representative school-based samples. Study findings were compared to national survey data from the corresponding time period. RESULTS: Estimated smoking rates for lesbians, gays, and bisexuals ranged from 38% to 59% among youth and from 11% to 50% among adults. National smoking rates during comparable periods ranged from 28% to 35% for adolescents and were approximately 28% for adults. CONCLUSIONS: While information in the published literature is limited, it appears that smoking rates are higher among adolescent and adult lesbians, gays, and bisexuals than in the general population. Steps should be taken to ensure representation of lesbians, gays, and bisexuals in tobacco-use surveillance and to collect data in order to understand the apparent high smoking rates in these groups. Attempts should be made to target prevention and cessation interventions to lesbians, gays, and bisexuals.

Adolescent↗
PubMed2001

A tracer study of headspace ventilation in a collector sewer.

A field-scale tracer test was conducted to evaluate in-situ ventilation rates in a major collector sewer. The sewer under study was approximately 11 km long and ranged from 0.61 to 2.1 m in diameter. For the purposes of the tracer testing, the collector was divided into four reaches, each of which was tested individually. The tracer test involved injecting a measured volume of CO gas into a manhole over a short time period. CO concentrations were then measured in the collector headspace at selected manholes along the length of the reach. The technique employed successfully measured average headspace velocities over extended lengths of the collector. In a section that had a relatively stagnant headspace, approximately 1.1 km of sewer could be evaluated, with substantial tracer loss attributed to losses to manholes. In a section of the sewer with elevated headspace velocities, a section approximately 7.0 km long was successfully tested with one injection of tracer gas. The velocities observed in the collector varied substantially with time and location in the collector. The lowest velocities measured were in the upstream sections, with a minimum observed value of 3.8 m/min. The highest velocities were observed in the downstream sections, with a maximum value of 31.5 m/min. The presence of a substantial drop structure appeared to reduce the headspace velocity in the upstream reach. In general, there was an increasing trend in gas-phase flows with distance along the length of the collector. Flows at the discharge end of the collector were almost 2 orders of magnitude greater than those at the beginning.

Air Movements↗
PubMed2000

Carcinogenic nickel induces genes involved with hypoxic stress.

Carcinogenic nickel compounds alter the program of gene expression in normal cells and induce a pattern of gene expression similar to that found in nickel-induced cancers. Here we have demonstrated that nickel exposure induced hypoxic signaling pathways by inducing hypoxia-inducible transcription factor-1 (HIF-1), which mediated the induction of genes required by cells to survive hypoxia. We also show that a new gene, Cap43, is dependent upon HIF-1 because only HIF-1-proficient cells induced Cap43 when exposed to either hypoxia or nickel. We also show that glyceraldehyde-3-phosphate dehydrogenase, a gene induced by hypoxia through HIF-1, was similar to Cap43 in that it required HIF-1-proficient cells to be induced by either nickel or hypoxia. These data demonstrate that nickel exposure turns on signaling for hypoxic stress, which may be important in its carcinogenesis.

Animals↗
PubMed2000

Hypoxia-inducible factor-1 (HIF-1) up-regulates adrenomedullin expression in human tumor cell lines during oxygen deprivation: a possible promotion mechanism of carcinogenesis.

Little is known about the molecular mechanisms that control adrenomedullin (AM) production in human cancers. We demonstrate here that the expression of AM mRNA in a variety of human tumor cell lines is highly induced in a time-dependent manner by reduced oxygen tension (1% O2) or exposure to hypoxia mimetics such as desferrioxamine mesylate (DFX) or CoCl2. This AM expression seems to be under hypoxia-inducible factor-1 (HIF-1) transcriptional regulation, since HIF-1alpha and HIF-1beta knockout mouse cell lines had an ablated or greatly reduced hypoxia AM mRNA induction. Similarly, inhibition or enhancement of HIF-1 activity in human tumor cells showed an analogous modulation of AM mRNA. Under hypoxic conditions, immunohistochemical analysis of tumor cell lines revealed elevated levels of AM and HIF-1alpha as compared with normoxia, and we also found an increase of immunoreactive AM in the conditioned medium of tumor cells analyzed by RIA. AM mRNA stabilization was shown to be partially responsible for the hypoxic up-regulated expression of AM. In addition, we have identified several putative hypoxia response elements (HREs) in the human AM gene, and reporter studies with selected HREs were capable of enhancing luciferase expression after exposure to DFX. Furthermore, transient coexpression of HIF-1alpha resulted in an augmented transactivation of the reporter gene after DFX treatment. Given that most solid human tumors have focal hypoxic areas and that AM functions as a mitogen, angiogenic factor, and apoptosis-survival factor, our findings implicate the HIF-1/AM link as a possible promotion mechanism of carcinogenesis.

Adrenomedullin↗
PubMed1999

An integrated dialysis delivery network in Ontario.

In August 1995, the Ontario Ministry of Health (MOH) issued a request for proposal (RFP) for the establishment of new and expanded dialysis services. London Health Sciences Centre (LHSC) was successful in expanding its integrated dialysis delivery network with satellites in Stratford, Woodstock and Owen Sound. This achievement required collaboration of LHSC and host hospital staff to meet the challenging RFP requirements. With final approval received in January 1997, efforts were required to establish an operational model supporting self-care and full-care patients, to train satellite staff and patients, and to manage the resulting clinical impact. A balanced scorecard (Kaplan & Norton, 1992) evaluation model was developed. Initial outcome data indicate that full-care patients in satellites require more fallback support to London units, experience more hypotensive episodes during dialysis and, in some cases, demonstrate lower levels of dialysis adequacy and nutritional status when compared to satellite self-care patients. Findings from these data will assist in revising patient inclusion criteria and processes to optimize community-based dialysis.

Ambulatory Care↗
PubMed1994

Cigarette advertising and children's smoking: why Reg was withdrawn.

OBJECTIVE: To examine the appeal of the Embassy Regal "Reg" campaign to young people. DESIGN: Three quantitative surveys and one piece of qualitative research: (a) self completion questionnaire administered in classrooms, (b) questionnaire led interviews with children, (c) questionnaire led interviews with adults, and (d) group discussions with children and adults. SETTINGS: (a) Secondary and middle schools in England; (b) north of England, Scotland, and Wales; (c) north of England, Scotland, and Wales; and (d) Glasgow. SUBJECTS: (a) 5451 schoolchildren aged 11-15 recruited by stratified random sampling; (b) 437 children aged 5-10 recruited by quota sampling; (c) 814 adults aged 15-65 recruited by quota sampling; and (d) 12 groups of children aged 10-15, three groups of adults aged 18-24, and three groups of adults aged 35-55. RESULTS: Children were familiar with cigarette advertising and in particular the Reg campaign. Although younger children struggled to understand the creative content of the adverts, older and smoking children could understand and appreciate the humour. They considered Reg to be amusing and could relate to the type of joke used in the advert. In addition Reg's flippant attitude towards serious issues appealed to the children. While adults aged 18-24 understood the campaign they did not identify with it, and 35-55 year olds (the campaign's supposed target) were unappreciative of the campaign. CONCLUSIONS: The Reg campaign was getting through to children more effectively than it was to adults and held most appeal for teenagers, particularly 14-15 year old smokers. It clearly contravened the code governing tobacco advertising, which states that advertising must not appeal to children more than it does to adults, and it may have had a direct impact on teenage smoking. In view of these findings the Advertising Standards Authority's decision to withdraw the Reg campaign seems appropriate.

Adolescent↗
PubMed1994

The expression of the 'pre-menstrual syndrome' in measures of mood and sustained attention.

Twenty-eight women performed two demanding sustained attention tasks in the premenstrual and intermenstrual phases of the menstrual cycle. Mood was assessed before and after performance. No effects of phase were found on perceptual sensitivity and response criterion, but response time on the less demanding of the two tasks was slower in the premenstrual phase. There were no effects of phase on pre-task mood, but following performance, premenstrual women were lower in energy and in pleasantness of mood. Moods varied with phase irrespective of usage of the contraceptive pill, but effects on response time were stronger in non-pill users. Performance data suggest that speed of visual discrimination varies with the cycle, but this finding is of little practical significance. The mood data suggest that the affective correlates of the cycle vary with situational stress, and, in the workplace, it may be desirable to reduce stress and workload during the premenstrual phase.

Adult↗
PubMed1994

Uveal effusion syndrome.

The history and clinical findings are presented of a patient who suffered from the uveal effusion syndrome over a 10-year period from 1956. The funduscopic appearance is illustrated both at the time of initial presentation and 36 years later. This condition typically affects healthy middle-aged men and causes recurrent, spontaneous, serous retinal and ciliochoroidal detachments, often resulting in significant visual impairment. Two separate hypotheses have been postulated to explain the pathogenesis of the uveal effusion syndrome, one relating to abnormally thickened sclera, the other to chronic bulbar hypotony. Both are discussed, as is the rationale behind the current management of this unusual condition.

Humans↗
PubMed1993

Characteristics of early onset esotropia.

Some 115 patients with a reported onset of esotropia within the first six months of life were studied retrospectively to assess ocular findings and the evolution of any changes with time. All patients had been treated by one ophthalmologist and one orthoptist since 1972. Of the 115 patients, 27% had an accommodative element associated with the esotropia. Patients with an accommodative esotropia had higher levels of hypermetropia when compared to the non-accommodative group, but there were no other distinguishing characteristics. The groups exhibited a large variation in angle size, ranging from four to 45 degrees at the initial visit. The presence of fusion, amblyopia and the degree of hypermetropia had no significant effect on the course of the squint. Amblyopia was noted in 67% of cases and appeared to stabilise at a later-than-expected age, with 66% of patients with amblyopia stabilising between eight and 11 years. Surgical intervention had no effect on the incidence of amblyopia at the initial or final visits.

Accommodation, Ocular↗
PubMed1993

The long-term results of surgical correction of childhood esotropia.

The results of surgical management by one ophthalmologist of 102 patients with congenital esotropia and 74 patients with acquired esotropia in childhood were analysed. The majority of patients had undergone a monocular recession-resection procedure, with 91% and 93% of patients showing a reduction in the angle, of more than five degrees, following surgery for congenital and acquired esotropia respectively. Unexpectedly, varying the amount of lateral rectus resection from 3 to 6 mm, when combined with a constant 5 mm medial rectus recession, did not produce significantly different amounts of change in the ocular alignment after surgery. Patients with congenital esotropia generally developed a stable postoperative angle later than patients with acquired esotropia. The degree of improvement of ocular alignment with surgery was independent of hypermetropia, presence of preoperative amblyopia or fusion.

Amblyopia↗
PubMed1988

Anaesthesia for caesarean section in a patient with Jervell, Lange-Nielsen syndrome.

The anaesthetic management of a patient with Jervell, Lange-Nielsen syndrome (a form of congenitally prolonged QT interval) requiring emergency Caesarean section is presented. An epidural anaesthetic using 3-chloroprocaine produced a safe and satisfactory anaesthetic for the procedure in a patient prone to ventricular arrhythmias and cardiac arrest. High levels of circulating catecholamines have been postulated as one of the causes of the arrhythmias in these patients, making it advisable to select drugs and techniques known to minimize catecholamine levels. Although communication can be difficult in these profoundly deaf patients, it is important in order to reduce the emotional stress. Elective Caesarean sections under general anaesthesia have been reported; it appears that a well planned regional anaesthetic is equally safe.

Adult↗
PubMed1972

The role of intracellular pH in the regulation of cation exchanges in yeast.

1. When yeast oxidizes propan-2-ol in the presence of KCl no uptake of K(+) occurs. 2. When propionate is added to suspensions containing propan-2-ol, or if the suspensions are bubbled with CO(2), a considerable uptake of K(+) occurs. 3. Maximum K(+) uptake occurs at a propionate concentration of 2mm. 4. The addition of 20mm-propionate to the suspension lowers the intracellular pH of the yeast from a resting value in the region of 6.2 to approx. 5.6. 5. When K(+) uptake is measured in the presence of 20mm-propionate, progressive changes in the rate of K(+) uptake and intracellular pH occur. The optimum rate of K(+) uptake occurs at an intracellular pH of 5.70. 6. The effect of both intra- and extra-cellular pH on K(+)-K(+) exchange was studied and an optimum rate was found at an extracellular pH of 5.35, the corresponding intracellular pH being 6.44. 7. When a Na(+)-loaded yeast oxidizes propan-2-ol in the presence of KCl, a steady efflux of Na(+) and influx of K(+) occurs. The addition of 10mm-propionate to the suspension markedly inhibited the Na(+) efflux but only slightly decreased the K(+) influx. 8. The effect of both extra- and intra-cellular pH on Na(+) efflux was studied with propan-2-ol and with glucose. The results can be best interpreted in terms of intracellular pH changes, and an optimum was obtained at approx. pH6.40.

1-Propanol↗
PubMed1971

The effect of diffusible acids on potassium ion uptake by yeast.

1. When yeast oxidizes ethanol at different pH values the uptake of K(+) corresponds closely to the amount of acetate accumulated at each pH value. 2. The addition of semicarbazide to the suspension buffered at pH4.75 inhibited both the K(+) uptake and the acetate accumulation by about 50%. 3. The addition of either acetate or propionate to the suspensions markedly increased the K(+) uptake. 4. The addition of acetate to the suspensions lowered the intracellular pH of the yeast from a resting value of pH5.80 to 5.56. 5. The ratio of the initial rate of K(+) uptake to O(2) consumption was 0.77. This ratio was increased to 1.77 in the presence of 10mmol of propionate/l.

Acetates↗