PubMed Health⌕ Search

Biomedical subjects

S O'Hickey

Publications and source records attributed to S O'Hickey.

16 recordsLinked to original sources
PubMed1996

Outcome for patients colonised with Burkholderia cepacia in a Birmingham adult cystic fibrosis clinic and the end of an epidemic.

BACKGROUND: There has been increasing concern since 1979 about the emergence of Pseudomonas cepacia (Burkholderia cepacia) in patients with cystic fibrosis in the UK and elsewhere. Colonisation of the sputum has been shown to be associated with increased morbidity and mortality. Evidence suggests person to person transmission and some centres have segregated those colonised with B cepacia from other patients with cystic fibrosis. The outcome of patients colonised by B cepacia has been studied, together with the effects of strict segregation. METHODS: The outcome in 18 patients with sputum colonised by B cepacia was compared with that in age, sex, and severity matched controls with no evidence of B cepacia colonisation by a retrospective case note study. RESULTS: No difference between cases or controls were found in the 24 month period prior to colonisation by B cepacia in lung function, number of days in hospital, or outpatient visits. Colonisation led to an increased rate of loss of lung function and utilisation of hospital services. There was an increase in the numbers of transplants and deaths amongst the cases. Since 1992 there have been only three new cases of B cepacia colonisation and the incidence and prevalence of the organism has fallen dramatically since segregation commenced. CONCLUSIONS: B cepacia appears to be linked to the decline in colonised individuals. There was no evidence that colonisation occurred in patients declining for other reasons. B cepacia colonisation confers a worse prognosis than Pseudomonas aeruginosa alone. Segregation appears to limit the spread of the organism from infected individuals to other patients with cystic fibrosis.

Adult↗
PubMed1994

Planning oral health care for the elderly in Israel for the years 2000 and 2025.

The methodology and conclusions of this workshop are reported here because the problems requiring solution are not unique to Israel. They will increasingly have wide geographical and political application. The population of Israel since its establishment in 1948 has increased about sixfold. The numbers of the elderly (65+) have increased about tenfold. The current situation must be examined and estimates obtained for the next ten years. Only thus can the system be enabled to cope with the problem as it develops. The chosen method was a carefully preplanned, multisectorial workshop. Recommendations were discussed, amended and finalised. The recommendations of the workshop included: Baseline national data is urgently required. Guidelines are required for selecting specific target populations to which priority should be given. The current favourable situation of adequate oral health manpower in Israel makes it possible to encourage providers of oral health care towards treatment for the elderly. It is essential that the appropriate health authorities allocate sufficient funds for the following urgent purposes: the conduct of a national survey of the elderly population; the establishment of oral health units on a trial basis in some selected hospitals; support institutions of higher education to facilitate training in geriatric dentistry. CONCLUSIONS. The workshop was multidisciplinary because it was necessary to include all the expertise and experience available as vital elements of the policy making process. This type of workshop was found to be an effective tool for planning oral health services.

Aged↗
PubMed1993

Life-threatening right ventricular thrombosis in association with phospholipid antibodies.

An 18 year old man presented with cough and dyspnoea caused by pulmonary infarction. A large friable mass of organising thrombus in an anatomically normal right ventricle was identified as an embolic source. The acute illness was associated with raised titres of anticardiolipin antibodies, one of the antiphospholipid group. This thrombus recurred after surgical removal but subsequently was dissipated after treatment with oral corticosteroids and long-term oral anticoagulation.

Adolescent↗
PubMed1989

Public water fluoridation in Ireland: twenty-five years on.

In July of this year, 1989, Ireland celebrates 25 years of fluoridation of the public water supplies. No other country has had such a long experience of a national mandatory public water supply fluoridation programme. There is good reason therefore to review experiences and attempt to draw some conclusions.

Child↗
PubMed1987

Fibreoptic bronchoscopy in the elderly.

To evaluate the efficacy and safety of fibreoptic bronchoscopy in the elderly, the bronchoscopy records of 1000 patients were retrospectively reviewed. Of these, 423 were in-patients aged 65 years or over. This population was further subdivided into 'young' elderly (65-74 years old) and 'old' elderly (75+ years old). The indications for bronchoscopy in each group were similar and included haemoptysis, chest radiographic changes suggestive of collapse or consolidation, and hilar or paratracheal shadowing. The results in each group were also comparable and bronchoscopy was not tolerated in only five. A visible tumour was present in 165 patients. We conclude that, like upper gastrointestinal endoscopy, fibreoptic bronchoscopy in the elderly is safe, well tolerated and has a significant diagnostic yield.

Aged↗
PubMedDate not supplied

Pathogenetic mechanisms of exercise-induced asthma and the refractory period.

Exercise is a powerful stimulus to the development of asthma. In most asthmatic subjects the airways obstruction recovers spontaneously within 60 minutes, but in some subjects there is more prolonged airflow obstruction which requires bronchodilator treatment. Approximately 40-50% of subjects with EIA will show a refractory period of two to four hours after an initial exercise task, during which time an identical exercise task will evoke significantly less (less than 50%) bronchoconstriction. In some patients, particularly children, EIA will be followed three to nine hours later by a further episode of bronchospasm, termed the late asthmatic response. There remains considerable debate about the pathogenesis of EIA the refractory period and the late asthmatic response.

Asthma↗