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Biomedical subjects

P O'Sullivan

Publications and source records attributed to P O'Sullivan.

At least 19 recordsLinked to original sources
PubMed2006

Malignant chest wall neoplasms of bone and cartilage: a pictorial review of CT and MR findings.

Malignant tumours of the chest wall are uncommon. The purpose of this pictorial essay is to describe the CT and MRI findings of malignant neoplasms affecting the bony skeleton of the chest wall and the costal cartilages. The most common primary malignant neoplasms involving the bony skeleton of the chest wall are chondrosarcoma, osteosarcoma and Ewing's sarcoma/primitive neuroectodermal tumour. Metastases, multiple myeloma and invasive primary lung cancer are the most frequent secondary lesions. We performed a retrospective review of the radiology and pathology archive at our institution from 1 July 2000 to 31 December 2004 and identified 31 of these lesions. Several of these tumours have distinctive radiological features, allowing a confident radiological diagnosis to be suggested.

Adult↗
PubMed2006

Soft tissue tumours and mass-like lesions of the chest wall: a pictorial review of CT and MR findings.

Soft tissue tumours and tumour-like lesions of the chest wall are uncommon. The purpose of this pictorial essay is to describe the imaging findings of chest wall soft tissue tumours and tumour-like lesions. We searched the radiological and pathological archive at our institution retrospectively and reviewed the literature on soft tissue tumours of the chest wall. Common chest wall soft tissue tumours and mass-like lesions include peripheral nerve tumours, lipomas, liposarcomas, haemangiomas, elastofibromas, metastases, lymphoma and abscesses. Other lesions encountered include desmoid tumours and malignant fibrous histiocytoma. Many have distinctive radiological findings or occur in specific locations, allowing a specific radiological diagnosis to be suggested.

Adult↗
PubMed2006

Effects of presentation method on the understanding of informed consent.

BACKGROUND/AIM: Knowledge of which presentation methods impart the most information to patients can improve the informed consent discussion. The purpose of this study was to determine if the comprehension and recall of the informed consent discussion varied with presentation method. METHODS: Randomised, prospective study at the University of Arkansas for Medical Sciences. 90 freshmen medical students were randomly assigned to one of three groups and separately went through an informed consent on cataract surgery. Group A heard an informed consent presentation. Group B was shown diagrams while hearing the same presentation. Group C heard the consent and then watched an informational video on cataract surgery. A 10 point multiple choice quiz was administered after the presentation and repeated again 1 week later. RESULTS: Scores from each group were averaged as number correct out of 10 questions. For same day scores, group C scores (7.70 (SD 1.24)) were significantly higher than group A (6.39 (1.63)). One week testing revealed that group C (6.96 (1.62)) recalled more between the two time periods and scored significantly higher than groups A (5.15 (2.11)) and B (5.54 (1.64)). CONCLUSIONS: This study found differences in the participants' ability to recall facts based on the manner in which the material was presented. It clearly demonstrated that the use of visual aids improved the ability to remember facts and risks associated with cataract surgery beyond a verbal presentation alone. It also showed a benefit of the repetition of information as provided by audiovisual presentations that can be used in conjunction with the physician-patient discussion.

Audiovisual Aids↗
PubMed2006

Central line pump infusion and large volume mediastinal contrast extravasation in CT.

The use of multidetector CT scanners for CT angiography requires rapid injection of radiographic contrast media. Central venous catheters are now widely used for this purpose. Several complications may occur while using central venous access for rapid, large volume contrast injection such as catheter rupture and contrast extravasation. We describe a case in which inadvertent malposition of a central venous catheter led to a high volume extravasation of contrast in the mediastinum in a trauma patient.

Adult↗
PubMed2006

Pulmonary and nodal multiple myeloma mimicking lymphoma.

Multiple myeloma is a haematological malignancy characterized by the occurrence of plasma cell tumours within the bone marrow. In advanced multiple myeloma, metastatic deposits outside the bone marrow (extramedullary) are rare. Reported extramedullary sites include the upper respiratory tract and lymph nodes. Parenchymal pulmonary plasmacytoma is exceptionally rare. We describe such a case in a 51-year-old male, who underwent allogenic marrow transplantation. 6 months post-transplantation developing nodal and hilar pulmonary multiple myeloma, the radiological appearances mimicking lymphoma.

Bone Marrow Transplantation↗
PubMed2003

Generic performance assessment for a deep repository for low and intermediate level waste in the UK--a case study in assessing radiological impacts on the natural environment.

Concentrations of radionuclides in soil and surface water, taken from a generic performance assessment of a repository for low and intermediate level radioactive waste, assumed to be located in the UK, have been used as the basis for a case study in assessing radiological impacts on the natural environment. Simplified descriptions of the terrestrial and aquatic ecosystem types likely to be impacted have been developed. A scoping assessment has identified (226)Ra, (210)Po, (234)U, (230)Th and (238)U as having the highest potential for impact, with doses from internally incorporated alpha emitters as being potentially of particular importance. These nuclides, together with (36)Cl and (129)I (which have proved to be of importance in radiological risk assessments for humans) were included in a more detailed dose assessment. A basic methodology for dose assessment of ecosystems is described, and has been applied for the defined impacted ecosystems. Paucity of published data on concentration factors prevented a more detailed assessment for terrestrial ecosystems. For the aquatic ecosystem, a more detailed assessment was possible and highest calculated absorbed dose rates (weighted for the likely higher biological effectiveness of alpha radiation) were about 6.5 microGy h(-1). We conclude that harm to the impacted ecosystems is unlikely and make the observation that the lack of concentration factor or transfer factor data for a sufficiently wide range of species, ecosystems and nuclides appears to be the principal obstacle to establishing a comprehensive framework for the application of radiological protection to ecosystems.

Animals↗
PubMed2003

A reappraisal of the role of cerium in burn wound management.

A rare earth element, cerium, was introduced as an antibacterial agent in 1976 but has rarely been used due to the emphasis on wound excision. Used in combination with silver sulphadiazine, it may improve patient survival when excision is not possible.

Administration, Topical↗
PubMed2001

Racial differences in breast cancer screening among women from 65 to 74 years of age: trends from 1987-1993 and barriers to screening.

Breast cancer mortality is decreasing for elderly white women but increasing for elderly black women. National surveys were used to study racial differences in breast cancer screening and effects of Medicare funding for mammography and to examine explanatory fac- tors. A total of 13,545 women, aged 65-74, from the Health Care Finance Administration's Master Beneficiary File participated. After Medicare funding for screening mammography, the percent reporting a mammogram increased for white women, but not for black women. Clinical breast examination and breast self-examination decreased. Physician's recommendation, geographic area, education level and health status were the variables significantly affecting mammography usage for both races. Physicians recommended mammography more often if women were white, married, educated beyond high school and had an annual income greater than $20,000. These results support the need to design and test strategies specifically for black women and interventions to emphasize physician recommendations for breast cancer screening.

Black or African American↗
PubMed2000

A study of children's concepts of their internal bodies: a comparison of children with and without congenital heart disease.

This study examined the following: (1) the knowledge children with and without congenital heart disease have about their internal bodies, (2) the relationship of this knowledge with age, disease severity, and previous health care experiences, and (3) how the differences between beliefs about the interior body and the value assigned to specific body parts differed between children with congenital heart disease and their unaffected peers. One hundred participants, 50 with cardiac disease and 50 comparisons, between 5 and 15 years of age, completed the inside the Body Test; the severity of the conditions of the children with cardiac problems was evaluated with the Permanent Impairment Evaluation Guide. Results indicated that there were no differences between the 2 groups on knowledge of body parts, body-part function, nor the values that were assigned. Implications for practice are discussed.

Adolescent↗
PubMed1999

Vaginal sonography and gender preference for sonographer.

PURPOSE: The invasive nature of vaginal sonography, recently introduced as an improved diagnostic method for imaging the contents of the pregnant uterus, has provoked discussion about patient preference for female sonographers. This study examined whether patients had a gender preference for the sonographer who would conduct such an examination. METHODS: Over 3 months, a written survey was given to pregnant women to complete anonymously while waiting for their scheduled sonographic examination. The survey covered gender preference for the sonographer and education, ethnicity, and previous experience with the procedure. Surveys were turned in by 1,002 pregnant women. RESULTS: Of the women whose survey responses were analyzed, 62% preferred a female sonographer. The principal reason given for this preference was comfort with the same gender. The majority of respondents were 25-40 years old, married, white, and multiparous. The level of education varied widely. CONCLUSIONS: These findings point to a need to seek consumer input when new technology is introduced, to provide women with choices where possible, and to ensure that they have access to information about those choices.

Educational Status↗
PubMed1998

Correlates of disruptive behavior in severely cognitively impaired nursing home residents.

This article provides information about correlates of "disruptive behaviors" among nursing home residents with dementia. We used averages of multiple observations for a wide range of behaviors (n = 45) across 11 months to gather this information. We placed behaviors into four separate categories: physically aggressive, physically non-aggressive, vocally agitated, and vocally aggressive. Then, we tested associations between these categories and demographic, cognitive, and health variables. Cognitive status and selected demographic variables were associated with the behavior categories; adding health variables did not improve prediction. Lower cognitive status was associated with more disruptive behaviors. Our findings suggest that cognitive status, but not health variables, predicts disruptive behavior among nursing home residents with dementia.

Aged↗
PubMed1997

Use of the ED as a regular source of care: associated factors beyond lack of health insurance.

STUDY OBJECTIVE: To determine the characteristics and health care experiences of patients who identify the ED as their usual source of care. METHODS: We conducted a cross-sectional survey in a Level I trauma center ED at an urban teaching hospital. Our population comprised 892 adults who presented to the ED over the course of 30 days. We asked participants about their regular source of health care, previous health care experiences, and perceptions of the use of the ED. RESULTS: Patients who reported the ED as their regular source of care were three times more likely to have used the ED more than once in the preceding year. Among the regular ED users, 68% desired a physician as their regular source of care, and 46% of these subjects said they had tried unsuccessfully to get one in the preceding year. Five variables were associated with self-report of the ED as the regular source of health care: annual income less than $30,000, having been refused care in an office or clinic in the past, perception that an ED visit costs less than an office visit, absence of chronic illness, and unwillingness to use the ED if a $25 copayment were in effect. CONCLUSION: Low income, perceived mistreatment by health care providers, and misperception about charges contribute to use of the ED as a regular site for health care. These factors suggest the difficulty of altering health care use patterns in this group.

Adolescent↗
PubMed1997

Benign versus malignant breast disease: comparison of contrast-enhanced MR imaging and Tc-99m tetrofosmin scintimammography.

PURPOSE: To compare technetium-99m tetrofosmin scintimammography with contrast material-enhanced magnetic resonance (MR) imaging in the characterization of palpable breast masses. MATERIALS AND METHODS: Forty-seven patients (mean age, 51 years) with a palpable breast mass were prospectively examined with scintimammography, MR imaging, and conventional mammography 2 weeks before fine-needle aspiration biopsy. RESULTS: In three patients, MR imaging was aborted. Of the remaining 44 patients, 21 had biopsy-proved cancer and 23 had benign disease. The sensitivity of mammography was 81%; specificity, 82%; positive predictive value (PPV), 85%; and negative predictive value (NPV), 78%. The sensitivity of scintimammography was 95%; specificity, 91%; PPV, 91%; and NPV, 95%. The sensitivity of MR imaging was 90%; specificity, 91%; PPV, 90%; and NPV, 91%. In 11 patients with previous breast cancer, scintimammographic findings were positive in all four with tumor recurrence and negative in all seven with benign disease. Masses were correctly characterized with MR imaging in eight of these 11 patients. CONCLUSION: Although both techniques accurately differentiate benign from malignant palpable breast masses, scintimammography is more accurate in the posttreatment breast. Because of lower cost, wider availability, and high patient acceptance, scintimammography may provide a valuable alternative to MR imaging for noninvasive characterization of palpable breast disease.

Adult↗
PubMed1997

Evaluating critical thinking skills of baccalaureate nursing students.

This study evaluates the critical thinking skills of students enrolled in a baccalaureate nursing program, using the WGCTA, for the classes of 1993 through 1996. Scores were obtained at entry and at end of junior and senior years. The mean entry WGCTA score was 56 for all four classes; however, the 1995 and 1996 classes had significantly higher scores than the class of 1994. Critical thinking scores were higher at entry for older students and students who had completed another education degree; however, critical thinking scores were lower for students who had previous nursing experience. After adapting for age, previous degree, and nursing experience, no significant differences in the WGCTA scores from entry to end of junior and senior years emerged for the classes of 1993, 1994, 1995. Critical thinking skills have become the hallmark of education. The National Education Goal Panel has advocated for an increase in the ability to think critically, communicate effectively and solve problems (Banta, 1993). In turn, the nursing profession has incorporated these goals of higher education into its educational programs. The National League for Nursing (NLN) includes the measurement of critical thinking as a required outcome in the evaluation and accreditation of baccalaureate and higher degree programs in nursing. This critical thinking outcome must reflect the student's skill in analysis, reasoning, research, or decision making as these skills relate to the nursing discipline (National League for Nursing, 1992). To meet the NLN's critical thinking outcome criterion, nursing programs must have a method of evaluating this skill. Many programs use the Watson-Glaser Critical Thinking Appraisal (WGCTA), which is a standardized instrument. The College of Nursing at the University of Arkansas for Medical Sciences (UAMS) adopted this instrument to evaluate the critical thinking skills of students in the baccalaureate nursing program.

Adult↗
PubMed1996

Examining the ear: clinical teaching.

Although otolaryngology represents up to 20% of the workload of general practitioners, the time allocated in the undergraduate medical curriculum to clinical teaching of ENT disorders is disproportionately small. Many GPs have indicated a desire for further training in ENT, particularly in small groups. This study was carried out on a group of 27 GPs who wished to revise their diagnostic skills in otoscopy by attending a 2-hour teaching session on basic examination of the ear and the recognition and management of common otological conditions. The GPs skill in otoscopy before and after the course was assessed subjectively by means of a self-administered questionnaire and scored objectively by ENT surgeons. Aspects of otoscopy chosen for assessment were technique of examination of the external ear, choosing correct speculum size, techniques of holding the otoscope and pinna, tympanic membrane description and diagnostic ability. An improvement between the objective pre- and post-workshop scores was found for assessment of the external ear, choice of speculum size, description of the tympanic membrane and diagnostic ability. No significant differences in the pre- and post-workshop scores was found for the techniques of holding the otoscope or holding the pinna. The majority of the GPs found the workshop beneficial. Postgraduate teaching of specialist diagnostic skills such as otoscopy to GPs is useful. An improvement in such skills should enable the GPs to manage ENT problems more confidently and refer patients appropriately to the ENT outpatients.

Clinical Competence↗
PubMed1996

Relation of denial of alcohol problems to neurocognitive impairment and depression.

Forty-six participants in an alcohol rehabilitation program were assessed to determine whether neuropsychological impairment was associated with a higher level of denial of alcohol-related problems and whether depressive symptoms were associated with a lower level of denial. Denial was measured based on the discrepancy between patients' rating of their alcohol-related problems on a visual analogue scale and a psychiatrist's rating. The neuropsychological functioning of the 15 patients in the group who denied alcohol problems was similar to that of the other patients. A modest inverse correlation was found between the level of depressive symptomatology and the level of denial.

Adult↗