Search PubMed⌕ Search

Biomedical subjects

D O'Reilly

Publications and source records attributed to D O'Reilly.

At least 37 records · Page 2Linked to original sources
PubMed2000

Adult hypoxaemia in the perioperative period: a review of the literature.

As a group of academic skills, learning to search for, obtain, read and critically review literature represents a considerable achievement. For the many perioperative nurses who may never be able to pursue their own research project, reading literature reviews is an excellent alternative which enables individuals to become better and more critically informed. A review of the available literature may provide answers to questions or indicate where a subject is in need of further research. In this article by Denise O'Reilly, perioperative hypoxaemia is defined and a range of literature about the subject is critically reviewed.

Adult↗
PubMed1999

An ex-vivo investigation into the effect of bracket displacement on the resistance to sliding.

This ex-vivo study investigated the effect that repeated bracket displacement has on sliding friction and the magnitude of bracket displacement, and hence tooth movement, required to release bracket/archwire binding. The design consisted of an ex-vivo laboratory study. A jig was designed that allowed repeated displacement of a bracket to occur, while the resistance to sliding (friction) was measured using an Instron universal testing machine. One type of stainless steel bracket was used in conjunction with four archwire types (0.016-inch stainless steel, 0.019 x 0.025-inch stainless steel, 0.021 x 0.025-inch stainless steel, 0.019 x 0.025-inch beta-titanium) and four magnitudes of displacement. Repeated bracket displacement has a significant effect on the sliding resistance at the bracket/archwire interface (P < 0.001). The reduction in sliding resistance noted with displacement depended on the archwire. Over the range of displacements tested, there was an 85 and 80 per cent reduction associated with 0.021 x 0.025-inch and 0.019 x 0.025-inch stainless steel, respectively. For 0.019 x 0.025-inch beta-titanium and 0.016-inch stainless steel, these reductions were 27 and 19 per cent, respectively. The importance of true friction, given the likelihood of bracket and/or archwire displacements in vivo, may be lessened.

Analysis of Variance↗
PubMed1999

Asbestos related mortality in Northern Ireland: 1985-1994.

BACKGROUND: The association between Belfast and research into the hazardous effects of asbestos exposure goes back many years. This paper aims to update previous papers and review the burden of asbestos related disease in Northern Ireland today. METHODS: A study was carried out of all deaths in Northern Ireland between 1985 and 1994 inclusive, in which an asbestos related disease was mentioned anywhere on the death certificate. RESULTS: During this 10 year period, 527 asbestos related deaths were recorded; 88 per cent of these were in men. A total of 410 (77.8 per cent) were registered as the primary cause of death but only 405 (76.9 per cent) of cases were the subject of an autopsy. Standardized rates of pleural cancer in males have been increasing at 3.2 per cent per year though the trend was not significant. Lower rates in the last two years may herald the commencement of a decline. Deaths were clustered around the Belfast estuary, the site of Northern Ireland's shipbuilding industry. High proportional mortality ratios were demonstrated for occupations associated with the shipbuilding and construction industries. Evidence is presented that casts doubt on the attribution of peritoneal cancers in females to asbestos exposure. If lung cancers are included, there may be an average of 81 asbestos related deaths in Northern Ireland every year. CONCLUSION: Asbestos related diseases continue to extract a heavy burden of ill health in Northern Ireland today. There are some indications that the upward trend may be on the wane but confirmation of this will have to await further data. Measures to reduce exposure in the workplace to both asbestos and to tobacco smoke are the only means of reducing this burden.

Aged↗
PubMed1999

Identification of phosphorylation sites within the herpes simplex virus tegument protein VP22.

The herpes simplex virus protein VP22 is a major phosphoprotein of infected cells. In this study, we identify two serine phosphorylation sites within VP22 and show that the N-terminal site is a substrate for casein kinase II, while the extreme C-terminal site is a substrate for another, as yet unidentified, cellular kinase. Furthermore, we show that a mutant of VP22 which has both sites altered is unable to incorporate phosphate in vivo, confirming that there are no other phosphorylation sites within VP22.

Animals↗
PubMed1998

Efficiency of institutional long-term care and annual demands for placement.

The objective of this study was to determine the efficiency of and annual demands for institutional long-term care placement in the St. John's region. The study population comprised all applicants assessed for institutional long-term care through the Community Health St. John's Region Single Entry System in 1995-96. The outcome measures used for the study included estimates of client resource utilization employing the RUGs III and Alberta Resident Classification System; hospital beds occupied; time to placement; and annual demands on long-term care. The study concludes that objective criteria for admission to supervised care and nursing home care may help reduce the number of inappropriate placements (thus maximizing the use of existing nursing home beds) and decrease annual demands. Investment in alternatives to nursing home care for those with modest disability is suggested.

Activities of Daily Living↗
PubMed1998

Evaluation of the impact of non-inpatient i.v. antibiotic treatment for acute infections on the hospital, primary care services and the patient.

The aim of this study was to assess the feasibility of providing i.v. antibiotic therapy outside hospital. The main outcome measures were the direct costs of providing i.v. antibiotic therapy in the community compared with standard hospital treatment and the perceptions of patients and General Practitioners (GPs). A total of 29 patients entered the study, of whom 15 received teicoplanin and 14 ceftriaxone. The costs of drugs exceeded the cost of the estimated alternative treatments (median Pound Sterling 208 and Pound Sterling 126 respectively) and this was only partially compensated for by a small reduction in costs of consumables. The staff time required to train patients was compensated for by savings in drug preparation and administration. Sensitivity analysis showed that these conclusions were sensitive to drug and patient selection, and that treatment of skin and soft tissue infections outside hospital with ceftriaxone was likely to have similar variable costs to treatment in hospital with drugs such as flucloxacillin. Non-inpatient i.v. (NIPIV) therapy was estimated to save a total of 532 bed days in the year of the study. Patients strongly preferred non-inpatient treatment to hospital treatment. GPs identified a number of potential disadvantages, mainly concerning safety and lack of support for patients at home. Following the study a strategy for development of NIPIV services in Tayside has been developed with local GPs and a plan has been agreed for funding a community liaison nurse based on the impact of NIPIV therapy on future bed requirements in Dundee Teaching Hospitals Trust.

Acute Disease↗
PubMed1998

The two communities in Northern Ireland: deprivation and ill health.

BACKGROUND: The aim of this study was to examine differences in socio-economic standing and ill health between the two communities in Northern Ireland. METHODS: This was a descriptive epidemiological study. Deaths from 1991 to 1995 inclusive were used to calculate standardized mortality rates (SMR, under 75 years) at small level using the 1991 Census population estimates. The standardized limiting long-term illness ratios (SIR) were based on the appropriate Census question. Regression models were tested with SMR and SIR as dependent variables and a wide range of socio-economic indicators, including income support and family credit uptake, as independent predictors. RESULTS: Northern Ireland is a very polarized society. More than 60 per cent of the population live in areas which have more than 80 per cent of one religion. Areas with a preponderance of Catholics tend to be more deprived. Unemployment rates, percentage renting, car availability, and education attainment are all worse in Catholic areas. However, there is considerable heterogeneity between areas with similar levels of religious affiliation and the overall pattern varies with the indicator chosen. SMRs rise stepwise with increasing percentage of Catholics. SIRs increase with increasing polarization of areas, but this is much more marked in those with a predominantly Catholic affiliation. Altogether 46.8 per cent of the variance in SMR and 77.9 per cent of that of SIRs could be explained by socio-economic variables alone. Denomination did not have any residual predictive value. CONCLUSIONS: Policy-makers should continue to periodically monitor for differences between the two communities including any differences in service accessibility and uptake. Efforts should be directed towards reducing the inequalities in health for all sections of the community.

Adolescent↗
PubMed1998

Patient removals from general practitioner lists in Northern Ireland: 1987-1996.

BACKGROUND: Being struck off a general practitioner's list is a major event for patients and a subject for much media attention. However, it has not hitherto received much research attention. AIMS: To quantify the numbers of patients removed at doctors' request in Northern Ireland between 1987 and 1996. To describe the characteristics of those removed and to determine if the rate of removal has increased. METHODS: This is a descriptive epidemiological study involving a secondary data analysis of records held by the Central Services Agency. RESULTS: Six thousand five hundred and seventy-eight new patients were removed at general practitioner (GP) request between 1987 and 1996. This equated to 3920 removal decisions, a rate of 2.43 per 10,000 person-years. The very young and young adults had the highest rates of removal; most of the young being removed as part of a family. Ten point six per cent of removed patients had a repeat removal, and 16.3% of first removal decisions required an assignment to another practice. Family removals have decreased and individual removals have increased over the 10 years. Disadvantaged and densely populated areas with high population turnover were associated with higher rates of removal, though heterogeneity is evident between general practitioners serving similar areas. Compared to the period 1987 to 1991, removal rates for the years 1992 to 1993 were reduced by 20.0% (95% confidence interval (CI) for rate ratio (RR) 0.73-0.87), and those for the years 1994 to 1996 increased by 8% (95% CI = 1.01-1.16). The greatest increase was in the over-75 years age group (standardized RR = 1.60; 95% CI = 1.57-1.62). CONCLUSIONS: Removals are relatively rare events for both patients and practices, though they have been increasing in recent years. Further research is needed to understand the processes that culminate in a removal.

Adolescent↗
PubMed1998

More equitable systems for allocating general practice deprivation payments: financial consequences.

BACKGROUND: The allocation of general practitioner (GP) deprivation payments has been a controversial topic since they were first proposed. It has recently been suggested that the current system could be made more equitable if the payments were allocated at enumeration districts and if there was a more graded relationship between Jarman score and funding. However, the implications of these changes on the distribution of deprivation payments have not been worked out. AIM: To explore the resource implications of the proposed changes to the methods of allocating GP deprivation payments within Northern Ireland, one of the few places in the United Kingdom (UK) where this can be done. METHOD: Three alternatives to the present system, incorporating the proposed changes, were modelled. The reallocation of deprivation payments between areas was determined. RESULTS: The proportion of population attracting GP deprivation payments depends on the scheme chosen. A system that entails a lower threshold Jarman score and more payment bands will bring between two and three times more areas and people within the scheme. Each of the three alternatives would redirect funds away from areas within the current payment bands towards those that previously failed to attract any deprivation payments. The loss would be greatest for those areas within the present 'low' payment band and least for those in the 'high' payment band. CONCLUSIONS: More equitable alternatives for allocating GP deprivation payments are feasible, although they will lead to significant movements of funds between areas. This may necessitate the introduction of further transitional payments.

Cost Allocation↗
PubMed1998

General practitioner deprivation payments in Northern Ireland: is the current system equitable?

The allocation of General practitioners deprivation payments has been a contentious issue since it was first proposed. This paper examines the method of allocation of such payments in Northern Ireland. A more equitable system would be based on enumeration districts, have a lower Jarman score and a closer relationship between Jarman score and remuneration. Unlike other parts of the UK these changes are now possible in Northern Ireland and should be implemented.

Catchment Area, Health↗
PubMed1997

A single serine residue at position 375 of VP16 is critical for complex assembly with Oct-1 and HCF and is a target of phosphorylation by casein kinase II.

We show that VP16 is phosphorylated by cellular kinases in vivo and in vitro and map the major sites of phosphorylation to be on serines towards the C-terminus, downstream of position 370 in both cases. Deletion of the acidic activation domain had no effect on phosphorylation, refining the sites to between position 370 and 411. Within VP16, the C-terminal boundary for complex formation with Oct-1 and HCF lies at position 388, and between 370 and 388 lies one serine, at position 375. This is a consensus casein kinase II (CKII) site and, using purified wild-type and mutant proteins, we show that it is the main CKII site in the body of the N-terminal complex-forming region. This site is also phosphorylated in nuclear extracts. Although other sites, mainly Ser411, are also phosphorylated by nuclear kinase(s), the single substitution of Ser375 to alanine abolishes CKII phosphorylation in vitro and virtually eliminates complex formation. This serine lies in a surface-exposed region of VP16 and, although complex formation is disrupted, other activities of the mutant are unaffected. Ser375 is also required in vivo where substitution to alanine abolishes transactivation, while replacement with threonine restores normal levels of activity.

Amino Acid Sequence↗
PubMed1997

Short stature and heart disease: nature or nurture? The EARS Group.

BACKGROUND: Previous studies have demonstrated that short men are at increased risk of coronary heart disease (CHD). It has been suggested that the inverse relationship between adult height and CHD risk could be attributable to the fetal origins of CHD. METHOD: The hypothesis that transmissible factors could partly explain the association has been tested in the European Atherosclerosis Research Studies (I and II), in which a sample of healthy university students (cases), drawn from 18 European countries (male: n = 721; female: n = 330), whose fathers had had a documented myocardial infarction before the age of 55 years were compared to age- and sex-matched controls (male: n = 1056; female: n = 638). Information about lifestyle and birthweight was collected and a fasting blood sample was obtained from each subject. RESULTS: In females there was no difference in height between cases and controls but male cases were shorter than controls, on average by one cm, both in the EARS I (P = 0.02) and the EARS II studies (P = 0.01) and this difference was independent of reported birthweight and the fathers' educational attainment. In logistic regression the relationship was independent of the subjects' apolipoprotein B level, the other major biological discriminator of case-control status. CONCLUSION: In men at least, height appears to be an independent transmissible risk factor for CHD.

Adolescent↗
PubMed1996

Phosphorylation of the herpes simplex virus type 1 tegument protein VP22.

The herpes simplex virus type 1 tegument protein VP22 is known to be highly phosphorylated during infection. Here we show that two electrophoretic forms of VP22 can be identified in infected cell extracts and that this heterogeneity is accounted for by phosphorylation. Furthermore, the nonphosphorylated form of VP22 appears to be specifically incorporated into virions. We also show that the phosphorylated form of VP22 is the only form detected during transient transfection and as such that VP22 can act as a substrate for a cellular kinase. Phospho-amino acid and phospho-peptide analyses of in vivo labeled VP22 were utilized to demonstrate that the phosphorylation profiles of VP22 synthesized during transfection and infection are the same. In both cases VP22 was modified solely on serine residues located in the N-terminal 120 residues of the protein. Moreover, in vitro phosphorylation was utilized to show that the constitutive cellular kinase, casein kinase II, which has four serine consensus recognition sites at the N-terminus of VP22, phosphorylates VP22 in the same manner as observed in vivo. This kinase also phosphorylates VP22 at the N-terminus in intact capsid-tegument structures. Casein kinase II is therefore likely to be the major kinase of VP22 during infection.

Animals↗
PubMed1996

Reduction of post-operative nausea and vomiting with the combination of morphine and droperidol in patient-controlled analgesia.

PURPOSE: To determine whether low doses of droperidol mixed with morphine in patient-controlled analgesia (PCA) would extend the duration of prophylaxis against postoperative nausea and vomiting. METHODS: Healthy women having elective open-abdominal gynaecological surgery consented to this double-blind, placebo-controlled study. Subjects were randomized to receive placebo, or 1 mg droperidol before induction followed by droperidol 0.0 (bolus group), 0.02 (0.02 group), or 0.04 (0.04 group) mg.mg-1 of PCA morphine. Study endpoints included severity of nausea, episodes of vomiting and rescue antiemetic doses, pain, and sedation and were assessed at 1, 2, 4, 8, 12, 16, 20 and 24 hr postoperatively. RESULTS: Seventy-one subjects completed the study. The groups were similar in age, weight, surgical time, pain scores, and morphine used. The 0.04 group had lower mean visual analogue scale scores for nausea (P < 0.05 vs all other groups). The incidence of vomiting was lower in all treatment groups (P < 0.05 for all groups vs placebo). The 0.04 group had lower rescue antiemetic requirements than the bolus group (P < 0.03). Mean sedation scores were low in all groups but were increased with PCA droperidol (P < 0.02). CONCLUSIONS: Droperidol 1 mg before induction of anaesthesia reduces postoperative vomiting. The addition of droperidol 0.04 mg.mg-1 of PCA morphine further reduces (i) severity of nausea and (ii) rescue antiemetic requirements postoperatively. No clinically significant side-effects were attributed to this regimen.

Adolescent↗
PubMed1996

Cancer in Northern Ireland by 2002.

An estimate of cancer deaths and incidence for the years 1997 and 2002, taking account of current trends and population projections for Northern Ireland is presented below. These numbers will be of value to those planning services and, in particular, for those implementing the report "Cancer Services - Investing for the Future". Cancer deaths are expected to rise by almost 13% to 4056 by the year 2002. Marked rises are expected in the number of deaths from cancer of the lung, oesophagus, kidney, bladder and prostate with smaller rises in deaths from breast and pancreatic cancer. The fall in stomach cancer is expected to continue as is the trend of lower deaths from cervical cancer. Deaths from cancer of the colon and rectum are expected to remain static. Estimates of cancer incidence currently and for the years 1997 and 2002 are also included. The impact of tobacco use by the population, which poses a current and future serious threat to public health is highlighted.

Aged↗