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Biomedical subjects

R O'Laoide

Publications and source records attributed to R O'Laoide.

12 recordsLinked to original sources

Drainage catheters: in vitro comparison of internal retention mechanisms.

In five drainage catheters, internal retention mechanisms (locking pigtail [14 and 8 F], inflatable balloon [14 F], or wings [14 and 24 F]) were evaluated for resistance to and distortion from dislodgment. Catheters were inserted into simulated tissue, and weight was added until dislodgment occurred. Resistance to dislodgment increased when the mechanisms were locked; the locking pigtail supported the most weight. Distortion caused by dislodgment was minimal.

Catheters, Indwelling↗

Reasons underlying negative mammography in patients with palpable breast cancer.

It is well recognized that a negative mammogram report does not exclude the presence of breast carcinoma. This study examines the accuracy of mammography in patients with palpable breast cancer. In particular, the study evaluates the reasons underlying negative mammography in breast cancer. All patients with Paget's disease, carcinoma in situ lesions or lesions infiltrating skin were excluded. A total of 291 patients presenting with palpable breast carcinoma underwent mammography prior to biopsy. False negative reports occurred in 16.5% (48). The sensitivity of mammography increased with age, from 70% (14/20) in 31-40-year-olds to 91% (113/124) in women over 60 years. Retrospective review of false negative mammograms showed that 30% of these were deemed normal while 20% were obvious oversights. The remaining 50% showed subtle radiographic abnormalities, consistent with but not diagnostic of malignancy.

Adult↗

Symptomatic hepatic cysts: percutaneous drainage and sclerosis.

PURPOSE: To evaluate the authors' experience with treatment of symptomatic hepatic cysts by means of percutaneous catheterization and sclerosis. MATERIALS AND METHODS: Twenty patients with 24 symptomatic hepatic cysts underwent percutaneous drainage and sclerosis. Ten patients had polycystic disease, and 10 had solitary cysts. Sclerosants used were alcohol, tetracycline, doxycycline, or a combination. RESULTS: Twenty-one of 24 cysts in 17 of 20 patients were treated successfully. Treatment was unsuccessful in three patients: one patient with innumerable medium-size and small cysts, one patient in whom only a needle was inserted (no catheter), and one patient with a cystic metastasis (rather than a simple cyst) that recurred. Complications included pleural effusion in two patients and secondary infection in one patient. The range of blood alcohol levels was 0-0.8 mg%. CONCLUSION: Percutaneous catheter drainage with sclerosis is an effective method of therapy for symptomatic hepatic cysts; careful patient selection is essential for proper therapy.

Adult↗

Malignant ureteral obstruction: treatment with metal stents--technique, results, and observations with percutaneous intraluminal US.

PURPOSE: To test the technical feasibility and results of placement of metal stents into ureters obstructed by extensive tumor. MATERIALS AND METHODS: Six consecutive patients (two men and four women, aged 35-66 years and with incurable malignancies) underwent insertion of metallic endoprostheses in nine obstructed ureters through percutaneous tracts. RESULTS: Metal stents were inserted without technical difficulty in all obstructed ureters. The stents functioned well in four patients. In two patients, the metal were not tolerated and plastic double-J stents were placed through the metal stents; this permitted effective functioning and withdrawal of the protective external catheter. Intraluminal ultrasonography depicted stent clogging and debris, dimensions of stent opening, and tumor level. CONCLUSION: Insertion of metal stents in the ureter is technically straightforward and was well tolerated by patients. However, the efficacy is variable, and a greater beneficial effect than is achieved with plastic stents is not established.

Adult↗

Ultrasound guided biopsy of nonpalpable and difficult to palpate thyroid masses.

We reviewed our experience with ultrasound-guided biopsies of masses of the thyroid gland that were either nonpalpable or difficult to localize by palpation to evaluate the technique and correlate the results. Thirty-two biopsies were performed upon 25 patients whose clinical presentations were palpable nodule (six patients), throat discomfort (two patients), postpartial thyroidectomy follow-up evaluation (two patients), incidental discovery of a mass--by ultrasound of the neck (two patients), roentgenogram of the chest (two patients), computed tomography of the chest (one patient) and during tracheostomy placement (one patient). Other presentations were eliminate infection (one patient), odynophagia (one patient), hoarseness (one patient), cold nodule on a nuclear medicine study (one patient), hyperparathyroidism (one patient), rule out metastasis from carcinoma of the colon (one patient), persistent cough (one patient), enlarged thyroid gland (one patient) or family history of carcinoma of the thyroid gland (one patient). Fifteen patients had nuclear medicine studies showing either a cold nodule (ten patients), multinodular goiter (one patient), normal examination (two patients), hot nodule (one patient) or no thyroid gland activity (one patient). The ultrasound examinations showed either a hypoechoic nodule (25 patients), inhomogeneous or mixed echogenic nodule (six patients) or a hyperechoic nodule with hypoechoic rim (one patient). The nodules ranged in size from 3 milliliters to 7 centimeters. Twenty-six lesions were less than 3 centimeters in diameter; of the other six, four were substernal goiters. Six patients had a previous nondiagnostic biopsy directed by palpation only. Biopsy was performed using real-time ultrasound guidance with various needles. One patient had a small hematoma, which was the only complication in the study. The results of the biopsies were diagnostic in 26 of 32 patients. The final diagnosis was benign follicular cells (ten patients), adenomatous nodule (seven patients), follicular neoplasm (three patients), colloid cyst (two patients), aspergillus (two patients), fibrosis (one patient) and papillary carcinoma (one patient). Six of the biopsies yielded unsatisfactory specimens. One of the patients with a diagnosis of benign follicular cells on biopsy had a follicular carcinoma after surgical pathologic factors were obtained; that was the only false-negative result. We conclude that ultrasound-guided biopsy of the thyroid is a safe and useful method of evaluating nonpalpable and difficult to palpate thyroid masses.

Adolescent↗

Short course chemotherapy for pulmonary tuberculosis. A randomised controlled trial of a six month versus a nine month oral regimen.

We report on the first trial in the Republic of Ireland to look at chemotherapy for TB. This management trial, carried out in single unit, which treats a third of all TB cases in the Republic of Ireland compared to effectiveness of a three drug/nine month regimen (Rifampicin (R), Isoniazed (R), supplemented with Ethambutol (E) for the first two months = RHE9) with a four drug six months regimen (R, H supplemented with E and Pyrazinamide (Z) for the first two months = RHEZ6). Two hundred and eighty eight patients (288) were entered into the study. A total of 143, (76 were in the RHE9 group and 67 in the RHEZ6 group) completed the trial as planned. At the end of the third month, significantly more patients in the RHEZ6 regimen (98%) were culture negative compared to the RHE9 regimen (88%). All were culture negative at the end of chemotherapy. Drug intolerance was seen in 35 (12%) patients with no significant difference in hepatitis between the two regimens. Toxicity from Pyrazinamide was minimal. One hundred and forty five (145) patients were invalid for analysis for the following reason:- bacteriologically negative TB (41), drug intolerance (35), death (23), non-compliance (19), diagnosis not TB (10), drug resistance (7), extrapulmonary disease (4), consent withdrawn (3), Mycobacteria other than tuberculosis (3). All patients are being followed to monitor relapse rates.

Administration, Oral↗

Arachidonic acid metabolites and small airways disease in non-smoking sarcoidosis patients.

The present study was designed to assess the occurrence of small airways disease (SAD) in non-smoking sarcoidosis patients by pulmonary function measurement; and to investigate the possible mechanisms of SAD by measuring the in vitro production of arachidonic acid metabolites (PGE2 and LTB4) by peripheral blood mononucleocytes from sarcoidosis patients. SAD did in fact occur in 15 of the 32 sarcoid patients studied. The increase in LTB4 and decrease in PGE2 observed in SAD patients could imply a causative role for these arachidonic acid metabolites in SAD.

Arachidonic Acids↗

Assessment and management of transient ischaemic attack--the role of the TIA clinic.

BACKGROUND: As the risk of early stroke following transient ischaemic attack (TIA) is increasingly recognised, the management of patients presenting with symptoms suggestive of TIA presents a clinical challenge. METHODS: Analysis of prospectively collected data on patients referred to a TIA clinic in St. Vincent's University Hospital, between January 2003 and July 2004. RESULTS: One-hundred-and-seventeen (117) patients (mean age 75.5 years) were assessed. The majority (79%) were referred from Accident and Emergency and 61% were seen within one week of referral. Seventy-two patients (62%) had a final diagnosis of cerebrovascular disease (56 TIA, 16 completed strokes), of whom five (7%) and four (5.5%) had severe (> 70%) and moderate (> 50%) symptomatic carotid artery stenosis, respectively, whilst seven patients (10%) had newly diagnosed atrial fibrillation, five of whom were anticoagulated. Non-cerebrovascular diagnoses were made in twenty-seven patients (24%). CONCLUSION: A TIA clinic, in co-ordination with Accident and Emergency Services, provides a safe and efficient alternative to hospital admission for patients with TIA symptoms and a low early stroke risk.

Aged↗

Drainage efficiency of double-lumen sump catheters and single-lumen catheters: an in vitro comparison.

PURPOSE: To compare the drainage efficiency of double-lumen sump catheters and single-lumen catheters in an in vitro model. MATERIALS AND METHODS: Four 12-F, 27.5-cm catheters were used in the study. Three of these had a double lumen with a 7-F internal diameter drainage lumen and one had a single lumen with an 8-F internal diameter drainage lumen. The sump hole opened internally to the drainage lumen in one catheter, opened externally in one catheter, and was occluded in one catheter. Catheters were connected to continuous low-wall suction and were immersed in water, viscous fluid, and viscous fluid with particles. The volume of fluid drained by each catheter was measured and compared. RESULTS: The single-lumen catheter with an 8-F internal diameter drainage lumen drained a volume equal to or larger than that for double-lumen catheters with a 7-F internal diameter drainage lumen for each type of fluid. The open sump of the double-lumen catheters may have decreased the catheter's drainage efficiency by allowing air to be suctioned into the catheter. CONCLUSION: Single-lumen catheters performed as well as or more efficiently than double-lumen catheters of the same outer diameter in this in vitro model.

Catheterization↗