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Biomedical subjects

Maureen Lynch

Publications and source records attributed to Maureen Lynch.

8 recordsLinked to original sources
PubMed2003

The pathology of rotavirus-associated deaths, using new molecular diagnostics.

Rotavirus, the most common cause of severe, dehydrating gastroenteritis among children worldwide, annually causes approximately 500,000 deaths among children aged <5 years. The primary site of rotavirus infection is the small intestine. Pathologic investigations of patients who died of rotavirus infection are limited to data from a few reported autopsies, and dehydration with electrolyte imbalance is believed to be the major cause of death. Several recent reports suggest that children who died during a rotavirus illness were viremic before death, because rotavirus was detected at several extraintestinal sites. We report 3 rotavirus-associated deaths among children, 2 of whom had evidence of rotavirus genome in extraintestinal tissues detected by use of novel molecular diagnostic methods. The part played by rotavirus in fatal cases is unclear and requires additional investigation of diarrhea-associated deaths, because a better understanding might alter the approach to treatment and the need for antiviral therapy.

Brain Stem↗
PubMed2003

Kawasaki syndrome hospitalizations in Ireland, 1996 through 2000.

OBJECTIVE: To describe the epidemiologic characteristics and estimate the incidence of Kawasaki syndrome (KS) among children in Ireland. METHODS: Hospital discharge records with a KS diagnosis among patients <18 years of age were examined using Ireland's Hospital In-Patient Enquiry database for 1996 through 2000. RESULTS: During the study period 265 hospitalizations associated with KS among children <18 years of age were recorded in Ireland. Of those, 194 (73%) occurred among children <5 years of age. The median age of patients at admission was 2 years. The average annual KS hospitalization rate for children <5 years of age was 15.2 per 100 000 children, and among that group the hospitalization rate was higher for infants <1 year of age than for children 1 to 4 years of age (19.7 and 16.0 per 100 000 children, respectively). Most KS hospitalizations occurred among children <5 years of age and among boys. The highest monthly number of hospitalizations occurred during the months of November through January. No deaths associated with KS were reported among hospitalized children. CONCLUSION: Hospital discharge data provide useful information on the epidemiology of KS in Ireland. The hospitalization rate for KS in Ireland is similar to rates in the United States and may be higher than those in other European countries, although the European studies differ in methodologies and time periods.

Adolescent↗
PubMed2002

Molecular and immunological methods to detect rotavirus in formalin-fixed tissue.

In 1999, a tetravalent rhesus-based rotavirus vaccine was withdrawn from the market after reports of intussusception cases among vaccinated infants. Methods to detect rotavirus in formalin-fixed pathology specimens from such patients will be important in examining the possible associations between the vaccine and intussusception, in investigating fatalities caused by natural rotavirus infection, and in furthering our understanding of the pathogenesis of rotavirus disease. Three different methods, reverse transcription-polymerase chain reaction (RT-PCR), immunohistochemistry (IHC), and in situ hybridization (ISH), were developed to detect rotavirus in infected cell lines that were fixed in formalin and embedded in paraffin. Using specific primer pairs to identify the VP4 gene with a one-step RT-PCR method, we detected simian rotavirus strains RRV and YK-1 in the liver of an RRV-infected SCID mouse and in the small intestine of an YK-1 infected macaque, respectively. Using a two-step indirect immunoalkaline phosphatase technique, we found RRV antigens in the liver of an infected SCID mouse with a rabbit polyclonal anti-group A rotavirus antibody and a murine monoclonal anti-rotavirus VP2 antibody. Using riboprobes designed to detect RRV genes, VP4 and NSP4, we obtained a positive hybridization signal in the same area of the infected SCID mouse liver as the area in which rotavirus antigens were localized. These techniques should prove valuable to detect rotavirus antigens and nucleic acids in tissues from patients infected naturally with rotavirus or with intussususception associated with rotavirus vaccine.

Animals↗
PubMed2000

Rotavirus vaccines.

The past few years have seen important developments in understanding the epidemiological and virological characteristics of rotaviruses, and rapid progress has been made in rotavirus vaccine development, but further challenges remain before a vaccine is introduced into widespread use. The licensure of the first rotavirus vaccine, a tetravalent rhesus-based rotavirus vaccine, in the United States in 1998, marked a significant advance in preventing the morbidity associated with rotavirus diarrhea. The association between the tetravalent rhesus-based rotavirus vaccine and intussusception has created significant hurdles as well as new opportunities to study the pathogenesis of rotavirus and rotavirus vaccine infection. Several other rotavirus vaccine candidates are in late stages of development, and results from trials have been encouraging.

Journal Article↗
PubMedDate not supplied

Ensuring a good death.

PURPOSE: The purpose of this article is to describe how the commitment of the Dana-Farber Cancer Institute to pain management, quality of life, and optimal end-of-life care is operationalized through a comprehensive pain and palliative-care program. OVERVIEW: Institutional standards for pain management often address only the physical aspects of pain. Effective pain management requires assessment and interventions that address the multidimensional nature of pain, suffering, and quality of life throughout the cancer continuum. This approach seeks to lay the foundation of comfort and peace associated with a good death. CLINICAL IMPLICATIONS: Institutional pain management standards need to reflect the complexity of pain, especially cancer-related pain, by emphasizing comprehensive, holistic assessment and multimodality approaches to pain control and quality-of-life issues.

Cancer Care Facilities↗
PubMedDate not supplied

Integrating complementary and conventional symptom management in a cancer center.

One goal of oncology nursing is to help patients achieve the best possible quality of life. In the conventional care perspective, quality of life has four aspects: physical, emotional, social, and spiritual. From the complementary care perspective, it is defined as harmony of body, mind, and spirit. Integrating these perspectives of quality of life allows us to have a fuller and richer view of the patient, accentuating the core of his or her being: values, beliefs, and goals. The Pain and Symptom Management Service has embraced this integrated view and, by doing so, has improved symptom management outcomes for patients and their families.

Adult↗
PubMedDate not supplied

Palliative sedation.

Concerns about suffering usually arise as patients contemplate end of life. For most, an array of available therapies will alleviate suffering. However, for others, these therapies may not be adequate, despite impeccable assessment and management. In these circumstances, palliative sedation may be an option for the relief of suffering. As patients, families, and clinicians contemplate this option, controversies and concerns about hastening death, euthanasia, and limiting life-sustaining therapies can arise. This article explores some of these concerns.

Procedural Sedation↗