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Biomedical subjects

J D O'Brien

Publications and source records attributed to J D O'Brien.

At least 19 recordsLinked to original sources
PubMed1995

Lymphangiomyomatosis recurrence in the allograft after single-lung transplantation.

The evolution of lung transplantation has offered an additional treatment option for patients with a variety of end-stage lung diseases, including some with systemic disorders. Lymphangiomyomatosis (LAM) is a multisystem disease of premenopausal women. The lung is the most frequently involved vital organ, and respiratory failure is the most common case of death. A small number of patients with LAM have undergone lung transplantation. This report describes a case of recurrent LAM in the allograft after single lung transplantation and discusses the implications of this finding.

Adult↗
PubMed1995

Nephrobronchial fistula and lung abscess resulting from nephrolithiasis and pyelonephritis.

There are multiple etiologies reported as causes of lung abscess; however, this differential rarely includes intra-abdominal abnormalities other than extension of a hepatic process. We describe a patient who was found to have a lung abscess and empyema resulting from the development of a nephrobronchial fistula secondary to nephrolithiasis and pyelonephritis. The patient had no urinary symptoms or known abdominopelvic infection and the etiology of lung abscess was only incidentally discovered after chest CT revealed extension of pleural fluid below the diaphragm.

Bronchial Fistula↗
PubMed1992

Estimation of small bowel transit time following colectomy and ileal reservoir construction.

A study was carried out to evaluate the breath hydrogen test as a method of estimating small bowel transit in patients with an ileal pouch and to determine whether gut transit time influenced functional outcome. Twelve patients with an ileal reservoir and ten control subjects ingested a test meal of 400 ml chicken soup, 20 g lactulose and 50 ml dilute barium solution. Concurrent breath hydrogen testing and radiological screening was carried out until the head of the test meal reached the ileal pouch or caecum. At the time that the test meal arrived in the pouch, faecal anaerobic bacterial counts were obtained. Pouch compliance, functional capacity and anal sphincter pressures were also measured. While there was an excellent correlation between radiological and breath hydrogen measures of orocaecal transit time in controls (P less than 0.001), no such relationship was found for oropouch transit. Four of the 12 patients with a pouch produced no hydrogen after test meal ingestion, while in two other such patients breath hydrogen peaks occurred when the head of the meal was in the jejunum. The magnitude of the breath hydrogen rise in patients with an ileal pouch correlated well with faecal anaerobic bacterial counts (P less than 0.01). The median (95 per cent confidence interval) radiological small bowel transit time was more rapid in patients with a pouch than in control subjects: 28 (23-33) versus 72 (46-86) min (P less than 0.01). Increased 24-h frequency of defaecation was associated with more rapid small bowel transit after ileal reservoir construction (P less than 0.01) but correlated with neither pouch capacity nor compliance. These data show that small bowel transit time may be a determinant of ileal pouch function but that breath hydrogen estimation of gut transit time in patients with an ileal reservoir is unreliable.

Breath Tests↗
PubMed1992

Psychometric differentiation of conduct disorder and attention deficit disorder with hyperactivity.

Using a retrospective chart review procedure, children diagnosed as having attention deficit disorder with hyperactivity (ADDH), conduct disorder (CD), and ADDH+CD, as defined by DSM-III, were compared on measures of cognitive and academic functioning as well as on a continuous performance test (CPT). The groups did not differ in age or IQ, but children in the ADDH and ADDH+CD groups missed significantly more target stimuli on the CPT and performed significantly poorer on measures of academic achievement than did the pure CD group. However, poor CPT performance was not accounted for by learning problems. These findings in clinically referred patient groups are consistent with dimensional and epidemiological studies that suggest that ADDH may be a cognitively based disorder, whereas CD children are characterized by behavioral symptoms with fewer cognitive and learning deficits.

Attention↗
PubMed1991

Current prevention concepts in child and adolescent psychiatry.

This paper has attempted to show how prevention in child and adolescent mental health has been neglected for years. It continues with a discussion of current concepts of prevention and chooses one risk factor, maternal mental disorder to focus on. A new concept in prevention--previewing--is addressed and its tremendous potential for primary prevention is considered. Finally, previewing and its use in the direct therapy of the older child is discussed.

Adolescent↗
PubMed1990

Validation of hyperactive, aggressive, and mixed hyperactive/aggressive childhood disorders: a research note.

Eighty-five non-referred school children were divided into four groups based upon the IOWA Conners Teacher's Questionnaire: pure hyperactive (HYP), pure aggressive (AGG), mixed hyperactive/aggressive (HYP/AGG), and normal controls. The groups were compared on neurobehavioral tests believed to assess inattention and impulsivity. A continuous performance test indicated that the HYP group was more inattentive than the other groups and the HYP/AGG group was most impulsive. The AGG group did not differ from controls. The data support the distinction between HYP, AGG and HYP/AGG groups of children selected by the IOWA Conners.

Aggression↗
PubMed1989

Cross-gender behavior and psychopathology in boy psychiatric outpatients.

One hundred 5- to 12-year-old boys referred for outpatient psychiatric evaluation were assessed for cross-gender behavior using the Child Behavior and Attitude Questionnaire (CBAQ) and the Child Game Participation Questionnaire (CGPQ), and for possible associated psychopathology using the Child Behavior Checklist (CBCL) and clinical psychiatric (DSM-III) diagnoses. On the two feminine scales of the CBAQ and CGPQ, 30 to 50% scored within defined clinical ranges. High feminine scale scorers did not have higher Total CBCL scores than lower feminine scale scorers, and scores on the feminine scales correlated minimally with scores on the CBCL broad and narrow-band behavior problem scales, except for a significant positive correlation with the Delinquent subscale. No particular clinical psychiatric diagnoses were significantly associated with high feminine scorers: however, high feminine behavior scorers tended to have more conduct problems and mixed adjustment disorders and less anxious and depressive psychopathology. Clinicians were not alert to the degree of cross-gender behavior found, perhaps due to the concomitant externalizing psychopathology and masculine behavior in these same patients.

Anxiety, Separation↗
PubMed1989

Are ADDH and ADHD the same or different?

To assess the relationship between the DSM-III criteria for attention deficit disorder with hyperactivity (ADDH) and the DSM-III-R criteria for attention-deficit hyperactivity disorder (ADHD), children from an inner city parochial school were evaluated using a 30-item teacher questionnaire consisting of the DMS-III and DSM-III-R criteria for these disorders, the revised Conners Parent and Teacher Questionnaires, and a continuous performance test. Diagnostic groups were established based on teacher ratings of the DSM items and evaluated in relation to the rating scale data and continuous performance test. While children who were identified by teachers as having ADDH almost always satisfied the criteria for ADHD, a new group of children who were hyperactive and impulsive but less clearly inattentive also met the criteria for ADHD. Implications of the change in diagnostic criteria are discussed.

Attention↗
PubMed1989

Perturbation of upper gastrointestinal transit and antroduodenal motility by experimentally applied stress: the role of beta-adrenoreceptor mediated pathways.

A series of three experiments were performed on healthy adult volunteers to investigate the possible role played by beta-adrenoreceptor mediated pathways in the disturbance of human upper intestinal motor function by hand immersion in cold water. In the first experiment, (an extended pilot study on one individual), orocaecal transit of a standard meal was measured on 36 occasions with and without cold water stimulation and with and without a series of alpha and beta blocking drugs. Cold water stimulation consistently delayed transit in this individual, an effect which was attenuated by prior beta-blockade. In a double blind trial of the effect of beta-blocker atenolol v placebo on transit in nine individuals, a consistent reduction in the cold water induced transit delay was observed (p less than 0.01) independent of any direct effect of beta-blockade. In the third experiment seven individuals underwent repeated studies of antroduodenal pressure activity comparing the effects of cold and warm water stimulation with and without beta blockade to determine whether the observed transit effect could be related to an action on gastrointestinal motility. Cold water stimulation reduced antroduodenal motility, but no consistent effects of previous beta blockade were noted. These studies indicate the presence of a beta-adrenoreceptor mediated pathway in the cold water induced delay of orocaecal transit but not in the inhibition of gastroduodenal motility. Further studies are indicated to determine the site and mode of action of this transit effect more precisely.

Adolescent↗
PubMed1988

Effect of codeine and loperamide on upper intestinal transit and absorption in normal subjects and patients with postvagotomy diarrhoea.

Patients with chronic severe diarrhoea after truncal vagotomy and pyloroplasty are often difficult to treat using conventional antidiarrhoeal drugs and remain severely disabled. We examined the effect of two drugs, codeine phosphate and loperamide, on upper intestinal transit and carbohydrate absorption, measured non-invasively by serial exhaled breath hydrogen monitoring, in patients with postvagotomy diarrhoea who had previously failed to gain relief from drug therapy. Orocaecal transit was consistently faster in these patients than a group of controls and was associated with malabsorption of glucose. Codeine phosphate 60 mg significantly delayed transit in patients and controls and was associated with a reduction in glucose malabsorption and improvement in symptoms. Loperamide also delayed transit and improved symptoms, but the doses required for this effect (12-24 mg) were higher than usually considered necessary in secretory diarrhoea. These studies indicate that rapid intestinal nutrient transit and associated malabsorption is a factor in the development of diarrhoea postvagotomy and that symptomatic relief can be achieved in most patients by more rational use of existing drugs.

Adult↗
PubMed1987

Action of centrally mediated autonomic stimulation on human upper gastrointestinal transit: a comparative study of two stimuli.

Two well established experimental stressors, hand immersion in cold water, and mental stimulation with dichotomous listening, were applied to 37 normal subjects after the ingestion of a standard meal. Orocaecal transit was measured by serial exhaled breath hydrogen sampling. Cold water significantly delayed transit compared with warm water control (warm water 71.8 +/- 3.6 mins v cold water 93.2 +/- 5.7 mins p less than 0.01), with significant rises in blood pressure pulse rate perceived discomfort and plasma catecholamines. In contrast mental stimulation was unaccompanied by any change in transit (control; 67.4 +/- 4.7 v test 64.3 +/- 5.3 mins p greater than 0.1) despite a significant rise in pulse rate, skin conductance and plasma catecholamines. Repeated cold water immersion studies in eight individuals produced consistent orocaecal transit and autonomic responses, whereas mental stimulation showed reduced autonomic responses on repeat testing, suggesting that tolerance to the stimulus had occurred. The results of these studies show stimulus specific gastrointestinal response patterns to autonomic stimuli, and appear to have important implications for the design of future studies of human gastrointestinal autonomic physiology and for the investigation of patients with stress related gut dysfunction.

Acoustic Stimulation↗