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Biomedical subjects

D O'Neill

Publications and source records attributed to D O'Neill.

At least 163 records · Page 9Linked to original sources
PubMed1981

Myocardial contusion in blunt chest trauma: a ten-year review.

A retrospective review was undertaken of 169 patients admitted to an Intensive Therapy Unit with a major chest injury to determine the incidence, clinical features and outcome of patients with myocardial contusion. This injury occurred in 29 (17%) patients, of whom 24 (83%) had significant cardiovascular complications and five died as a direct result of the injury. The interval between injury and diagnosis was 3.2 +/- 2.3 days (mean +/- SD) from injury and in six patients the diagnosis was made only at necropsy. Increased awareness of myocardial contusion is required for earlier diagnosis and prevention of complications.

Adolescent↗
PubMed1977

Comparision of a glutaraldehyde-modified pollen--tyrosine adsorbate with an alum-precipitated pollen vaccine in the treatment of hay fever.

Nineteen patients with hay fever symptoms received nine weekly injections of pyridine-extracted alum-precipitated grass pollen vaccine (Alavac P). The results were compared with agroup of twenty patients who received a three injection series of a glutaraldehyde-modified pollen-tyrosine vaccine (Pollinex). In both groups 65% had a subjective improvement in their symptoms and no significant difference in symptom scores was obtained throughout the pollen season. In the Pollinex group a lower incidence of systemic side effects was recorded.

Adolescent↗
PubMed1975

Performance in gripping and turning -a study in hand/handle effectiveness.

The biomechanics of the hand/handle linkage were studied to generate data for the optimal design of screwdrivers and other devices which are gripped and used forcefully against resistance. Comparisons were made between smooth and rough steel cylinders and a range of commercially available screwdrivers of varying size, shape and surface quality. None of the screwdrivers was significantly better for the exertion of torque than rough cylinders of the same mean diameter, nor was any worse than a comparable smooth cylinder. It is therefore concluded that for forceful activity the precise shape of the handle is unimportant, the effectiveness of the activity being limited by the size of the handle and the quality of the hand/handle interface.

Journal Article↗
PubMedDate not supplied

Stroke: non-motor sequelae, medical co-morbidity and patterns of intervention after referral to a special interest service.

Stroke poses a considerable financial burden on the health services as well as contributing to enormous personal suffering. A study was undertaken in 100 patients over 65 years old in a geriatric unit. Neuro-radiology confirmed cerebral infarcts in 91 and 89 per cent had additional neuro-medical problems. Specific sequelae of stroke occurred in 53 per cent of which 21 per cent related to dysphagia. Among various treatments 61 per cent were referred for physiotherapy and occupational and speech/language therapy. Knowledge of the nature and timing of complications is important in planning stroke services and the input of early medical specialist assessment has been shown to influence mortality and rehabilitation outcome.

Aged↗
PubMedDate not supplied

Renal transplantation performed across a positive crossmatch: a single centre experience.

UNLABELLED: The importance of certain positive crossmatches (CM+) in kidney transplantation remains controversial. Fifty consecutive kidney transplants were performed across a CM+ between Jan. 1990-April 1994. In 19 cases there was an isolated B-cell CM+ (Group I), in 24 an historic T-cell IgM CM+ (Group II) and in 7 an historic T-cell IgG CM+ (Group III). Comparing groups I:II:III: early acute rejection affected 32%, 42%, 57% of grafts; mean serum creatinine at 3 months was 166, 150, 229 umol/l (p < 0.05); 1 yr graft survival was 95 per cent, 96 per cent, 71 per cent (p = 0.09). In group III both graft losses were in the setting of an additional current B-cell CM+. CONCLUSIONS: Transplantation performed in either the presence of an isolated B-cell CM+ or in the presence of an historic T-cell IgM CM+ was associated with acceptable outcomes at 1 yr. An historic T-cell IgG CM+ was confirmed as a contraindication to transplantation in most circumstances, especially when coupled with a current B-cell CM+.

Adult↗
PubMedDate not supplied

The identification and assessment of undernutrition in patients admitted to the age related health care unit of an acute Dublin general hospital.

OBJECTIVES: To profile those over 65 yr admitted to an acute geriatric medical service. To identify and assess their undernutrition risk and quantify the nutritional intervention they received. METHODS: Forty-nine consecutive admissions were recruited, 23 various parameters were assessed. A diagnosis of undernutrition was made according to a specifically designed flow chart. RESULTS: Eighty-four per cent of recruits were at risk of undernutrition on admission and 80 per cent were moderately to severely at risk. There was deterioration from baseline nutritional status in 29 per cent of previously well nourished patients with hospitalization. In the undernourished group, an improvement and/or stasis from baseline was achieved in 75 per cent, with intervention. CONCLUSIONS: The risk of undernutrition on admission to hospital and during treatment is an indicator of the need for nutrition services and nutritional screening for all acute medical services for older people.

Aged↗
PubMedDate not supplied

Unusual case of tracheal agenesis.

We describe the clinical presentation and pathological features of an unusual case of tracheal agenesis. The axial derivatives of the primitive foregut between the larynx and stomach were represented by a single structure featuring sequential segmentation into regions showing exclusively tracheal or esophageal differentiation in a pattern that is not easily classified by existing nosologic systems nor explained by the conventional hypothesis of dysontogenesis.

Abnormalities, Multiple↗
PubMedDate not supplied

Health and relicensing policies for older drivers in the European union.

BACKGROUND: The number of older drivers is increasing rapidly in the developed world. Many states of the European Union (EU) have initiated legislation to screen older drivers for age-related disease, despite evidence that screening may be harmful or have no positive effect. METHODS: We reviewed the current situation in the EU by sending a questionnaire to the Driver and Vehicle Licensing Agency in each member state. RESULTS: All fifteen countries replied. Regular medical screening occurs in ten. European Council Directive 91/439/EEC forms the basis for national guidelines on medical fitness to drive, but these are not specific for age-related illness, and interpretation of the directive varies between countries. Specific guidelines are not available in all countries for the age-related conditions of dementia, stroke, and Parkinson's disease. In nine countries a medical colleague is available for consultation in difficult cases. Drivers are required to report illness to the Driver and Vehicle Licensing Agency only in the United Kingdom. In six countries, there is mandatory reporting by physicians of conditions which may pose a risk to driving. CONCLUSIONS: There is considerable heterogeneity within the EU on the processes of older driver screening. This diversity may facilitate research into the effect of different policies on safe mobility of older people. If changes in the screening process are considered, further knowledge is needed on issues such as older driver exposure and valid measures of safe mobility for the EU. More evidence-based research is required to help policy makers frame future guidelines and legislation, so as to promote safe mobility of older people.

Aged↗
PubMedDate not supplied

Circulating leptin levels and weight loss in Alzheimer's disease patients.

Weight loss is common in Alzheimer's disease (AD) and is predictive of mortality. Leptin, an adipocyte-derived peptide hormone is implicated in the regulation of satiety and energy expenditure. It acts on the hypothalamus to suppress appetite and increase energy expenditure. We undertook this study to determine if inappropriately elevated leptin levels play a role in AD-associated weight loss. Serum leptin levels of 8 patients in each of the following groups were determined: (1) AD, body mass index (BMI) >25; (2) AD, BMI <20; (3) non-Alzheimer's (vascular) dementia (VaD), BMI >25, and (4) VaD, BMI <20. Mean serum leptin levels were significantly lower in below-appropriate-weight patients (both AD and VaD) than in appropriate-weight controls. Below-appropriate-weight AD patients had a significantly lower mean serum leptin concentration than appropriate-weight VaD controls. Weight loss is a feature of AD. Inappropriately elevated leptin levels do not appear to be implicated. Indeed, we have shown that the afferent limb of the leptin feedback loop is intact in below-appropriate-weight AD patients and suggest hypothalamic dysfunction may underlie this feature.

Aged↗
PubMedDate not supplied

Distinguishing between patients with depression or very mild Alzheimer's disease using the Delayed-Word-Recall test.

The present study investigated the accuracy of an extended version of the Delayed Word Recall (DWR) test in distinguishing patients with very mild Alzheimer's disease (AD) (Mini Mental State Examination score > or = 23) from community-dwelling depressed/dysthymic patients. The DWR test was administered to 26 non-depressed patients who, at the time of DWR administration or on follow-up, fulfilled NINCDS/ADRDA criteria for probable AD, and to 20 age-matched non-dementing patients with a diagnosis of major depression (n = 12) or dysthymia (n = 8) according to DSM-III-R criteria. Sensitivity and specificity were, respectively, 96 and 100% for DWR free recall, and 92 and 100% for DWR recognition. In this study both DWR free recall and recognition measures were highly sensitive and specific in distinguishing very-mild-AD patients from depressed/dysthymic patients. The investigation of more severely depressed patients is warranted.

Aged↗
PubMedDate not supplied

Potential for treatment with thrombolysis in an Irish stroke unit.

Since the publication of the NINDS rt-PA trial in 1995, tissue plasminogen activator has been licensed for the treatment of acute cerebral infarction in the U.S. The demonstrated benefit was confirmed to patients presenting within three hours of symptom onset on adhering to study guidelines, which subsequently have formed the basis for a protocol for thrombolysis in acute stroke. The implementation of a thrombolysis programme in Ireland would require a restructuring of hospital facilities to manage acute stroke. We conducted a prospective study of 100 patients admitted to an acute stroke unit to assess the potential for intervention with t-PA under NINDS guidelines. Data was collected on stroke type. CT appearances, time of onset of stroke and laboratory parameters. Only 6% of all strokes assessed were eligible for thrombolysis and time to presentation was the major excluding factor. When time was removed as an exclusion criteria only 1/5 of all strokes were potential candidates in this best case scenario. Thrombolysis does improve outcome in cerebral infarction in a a strictly controlled setting but only 6% of our patients would currently be eligible for treatment. While this may improve with better public education regarding stroke and it's treatment, only a 1/5 of our patients would still be eligible were they all to present within 2 hours of symptoms onset.

Acute Disease↗
PubMedDate not supplied

Beyond hemiplegia.

Explore the source record for details and available documents.

Aged↗