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Biomedical subjects

P McCarthy

Publications and source records attributed to P McCarthy.

At least 109 records · Page 6Linked to original sources
PubMed1985

Cytoprotective agents and ulcer relapse.

This study establishes that real differences between relapse rates exist, and confirmed previous observations by Pounder et al. that relapse rates influence clinical outcomes in ulcer populations. The results make it clear that the way in which a drug influences relapse is an important determinant of therapeutic efficiency, additional to the requirement for healing efficiency. Cytoprotective agents as a group appear to be associated with lower relapse rates than cimetidine. It is not known whether the differences are peculiar to cimetidine, specific to the blockade of H2-histamine receptors, or whether they relate to the process of inhibition of secretory processes generally. Clearly, further comparisons are needed; however, conventional clinical trials are not designed to provide the necessary information. For the healing of peptic ulcers, lower relapse rates appear to provide therapeutic advantage to members of the cytoprotective group when compared with agents acting via anti-secretory mechanisms, in addition to that associated with the local (non-systemic) mode of action where applicable.

Aluminum↗
PubMed1985

Burnout in psychiatric nursing.

Burnout is a syndrome characterized by progressive physical and emotional exhaustion involving the development of negative job attitudes and perceptions and a loss of empathic concern for patients. It is caused by chronic emotional stress resulting from prolonged intensive involvement with people. If unchecked, burnout will lead to a deterioration in the quality and quantity of nursing care received by patients. This study examines staff burnout among 31 registered psychiatric nurses working in a variety of clinical areas in the hospital setting. The Staff Burnout Scale for Health Professionals (SBS-HP) was used to determine the relationship of SBS-HP scores to respondents age, sex, and area of work. A comparison is made between this study and current research.

Adult↗
PubMed1985

The choice of ulcer healing agent influences duodenal ulcer relapse rate and long-term clinical outcome.

The mode of pharmacological healing influences subsequent ulcer relapse. Duodenal ulcer relapse following healing and withdrawal of active therapy has been studied in 18 prospectively randomised comparative studies involving cimetidine and alternative healing agents. Most studies (eleven of the 18) showed comparative agents with a lower (greater than 10%) incidence of relapse than cimetidine while a minority (seven of the 18) showed equal (+/- 10%) relapse. The probability of this distribution occurring by chance is less than 1:1000 (p = 0.0005, sign test). In three of the 11 published comparative studies the relapse rate was significantly higher in those who had previously received cimetidine (p less than 0.05, two-sided significance test). This was despite the fact that most of the individual studies were small and required a substantial difference in results for the 5% significance level to be reached. Paired comparative incidences of relapse at six months were converted to relapse rates (percentage of healed population relapsing monthly), average rates for comparative agents were 8.05 +/- 2.7% while those for cimetidine were 16.9 +/- 4.4% (means +/- SEM, n = 5); cimetidine relapse rates derived from non-comparative trials were 17.0 +/- 1.9% (means +/- SEM, n = 7). Higher relapse rates translate into larger numbers of patients at risk and in need of active therapy. These results are of biological and clinical significance. Differences in relapse must reflect beneficial effects of one group of agents on the ulcer diathesis or adverse effects of the comparator, cimetidine. Each alternative reflects negatively on cimetidine as an antiulcer medication; however, confirmation of adverse effects would force radical review of most current therapy of ulcer disease. Research into ulcer therapeutics must emphasise both the relapse and the healing potential of pharmacologic agents.

Anti-Ulcer Agents↗
PubMed1985

Plasma concentrations after oral or intramuscular vitamin K1 in neonates.

One hundred and seven healthy, breast fed infants received 1 mg vitamin K1 either at birth (orally or intramuscularly) or with the first feed (orally). Venous blood samples collected in the next 24 hours were assayed for plasma vitamin K1. In babies given the vitamin orally at birth, the peak median concentration (73 ng/ml) occurred at four hours. By 24 hours median plasma concentrations had fallen to 23 ng/ml and 35 ng/ml in the groups fed vitamin K1 at birth or with the first feed, respectively; this difference was not, however, significant. Plasma concentrations after intramuscular injection exceeded those in the oral groups at all comparable times, with a peak median concentration of 1781 ng/ml at 12 hours falling to 444 ng/ml at 24 hours. Since median plasma vitamin K1 concentrations 24 hours after oral administration were some 100 times and 1000 times greater than previously estimated adult and newborn values respectively, this study supports giving vitamin K1 orally at birth to well, mature babies to protect against early haemorrhagic disease of the newborn. Further studies are needed to determine the optimum dose for protection over subsequent weeks.

Administration, Oral↗
PubMed1985

Respiratory conditions: effect of housing and other factors.

The public health movement has been concerned with the relation between housing and health for well over a century. Nevertheless the Black Report still identified housing as one of the major causes of ill-health and suggested, on one indicator at least, that council housing is the least healthy form of tenure. An exploratory study concerning housing and health in a north eastern local authority area is described. It was found that smoking, work experience, and age were the most important determinants of self assessed respiratory conditions. When the background factors were held constant people in areas of 'bad' housing were found to report more respiratory symptoms than those in 'good' housing areas. Respiratory conditions were affected by the age of housing, and flats were found to be worse than houses. High rise flats were worse than low or medium rise flats.

Adult↗
PubMed1985

Clinical predictors of acute bacterial diarrhea in young children.

This prospective study assessed the value of presenting history, physical examination, and screening laboratory tests in predicting whether diarrhea in a young child is associated with a stool culture positive for a bacterial pathogen. Acutely ill children less than 4 years old were studied in a hospital outpatient setting. Two hundred patients were seen in a 9 1/2-month period, which encompassed the seasons of summer, fall, and winter. One hundred ninety-five patients had cultures completed and twenty-nine (15%) had a bacterial pathogen isolated. The best predictive variable for a stool culture positive for a bacterial pathogen was the presence of polymorphonuclear cells in the stool, with a sensitivity of 85%, a specificity of 88%, and positive and negative predictive values of 59% and 97%, respectively. A cluster of three historical variables--abrupt onset of diarrhea, greater than four stools per day, and no vomiting before the onset of diarrhea--was identified that delineated a subpopulation of patients with an increased probability of having a stool culture positive for a bacterial pathogen (27% v 4% if any of the three variables was absent). It is suggested that these findings can be combined in a stepwise manner using the historical cluster as an initial screening, followed by examination for stool polymorphonuclear cells in the high probability subgroup, to identify those patients with a very high probability of having a bacterial pathogen isolated in their stool.

Aeromonas↗
PubMed1983

Grain exposure--symptoms and lung function.

Eighty dock workers handling grains and other cargoes were surveyed by respiratory and occupational questionnaires, spirometry, skin tests with common allergens and grain extracts, and serological tests. Sixty-nine of the men reported chest symptoms during exposure to barley dust and 13 men reported evening feverish episodes after handling barley. Symptoms were not related to smoking or atopic status. No gross deficits in lung function were detected. Six men handling barley and four handling non-dusty cargoes had their lung function measured over two working days. Falls in ventilatory capacity occurred in the six workers handling barley but not in the four handling non-dusty cargoes. Six previously unexposed subjects spent 2 h in a barley dust atmosphere of a silo and had lung function measured before and after the exposure. All subjects had falls in ventilatory capacity. In four these lasted 24 h or more and were associated with systemic symptoms. As with cotton dust the agent(s) responsible for symptoms from grain dust exposure remains uncertain. Our findings on the dock workers suggest that specific immunological responses are not involved.

Adult↗