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Biomedical subjects

J Ryan

Publications and source records attributed to J Ryan.

At least 109 records · Page 6Linked to original sources
PubMed1996

Managing patients with deliberate self harm admitted to an accident and emergency observation ward.

OBJECTIVE: To review the case records of patients admitted to an accident and emergency (A&E) observation ward following deliberate self harm. METHODS: The hospital notes of 568 patients admitted during one year following episodes of deliberate self harm were reviewed. The study was retrospective. RESULTS: The majority of these patients had taken an overdose and were between 18 and 35 years of age. Most patients were admitted to the observation ward after midnight or in the evening and were subsequently managed by an A&E based deliberate self harm team. Only 20% of admissions required evaluation by a psychiatrist. Most patients were discharged the next day without further follow up. CONCLUSIONS: The use of a specialised A&E based team and an A&E observation ward is appropriate for the management of many deliberate self harm patients.

Adolescent↗
PubMed1996

Suicide rate following attendance at an accident and emergency department with deliberate self harm.

OBJECTIVE: To determine the risk of suicide in patients attending an accident and emergency (A&E) department with deliberate self harm. METHODS: Information was obtained on suicides and open verdicts from the coroner's office and cross checked with computerised records in the A&E department. RESULTS: There was a trend to suicide among younger socially isolated males and older females. CONCLUSIONS: There is a significant association between suicide and a previous attendance at A&E with deliberate self harm. Appropriate assessment of these patients is an efficient way of managing self harm.

Adult↗
PubMed1996

"Fast tracking" patients with a proximal femoral fracture.

OBJECTIVE: To assess the management of elderly patients presenting to the accident and emergency (A&E) department with a proximal femoral fracture. METHODS: A retrospective audit carried out on 30 patients with proximal femoral fracture showed an unacceptably long waiting time in the A&E department. A new "fast track" system for managing these patients, involving the use of a flow chart for expediting admission, was devised. A prospective study of 100 patients > 60 years of age with proximal femoral fracture admitted by fast track system was then carried out. RESULTS: Implementation of the fast track system resulted in earlier admission to the ward (median time to admission 2.5 h v 4.5 h in the retrospective audit, P < 0.001). Eighteen patients were not admitted by fast track during the study period, in some cases because of inconclusive diagnosis or because there was no identifiable orthopaedic bed; mean admission time for this group was 4 h 8 min. CONCLUSIONS: The fast track system was of benefit to all involved, including the patient, A&E staff, ward staff, and orthopaedic personnel.

Aged↗
PubMed1996

The expression of stem cell factor and its receptor, c-kit in human endometrium and placental tissues during pregnancy.

Stem cell factor (SCF) and its receptor Kit regulate the proliferation and survival of early hematopoietic cell types as well as germ cells and melanocytes. As SCF augments the effects of several hematopoietic growth factors that are produced in reproductive tissues during pregnancy and also plays an important role in cell migration, proliferation, and survival, we studied the expression and localization of this receptor/ligand in human endometrial and placental tissues. Kit was detected by Western blot analysis in early decidual and placental tissues (8-19 weeks gestation) and in term placenta. Immunohistochemistry localized Kit mainly in trophoblast and to a lesser extent in scattered cells in the placental villous core and decidual stroma. Ribonuclease protection assay showed that SCF messenger ribonucleic acid (mRNA) expression increased 3-fold in decidua from early pregnancy compared to proliferative and secretory endometrium (P < 0.05). Placental tissues expressed 4- to 8-fold higher levels of SCF mRNA compared to decidus (P < 0.05). Isolated placental villous core expressed 7-fold higher levels of SCF mRNA than did trophoblast (P < 0.05). Thus, SCF and its receptor Kit are expressed in human endometrium and placental tissues during pregnancy, and the pattern of receptor/ligand expression suggests that endometrial and placental villous core SCF may have a paracrine effect on trophoblast through the receptor Kit.

Base Sequence↗
PubMed1996

Prevalence of adverse reactions in nuclear medicine. Pharmacopeia Committee of the Society of Nuclear Medicine.

UNLABELLED: This investigation sought to determine the prevalence of adverse reactions to radiopharmaceuticals and to nonradioactive drugs used in interventional nuclear medicine. We also tabulated all adverse reactions reported to manufacturers of radiopharmaceuticals commercially available in the United States. METHODS: A prospective 5-yr study was performed of 18 collaborating institutions using a questionnaire which enumerated monthly the number of procedures used and adverse reactions noted. An algorithm to determine the level of etiologic probability of an adverse reaction from an administered radiopharmaceutical was developed. We reviewed all available literature on adverse reactions in nuclear medicine. RESULTS: During this period, 783,525 radiopharmaceutical and 67,835 nonradioactive drug administrations were analyzed. Ten of the 18 adverse reactions to radiopharmaceuticals were rashes. No patient experiencing an adverse reaction to a radiopharmaceutical required hospitalization or had significant sequelae. Reproducibility of the adverse reactions algorithm was validated by independent evaluation of 30 adverse reaction reports from the U.S. Pharmacopeia-Society of Nuclear Medicine adverse reaction reporting system. All adverse reactions to 49 commercially available radiopharmaceuticals were tabulated and referenced. CONCLUSION: Radiopharmaceuticals have an excellent safety record. An algorithm to evaluate putative radiopharmaceutical reactions is highly reproducible.

Adverse Drug Reaction Reporting Systems↗
PubMed1995

Use of posterior night splints in the treatment of plantar fasciitis.

Plantar fasciitis is a frequent cause of heel pain in athletes, as well as in persons who are not involved in sports. Stretching, strengthening, correction of training errors and orthotics are essential components in any treatment program. For patients who do not respond to these interventions, posterior night splints can obviate the need for invasive therapies such as corticosteroid injections and surgery.

Decision Trees↗
PubMed1995

Photodynamic laser cyclodestruction with chloroaluminum sulfonated phthalocyanine (CASPc) or Photofrin (PII) vs. Nd:YAG laser cyclodestruction in a pigmented rabbit model.

BACKGROUND AND OBJECTIVE: To investigate Photofrin (PII) and CASPc for photodynamic therapy (PDT) of the ciliary body in rabbits. STUDY DESIGN/MATERIALS AND METHODS: PII (10 mg/kg) or CASPc (1 mg/kg) was given by ear vein. Pharmacokinetics were studied in frozen sections by fluorescence microscopy (CCD camera based low light detection system with digital image processing) at 1 and 24 h (8 rabbits; 16 eyes). Laser light was delivered (argon pumped dye laser; 630 and 675 nm; 8 rabbits; 16 eyes) by contact fiberoptic. To compensate for iris attenuation, irradiance was 125 mW/cm2 (20, 40, 80, or 160 J/cm2). Controls (4 rabbits; 8 eyes) received laser light without photochemicals (OD) and for comparison, continuous wave Nd:YAG laser by fiberoptic (0.8-1.2J; OS). RESULTS: Localization studies showed intravascular distribution with some selective ciliary body distribution at 24 h (PII > CASPc). Rabbits treated with PII or CASPc exhibited variable amounts of gross ciliary body edema, infarction, and necrosis by 24-48 h. This response was not seen in PDT control tissues; damage was seen in the iris and ciliary body, with partial vacuolization of the pigment epithelium. CONCLUSION: PDT may offer a more selective approach to ciliary body destruction. A small but significant thermal effect was seen during PDT from melanin photon uptake with damage to iris and ciliary body. Thermal damage and potential interaction with ocular visual pigments may limit use of these photochemicals and wavelengths for PDT of the ciliary body.

Animals↗
PubMed1995

Fertilization rates using intracytoplasmic sperm injection are greater than subzonal insemination but are dependent on prior treatment of sperm.

OBJECTIVE: To determine a suitable method of sperm preparation for use in micromanipulation. To compare the fertilization rates of sibling oocytes inseminated by intracytoplasmic sperm injection (ICSI) and subzonal insemination (SUZI). DESIGN: Two methods of gamete micromanipulation to overcome male factor infertility were compared. Within this study, three trials were conducted to determine the most suitable method of sperm preparation. This method then was used to complete the study. SETTING: Procedures were performed in a teaching hospital research environment. PATIENTS: Ninety-six patients were recruited for this study, undergoing 99 stimulation cycles. INTERVENTIONS: Sibling oocytes were inseminated by subzonal sperm or intracytoplasmic injection. MAIN OUTCOME MEASURES: Fertilization, zygote development, and pregnancy rates. RESULTS: In the absence of manipulative pretreatment of sperm (trial 1), there was no difference in normal fertilization rates between ICSI and SUZI (19% and 25%, respectively). In the second trial there again was no sperm pretreatment for SUZI but, for ICSI, a polyvinylpyrrolidone (PVP) solution was used to reduce sperm velocity and the sperm tails were incised before injection. The fertilization rates were significantly different between ICSI (44%) and SUZI (17%). In the third trial, PVP was added to the sperm used for both types of insemination and the sperm tails also were incised for the ICSI insemination. Fertilization was again significantly different (16% for SUZI and 44% for ICSI). The trial 2 method of sperm preparation then was used to complete the study (trial 4) and confirmed the results of trial 2 (21% for SUZI and 42% for ICSI). The results suggest that ICSI can give improved fertilization compared with SUZI provided the sperm are treated before injection. No significant differences were found in the development rates of zygotes suitable for transfer or cryopreservation between the two micromanipulation methods.

Cytoplasm↗
PubMed1995

Stability of vocational interests among the intellectually gifted from adolescence to adulthood: a 15-year longitudinal study.

A sample of 162 intellectually gifted adolescents (top 1%) were administered the Strong-Campbell Interest Inventory at age 13. Fifteen years later, they were administered the Strong again. This study evaluated the intra- and interindividual temporal stability of the 6 RIASEC (Realistic, Investigative, Artistic, Social, Enterprising, Conventional) themes and the Strong's 23 Basic Interest Scales. Over the 15-year test-retest interval, RIASEC's median interindividual correlation for the 6 themes was .46; the median of all 162 intraindividual correlations was .57. Configural analyses of the most dominant theme at age 13 revealed that this theme was significantly more likely than chance to be either dominant or adjacent to the dominant theme at age 28--following RIASEC's hexagonal structure. For intellectually gifted individuals, it appears to be possible to forecast salient features of their adult RIASEC profile by assessing their vocational interests during early adolescence, but some RIASEC themes seem more stable than others.

Adolescent↗
PubMed1995

Saliva and serum as diagnostic media for antibody to hepatitis A virus in adults and in individuals who have received an inactivated hepatitis A vaccine.

Saliva was evaluated as a diagnostic fluid for screening individuals for evidence of previous hepatitis A virus (HAV) infection and for evidence of seroconversion after vaccination with inactivated hepatitis A vaccine. A new and simple saliva collection method and an assay for detection of HAV antibody were used; the assay used an antibody capture format. There was complete concordance between the results of saliva-based assays and those of serum-based assays, both of which were used for determining previous natural HAV exposure. However, for vaccine recipients, 100% concordance for saliva-based and serum-based assays occurred only at serum titers of > 9,000 mIU/mL, which were determined with use of the modified HAVAB assay. Saliva provides adequate sensitivity and specificity for determining naturally acquired HAV infection, although it is not useful in clinical trials for determining seroconversion after HAV vaccination.

Adult↗
PubMed1995

A statewide institute to deliver professional development programs to school health personnel in Massachusetts.

Schoolchildren suffer from health problems ranging from chronic medical and developmental problems to new morbidities related to drugs, violence, and sexual behavior. To help administrators, teachers, and health personnel meet the new challenges in schools, nursing educators from the University of Massachusetts and Simmons College developed the UMass-Simmons School Health Institute. The Institute delivers a series of professional development programs in all regions of the commonwealth to: 1) devise innovative strategies to remove health barriers to learning and to promote the health of children and adolescents, and 2) enhance the design, implementation, integration, and management of comprehensive school health programs, including those mandated and regulated by the Commonwealth of Massachusetts. This article describes a statewide model to prepare school health personnel for delivery of comprehensive school health services.

Adolescent↗
PubMed1995

HIV malingering in the accident and emergency department.

This paper reports a number of cases of patients attending an accident and emergency (A&E) department claiming to be HIV positive when they have been tested negative and are known to be negative by other departments in the hospital. The reasons for these patients claims are not always apparent. These patients may place an inappropriate workload on an already busy department. We caution doctors working in A&E departments to be vigilant when dealing with patients who claim to be HIV positive when there are no clinical or laboratory findings to substantiate the claim and we recommend liaison between relevant departments within a hospital and the patient's general practitioner (GP) when dealing with these patients.

Adult↗
PubMed1995

Using a metal detector to locate a swallowed ring pull.

A 48-year-old man accidently swallowed the ring pull from a soft drink can. He complained of pain in his chest. Chest radiographs were normal. A metal detector emitted a strong response when passed across the front of his chest. Oesophagoscopy was carried out and the ring pull was successfully removed. We recommend the wider use of metal detectors by accident and emergency (A&E) department staff particularly when dealing with patients who have ingested metals of low radiodensity.

Aluminum↗