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Biomedical subjects

D R Collins

Publications and source records attributed to D R Collins.

50 records · Page 3Linked to original sources
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

Differential fear conditioning induces reciprocal changes in the sensory responses of lateral amygdala neurons to the CS(+) and CS(-).

In classical fear conditioning, a neutral sensory stimulus (CS) acquires the ability to elicit fear responses after pairing to a noxious unconditioned stimulus (US). As amygdala lesions prevent the acquisition of fear responses and the lateral amygdaloid (LA) nucleus is the main input station of the amygdala for auditory afferents, the effect of auditory fear conditioning on the sensory responsiveness of LA neurons has been examined. Although conditioning was shown to increase CS-evoked LA responses, the specificity of the changes in responsiveness was not tested. Because conditioning might induce nonspecific increases in LA responses to auditory afferents, we re-examined this issue in conscious, head-restrained cats using a differential conditioning paradigm where only one of two tones (CS(+) but not CS(-)) was paired to the US. Differential conditioning increased unit and field responses to the CS(+), whereas responses to the CS(-) decreased. Such changes have never been observed in the amygdala except in cases where the CS(-) had been paired to the US before and fear responses not extinguished. This suggests that fear conditioning is not only accompanied by potentiation of amygdalopetal pathways conveying the CS(+) but also by the depression of sensory inputs unpaired to noxious stimuli.

Acoustic Stimulation↗
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↗