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Biomedical subjects

C O'Donnell

Publications and source records attributed to C O'Donnell.

At least 37 records · Page 2Linked to original sources
PubMed2000

1998 Australian radiology workforce report.

The 1998 Australian Radiologist Workforce Survey findings form the basis of the present report, prepared by the Workforce Committee of the Royal Australian and New Zealand College of Radiologists (RANZCR). A more detailed report can be accessed through the RANZCR web site (http:@www.ranzcr.edu.au). This follows similar previously published reports by the Workforce Committee in the 1990s. The issues of radiologist workforce supply and demand are examined, and benchmarks again reviewed. One of the conclusions of the present report is a possible upcoming shortage of radiologists in Australia, due to several factors, including a possible increase in the attrition rate of an ageing radiologist population, increasing female participation in the workforce, and increasing medical imaging utilization rates. In comparison with other Organization for Economic Cooperation and Development (OECD) nations, Australia had a mid-range supply of radiologists, and also medical imaging utilization, although there has been an increase in the latter. Australian radiologist annual workloads appear to be increasing.

Adult↗
PubMed1999

Autoantibodies to leukocyte alphaMbeta2 integrin glycoproteins in HIV infection.

HIV infection is often associated with polyclonal B-cell activation, autoantibodies, and clinically evident autoimmune disease. Because neutropenia and anti-neutrophil autoantibodies are common clinical features of HIV disease, we studied a series of HIV+ patients to determine whether anti-alphaMbeta2 integrin (MAC-1) specific anti-neutrophil autoantibodies occur in HIV disease, as we have shown to occur in patients with immune neutropenia not associated with HIV. Two new assays specific for anti-alphaMbeta2 IgG were developed to carry out these studies: an ELISA method using affinity-purified alphaMbeta2 integrin protein, and a flow cytometry method using subclones of the 293 human fetal kidney cell line, stably transfected with cDNAs for the alphaM and/or beta2 integrin subunits. In studies of the sera of 20 untreated HIV+ individuals, anti-alphaMbeta2 activity was detected in 9 (45%) by one or the other of these assays and in 5 (25%) by both assays. Seven of the 20 HIV+ study subjects had unexplained neutropenia, and of these, 6 (86%) were positive for anti-alphaMbeta2 autoantibodies. Our findings indicate that anti-alphaMbeta2 integrin autoantibodies are frequent in HIV+ individuals, particularly when unexplained neutropenia is also present, and raise the possibility that these autoantibodies may have a role in the acquired neutrophil dysfunction and increased risk of nonopportunistic bacterial infections observed in HIV disease.

Autoantibodies↗
PubMed1999

Emotional contagion, empathic concern and communicative responsiveness as variables affecting nurses' stress and occupational commitment.

Based on data gathered from registered nurses at two hospitals, this research examined the extent to which empathy variables contributed to nursing stress and occupational commitment. The empathy variables examined were emotional contagion (i.e. sharing the emotions of patients), empathic concern (i.e. being concerned for patients) and communicative effectiveness (i.e. effectively communicating with patients and their families). Nursing stress was explored through the variables of depersonalization, reduced personal accomplishment and emotional exhaustion. Multiple regression analyses revealed that the combination of the three emotional communication variables explained significant proportions of the variance in all three of the stress variables, as well as occupational commitment. The analyses further revealed that a lack of empathic concern and poor communicative responsiveness accounted for significant proportions of the variance in depersonalization. Lack of empathic concern, poor communicative responsiveness and high emotional contagion significantly contributed to reduced personal accomplishment. Emotional contagion explained a significant proportion of the variance in emotional exhaustion. Emotional contagion also significantly reduced occupational commitment. The findings are discussed in terms of nursing education and administration.

Achievement↗
PubMed1999

Unintended outcomes of health care delivery and the need for a national risk management approach.

Unlike the situation in occupational health and safety, there is no nationally coordinated approach to risk management to prevent unintended outcomes of health care provision and improve health care quality. There is a related absence of linkages between quality assurance process, other programs aimed at patient injury prevention and professional indemnity insurance systems. This article discusses the Australian health policy direction and argues for a coordinated national health risk management approach developed through contract requirements which include duty of care and information provision, nationally approved standards and codes, professional liability requirements, and supporting health education, research and information technology development.

Australia↗
PubMed1998

Prevalence and natural history of urinary symptoms in a longitudinal national prostate cancer screening (community-based) study.

The AUA Symptom score (AUASS) was administered for three consecutive years to participants in a national prostate cancer screening study. Although the prevalence symptom free (AUSS=0) individuals was very low (<7%) in this cohort of 16 000 men, mean AUASS and proportion of men in the mild, moderate and severe categories are equivalent to community-based studies from around the world. Across all ages and races, AUASS drops after 12 months but returns to original levels at 24 months. No differences in AUASS were noted for race when adjusted for age. Age is most strongly correlated to the increase in AUASS and to the severity of urinary symptoms.

Journal Article↗
PubMed1998

Sex differences in symptom presentation associated with acute myocardial infarction: a population-based perspective.

OBJECTIVES: To describe sex differences in symptom presentation after acute myocardial infarction (AMI) while controlling for differences in age and other potentially confounding factors. BACKGROUND: Although several studies have examined sex differences in diagnosis, management, and survival after AMI, limited data exist about possible sex differences in symptom presentation in the setting of AMI. METHODS: Community-based study of patients hospitalized with confirmed AMI in all 16 metropolitan Worcester, Mass., hospitals (1990 census population = 437,000). Men (n = 810) and women (n = 550) hospitalized with validated AMI in 1986 and 1988 comprised the study sample. RESULTS: After simultaneously controlling for age, medical history, and AMI characteristics through regression modeling, men were significantly less likely to complain of neck pain (adjusted odds ratio (OR) = 0.52; 95% CI: 0.35, 0.78), back pain (OR = 0.38; 95% CI: 0.26, 0.56), jaw pain (OR = 0.50; 95% CI: 0.31, 0.81), and nausea (O.R. = 0.58; 95% CI: 0.45, 0.75) than women. Conversely, men were significantly more likely to report diaphoresis (OR = 1.27; 95% CI: 1.00, 1.61) than women. There were no statistically significant sex differences in complaints of chest pain though men were more likely to complain of this symptom. CONCLUSIONS: The results of this population-based observational study suggest differences in symptom presentation in men and women hospitalized with AMI. These findings have implications for public and health care provider education concerning recognition of sex differences in AMI-related symptoms and health care seeking behaviors.

Aged↗
PubMed1998

Antenatal indomethacin--adverse fetal effects confirmed.

We examined the association between antenatal indomethacin exposure and adverse neonatal outcome in a matched retrospective cohort study of infants born to 72 mothers at less than 31 weeks' gestation. Indomethacin-exposed mothers were matched to controls by gestational age at delivery, antenatal corticosteroid exposure, prolonged spontaneous rupture of membranes, multiple pregnancy, thyrotrophin releasing hormone (TRH) exposure, and neonatal sex. Periventricular haemorrhage was significantly increased for infants delivered within 48 hours of maternal indomethacin exposure (Grade 1 and 2 19% versus 6%, and Grades 3 and 4 28% versus 3% (p<0.03)). Persistent patent ductus arteriosus was more common in those infants delivered within 48 hours of maternal indomethacin exposure (40% versus 20% (p<0.04)). More neonates exposed to antenatal indomethacin failed to respond to postnatal indomethacin to close a patent ductus arteriosus, 60% versus 0% (p<0.04). There were no adverse effects demonstrated of indomethacin administered greater than 48 hours from delivery. We have confirmed a probable association between antenatal indomethacin administration and an increased incidence of neonatal periventricular haemorrhage, patent ductus arteriosus, and impaired renal function. The adverse neonatal effects appear to be greatest when indomethacin is administered within 48 hours of delivery. We recommend that indomethacin should be used with caution as a tocolytic agent for the treatment of preterm labour at gestations less than 31 weeks.

Cerebral Hemorrhage↗
PubMed1998

Leptin attenuates respiratory complications associated with the obese phenotype.

A profile of respiratory complications has been associated with the onset and development of obesity in humans. Similar phenotypes have been routinely demonstrated in genetic animal models of obesity such as the ob mouse (C57BL/6J-Lepob). The objective of the present study was to test the hypothesis that a constellation of respiratory complications are attenuated with leptin (i.e., protein product of the ob gene) replacement. Daily leptin administration during a 6-wk period was conducted to control body weight of mutant ob mice similar to genotypic control groups. During the treatment period, repeated baseline ventilatory measurements were assessed by using whole body plethysmography while quasistatic pressure-volume curves were performed to further explore the role of leptin in improving lung mechanics. Diaphragmatic myosin heavy chain (MHC) isoform phenotype was examined to determine proportional changes in MHC composition. In room air, breathing frequency and minute ventilation were significantly (P < 0.01) different among ob treatment groups, suggesting that leptin opposed the development of a rapid breathing pattern observed in vehicle-treated ob mice. Quasistatic deflation curves indicated that the lung volume of leptin-treated ob mice was significantly (P < 0.05) greater relative to vehicle-treated ob mice at airway pressures between 0 and 30 cmH2O. Diaphragm MHC composition of leptin-treated ob mice was restored significantly (P < 0.05) to resemble the control phenotype. In this genetic mouse model of obesity, the results suggested that respiratory complications associated with the obese phenotype, including rapid breathing pattern at baseline, diminished lung compliance, and abnormal respiratory muscle adaptations, are attenuated with prolonged leptin treatment.

Animals↗
PubMed1998

Contact lens wear and diabetes mellitus.

An estimated 30,000 diabetic patients in the United Kingdom currently wear contact lenses. Anecdotal clinical experience indicates that such patients have an increased risk of developing potentially sight-threatening ocular complications such as ulcerative keratitis. The corneal complications associated with diabetes, for example structural changes in the epithelial and endothelial cells, have led to some controversy regarding the suitability of contact lenses for diabetic patients. There have been few published studies documenting the ocular response of the diabetic eye to current generation contact lens materials. The purpose of this paper is to review the anterior eye manifestations of diabetes and to discuss how such changes could influence contact lens wear.

Journal Article↗
PubMed1997

Differential collagen I gene expression in fetal fibroblasts.

PURPOSE: Fetal wound healing is characterized by the regeneration of normal dermis and the absence of scar. Transforming growth factor beta-1 (TGF-beta1) is a ubiquitous cytokine with potent fibrogenic effects in both postnatal and fetal wounds. Supplementing fetal wounds with TGF-beta1 results in increased fibrosis consisting primarily of collagen I. We hypothesized that the lack of scar formation in fetal wounds may be caused by differential collagen I gene (COL1A1) expression. The authors examined basal collagen Ia gene expression in human fetal, newborn, and adult dermal fibroblasts after stimulation with exogenous TGF-beta1. METHODS: Subconfluent human dermal fibroblasts from fetal, newborn, and adult cell lines were incubated for 24 hours, then stimulated by incubation for 4 hours with 1 ng/mL of human recombinant TGF-beta1, or with media alone for basal collagen gene expression, and then placed in guanidium isothyocyanate buffer. To quantitate COL1A1 gene expression, total cellular RNA was extracted and subjected to northern and slot blot hybridization analysis with Dig-labeled COL1A1 probes. The membrane was exposed to x-ray film for 15 minutes and developed. RESULTS: Scant COL1A1 gene transcript was detected in control fetal fibroblasts. Brief stimulation with of TGF-beta1 upregulated the COL1A1 gene transcription in fetal fibroblasts. Gene expression for COL1A1 in both postnatal cell lines appeared similar in treated and untreated cells. Housekeeping control (GAPDH) confirmed no difference in total amount of RNA at the start or end of the experiment. CONCLUSION: COL1A1 gene expression is notably absent in unstimulated fetal fibroblasts, but is upregulated by TGF-beta1. In contrast, postnatal fibroblasts demonstrate significant constitutive COL1A1 gene expression at baseline and unchanged after TGF-beta1 stimulation. This differential regulation may contribute to the ability of fetal wounds to regenerate without scar and explain the effect of exogenous TGF-beta1 to increase fibroplasia in fetal dermal incisional wounds.

Adult↗
PubMed1997

A cross-sectional study of vasectomy, time since vasectomy and prostate cancer.

Past studies of the association of vasectomy and prostate cancer have reported inconsistent results. Our objective was to investigate whether vasectomy and time since vasectomy are associated with a higher risk of prostate cancer. We conducted a cross-sectional study on unduplicated records of >95 000 participants in a longitudinal study (1993-1995) of prostate cancer screening conducted during Prostate Cancer Awareness Week. Vasectomy was reported by 28%, and there were 2530 biopsies. (chi)(2) tests and logistic regression analyses were used and found that vasectomy and an increased length of time since vasectomy are not associated with a higher risk of prostate cancer.

Journal Article↗
PubMed1997

1996 Australian radiology workforce report.

A questionnaire was sent to all radiologists in Australia using a mailing list supplied by individual State Workforce subcommittee members. A reply rate of 72% was obtained. There are currently 1061 radiologists (1010.5 full-time equivalents) or 55.5 radiologists per million population, placing Australia in the mid-range compared with other OECD countries. This has increased slightly from 54.1 in 1994. There is a small but definite State variation. Utilizing current trainee numbers and traditional attrition rates, there is no projected change in these figures (55.3 in 2001), but the continued introduction of 'migrant' radiologists is postulated to cause an increase (56.6 with 25 migrants and 58.4 with 50 migrants in 2001). Analysis of work-practice indicates a performance rate of 14,100 procedures per year per practising radiologist. There is again a State variation. It is estimated that the total number of medical imaging procedures per 1000 population per year (rendered by radiologists) is 815. These latter two figures place Australia in the mid-range compared with the United States and Great Britain. General radiography, mammography, ultrasound, and CT are the most common procedures (in that order), and are performed by the largest proportion of radiologists.

Adult↗
PubMed1997

Severity of alcohol dependence and its relationship to neurological soft signs, neuropsychological impairment and family history.

We examined the relationship between severity of alcohol dependence, subtle neurological impairment, neuropsychological deficits and genetic vulnerability among 36 day hospital attenders who satisfied the DSM-III-R criteria for alcohol dependence. Severity of alcohol dependence was unrelated to the presence of a family history, but was correlated with neurological soft signs and neuropsychological impairment. Neurological soft signs were correlated with neuropsychological impairment on both Trail A and Trail B. Patients with an affected first-degree relative exhibited more neurological soft signs. These data indicate that severity of alcohol dependence is related not only to neuropsychological impairment, but also to subtle neurological deficits which may not be apparent on conventional neurological examination. Patients with a positive family history of alcohol dependence may be particularly susceptible to the neurological sequelae of alcohol dependence, or may have neurological deficits which antedate their alcohol dependence.

Adult↗
PubMed1997

Who's the patient here? Inpatient psychiatric rehabilitation in a state hospital setting.

1. The primary focus of psychiatric rehabilitation is on improving the competencies of persons with psychiatric disabilities. 2. Both patients and staff must change their ideas about themselves and each other before the work of rehabilitation could move forward. 3. Institutional rigidity works against psychiatric rehabilitation, with its value on individual growth and self-sufficiency.

Activities of Daily Living↗
PubMed1996

Inhibition of return along the path of attention.

Two experiments were conducted to examine inhibition of return (IOR) at four potential target locations (a near and a far location in each visual hemifield). In the first experiment, the locations were aligned horizontally and IOR was found at the near locations when the cues were presented at the far locations but not at the far locations when the cues were presented at the near locations. In the second experiment, the locations were not horizontally aligned and IOR was not found for near locations when the far locations were cued. The results suggest that IOR may be an attentional phenomenon and that attention may operate in an analog fashion such that locations in the path of the attentional movement may be attended to.

Adult↗
PubMed1996

Computed tomography detection of active mesenteric hemorrhage following blunt abdominal trauma.

Following blunt abdominal trauma, patients still may be actively bleed ing, despite seeming hemodynamically stable. By detecting extravasation of contrast-enhanced blood in the absence of any other evidence to support solid visceral injury as the source, computed tomography (CT) scanning was able to indicate ongoing hemorrhage in two patients, thought most likely of mesenteric origin. This information influenced the decision for intervention, which in these two cases was laparotomy, where bleeding torn mesenteric vessels were confirmed.

Abdominal Injuries↗