Search PubMed⌕ Search

Biomedical subjects

J O'Donnell

Publications and source records attributed to J O'Donnell.

At least 55 records · Page 3Linked to original sources
PubMed1999

Injury analyses of fatal motorcycle collisions in south-east Scotland.

The timing of death and pathological findings in fatal motorcycle accidents in south-east Scotland between 1987 and 1997 were investigated. Of the 59 motorcyclists who died, 38 were dead when found at the accident scene, six others were alive when found but died at the scene, two died in an ambulance in transit to hospital and 13 died after reaching hospital. Scoring of the injuries according to the Abbreviated Injury Scale revealed Injury Severity Scores (ISS) ranging from 25 to 75. Overall, injuries to the head, neck and chest were responsible for the most severe injuries. Twenty-five motorcyclists had injuries acknowledged to be unsurvivable (ISS = 75), most of which involved the thoracic aorta, brainstem and cervical spinal cord. The greatest potential to reduce the death rate amongst motorcyclists lies with accident prevention/injury reduction measures, rather than through improved treatment of injuries. Efforts to try to alter driving behaviour and to improve the design of vehicles and helmets need to continue.

Abbreviated Injury Scale↗
PubMed1999

Metabolism of pamaqueside, a cholesterol absorption inhibitor, in Long-Evans rat: effect of bile duct cannulation on absorption.

The metabolism of pamaqueside, a cholesterol absorption inhibitor, was studied in the bile duct cannulated and non-cannulated rat after an oral dose (100 mg/kg) and an i.v. dose (6 mg/kg) of [14C]pamaqueside. Faeces was the major route of excretion in all rat. Only 0.1% of the radioactivity was recovered in the urine of the non-cannulated rat. In contrast, approximately 17% of the total dose was recovered in the bile and urine in the bile duct cannulated rat. Following an i.v. dose, an almost equal percentage of radioactivity was excreted in the bile and urine of the bile duct cannulated rat. 3. The aglycone (M1) was the major metabolite in rat and was present in greater amounts in the faeces of the bile duct cannulated rat. The structural elucidation of metabolites in the bile and urine indicated that M1 was metabolized oxidatively via a novel ring opening, and the oxidative metabolites further underwent sulphate conjugation. The oxidative ring opening of pamaqueside (the cellobioside ring intact) was also observed following an i.v. dose to rat suggesting that oxidative ring opening was the major route of metabolism of saponins, at least in rat. The study demonstrated that the absorption and metabolism of pamaqueside was altered by surgical cannulation of rat.

Animals↗
PubMed1999

Patients' attitudes to medical students in the accident and emergency department.

The objective of this study was to assess patients' attitudes towards medical students in the accident and emergency department. Patients attending a university department of accident and emergency were given a questionnaire asking about their attitudes to medical students. Ninety-three per cent of the patients would not object to being seen and examined by a medical student in the accident and emergency department. No patients reported feeling pressurized to accept this proposal. It is concluded that most patients attending the emergency department had favourable attitudes towards medical students.

Adult↗
PubMed1999

Dropped hallux after the intramedullary nailing of tibial fractures.

We made a prospective study of 208 patients with tibial fractures treated by reamed intramedullary nailing. Of these, 11 (5.3%) developed dysfunction of the peroneal nerve with no evidence of a compartment syndrome. The patients with this complication were significantly younger (mean age 25.6 years) and most had closed fractures of the forced-varus type with relatively minor soft-tissue damage. The fibula was intact in three, fractured in the distal or middle third in seven, with only one fracture in the proximal third. Eight of the 11 patients showed a 'dropped hallux' syndrome, with weakness of extensor hallucis longus and numbness in the first web space, but no clinical involvement of extensor digitorum longus or tibialis anterior. This was confirmed by nerve-conduction studies in three of the eight patients. There was good recovery of muscle function within three to four months in all cases, but after one year three patients still had some residual tightness of extensor hallucis longus, and two some numbness in the first web space. No patient required further treatment.

Adolescent↗
PubMed1999

On-farm quality assurance programs: a survey of producer and industry leader opinions.

To assess interest in implementing a California dairy quality assurance program, practices and opinions of dairy producers and industry leaders were surveyed by a mailed questionnaire and by focus groups. The majority of the 55 participants in the focus group were dairy producers; processor marketing executives, extension dairy advisors, packinghouse executives, and dairy veterinarians were represented. The consensus among the focus groups was that a quality assurance program should be voluntary, be managed by creameries, and confer an economic advantage to participants. Focus group members listed chemical and microbial food safety (in both meat and milk), environmental health, and animal welfare as issues that should be addressed. Of the 1440 questionnaires mailed with producers' milk checks, 413 were returned. Information was collected regarding opinions and practices pertaining to administration of drugs to animals, medical records and animal identification, culling practices, manure management, cow welfare, and feeding of animal protein. An overwhelming 99% of producers believed they were responsible for the safety of meat and milk leaving the farm. Sixty percent of producers said that they would consider joining a California-specific quality assurance program, whereas 9% indicated that they would not. Producers would be more likely to join if their processor believed it would impart a market advantage and if the program standards were controlled by producers.

Animals↗
PubMed1998

Changing teaching practices to promote achievement and bonding to school.

An intervention to modify teaching practices in grades five and six was evaluated. Results showed that higher levels of teacher implementation of the modified practices favorably influenced students' levels of classroom opportunity, involvement, reinforcement, and bonding to school. Levels of academic achievement were also increased. The importance of assessing implementation in theory-guided experimental studies is discussed.

Adolescent↗
PubMed1998

Donor-derived Plasmodium vivax infection following volunteer unrelated bone marrow transplantation.

A 14-year-old girl from the UK underwent volunteer unrelated donor bone marrow transplant (VUD BMT) for accelerated phase chronic myeloid leukaemia. On day +40 she became febrile, and peripheral blood smears demonstrated a 1% Plasmodium vivax parasitaemia. Although she had never been outside the UK, her male donor had documented Plasmodium vivax infection during a vacation in Papua New Guinea. Following appropriate treatment, he had been asymptomatic for 11 months before marrow harvesting. This is the first case report of malarial transmission by VUD BMT, and illustrates the potential problem of recrudescence of latent, dormant forms of Plasmodium vivax infection following transplantation into an immuno-compromised recipient. Even after appropriate therapy, malarial infection should be included in the differential diagnosis for all post-transplant febrile episodes.

Adolescent↗
PubMed1998

Incorporating palliative care into primary care education. National Consensus Conference on Medical Education for Care Near the End of Life.

The confluence of enhanced attention to primary care and palliative care education presents educators with an opportunity to improve both (as well as patient care) through integrated teaching. Improvements in palliative care education will have benefits for dying patients and their families, but will also extend to the care of many other primary care patients, including geriatric patients and those with chronic illnesses, who make up a large proportion of the adult primary care population. In addition, caring for the dying, and teaching others to carry out this task, can be an important vehicle for personal and professional growth and development for both students and their teachers.

Curriculum↗
PubMed1998

Severe cardiac dysrhythmia in patients using bromocriptine postpartum.

Used worldwide since 1980 for the prevention of breast engorgement in the puerperium, in 1994 bromocriptine mesylate was withdrawn from the American market as an agent suitable for ablactation. The relevant recommendation of the Food and Drug Administration rested on case reports that described severe vasospastic reactions among users of the drug. Some patients so affected suffered stroke, intracranial bleeding, cerebral edema, convulsions, myocardial infarction, and puerperal psychosis. More recently, it has been suggested that the side effects of the drug may also include circulatory collapse secondary to cardiac dysrhythmia. This report describes two additional cases in this category. The antepartum clinical evaluation of these women suggested that they were predisposed to arrhythmias.

Adult↗
PubMed1998

Cardiac troponins in patients with renal dysfunction.

Cardiac troponin T (cTnT) and cardiac troponin I (cTnI) were measured in 198 patients with renal dysfunction [132 men: median (range) age 66.1 (8.2-90.3) years]. cTnT was measured by two methods: ELISA and Enzymun (Boehringer Mannheim UK, Lewes, UK), both with a detection limit of 0.05 microgram/L in 179 and 78 patients, respectively. cTnI was measured in 80 patients by the OPUS plus and OPUS Magnum systems (Dade-Behring, Milton Keynes, UK) with a detection limit of 0.5 microgram/L. Patients were classified as having chronic renal impairment (CRI), chronic renal failure (CRF), acute renal failure including those with multiple organ failure on renal replacement therapy (ARF), and patients with chronic renal failure treated with haemodialysis (HD). Cardiac troponins were detectable in the serum of patients with renal dysfunction. cTnT was detectable in 113/179 (63.1%) and 33/78 (42.3%) by the ELISA and Enzymun methods respectively. cTnI was detectable in 17/80 (21.3%). cTnT (ELISA and Enzymun methods) and cTnI were detectable with increased frequency in the CRF, HD and ARF patient groups compared with the CRI group. Cardiac troponin concentrations did not correlate with serum creatine kinase (CK) activity, CK-MB, or urea or creatinine levels. Serial cardiac troponin measurements may be required to confirm or exclude a diagnosis of acute coronary syndromes in patients with renal dysfunction.

Acute Kidney Injury↗
PubMed1998

Avoidance of 20% carbon dioxide-enriched air with humans.

Four college students were exposed to a Sidman avoidance procedure to determine if an avoidance contingency involving 20% carbon dioxide-enriched air (CO2) would produce and maintain responding. In Phase 1, two conditions (contingent and noncontingent) were conducted each day. These conditions were distinguished by the presence or absence of a blue or green box on a computer screen. In the contingent condition, CO2 presentation were delivered every 3 s unless a subject pulled a plunger. Each plunger pull postponed CO2 presentations for 10 s. In the noncontingent condition, CO2 presentations occurred on the average of every 5 min independent of responding. Following stable responding in Phase 1, condition-correlated stimuli were reversed. In both conditions, plunger response rate was high during the contingent condition and low or zero during the noncontingent condition. Furthermore, subjects avoided most CO2 presentations. However, CO2 presentations did not increase verbal reports of fear. Overall, the results from the present study suggest that CO2 can be used effectively in basic studies of aversive control and in laboratory analogues of response patterns commonly referred to as anxiety.

Air↗
PubMed1998

Planning and implementing an anesthesia crisis resource management course for student nurse anesthetists.

Development of Anesthesia Crisis Resource Management (ACRM) skills is a highly desirable outcome of a nurse anesthesia educational program. Access to an ACRM course is limited by a variety of factors including cost, availability of a center, time constraints, and the lack of adequately prepared CRNA faculty. The authors describe a Nurse Anesthesia Program's planning and implementation of an ACRM course by using a high fidelity human simulator. Key supportive and logistical elements necessary to implement an ACRM course are described. The authors address administrative concerns, faculty preparation needs, and explain the process of course design. Strengths of the course and problems encountered during the implementation of the experience are described. Feedback from participating students, faculty perceptions, and lessons learned from the experience are shared.

Clinical Competence↗
PubMed1998

Anesthesia for an achondroplastic dwarf with bilateral vocal cord granuloma: use of a Xomed Hunsaker Mon-Jet ventilation tube.

Technological advances have greatly improved the management of the patient undergoing microlaryngeal surgery. The use of a laser, high frequency jet ventilation (HFJV), total intravenous anesthetic techniques (TIVA), and specially designed endotracheal tubes (Xomed Hunsaker Mon-Jet ventilation tube [Xomed Surgical Products, Jacksonville, FL]) are recognized as cutting edge approaches to the management of these cases. The use of high technology adjuncts requires considerable skill and knowledge from the perspective of the anesthesia provider. This case report describes an approach to anesthetic management for a patient with a history of achondroplastic dwarfism having laser excision of bilateral vocal cord granulomas. Further increasing the complexity of the case was the surgical use of an autogenous tissue glue, which required a period of 'airway silence' during the application process.

Achondroplasia↗
PubMed1998

Exercise-induced rhabdomyolysis.

We describe the case of a previously well 55-year-old man who presented to the accident and emergency department with marked swelling of both forearms 6 days after being pulled at speed on a 'fun ride' by a speedboat whilst holding on to a rubber dinghy. Immediately after the event he had marked weakness of both arms lasting 2 days and this was followed by swelling of his forearms. The patient had also noticed a darkening of his urine during this period. On examination there was marked pitting oedema of both forearms. Neurovascular examination of both arms was normal. Laboratory investigations revealed a grossly elevated serum creatinine kinase at 4969 IU/l, with normal urea and electrolyte levels. Urine dipstick testing was also normal at the time of presentation. The patient was discharged home and made an uneventful recovery. We describe the pathophysiology of exercise-induced rhabdomyolysis and discuss its clinical presentation and management.

Arm↗
PubMed1998

Information technology in accident and emergency departments.

The aim of this study was to assess the availability and use of information technology in accident and emergency departments (A&E) in the UK. A postal questionnaire was sent to every general A&E department in the UK which sees more than 25,000 new attendances/year (n = 217). Responses were obtained from 159 (73.3%) departments, of which 129 (81.1%) were computerized. Computer data was used for administration in 96.9%, for audit in 79.1% and for research in only 41.1%. Most used several sources of toxicology information, but telephone advice from the poisons information bureau was the main source. Of the hospitals, 74.2% offered courses in computer technology to their staff. The availability of information technology varies widely between departments. If the most is to be made of available technology, staff training must be more widely available and more actively promoted.

Computer User Training↗
PubMed1997

Successful second bone marrow transplant for Fanconi's anaemia following escalation of conditioning.

Allogeneic bone marrow transplantation represents the treatment of choice for severe bone marrow failure in patients with Fanconi's anaemia (FA). In view of the increased sensitivity to alkylating agents documented in this condition, much attention has focused on reducing the conditioning chemotherapy. We present a 13-year-old girl in whom sibling allogeneic BMT after conditioning with low-dose cyclophosphamide only resulted in graft rejection. However, a second transplant using the same donor proved successful following a more intensive conditioning regimen. This case demonstrates the phenotypic variability of FA, and highlights the need for tailoring the conditioning regimen for a given patient.

Adolescent↗