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Biomedical subjects

P Daly

Publications and source records attributed to P Daly.

67 records · Page 4Linked to original sources
PubMed1985

Lack of reflex increase in myocardial sympathetic tone after captopril: potential antianginal effect.

Many vasodilators have been tried as antianginal agents, but the reflex increase in sympathetic tone produced by these drugs necessitate their use with caution in patients with angina. In the first part of this study, captopril was given to 14 patients with angina and systolic arterial pressures of greater than 120 mm Hg. Over the short term, captopril decreased arterial blood pressure (from 110 +/- 18 to 98 +/- 18 mm Hg, p less than .01) without increasing heart rate (75 +/- 15 vs 74 +/- 15 beats/min), arterial concentrations of epinephrine (0.38 +/- 0.28 vs 0.34 +/- 0.25 nM) or norepinephrine (2.7 +/- 2.1 vs 2.8 +/- 2.1 nM), or transmyocardial norepinephrine balance (216 +/- 254 vs 146 +/- 170 p mol/min). Captopril decreased average myocardial oxygen consumption (9.7 +/- 4.1 to 8.2 +/- 2.7 ml/min, p less than .01). Given over the long term (mean 5.5 months), captopril decreased the severity of angina from NYHA classification 3.0 +/- 0.8 to 1.6 +/- 0.8. In the second part of this study, captopril was given in a prospective, randomized, double-blind, placebo-controlled study to 21 patients with stable exercise-induced angina and systolic arterial pressures greater than 120 mm Hg. Captopril increased exercise time (309 +/- 137 vs 374 +/- 142 sec, p less than .05) without changing anginal threshold (rate-pressure product 17.0 +/- 6.0 vs 17.1 +/- 5.6 X 10(-3)). We conclude that captopril decreases mean arterial pressure without causing a reflex increase in myocardial sympathetic tone.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

Acute effects of captopril on the coronary circulation of patients with hypertension and angina.

Patients with hypertension have a high incidence of coronary artery disease. Captopril, the angiotensin-converting enzyme inhibitor, was given to eight patients with hypertension and coronary artery disease; it decreased mean arterial pressure from 121 to 103 mm Hg (p less than 0.01) but had no effect on heart rate. The rate-pressure product decreased from 12.5 to 11.4 X 10(3) (p less than 0.01). The change in coronary blood flow (90 to 80 ml per minute) and myocardial oxygen consumption (965 to 852 ml per minute) tended to parallel the decrease in the rate-pressure product. Captopril did not change global myocardial lactate (20 to 34 percent) or oxygen (9.6 to 10.0 volume percent) extraction. Hence, captopril decreases the rate-pressure product and tends to decrease myocardial oxygen consumption without causing global myocardial metabolic deterioration.

Aged↗
PubMed1982

Postural response of the head to bite opening in adult males.

The postural position of the head is a resultant of muscular interactions and reactions, influenced by gravity and functional demands. In order to investigate possible postural adaptation of the head to an altered functional status, a standard degree of jaw opening was produced by mechanical means in the mouths of thirty young males. There was an extension of the head associated with the jaw separation. In the majority of cases, a recovery to approximately the original posture resulted within 1 hour after removal of the bite-opening device.

Adaptation, Physiological↗
PubMed1982

Localization of Ca2+ + Mg2+-ATPase of the sarcoplasmic reticulum in adult rat papillary muscle.

Localization of the Ca2+ + Mg2+-ATPase of the sarcoplasmic reticulum in rat papillary muscle was determined by indirect immunofluorescence and immunoferritin labeling of cryostat and ultracryotomy sections, respectively. The Ca2+ + Mg2+-ATPase was found to be rather uniformly distributed in the free sarcoplasmic reticulum membrane but to be absent from both peripheral and interior junctional sarcoplasmic reticulum membrane, transverse tubules, sarcolemma, and mitochondria. This suggests that the Ca2+ + Mg2+-ATPase of the sarcoplasmic reticulum is antigenically unrelated to the Ca2+ + Mg2+-ATPase of the sarcolemma. These results are in agreement with the idea that the sites of interior and peripheral coupling between sarcoplasmic reticulum membrane and transverse tubules and between sarcoplasmic reticulum and sarcolemmal membranes play the same functional role in the excitation-contraction coupling in cardiac muscle.

Animals↗
PubMedDate not supplied

Management of patients undergoing splenectomy in an Irish teaching hospital: impact of guidelines.

INTRODUCTION: Overwhelming post-splenectomy infection (OPSI) has a 50-70% mortality rate and carries a lifetime risk for the asplenic patient. Specific British guidelines have been developed to reduce its incidence. AIMS: To determine whether British guidelines were being followed in our own institution and what impact they had on overwhelming post-splenectomy infection. METHODS: Retrospective chart review of 100 splenectomies performed by Department of Surgery, Beaumont Hospital from January 1990 to January 2000. RESULTS: Twenty per cent of patients were discharged without any recommended vaccinations. Prophylactic antibiotics were not prescribed in 53% of patients. Just 12% of charts document a verbal explanation of the complications and management of asplenia to the patient. Overall septic mortality was 12%, of whom 8% died in hospital and 4% after discharge. CONCLUSION: Management of the asplenic patient has improved but is far from complete. A central register of asplenic patients and national asplenic guidelines should be established in Ireland to ensure optimum patient care.

Adolescent↗
PubMedDate not supplied

High dose chemotherapy and stem cell support for poor risk and recurrent nonseminomatous germ cell cancer: initial experience with sequential therapy.

BACKGROUND: Approximately 20% of patients with germ cell tumours do not respond fully to standard therapy, or relapse after treatment. The prognosis of these patients is poor with conventional chemotherapy. Preliminary data suggest that they may have a higher durable response rate with high dose chemotherapy and peripheral blood stem cell support. AIMS: To treat a group of testicular cancer patients, either with relapsed disease or with poor prognostic features initially, with high dose chemotherapy and stem cell support, and evaluate their outcome. METHODS: Five patients with testicular cancer were treated with high dose chemotherapy and stem cell support. Of these, four underwent this treatment as salvage therapy and one patient with poor prognostic features was treated as primary treatment. RESULTS: At an average follow-up of 18 months, four patients remain free of disease while one patient has developed relapse. CONCLUSION: This report provides further support for high dose chemotherapy in this setting although randomised, controlled trials are essential to clarify its use.

Adult↗
PubMedDate not supplied

An outbreak of mumps among young adults in Vancouver, British Columbia, associated with 'rave' parties.

UNLABELLED: In early 1997 an unexpectedly high number of cases of mumps was reported in Vancouver, British Columbia. METHODS: A case control study was conducted to address four objectives: 1) Describe the outbreak and the population at risk, 2) examine the impact of mumps on this population, 3) identify personal risk factors for infection, and 4) test the hypothesis that social gatherings, 'rave' parties in particular, were a risk factor in this outbreak. RESULTS: Mumps infection was associated with: attending a rave party [OR = 17; 95% CI: 2.7-710], residing in Vancouver [OR = 3.7; 95% CI: 1.4-10], and contact with a person with mumps [OR = 13; 95% CI: 2-552], during the 'exposure' period. Vaccine effectiveness, ascertained by self-reported immunization status, was 80% [95% CI: 29%-96%]. CONCLUSIONS: Attendance at rave parties was associated with mumps infection during this outbreak. Many persons aged 17-40 may remain susceptible to mumps; in BC these persons are eligible for one dose of MMR and should be encouraged to be vaccinated.

Adolescent↗
PubMedDate not supplied

Legibility of doctor's signatures: novel approaches to improving an age-old problem.

UNLABELLED: In today's medico-legal environment, the importance of identification of the authors of notes in patient medical charts cannot be overemphasized. We evaluated three different techniques of signing patient notes, over a one month period, in order to determine which technique was the most effective in identifying the author of the note. Surgical NCHDs in our hospital were divided into three groups. Group 1 was asked to sign the notes as they normally would. Group 2 was asked to print their name in block capitals after their signature and Group 3 was given pens with a personal self inking stamp to be used in addition to signing the notes. The number of signatures in all the charts, compliance with the assigned technique and the legibility of signatures were calculated. RESULTS: in Group 1, all NCHDs signed their name when writing notes (100% compliance), however the NCHD's signature was identified only 37% of the time. In Groups 2 (who signed in block capitals) and Group 3 (who used the pen with personalised stamp) the author was identifiable 100% of the time when the respective signing method was used. Using the pen with personalised self inking stamp was significantly more popular (77% compliance) compared to signing in block capitals (46% compliance). In conclusion the pen, with personalised self inking stamp, provides a fast and effective means to clarify signatures of NCHD's documentation, which is not only important in a day to day patient management, but is essential from a medico-legal stand point.

Handwriting↗
PubMedDate not supplied

Evaluation of the promotional materials used during the measles mass immunization campaign in Ontario and British Columbia.

OBJECTIVE: To evaluate the promotional materials used during measles mass immunization campaign. DESIGN: A telephone survey was conducted among parents of targeted children in Ontario and British Columbia (BC). RESULTS: The leaflet distributed at school was considered to be the most useful source of information for 79% and 69% of the parents of school-aged children in Ontario and BC, respectively. Newspaper articles (27%) and information obtained through public health nurses (24%) were the most appreciated sources of information for the parents of preschoolers only. There was a notable increase in the proportion of parents who considered measles immunization important as well as those who had concerns about measles immunization at the time of the interview compared with the period before the mass campaign. CONCLUSION: The leaflet distributed at school (for parents of school-aged children) and newspaper articles and information obtained from public health nurses (for the parents of preschoolers only) were found to be the most useful sources of information.

Attitude to Health↗