Biomedical subjects
J Cuddihy
Publications and source records attributed to J Cuddihy.
Seasonal variation of community acquired pneumococcal pneumonia admissions.
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A heart health assessment programme in general practice in County Kilkenny, Ireland.
The Kilkenny Faculty of the Irish College of General Practitioners and the Kilkenny Health Project have established a Health Assessment Programme (HAP) to standardise the examination and recording of coronary heart disease (CHD) risk factors in general practice. Criteria were agreed for classification and coding of demographic data, relevant medical history and risk behaviours. Height, weight and blood pressure are measured and venous blood sample is taken for total cholesterol estimation. The assessment is followed by appropriate counselling. The HAP was first targetted at men and women aged 40 to 49 years. During the first 16 months of the programme, 2102 assessments were carried out by 41 general practitioners, which represents 29% of the target group. Those taking part had a lower social class distribution when compared with participants in the KHP baseline survey in 1985. There were no significant differences between the two groups in smoking prevalence or in the distribution of body mass index. Median cholesterol was 5% lower in the HAP group than at the baseline survey. 16% of the HAP clients had diastolic blood pressures of 90 mm Hg or more. The HAP has demonstrated that it is feasible to measure CHD risk factors in a variety of general practice settings. The format facilitates a preventive orientation and has proved acceptable to patients.
Rudolf Ludwig Carl Virchow.
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Efficacy of fibrinolysis in the emergency department for acute myocardial infarction.
BACKGROUND: Patients with an acute myocardial infarction require a rapid response to their symptoms and the earlier fibrinolysis is given (where indicated), the better the outcome. AIMS: The aim of this study is to compare 'door to needle times' for fibrinolysis in Acute Myocardial Infarction (AMI) in three phases of one year each, at Letterkenny General Hospital. METHODS: In the PREINTERVENTION year all fibrinolysis was performed in the Coronary Care Unit (CCU). In the INTERVENTION year Emergency Department (ED) fast track fibrinolysis was introduced and in the POST INTERVENTION year most fibrinolysis was performed on fast track in the ED. RESULTS: The time saved by the introduction of ED fibrinolysis was significant, 41 minutes on average per patient. Elderly, female patients were more likely to bypass ED fast track fibrinolysis and to be brought to CCU for fibrinolysis, with attendant delays. This has educational implications in relation to the variation in clinical presentation of AMI with age and sex. CONCLUSION: The ED fast track fibrinolysis system is recommended as an effective, safe, achievable and worthwhile intervention towards improving 'door to needle times' for fibrinolysis in AMI.
Legionnaires' disease in Ireland--a cause for concern?
Legionnaires' disease is a multi-system illness that can have widespread clinical symptoms, though the principle manifestation is pneumonia. A review of all legionnaires' disease case notifications in Ireland in the 4 year period 1998-2001 was undertaken to assess the degree of concern health authorities here should have in relation to this disease. There were 17 cases of legionnaires' disease (all were legionella pneumophila serogroup 1) notified to the National Disease Surveillance Centre in the period 1998-2001. Nine cases were travel-associated cases with the majority of cases occurring during the summer months. There were 2 deaths. It would appear that legionnaires' disease is rare in Ireland but when compared with other European countries Ireland is conspicuous by its low rate. This would suggest that a major degree of under diagnosis and under reporting of legionnaires' disease currently exists in Ireland.
Case report of benign inter-cranial hypertension secondary to tetracycline.
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