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Biomedical subjects

A Keogh

Publications and source records attributed to A Keogh.

At least 55 records · Page 3Linked to original sources
PubMed1988

Psychological adjustment after cardiac transplantation.

Cardiac transplantation is viable therapeutic alternative for patients with end-stage heart disease, which offers a favourable short- and medium-term prognosis. The survival has improved from 20% of patients who survived at one year after transplantation in the 1960s to the present figures of 80%-85% of patients who are alive at one year, and 50%-70% of patients who are alive at five years, after transplantation. Therefore, it seems timely to focus attention on the psychological well-being of cardiac-transplant recipients. The medical literature is scant in regard to the psychiatric and the psychosocial impact of cardiac transplantation on recipients, and a systematic and prospective study of the psychosocial adaptation of recipients is lacking. Since 1984, we have been studying the emotional impact of cardiac transplantation on recipients and their families. This article presents the results for a group of recipients who have been assessed before transplantation, then followed-up at discharge from hospital and at four, eight and 12 months after transplantation. The study attempted to quantitate the recipients' anxiety, depression, body image and subjective quality of life by way of standardized self-assessment questionnaires. The recipients' satisfaction with relationships or their marital situation also was reported, as were their degree of rehabilitation at 12 months and their attitudes to various aspects of treatment after the transplantation. Before the transplantation, 53% of patients reported an increase in anxiety and 34% of patients recorded scores that indicated mild-to-moderate levels of depression. Thirty-seven per cent of patients showed a deterioration in the quality of their lives and 34% of patients had a negative body image. After the transplantation, significant improvements occurred in all parameters, which were maintained at follow-up.

Adaptation, Psychological↗
PubMed1988

Limitation of myocardial infarction by early infusion of recombinant tissue-type plasminogen activator.

In a double-blind randomized trial involving five Sydney hospitals and the city ambulance paramedical service, 145 patients with a first evolving myocardial infarction and with onset of pain less than 2.5 (mean 1.9 +/- 0.5 [SD]) hr previously were allocated to intravenous infusion of 100 mg recombinant tissue-type plasminogen activator (rt-PA) or placebo over 3 hr. The groups at entry were similar. At assessment 21 days later, left ventricular ejection fraction measured both by contrast and radionuclide ventriculography was higher in the rt-PA compared with the placebo group (61 +/- 13%, n = 64, vs 54 +/- 14%, n = 62, contrast, 2p = .006; 52 +/- 13%, n = 66, vs 48 +/- 13%, n = 62 isotope, 2p = .08). This indicates limitation of myocardial infarction by rt-PA.

Adult↗
PubMed1987

Survival of the weakest. Improving prospects for surgery in infants of birthweight less than 1,200 grams.

Over a six-year period seventeen infants of birthweight less than 1,200 grams (including nine of birthweight less than 1,000 grams) underwent major gastrointestinal surgery. Fourteen of the seventeen (82%) survived, a higher rate than previously reported. Nine infants had necrotising enterocolitis, three had oesophageal atresia and five had other types of intestinal obstruction. Six infants who were unfit to be transferred to the operating theatre underwent surgery on the neonatal unit: of these, four survived. We feel the outlook is optimised by conservative surgical intervention and by maximal medical support with intensive care monitoring, post-operative mechanical ventilation and intravenous alimentation. Survival after surgery is now very much the rule in the extremely low birthweight infant, even in those who are too sick to be transferred to the operating theatre.

Gastrointestinal Diseases↗
PubMed1985

Sheath impaction as a cause of defective intra-aortic balloon pump action in man.

Intra-aortic balloon counterpulsation became ineffective in a 63 inch (160 cm) 14 year old girl while console operation proceeded almost normally. The problem was simulated in a hydraulic model of the aorta and could be reproduced when the proximal end of the balloon engaged in the introducing sheath. Measurements of the balloon catheter and sheath against the patient indicated that such engagement had occurred during counterpulsation. The findings provide an explanation for apparent catheter 'kinkage' in other patients where there was difficulty running the Kontron console in automatic mode. Problems are preventable by total or partial withdrawal of the inserting sheath.

Adolescent↗