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Biomedical subjects

M J Hennessy

Publications and source records attributed to M J Hennessy.

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

Transient ischaemic attacks: evaluation and management.

Transient ischaemic attacks (TIAs) are temporary focal cerebral or retinal deficits that resolve within 24 hours. Attention should be given to the tempo and localisation of the clinical syndrome, as multiple and hemispheric TIAs are associated with the greatest incidence of early stroke. Evaluation of TIAs depends on the clinical symptoms, physical examination and investigations. Attention should be given to clinical evidence of generalised atherosclerotic disease, as death due to the complications of ischaemic heart disease is the commonest outcome in patients with TIA. Early attention should focus on risk factor modification, with emphasis on the treatment of hypertension and smoking cessation. Antiplatelet therapy should be instituted. Aspirin is the first-line treatment but, if not tolerated, clopidogrel is effective in preventing vascular complications. Anticoagulants are generally reserved for patients with atrial fibrillation and are associated with a significant reduction of stroke risk. The use of statins is becoming more widespread, with emerging evidence of their efficacy in reducing stroke risk. The risk of stroke is greatest in the weeks following TIA and patients should be referred for carotid duplex ultrasonography. Carotid endarterectomy for symptomatic internal carotid artery high grade stenosis virtually abolishes stroke risk in that vascular territory over subsequent years. TIAs should be regarded as an emergency requiring early diagnosis and prompt referral.

Atrial Fibrillation↗
PubMed1999

A study of mortality after temporal lobe epilepsy surgery.

OBJECTIVE: To determine early and late mortality in a cohort of 305 consecutive patients who had temporal lobe epilepsy (TLE) surgery over a 20-year period. METHODS: Survival status, cause of death, and postoperative clinical details of those who died were ascertained in a cohort of 305 patients who had TLE surgery. Mortality was related to postoperative seizure status, operative pathology, and side of resection. RESULTS: The survival status of 299 patients was established. Twenty deaths occurred. Mortality was 1 per 136 person-years, with a standardized mortality ratio (SMR) of 4.5 (95% confidence interval [CI], 3.2 to 6.6). Six deaths were sudden and unexpected (SUDEP). The SUDEP rate was 1 per 455 person-years. The overall death and SUDEP rates were lower than those reported for similar patient populations with chronic epilepsy. Mortality in patients who had right-sided resections for mesial temporal sclerosis (MTS) remained considerably elevated with a mortality rate of 1 per 54 person-years, an SMR of 32.0 (95% CI, 24.7 to 40.5), and a SUDEP rate of 1 per 134 person-years. These patients had significantly lower seizure remission rates than left-sided patients, but the excess mortality was not simply explained by those patients whose partial seizures were uninfluenced by surgery. Patients who died had more severe or convulsive seizures despite an overall reduction in seizure frequency. CONCLUSIONS: The present findings confirm previous reports that TLE surgery lowers but does not normalize the overall mortality associated with chronic epilepsy. In patients with right-sided MTS, however, the postoperative mortality has remained similar to other groups with medically intractable seizures.

Adolescent↗
PubMed1999

Coexistence of temporal lobe and idiopathic generalized epilepsies.

OBJECTIVE: To assess the interrelation of idiopathic generalized epilepsy (IGE) and temporal lobe epilepsy (TLE) when they coexist in the same patient. METHODS: The authors reviewed the electroclinical features of 350 consecutive patients who had temporal resection between 1975 and 1997 at the Maudsley and King's College Hospitals, London. RESULTS: Two patients had the unusual combination of TLE and IGE (0.57%). In the first, the clinical onset of juvenile myoclonic epilepsy followed the surgical resolution of his partial seizures but had been heralded for at least 5 years by subclinical spontaneous and photically induced generalized spike-wave discharges. In the second, TLE and juvenile absence epilepsy had a long parallel course before surgery. After surgery he had no further partial seizures. CONCLUSION: These cases suggest that when an idiopathic absence or myoclonic syndrome manifests in a patient with symptomatic TLE, the phenotype may not be a merged syndrome. Rather, the two conditions can retain their inherent electroclinical profile, responsiveness to treatment, and prognosis.

Adult↗
PubMed1997

Osteopenia in Rett syndrome.

Bone density analysis, dietary intake, and anthropometrics were compared in 20 subjects with Rett syndrome (RS), 25 normal control subjects, and 11 girls with cerebral palsy. Bone mineral density, bone mineral content, and spine (bone) mineral density were significantly reduced in the RS group. When weight and age were kept constant, the bone density was still reduced in the patients with RS. Subjects with RS are at risk for osteoporosis.

Adolescent↗
PubMed1996

Infection of a total knee arthroplasty by Candida parapsilosis. A case report of successful treatment by joint reimplantation with a literature review.

This article describes a case of total knee infection by Candida parapsilosis treated by joint reimplantation. Surgical treatment consisted of resection arthroplasty with wound stablization by external fixation. Antibiotic treatment consisted of 6 weeks of intravenous amphotericin B and 7 weeks of oral 5-fluorocytosine begun at the time of resection arthroplasty. Cultures at reimplantation were negative. Reimplanted components were all cemented with perioperative cefazolin antibiotic. No further antifungal treatment was necessary.

Amphotericin B↗
PubMed1993

A comparison of the amnesic effects of lorazepam in alcoholics and non-alcoholics.

The transient amnesia produced by lorazepam has been suggested to have much in common with the permanent amnesia associated with organic brain damage. The present study examined the amnesia associated with chronic alcoholism and acute lorazepam administration and hypothesised that because alcoholics have prior impairment, their response to lorazepam induced amnesia would differ from that of non-alcoholics. Memory functioning was tested in 20 chronic alcoholics and 20 non-alcoholic controls both before and after administration of either 2 mg lorazepam or a placebo. It was found that, although there were some discrepancies on some of the memory tests, both long term alcohol abuse and acute lorazepam administration impaired visual and verbal episodic memory but did not impair semantic or short-term memory (STM).

Adult↗
PubMed1991

Comparison of the amnesic effects of midazolam and diazepam.

Thirty patients undergoing gastroscopy received intravenous premedication with either midazolam or diazepam in a randomised double blind study. Mean dosages were similar for the midazolam (6.13 mg) and diazepam (6.4 mg) groups. Neuropsychological testing pre- and post-medication comprised the Wechsler Memory Scale, Complex Figure Test, Word Association Test, and a Tactile Memory Test. There was a significant impairment on post-medication tests requiring delayed recall of verbal, visual and tactile stimuli. Midazolam produced significantly greater anterograde amnesia than diazepam at similar mean dosages. With the exception of Digit Span and Associate Learning, cognitive tasks which do not require delayed recall were not affected. It is concluded that the amnesic deficit is discrete and not secondary to sedative effects.

Amnesia↗
PubMed1990

Design of a 13C (1H) RF probe for monitoring the in vivo metabolism of [1-13C]glucose in primate brain.

The design of an RF probe suitable for obtaining proton-decoupled 13C spectra from a subhuman primate brain is described. Two orthogonal saddle coils, one tuned to the resonant frequency of 13C and the other to the resonant frequency of 1H, were used to monitor the in vivo metabolism of [1-13C]glucose in rhesus monkey brain at 2.1 T. Difference spectra showed the appearance of 13C-enriched glutamate and glutamine 30 to 40 min after a bolus injection of [1-13C]glucose.

Animals↗
PubMed1988

The orthopedic management of Rett syndrome.

Musculoskeletal deformity sufficiently severe to require orthopedic surgery is a significant problem in Rett syndrome. Preliminary results from the study of 16 patients suggest deformity in nearly all patients. Eight patients in stage III and seven patients in stage IV showed clinical evidence of scoliosis. Radiographic studies confirmed a structural curve in nine of ten patients studied. Heel cord tightening was seen in nine of 16 patients. Hip instability was identified as an area of potential concern in the Rett patient.

Adolescent↗
PubMed1984

The development of gait: a study in African children ages one to five.

The purpose of this study was to describe quantitatively the gait development of a group of African children to determine how the pattern changes would relate to growth and maturation. This work applies an established technology of gait analysis to field conditions. 65 children of the Gusii tribe from southwestern Kenya were selected for study with an age range from 13 months to 69 months. Gait evaluation was performed by film recording free-cadence walking of the children. Growth in stature and age both influence the gait patterns. Developmental patterns of alteration in velocity, stride length, and cadence quantitatively measured in this study closely parallel observations made on children in laboratory settings by other workers.

Body Height↗