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Biomedical subjects

D Gallagher

Publications and source records attributed to D Gallagher.

At least 109 records · Page 6Linked to original sources
PubMed1988

Noninvasive measurement of retrograde conduction times in pacemaker patients.

Retrograde, or ventriculoatrial conduction (VAC) has been measured in 67% of pacemaker patients with SSS and 25% of patients with 3 degrees block. DDD pacers use the postventricular atrial refractory period (PVARP) to prevent sensing VAC. If the PVARP is too short, a pacer-mediated tachycardia (PMT) could occur. If too long, rapid atrial rates may not be sensed. To accurately set the PVARP, VAC must be measured. Five noninvasive methods are described: (1) Surface ECG during VVI pacing; (2) Atrial intracardiac electrograms during VVI pacing; (3) Initiating a PMT with long pacemaker AV interval; (4) Initiating a PMT at the maximum tracking rate; (5) DDI mode with electronic calipers. The description of these methods is intended to enable a physician to detect and measure VAC in patients with any manufacturer's DDD or VDD pacemaker.

Cardiac Pacing, Artificial↗
PubMed1988

Effects of glucose-6-phosphate dehydrogenase deficiency upon sickle cell anemia.

We studied the interactions of the A- variety of glucose-6-phosphate dehydrogenase (G6PD) deficiency and sickle cell anemia (HbSS) to see if G6PD deficiency influenced laboratory and clinical features of HbSS. A total of 801 male patients over age 2 had G6PD electrophoresis on cellulose acetate membranes. Assays of both G6PD activity and hexokinase activity were then done on all samples that had an electrophoretic pattern other than the normal wild type (GdB). The collection of clinical data used a standardized protocol. Using cluster analyses we classified 10.4% males to be G6PD deficient, while 18.4% had the functionally normal GdA+ enzyme. The prevalence of G6PD deficiency did not change significantly when age was stratified by decade, suggesting little survival advantage or disadvantage of the combination of G6PD deficiency and HbSS. Compared to patients who were not G6PD deficient, there were no significant differences in the hemoglobin concentration, mean corpuscular volume, reticulocyte count, bilirubin, or SGOT level in patients with HbSS who had G6PD deficiency. The incidence of painful episodes, sepsis, or acute anemic episodes was similar in both groups. Our results are consistent with recent studies of smaller numbers of patients that have found little influence of G6PD deficiency upon HbSS. Specifically, we found no evidence that G6PD enhanced the severity of hemolysis or increased the incidence of acute anemic episodes or sepsis in HbSS.

Adolescent↗
PubMed1987

Recruitment in the Cooperative Study of Sickle Cell Disease (CSSCD).

The Cooperative Study of Sickle Cell Disease (CSSCD) is a multiinstitutional investigation of the natural history of clinical course of sickle cell disease from birth through adulthood. The study is not a trial; rather, it involves data collection at 23 institutions in a uniform, standardized fashion on 3800 patients. Recruitment aspects that were addressed include issues related to recruitment of different age groups, ranging from newborns to pregnant women to patients over 50 years of age; the need to include mildly affected patients to ensure that the study would not reflect only a severe hospital-based population; recruitment from rural populations; and the need to screen and enter a newborn population at birth. The recruitment goal of entering 3200 patients, including 2100 patients with SS hemoglobinopathy, over a 24-month period was accomplished after 27 months.

Age Factors↗
PubMed1987

Assessment of depression in geriatric medical outpatients: the validity of two screening measures.

The validity of two screening measures for depression was assessed in a geriatric medical outpatient population. Sixty-eight patients completed both questionnaires; 31 also completed a clinical interview allowing for accurate diagnosis. Both screening measures were found to accurately identify those who were depressed. Clinical and research applications are discussed, including the complementary use of these screening measures with the physician's diagnosis.

Aged↗
PubMed1987

Assessing affect in the elderly.

This article describes a variety of interview and self-report measures that assess the emotions of older persons. Particular emphasis is placed on evaluation of depression, anxiety, and hostility because these are common, clinically significant negative emotions that elderly people experience. Several multidimensional scales that permit assessment of a range of emotions that include some positive feelings also are reviewed. Distinctions are drawn between instruments used primarily for diagnostic purposes versus those used for screening and/or evaluation of level of distress. Advantages and disadvantages of various instruments are presented, along with suggested future research directions.

Affect↗
PubMed1986

Bacteremia in sickle hemoglobinopathies.

We analyzed 178 episodes of bacteremia that occurred during 13,771 patient-years of follow-up of 3451 patients with sickle hemoglobinopathies. Age-specific incidence rates of bacteremia were calculated for patients with sickle cell anemia (SS) and sickle cell-hemoglobin C (SC) disease. The incidence rate was highest among children with SS and SC younger than age 2 years. Children with SC showed an abrupt decrease after age 2 years, whereas children with SS had a gradual decline in rate from 2 to 6 years of age. The predominant pathogen in patients younger than 6 years was Streptococcus pneumoniae (66%); gram-negative organisms were responsible for 50% of bacteremias in patients 6 years and older. Urinary tract infection was present during 73% of Escherichia coli bacteremias, and 77% of Salmonella bacteremias were associated with osteomyelitis. In contrast, no focus of infection was present in 52% of pneumococcal bacteremias. The incidence of pneumococcal bacteremia in children with SS younger than age 3 years was 6.1 events/100 patient-years; the case fatality rate for pneumococcal sepsis in this age group was 24%. No hematologic or demographic variables were associated with occurrence of pneumococcal bacteremia in young children. Retrospective analysis of pneumococcal bacteremia suggests that the prophylactic use of penicillin may decrease the incidence in children younger than 3 years of age.

Anemia, Sickle Cell↗
PubMed1986

An exploratory study comparing depressed and nondepressed elders' coping strategies.

Thirty-two nondepressed elders were given a self-report coping behavior measure that asked them to identify strategies used in response to a recent major life event, and the experience of "feeling down" or "depressed." The measure also asked the subjects to rate how helpful each coping technique was. The data was compared with those gathered from a depressed elderly sample of equal size, chosen by a post hoc matching method from a population of outpatients undergoing treatment for a separate study. The depressed group reported a greater use of avoidance coping behavior than did the nondepressed sample; they were also significantly more likely to use emotional discharge as a coping technique. The nondepressed population consistently rated all methods of coping as more helpful than did the depressed sample, regardless of frequency of use.

Adaptation, Psychological↗
PubMed1986

Characteristic depressive symptoms of bereaved elders.

Profiles of 21 self-reported depression symptoms from 196 recently bereaved elders (mean age = 67.70 years) were compared with those of 145 comparison control participants (mean age = 70.01). Responses from bereaved individuals were recorded approximately 2 months following the loss of their spouse. Comparison participants were married or, if single, had not lost a spouse to death or divorce in the previous 5 years. Results were consistent with the literature concerning normative bereavement reactions; that is, although bereaved people reported several features associated with depression, the likelihood of self-deprecatory cognitions was no greater among them than among control participants. Bereaved individuals were significantly more likely to report heightened dysphoria, dissatisfaction, and somatic disturbances typical of depression, even when variations in age, sex, number of years married, and educational and occupational status were taken into account. Differentiation of bereaved/control participants on some dysphoric features was dependent on the number of years married.

Aged↗
PubMed1985

Factors affecting predictability of radial keratotomy.

A major criticism of radial keratotomy (RK) has been its lack of predictability, a lack due in large measure to the use of simple correlational statistics assessing the relationship between refractive result and each predictor-variable being evaluated separately. This report utilizes multivariate analysis in an attempt to account for the effects of a number of predictor-variables simultaneously. Variables studied are patient age, optical zone size, number of incisions, mean incision depth, preoperative average keratometry, preoperative average applanation tension, patient sex, and age-sex interrelationship. The area of the optical clear zone selected by the surgeon was found to be the most important factor determining refractive change as a result of RK, explaining one-quarter to one-half of the variability of the procedure. The effects of the other factors and the limitations of the method are discussed. Although this method cannot produce a fully predictive equation, we believe this analysis can serve as a good starting point for beginning RK surgeons and a method by which experienced RK surgeons can improve their techniques.

Adult↗