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Biomedical subjects

G O'Leary

Publications and source records attributed to G O'Leary.

At least 19 recordsLinked to original sources
PubMed2004

Efficacy and pitfalls of fine needle aspiration in the diagnosis of neck masses.

BACKGROUND: Fine needle aspiration biopsy (FNAB) is now well established in the assessment of cervical masses. The purpose of the present study is to review the efficacy of this procedure, as well as to identify any pitfalls that may limit its usefulness. METHODS: One hundred and ninety aspirations of neck masses performed over a recent five-year period were reviewed. The definitive diagnosis of the mass was determined in each case by review of the patients' case notes. RESULTS: Thirty seven per cent of all neck lumps were malignant. The most common cause for a false-negative result, in the case of a carcinomatous mass when an adequate sample had been obtained, was a cystic neoplasm. One quarter of all cystic lateral cervical masses not considered suspicious for malignancy by FNAB turned out to be malignant. CONCLUSION: Repeating FNAB in cases where the original result is negative for carcinoma may increase the sensitivity of FNAB in the detection of cystic carcinomas.

Adenoma↗
PubMed2001

3,4-methylenedioxymethamphetamine (MDMA): a review.

This article reviews the history, pharmacology, and adverse events associated with the use of 3,4-methylenendioxymethamphetamine (MDMA), commonly known as Ecstasy. Past research describing the neurotoxic effects of MDMA in animals, current research on the neurotoxic effects of MDMA in humans, and the attendant changes in psychologic functioning will be highlighted in this review. Finally, the limitations of human research on the effects of MDMA and suggestions for future MDMA research will be discussed.

Brain↗
PubMed2001

Opioid antagonists in the treatment of alcohol dependence.

This article reviews the use of opioid antagonists in the pharmacologic treatment of alcohol dependence. The rationale for using the opioid antagonists naltrexone and nalmefene to prevent relapse in alcohol-dependent subjects is discussed by reviewing past and current clinical trials. The role of psychotherapies, particularly coping skills therapy, in combination with opioid antagonists is highlighted in the presentations of the clinical data. Finally, future research directions for opioid antagonists are discussed.

Alcoholism↗
PubMed2001

Serious complication of tongue piercing.

The case of an 18-year-old patient who developed critical upper airway compromise after central tongue piercing is presented. Otolaryngologists must be aware of the many potential complications of tongue piercing and their management.

Adolescent↗
PubMed2000

Pharmacotherapies for cocaine dependence.

This article reviews the history of pharmacologic trials for the treatment of cocaine dependence as well as current treatments under investigation. The rationale for use of agents such as dopaminergic agents, antidepressants, and anticonvulsants is discussed. Early clinical trials with pharmacologic agents have demonstrated both positive and negative results; the possible reasons for these mixed outcomes is also discussed. Recent studies focusing on disulfiram, dopamine-selective antagonists, citicoline, aspirin, and a cocaine-specific vaccine are presented to highlight innovative and potentially effective treatments for individuals with cocaine dependence.

Clinical Trials as Topic↗
PubMed2000

Antiproliferative actions of inhalational anesthetics: comparisons to the valproate teratogen.

The antiproliferative potential of the volatile anesthetics isoflurane, enflurane and sevoflurane was determined and compared to the valproate teratogen. The in vitro system employed, a G1 phase proliferative arrest endpoint in C6 glioma, has served previously to discriminate agents with known teratogenic potential in vivo. Based on estimated IC(50) values that were within twice the estimated minimum aveolar concentration value, the rank antiproliferative potency of the inhalational anesthetics employed was isoflurane=enflurane>>sevoflurane. Flow cytometric analysis of growth-arrested cell populations failed to reveal specific accumulation in any cell cycle phase and the lack of a G1 phase-specific effect was confirmed by the absence of a transient, time-dependent sialylation event in synchronized cells. The antiproliferative mechanism of volatile anesthetics, and valproate, was mediated at hydrophobic binding sites, as increasing the hydration sphere of the drug-micelle complex, using the hygroscopic qualities of the dimethylsulfoxide vehicle, completely reversed this effect. Our findings suggest inhalational anesthetics lack the specific in vitro characteristics of the valproate teratogen.

Anesthetics, Inhalation↗
PubMed2000

Neural fibrolipoma: an unusual case.

A 45-year-old gentleman presented with a diffuse left neck mass. Surgical exploration revealed a large lipomatous lesion. Histological examination identified this to be a neural fibrolipoma. This is the first reported case of this lesion in the neck.

Head and Neck Neoplasms↗
PubMed1998

Synthesis, anti-human immunodeficiency virus activity and esterase lability of some novel carboxylic ester-modified phosphoramidate derivatives of stavudine (d4T).

We report the design, synthesis and antiviral evaluation of a series of lipophilic, masked phosphoramidate derivatives of the anti-human immunodeficiency virus (HIV) nucleoside analogue d4T, designed to act as membrane-soluble prodrug forms for the free nucleotide. In particular, we report a series of 12 novel compounds with systematic variation in the structure of the carboxylate ester function. In order to rationalize the changes in antiviral action with variation of this moiety we applied our recently developed 31P NMR-based assay for carboxyesterase lability to this series. However, no clear positive correlation emerged, indicating that, at least within this series, factors other than simple esterase lability may be the major determinants of antiviral potency.

3T3 Cells↗
PubMed1996

Epidural morphine vs hydromorphone in post-caesarean section patients.

PURPOSE: The purpose of this randomized controlled double blind study was to compare the efficacy of pain relief and the side effects of epidural hydromorphone and morphine in post-Caesarean patients. METHODS: In all patients, epidural anaesthesia was induced using carbonated lidocaine 2% with 1:200,000 epinephrine and 50 micrograms fentanyl, given in incremental doses. Patients in Group 1 (n = 24) received 0.6 mg hydromorphone and patients in Group 2 (n = 22) received 3 mg morphine after delivery of the infant. Pain, pruritus and nausea were measured using a visual analog scale (at times: baseline, on admission to the recovery room, 3, 6, 12, 18 and 24 hr postoperatively), by the number of requests for additional medications and by an overall satisfaction score. RESULTS: There was no difference between the groups in pain relief of in the incidence and severity of side effects. Pruritus was more pronounced within the first six hours in Group 1 and at 18 hr in Group 2. CONCLUSION: Hydromorphone provides no clinical benefit over epidural morphine for post operative analgesia following Caesarean section.

Adult↗
PubMed1995

Association of Epstein-Barr virus with sinonasal angiocentric T cell lymphoma.

AIM: To investigate whether non-Hodgkin's lymphomas arising in the sinonasal region or Waldeyer's ring contain the Epstein-Barr virus (EBV) genome in lesional tissue. METHOD: Sections from paraffin wax blocks of 22 lymphoid proliferations arising in the sinonasal region or Waldeyer's ring were studied with EBV encoded RNAs (EBER-1 and -2) using in situ hybridisation. RESULTS: EBV was detected in nuclei of tumour cells of five of seven T cell lymphomas and in nuclei of two of seven diffuse, large cell immunoblastic lymphomas of B phenotype in the sinonasal region. Of tumours arising in Waldeyer's ring, two of 10 non-Hodgkin's lymphomas (both large cell) were positive, as was a single case of Hodgkin's disease. Lymphoma of other types, including Western type Burkitt's lymphoma, and nodular and diffuse small cleaved cell lymphoma, were negative. CONCLUSION: EBV is highly associated with large cell lymphomas especially T cell lymphomas of sinonasal origin in the indigenous Irish population, underlining the importance of this virus in nasopharyngeal lymphomas in Northern European as well as Asian populations.

Adolescent↗
PubMed1992

The role of computed tomography in the management of peritonsillar abscess.

Twenty-four patients who fulfilled the clinical criteria for peritonsillar abscess (PTA) were randomized into two groups over a 6-month period. Group A (n = 13) underwent CT with contrast, whereas group B (n = 11) was managed without radiologic investigation. In group A, CT with contrast enabled differentiation of PTA from peritonsillar cellulitis in all 13 cases (100%) and demonstrated abscesses in 11 patients (85%), thereby allowing drainage at first attempt. Two patients with peritonsillar cellulitis were successfully managed with antibiotics only. In group B, all patients underwent needle aspiration. In seven patients (64%), pus was found after needle aspiration at first attempt and in one patient after needle aspirations at two locations. In three patients (27%), no pus was found after needle aspirations at three different locations. We conclude that CT enhances diagnostic accuracy, obviating unnecessary drainage procedures, and reduces patient morbidity.

Anti-Bacterial Agents↗
PubMed1991

Pain relief after tonsillectomy in adults: intramuscular diclofenac and papaveretum compared.

A wide variety of surgical and pharmacological methods have been described in an attempt to reduce pain after tonsillectomy, with conflicting results. Opiates are still widely used, despite unwanted side-effects. Recently the non-steroidal anti-inflammatory drugs have been shown to be effective against a variety of post-operative pains. Diclofenac is effective in both children and adults in the relief of pain after tonsillectomy when administered rectally, but absorption is variable, and suppositories are not widely accepted in the UK. The present double-blind study compared a single intramuscular dose of diclofenac with papaveretum in adults undergoing tonsillectomy. Post-operatively, the patients who received diclofenac had less pain and started drinking significantly sooner than the control group. There were no undesirable side-effects. Intramuscular diclofenac is superior to papaveretum in the relief of pain in adults undergoing tonsillectomy.

Adolescent↗
PubMed1989

The effect of distal anastomotic site on PTFE graft patency in lower extremity bypass.

The site of distal anastomosis of polytetrafluorethylene (PTFE) lower extremity bypass grafts may significantly affect results. We examined patency in 144 cases; 45 femoro-popliteal above knee (AK), 55 femoro-popliteal below the knee (BK) and 44 femoro-distal (D) PTFE bypasses, the groups being comparable with regard to other risk factors studied. Cumulative graft patency at 3 years was 71.3% for AK, 36.7% for BK, 16.4% for D and overall 35%. The site of distal anastomosis is an important determinant, of PTFE lower extremity bypass patency. We have abandoned the use of PTFE for BK and D, but feel that AK PTFE is a suitable alternative to autogenous reversed saphenous vein.

Aged↗
PubMed1988

Variceal bleeding, hypersplenism, and systemic mastocytosis. Pathophysiology and management.

Systemic mastocytosis is characterized by an abnormal proliferation of tissue mast cells. Though rarely a surgical disease, it occasionally presents as variceal bleeding secondary to portal hypertension. Ultrastructural studies of the liver and spleen and portal pressure measurements support the hypothesis that a perisinusoidal intrahepatic fibrosis is responsible for the increased portal pressure. When variceal bleeding complicates systemic mastocytosis, shunt surgery is indicated, with the type of shunt dictated by both hematologic and hemodynamic issues. Satisfactory blockade of histamine release can be achieved preoperatively by disodium cromoglycate and/or histamine antagonists to obviate any systemic effects precipitated by shunting of mast cell-rich splenic blood into the systemic circulation.

Adult↗
PubMedDate not supplied

Sexually transmitted diseases as seen by general practitioners in Ireland: use of a telephone survey.

A telephone survey of one of every five general practitioners in the Republic of Ireland was carried out in July 1978 for the purpose of establishing the frequency of diagnosis of venereal diseases during the preceding year. In addition, information was obtained on the subsequent management of the diseases. This type of survey was found to be economical and quick, and the response rate (98.6%) was excellent. The national frequency of diagnosis (per 100,000 population) was estimated from the sample to be 7.7 for syphilis, 97 for gonorrhea, and 2,000 for nonspecific venereal diseases. The rates of reporting of these diseases were less than or equal to 24.3%, 9.8%, and 3.1%, respectively, of the estimated frequencies. Sixty-nine percent of the general practitioners treated the patients themselves; 51% treated on the basis of clinical diagnosis alone.

Family Practice↗