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Biomedical subjects

C A Cahill

Publications and source records attributed to C A Cahill.

10 recordsLinked to original sources
PubMed1990

Psychophysiologic aspects of dyspnea in chronic obstructive pulmonary disease: a pilot study.

The level of dyspnea reported by the patient with chronic obstructive pulmonary disease is related to both the physiologic and psychologic state of the person at the time. The purpose of this pilot study was to explore, from a psychophysiologic perspective, the differences in anxiety, depression, and somatization during times of high and low levels of dyspnea. Six male subjects with chronic obstructive pulmonary disease, with a mean age of 64 years and a mean forced expiratory volume in 1 second that was 44% of predicted, completed the study. They were assessed for clinical signs and their level of dyspnea indicated on a vertical visual analogue scale, after which they completed the Spielberger State Anxiety Inventory and the Brief Symptom Inventory. Arterial blood was then drawn for blood gas analysis and determination of cortisol level. All measures were repeated twice, once when the subject reported a high level of dyspnea and once when he reported a low level. Analysis of the data by use of t tests for paired groups indicated that during times of high dyspnea levels subjects had greater anxiety, accessory muscle use, cortisol level, and PCO2 level. Subjects receiving oral prednisone had high depression levels that increased during times of severe dyspnea. Somatization, PO2, respiratory rate, depth of respiration, and other clinical signs did not change with dyspnea level. These results indicate that dyspnea is accompanied by both psychologic and physiologic changes that can be targeted to assist in alleviating this distressing symptom.

Aged↗
PubMed1989

Depression, somatization and steroid use in chronic obstructive pulmonary disease.

Steroid therapy has become part of the adjunctive treatment for COPD patients in some settings. Emotional changes have been reported in some patients while on these medications, but whether these changes are associated with the pathophysiological state or a side effect of the medication is not known. In this study self-reports of depression and somatic complaints were compared between two groups of COPD patients, 20 not receiving steroids and 20 receiving steroids. Both groups demonstrated comparable levels of disease and somatic complaints. Mean FEV1 value for those not receiving steroids was 34% of predicted while the mean for those receiving steroids was 30% of predicted. Depression was found to be significantly higher (t = 11.21, df = 38, p less than 0.01) in the group receiving steroids when compared to those not receiving steroids using a Student's t test. The higher degree of depression among steroid treated COPD patients has implications for clinical practice. The emotional status of this group of patients needs to be monitored and interventions initiated when necessary.

Aged↗
PubMed1989

Individual professionalism: part of the solution to the nursing shortage crisis.

Changes in the health care delivery system in the United States have affected the practice of nursing. Disruption in the status quo has led to confusion as to the functions and role of nurses among health professionals, the public, and the nurses themselves. As demand for nursing services has increased, more and more nurses are leaving practice and fewer individuals are choosing nursing as a career. Others have proposed causes and solutions to this most recent shortage, which are primarily directed at changing the structure of the delivery system or the reward system for practice. The authors suggest that individual nurses have a role in the solution.

Attitude of Health Personnel↗
PubMed1989

Carotid sinus baroreflex control of beta-endorphin release in anesthetized dogs.

A quantitative assessment of the carotid sinus baroreflex release of endogenous plasma beta-endorphin-like immunoreactive material has been established. The carotid sinuses of 12 pentobarbital sodium-anesthetized dogs were isolated bilaterally and perfused with a constant pressure maintained by infusion or withdrawal of normal saline. Mean arterial pressure (MAP) and heart rate (HR) were monitored. Carotid sinus pressure (CSP) was changed from 200 to 50 mmHg in 25 mmHg steps before and after vagotomy. At each interval of CSP, 10 ml mixed venous blood were collected, and beta-endorphin-like peptides were extracted from plasma and assayed. Concentrations of plasma beta-endorphin-like material were determined by radioimmunoassay. Sigmoidal responses of MAP and HR were revealed during changes in CSP. No significant differences in beta-endorphin-like immunoreactivity (beta-END-L-I) were measured at CSP of 200 and 50 in the intact condition (35.9 +/- 3.9 and 35.0 +/- 6.4 fm/ml, respectively). However, after vagotomy, beta-END-L-I measured at 50 mmHg CSP was significantly elevated to 53.3 +/- 5.2 fm/ml compared with the value of 35.5 +/- 7.2 fm/ml at CSP of 200 mmHg. The results suggest that the release of beta-endorphin is modulated by the action of the carotid baroreflex as a normal component of an integrated efferent response. However, this response is normally buffered by reflexes with vagal afferents.

Animals↗
PubMedDate not supplied

Beta-endorphin levels during pregnancy and labor: a role in pain modulation?

Discovery of the endogenous opiate system of the brain has revolutionized the study of pain and pain management. In this study a convenience sample of 10 pregnant women, 16 nonpregnant women, and 18 men were studied to determine if changes in plasma beta-endorphin-like immunoreactivity affected pain perception during labor. Pregnant women had plasma levels of beta-endorphin significantly higher than nonpregnant women at the midpoint of their menstrual cycle, t = 3.74, df = 31, p = .007. Self-reported pain perception scores were not correlated with plasma beta-endorphin levels. However, as labor progressed, the women reported increased discomfort between contractions and during contractions while beta-endorphin levels increased only slightly. Close examination of the pain pattern indicates that pain perceived by the women between contractions increased at a greater rate than during contractions. This pattern suggests that opiate-active beta-endorphin may increase the ability of women to tolerate acute pain.

Female↗
PubMedDate not supplied

Food intake of women with breast cancer during their first six month of chemotherapy.

Significant alterations in the nutritional patterns of the patient with cancer can inhibit the patient's ability to combat the disease and withstand the impact of cancer treatments. This study compared the food intake patterns of women with breast cancer receiving adjuvant chemotherapy with those of healthy women to determine if significant alterations in food intake occurred during the first six months of treatment. Results indicated that, although alterations in taste did occur, food aversions did not develop. Throughout the study, women with breast cancer were eating a significantly greater number of calories and food servings than women who did not have breast cancer. The women with breast cancer were likely to report taste changes for foods such as beef, pork, chicken, coffee, and cakes. However, these taste changes could not account for alterations in dietary intake.

Adult↗