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Biomedical subjects

P Ryan

Publications and source records attributed to P Ryan.

At least 19 recordsLinked to original sources
PubMed1992

Distribution of heavy metals in Elcho Island, Northern Territory, Australia.

The concentration of four metals in waters and seven metals in oysters, clams and sediments from Elcho Island, Northern Territory, were determined during the dry season of 1987. The measured concentration of cadmium, zinc, copper and lead in unfiltered water were: cadmium, 0.02-0.27; zinc, 0.09-3.70; copper, 0.60-4.78; lead, 0.12-2.39 micrograms l-1, and iron, cadmium, zinc, manganese, copper, nickel and lead in oysters, 13.07-273.55, 0.29-10.63, 2.39-8.51, 0.25-4.84, 0.45-8.76, 0.16-0.59, 2.59-9.38 micrograms g-1 wet weight, and in clam, 94.84-419, 6.0-20.3, 1.09-6.28, 2515-6256, 0.47-3.18, 1.71-5.64, 0.45-2.17 micrograms g-1 wet weight, and in sediments, 3219.1-10871.1, 1.36-2.68, 2.7-6.55, 19.4-105.7, 0.65-1.91, 4.16-21.8 and 5.66-23.9 micrograms g-1 dry weight. Accumulation of manganese in razor clam was highest in spite of low concentration in the surrounding sediment, therefore it could be used as a bioindicator of manganese in a tropical environment. The level of cadmium and lead exceeded the National Health and Medical Research Council (NHMRC) recommended limit. In general, level of other metals were lower as compared to the concentration of these metals in Darwin Harbour.

Animals↗
PubMed1992

Risk factors for tumors of the brain and meninges: results from the Adelaide Adult Brain Tumor Study.

A population-based case-control study of incident primary brain tumors in adults was carried out in Adelaide, Australia in the period 1987 through 1990. It included 110 subjects with newly diagnosed primary glioma, 60 subjects with meningioma and 417 controls selected from the Australian Electoral Roll and frequency-matched to cases for age (within 2 years), sex and postal code. Some interesting new associations were found: (1) an increased risk of glioma in women who reported working with cathode-ray tubes (relative risk = 4.1, 95% confidence interval: 1.3-13.2); (2) a decreased risk of glioma in those with a history of allergic diseases (relative risk = 0.5, 95% confidence interval: 0.3-0.9); and (3) an increased risk of meningioma in those exposed to passive smoking from a spouse, especially amongst females (relative risk = 2.7, 95% confidence interval: 1.2-6.1). A pooled analysis of the multi-center group of studies to which the present study belongs should allow more confident claims concerning risk factors for brain tumors.

Adult↗
PubMed1992

Knowledge of, attitudes toward, and barriers to pharmacologic management of cancer pain in a statewide random sample of nurses.

The knowledge of, attitudes toward, and perceived barriers to pharmacologic management of cancer pain were examined in a random statewide sample of nurses (N = 790), using an 82-item questionnaire. Although only 7% of the nurses reported working in oncology settings, 59% of the nurses reported having worked with patients with cancer in the last 6 months. The scores on the knowledge test ranged from 11% to 93% correct, with a mean percent correct of 56.4% (+/- .92). Nurses reported relatively liberal attitudes toward pain management, yet also reported believing that 22% of patients over report pain. Results are discussed with respect to implications for practice and education.

Adult↗
PubMed1992

First experimental sutureless end-to-end laser anastomosis of the large bowel. Short-term results.

Completely sutureless end-to-end large bowel anastomoses were successfully created in New Zealand white rabbits (n = 26) by using a low-energy (0.4-W wave of power) Nd:YAG laser to produce welded anastomoses. In this study, the short-term integrity, degree of narrowing, macroscopic appearance, and microscopic findings were compared with those of the conventional interrupted one-layer anastomosis (n = 24) at zero, one, four, and seven days after surgery. Two rabbits in the laser group died from leakage. All remaining animals had an uneventful postoperative course. The bursting pressures in the laser group at zero, one, and four days were lower than those in the control group. The narrowing index of the laser anastomosis was higher than that of the suture anastomosis at four and seven days. However, the laser anastomoses showed fewer adhesions, no instances of bowel obstruction, and histologic healing with less fibrosis. The technique of laser anastomosis presents a promising alternative to suturing in reconstitution of the large bowel.

Anastomosis, Surgical↗
PubMed1992

Identification of the site of severe colon bleeding by technetium-labeled red-cell scan.

In cases of severe colon bleeding, it is more important to know the site than the cause, in case surgery is required. Technetium-labeled red-cell scan (TLRCS) is known to identify the site of bleeding at the rate of 0.1 ml per minute or more. The aim of this retrospective study was to see whether TLRCS was a reliable indicator of the site of severe colon bleeding. A retrospective study was made of patients investigated in this way for acute, severe colon bleeding at St. Vincent's Hospital, Melbourne, from 1984 to 1988 (five years). TLRCS identified the site of bleeding in less than half of the cases but correctly identified the site in all nine patients in whom bleeding was so severe as to require emergency surgery, avoiding total colectomy in eight cases.

Aged↗
PubMed1992

Identification of immunodominant Trypanosoma musculi antigens recognized by monoclonal antibody and curative immunoglobulin G2a antibody.

Trypanosoma musculi obtained from normal or irradiated (900 rad) hosts or from in vitro cultures were lysed and analysed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). Similar protein banding patterns with a molecular weight (mol. wt) range from 34 to 68 kDa were observed between the two bloodstream forms. In comparison, lysates of cultured parasites showed a unique banding pattern of antigens within the same mol. wt range. Western blot of bloodstream form lysates, probed with immune plasma (IP), revealed a wide range of parasite proteins. However, when probed with the IgG2a-enriched fraction of IP, a major band of approximately 66 kDa was detected on the blot. Several bands of higher mol. wt were also observed. When anti-T. musculi monoclonal antibodies were used to probe the blot, the 66 kDa protein was again recognized. Using indirect fluorescence, live bloodstream form parasites were analysed by flow cytometry and the p66 protein was determined to be a surface molecule. Finally, lysates of 35S-methionine-labelled trypanosomes were immunoprecipitated with Sepharose linked anti-T. musculi monoclonal antibodies and the eluted ligand analysed by SDS-PAGE and autoradiographed. The 66 kDa band was identified, therefore confirming that this protein was of parasite origin.

Animals↗
PubMed1992

Amalgam fillings, diagnostic dental x-rays and tumours of the brain and meninges.

A population-based case-control study of incident brain tumours in adults in Adelaide, South Australia considered possible associations of exposures to amalgam fillings and diagnostic dental X-rays with subsequent development of glioma and meningioma. The study, conducted in 1987-1990, recorded data from 110 subjects with glioma, 60 with meningioma and 417 controls. Principal findings were unexplained decreased risks for glioma associated with both exposure to amalgam fillings (age- and sex adjusted relative risk = 0.47, 95% confidence interval: 0.25-0.91; P = 0.02) and to diagnostic dental X-rays (adjusted relative risk = 0.42; 95% confidence interval: 0.24-0.76; P = 0.004), and a possible increased risk for meningioma in males exposed to dental X-rays. The choice of the unexposed comparison group is important in determining if an increased risk is associated with panoramic or full-mouth X-rays in glioma.

Adult↗
PubMed1992

Measurement of bone mass.

The clinical attraction of being able to measure bone density in a precise and accurate manner is clear. With this information, clinicians can identify osteopenic postmenopausal women, assess the effects of disease on the skeleton, and examine the effect of therapy. Significant advances have been made in the last decade in methodology of bone-mass measurements, leading to a number of safe, precise, and accurate techniques. The field continues to change and, for example, dual photon absorptiometry, which itself was a major advance, has now effectively been superceded by dual energy X-ray absorptiometry. It is predicted that such methodology will continue to find an expanding role and will soon be considered part of routine clinical practice. A brief review of the various methodologies that have commonly been used for bone-mass measurements is presented.

Absorptiometry, Photon↗
PubMed1992

Effect of epidural and general anaesthesia compared with general anaesthesia alone in large bowel anastomoses. A prospective study.

OBJECTIVE: To find out whether patients did better after operations that entailed a large bowel anastomosis if they were given combined epidural and general anaesthesia with spontaneous ventilation rather than standard general anaesthesia with muscle relaxation and ventilation. DESIGN: Prospective randomised trial. SETTING: Specialist unit, teaching hospital. SUBJECTS: 80 patients undergoing large bowel anastomoses. MAIN OUTCOME MEASURES: Incidence of chest infection, wound infection, anastomotic breakdown, urinary tract infection, deep vein thrombosis, pulmonary embolism, median hospital stay and death. RESULTS: There were no differences between the groups, but the results were better during the trial period (1985-89) than during the period 1978-83. CONCLUSION: Factors that influence anastomotic healing are complex and improved surgical techniques, postoperative monitoring and patient care may account for the improvement in results compared with the earlier period.

Aged↗
PubMed1991

Adenoma-carcinoma sequence of the large bowel.

Fifty-two surgically removed large bowel specimens and 3 colonoscopically removed polyps with mucosal carcinomas were studied. Among 36 frank colorectal carcinomas, six (17%) had a focus of adenomatous remnant. The average size of carcinomas without adenomatous remnant was 56.0 mm and of those with adenomatous remnant was 44.3 mm. Four (67%) of 6 submucosal carcinomas and all of 4 mucosal carcinomas showed an adenomatous remnant. The average size of submucosal carcinomas was 17.7 mm and that of mucosal carcinomas was 16.3 mm. The smaller and less advanced the carcinoma, the more likely it was to show an adenomatous remnant, suggesting that carcinomas arise in adenomas and destroy surviving benign tumour as they grow. Coexisting adenomas were seen in 19 of 46 neoplasm-bearing patients (41%) and 1 of 9 patients (11%) without neoplasms. Average sizes of adenomas with moderate and mild atypia were 13.0 mm and 8.2 mm respectively, which were smaller than the sizes of submucosal and mucosal carcinomas. Although the numbers were small, these findings support the concept of adenoma-carcinoma sequence. Twenty-one flat elevations were collected during the study. Ten were neoplasm (9 adenomas and an early carcinoma), ten were metaplastic polyps and one was a histologically normal mucosal protrusion. The atypism of 10 flat adenomas increased with increasing size, as with ordinary adenomas. As 10 of 55 adenomas (18.2%) were flat adenomas, which are difficult to detect during routine colonoscopic examination, colonoscopists should make every effort to discover flat adenomas, which seem to play an important role in the adenoma-carcinoma sequence.

Adenoma↗
PubMed1991

The Nursing Minimum Data Set: abstraction tool for standardized, comparable, essential data.

The Nursing Minimum Data Set (NMDS) represents the first attempt to standardize the collection of essential nursing data. These minimum core data, used on a regular basis by the majority of nurses in the delivery of care across settings, can provide an accurate description of nursing diagnoses, nursing care, and nursing resources used. Collected on an ongoing basis, a standardized nursing data base will enable nurses to compare data across populations, settings, geographic areas, and time. Public health nurses will be able to evaluate and compare services. The purpose of this article is to discuss briefly the following aspects of the NMDS: background including definition, purposes, and elements; availability and reliability of the data; benefits; implications of the NMDS with emphasis on nursing research; and health policy decision making.

Education, Nursing↗
PubMed1991

Two kinds of diverticular disease.

Two kinds of acquired diverticular disease were identified. The more common variety presented with pain, bowel symptoms or fistulae, and the less common with bleeding. The former patients rarely had a history of bleeding and among the latter pain and bowel symptoms were uncommon. In contrast to the few, chiefly sigmoid, diverticular often found in the former group, barium enemas of those presenting with bleeding usually showed densely packed and extensive diverticula. Even where there was no history suggesting perforation or evidence of it at operation, specimens resected for the more common form of diverticular disease invariably showed histological evidence of previous perforation. There was no histological evidence of previous perforation in those specimens resected for bleeding. This retrospective clinical, radiological and histological study supported the idea that there are two kinds of diverticular disease, one associated with perforation and its sequelae, the other associated with bleeding.

Acute Disease↗
PubMed1991

Osteoporosis: a growing epidemic.

The osteoporosis epidemic will continue unabated unless the issue of prevention of bone loss is seriously addressed. While a continuing programme of education for both the medical profession and the general public is necessary, positive action is required. Women lose bone at an accelerated rate following the menopause and this seems to be the optimal time for intervention. Those women who enter the menopause with the lowest bone density are at greatest risk of subsequent fracture. An individual's bone density can be accurately measured and those women who have the lowest bone density should have hormone replacement therapy (HRT) recommended, but it is important to discuss fully the possible benefits and risks. It is probable that non-hormonal agents for prevention of bone loss will be available in the near future, and cyclical diphosphonate therapy appears particularly promising. However, at the present time, long-term HRT is the mainstay for the prevention of bone loss.

Aged↗
PubMed1990

Nature, nurture, nutrition: interdisciplinary programs to address the prevention of malnutrition and dehydration.

Malnutrition and dehydration are common problems in nursing home patients. One explanation for this may be the large number of patients requiring feeding assistance. The Dysphagia Team at the Department of Veterans Affairs Medical Center in Miami, Florida served as the primary source in the expansion of a nutritionally supportive environment to assist in the prevention of malnutrition and dehydration in patients with feeding/swallowing disorders. "Silver Spoons," a program in which volunteers provide supervised feeding, "Happy Hour," a time each day during which an atmosphere is provided that encourages socialization and hydration, and "Second Seating," during which lunch is provided for patients who require modification of eating style, food texture, or timing are described. Analysis of the program's outcomes show it to be timely, pleasing to patients, and cost-effective.

Aged↗