Search PubMed⌕ Search

Biomedical subjects

P Mahoney

Publications and source records attributed to P Mahoney.

At least 19 recordsLinked to original sources
PubMed1999

Prognostic significance of atrial fibrillation in patients at a tertiary medical center referred for heart transplantation because of severe heart failure.

Atrial fibrillation (AF) occurs frequently in advanced heart failure. The prognostic significance of AF remains controversial. To determine the relation of AF to survival in patients with advanced heart failure, 234 consecutive patients referred for heart transplantation evaluation from January 1993 to June 1996 were studied to determine the effect of AF on event-free survival (freedom from death, heart transplantation, or placement of a left ventricular assist device). Clinical characteristics of the study population included: age, 51 +/- 17 years; maximum exercise oxygen consumption, 14.2 +/- 5.3 ml/kg/min; left ventricular ejection fraction, 24 +/- 11%; pulmonary capillary wedge pressure, 23 +/- 9 mm Hg; and ischemic etiology, 52%. Medical therapy included: diuretics (86%), angiotensin-converting enzyme inhibitors (80%), digoxin (80%), and anticoagulation therapy (72%). Mean duration of follow-up was 1.1 +/- 1.0 years. Sixty-two patients (27.4%) had AF. One-year event-free survival of the study population was 48%. No difference in event-free survival between patients with and without AF was observed. Univariate predictors of decreased event-free survival included: (1) advanced New York Heart Association class; (2) higher pulmonary capillary wedge pressure; (3) lower cardiac index; (4) lower maximum exercise oxygen consumption; (5) use of inotropic therapy; and (6) greater pulmonary artery systolic pressure. By multivariate analysis, independent predictors of decreased event-free survival included advanced New York Heart Association class (p <0.002) and higher pulmonary capillary wedge pressure (p = 0.02). Thus, AF in patients with advanced heart failure is not associated with decreased event-free survival.

Adult↗
PubMed1999

Using research to establish protocols for practice: a statewide study of acute care agencies.

The purpose of the study was to examine research utilization practices relative to developing and revising practice protocols in acute care agencies in Delaware. Nurse leaders in 13 acute care agencies identified resource nurses most familiar with the development and revision of agency protocols. Thirty-two resource nurses from 11 agencies, representing critical care, emergency, general medical, general surgical, obstetric, and psychiatric nursing, were interviewed. Interviews were tape-recorded and transcribed. Examples of research-based protocols, defined as those supported by research citations, were obtained. The authors found that the majority of protocols submitted, although referenced, were not research-based. Most institutions used textbooks and standards to support nursing practice protocols. The authors concluded that nurses who are responsible for developing and revising agency protocols were not familiar with the use of research findings to guide the development or revision of protocols and were unsure what constituted the "use of research."

Acute Disease↗
PubMed1997

Excision of a locally invasive thymoma causing cranial vena caval syndrome in a dog.

A 9-year-old female Golden Retriever was examined because of inappetance, labored breathing, edema, and distension of the veins of the neck. Thoracic radiography revealed pleural effusion and a cranial mediastinal mass. Biopsy results obtained by use of fine-needle aspiration were consistent with thymoma. At surgery, the tumor was found to have invaded the cranial vena cava. Extra- and intravascular portions were removed without complications, and the dog's clinical signs resolved. To our knowledge, this is the first documented report of an invasive thymoma causing cranial vena caval syndrome that has been successfully treated in a dog. In this instance, the simplest surgical method, namely venotomy and tumor extraction using venous inflow occlusion, was successful, obviating the need for temporary or permanent vascular conduits or grafts. These findings indicate that there is potential for surgical correction of invasive thymoma with cranial vena caval syndrome in some animals, and the prognosis is not always poor.

Animals↗
PubMed1997

Laparoscopic cholecystojejunostomy: a technical application in unresectable biliary obstruction.

Laparoscopic cholecystojejunostomy was accomplished utilizing an endoscopic gastrointestinal stapler in 2 patients with biliary obstruction and jaundice secondary to inoperable pancreatic carcinoma. This technique was performed on patients judged to be poor candidates for an open resection, due to medical conditions and associated comorbidities. The actual operating time, taking into account delays not related to the operation or technique, was 45-60 min. Both patients experienced immediate significant overall clinical improvement with minimal operative sequelae. The first patient was eating and ready for discharge in 4 days, and the second was prepared for discharge in less than 24 h. This operative procedure offers the patient excellent palliation with many advantages over traditional open surgery.

Aged↗
PubMed1996

Battlefield trauma life support: its use in the resuscitation department of 32 Field Hospital during the Gulf War.

32 Field Hospital was one of two forward British field hospitals deployed during the 1990-1991 Gulf War in northern Saudi Arabia. We describe the use of Battlefield Trauma Life Support (BATLS), a military derivation of Advanced Trauma Life Support (ATLS) as used in the hospital's resuscitation department and discuss the application of ATLS principles in the military environment. Teaching BATLS to doctors, nurses, and combat medical technicians provided a common system for all department members to work toward. This proved to be an efficient system for horizontal casualty management by a trauma team of three people.

Hospitals, Military↗
PubMed1995

Comparison of the immediate, residual, and cumulative antibacterial effects of Novaderm R,* Novascrub R,* Betadine Surgical Scrub, Hibiclens, and liquid soap.

BACKGROUND: Triclosan (Irgasan), an antibacterial active against staphylococci and coliform bacteria, has been formulated for use as a handwash. There has been only one previous report of the use of the glove juice test to determine the immediate, residual, and cumulative effects of a 1% triclosan-based handwash product. There have been no previous studies on the use of 1% triclosan combined with povidone-iodine (PI) in a handwash product. METHODS: The glove juice technique was used to document and compare the immediate, 3-hour residual, and 5-day cumulative effects on the mean log10 bacterial counts of 1% triclosan-based handwash product and 1% triclosan with 5% PI. A standardized surgical handwashing technique was used before sample collection. These results and the identity and type of the aerobic bacteria cultured from the samples were compared with the results of standardized washing and glove juice sampling with 4% weight/volume chlorhexidine gluconate (CHG), 7.5% PI, and a nonantimicrobial liquid soap. RESULTS: All five tested products showed significant log10 reduction from baseline on day 1, hour 0 (p < 0.05). There was no significant difference between the mean log10 bacterial count when 7.5% PI, 4% CHG, and 1% triclosan with 5% PI were compared with each other immediately after washing (p > 0.05). There was a significant difference between 1% triclosan and the liquid soap when they were each compared with 4% CHG, 7.5% PI, and 1% triclosan with 5% PI. There was no statistically significant difference between the 1% triclosan product and the liquid soap (p > 0.20). All products were effective at reducing the immediate bacterial count from the baseline level. All formulations except the liquid soap showed significant cumulative effect (p < 0.05) after multiple washes, with no significant difference between the cumulative effects of the liquid soap and 1% triclosan (p > 0.05). Both products differed significantly (p < 0.05) from the CHG, PI, and triclosan with PI. CHG, PI, and triclosan with PI showed effects significantly different from each other (p < 0.05). CONCLUSIONS: Triclosan combined with PI resulted in the prevention of bacterial regrowth at 3 hours such as occurred when PI alone was used. Triclosan-containing products have a small cumulative effect, although not as great as that produced by CHG. The triclosan-based products did not appear to select for gram-negative bacterial overgrowth, although the study period may have been too short to detect such an effect.

Adolescent↗
PubMed1986

Growth and development following marrow transplantation for leukemia.

One hundred forty-two patients between the ages of 1 and 17 years who survived disease-free more than 1 year after marrow transplantation for hematologic malignancy had growth and development evaluations from one to 14 years posttransplant (median 4 years). Prior to transplant all children received multiagent chemotherapy and 55 also received central nervous system irradiation, but none had growth and development evaluations. Marrow transplant preparation included high-dose chemotherapy and total body irradiation (TBI) given as a single dose of 9.2 to 10.0 Gy (79 patients) or as fractionated doses of 2.0 to 2.25 Gy/d for six to seven days (63 patients). After transplant abnormal thyroid function was present in 39%. Stimulated 11-desoxycortisol levels were subnormal in 24% of patients evaluated. Growth hormone (GH) deficiency was present in 17 of 25 children who received previous cranial irradiation. Partial GH deficiency was present in 4 of 25 who received previous cranial irradiation and in 6 of 18 who had not received cranial irradiation. Height velocity was decreased in all patients. After transplant, height was significantly influenced by chronic graft-v-host disease and single-dose TBI. Sixty-eight percent had delayed development of secondary sexual characteristics. Gonadal failure occurred in nearly all who were postpubertal at transplant. While it is not possible to determine how many of these endocrine abnormalities occurred as a result of treatment administered prior to transplantation, these data do demonstrate that children who become long-term survivors after marrow transplantation for hematologic malignancy have endocrine abnormalities that adversely affect growth and development.

Adrenal Cortex↗
PubMed1977

Postoperative arterial hypoxaemia.

Postoperative arterial oxygen tension was measured in a group of patients. Unacceptably low levels were found in 32% of the patients and this hypoxaemia persisted in some cases for three days. The results enforce the principle that some patients whould be given prolonged oxygen therapy and this should cease only when blood gas analysis demonstrate the patients ability to maintain a safe PaO2 breathing air.

Humans↗
PubMed1977

Radiological lung volume in surgical patients.

Radiological total lung capacity (T.L.C.) was measured preoperatively and postoperatively in a group of patients. A decrease in T.L.C. postoperatively in patients who smoke was demonstrated. The use of radiological T.L.C. in the study of postoperative respiratory dysfunction is suggested.

Aged↗
PubMed1976

Pulmonary water content in critical illness.

Pulmonary extravascular water content was measured using a double indicator technique and results compared with chest radiography. It is concluded that careful chest radiography is an effective and simple technique for assessing the pulmonary extravascular water content.

Body Water↗
PubMed1976

Post-operative respiratory function: a ventilation-perfusion study.

Many studies have shown that after uncomplicated abdominal surgery arterial hypoxaemia frequently occurs because of regional underventilation in relation to perfusion. This paper produced evidence that shows a small increase in physiological dead space to tidal volume ratio following general anaesthesia for abdominal surgery. This increase is thought to be due to tachypnoea rather than alteration in pulmonary blood flow.

Abdomen↗
PubMed1975

Pulmonary oedema in chronic bronchitis - a haemodynamic study.

Right heart catheterization was performed in ten patients with pulmonary oedema. Mean wedge pressures in excess of 12 mmHg above the mid-axillary line were regarded as abnormal and indicating left heart failure. If the wedge pressure was less than 12 mmHg, and pulmonary congestion was present, frusemide was given. Brief descriptions of the ten cases are given.

Aged↗
PubMed1974

Australia antigen: detection and transmission in shellfish.

Australia antigen was found in clams contaminated by drainage of untreated sewage from a coastal hospital. In closed-system aquariums, the antigen was ingested by clams and transmitted to previously uninfected clams. In opensystem aquariums, the titer of Australia antigen decreased with time, suggesting viral concentration rather than replication.

Animals↗
PubMedDate not supplied

Choosing a health plan: what information will consumers use?

Employers and policymakers are looking for ways to encourage competition among health plans, thus lowering costs and improving quality. Employers hope to foster competition among health plans by creating standardized measures of quality that supplement the traditional benefits and cost information employees use to compare plans and make choices. This DataWatch examines employees' interest in standardized measures of plan performance. Results from a survey of Massachusetts state employees show that cost and benefit information receive high rankings, but certain plan performance information does not.

Adult↗