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Biomedical subjects

C O'Connor

Publications and source records attributed to C O'Connor.

90 records · Page 5Linked to original sources

Students' decisions to select HIV services for clinical experiences.

The ever-growing numbers of persons living with HIV/AIDS emphasizes the need for highly trained healthcare professionals to care for this population. Understanding why nursing and medical students would choose HIV services for clinical rotations, and the impact of those clinical experiences on their future professional practice, is key to recruiting healthcare providers to care for this population.

Adult↗

Association of physical fitness and transient myocardial ischemia in patients with coronary artery disease.

PURPOSE: To examine the relationship between physical fitness and transient myocardial ischemia (TMI) in the laboratory and during daily life, in a sample of coronary patients with a recent positive exercise test. METHODS: 47 patients with coronary disease (CAD) participated in laboratory mental and exercise stress testing and 48-hour outpatient Holter monitoring after being withdrawn from ant-ischemic medications. During laboratory testing, left ventricular performance was assessed by radionuclide ventriculography. Physical fitness was assessed by measurement of oxygen consumption during symptom-limited exercise treadmill testing. RESULTS: Higher physical fitness subjects were less likely to exhibit wall-motion abnormalities in response to mental stress (P < .05), and to exercise stress (P < .05) testing. They also had smaller decreases in left ventricular ejection fraction (LVEF) in response to mental stress than less fit subjects (P .056), and exhibited a mean increase in LVEF during exercise, compared to the less fit subjects who exhibited a decrease in LVEF (P < .02). Moreover, higher fit subjects exhibited fewer episodes of TMI (P < .04), for a shorter duration (P < .04), and less total ischemic burden (P < .04) during Holter monitoring. CONCLUSION: These findings suggest that within a population of CAD patients, higher levels of physical fitness are associated with less TMI assessed in the laboratory and during routine activities of daily living.

Adult↗

Predictive value of selected admission criteria for graduate nursing education.

To determine if there are admission criteria that predict success in graduate nursing education, an investigation was conducted of 193 graduates who had successfully completed the masters nursing program at a private eastern university. Admission criteria and other variables chosen were nursing, nonnursing, and cumulative undergraduate grade point averages (GPAs); verbal, quantitative, and combined Graduate Record Examination (GRE) scores; age at entrance; number of years intervening between attainment of the bachelors and completion of the masters degree; and, number of years intervening between the basic nursing education and the completion of the masters degree. Each variable was correlated with masters GPA for degree of association. Pearson's coefficient of correlation was used to analyze the data. Subgroups were analyzed in relation to the chosen area of clinical concentration: community health, psychiatric, medical-surgical, and maternal-child nursing; basic nursing education: diploma or generic baccalaureate; and, marital status: single or married. Nursing, nonnursing, and cumulative undergraduate GPAs were found to be weakly associated with the masters GPA except for the psychiatric subgroup which showed a moderate correlation between the cumulative under-graduate and the masters GPAs. Weak associations were found between verbal, quantitative, and total GRE scores and the masters GPA, with two exceptions: for psychiatric and community health subgroups there were moderate degrees of association between verbal GRE scores and the masters GPA. Age was not an effective criterion for predicting degree of success in the program. Both measures of intervening years were found to be weakly associated with the masters GPA.

Age Factors↗

Lack of effect of gold salts on acetylcholine or histamine contraction of canine tracheal and bronchial smooth muscle.

In vitro gold salt incubation with proximal and distal canine airway smooth muscle was compared to untreated canine airway muscle with respect to histamine and acetylcholine-induced contraction. Gold chloride and gold sodium thiomalate had no effect on either proximal or distal canine airway smooth muscle agonist-induced contraction. Gold chloride in concentrations greater than 10(-5) M had a direct contractile effect. These results differ from previous studies which showed an inhibition of the histamine response of guinea-pig tracheal smooth muscle following in vitro preincubation with gold salts. This difference suggests that the mechanism(s) of the beneficial effects of long-term gold salt therapy on human asthma cannot be reliably studied with short-term in vitro animal preparations without first assessing species differences with respect to the effects of therapeutic agents. Human airway smooth muscle preparations would be the best means of addressing this question.

Acetylcholine↗

Albumin priming does not prolong hemofilter life.

The hypothesis was tested that prepriming a hemofilter and lines with heparinized human albumin (NSA) instead of heparinized saline (NS) increases filter survival time. In a university affiliated intensive care unit, all patients were eligible who required continuous venovenous hemodiafiltration and who did not have pre-existing coagulopathy or contraindications to heparin. New hemofilters were randomized to priming with 2 liters NS or 1 liter NS followed by 500ml NSA. The prime was recirculated for at least 30 minutes before connection to the patient. Anticoagulation was tightly controlled, aiming for a patient activated partial thromboplastin time (APTT) of 60 seconds. Survival analysis was used to compare filter life. Elective discontinuation (e.g., for surgery) were treated as censored data. A total of 91 hemofilters were used in 40 patients during 9 months: 45 randomized to NS, and 46 to NSA. Of these, 57 hemofilters were used until spontaneous failure, 28 NS and 29 NSA; 34 hemofilters were electively discontinued, 17 in each group. Anticoagulation was identical in both groups; the mean APTT value (+/- SE) was 58.2 seconds (+/- 3.1) for NS and 58.0 seconds (+/- 2.8) for NSA (p > 0.9 unpaired t-test). Platelet counts were very similar at 170 x 10(9) (+/- 21.8) for NS and 181 x 10(9) (+/- 23.7) for NSA (p = 0.74 unpaired t-test). There was no significant difference in the filter life between the two groups. For NS, median filter life was 37.8 hours (range 0.6-120); for NSA, median filter life was 45.4 hours (range 2.5-109; p = 0.998 log rank). The power to detect a 50% improvement in filter life was > 90%. Based on this data, the use of albumin priming as an aid to increased hemofilter life can not be recommended.

Acute Kidney Injury↗

Psychosocial factors and coronary disease. A national multicenter clinical trial (ENRICHD) with a North Carolina focus.

In addition to traditional risk factors (cigarette smoking, high blood pressure, and elevated cholesterol) psychosocial factors (depression, social isolation, and low socioeconomic status) have an adverse impact on prognosis of patients with CAD. Several studies of psychosocial and behavioral treatments provide encouraging evidence for the clinical efficacy of psychosocial interventions in CAD patients. A new, multicenter clinical trial now underway (see sidebar) will evaluate the impact of psychosocial interventions (compared to usual care) on all-cause mortality and nonfatal MI in post-MI patients with depression or perceived low levels of social support or both.

Clinical Trials as Topic↗