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Biomedical subjects

J O'Hare

Publications and source records attributed to J O'Hare.

17 recordsLinked to original sources
PubMed1993

Endophthalmitis as a presentation of meningococcal septicaemia.

Meningococcal infections can present in diverse clinical forms ranging from fulminant, occult, chronic meningococcaemia to meningitis. Rare presentations may include conjunctivitis, sinusitis, pneumonia, pericarditis, arthritis, and osteomyelitis. We present a very unusual case of meningococcaemia presented as an endophthalmitis.

Adult↗
PubMed1993

Antibiotic pharmacoeconomics: an attempt to find the real cost of hospital antibiotic prescribing.

Antibiotics account for a large part of all hospital pharmacy budgets, but the actual cost of their prescription is unknown. These costs include intravenous administration, labour, serum antibiotic assay, monitoring of haematological and biochemical indices, disposal of sharps and adverse effects. An in-house method of costing antibiotic therapy is presented, to quantify these hidden expenses. Since not only an awareness, but an accurate quantification, of hidden costs is required, a study of various hospital procedures relating directly to antibiotic therapy was undertaken in an acute medical ward; this involved the identification of particular staff members performing various procedures, consumables used and time taken. The cost of five-day courses of gentamicin, penicillin G, ampicillin, flucloxacillin, cefuroxime, ceftotaxime and erythromycin has been calculated; drug and hidden costs for each are presented graphically for comparison. The breakdown cost for gentamicin is presented to illustrate the method. The costing of adverse effects has not been attempted. We suggest that costings of this sort are used in cost-benefit analysis of antibiotic use. These calculations have been incorporated into a computer spreadsheet and this costing service will be offered to clinical areas of our hospital.

Anti-Bacterial Agents↗
PubMed1992

Technique for calculation of the true costs of antibiotic therapy.

An in-house method for costing antibiotic therapy is presented which quantifies hidden costs including costs arising from intravenous administration, labour, serum antibiotic assay, monitoring of haematological and biochemical indices and disposal of sharp instruments. A study of various hospital procedures relating directly to antibiotic therapy was undertaken in an acute medical ward, which involved determination of staff members performing various procedures, consumables used and time taken. Results of this study facilitated accurate quantification of hidden costs of i.v. antibiotic therapy in this ward. Using these results, the cost of five-day courses of gentamicin, cefuroxime, penicillin G, flucloxacillin and erythromycin were calculated. The costing of adverse effects was not attempted. It is recommended that a costing technique of this sort is used in cost-benefit analysis of antibiotic use, as the cost of the drug alone is misleading.

Anti-Bacterial Agents↗
PubMed1991

Thromboblastic hyperthyroidism: sensitive monoclonal TSH assay demonstrates suppressed immunoreactive TSH.

We describe a case of frank clinical hyperthyroidism due to hydatidiform mole. This is thought to be due to human chorionic gonadotrophin (hCG) or a closely related molecule produced by the tumour. hCG can cross-react with TSH in older TSH radioimmunoassays causing falsely elevated TSH levels. We demonstrate this does not occur with a chemiluminescent immunometric (monoclonal) TSH assay despite circulating hCG levels greater than 10(6) u/L.

Adult↗
PubMed1991

Audit of hyperthyroxinaemia and thyrotoxicosis using a sensitive TSH assay.

The aim of this study was determine (a) the causes of hyperthyroxinaemia and (b) the biochemical profile of thyrotoxicosis in a general hospital laboratory for one year using a sensitive TSH assay. Total T4 (TT4) and TSH were measured in all 8,382 samples and TT3, free T4, free T3 and thyroxine binding globulin (TBG) in selected cases. TT4 was elevated in 215 (2.6%). 159 (74%) were due to thyrotoxicosis; 41 (19%) to elevated TBG and 15 (7%) non-thyroidal illness. Thyrotoxicosis (serum TSH less than 0.15m U/1) occurred in 223 (2.7%) of all patients and was diagnosed with high TT4 in 159 (71%), normal due to intercurrent illness. 352 (4%) patients had suppressed TSH while all thyroid hormone values were normal. Thus TT4 may be elevated from causes other than thyrotoxicosis sufficiently frequently to necessitate routine TSH measurements. While Normal TSH measurements nearly always excludes thyrotoxicosis, suppressed values are insufficient to establish a diagnosis or monitor thyroxine replacement therapy.

Humans↗
PubMed1990

A group orientation program for families of newly admitted cancer patients.

Diagnosis and treatment of cancer is traumatic for patient and family, and hospital admission is the climax of the crisis. The authors describe a program in which social workers and former cancer patients orient families to a cancer center at the time of patient admission. The goals of the program are to lessen anxiety and increase mastery at this entry point into the medical system. No medical information is given during the group sessions. Content includes information on hospital facilities, treatment equipment, common feelings that cancer patients and their families experience, ways that family members can support the patient, and the roles of various hospital staff. The sessions also serve as a screening tool for the hospital to identify families that may need additional intervention. The program lessens the trauma for patients and their families, engages family members in treatment, and facilitates positive interactions between the hospital staff and members of patients' support networks.

Cancer Care Facilities↗
PubMed1988

In vitro susceptibility of Trichomonas vaginalis to 50 antimicrobial agents.

We determined the susceptibilities of five strains of Trichomonas vaginalis, one of which was metronidazole resistant, to 50 antimicrobial agents. For the metronidazole-susceptible strains, the most active agents were metronidazole, tinidazole, mebendazole, furazolidone, and anisomycin. Against the resistant strain mebendazole, furazolidone, and anisomycin were the most active. Antifungal agents, beta-lactams, macrolides, aminoglycosides, and folic acid antagonists were ineffective against all strains.

Animals↗
PubMed1986

Safety and immunogenicity of bovine rotavirus vaccine RIT 4237 in 3-month-old infants.

To assess the safety and immunogenicity of bovine rotavirus vaccine, we administered attenuated strain RIT 4237 to 54 inner-city infants randomized to one of three groups in a double-blind fashion to receive a dose at 3 and 5 months of age of either placebo, vaccine virus at 10(7) TCID50/ml, or vaccine virus at 10(8) TCID50/ml. Vaccination began in early fall 1984, and continued through spring 1985. Forty-nine infants received one dose of vaccine or placebo; 43 received both doses of vaccine or placebo. At 2 and 3 months after vaccination, homologous geometric mean neutralizing antibody titers were significantly higher in children who received either dose of vaccine compared with placebo recipients. Cumulative seroconversion to bovine rotavirus after either dose of vaccine virus was 87% at 6 months of age. Seroconversion was significantly higher (P less than 0.01) in both vaccine groups compared with the placebo group. No ill effects were associated with vaccine administration. RIT 4237 vaccine appears to be safe and immunogenic when administered to young infants living in the United States.

Animals↗