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Biomedical subjects

M Crowe

Publications and source records attributed to M Crowe.

65 records · Page 4Linked to original sources

The significance of free blood in liquid and solid tumours.

Impregnation of the vasculature with ink was used to study microvascular changes induced in rats by liquid (ascites) and solid growth of W256 and Y-P388 tumour cells. Ascites fluid produced by both tumours was heavily blood-stained; the deep red colour of solid tumour deposits was similarly due to the presence of free blood. In both types of tumour growth this free blood was due to diapedesis of erythrocytes through tips of capillary sprouts which grow when neovascularization (angiogenesis) occurs in response to any suitable (non-neoplastic or neoplastic) stimulus. Ascites growth of these tumours induced profuse sprouting from the peritoneal capillaries; this sprouting, together with the "bleeding" it caused, were inhibited by local pre-irradiation of the peritoneal vasculature with X-rays before intraperitoneal inoculation of rats with the tumours. Similar angiogenesis with bleeding did not occur following inoculation with an allogeneic tumour in rats which had been previously immunized against the tumour. LI tumour cells (tumour cells lethally irradiated in vitro to destroy their proliferative integrity, but which remain metabolically active) also induced sprouts to grow in close proximity to the implanted LI cells, but heat-killed tumour cells caused no sprouting. The nature and significance of neovascularization of tumours and their so-called "haemorrhagic" growth are discussed.

Angiogenesis Inducing Agents↗

Prevalence of risk factors for ischaemic stroke and their treatment among a cohort of stroke patients in Dublin.

BACKGROUND: The majority of strokes are due to ischaemia. Risk factors include atrial fibrillation, hypertension and smoking. The incidence can be reduced by addressing these risk factors. This study examines the prevalence of risk factors and their treatment in a cohort of patients with ischaemic stroke registered on a Dublin stroke database. METHODS: Patients admitted to any of three acute hospitals with a diagnosis of stroke during a one-year period in 1997/98 were registered on a database using the European Stroke Database format. Data relating to common risk factors were analysed. RESULTS: There were 238 ischaemic stroke cases registered. The most frequent medical risk factors were: hypertension (45%), atrial fibrillation (27.3%), and previous disabling or non-disabling stroke (33.2%). There was an increasing trend with advancing age for atrial fibrillation (p < 0.001). Some 23% (54/233) were current smokers. A significantly higher proportion of patients with no medical risk factors were smokers or consumed excessive alcohol compared with those who had medical risk factors. CONCLUSION: Medical risk factors for stroke were common among stroke patients and not optimally treated, particularly with regard to atrial fibrillation and previous stroke. Smoking was a major behavioural risk factor among younger patients and much health gain could be achieved in this group through primary prevention strategies.

Adult↗

Hospital services for patients with acute stroke in Ireland: the Volunteer Stroke Scheme survey of consultant opinion.

A national postal survey of hospital based consultants with responsibility for acute care of stroke admissions was performed in November, December 1998. Of 162 survey forms, 140 (86.4%) were returned representing consultants working in all 38 acute general hospitals (total 10,067 hospital beds) of whom 135 indicated that stroke patients were admitted under their care. Patients were admitted under 11 different subspeciality groups to various medical and surgical wards. Only 18.5% of consultants worked in hospitals where there was a physician/neurologist with specific responsibility for stroke, whilst only 19.5% were aware of a policy in their hospital for implementation of minimum standards of care for stroke patients or a recent audit of stroke care (9%). A substantial number of hospitals in certain health board areas have no access to a consultant led rehabilitation unit within their own health board area whilst 18/38 hospitals have no on-site CT brain scanning. Despite the proven value of organised hospital stroke care, this survey documents major deficiencies in this country. We suggest that each health board would review its services to include in each hospital a consultant physician with special responsibility for co-ordination and development of appropriately staffed and funded stroke services.

Health Services Accessibility↗

Sex therapy: the successes, the failures, the future.

Sexual dissatisfaction or dysfunction occurs in one fifth to one third of the adult population. Although great advances have been made in the pharmacological treatment of impotence, psychological and relationship therapy remain the mainstay of the treatment of sexual problems within relationships.

Combined Modality Therapy↗

The i.v. nurse and the i.v. drug abuser: medical and psychosocial implications.

When I.V. nurses treat I.V. drug abusers, they must be aware of the medical and psychosocial issues relevant to this group. Medical issues include the I.V. drug abuser's depleted venous access and this group's high rate of infection with HIV and other blood pathogens. Psychosocial issues relate to the various social and psychological problems associated with drug abuse. Further, when caring for these patients who are at high risk for HIV and other serious blood infections, the I.V. nurse may experience a conflict between her desire to care for the patient and her fear of contracting HIV or another infection through patient contact. Education is recommended so that I.V. nurses can reduce their risk of infection with blood-borne diseases and can better understand these patients. Also suggested are a multidisciplinary approach to treatment and referral to drug rehabilitation programs.

Acquired Immunodeficiency Syndrome↗

A plan for action to reduce hospital-acquired infection.

Surveillance is recognised as an essential component of the prevention and control of infection in hospitals. The second National Prevalence Survey in 1993-94 showed a mean hospital-acquired infection prevalence rate of 9%. The Nosocomial Infection National Surveillance Scheme is being developed in England to measure the incidence of nosocomial infection; similar schemes are being developed elsewhere in the UK. Surveillance aims to reduce the risk of nosocomial infection by highlighting areas where changes need to be made, measuring the effects of change and leading to the development of guidelines for good practice.

Cross Infection↗

The development of a comprehensive stroke programme in the acute hospital.

Stroke is the third leading cause of death and an important cause of hospital admissions and long term disability. The incidence of stroke is estimated at 200 per 100,000 of the population, Dublin has approximately 2,400 new strokes per annum. In 1989 a comprehensive stroke programme was introduced in St Vincent's Hospital. The aim was to provide patients with a coordinated approach to rehabilitation. A study of the programme was conducted in 1993 by detailed chart review. 129 patients with a clinical diagnosis of stroke were referred to the programme during a 12 month period. 27.13% were under age 65 and 72.87% were over 65 years, 18% died and 44.2% were discharged home, independently mobile. The study findings suggest that the comprehensive stroke programme in St Vincent's Hospital represents a feasible model of care in the acute general hospital setting.

Acute Disease↗