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C Duggan

Publications and source records attributed to C Duggan.

82 records · Page 5Linked to original sources

Age differences in patient recovery patterns following coronary artery bypass surgery.

OBJECTIVE: The purpose of this study was to determine whether physical, psychological and social recovery within the first 6 weeks following coronary artery bypass surgery varied by age. METHODS: A repeated measures design was used for this study. Data were collected from a convenience sample of three age groups of patients at the following times: prior to hospital discharge and at 1, 3 and 6 weeks after discharge. The three age groups studied were less than 60 years, 60 to 70 years and more than 70 years. Data were collected by interview and mail questionnaires. The initial sample consisted of 258 patients, of whom 184 completed the study. Eleven instruments were used to measure recovery including the Sickness Impact Profile, Beck Depression Inventory, Rosenberg Self-Esteem scale and the Symptom Inventory. RESULTS: No significant differences were found among the age groups for any of the physical, psychological or social recovery measures. Within each age group physical, psychological and social recovery improved significantly over time. Although patients more than 70 years of age remained in the hospital significantly longer, once discharged, they did not have more difficulty with recovery than the other age groups. DISCUSSION: As expected, all age groups experienced significant improvement in recovery over time. CONCLUSIONS: Contrary to what past research about cardiac surgery and the elderly might lead one to expect, in this study, the oldest patients did not have the poorest recovery patterns. Persons more than 70 years had recovery patterns similar to those of younger age groups.

Adult↗

The management of acute diarrhea in children: oral rehydration, maintenance, and nutritional therapy. Centers for Disease Control and Prevention.

Worldwide, diarrhea remains one of the most common illnesses among children. In the United States, children < 5 years of age experience > 20 million episodes of diarrhea each year, leading to several million doctor visits, 200,000 hospitalizations, and approximately 400 deaths. Much of this morbidity is due to the dehydration associated with acute watery diarrhea. Consequently, the proper management of children with acute diarrhea is important for all practitioners as well as for parents of small children. The development of oral therapy for the rehydration and maintenance of children with dehydrating diarrhea has become the worldwide mainstay of national diarrheal control programs. More recently, proper nutrition for children with diarrhea is viewed as an important adjunct to therapy, whereas antibiotics and other drugs play only a limited role. Intravenous therapy remains essential for diarrheal episodes associated with severe dehydration. This document reviews the proper management of diarrhea among children. Particular attention is given to the use of oral therapy for rehydration and maintenance therapy for the dehydrated child and nutritional management. In the United States, the improved management of children with diarrhea could lead to a noticeable decrease in the number of children who are hospitalized or die as a result of diarrheal illness. This report contains recommendations prepared by the Centers for Disease Control and Prevention (CDC), with input from a panel of pediatric and diarrheal management experts, which are consistent with recommendations endorsed by the American Academy of Pediatrics.

Acute Disease↗

The family and HIV.

The impact of HIV and AIDS on the family is described, with particular focus on the situation where the child is the first member of the family to be diagnosed. The results of the social stigma, the effect on relationships together with the global, economic and cultural aspects of the disease make it unique. These issues are discussed and an integrated approach to confidentiality, the provision of services for families and involvement of the community is described.

Confidentiality↗

Tumor necrosis factor-alpha induces vitamin D-1-hydroxylase activity in normal human alveolar macrophages.

The induction of 1-hydroxylase in alveolar macrophages by tumor necrosis factor-alpha (TNF) was examined in view of recent evidence suggesting that local production of 1,25-(OH)2D3 may play a role in the regulation of immune functions. Incubation of pulmonary alveolar macrophages from normal human subjects with recombinant TNF caused a 2- to 10-fold increase in 25-hydroxyvitamin D3-1-hydroxylase activity. The dose-response curve was linear over the range 0.05-5.0 IU/ml, and no further increase was seen at higher concentrations. The increase in 1-hydroxylase activity was present after 12 h and reached a maximum after 3 days. The effect of TNF was inhibited in a dose-dependent manner by the presence of 1,25(OH)2D3 (10(-10)-10(-8) M) in the incubation media for 5 days but was unaffected by 10(-9) M 1,25(OH)2D3 after 12 h. The enhancement of macrophage 1-hydroxylase activity by TNF was comparable to that induced by gamma interferon (IFN) but the effects of maximal doses of both agents were not additive. The presence of antibody to TNF resulted in a 76% inhibition of TNF-induced 1-hydroxylase but had no significant effect on IFN-induced 1-hydroxylase activity.

25-Hydroxyvitamin D3 1-alpha-Hydroxylase↗

A pilot study of erythrocyte choline flux and content in affective disorders.

Choline influx and choline content were measured in healthy volunteers (N = 36), patients with unipolar affective disorder (N = 28), and bipolar patients before and during treatment with lithium (N = 14, N = 13 respectively). Erythrocyte choline content was not found to be significantly elevated in any of the groups studied, except in patients taking lithium. Choline influx into the erythrocytes of healthy controls was found to decrease with increasing age, while choline influx into lithiated erythrocytes increased with increasing age in patients. An inverse relationship between erythrocyte choline influx and content was found to exist only in the erythrocytes of elderly healthy volunteers (greater than or equal to 60 years old).

Adult↗

Automated differential threshold perimetry for detecting glaucomatous visual field loss.

Because early glaucomatous visual field defects occur asymmetrically across the horizontal meridian, we analyzed data from automated perimetry by comparing sums of threshold values of corresponding groups of points in the superior and inferior hemispheres of the central 30 degrees tested by the Humphrey Field Analyzer. We developed patterns and criteria from 25 early glaucomatous and 36 normal control eyes to achieve optimal balance between sensitivity (96%) and specificity (86%). Application of these criteria to an independent group of 27 glaucomatous and 105 control eyes yielded a sensitivity of 88.9% and specificity of 85.7%. Minor modification of the criteria improved sensitivity and specificity to more than 90% for both patients and controls.

Adult↗