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C Blake

Publications and source records attributed to C Blake.

41 records · Page 3Linked to original sources
PubMedDate not supplied

The Short Form 36 (SF-36) Health Survey: normative data for the Irish population.

BACKGROUND: Generic measures of quality of life have a wide application in health research. They measure disease impact by comparing scores in patient groups with a healthy population. They also facilitate comparative studies between different patient groups. The SF-36 Health Survey quantifies respondents' perceptions of their functioning in eight dimensions of daily life. AIM: The aim of this study was to set normative values for the SF-36 in the Irish population aged 18 years and over. METHOD: A random sample of 800 subjects was drawn from the electoral register using the RANSAM method of sampling. RESULTS: Two hundred and ninety five (37%) valid questionnaires were returned for analysis. The SF-36 was found to have acceptable internal consistency and validity. Normative values for the total population are presented, in addition to results for males and females across seven age groups. Ageing was associated with a decline in the physical dimensions of health. CONCLUSIONS: There was no evidence to suggest that there were significant differences in health status between males and females, or between this Irish sample and the published norms for the US population.

Adolescent↗
PubMedDate not supplied

Management of variceal bleeding in the 1990s.

BACKGROUND: Variceal bleeding is a common and serious problem. OBJECTIVE: To review the current management of patients with variceal bleeding. SUMMARY: Therapeutic options now include pharmacologic reduction of portal hypertension, endoscopic obliteration of varices, placement of decompressive shunts (both surgical and percutaneous), and liver transplantation. Each of these options may be required in different settings. A nonselective beta blocker can prophylactically reduce the risk of an initial bleed. Acute variceal bleeding is best managed by endoscopic sclerosis. Selection of therapy to prevent recurrent bleeding should be based on a full evaluation of the risk of bleeding and of liver failure. CONCLUSIONS: Successful management requires a multidisciplinary team, full patient evaluation, and selection of appropriate therapy.

Acute Disease↗
PubMedDate not supplied

Physical function, employment and quality of life in end-stage renal disease.

INTRODUCTION: The impact of end-stage renal disease (ESRD) on quality of life (QoL) can be measured in terms of physical, psychological and social consequences, including the ability to work. SUBJECTS AND METHODS: This multi-center, cross-sectional study explored relationships between QoL, employment status and physical function in ESRD patients aged 18-65 years, via a customised interviewer-administered questionnaire, which included the SF-36 health survey. The International Labour Office method was applied to describe employment rate. RESULTS: 144 patients (85 male, 49 female), comprising 49 haemodialysis (HD), 35 peritoneal dialysis (PD) and 60 renal transplant (TX) patients were studied. Mean age was 44 +/- 12 years. 32 were voluntarily not working, leaving 112 in the labour force. Of the latter, 49% were unemployed, in contrast with the concurrent national rate of 10%. QoL in the ESRD group was reduced in the SF-36 physical and social dimensions compared to population norms. Unemployed ESRD patients scored significantly lower than those employed in physical function, role physical, bodily pain, general health, vitality and role emotional scales. Logistic regression demonstrated that multiple comorbidities (p<0.005), a premorbid physical occupation (p<0.05) and poor physical function (p<0.05) predicted unemployment in ESRD independent of all other variables. Multiple regression showed that age (p<0.05), female sex (p<0.05) and a diagnosis of musculoskeletal disease (p<0.005) were independent predictors of poor physical function. CONCLUSIONS: These findings suggest that vocational rehabilitation of ESRD patients must consider physical function and occupational demands as well as co-morbidity and that musculoskeletal disease is key factor in impaired physical function.

Adolescent↗
PubMedDate not supplied

Granulocyte-macrophage colony-stimulating factor and interferon-gamma prevent dexamethasone-induced immunosuppression of antifungal monocyte activity against Aspergillus fumigatus hyphae.

Treatment with corticosteroids is an important risk factor for development of invasive aspergillosis. We evaluated the effect of dexamethasone (DEX) on superoxide anion (O2-) release and damage caused by elutriated human monocytes (EHM) on unopsonized hyphae of Aspergillus fumigatus. In addition, we studied the effects of granulocyte-macrophage colony-stimulating factor (GM-CSF) and interferon-gamma (IFN-gamma) on these functions of DEX-treated EHM. Treatment of EHM with concentrations of DEX ranging from 5 to 500 nM (1.4-140 ng ml-1) for 48 h suppressed O2- release in response to phorbol myristate acetate in a dose-dependent fashion. Similarly, DEX significantly suppressed hyphal damage caused by EHM as measured by colorimetric MTT assay. Both GM-CSF (5 ng ml-1) and IFN-gamma (1.2 ng ml-1) added at day 0 to the EHM together with DEX (500 nM) significantly enhanced O2- release and percentage hyphal damage, preventing the DEX-induced suppression of EHM function. Thus, GM-CSF and IFN-gamma prevented the deleterious effects of DEX on antifungal activity of EHM against Aspergillus suggesting a potential therapeutic role in patients at risk for or suffering from invasive aspergillosis.

Adult↗