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Biomedical subjects

P Sullivan

Publications and source records attributed to P Sullivan.

At least 91 records · Page 5Linked to original sources
PubMed1996

Reported prevalence of hepatitis C among clients of needle exchanges in southeast Queensland.

The aim of the study was to estimate the prevalence of hepatitis C infection among attenders of several high-volume needle exchanges in southeast Queensland, and to compare the prevalences among the needle exchanges. Clients at four needle exchanges were surveyed over a five-day period by means of a self-administered questionnaire. A high proportion of respondents (76 per cent) reported having been tested for hepatitis C antibodies and the overall prevalence of reported hepatitis C infection was 34 per cent. Thirty-one per cent of the respondents were amphetamine injectors, among whom there was a lower prevalence of reported hepatitis C infection than among opioid injectors (odds ratio 0.18, P < 0.01). There were some differences in the respondents' characteristics and in hepatitis C prevalence between different needle exchanges. The reported prevalence of HIV infection was 2 per cent. This study highlights the importance of surveying a range of needle exchanges to obtain a representative sample of needle-exchange clients overall. The low prevalence of hepatitis C in some groups of injecting drug users suggests that it is possible to prevent hepatitis C transmission among injecting drug users, and points to the opportunity for aiming hepatitis C prevention strategies at these groups.

Adolescent↗
PubMed1996

Simulation of diabetic eye disease to compare screening policies.

AIMS/BACKGROUND: The purpose of the project was to develop a technique for evaluating screening policies in the treatment of insulin dependent diabetic retinopathy. The study was concerned with patients who contracted the disease, aged under 35 years. Simulation was used to describe the progress of a cohort of patients through disease and treatment. METHOD: Data, derived from a literature survey of European and American population and clinic studies, were used to model as closely as possible the development of retinopathy in all its stages, together with the effects of screening and treatment. The model output was validated against published data. RESULTS: The results showed that where screening sensitivities are high, the frequency of screening makes little difference to the years of sight saved, but it does make a difference if screening sensitivities are close to 50%. CONCLUSIONS: Although annual screening is normally desirable, biannual screening could be considered where patient compliance and screening sensitivities are both high.

Adolescent↗
PubMed1996

Elements of a successful short-stay inpatient psychiatric service.

In 1989 Johns Hopkins Hospital modified the Meyer 3 short-stay psychiatric service, which has allowed the hospital to comply with state requirements to control inpatient costs and has increased revenues. Strategies and organizational changes that were implemented to reduce length of stay include use of a screening tool by the admitting physician to ensure appropriate referrals to the service, modification of morning and afternoon rounds and strengthening of linkages with the psychiatric emergency department and outpatient services to enhance communication, replacement of inexperienced first-year residents in the emergency department with senior residents on 24-hour call who are closely supervised by short-stay service staff, and enhanced training for service nurses. Patients who are functionally disabled and who need assistance in activities of daily living have longer stays. Patients with substance use disorders are now referred to an ultra-short-stay unit.

Activities of Daily Living↗
PubMed1996

Low-dose theophylline modulates T-lymphocyte activation in allergen-challenged asthmatics.

Theophylline has been shown by several investigators to attenuate the late asthmatic response (LAR) to inhaled allergen, suggesting that it has anti-inflammatory or immunomodulatory properties. We have, therefore, undertaken a double-blind, placebo-controlled study to examine the effects of low-dose theophylline on bronchoalveolar lavage (BAL) and blood T-lymphocyte profile and activation in asthmatics following antigen challenge and the development of a LAR. Peripheral blood and BAL samples were obtained from 17 subjects with mild atopic asthma before and after 6 weeks of treatment with either oral theophylline or placebo. The mean serum theophylline concentration achieved was 6.6 micrograms.mL-1, which is below the currently accepted therapeutic range. Following theophylline therapy, there was a significant decrease in the number of BAL lymphocytes compared to placebo. On flow cytometric analysis of BAL cells, a significant loss of CD3+ T-lymphocytes, comprising both CD4+ and CD8+ subsets, was demonstrated. Moreover, there was a decrease in the number of BAL CD4+ T-cells expressing the activation marker very late activation antigen-1 (VLA-1), and an apparent reduction in human leucocyte antigen-DR (HLA-DR). Correspondingly, this was accompanied in the blood by an elevation in the proportion of activated CD4+ T-lymphocytes, in particular those expressing HLA-DR. These findings provide further evidence that theophylline has an anti-inflammatory action in asthma.

Adult↗
PubMed1996

Organ transplantation at the Hartford Transplant Center.

Over 1,243 organ transplants have been performed at the Hartford Transplant Center over the past two decades. Survival in kidney, heart, liver, and pancreas patients is at or above the national average. Hartford was one of the first centers to use triple immunosuppression, which significantly improved survival in kidney transplantation. For recipients of kidneys from living related donors and cadaveric kidneys, two-year actuarial graft survival has been 98% and 83%, respectively, over the last five years. For heart and liver transplants, two-year survival has been 79% and 67%, respectively. Despite high success rates at most transplant centers, donor organs remain scarce. This problem needs to be addressed through increased cooperative efforts in the health-care community and the general public.

Adolescent↗
PubMed1995

Private health care dominates meeting as general council calls for national debate on issue.

The CMA's General Council has decided to withhold its stamp of approval for a "private parallel" health care system by voting against a motion to remove legislative barriers to private insurance. However, General Council did call on the CMA to take the issue directly to Canadians and conduct a national debate. General Council did pass a "Blueprint for Action"--16 resolutions spelling out the CMA's views on ways to protect Canada's medicare system.

Canada↗
PubMed1995

Nova Scotia health minister issues plea for more MD participation in politics.

Dr. Ronald Stewart admits that there are negative aspects to becoming a politician, but when he addressed a recent national meeting of Canada's emergency physicians he pleaded for more physician involvement in the political process. Stewart, an emergency physician who serves as Nova Scotia's health minister, thinks work as a politician can be both frustrating and fulfilling.

History, 20th Century↗
PubMed1995

Audience sceptical as critic challenges current system for paying Canada's MDs.

A recent CMA-sponsored conference on negotiations brought medical leaders from across Canada to Ottawa in September to hear experts discuss the current health care environment. Among the speakers was Dr. Michael Rachlis, a widely quoted critic of physicians' current role in the health care system. He said physicians and patients currently face major "equity issues," as some patients have a difficult time finding medical help because their serious illnesses are "worth" less to doctors, many of whom prefer to see patients with simple problems that can be dealt with in a few minutes. Several physicians reacted strongly to the criticism.

Canada↗
PubMed1995

Interleukin-1 beta-induced nitric oxide synthase expression by rat pancreatic beta-cells: evidence for the involvement of nuclear factor kappa B in the signaling mechanism.

Recent evidence indicates that overproduction of nitric oxide mediates cytokine-induced inhibition of insulin secretion by pancreatic islets. The current studies were designed to characterize signaling events involving the transcriptional factor NFkappaB in interleukin-1 (IL-1)-induced expression of inducible nitric oxide synthase (iNOS) by primary and transformed rat pancreatic beta-cells. Due to limitations of cell numbers of purified primary beta-cells, biochemical and molecular studies were performed primarily using the insulinoma cell line, RINm5F. Inhibitors of NFkappaB, diethyldithiocarbamate, pyrrolidine dithiocarbamate, and N-acetyl cysteine prevent IL-1-induced iNOS expression at the level of messenger RNA, protein, and nitrite generation. IL-1 induces a time-dependent translocation of NFkappaB from cytosol to nucleus, with maximal translocation observed approximately 15-30 min after IL-1 treatment, as determined by electrophoretic mobility shift assays. The specificity of the band containing the NF kappa B DNA-protein complex was shown by competition with a 150-fold excess of nonradiolabeled NF kappa B oligonucleotide. Supershift assays using immunoglobulins G against NF kappa b subunits p50 an p65 indicate that the protein complex contains a heterodimer of p50 and p65. IL-1-induced translocation of NF kappa B was blocked by 100 microns 100 microM diethyldithiocarbamate or 100 microM pyrrolidine dithiocarbamate, further establishing a critical role for NF kappa B in the induction of iNOS by IL-1 in rat pancreatic beta-cells. Activation of tyrosine kinase appears to precede NF kappa B activation, as the tyrosine kinase inhibitor genistein (100 microM) blocks IL-1-induced translocation of NF kappa B. An understanding of the signal transduction pathway of cytokine-induced nitric oxide generation by beta-cells will provide strategies of intervention to further evaluate the role of nitric oxide in mediating beta-cell dysfunction.

Animals↗
PubMed1995

A qualitative approach to the evaluation of a cardiac education follow-up program.

The purpose of this study was to evaluate a Cardiac Education Follow-Up Program from the consumer's perspective. Nine cardiac patients between the ages of 51 and 70 participated. All had diagnoses of myocardial infarction and had taken the Program within the previous month. Patton's (1986) utilization-focused approach to evaluation provided the conceptual orientation and the Davis Patient Interview Guide (DPIG) was used for data collection. Results indicated that four aspects of the Program were of predominant interest/concern: information; support; the cardiologist's session; and the room in which the class was offered. Recommendations for program modification, using the results of the consumer's evaluation, are identified.

Aged↗
PubMed1994

Anti-inflammatory effects of low-dose oral theophylline in atopic asthma.

Theophylline, in addition to its bronchodilator effect, may attenuate inflammation in asthma. We did a double-blind placebo-controlled study of the effect of oral theophylline on the inflammatory response of the bronchial mucosa to inhalation of allergen in 19 atopic asthmatic subjects. Bronchoscopy and bronchial biopsy were done 24 hours after allergen inhalation before and after six weeks of treatment with oral slow-release theophylline, 200 mg 12 hourly. The mean serum concentration was 36.6 mumol/L, which is below the currently-accepted therapeutic range. After treatment with theophylline there was a significant reduction in the number of EG2-positive activated eosinophils (5.9 before and 2.1 after treatment, Wilcoxon signed rank p < 0.05) and total eosinophils (16.7 before and 7.6 after treatment, p < 0.05) beneath the epithelial basement membrane. We conclude that low-dose oral theophylline attenuates airway inflammatory response to allergen inhalation in atopic asthma.

Administration, Oral↗