Biomedical subjects
D Meagher
Publications and source records attributed to D Meagher.
A clinical trial of active management of labor.
Explore the source record for details and available documents.
Personality, functioning, and recovery from major depression.
The effect of personality on the effectiveness of electroconvulsive therapy in those with severe depressive illness has been investigated in a few studies, and the results are conflicting, with some demonstrating no effect and others the opposite. These studies, however, used hospital readmission as the only outcome measure, and the methods of personality assessment varied. To study this question in further detail, 40 patients were assessed while receiving inpatient electroconvulsive therapy, at the time of discharge, every 6 weeks for 6 months, and at 1 year after discharge. A number of outcome variables were assessed, including both symptomatic and social functioning measures as well as readmission to hospital. Premorbid personality was also assessed after discharge. The results demonstrate that personality is a predictor of social function at the time of discharge from hospital. In those patients with personality disorders, social recovery is slower than in those with normal personalities. Personality status did not distinguish the speed of symptomatic recovery or of readmission. The significance of these findings is discussed.
A survey of new long-stay hospital patients in an Irish health board area.
OBJECTIVES: The aims of this study were to determine the number and rate of accumulation of new long-stay hospital patients in one of Ireland's eight health board areas, to describe their demographic and clinical features, and to assess their needs in relation to possible community placement. METHODS: Demographic and clinical information was obtained on all patients over age 17 who had been continuously hospitalized in area hospitals for more than one year and less than six years on the census day of March 1, 1992. The Community Placement Questionnaire was used to rate the patients' social functioning, problem behavior, physical disability, social contact, and needs for accommodation and day care. RESULTS: The survey identified 175 new long-stay patients, mainly middle aged to elderly. Schizophrenia was the most common psychiatric diagnosis. The bed occupancy rate for these patients was 14 per 100,000 population, and the annual accumulation rate was 2.3 per 100,000 population. CONCLUSIONS: New long-stay patients were chronically ill with significant psychiatric and social disabilities. Involuntary patients were overrepresented in the group. Two-thirds could be placed in the community if facilities were available and had sufficiently high staffing levels.
M.D.M.A. ("Ecstasy"); a case of possible drug-induced psychosis.
3, 4, Methylenedioxymetamphetamine (M.D.M.A., Ecstasy) is a modified amphetamine with stimulant and hallucinogenic properties. Ecstasy has been increasingly abused in Dublin in recent years. It is commonly perceived by users as a safe drug. We report a case of prolonged psychosis following brief recreational use of Ecstasy.
Proof of differentiative mode of action of all-trans retinoic acid in acute promyelocytic leukemia using X-linked clonal analysis.
Using X-linked clonal analysis, mechanism of action of all-trans retinoic acid (ATRA) was sought in a 16-year-old female with relapsed clonally evolved acute promyelocytic leukemia (APL), who achieved complete remission. On ATRA, metamorphosis of peripheral blood leukemic promyelocytes to mature neutrophils was observed, despite the persistence of t(15;17) in 100% of bone marrow metaphases. DNA was extracted from fractionated serial blood specimens, collected at diagnosis, in first complete remission (CR), relapse, and during ATRA treatment. Using a phosphoglycerokinase (PGK) probe, the patient was heterozygous for both Bgl I and Bst XI PGK polymorphisms. Methylation analysis showed monoclonal leukemic promyelocytes with a polyclonal first CR achieved by standard chemotherapy. Subsequent examination, in relapse, of granulocytes appearing during ATRA treatment showed these to be monoclonal, proving these were derived from the neoplastic clone. The X-linked clonal analysis methodology has provided in vivo evidence of cellular differentiation as the mechanism of action of ATRA. Parallel studies of cytogenetic and clonal analysis showed a regression of the t(15;17) cytogenetic abnormality and return of a polyclonal PGK methylation pattern in 5 weeks, indicating a repopulation of marrow by normal stem cells. As standard cytogenetic techniques are inappropriate for nondividing cells, X-linked clonal analysis provides a marker system to allow insight into mechanism of drug action in malignant hematologic disease.
The effect of an educational program on knowledge & attitudes about blood pressure by junior high school students: a pilot project.
This study tested the effectiveness of a 10 minute videotape and complementary print program guide on the knowledge and attitudes of junior high school students about blood pressure (BP). A randomized two group pre-test, post-test and delayed post-test design was used. The experimental group received an educational session on BP, designed for this study, which consisted of a 40-minute session, comprised of a 10-minute video presentation and discussion by the teacher on BP (guided by the program guide). The educational session was effective in improving students knowledge of BP at one week post-test; however, this positive effect did not persist at the three month post-test. Student interest in, or knowledge of, their own BP was not obviously affected by the session. The findings were interpreted in light of Social Learning Theory (SLT) and the PRECEDE Model of Health Education (PMHE). In testing the effect of one component of an educational program, i.e., the videotape and teacher lesson the environmental determinants of behaviour change could not be addressed in this study. The educational session was able, however, to achieve the desired knowledge change. The 10-minute videotape and complementary print program guide was shown to be a viable educational tool and can therefore be utilized as a resource in a broader multi-faceted program of cardiovascular (CV) health promotion.
Women and heart disease--why be concerned? We can make a difference!
Explore the source record for details and available documents.
Condylar fractures of the third metacarpal bone and third metatarsal bone in 75 horses: radiographic features, treatments, and outcome.
Explore the source record for details and available documents.
Traumatic intracranial haemorrhage in firstborn infants and delivery with obstetric forceps.
Exclusive of breech presentation, traumatic intracranial haemorrhage was demonstrated at necropsy on 27 occasions in 36 420 consecutive firstborn infants. All 27 were forceps deliveries. The main conclusion is that serious injury to the forecoming head at birth is almost invariably a direct effect of forceps. The relevance of this conclusion to some aspects of contemporary obstetric practice is discussed briefly.
Osteochondrosis of the shoulder joint of the horse.
Osteochondrosis of the shoulder joint in the horse was diagnosed radiographically in 54 shoulders of 38 horses. Clinical signs were those of an intermittent lameness characterized as a swinging leg shoulder lameness with pain elicited by extension, flexion or abduction of the limb. Diagnosis of shoulder lameness was supported by blocking the shoulder joint with local anesthetics. Radiographic changes consisted of: (1) alteration in the contour of the humeral head and glenoid cavity, (2) periarticular osteophyte formation, (3) sclerosis of the subchondral bone, and (4) bone cyst formation. The primary bony lesion in the shoulder of the horse is similar to that described in the dog, pig, bull, turkey and broiler chicken. Secondary joint disease is a prominent finding with osteochondrosis of the shoulder in the horse. A follow-up study of 17 horses indicated that many of the affected horses had been sold and were being used for pleasure riding and breeding purposes. Those horses still in use usually had less severe radiographic changes at the time of diagnosis.
An exploration of environmental variables and patient falls.
Explore the source record for details and available documents.
Clinical course and outcome of thirty-five pregnancies in infertile hyperprolactinemic women.
Thirty-five pregnancies occurred during a 21-month follow-up period in 68 women (51%) who presented with infertility and hyperprolactinemia. Bromocriptine was used in 33 patients, of whom 25 (76%) conceived. In the remaining 35 patients who did not receive bromocriptine, there were 10 pregnancies (28%). The presence or absence of menses and galactorrhea in infertile hyperprolactinemic women treated with bromocriptine did not affect significantly the pregnancy rate. No pituitary complication occurred during pregnancy in any hyperprolactinemic patient and there was no change in sellar x-ray appearance, even in two patients whom a plain skull x-ray showed a minor sellar abnormality. Of the 35 pregnancies, 25 occurred after bromocriptine therapy, 2 after thyroxine therapy, 2 after clomiphene therapy, and 6 without any treatment. Five pregnancies ended in first-trimester abortion, including four after bromocriptine treatment. It is concluded that hyperprolactinemia is a good prognostic factor in infertility and that the majority of patients become fertile after a course of bromocriptine. No congenital abnormalities were observed in the offspring of patients treated with bromocriptine, but the abortion rate was higher than average.
Prolactin measurements: preliminary clinical report.
Explore the source record for details and available documents.
Pelvic infection associated with the intrauterine device.
Explore the source record for details and available documents.
Congenital anomalies of the diaphragm. Personal experience with thirty-five consecutive cases.
A personal experience of thirty-five consecutive patients with congenital anomalies of the diaphragm is reported. The anomalies included twenty-five Bochdalek hernias, seven diaphragmatic eventrations, and three esophageal hiatal hernias. Except for the patients with esophageal hiatal hernias, virtually all patients presented with respiratory embarrassment, twenty-seven of the thirty-five within 24 hours of birth. An especially high mortality is associated with this early onset of symptoms. The treatment was surgical with a thoracic approach used for right Bochdalek defects and eventrations, and an abdominal approach used for left Bochdalek hernias. The importance of proper preoperative and postoperative management in a well equipped neonatal intensive care unit is emphasized.
Interspecific somatic cell hybridization between asparagine-requiring and drug-resistant cell lines.
Explore the source record for details and available documents.
Oxygenation of blood with low oxygen gas mixtures by means of a bubble oxygenator.
Explore the source record for details and available documents.