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Biomedical subjects

P Curran

Publications and source records attributed to P Curran.

14 recordsLinked to original sources
PubMed1996

The pattern of alcohol consumption of a general hospital population in north Belfast.

This study aimed to examine the pattern of alcohol use among those attending a General Hospital and to explore the perception of safe drinking. The Alcohol Use Disorders Identification Test (AUDIT) questionnaire was given for self-completion to all inpatients and outpatients on separate days and to all adults attending the Accident and Emergency Department (A&E) on both a midweek and a weekend period. Additional questions to determine attitudes to, and intake of, alcohol were also given. Of the 464 people approached, 82% completed the questionnaire. Twenty-nine per cent of outpatients, 37.5% of inpatients and 20% of those attending A&E were leetotal. Fifteen per cent of outpatients, 16% of inpatients and 38.5% of those attending A&E scored as misusers of alcohol according to the AUDIT questionnaire. Males were three times more likely to misuse alcohol than females. Younger women were much more likely to misuse alcohol than older women. An unexpectedly large number of those attending the gynaecological clinic reported alcohol misuse. Of the inpatient alcohol misusers identified by AUDIT, only 50% were independently detected by either nursing or medical staff, the lower misuse scores being more frequently missed. We conclude that there continues to be a significant identifiable proportion of alcohol misuse that goes undetected. These individuals attend throughout the hospital and a simple self-completion questionnaire would considerably aid their detection.

Adult↗
PubMed1995

Psychological consequences of the Kegworth air disaster.

BACKGROUND: The study sought to quantify psychiatric morbidity among survivors of a major air crash and to identify aetiological factors linked with post-traumatic stress disorder (PTSD). METHOD: Sixty-eight of the 79 survivors (86%) were assessed at a clinical interview within one year of the disaster. The majority also completed the General Health Questionnaire, the Impact of Events Scale (IES) and the Zung Anxiety and Depression Scales. RESULTS: Fifty-four of the study group (79%) met DSM-III-R criteria for a psychiatric disorder within one year of the disaster, of whom 27 (50%) had PTSD. Those who saw injured or dead people at the scene, or had sustained less severe injuries as measured by their Injury Severity Scores, or were under 35 years old, were significantly more likely to develop PTSD. CONCLUSIONS: High rates of psychiatric morbidity are found in survivors of transportation disasters. Further studies are needed to identify those at most risk and to evaluate the benefits of psychological intervention.

Adult↗
PubMed1995

Computing education of medical students through a study of hospital and clinical activities: seven years' experience.

With the widespread use of information technology (IT) in health care, the need to teach computing to doctors and medical students has become increasingly apparent. This paper describes a course for medical students immediately before their clinical training; it lasts one semester and was first introduced in 1987 at St. George's Hospital Medical School, London. It is generally accepted that the present curriculum leaves little opportunity for the introduction of new subjects. This paper therefore describes the content of an elective in computing and the reactions of medical students to it. It is intended that this paper will help other educationalists who may obtain insights and consequently be able to negotiate medical informatics changes into their medical school environments.

Computer Literacy↗
PubMed1994

Modulation of adenylylcyclase by protein kinase C in human neurotumor SK-N-MC cells: evidence that the alpha isozyme mediates both potentiation and desensitization.

Exposure of human SK-N-MC neurotumor cells to 4 beta-phorbol 12-myristate 13-acetate (PMA) increased isoproterenol stimulation of cyclic AMP levels by severalfold. This potentiation was blocked by inhibitors of protein kinase C (PKC) and did not occur in cells in which PKC had been down-regulated. PMA treatment also enhanced the stimulation by dopamine, cholera toxin, and forskolin. Thus, the effect of PMA on the adenylylcyclase system was postreceptor and involved either the guanine nucleotide binding regulatory (G) proteins or the cyclase itself. As PMA treatment did not impair the inhibition of isoproterenol stimulation by neuropeptide Y, an involvement of the inhibitory G protein Gi was unlikely. Cholate extracts of membranes from control and PMA-treated cells were equally effective in the reconstitution of adenylylcyclase activity in S49 cyc- membranes, which lack the stimulatory G protein subunit Gs alpha; thus, Gs did not appear to be the target of PMA action. Membranes from PMA-treated cells exhibited increased adenylylcyclase activity to all stimulators including Mn2+ and Mn2+ plus forskolin. In addition, activity was increased when control membranes were incubated with ATP and purified PKC from rat brain. This is consistent with a direct effect of PKC on the adenylylcyclase catalyst in SK-N-MC cells. PMA treatment also resulted in a shift to less sensitivity in the K(act) for isoproterenol but not for dopamine or CGP-12177 (a beta 3-adrenergic agonist) stimulation. Thus, the beta 1 but not the D1 or beta 3 receptors were being desensitized by PKC activation. Analysis of SK-N-MC cells by western blotting with antibodies against different PKC isozymes revealed that both the alpha and zeta isozymes were present in these cells. Whereas PKC-alpha was activated and translocated from cytosol to membrane by phorbol esters, the zeta isozyme was not. Thus, PKC-alpha, which has been implicated in desensitization in other cell lines, also appears to potentiate adenylylcyclase activity.

Adenylyl Cyclases↗
PubMed1994

Non-Hodgkin's lymphomas of the nose and paranasal sinuses in the pediatric population.

Paranasal and nasal neoplasms often elude early diagnosis in the pediatric population. This report examines 3 cases of nasal and paranasal sinus lymphomas out of 29 lymphomas and lymphoproliferative disorders seen from 1983 to 1990. Diagnostic delays are common. The development of orbital signs and symptoms often leads to diagnosis. Computed tomography and magnetic resonance imaging are important in delineating the extent of disease and allow appropriate staging. Transnasal biopsy yields the definitive diagnosis, with low associated morbidity. Aggressive chemotherapy and irradiation prolongs survival; with this regimen all of our patients have remained alive, although 1 has residual disease. B-cell lymphomas are more common than T-cell varieties in children. One patient demonstrated B-cell immunodeficiency and preleukemia prior to developing primary paranasal sinus non-Hodgkin's lymphoma; this case reiterates the systemic nature of lymphoma, Key differences between children and adults in the manifestations of nasal and sinus lymphomas are emphasized.

Child, Preschool↗
PubMed1992

Regulation of neutrophil superoxide by antichymotrypsin-chymotrypsin complexes.

The ability of neutrophils to generate free radicals is a crucial component of host defense (Babior, B. M. (1978) N. Engl. J. Med. 298, 659-668, 721-725. Neutrophil oxidants, however, can cause significant host tissue destruction (Weiss, S. J. (1989) N. Engl. J. Med. 320, 365-376), and the regulation of free radical production is not well understood. We have previously shown that recombinant antichymotrypsin (rACT), a serine protease inhibitor, inhibits superoxide production in intact neutrophils (Kilpatrick, L., Johnson, J. L., Nickbarg, E. B., Wang, Z., Clifford, T. F., Banach, M., Cooperman, B. S., Douglas, S. D., and Rubin, H. (1991) J. Immunol. 146, 2388-2393). Using a cell-free NADPH oxidase preparation, we now demonstrate that rACT alone has no effect on superoxide production and that antichymotrypsin-chymotrypsin (rACT.CT) complexes are required to inhibit superoxide, suggesting that neutrophil chymotrypsin-like proteases produce conformational changes in ACT, allowing it to become active in regulating superoxide production. Additionally, we have identified NADPH oxidase itself as the target for rACT.CT and have demonstrated that rACT.CT interferes specifically with activation of the NADPH oxidase without changing the Km for NADPH or the rate constant describing the rate-limiting step in activation. These observations suggest an important role for antichymotrypsin in the regulation of NADPH-oxidase activation, which is a prerequisite for neutrophil superoxide production, and predict possible therapeutic uses for rACT in conditions where unregulated neutrophil-free radical production has been implicated in the mechanism of tissue destruction.

Arachidonic Acid↗
PubMed1992

Communication of discharge information for elderly patients in hospital.

The delivery of the discharge note to the general practitioners following discharge of elderly patients from a geriatric medical unit was studied over a two-month period. Handwritten discharge notes were received by the general practitioners in 75% of cases, and the delay was reduced to a median of two days by the use of a pre-printed envelope. Postal communications were also received by 89% of general practitioners after a median delay in two days. A dual system of hand-delivery and postal delivery would ensure faster and more complete receipt of information.

Aged↗
PubMed1990

Backslabs and plaster casts: which will best accommodate increasing intracompartmental pressures?

Plaster-of-Paris backslabs are presently used after closed or operative reduction of fractures as they are thought to accommodate any swelling which may occur. This study was designed to examine the ability of different types of cast to expand with increasing internal pressure. The results of the study show clearly that a split and spread cast is the only safe cast to use after fracture as it allows for swelling. Backslabs are no better than a complete plaster at accommodating increased internal pressure. It is therefore recommended that backslabs are no longer used to maintain reductions when swelling is anticipated.

Casts, Surgical↗
PubMed1990

Effects of counselling on knowledge about HIV-1 among transfusion recipients and their partners. Transfusion Safety Study Group.

The present study determined how much HIV-1-positive persons knew about AIDS, and HIV-1 transmission and prevention, in comparison with HIV-1-negative controls in a predominantly heterosexual cohort. The subjects were blood donors, blood recipients, hemophiliacs, and their sexual partners. A 16-item questionnaire about AIDS, HIV-1 transmission, and knowledge of safe sexual practices was administered to 228 subjects to determine background information. The HIV-1-positive cohort answered more questions correctly (mean = 8.5) than did the HIV-1-negative cohort (mean = 6.5), largely as a result of general information about AIDS among those with steady sexual partners. All persons, however, were poorly informed about HIV-1 transmission and safe sexual practices. Thus, there is a great need for effective counselling.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Health beliefs and physician identified "worried well".

Health belief variables of the frequent and inappropriate user of medical services, or "worried well," were examined in two studies. Study 1 showed the physician identified "worried well" to be concerned about both general and mental health issues and to perceive typically minor symptoms as more serious than other frequent appropriate users, infrequent users, and mental health comparison groups. Study 2, a prospective study, measured beliefs and subsequent use for one year. Ratings of inappropriateness of use and psychosomatic involvement made by medical providers were predicted by high degrees of self reported somatic symptomatology, mental health concern, belief in self responsibility for health care, belief that one should handle one's own problems, and a limited belief in the responsibility of powerful others for health care.

Adolescent↗
PubMedDate not supplied

An independent labor-support nursing service.

The development of a monitrice service as an independent nursing practice is described including design, legality, implementation into several hospitals, and response by the consumer, provider, and hospital staff. Specific information also includes orientation to hospitals, scheduling, pricing, and a description of the service.

Female↗
PubMedDate not supplied

Epidemiologists in the United States: an assessment of the current supply and the anticipated need.

We provide 1985 estimates of the work force of epidemiologists in the United States, the number of graduates from training programs in epidemiology, and a projection of the future need for these health professionals. Our methods included a search of mailing lists from professional organizations, mail contact with graduate training programs, telephone interviews with experts, and a review of job announcements in professional journals. The study indicates that the current work force of epidemiologists in the United States is estimated to include 4,600 persons, more than half of whom are physicians; most epidemiologists are located in either a state with a major federal public health agency or one with a large population; and programs in epidemiology graduate an average of 475 persons with one or two years of master's level education and approximately 80 with doctoral-level education each year. After considering the factors that influence the supply of epidemiologists, we project a substantial need for more epidemiologists in the future than current sources will provide.

Education, Medical, Graduate↗