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Biomedical subjects

M Morgan

Publications and source records attributed to M Morgan.

At least 253 records · Page 14Linked to original sources
PubMed1990

The structure of problem behaviours among Irish adolescents.

Problem behaviour theory proposes that adolescent substance use and other problem behaviours comprise a single dimension reflecting a general underlying tendency towards deviance. This general deviance hypothesis was tested with survey data obtained from 2731 adolescents from Dublin, Ireland. A series of hierarchical maximum likelihood factor analyses indicated that three specific factors were necessary to account for the covariation among problem behaviour measures. These factors corresponded to substance use (drinking, smoking, marijuana use, and other drug use), relatively minor problem behaviours (swearing, lying), and relatively serious problem behaviours (stealing, vandalism). Contrary to the general deviance hypothesis, a second order factor representing general deviance accounted for only 14% of the variance in substance use, on the average, as opposed to 74% of the variance in minor and serious problem behaviours. These findings thus indicate that substance use among these Irish adolescents is relatively independent of a general tendency toward deviance. They also suggest that the general deviance hypothesis, as it usually is applied, may be culturally specific and relevant only for adolescents from the United States and similar cultural contexts.

Adolescent↗
PubMed1990

An evaluation of the Level 1 blood warmer series.

The Level 1 blood warmer series comprises three infusion sets and two blood warmers of different power outputs. All systems were found to be extremely efficient, with the larger 500 series capable of warming the equivalent of 80 units of blood an hour almost to body temperature.

Blood Transfusion↗
PubMed1990

Propofol for long-term sedation in the intensive care unit. A comparison with papaveretum and midazolam.

Thirty-seven patients with a wide range of illnesses were studied during mechanical ventilation of the lungs in an intensive care unit. Fifteen were sedated with a continuous propofol infusion, with analgesia provided by bolus doses of papaveretum. Twelve received a continuous infusion of papaveretum, supplemented by bolus doses of midazolam. The level of sedation was assessed every four hours and measurements were made of haemodynamic and respiratory variables. Levels of sedation were generally satisfactory in both groups. Six patients who received propofol required the use of muscle relaxants, because of their strong respiratory drives, to achieve synchronisation with the ventilator. There was no significant difference in respiratory or haemodynamic variables between the groups, but several patients required inotropic support because of their disease. There was no evidence of inhibition of adrenal steroidogenesis in the propofol group. Propofol can be a useful sedative agent in the intensive care unit, but sedative regimens should be tailored to individual patient requirements.

Adolescent↗
PubMed1990

Comparison of intramuscular ketorolac and morphine in pain control after laparotomy.

Ketorolac, a prostaglandin synthetase-inhibiting analgesic, was compared with morphine for relief of pain after laparotomy for gynaecological surgery. Eighty patients were studied; they were given either ketorolac 30 mg intramuscularly followed by 10 mg 4-hourly as required, or morphine 10 mg intramuscularly 4-hourly as required, administered in a double-blind, randomised fashion. Pain scores (verbal and visual analogue) were recorded at baseline and assessed at 30 and 60 minutes and then hourly for 6 hours. Pain relief was measured at the same times. Pain and pain-relief scores were further assessed on the evening of day 1 and at 24 hours. Pain scores were similar in the two groups but pain-relief scores were better in the morphine group. A considerable number of patients suffered postoperative nausea and vomiting but there was no difference between the groups. One patient in the ketorolac group had unexplained hypotension. It is concluded that ketorolac can provide effective postoperative analgesia.

Adult↗
PubMed1990

Cytomegalovirus retinopathy and the acquired immune deficiency syndrome: results of treatment with ganciclovir.

Cytomegalovirus (CMV) infection of the retina is the commonest potentially blinding ocular manifestation of AIDS. Recently the acyclic nucleoside dihydroxypropoxymethyl guanine (DHPG, ganciclovir) has become available to treat sight-threatening CMV retinopathy. This paper reports the clinical features and results of ganciclovir therapy in 48 patients seen over a four-year period. Seven patients were excluded from the study due to inadequate follow-up, leaving 41 patients as the study group. All patients responded clinically to this therapy. Patients were treated initially with high-dose ganciclovir (10 mg/kg/day) and then continued on lower dose treatment (5 mg/kg/day) indefinitely. Significant bone marrow toxicity developed in 12 patients (29.3%) requiring temporary cessation of therapy. Patients treated with ganciclovir retained vision and had increased survival times when compared to untreated patients. A poor visual outcome occurred when there was involvement of the macula or optic nerve head at presentation or when there was an interruption of ganciclovir therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Variations in lengths of stay and rates of day case surgery: implications for the efficiency of surgical management.

Variability in lengths of acute hospital stay and rates of day case surgery is shown to be a continuing pattern which occurs both between and within countries. A model of the determinants of health service activity is presented and the contribution of different factors to the observed variations is assessed. Differences in methods of funding health services are identified as a major determinant of the between country variations, while the within country variations largely reflect the influence of local differences in facilities and services and the organisation of care at a hospital level, as well as the independent effects of differences in clinical practice style. The main rationale for advocating a reduction in length of stay and increased use of day surgery is to increase efficiency by reducing costs per case while maintaining the quality of care. These criteria of costs, clinical outcomes and patient acceptability are examined in relation to day case surgery for an intermediate surgical procedure (inguinal hernia repair) and short stay surgery for cholecystectomy. The precise cost savings are shown to depend on the methods of costing, assumptions made and facilities employed, while factors influencing the outcomes achieved include the criteria of patient selection, the surgical techniques employed, and the adequacy of preoperative communication. Barriers to the more widespread adoption of short stay and day case surgery include practical and organisational constraints on clinical practice at a hospital level, lack of awareness among clinicians as to how far their practices differ from current norms, and clinical barriers raised by surgeons who do not see short stay policies as advantageous. Mechanisms to promote changes in clinical practice styles include independent professional audit, peer review, and involvement of clinicians in budgeting and resource allocation. Assessing quality requires that attention is given to patient acceptability and satisfaction as well as to the monitoring of clinical outcomes.

Ambulatory Surgical Procedures↗
PubMed1990

Single application treatment of human papillomavirus infection of the cervix and vagina with trichloroacetic acid: a randomized trial.

Treatment of human papillomavirus (HPV) infection of the lower genital tract with trichloroacetic acid was evaluated in a randomized, double-blind fashion at the Hospital of the University of Pennsylvania. Thirty-four patients who had colposcopic and histologic evidence of HPV without dysplasia were entered into the study and randomly placed into either a treatment or placebo group. The treatment group received a single topical application of 50% trichloroacetic acid to the vagina and cervix on day 1. The placebo group was treated in the same manner using saline. The patients were evaluated at 4 and 16 weeks post-treatment for cytologic and histologic evidence of HPV. No differences between the treatment and placebo groups were found. Only one of 16 patients in the treatment group and three of 18 in the placebo group were free of HPV infection at the 4- and 16-week evaluations. Our data suggest that treatment of subclinical HPV infection with trichloroacetic acid is ineffective at this concentration.

Adolescent↗
PubMed1989

Transport and accumulation of 2-deoxy-D-glucose in wild-type and hexokinase-deficient cultured Chinese-hamster ovary (CHO) cells.

Hexokinase-deficient mutants and wild-type Chinese-hamster ovary cells have been used to investigate the role of hexokinase in uptake and accumulation of 2-D-deoxyglucose (2-dGlc). The evidence for a specific sugar transport system in both types of cells is that there is similar saturable phloretin-sensitive uptake of 2-dGlc and 3-O-methyl-D-glucose (3-OMG) in both types of cell. In wild-type cells, 2-dGlc is accumulated to a tissue:medium ratio of 10- and in the mutant only 3-fold; 3-OMG is not accumulated by either mutant or wild-type cells. The evidence that hexokinase affects the membrane transport process is that the rate of exit of free 2-dGlc from wild-type cells is 5-fold less than from mutant cells, whereas there is no difference in the rate of loss of 3-OMG between mutant and wild-type cells.

3-O-Methylglucose↗
PubMed1989

Stage II papillary clear cell adenocarcinoma of the vagina during observation in a diethylstilbestrol-exposed daughter.

Although many cases of Diethylstilbestrol (DES)-associated clear cell adenocarcinoma (CCA) of the cervix and vagina have occurred, few have arisen in patients whose initial gynecologic evaluation has revealed only nonmalignant DES-related changes. We report a case of a 32-year-old lady who developed a stage II CCA after 8 years of thorough gynecologic examinations. This case substantiates the need for long-term gynecologic assessment in DES daughters.

Adenocarcinoma, Papillary↗
PubMed1989

Using self-generated identification codes to match questionnaires in panel studies of adolescent substance use.

The usefulness of self-generated codes for anonymously linking data in panel studies of adolescent substance use was investigated in a study of Irish post-primary students and sample bias resulting from this procedure considered. A seven element code exactly matched 71% of questionnaires over one month when school absences were taken into account. Allowing codes to differ on one element to compensate for respondent errors increased matching success to 88% without resulting in appreciable mismatching. Unmatched compared with exactly matched respondents tended to be male, lower SES, have more spending money, and were less closely bonded to school and religion. They also were more involved in smoking, drinking, and drug use and had more favorable beliefs toward these behaviors. Off-one respondents generally were intermediate on these measures. However, the differences were small and the characteristics of the combined matched respondents closely resembled those of the total sample. When predicting substance use, the regression coefficients were quite similar for the matched and unmatched groups and the total sample. The data thus provide evidence for the usefulness of self-generated codes in panel and longitudinal studies of adolescents when anonymity and confidentiality are of concern.

Adolescent↗
PubMed1989

Hormonal and metabolic responses to cholecystectomy: comparison of extradural somatostatin and diamorphine.

We have studied the metabolic and hormonal responses to surgery, and the pain scores and analgesic requirements in 24 patients undergoing cholecystectomy, allocated randomly to three groups to receive either general anaesthesia alone, or general anaesthesia with extradural diamorphine 0.1 mg kg-1, or general anaesthesia with extradural somatostatin to a total dose of somatostatin 3 mg. The only significant effect of extradural diamorphine was a decrease in the glucose response to surgery. Somatostatin 3 mg by the extradural route caused a significant increase in the concentration of circulating somatostatin which resulted in a significant decrease in plasma growth hormone and insulin after 60 min of surgery, together with an increase in plasma glycerol concentration. Patients in the diamorphine group required significantly less i.v. analgesia in the postoperative period than the other two groups. Intraoperative somatostatin failed to provide any postoperative analgesia.

Adult↗
PubMed1989

Health locus of control and health beliefs in relation to adolescent smoking.

Results from a survey of 10,579 schoolchildren aged 11-16 years indicated various relationships between age, smoking behaviour, health locus of control beliefs, expressed concern with different consequences of illness and beliefs in the efficacy of different strategies for staying healthy. In particular, smokers, compared with non-smokers, showed less belief in the importance of 'powerful others' or 'personal control' but more belief in the importance of 'chance' as an influence on health outcomes. With regard to consequences of illness, smokers cared more than non-smokers about not being allowed to see friends, but less about getting behind in school or being a nuisance to others; they were also less convinced of the benefits of preventive health behaviours such as eating good food and taking exercise. Implications for health education approaches are discussed.

Adolescent↗