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M O'Leary

Publications and source records attributed to M O'Leary.

82 records · Page 5Linked to original sources
PubMedDate not supplied

Adherence to disease-modifying therapy in multiple sclerosis: Part I.

Multiple sclerosis (MS) is a chronic, debilitating disease for which there is no cure. However, the recent introduction of injectable immunomodulating agents has made it possible to reduce the frequency of relapsing episodes and to possibly slow its progression. The use of these agents is recommended by the National MS Society, however, their true potential cannot be realized if patients do not accept them and healthcare professionals do not promote them. Because MS is unpredictable, and treatments can produce side effects, ensuring adherence to the recommended therapy is a complex and challenging issue. A better understanding of the obstacles to adherence, and the identification of possible solutions, should be of value to nurses, who have numerous opportunities to encourage patients to initiate and continue therapy. This article, which is in two parts, describes the particular problems of treatment adherence, and proposes that the transtheoretical model of behavior change can be useful in achieving treatment goals in MS and in other chronic disease states. This model is based upon the concept that a patient's "readiness for change" is crucial, and that attempts at intervention should be sensitive to the patient's changing conditions and state of mind. Nurses who work with patients with MS and other chronic diseases can apply the model to help their patients accept and adhere to the demands of ongoing treatment.

Chronic Disease↗
PubMedDate not supplied

Adherence to disease-modifying therapy in multiple sclerosis: Part II.

Multiple sclerosis (MS) is a chronic, debilitating disease for which there is no cure; however, the recent introduction of injectable immunomodulating agents has reduced the rate of relapsing episodes and possibly slowed the progression of the disease. These disease-modifying agents are recommended by the National MS Society, but their true potential cannot be realized if patients do not accept them and healthcare professionals do not promote them. Since MS has an unpredictable course, and treatments can produce side effects, adherence to the recommended therapy is a complex and challenging issue. Improved understanding of the obstacles to adherence and the identification of possible solutions should be of value to nurses, who have numerous opportunities to encourage patients to initiate and continue therapy. Part I of this article, published in the September/October 2001 issue of Rehabilitation Nursing, described the particular problems of treatment adherence in MS. Part II proposes that the transtheoretical model of behavior change can be a useful tool in achieving both patient acceptance and treatment goals. This model is founded upon the concept that readiness for change is crucial, and that attempts at intervention should be sensitive to the patients' changing conditions and states of mind.

Humans↗
PubMedDate not supplied

Guidelines for the management of hepatitis C in general practice: a semi-qualitative interview survey of GPs' views regarding content and implementation.

BACKGROUND: Hepatitis C is a common infection among people who attend GPs for methadone maintenance treatment. AIM: To determine the views of GPs towards clinical guidelines for the management of hepatitis C among current or former injecting drug users in advance of their implementation. METHODS: A purposive sample of 14 GPs (10% of the total prescribing methadone at the time the guidelines were developed) was invited to review a pre-publication draft of the guidelines and interviewed regarding content, presentation, perceived barriers to implementation and suggested interventions to facilitate effective implementation of the guidelines. RESULTS: GPs indicated the guidelines were useful but suggested aspects of presentation should be clarified. Organisational issues were identified as the principal barriers to effective implementation, with the provision of additional nursing support the principal intervention suggested to facilitate implementation. CONCLUSIONS: Interviewing intended recipients may be an important step in ensuring clinical practice guidelines are effectively implemented.

Attitude of Health Personnel↗
PubMedDate not supplied

One course versus two courses of antithymocyte globulin for the treatment of severe aplastic anemia in children.

PURPOSE: The aim of the therapeutic trials was to optimize the treatment of severe aplastic anemia (SAA) and moderate aplastic anemia in children who lack a suitable bone marrow donor, using immunosuppressive therapy in the most effective combination and dose. PATIENTS AND METHODS: Two sequential therapeutic trials for the treatment of severe and moderate aplastic anemia in children were conducted by 10 institutions. The treatment protocols included antithymocyte globulin (ATG), prednisone, and cyclosporine A (CSA); patients entered on the first protocol, 0190 (ATG X 2), were given two courses of ATG, and those enrolled on the second protocol, 0190B (ATG X 1), were given only one course of ATG. Ten patients were evaluable on ATG X 2. All patients had SAA; three had hepatitis-induced severe aplastic anemia (HI-SAA). Twelve patients were evaluable on ATG X 1; all had SAA, one of whom had HI-SAA. RESULTS: Seven of 10 patients on ATG X 2 responded, and eight of 12 patients treated on ATG X 1 responded. CONCLUSION: Treatment with immunosuppressive therapy using ATG, CSA, and prednisone was very well tolerated. The response rates in both protocols were similar, and results compare favorably with those of previous therapeutic trials, suggesting that a second course of ATG is not necessary.

Adolescent↗
PubMedDate not supplied

Tonsillectomy--cold dissection vs. hot dissection: a prospective study.

Throughout the years, investigators and surgeons have developed new techniques for tonsillectomy aiming to lessen the postoperative morbidity and complications of tonsillectomy. It is generally accepted that the ideal method should decrease operative time, blood loss, postoperative haemorrhage and morbidity. To compare the technique and post-operative morbidity of two different tonsillectomy methods: cold dissection and bipolar electrodissection. A prospective study including a total of 545 children (Age: 3-16 yrs) undergoing tonsillectomy at The Children's University Hospital in Dublin, Ireland, from January 2003 to December 2003. The incidence of primary, secondary haemorrhage and postoperative pain was compared between both techniques. The overall rate of haemorrhage was 3.6% (20 patients) this included primary haemorrhage in 0.3% (2 patients) and secondary haemorrhage in 3.3% (18 patents). Primary haemorrhage occurred only in the electrodissection technique. As regards to secondary haemorrhage it was higher in the electrodissection technique 2.3% (12 patients) compared to 1% (6 patients) of the cold dissection technique. Patients rated pain to be more severe in the electrodissection technique compared to the cold dissection technique. Cold dissection tonsillectomy technique is still considered to be a safe and effective method with less posoperative morbidity complications as evidenced from our study.

Adolescent↗
PubMedDate not supplied

ENU-induced in vitro neoplastic transformation of rat mammary epithelial cells.

Normal mammary epithelial cells, originating from female Sprague-Dawley rats, were grown in Dulbecco's Modified Eagles Medium containing 25% horse serum and hormone supplements. Once established as an epithelial cell culture, the cells were treated with N-ethyl-N-nitrosourea (ENU) in various doses (25-500 ug/ml) to study the process of in vitro mammary epithelial cell neoplastic transformation. The ENU-treatment of primary mammary epithelial cell culture resulted in a sequence of phenotypic changes, termed stages I-V. The rat mammary epithelial cells, after a period of approximately 30 days post-ENU exposure, showed a marked proliferation of morphologically altered cells which formed multi-layered colonies. Subsequently, these cells acquired the capacity to form colonies in soft agar and eventually produced a high yield of palpable tumors when inoculated into newborn female isologous hosts or female athymic nude mice. The immediate effect of ENU on these cells was monitored by measurement of cellular DNA content, unscheduled DNA synthesis, cell proliferation and chromosomal aberrations. The ENU effect on cell proliferation and DNA synthesis was dose dependent; doses greater than 100 ug/ml reduced the cell number and DNA synthesis. Cytofluorometric histograms of non-ENU-treated rat mammary epithelial cells showed a near diploid population of cells. The ENU exposed cells subsequently became hyperdiploid (24-72 hours after ENU) and then regained their near diploid pattern at 120 hours after ENU exposure. The ENU-treated cells also showed a second peak of cells with DNA content in the tetraploid and octaploid range at 24-72 hours after ENU exposure. Single chromatid breaks, isochromatid breaks, chromosomal exchanges, multiple chromosomal breaks and double minutes were among the chromosomal aberrations seen in ENU-treated cells. Most of the chromosomal aberrations peaked at 6 hours post-ENU exposure. The ENU-induced model of in vitro meplastic transformation of rat mammary epithelium as described in this communication appears to provide a good model for the systematic study of the early critical cellular events prerequisite to this carcinogenic process.

Animals↗
PubMedDate not supplied

Characteristics of normal rat mammary epithelial cells and N-ethyl-N-nitrosourea-induced mammary adenocarcinoma cells grown in culture.

The characteristics of normal mammary epithelial cells derived from Lewis and Sprague-Dawley rats and N-Ethyl-N-Nitrosourea (ENU)-induced mammary gland adenocarcinoma cells derived from Sprague-Dawley (CD) and Fisher (CDF) rats and grown in culture were compared. After collagenase treatment, the rat mammary epithelial cell aggregates were placed in a hormone-supplemented medium. The normal mammary epithelial cells (NE) attached to the surface of the dish within 50 hours, whereas the mammary adenocarcinoma cells (MA) attached within 24 hours and grew as cell multilayers. After the colonies of NE and MA cells became confluent, the culture system entered a steady state in which the cells from the upper layer were shed into the medium. The rate of proliferation and squame detachment in confluent cultures was increased by the presence of epidermal growth factor (EGF). Rhodanile blue staining and transmission electron microscopy showed that the shed cells were partially keratinized. In addition, cultured MA (but not normal) cells were able to grow in soft agar and form tumors when inoculated into appropriate hosts. The opposite was true in each case for the mammary adenocarcinoma cells. Karyotypes of normal and neoplastic rat epithelial cells revealed a hypodiploid modal number of chromosomes.

Adenocarcinoma↗
PubMedDate not supplied

Lectin binding sites in normal rat ovary and ENU-induced Sertoli cell tumors of the ovaries.

A panel of seven fluorescein isothiocyanate (FITC) labeled lectins were used to study the distribution of specific binding sites in histologic sections of rat ovaries and ENU-induced Sertoli cell tumors (SCT) of the ovaries. Ten SCT and 5 normal ovaries derived from Berlin Druckey IV (BD-IV) rats were examined by FITC lectins. The tissues examined were fixed in 10% buffered formalin and embedded in paraffin blocks. In normal ovaries, lectin binding sites were more uniform, ordered and consistent than in ovarian SCT where some lectin staining appeared disorderly inconsistent and varied with the degree of tumor differentiation. Two lectins, (from Triticum vulgaris [WGA] and Arachis hypogaea [PNA], uniformly stained the apices of the ovarian surface epithelium and subadjacent tunica vaginalis. The ovarian stroma, oocyte nucleus, follicular and granulosa-theca cells, stained uniformly strong with succinated Con A (from Con-canavalia ensiformis). Three lectins (from Triticum vulgaris, Ulex europeaus [UEA-1] and Arachis hypogeae) accentuated the basal lamina in the SCT and normal ovarian follicles. The zona pellucida was strongly labeled with lectin derived from Triticum vulgaris, Ricinus communis (RCA) and moderately with lectin derived from Arachis hypogeae. The oviduct ampulla exhibited an intracytoplasmic strong vesicular labeling with lectins derived from Triticum vulgare, Dolichos biflorus (DBA), Glycin max (Soybean-SBA) and Arachis hypogeae. The SCT cells showed an inconsistent, irregular labeling pattern with lectins derived from Ulex europaeus, Dolichos biflorus and Soybean mostly as a coarse granular cytoplasmic labeling. Neuraminidase digestion enhanced lectin staining with PNA in normal ovary and in SCT. This data provided at list of lectin markers for distinct components of the BD-IV rat ovary and ovarian SCT.

Animals↗