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Biomedical subjects

M Kelleher

Publications and source records attributed to M Kelleher.

50 records · Page 3Linked to original sources
PubMed1985

Effects of converting enzyme inhibition on blood pressure, plasma renin activity (PRA) and plasma aldosterone in hypertensive diabetics compared to patients with essential hypertension.

Hypertension with diabetes mellitus has been associated with suppression of the renin-angiotensin-aldosterone system. We have studied the effects of the converting enzyme inhibitor, captopril, on blood pressure, plasma renin activity (PRA) and plasma aldosterone in 10 stable hypertensive diabetic subjects and 10 age-matched patients with essential hypertension. There was no clinical evidence of complication in the diabetic subjects and their diabetic treatment remained unchanged throughout the study. Mean captopril doses used were similar in both groups. In the diabetics and the essential hypertensives, treatment resulted in a significant and similar decrease in blood pressure. Pre-treatment basal and stimulated PRA and the change of PRA with captopril were also similar. Pre-treatment stimulated plasma aldosterone and the response of aldosterone to postural stress was significantly lower in the diabetic group, suggesting an impaired adrenal responsiveness to stress. Despite this, our findings indicate that the hypotensive action of captopril is at least as effective in hypertension associated with otherwise uncomplicated diabetes mellitus as in essential hypertension.

Aldosterone↗
PubMed1976

Reliability of psychiatric assessment in older patients.

A number of the causes of psychiatric diagnostic disagreement are discussed in this paper. The use of the Geriatric Mental Status interview to achieve diagnostic reliability is examined in three studies in which U.S.--U.K. Cross-National Project psychiatrists rated and diagnosed thirty-two British and twenty-one American patients. There were no systematic differences between U.S. and U.K. team members in their diagnoses; and agreement on six principal diagnostic categories was achieved in about three-quarters of the cases. The reliability fo the ratings of psychopathology that formed the basis for the diagnoses was satisfactory and is reported in detail.

Aged↗
PubMed1976

The geriatric mental status interview (GMS).

The Geriatric Mental Status interview (GMS) is a semi-structured interview technique for assessing psychopathology in elderly patients. It is administered by a trained interviewer in a session of less than one hour. Between 100 and 200 question are asked and almost 500 items are rated. Twenty-one factor scores have been identified and the reliability of the ratings has been established. The interview is acceptable to the patient and is useful for making diagnostic distinctions and evaluation progress

Aged↗
PubMed1976

Assessment of the older psychiatric inpatient.

Instruments, whether used in psychometrics or in other fields, must have a practical application if they are to repay the care spent in their use and development. The Geriatric Mental State schedule was developed in response to the need to answer the question whether functional psychiatric disorders were being misdiagnosed as organic brain syndrome and, if so, to what extent this influenced treatment and outcome. In the hospitals studied it was found that American psychiatrists were more likely to diagnose organic brain syndrome than British psychiatrists. Although elderly patients with affective disorder were less likely to be given American patients was as good, if not better, than the outcome in the British patients.

Affective Symptoms↗
PubMedDate not supplied

Carers' views on services for the elderly mentally ill.

BACKGROUND: Recent health policy emphasises the involvement of the consumer and carer in health and social care issues. Demographic projections predict a rise in the number of elderly people in Ireland and the number of elderly people with a mental illness. The identification of gaps in service provision should result in appropriate planning for this group in the future. OBJECTIVE: The aim of the study was to assess carers' opinions of services for the elderly mentally ill in the Limerick area. METHOD: A questionnaire was sent to the carers of patients referred to the Psychiatry of Old Age service. Information was gathered on satisfaction with existing services for the elderly. Carers were also asked to identify which services they felt they needed. RESULTS: The overall response rate was 51%, but the response rate for individual items varied. Both formal and informal services for the elderly are underused. The need for long-term care places was highlighted and carers wished for more information and emotional support. CONCLUSION: This study highlighted the aspects of the service that carers value, which should help guide future service development.

Adult↗
PubMedDate not supplied

Assessment of the older person in the community.

The Cross-National Geriatric Community study is being conducted by the United States-United Kingdom Cross-National Project. Semi-structured interviews have been completed with over 850 community residents over the age of sixty-five years randomly selected from the metropolitan regions of New York and London. The assessment techniques described in this section may be of interest not only to other research workers conducting geriatric community surveys but also to health professionals concerned with the clinical examination of the older ambulatory patient and the early detection and appropriate referral of the need for health and social services.

Aged↗
PubMedDate not supplied

Increasing resistance to ciprofloxacin among isolates of Neisseria gonorrhoea in Dublin.

Neisseria gonorrhoeae cases are increasing in Ireland. Ciprofloxacin is often used as first line treatment for this infection in STI clinics. A retrospective study to analyze resistance in two Dublin clinics was undertaken. Cases were defined as patients from whom an isolate of N. gonorrhoea was recovered. All cases from two clinics between January 1997 and June 2003 were included. Antimicrobial resistance data was correlated with sex and sexuality. One thousand one hundred and eighty laboratory-confirmed cases were identified. Eighty seven percent were male. Sixty nine percent were MSM. Twenty seven percent of isolates demonstrated reduced susceptibility to penicillin and 6% to ciprofloxacin. Isolates with reduced susceptibility to ciprofloxacin increased year on year from 3.8% in 1997 to 15% in 2003. Prevalence of isolates of N. gonorrhoea with reduced susceptibility to ciprofloxacin has exceeded 10% in these clinics since 2002. In concordance with international guidelines, ceftriaxone became the treatment of choice for gonorrhoea in July 2003.

Ambulatory Care Facilities↗