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Biomedical subjects

N Hickey

Publications and source records attributed to N Hickey.

At least 55 records · Page 3Linked to original sources
PubMed1984

Mortality from coronary heart disease-trends for the Republic of Ireland.

A study of certified mortality between 1968 and 1981 indicates that mortality from all causes commenced to decline from the mid 1970s in the Republic of Ireland. This trend was apparent for both sexes and for all ages except for men aged 55-64 years. A similar trend of lesser magnitude is suggested for coronary heart disease mortality in males, but not in females. The decrease in the percentage of male cigarette smokers in the population which is also reflected in a marked decline of smoking among male coronary patients, may be related to the trends in mortality.

Adult↗
PubMed1984

Factors affecting dietary compliance in coronary patients included in a secondary prevention programme.

Nutrient intake was altered favourably in the diets of 38 cardiac patients who were followed up for 1 year as part of a rehabilitation programme. Total energy intake was reduced from 3540 kcal (14.9 MJ) to 2484 kcal (10.4 MJ). Fat intake was reduced from 41 to 37 per cent of energy intake with an accompanying increase in P : S ratio from 0.18 to 0.60. Cholesterol intake was reduced from 564 to 332 mg. Carbohydrate was increased from 38 to 41 per cent of energy intake with an increase in fibre intake from 18 to 24 g. The energy contributed by alcohol was reduced from 6 to 5 per cent. Patients varied in their compliance but all patients made some changes in their dietary intake. Changes in body weight, serum cholesterol levels, cigarette-smoking status and levels of physical activity tended to correspond with the recorded changes in nutrient intake. A low level of education, low socio-economic group, lack of understanding of the illness by the patient and inadequate communication were associated with reduced compliance. Initial motivation and anxiety levels in hospital had less effect on compliance.

Adult↗
PubMed1983

Long term effect on mortality of stopping smoking after unstable angina and myocardial infarction.

Subjects who stop smoking cigarettes after myocardial infarction have an improved rate of survival compared with those who continue, but to date it was not known whether the benefit persisted for more than six years. A total of 498 men aged under 60 years who had survived a first episode of unstable angina or myocardial infarction by two years were followed up by life table methods for a further 13 years. Mortality in those who continued to smoke was significantly higher (82.1%) than in those who stopped smoking (36.9%). These differences increased with time. Mortality in those who were non-smokers initially and who continued not to smoke was intermediate (62.1%). The adverse effect of continued smoking was most pronounced in those with unstable angina. Continuing to smoke increased the rate of sudden death to a greater degree in those with less severe initial attacks, while the effect of smoking on fatal reinfarctions was most apparent in those with a more complicated presentation. These findings suggest that stopping cigarette smoking is the most effective single action in the management of patients with coronary heart disease.

Angina Pectoris↗
PubMed1983

Natural history of coronary heart disease: a study of 586 men surviving an initial acute attack.

A total of 586 men who survived an initial attack of unstable angina or myocardial infarction have been followed for up to 15 years. A policy of early mobilization and sustained risk factor advice was employed. A conservative approach to treatment was adopted during the acute and follow-up stages. Drugs were employed only for symptomatic reasons, and only two patients proceeded to coronary artery bypass surgery. Survival at 5, 10, and 15 years was 80%, 61%, and 43%. Older patients and those with more severe initial attacks had a higher mortality, but these factors did not relate to combined fatal and nonfatal recurrence of myocardial infarction. Of 22 studies reviewed, 18 report a higher mortality than does our study. Four studies, none strictly comparable, report a similar 5-year mortality. A conservative approach to management does not appear to be harmful and may be beneficial.

Age Factors↗
PubMed1983

Cigar and pipe smoking related to four year survival of coronary patients.

Six hundred and thirty-four male patients under 60 years who survived a first attack of unstable angina or myocardial infarction were followed for a period of four years. Details of initial and follow-up smoking habits were examined. Patients who continued to smoke cigarettes or cigars had an excess mortality compared with non-smokers, with those who stopped smoking, and with cigarette smokers who changed to pipe smoking. Pipe smokers who continued smoking the pipe had an observed mortality which was greater than that of the non-smokers, but the numbers were small and the results were not statistically significant. The effect of smoking habit on mortality was not influenced by two other determinants of prognosis: age and severity of initial attack. These results confirm that the long-term prognosis of patients after unstable angina or myocardial infarction may be significantly influenced by smoking habits. They are consistent with the hypothesis that cigar and pipe smoking may have an adverse effect after myocardial infarction but further studies are needed to corroborate the association between cigar and pipe smoking and prognosis of coronary heart disease.

Adult↗
PubMed1982

Social networks, attachments and support in minor affective disorders: a replication.

Significant deficiencies in personal social networks and social support in non-psychotic psychiatric out-patients have been reported by Henderson ad his colleagues. In a replication study, 50 non-psychotic psychiatric out-patients were compared with 50 matched controls. Patients reported spending less time in social interaction, but more time in unpleasant interaction during the previous week; they also had fewer attachment figures, close relatives and good friends and fewer social contacts than controls. However, the separate analysis of Neurotic and Retarded depressives (using the Present State Examination) failed to replicate all these findings in the Retarded depressives. It is concluded that these associations are confirmed in neurotic patients, but that the more severe depressive disorders require further investigation.

Adolescent↗
PubMed1981

Unstable angina: natural history and determinants of prognosis.

One hundred one patients with unstable angina were treated conservatively without the routine use of beta receptor blocking agents, calcium antagonist drugs, anticoagulant agents or nitrates. Only two patients underwent arteriography and coronary arterial bypass surgery during hospitalization and one patient during the 1st year of follow-up study. The 28 day mortality rate was 4 percent and the total 1 year cardiac mortality rate 10 percent. Two patients died from carcinoma. The incidence rate of nonfatal myocardial infarction was 9 percent during the first 28 days and a further 3 percent for the 1st year. These results compare favorably with the immediate and 1 year prognosis reported from other studies using different treatment procedures, including modern intensive drug treatment and coronary arterial bypass surgery. Various factors studied during the acute stage of unstable angina were assessed in an effort to predict the immediate and long-term outcome. Only persistence of pain after admission to the hospital was found a significant indicator of an adverse prognosis. Modern medical treatment of unstable angina with beta receptor blocking agents, calcium antagonist drugs, anticoagulant agents, nitrates and antiarrhythmic agents is critically examined. The paucity of proper randomized controlled studies confirming the value of medication is underlined. There is little evidence to show that aggressive or intensive medical or surgical treatment is superior to a conservative approach to management in the coronary care unit. This approach includes bed rest until the pain has resolved, symptomatic drug treatment only, the minimal use of invasive investigations and careful risk factor intervention.

Adrenergic beta-Antagonists↗
PubMed1981

Trends in cigarette smoking among coronary patients between 1961 and 1975.

Between 1961 and 1975 the proportion of cigarette smokers among male patients with acute coronary heart disease showed a progressive decline from 87.1 to 66.1%. There was a corresponding increase in the proportion of ex-smokers and non-smokers. Factors which might have accounted for this trend were examined. Changing diagnosis, altered prevalence of other risk factors and social class changes in patient referral would not appear to have accounted for the observed smoking trends. It is suggested that the observed trends in cigarette-smoking habits may be real and that they may represent a change in the epidemiological pattern of coronary heart disease in Ireland.

Blood Pressure↗
PubMed1981

The treatment of obesity with a new liquid formula diet.

The effect of a liquid formula diet (330 kcal) was studied in 23 moderately obese male and female patients at the hospital outpatient clinic. All subjects had a Quetelet index of at least 285 at entry. The patients (60.8 per cent) who appeared to adhere to the diet for a 4-week period had a mean loss of 7.9 kg (men) and 5.2 kg (women). Over the 8 weeks of the study, nine (19.1 per cent) patients continued to attend the clinic, with further weight loss. No serious adverse effects of treatment were recorded.

Adult↗