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Biomedical subjects

P O'Connor

Publications and source records attributed to P O'Connor.

At least 19 recordsLinked to original sources
PubMed1992

Effect of cocaine injections on the neuroendocrine response to the serotonin agonist MK-212.

This study was undertaken to examine whether several of the hormones that can be released by activation of serotonin receptors will be affected by long-term cocaine administration. Male rats received cocaine injections (15 mg/kg, IP) twice daily for 7 days. Forty-two hr after the last cocaine injection, the rats were challenged with increasing doses (0, 1, 5, 10 mg/kg, IP) of the 5-HT1/5-HT2 agonist MK-212 (6-chloro-2-[1-piper-azinyl]-pyrazine). The following observations were made: (1) cocaine reduced the rate of body weight gain; (2) cocaine inhibited the stimulatory effect of MK-212 on plasma vasopressin, oxytocin, and prolactin concentrations and on plasma renin activity and concentration; (3) cocaine did not inhibit the stimulatory effect of MK-212 on plasma ACTH or corticosterone concentrations. The data indicate that a wide-spectrum 5-HT (serotonin) agonist such as MK-212 can reveal differential neuroendocrine responses. This effect could be related to cocaine-induced changes in the different 5-HT receptor subtypes that regulate the secretion of these hormones.

Adrenocorticotropic Hormone↗
PubMed1992

Depressive symptoms in women in the six months after miscarriage.

This study, the first systematic investigation of the psychiatric impact of miscarriage, tests whether miscarriage markedly increases depressive symptoms in the 6 months after loss. We interviewed 382 miscarrying women entering the study at 2 weeks, 6 weeks, or 6 months after loss and, for comparison, 283 pregnant women and 318 community women not recently pregnant. Among women interviewed 2 weeks after miscarriage the proportion highly symptomatic on the Center for Epidemiologic Studies-Depression scale was 3.4 times that of pregnant women (95% confidence limits 2.0 and 5.0) and 4.3 times that of community women (95% confidence limits 3.0 and 5.8). Among women first interviewed 6 weeks and 6 months after miscarriage the proportion highly symptomatic was three times that of the community women. Women reinterviewed at 6 weeks and 6 months did not have elevated symptom levels, a result attributed to the unintended therapeutic and test effects of study interviews. Interviews were fully structured, readily administered by telephone by nonmedical personnel. The possibility that such interviews afford miscarrying women substantial psychologic benefits merits future investigation.

Abortion, Spontaneous↗
PubMed1992

Hospital palliative care services: three models in three countries.

There is an increasing trend toward providing palliative care services within general hospitals. The history and work of three hospital palliative care teams is reviewed, one in New York, one in London, and one in Ontario, Canada. The evolution, leadership, structure, functioning, and financing of the teams is discussed. Indicators of success and survival, principally financial support, leadership, and acceptability within hospitals, are considered. It is recommended that the service traditionally limited to oncology patients be extended to other patient groups. It is also recommended that, taking into account cultural and institutional differences, standardized mechanisms be adopted so that services can be systematically audited and changes implemented. Research and education will become increasingly important if services within hospitals are to survive.

Hospices↗
PubMed1992

Reliability of lumbar isometric torque in patients with chronic low back pain.

In this study, the test-retest reliability of lumbar isometric strength testing in patients with chronic low back pain (CLBP) was assessed. Isometric torque measurements were obtained from 89 patients with CLBP at seven different angles of lumbar flexion. Because previous studies have demonstrated significant strength differences between male and female subjects, separate data analyses were performed for each gender. Results indicated moderate to high reliability for patients with CLBP when tested at individually determined angles of flexion within their idiosyncratic range of motion (ROM) (female subjects: r = .59-.96, P less than .05, SEE = 12.0-24.2 N.m; male subjects: r = .71-.93, P less than .05, SEE = 25.1-62.1 N.m). For comparison with previously published data on asymptomatic controls, an additional set of analyses was conducted for subjects with full lumbar ROM. Similar reliability was demonstrated for this subsample (female subjects: r = .57-.93, P less than .05, SEE = 12.4-27.9 N.m; male subjects: r = .63-.93, P less than .05, SEE = 34.2-44.2 N.m). The authors concluded that isometric lumbar extension torque could be reliably measured in patients with CLBP at multiple positions within the full ROM, although reliability decreased at the most extended positions. The demonstrated reliability will allow researchers to assess treatment effects and group differences without undue concern for artifact attributable to measurement error.

Back Pain↗
PubMed1992

The epidemiology of severe injuries to children in northern Manhattan: methods and incidence rates.

The epidemiology of injury incidence in inner-city children has not previously been described. This study presents the methods used and the incidence rates found for severe injury (causing hospitalisation or death) in a population of 89,000 children under age 17 years in northern Manhattan, a largely poor area of New York City. The average annual incidence rate (measured from 1983 to 1987) for severe injuries to children under 17 was 846/100,000 a year. The vast majority (79%) were classified as unintentional. Nine per cent were due to assault, 3% were self-inflicted and in an additional 9% the intention was unclear. Classified by cause, the highest incidence (per 100,000/year) was found for falls (218), vehicle-related (141, primarily pedestrian), ingestion (119) and burns (110). Guns caused 3% of the injuries (27). The death rate from injury was 18.7/100,000, 36% of which was due to homicide. In an additional 28%, intentional injury was suspected. The suicide rate was 0.4/100,000. The leading causes of injury death included guns and burns (both 2.7/100,000). Compared with childhood injury rates in predominantly rural and suburban populations, the rates reported here for northern Manhattan are higher for overall injury incidence (fatal and non-fatal) and for homicide, but lower for injury mortality not due to homicide.

Acute Disease↗
PubMed1992

The contribution of maternal depressive symptoms and life events to child behaviour problems.

The effect of maternal depressive symptoms and stressful life events on child behaviour problems has been the focus of clinical and epidemiological research for some years. We interviewed 80 women drawn from the New York City area regarding their life events in the preceding 6 months, current levels of depressive symptoms and behaviour problems in their children. For each woman, one child between the ages of 3 to 8 was selected for study analysis. Maternal depressive symptoms and maternal life events in general, as well as undesirable events in particular, contributed independently to child behaviour problems in multivariable analyses controlling for maternal education. This association did not vary by maternal marital status, or gender or age of the child. Events judged on common sense grounds to be especially disruptive of the child's routine did not contribute to child behaviour problems, independently of maternal depressive symptoms. Future research should devote more attention to specification of the life events under study and of factors that may buffer both the mother and the child from their pathogenic effects.

Adult↗
PubMed1992

Determinants of depressive symptoms in the early weeks after miscarriage.

OBJECTIVES: We tested whether and under what conditions miscarriage increases depressive symptoms in the early weeks following loss. METHODS: We interviewed 232 women within 4 weeks of miscarriage and 283 pregnant women and 318 community women who had not recently been pregnant. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression (CES-D) Scale. RESULTS: Among women who had miscarried, the proportion who were highly symptomatic on the CES-D was 3.4 times that of pregnant women and 4.3 times that of community women. Among childless women, the proportion of women who had miscarried who were highly symptomatic was 5.7 times that of pregnant women and 11.0 times that of community women. Women who had miscarried were equally depressed regardless of length of gestation; among pregnant women, depressive symptoms declined with length of gestation. Among women who had miscarried, symptom levels did not vary with attitude toward the pregnancy; among pregnant women, depressive symptoms were elevated in those with unwanted pregnancies. Prior reproductive loss and advanced maternal age (35+ years) were not associated with symptom levels in any cohort. CONCLUSIONS: Depressive symptoms are markedly increased in the early weeks following miscarriage. This effect is substantially modified by number of living children, length of gestation at loss, and attitude toward pregnancy.

Abortion, Spontaneous↗
PubMed1992

The use of baseline investigations in patients admitted from an accident and emergency department.

We studied the use of four investigations on patients admitted from our Accident and Emergency Department: full blood count, urea and electrolytes, chest x-ray and electrocardiogram. We found 1) that these investigations were performed on a high proportion of patients admitted 2) that a high percentage of these investigations yielded normal results. We suggest that a greater emphasis should be placed on clinical assessment, rather than the 'routine' use of investigations.

Diagnostic Tests, Routine↗
PubMed1992

Respite care services to caretakers of chronically ill children in California.

Caring for chronically ill and/or technology-dependent children at home can be emotionally, physically, psychologically, and financially exhausting for the caregiver. Caregivers require temporary relief from the burden of day-to-day care of these children. Respite care offers the opportunity for this relief. A study was conducted to survey the availability of respite care for chronically ill and technology-dependent children in California. Survey findings from 45 agencies indicated that 38% provided respite care for chronically ill and/or technology-dependent children. Fifty percent of agencies provided care for less than 10 chronically ill and/or technology-dependent children per year. Major problems associated with provision of respite services were inadequate reimbursement and insufficient request for services.

California↗
PubMed1992

Sports injuries and the accident and emergency department--ten years on.

A six month prospective survey in 1990 of sports injuries presenting to the A+E department of St James and the Mater hospitals revealed 1594 patients, accounting for 3.8% of the total number of new patients seen in that period. These results were compared to a similar study conducted in the Mater in 1980. Comparison with the 1980 study showed similar patterns with respect to sex, sport and site of injury. There was an increase of the age at which sport was played as evidence by the age of those injured. Whilst delay in presentation has improved somewhat, 57% of patients stil waited more than 12 hours before attending. Management of the total spectrum of injury has changed. More X-Rays were taken and on-site physiotherapy has been established in both A+E departments. Despite such an accessible facility the use of physiotherapy in sports injuries could be improved. There was also variation in the treatment of non-orthopaedic injury. We recommend that education of sport participants continue, especially in the areas of protective equipment and early presentation for medical assessment. We further propose that A+E staff be educated in the special needs of sports men and women, and that as recommended previously in the 1980 study, a Central Sports Injury Clinic for the six Dublin hospitals be established.

Adolescent↗
PubMed1992

Low energy high frequency pulsed electromagnetic therapy for acute whiplash injuries. A double blind randomized controlled study.

The standard treatment of acute whiplash injuries (soft collar and analgesia) is frequently unsuccessful. Pulsed electromagnetic therapy PEMT (as pulsed 27 MHz) has been shown to have pro-healing and anti-inflammatory effects. This study examines the effect of PEMT on the acute whiplash syndrome. One half of the 40 patients entering the study received active PEMT collars: the other half facsimile (placebo). All patients were given instructions to wear the collar for eight hours a day at home and advised to mobilise their necks. At 2 and 4 weeks the actively treated group had significantly improved (p less than 0.05) in terms of pain (visual analogue scale). By chance movement scores for the PEMT group were significantly worse at entry to the study than the control group (p less than 0.05). At 12 weeks they had become significantly better (p less than 0.05). PEMT as described is safe for domiciliary use and this study suggests that PEMT has a beneficial effect in the management of the acute whiplash injury.

Accidents, Traffic↗
PubMed1991

The Stanford experience with high-dose etoposide cytoreductive regimens and autologous bone marrow transplantation in Hodgkin's disease and non-Hodgkin's lymphoma: preliminary data.

Seventy-seven Hodgkin's disease and non-Hodgkin's lymphoma (NHL) patients received high-dose etoposide in combination with cyclophosphamide and either fractionated total body irradiation (TBI) (n = 28) or carmustine (n = 49) prior to autologous bone marrow transplantation. Marrow from NHL patients was purged in vitro with a panel of monoclonal B- and T-cell antibodies and complement. Six toxic deaths (8%) occurred, all in patients who received carmustine. With a median follow-up of 1 year, 57 patients are alive and free from progressive disease. The 1-year actuarial survival and freedom from progression are 85 and 73% in fractionated TBI/etoposide/cyclophosphamide-treated patients and 79 and 72% in carmustine/etoposide/cyclophosphamide-treated patients. Forty-five of these patients participated in prospective trials for which eligibility criteria were (1) less than 25% curability with conventional therapy; (2) achievement of minimal disease state with conventional therapy; and (3) transplantation early in the course of disease. One-year actuarial survival for 18 patients with relapsed Hodgkin's disease is 80% and for 21 relapsed intermediate and high-grade NHL patients, 70%. One NHL Burkitt's patient was transplanted on a protocol for high-risk intermediate and high-grade NHL in first remission. Five patients with follicular mixed or small cleaved NHL were also transplanted in first remission.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Reproducibility of maximal versus submaximal efforts in an isometric lumbar extension task.

The purpose of this study was to investigate the differences in test-retest reliability between maximal and submaximal efforts in an isometric lumbar extension task and to test the hypothesis that submaximal efforts would be less consistent than maximal efforts. Twenty subjects were asked to produce maximum voluntary contractions at seven different positions in a lumbar extension machine. Each subject was tested twice in a maximal-effort condition and twice in a 50% effort condition. The order of the effort conditions was counterbalanced across subjects so that half of the subjects performed the maximal-effort tests first and half performed the submaximal effort first. Results indicated high test-retest correlations at all angles in both conditions. There were no differences in test-retest reliability between effort conditions. Therapist ratings of consistency did not differ between conditions, and therapists could not discriminate between conditions on the basis of effort consistency. Because subjects could reliably reproduce a submaximal effort, it was concluded that consistency interpretations of isometric strength testing may be misleading.

Adult↗
PubMed1991

Whiplash injury.

Explore the source record for details and available documents.

Expert Testimony↗
PubMed1991

Families, parks, gardens and toxocariasis.

Toxocara canis antibody titres were measured in members of 30 families. 73/140 (52.1%) family members were seropositive for T. canis at a dilution greater than or equal to 1:50 and 11 (7.8%) had reciprocal titres greater than or equal to 800. Toxocara ova were sought (a) in relation to the 30 families and (b) in the community. No toxocara ova were found in household dust samples. 38% of family gardens contained toxocara ova while 6% of soil samples from public parks and open spaces around housing estates were positive. None of the faecal specimens from pet dogs were positive for toxocara ova as compared to 6.2% of stray dogs. 5.3% of canine faecal samples from the streets contained toxocara ova. In this study household garden soil was a potentially greater source of toxocara infection than soil in public parks and open spaces.

Adolescent↗
PubMed1991

Drug-drug interactions in hospital.

Drug prescription charts of 200 randomly selected general medical patients in two Dublin hospitals were examined for potential drug-drug interactions. Using the Stockly Interaction alert, 37% of these patients had potential interactions but in only three was there clinical evidence that an interaction occurred. In an analysis of 150 spontaneous (yellow card) adverse drug reactions reports interactions contributed to only 8%. These results suggest that the importance of interactions as a cause of drug toxicity is commonly over-estimated.

Aged↗