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Biomedical subjects

P Finnegan

Publications and source records attributed to P Finnegan.

35 records · Page 2Linked to original sources
PubMed1977

Evaluation of pressure-derived indices of right ventricular contractility.

Myocardial function was studied in 23 subjects using indices of contractility based on the right ventricular pressure pulse. Pressure-velocity curves were plotted during early systole and contractile element velocity was derived. The pressure-velocity curves varied in shape and curves with single, linear descending slopes occurred in only 7 subjects. The other pressure-velocity curves were either biphasic or hyperbolic in form. The derivation of Vmax and Vpm and beat-to-beat analysis of these indices was therefore difficult. The effects of a number of physiological variables, e.g. right ventricular enddiastolic pressure, respiration and the infusion of isoprenaline were examined. It was demonstrated that Vmax and Vpm were not independent of the loading conditions of the ventricle. The infusion of isoprenaline changed the shape of the pressure-velocity curves and increased the problems of analysis. The theoretical and practical difficulties involved in this type of analysis are discussed.

Blood Flow Velocity↗
PubMed1976

Results of total correction of the tetralogy of Fallot. Long-term haemodynamic evaluation at rest and during exercise.

Postoperative haemodynamic evaluation was performed on 15 patients 7 to 14 years (mean, 11 years) after total intracardiac repair of Fallot's tetralogy. The average age of the patients at the time of postoperative catheterization was 20 years (range 12 to 29) and they were all asymptomatic. Before operation 11 patients were severely cyanosed and disabled and 4 had mild cyanosis with anoxic spells. The cardiac output and right heart pressures were measured at rest and after 5 minutes of submaximal exercise on a bicycle ergometer. It was shown that the degree of residual obstruction of the pulmonary outflow tract was slight and that the right ventricular/pulmonary arterial systolic gradient (RV/PA gradient) exceeded 20 mmHg (2-6 kPa) at rest in only 3 patients. The mean cardiac index at rest was 5-4 l min-1 m-2 which increased to 8-3 l min-1 m-2 during exercise. The response of the cardiac output during exercise was either normal or supranormal in 14 of the 15 patients. In the remaining patient the response was marginally below the normal range. Pulmonary valvular regurgitation was present in 8 patients but there was no detectable difference in the cardiac function of these patients compared with patients with competent pulmonary valves. Six of the patients investigated had also had cardiac catheterizations performed 1 to 4 years after operation. The results of the present study show that remarkably little change has occurred in their haemodynamic status in the intervening years. Though these results are encouraging, further studies are required to determine the eventual outcome of the RV pressure and volume overload.

Adolescent↗
PubMed1975

Pulmonary sarcoidosis: A clinico-pathological study.

The light and electron microscopic changes in biopsy tissue from the lung of a 30-year-old housewife severeley incapacitated by diffuse pulmonary sarcoidosis with pulmonary hypertension are presented. The lung tissue was distorted by numerous granulomas in the interstitial tissues and within alveoli. Many pulmonary blood vessels including arteries were damaged by the granulomas. The ultrastructural features of the epithelioid cells were found to be distinctive and probably specific. The giant cells which accompanied the epithelioid cells contained two types of inclusion body: one appeared to be related to the Schaumann body but the nature and origin of the second type was not clear. Many of the granulomas were surrounded by avascular fibrous tissue which contained, in addition to mature fibroblasts, myofibroblasts and a primitive form of cell that appeared to be a fibroblast precursor. It was conjectured that the myofibroblasts, through their contractile powers, might increase the distortion of the lung architecture and thereby the patient's disability. The alveolar walls were thickened by a diffuse infiltrate of macrophages and epithelioid cells but there was no excess of collagen and elastic fibres. The evidence suggested that the epithelioid cells developed from macrophages. From the cellular nature of the diffuse infiltration of the alveolar walls and the absence of fibrosis it seemed that the disease was still at an early and active stage, a conclusion strengthened by the fact that treatment with corticosteroids led to marked and sustained clinical improvement.

Adult↗
PubMed1973

Long-term domiciliary oxygen in chronic bronchitis with pulmonary hypertension.

Five patients with chronic bronchitis and pulmonary hypertension were treated with oxygen in their homes for periods of between 6 and 24 months. Oxygen was supplied for 15 hours daily from cylinders or from an oxygen concentrator and few practical difficulties arose. After 23 to 59 weeks of treatment there were significant decreases in pulmonary arterial pressure and vascular resistance, and four of the five patients no longer had pulmonary hypertension at rest. Two of these patients had shown little response after three weeks of treatment. There was a reduction in the number of episodes of congestive cardiac failure compared with the corresponding period before treatment. Two of the patients improved enough to return to work. These results are encouraging enough to justify a controlled trial of the treatment in a large number of patients.

Adult↗
PubMed1972

Daily requirement of oxygen to reverse pulmonary hypertension in patients with chronic bronchitis.

We have shown previously in patients with chronic bronchitis that correction of the hypoxaemia by continuous administration of oxygen substantially reduced the pulmonary hypertension by reversal of structural changes in the pulmonary resistance vessels. We have now demonstrated that such improvements may occur with less than continuous oxygen. Treatment with oxygen for 18 hours daily significantly decreased pulmonary arterial pressure and pulmonary vascular resistance. Oxygen therapy for 15 hours a day also decreased pulmonary vascular resistance; such a regimen is practicable in the home, is consistent with a working day free from the constraints of an oxygen supply, and should reduce the number of episodes of congestive cardiac failure.

Adult↗
PubMedDate not supplied

Trends in viral meningitis hospitalisations and notifications in the North Eastern Health Board (1997 - 2001): a cause for concern?

This study aimed to compare trends in both hospital admissions and notifications of viral meningitis in the North Eastern Health Board (NEHB). Hospital admissions from 1997 to 2001, involving NEHB residents with an infectious disease diagnosis, were examined and viral meningitis cases were analyzed. During this period 265 NEHB residents were admitted to hospital with viral meningitis--an increase of 429% between 1997 and 2001 with the bulk of this increase during 2000 and 2001. A total of 1,234 bed days were taken up by this cohort and the mean length of stay was 4.5 days (95% CI 4.2 - 4.9). The number of viral meningitis notifications in the NEHB was 38 (ranging from 4 in 1997 to 11 in 2001). This number is much lower than expected given the corresponding number of hospital admissions for the same period. Thus, most cases were not notified which means that current surveillance systems under-estimate the disease burden of viral meningitis. Such under-reporting has implications for infectious disease policy in Ireland.

Adolescent↗
PubMedDate not supplied

Storage and handling of vaccines by family doctors.

The aim of this study is to see if vaccine storage and handling procedures used by family doctors in a health board region maintain vaccines at maximum potency. All 144 family doctors in the region were invited to be part of the study. Doctors were interviewed in their practice premises about procedures used in dealing with vaccines. Following the interview, practice fridges were examined and temperature recorded. Samples of oral polio were taken from 20 randomly selected fridges for potency testing. Cold chain monitors and freeze watch indicators were used to monitor batches of vaccine stored. Of the 144 doctors, 142 (98.6%) agreed to participate. Of these, 140 used 111 fridges to store vaccine, 2 doctors store vaccine at room temperature. Of the 111 fridges, 6 (5.4%) had the power supply safeguarded, 9 (8.1%) had thermometers, and 36 (32.4%) had vaccine only stored therein. During defrosting, the vaccine in 22 (19.8%) of the fridges was not adequately protected. Of the 138 doctors who use multi-dose vaccine vials, 133 (97.2%) keep them for further use at the end of a day/session, of whom 3 store them at room temperature. The temperature recorded in 42 (37.8%) fridges was outside the recommended range. Thirteen (28.2%) cold-chain monitors indicated vaccine exposed to more than 10 degrees C. Eighteen (90%) of the oral polio samples showed a reduction in total titre of live virus, however, none were below the minimum acceptable. This study indicates that vaccine potency could be seriously compromised due to breaks in the cold-chain and suggests the need for guidelines to be drawn up, implemented and monitored to ensure the integrity of immunisation schemes.

Adult↗