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Biomedical subjects

M Fahey

Publications and source records attributed to M Fahey.

24 records · Page 2Linked to original sources
PubMed1984

Management of pneumonia in the prospective payment era. A need for more clinician and support service interaction.

We compared the diagnostic and therapeutic management of pneumonia during 1970 and 1971 with that during 1979 and 1980 in clinically similar populations at The Johns Hopkins Hospital, Baltimore. More patients received aminoglycoside and cephalosporin therapy during 1979 and 1980. Guidelines for the use of chest roentgenograms and cultures were exceeded in 14% to 24% of cases. Patients whose cases were judged to be suboptimally managed had significantly higher charges and length of stay. Aged patients and those requiring thoracentesis also used resources more intensively. Given the technologic explosion, clinicians cannot know the performance characteristics of all tests and medications they can order. To minimize inefficient and ineffective practices, it is essential that clinicians and support service directors develop guidelines for testing and antibiotic use. Deviations should trigger timely interventions. Management under prospective payment will also require identifying specific patient subgroups to verify appropriate utilization and to assure equitable reimbursement.

Aminoglycosides↗
PubMed1978

Pre-hospital trauma management.

Pre-hospital trauma care and management in the United Kingdom, West Germany, Denmark, the United States of America, Australia and New Zealand, are briefly compared. An analysis is presented of 738 serious motor vehicle accidents attended in Canterbury from November 1972 until February 1977, showing that the accidents with life threatening conditions commonly occurred more than 20km from the base hospital.

Accidents, Traffic↗
PubMedDate not supplied

Pancreastatin distribution and plasma levels in the pig.

Pancreastatin is a peptide isolated from porcine pancreas which has insulin-suppressive actions in vitro and sequence homology with chromogranin A. Using radioimmunoassay and immunocytochemistry we investigated whether pancreastatin has a more widespread distribution and a possible endocrine role in the pig. Pancreastatin immunoreactivity was found in plasma, adrenal gland, pancreas, anterior pituitary and throughout the gastrointestinal tract. The immunoreactivity was colocalized with chromogranin immunoreactivity in endocrine cells and ultrastructurally (in the pancreas) to storage granules. Characterization of pancreastatin-like immunoreactivity, using gel permeation and high performance liquid chromatography, separated 3 different pancreastatin-like immunoreactive forms: one molecular form, indistinguishable from synthetic pancreastatin 1-49, was predominant in pancreas and thyroid and released into the circulation postprandially. However, a high dose (greater than 1 nmol/l) infusion of pancreastatin 33-49 (the biologically active moiety in vitro) into conscious pigs had no effect on either basal or glucose-stimulated insulin secretion.

Adrenal Glands↗
PubMedDate not supplied

Bone tunnel enlargement after anterior cruciate ligament replacement.

Radiographic increase in the size of tibial and femoral tunnels has been observed. This retrospective study compared tibial tunnel diameter in 56 autograft and 87 allograft patellar tendon bone-tendon-bone anterior cruciate ligament replacements whose observed tunnel changes were correlated with clinical results at 1 year postoperatively. Tibial tunnel sclerotic margins were measured approximately 1 cm below the joint line. Exact tunnel dimension was calculated by using a magnification factor determined by the interference screw of known diameter within the same tunnel. Average allograft tunnel enlargement was 1.2 mm (-2.5 to 6.0) compared with the autograft tunnel enlargement of 0.26 mm (-2.5 to 2.7); the difference was significant (P > 0.0002). No significant difference was seen in KT-1000 arthrometer measurements between autograft or allograft groups, and no correlation was seen between increased tunnel size and clinical outcome as determined by the modified Hughston knee evaluation system. Tunnel measurement reproducibility was confirmed by independent repeated measurements. The significance of this tunnel enlargement is unknown and does not appear to adversely affect clinical outcome of allograft utilization. Possible explanations include an immune response with resorption, stress shielding proximal to the interference screw resulting in resorption, or an inflammatory response by synovium in the tunnel.

Adolescent↗
PubMedDate not supplied

What causes p53 mutations in patients with lung cancer?

We studied the association between occurrence of p53 mutations and both smoking history and family history of cancer (FH) in 109 lung cancer patients using the logistic regression model. A dose-response relationship between smoking defined as pack-years smoked (PY) and p53 mutations was clearly demonstrated [Odds ratio (OR) for PY 30-59: 1.92 (0.55-7.94); OR for PY 60: 4.21 (1.09-19.0); trend P=0. 04], but no association between p53 mutations and FH was obtained in male patients. In females, smoking habit [OR: 3.23 (0.48-25.4)] and FH [OR: 4.17 (0.84-25.0)] might both be associated with p53 mutations.

Adenocarcinoma↗