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Biomedical subjects

P Sullivan

Publications and source records attributed to P Sullivan.

At least 55 records · Page 3Linked to original sources
PubMed2000

Optimal treatment for Maori with alcohol and drug-use-related problems: an investigation of cultural factors in treatment.

There is an increasing emphasis on taking account of the diversity of social, psychological, and cultural factors in the assessment and treatment of alcohol and drug-use-related problems. In New Zealand the increasing use of customary Maori values, beliefs, and practices in the treatment of Maori with alcohol and drug-use-related problems has also been accompanied by the adaptation and integration of Western approaches to fit contemporary Maori sociocultural needs. This paper reports on an investigation of cultural factors and cultural identity in the alcohol and drug-user treatment of a clinical sample of Maori. The essential finding was a very high endorsement of the importance of cultural factors in treatment--irrespective of age, gender, mood, level of dependence, previous admissions, cultural connectedness, or whether they were treated in a Maori dedicated program or not. A significant number believed that a sense of belonging to an Iwi (tribe), identifying as a Maori and having pride in being Maori were also important in the recovery/healing process. The findings of this study support the need to investigate the relationship between specific "cultural factors" and other clinical components of effective treatment for Maori.

Adolescent↗
PubMed1999

The influence of ocular pulsatility on scanning laser Doppler flowmetry.

PURPOSE: To determine the effect of the cardiac cycle on scanning laser Doppler flowmeter measurements of retinal capillary blood flow in rhesus monkeys and humans. METHODS: Multiple scanning laser Doppler flowmetry images of rhesus monkey and human retinal capillary blood flow over a range of heart rates were obtained. Average flow values were determined for the 64 scan lines that compose the two-dimensional flow map. Cutaneous blood flow was measured simultaneously with a laser Doppler flowmeter. The temporal relationships between retinal capillary blood flow, peripheral arterial pulse, and cutaneous blood flow were determined. In addition, human retinal capillary blood flow in a 10 x 10-pixel area during different phases of the cardiac cycle was compared. RESULTS: Regular oscillations in human and rhesus monkey retinal capillary blood flow are evident as alternating bright and dark horizontal bands in scanning laser Doppler flowmetry images. These fluctuations are temporally correlated with cutaneous blood flow. Linear regression of actual vs predicted heart rate based on peaks in retinal capillary flow yielded r = 0.999 in a rhesus monkey and 0.938 in a human. Retinal capillary blood flow in a 10 x 10-pixel area fluctuated as much as 50% depending on the phase of the cardiac cycle. CONCLUSIONS: The alternating bright and dark banding pattern observed in scanning laser Doppler flowmetry scans of retinal capillary blood flow is related to the cardiac pulse. The errors introduced by pulse-related fluctuations in retinal capillary blood flow are significant and must be minimized or corrected for accurate and reproducible measurements of ocular hemodynamics.

Animals↗
PubMed1999

Salt sensitivity and hydration behavior of the toad, Bufo marinus.

Toads, Bufo marinus, were placed on laboratory tissue saturated with water or with hyperosmotic (250 or 500 mM NaCl or KCl) solutions, and their behavior was observed for 5 min. Toads placed on water initially allowed their ventral skin to touch the surface without abducting the hind limbs. During this "seat patch down" (SPD) behavior toads appeared to be evaluating the suitability of a hydration source prior to initiating "water absorption response" (WR) behavior with the hind limbs fully abducted and the ventral skin pressed to the moist surface. Toads dehydrated by more than 10% showed significantly shorter periods of SPD behavior and initiated WR behavior more frequently than did hydrated toads. Dehydrated toads placed on 250 mM NaCl initiated WR behavior in only 18% of the trials, but spent significantly more time showing SPD behavior than they did on water, indicating that this concentration is marginally acceptable to them. Recordings from spinal nerve #6 showed an increase in activity when 250 mM NaCl or KCl solutions were perfused over the outer surface of the ventral skin. The response to KCl was significantly greater than NaCl. The addition of 10 microM amiloride to 250 mM NaCl resulted in a higher frequency of WR behavior and reversibly inhibited the neural response to 250 mM NaCl. These results suggest that epithelial Na+ channels in the skin serve a sensory function in this species. Neither the hydrated nor dehydrated toads initiated WR behavior on 250 or 500 mM KCl solutions, indicating that toads have a lower tolerance of K+ than of Na+ salts.

Amiloride↗
PubMed1999

A population-based twin study in women of smoking initiation and nicotine dependence.

BACKGROUND: The development of drug dependence requires prior initiation. What is the relationship between the risk factors for initiation and dependence? METHODS: Using smoking as a model addiction, we assessed smoking initiation (SI) and nicotine dependence (ND) by personal interview in 1898 female twins from the population-based Virginia Twin Registry. We developed a twin structural equation model that estimates the correlation between the liability to SI and the liability to ND, given SI. RESULTS: The liabilities to SI and ND were substantially correlated but not identical. Heritable factors played an important aetiological role in SI and in ND. While the majority of genetic risk factors for ND were shared with SI, a distinct set of familial factors, which were probably partly genetic, solely influenced the risk for ND. SI was associated with low levels of education and religiosity, high levels of neuroticism and extroversion and a history of a wide range of psychiatric disorders. ND was associated with low levels of education, extroversion, mastery, and self-esteem, high levels of neuroticism and dependency and a history of mood and alcohol use disorders. CONCLUSIONS: The aetiological factors that influence SI and ND, while overlapping, are not perfectly correlated. One set of genetic factors plays a significant aetiological role in both SI and ND, while another set of familial factors, probably in part genetic, solely influences ND. Some risk factors for SI and ND impact similarly on both stages, some act at only one stage and others impact differently and even in opposite directions at the two stages. The pathway to substance dependence is complex and involves multiple genetic and environmental risk factors.

Adult↗
PubMed1999

Increased carbon monoxide in exhaled air of patients with cystic fibrosis.

BACKGROUND: Inflammation, oxidative stress, and recurrent pulmonary infections are major aggravating factors in cystic fibrosis. Nitric oxide (NO), a marker of inflammation, is not increased, however, probably because it is metabolised to peroxynitrite. Exhaled carbon monoxide (CO), a product of heme degradation by heme oxygenase 1 (HO-1) which is induced by inflammatory cytokines and oxidants, was therefore tested as a non-invasive marker of airway inflammation and oxidative stress. METHODS: Exhaled CO and NO concentrations were measured in 29 patients (15 men) with cystic fibrosis of mean (SD) age 25 (1) years, forced expiratory volume in one second (FEV(1)) 43 (6)%, 14 of whom were receiving steroid treatment. RESULTS: The concentration of exhaled CO was higher in patients with cystic fibrosis (6.7 (0.6) ppm) than in 15 healthy subjects (eight men) aged 31 (3) years (2.4 (0.4) ppm, mean difference 4.3 (95% CI 2.3 to 6.1), p<0.001). Patients not receiving steroid treatment had higher CO levels (8.4 (1.0) ppm) than treated patients (5.1 (0.5) ppm, mean difference 3.3 (95% CI -5.7 to -0.9), p<0.01). Normal subjects had higher NO levels (6.8 (0.4) ppb) than patients with cystic fibrosis (3.2 (0.2) ppb, mean difference 3.8 (95% CI 2.6 to 4.9), p<0.05) and were not influenced by steroid treatment (3.8 (0.4) ppb and 2.7 (0. 3) ppb for treated and untreated patients, respectively, mean difference 0.8 (95% CI -0.6 to 2.3), p>0.05). Patients homozygous for the DeltaF508 CFTR mutation had higher CO and NO concentrations than heterozygous patients (CO: 7.7 (1.8) ppm and 4.0 (0.6) ppm, respectively, mean difference 3.7 (95% CI -7.1 to -0.3), p<0.05; NO: 4.1 (0.5) ppb and 1.9 (0.7) ppb, respectively, mean difference 2.2 (95% CI -3.7 to -0.6), p<0.05). CONCLUSIONS: High exhaled CO concentrations in patients with cystic fibrosis may reflect induction of HO-1. Measurement of exhaled CO concentrations may be clinically useful in the management and monitoring of oxidation and inflammatory mediated lung injury.

Adrenal Cortex Hormones↗
PubMed1999

Sonography in the diagnosis of carpal tunnel syndrome.

OBJECTIVE: The few papers published on the use of sonography in carpal tunnel syndrome suggest it may be a useful diagnostic test. This study aims to prospectively evaluate the use of sonographic measurements of the median nerve in the diagnosis of carpal tunnel syndrome. SUBJECTS AND METHODS: Patients with documented carpal tunnel syndrome and a group of asymptomatic control subjects were enrolled and underwent high-resolution sonography of the carpal tunnel. A small-footprint linear array transducer was used to scan and measure the median nerve cross-sectional area and the maximum transverse and anteroposterior diameters. Data from the patient group and the control group were compared to establish optimal diagnostic criteria for carpal tunnel syndrome. RESULTS: Sixty-eight carpal tunnel syndrome patients (50 women, 18 men) with 102 affected nerves and 68 nerves in 36 asymptomatic controls (23 women, 13 men) were examined. Qualitative assessment alone was found to be unreliable. All measurements showed significant differences between patients and controls. The most predictive measurement was swelling of the median nerve, which was significantly greater in carpal tunnel syndrome patients compared with controls (mean, 0.13 cm2 versus 0.07 cm2). Thus, quantitative assessment of the median nerve provides an accurate diagnostic test (sensitivity, 82%; specificity, 97%), with an area larger than 0.09 cm2 being highly predictive of carpal tunnel syndrome. CONCLUSION: We confirm that median nerve cross-sectional area measurement correlates well with the presence of carpal tunnel syndrome and is both sensitive and specific for the diagnosis.

Carpal Tunnel Syndrome↗
PubMed1999

Sick-child daycare promotes healing and staffing.

Keeping working parents working when their children are mildly ill protects workplace productivity. This article presents a successful model for a medical center's sick-child day-care facility.

Absenteeism↗
PubMed1998

A clinical sample of Maori being treated for alcohol and drug problems in New Zealand.

AIMS: To document key clinical characteristics of a group of Maori being treated for alcohol and drug problems; compare the characteristics of Maori accessing dedicated Maori alcohol and drug treatment services with Maori accessing non-dedicated services; and investigate these clinical characteristics in relation to patient satisfaction. METHODS: A sample of 105 Maori with alcohol and drug problems, accessing the range of treatment services in the Canterbury area, undertook a semi-structured interview. RESULTS: Overall this sample of Maori were socially disadvantaged. Their main drug of use was alcohol, followed by cannabis, opioids and sedatives/hypnotics. There were no significant differences between the subjects who attended Maori dedicated services and those who attended non-dedicated Maori services in terms of demographic variables, alcohol and drug use history, current level of dependence, or anxiety/depression state. Subjects in dedicated Maori services were more likely to have had greater than 21 days of treatment compared to those in non-dedicated Maori services and were more likely to have been to their home marae than those in non-dedicated services. In multivariate analysis, Maori in dedicated Maori services were significantly more likely to be satisfied with treatment than those in non-dedicated services (odds ratio = 5.5, 95% confidence interval = 1.81-16.78). CONCLUSION: Further research is required to investigate the relationship between high patient satisfaction by Maori with alcohol and drug problems attending dedicated Maori treatment services, treatment effectiveness and the components of dedicated Maori services that may contribute to higher retention rates, greater patient satisfaction and increased positive treatment outcome.

Adolescent↗
PubMed1998

HIV and HCV prevalence among trawler crew.

A survey of 51 people who work on trawlers was carried out to describe injecting and sexual behaviour and the prevalence of HIV and HCV antibody. All crew members who were departing from an Australian port during the last week of February 1996 to work on trawlers were asked to complete a brief, self-administered questionnaire and provide a finger prick blood sample. Questionnaires were received from 51 (77%) and blood samples from 45 (68%) of the 66 crew from 15 vessels. Almost half the respondents reported ever injecting illicit drugs. No respondents had HIV antibody while 27% had HCV antibody detected. Among 20 injecting drug user (IDU) respondents, the prevalence of HCV was 55% (95% CI 32%-77%). Twelve respondents reported new sex partners in the past month of whom half reported no condom use with these sex partners. The survey emphasises the diversity of the IDU population in Australia. Yet it would appear that regardless of the sub-population surveyed that HCV is endemic among IDUs in Australia. Effective HCV prevention programs targeted specifically for these (and other) sub-populations of IDUs should be devised.

Adolescent↗
PubMed1998

Exhaled nitric oxide in chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction and a neutrophilic inflammation. Exhaled nitric oxide (NO) may be a marker of disease activity in a variety of lung diseases. We measured exhaled NO in patients with documented COPD and investigated whether the concentration of exhaled NO is related to the severity of disease as defined by lung function. We also investigated whether concentration of exhaled NO was different in COPD patients who received inhaled steroids compared with steroid-naive patients. We studied 13 current smokers with COPD, eight exsmokers with COPD, 12 patients with unstable COPD (exacerbation or severe disease), and 10 smokers with chronic bronchitis without airflow limitation. Exhaled NO levels were significantly higher in patients with unstable COPD (12.7 +/- 1.5 ppb) than in other groups (p < 0.01). Exhaled NO levels were significantly higher in smokers with COPD than in smokers with chronic bronchitis (4.3 +/- 0.5 versus 2.5 +/- 0.5 ppb, p < 0.05), and were even higher in patients with COPD who had stopped smoking (6.3 +/- 0.6 ppb, p < 0.01). Exhaled NO levels showed a significant negative correlation with their lung function assessed by % predicted FEV1 values (r = -0.6, p < 0.001). Exhaled NO levels in patients treated with inhaled steroids were significantly higher compared with steroid-naive patients (8.2 +/- 1.2 ppb versus 5 +/- 0.4 ppb, p < 0.05), but the first group included more severe patients as assessed by lung function. We conclude that exhaled NO could serve as a useful, practical marker for monitoring disease activity in COPD.

Administration, Inhalation↗