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Biomedical subjects

D O'Keeffe

Publications and source records attributed to D O'Keeffe.

34 records · Page 2Linked to original sources
PubMed1987

Rheumatoid arthritis of the cervical spine: early and progressive radiographic features.

One hundred thirty-three cervical spine radiographs of 50 patients with rheumatoid arthritis were examined. The patients were a representative random sample chosen from among 675 patients followed up for more than 10 years. The frequency of occurrence for each radiographic finding was correlated with the duration of rheumatoid arthritis. The six radiographic findings that occurred in 30% or more of patients with a disease duration of less than 10 years included odontoid erosions, subaxial subluxation, superficial apophyseal joint erosions, apophyseal joint sclerosis at levels C-4 through C-7, and diskovertebral joint narrowing and osteophytosis at C-4 through C-7. Familiarity with these early findings in the cervical spine may be helpful in both diagnosing and managing rheumatoid arthritis. Subaxial subluxation and superficial apophyseal joint erosions did not progressively increase in frequency with increasing duration of disease, but the other four features did. Other features that were uncommon in early disease became significantly more frequent in later decades.

Adolescent↗
PubMed1984

C-reactive protein as an indicator of infection relapse in patients with abdominal sepsis.

C-reactive protein (CRP) concentrations were monitored serially in 97 patients with abdominal sepsis to determine if differences in infection type or site would produce diagnostic or prognostic CRP level elevations. After surgery and abdominal infection, the average (+/- SD) CRP peak values were 21.2 +/- 9.0 mg/dL. The CRP values rose markedly with infection, rose further with surgery, and subsided to less than 10 mg/dL with cure. Persistent levels of more than 10 mg/dL indicated abscess formation or continued infection. The average normal value at complete tissue healing after resolution of infection was 1.2 mg/dL, which was not different from that for healthy volunteers. Analysis suggested that CRP concentrations were not predictive of the type, site, or severity of abdominal infection; however, since persistent elevations were frequently associated with new or unresolved bacterial infection, serial determinations may be helpful in monitoring the course of disease and response to treatment.

Abdomen↗
PubMed1984

Direct prenatal chromosome diagnosis of a malignancy.

A fetal tumor was suspected at 31 weeks of gestation. The occurrence of polyhydramnios led to an ultrasound examination, which revealed deformation of the fetal head, face, eye, and neck. This was confirmed by computerized tomography. Amniocentesis yielded cells with an inverted duplication of chromosome #1. This abnormality of chromosome #1 marked the malignant teratoma cells in the amniotic fluid. Cytogenetic analysis of tumor tissue and of normal tissue obtained postnatally confirmed that the abnormality of chromosome #1 observed in amniotic fluid cells was confined to the tumor. The constitutional karyotype was normal. To our knowledge, this is the first report of the direct chromosomal detection of malignancy before birth.

Adult↗
PubMed1982

A surgical approach to the treatment of fetal hydrocephalus.

Untreated fetal hydrocephalus results in gross cranial and facial abnormalities and profound brain damage. In an attempt to prevent both, a ventriculoamniotic shunt was implanted in a fetus with probable X-linked aqueductal stenosis and hydrocephalus. Performed at 24 weeks' gestation, the procedure used techniques similar to those used for intrauterine transfusion. After shunt placement, the fetal head size grew normally until after the 32d week, when the shunt failed. A cesarean delivery was performed at 34 weeks' gestation. The infant received a standard ventriculoperitoneal shunt after delivery, and his neonatal course has been evaluated through the first three months of life. In selected cases, the ventriculoamniotic shunt may be an acceptable treatment for fetal hydrocephalus.

Adult↗
PubMed1982

Sacrococcygeal teratoma: prenatal diagnosis with elevated alphafetoprotein and acetylcholinesterase in amniotic fluid.

A sacrococcygeal teratoma was suspected by ultrasound examination at 24 weeks gestation. The amniotic fluid alphafetoprotein was markedly elevated, as was maternal serum AFP. Gel electrophoresis of amniotic fluid showed an acetylcholinesterase band. Labour began at 25 weeks gestation and the chromosomally normal male fetus was found to have a sacrococcygeal teratoma equal to three-quarters of the weight of the fetus.

Acetylcholinesterase↗
PubMedDate not supplied

The need for a national strategy for chronic pain management in Ireland.

BACKGROUND: Chronic pain is defined as pain on a daily basis for more than six months. It affects 13% of the Irish population. Despite its prevalence and the impact on patient's quality of life there is no national strategy for this problem. AIM: To determine the need for a national strategy for chronic pain in Ireland. METHODS: The cost of low back pain (LBP) (common chronic pain condition), the level of education and research and current chronic pain clinic resources were investigated. RESULTS: The cost of LBP in Ireland is enormous: disability payments from the Department of Social and Family Affairs amounted to euros 348 million and insurance payments cost euros 10.5 million. The number of teaching hours timetabled for pain education in the schools of Medicine, Physiotherapy, Dentistry, Nursing and Psychology in Ireland's six universities varied significantly (e.g. 11.5-72 hrs in nursing). Research grants awarded from state organisations were limited to one over a four-year period. No current chronic pain clinics comply with recommended International Association for the Study of Pain (IASP) guidelines. CONCLUSION: A national strategy is needed to reduce costs, standardise teaching and increase pain clinic resources to maximise patient care.

Chronic Disease↗
PubMedDate not supplied

Pain clinic attenders: an audit.

An audit of the first 135 referrals to a new Multidisciplinary Pain Clinic was conducted. Demographic data, pain experience and pain effects were recorded. Chronic Non-Malignant Pain was the diagnosis found most frequently. In that group, the mean duration of pain was seven years, the mean number of surgical operations was 1.95 and the mean number of medications being consumed at the time of presentation 3.5. Impaired occupational, social and recreational functioning was noted. Twice as many women were affected as men and all educational and socio-economic groups were represented. Patient profiles were similar to data published on chronic pain patients attending the Mayo Clinic, Minnesota, USA.

Adolescent↗
PubMedDate not supplied

What cost chronic pain?

Chronic non-malignant pain costs the American economy $40 billion a year. An attempt to quantify the total cost to the Irish economy of 95 patients attending a Multi-Disciplinary Pain Clinic was made. The cost to the Health Services was estimated and added to the amount of Social Welfare payments received and the lost earnings of each patient. The results indicated that the 95 patients cost 1.9 million pounds at the time of referral. A subgroup of 22 patients who were younger and unemployed, accounted for 1.5 million pounds. Allocation of resources to treat these patients is necessary.

Chronic Disease↗