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Biomedical subjects

D O'Neill

Publications and source records attributed to D O'Neill.

At least 37 records · Page 2Linked to original sources
PubMed2001

Dementia with oropharyngeal dysphagia and myopathy.

A 72-year-old man was referred for geriatric evaluation with a view toward placement in institutional care. He presented originally to an internal medicine team with a six-month history of weight loss, constipation, generalized weakness, and apathy; investigations to rule out an underlying neoplasm were negative. Interdisciplinary assessment revealed coexisting dementia, myopathy, and oropharyngeal dysphagia. These findings prompted further diagnostic evaluation and a diagnosis of inflammatory myopathy with associated oropharyngeal dysphagia and dementia was made. The dementia, myopathy, and oropharyngeal dysphagia responded to steroids and rehabilitation and the patient regained his independence.

Aged↗
PubMed2001

Prenatal diagnosis of fetal abdominal lymphangioma by ultrasonography.

We present a case of abdominal lymphangioma in a fetus together with a review of the literature. Diagnosis was made at 20 weeks' gestation by antenatal ultrasonography. In keeping with other reports, the lesion was located on the left and serial ultrasonography demonstrated rapid growth with extension into the lower extremity.

Abdominal Neoplasms↗
PubMed2001

The effects of age on accident severity and outcome in Irish road traffic accident patients.

Road traffic accidents (RTA's) are the leading cause of fatal trauma in Ireland. Although older drivers are the safest group of drivers in the population, once involved in a crash they are more likely to sustain a severe injury or death. The experiences of Irish elderly RTA victims has not been previously documented. We studied older RTA patients admitted to two Irish trauma centres in 1995. Of 525 patients, 39 (7%) were aged over 65. We compared 38 patients aged 16-64 years for comparison and reviewed the notes in detail. Elderly patients were mostly pedestrians (23/38 - 61%) though 21% (8/38) were drivers with 8% (3/38) on public transport. Younger patients were mostly drivers (14/37 - 38%), cyclists (9/37 - 24%) or motorcyclists (7/37 - 19%). Older patients had a higher median Injury Severity Score, p < 0.05, were more likely to be female (p<0.01), involved in RTA's between 9am-5pm (p<0.05) and have pre-existing medical conditions (p<0.01). The following were significantly increased in older patients (p values): surgical (<0.01), medical (<0.01) and therapist workload (p<0.05), complications (<0.0001), length of stay (<0.01). Less elderly were discharged directly to home (p<0.001). Strategies to reduce the mortality and morbidity associated with RTA in the elderly should emphasise a) older pedestrians during daytime hours, b) attention to safety in public transport. Treatment must ensure adequate medical and therapist input to anticipate higher complication rates.

Accidents, Traffic↗
PubMed2000

The early experience of general practitioners using Green Prescription.

AIM: Sedentary lifestyle is a significant risk factor for increased morbidity and mortality in many medical conditions. A Hillary Commission initiative, Green Prescription is a written exercise prescription given by general practitioners (GPs) to sedentary patients to encourage physical activity. Our aim was to establish the extent to which GPs in the North Health region in 1997 issued with Green Prescription packages had used them, the circumstances under which they were used, and barriers to their use. METHODS: 433 GPs issued with packs were faxed a one-page questionnaire for immediate completion, with follow-up of non-responders. RESULTS: The response rate was 73%, with 65% of respondents having written Green Prescriptions. Their main reasons for use were patient need for more exercise and presence of high-risk medical conditions such as hypertension, cardiovascular disease, obesity and diabetes. Reasons for non-use were: GP already giving advice about physical activity; concern that Green Prescription was patronising and simplistic; compliance issues and time restraints. Some requested a computerised version. CONCLUSION: Non-responders may be non-users, hence we estimate that 48-65% of targeted GPs used Green Prescription. Barriers identified by GPs have assisted in Green Prescription development, which is now nationwide and assessed by independent researchers tri-annually.

Adult↗
PubMed2000

Do patient age and medical condition influence medical advice to stop smoking?

OBJECTIVE: to determine whether the age and medical condition of a patient influences hospital-based doctors' decision making when advising patients to stop smoking cigarettes. METHODS: we presented 142 doctors from four grades (consultant, registrar, senior house officer and house officer) and four specialities (medicine, surgery, psychiatry and anaesthetics), based in a Dublin teaching hospital, with 20 clinical vignettes. Each vignette described a patient from one of five age groups with one of four levels of health. The vignettes were randomly mixed. We asked doctors to say whether they would advise the patient in each case to quit smoking. RESULTS: hospital-based doctors are significantly less likely to advise patients aged over 65 years than younger patients of the hazards of cigarette smoking, irrespective of the person's physical or mental health (P < 0.001). CONCLUSION: the advice given to patients about their cigarette smoking habits by hospital doctors is strongly influenced not only by the patient's health, but also by the patient's chronological age.

Age Factors↗
PubMed2000

Identification of a key target sequence to block human immunodeficiency virus type 1 replication within the gag-pol transframe domain.

Although the full sequence of the human immunodeficiency virus type 1 (HIV-1) genome has been known for more than a decade, effective genetic antivirals have yet to be developed. Here we show that, of 22 regions examined, one highly conserved sequence (ACTCTTTGGCAACGA) near the 3' end of the HIV-1 gag-pol transframe region, encoding viral protease residues 4 to 8 and a C-terminal Vpr-binding motif of p6(Gag) protein in two different reading frames, can be successfully targeted by an antisense peptide nucleic acid oligomer named PNA(PR2). A disrupted translation of gag-pol mRNA induced at the PNA(PR2)-annealing site resulted in a decreased synthesis of Pr160(Gag-Pol) polyprotein, hence the viral protease, a predominant expression of Pr55(Gag) devoid of a fully functional p6(Gag) protein, and the excessive intracellular cleavage of Gag precursor proteins, hindering the processes of virion assembly. Treatment with PNA(PR2) abolished virion production by up to 99% in chronically HIV-1-infected H9 cells and in peripheral blood mononuclear cells infected with clinical HIV-1 isolates with the multidrug-resistant phenotype. This particular segment of the gag-pol transframe gene appears to offer a distinctive advantage over other regions in invading viral structural genes and restraining HIV-1 replication in infected cells and may potentially be exploited as a novel antiviral genetic target.

3' Untranslated Regions↗
PubMed2000

Clinical assessment of rehabilitation potential of the older patient: a pilot study.

Clinical assessment of 'rehabilitation potential' is an everyday occurrence in hospitals, where scarcity of dedicated rehabilitation facilities require clinicians to decide who is most likely to benefit from extended rehabilitation. We examined the reliability of this judgement by different interdisciplinary team members in 27 consecutive admissions to a geriatric rehabilitation ward. The reliability of a clinical judgement was in general quite poor (kappa = 0.21). A more reliable means of determining patient 'rehabilitation potential' is needed.

Aged↗
PubMed2000

An acute stroke service: potential to improve patient outcome without increasing length of stay.

Acute stroke is associated with a high morbidity and mortality: up to 24% of patients may not survive their hospital admission. Stroke unit care has been shown in a meta-analysis to reduce this morbidity and mortality. We present a three-year audit of the first acute stroke service in an Irish teaching hospital. The audit was carried out prospectively on 193 patients admitted to the acute stroke service, from July 1996 to end of June 1999. Details regarding patients, type and severity of stroke, length of stay and outcome were collected prospectively on a standard pro-forma. We observed a reduction in mortality from 19% to 15% to 9%, and an increasing percentage of patients discharged home from 55% to 64% to 68%, in year 1, year 2 and year 3 respectively. A trend towards a greater number of patients, younger age and improved outcome with lower mortality was observed from year to year, without significant change in length of stay. This study confirms the value to patients of organised stroke care in terms of reduction in mortality and morbidity without increasing length of stay or disability. We suggest that every acute hospital should have organised stroke care.

Acute Disease↗
PubMed1999

HemT-3, an alternative transcript of mouse gene HemT specific to male germ cells.

A number of genes are known to be expressed primarily in hematopoietic cells and testis and are thought to function in the control of both blood cell and male germ cell differentiation. We have recently identified a mouse gene, HemT, that encodes two alternatively spliced transcripts specific to hematopoietic cells (HemT-1 and HemT-2) and kidney (HemT-2). We have now isolated a third HemT transcript, HemT-3, that is found only in testis by Northern blot analysis and RT-PCR. HemT-3 is alternatively spliced and may be initiated differently from HemT-1 and HemT-2. RNA in-situ hybridization of testis from wild-type and germ-cell-deficient adult mice, as well as from mice at different developmental stages, indicates that HemT-3 is expressed only in early spermatocytes. HemT-3 cDNA has a major open reading frame related to a human glycosylphosphatidylinositol (GPI)-anchored protein, GML. Using an antibody generated against a peptide derived from the HemT-3 open reading frame, we have detected a testis-specific 22kDa protein by Western blot analysis.

Alternative Splicing↗
PubMed1999

A novel mouse gene, HemT, encoding an hematopoietic cell-specific transcript.

We performed differential display to identify hematopoietic cell-specific genes that are expressed differentially before and after mouse erythroleukemia cell (MELC) induction. In this study we report the identification, cloning, and characterization of one such mouse gene, HemT. Using Northern blot, RT-PCR and in situ hybridization, we show that HemT encodes three different transcripts. One of them, HemT-1, is hematopoietic-cell specific and may be erythroid cell-specific. Another, HemT-2, is expressed mainly in hematopoietic cells. HemT-1 and HemT-2 are alternative splicing products. A third type of HemT transcript is expressed only in testis. The erythroid transcript is expressed preferentially in uninduced MELC as compared to induced MELC, and is likely to be expressed in early erythroid cell populations.

Alternative Splicing↗