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Biomedical subjects

R M Ryan

Publications and source records attributed to R M Ryan.

At least 55 records · Page 3Linked to original sources
PubMed1994

Meconium analysis for improved identification of infants exposed to cocaine in utero.

We screened anonymously all mothers and infants born during a 3 1/2-month period to determine the prevalence of intrapartum cocaine use, test the maternal characteristics that are specific predictors of intrauterine cocaine exposure (IUCE), and compare the sensitivity of infant urine versus meconium samples for identification of IUCE. Of 1237 live births during the study period, a sample was obtained from 1201 mother-infant pairs. The overall prevalence of documented intrapartum cocaine exposure was 66 (5.5%) of 1201 pairs. Previously developed drug screening guidelines had a sensitivity of 89% for detecting IUCE in infants. Direct comparisons of samples from the same mother-infant pair revealed that there were no cases in which cocaine was found in infant urine but not in meconium; however, infant urine testing missed 25% of the infants who had positive findings in meconium. We conclude that (1) meconium testing was more likely than urine testing to identify an infant with IUCE, detecting an additional 33%; (2) there was significant maternal cocaine use (5.5%) in a teaching hospital with a mixed patient population; (3) maternal characteristics known to identify infants at risk of having IUCE were useful in our population; and (4) IUCE of neonates admitted to the neonatal intensive care unit was more common than that of infants admitted to the regular newborn nursery.

Cannabis↗
PubMed1994

Complications in ENT--a nationwide audit carried out in November 1992.

We report a prospective audit of complications following ENT surgery during November 1992 from 42 consultants across the United Kingdom. Complications were reported as codes, and results were analysed at the Royal College of Surgeons Comparative Audit Unit. A total of 174 complications were reported, giving an annualized complication rate per consultant of 5.7-7.0% (depending on whether only the most severe complication per patient is counted or all complications). This compares with an annual complication rate of 1.49% reported retrospectively for the year of 1991 by the same consultants.

General Surgery↗
PubMed1994

The imaginary audience, self-consciousness, and public individuation adolescence.

In this study, we examined the construct of the imaginary audience (Elkind & Bowen, 1979), presumably a precipitant of adolescent egocentrism, as it relates to public individuation and self-consciousness. We hypothesized that the imaginary audience inhibits public individuation and represents a critical form of public self-consciousness. We also argued that the imaginary audience is a normal aspect of early adolescent development that diminishes in the context of secure parental relationships by late adolescence but remains salient if these relationships are insecure. These hypotheses were examined in a cross-sectional study of 850 adolescents in the 7th, 8th, 9th, and 12th grades. Support was generally found for the hypothesized relations. The validity and limitations of the imaginary audience and public individuation constructs are discussed, along with more general theoretical issues concerning adolescent self-consciousness.

Adolescent↗
PubMed1994

Growth factors alter neonatal type II alveolar epithelial cell proliferation.

The type II alveolar epithelial cell plays a critical role in the repair of lung injury by repopulating the entire damaged alveolar epithelium. We report our studies of the effects of known growth factors on the in vitro proliferation of isolated neonatal rabbit type II cells. Transforming growth factor-alpha (TGF-alpha) and epidermal growth factor (EGF) increased [3H]thymidine incorporation, cell number, and labeling index above control. Transforming growth factor-beta (TGF-beta) decreased [3H]thymidine incorporation, cell number, and labeling index compared with control. When added simultaneously, TGF-beta blocked the stimulatory effect of TGF-alpha or EGF. If TGF-alpha is added before TGF-beta, the ability of TGF-beta to block the mitogenic effect of TGF-alpha was diminished the later in time TGF-beta was added. If TGF-beta was added first, later addition of TGF-alpha had no effect. The current work demonstrates that specific growth factors, including some known to be produced by other lung cells, alter the proliferation in vitro of isolated neonatal rabbit type II alveolar epithelial cells.

Animals↗
PubMed1994

Tyrosine kinase activity is necessary for growth factor-stimulated rabbit type II pneumocyte proliferation.

Tyrosine kinases are important in the signal transduction of a number of growth factors. As shown previously, transforming growth factor (TGF)-alpha stimulated proliferation of type II cells in vitro. The mitogenic effect of TGF-alpha could be blocked by the addition of the tyrosine kinase inhibitors genistein or tyrphostin. Tyrosine phosphorylation in type II cells exposed to growth factors was examined using an antiphosphotyrosine antibody. After addition of TGF-alpha, phosphorylation of a tyrosine protein with a molecular mass of 170 kD, presumed to be the epidermal growth factor receptor (EGF-R), peaked by 5 min, returning to baseline by 30 min. As expected, genistein or tyrphostin decreased the TGF-alpha-induced phosphorylation of the EGF-R. Addition of TGF-beta resulted in no newly phosphorylated tyrosine proteins. TGF-beta decreased the TGF-alpha-induced phosphorylation of the EGF-R. Previous work has shown that TGF-beta blocks the TGF-alpha stimulation of type II cell proliferation. It appears that TGF-beta interferes with TGF-alpha-induced phosphorylation of the EGF-R.

Adenocarcinoma↗
PubMed1994

Global monitoring of positive surgical outcome: a feasibility study at the Royal National Throat Nose and Ear Hospital.

We present early results of a study looking at the feasibility of positive outcome 'monitoring' after every operation at the Royal National Throat Nose and Ear Hospital. A system for quantitative 'measurement' of outcome after every operation is still light years away, and as a result audit of outcome has lagged behind audit of structure and process. Our 'monitoring' approach involves simply documenting, for every patient, whether the individual goal of the operation has or has not been achieved. Piloting this system over a 6-month period in 1993 suggests that it is feasible and useful, providing the results are used as pointers to more detailed study, rather than as endpoints in themselves.

Feasibility Studies↗
PubMed1993

A dark side of the American dream: correlates of financial success as a central life aspiration.

Aspiring for financial success is an important aspect of capitalist cultures. Three studies examine the hypothesis that values and expectancies for wealth and money are negatively associated with adjustment and well-being when they are more central to an individual than other self-relevant values and expectancies. Studies 1 and 2 use 2 methods to show that the relative centrality of money-related values and expectancies is negatively related to college students' well-being and mental health. Study 3, using a heterogeneous noncollege sample, extends these findings by showing that a high centrality of aspirations for financial success is associated with interview ratings of lower global adjustment and social productivity and more behavioral disorders. Discussion is focused on the deleterious consequences of materialistic world views and the need to examine differential effects of content regarding goals and values.

Adult↗
PubMed1993

Two types of religious internalization and their relations to religious orientations and mental health.

Two types of religious internalization are conceptualized that are presumed to vary in their relative autonomy. Introjection represents a partial internalization of beliefs and is characterized by self- and other-approval-based pressures. Identification represents adoption of beliefs as personal values and is characterized by greater volition. These 2 types of internalization are compared conceptually and empirically with existing measures of religious orientation and are used to predict varied functional outcomes. Results in 4 independent Christian samples show systematic construct validities and relations with mental health and self-related outcomes. Also, evangelical teenagers are shown to be higher on both introjection and identification than controls. Results are discussed both in terms of prior approaches to the psychology of religion and the significance of internalization for personality functioning.

Adaptation, Psychological↗
PubMed1993

Royal College of Surgeons comparative ENT audit 1990.

The Royal College of Surgeons Comparative Audit Service was set up in 1990 so that surgeons could pool their audit data, to provide 'standards' with which to compare their own figures. A total of 405 consultant otolaryngologists were circularized in December 1991 inviting them to return data about their resources, workload, case-mix and complications, and about two specific audit topics-Myringoplasty and Carcinoma of the Larynx--for the calendar year 1990. A total of 65 consultants returned proformas with data on 52208 admissions and 31240 surgical procedures. The 'average' respondent admitted 829 patients in the year (19% of these day cases and 14% emergencies) and performed 744 surgical procedures with a mean complication rate of 1.39% using three theatre sessions per week. Cancelled theatre sessions per annum per consultant ranged from 0 to 71. The mean known success rate after myringoplasty was 65%, with hearing improvement in 53%. The 'average' ENT surgeon saw 3.5 new cases of invasive carcinoma of the larynx and treated 69% of these with radiotherapy alone, compared with 14% surgery alone. As well as allowing a profile to be drawn up of the 'average' respondent, this audit allowed individual consultants returning data to compare their own figures in detail with the pooled data, which were presented graphically at a meeting in April 1992.

Carcinoma↗
PubMed1992

Treatment-resistant chronic mental illness: is it Asperger's syndrome?

In some cases of treatment-resistant chronic mental illness, it may be useful to reconsider the primary diagnosis. Patients with Asperger's syndrome, a rare pervasive developmental disorder, have characteristics such as eccentricities, emotional lability, anxiety, poor social functioning, repetitive behavior, and fixed habits that can mimic symptoms of other illnesses, including schizophrenia spectrum illness, bipolar disorder, anxiety disorders, and obsessive-compulsive disorder. Their disorganizing anxiety in response to stress, which may be accompanied by increased oddness of speech, can easily be misinterpreted as psychosis. The author describes features of Asperger's syndrome, discusses differential diagnosis, and presents care examples. A habilitative treatment plan that concentrates on modifying the patient's eccentricities into strengths and carefully tailors the work and living situation may be effective with some patients.

Adult↗
PubMed1992

Cellular and molecular responses to lung injury in relation to induction of tissue repair and fibrosis.

Those factors that determine whether tissue injury is followed by regeneration and repair or irreversible destruction and fibrosis are only now being elucidated. This article examines the lung's response to injury, the prominent role of polypeptide growth factors and cytokines in directing tissue responses, and the effects of injury on cell-specific expression of a number of genes.

Bronchopulmonary Dysplasia↗
PubMed1991

"The facts concerning the recent carnival of smoking in Connecticut" and elsewhere.

The behavior of health care practitioners toward their patients can greatly affect the patients' motivation for change. Mark Twain's story, "The Facts Concerning the Recent Carnival of Crime in Connecticut," is used to illustrate how traditional strategies for motivating patients to change can have the paradoxic effect of inhibiting change and growth. We use a theory of human motivation, referred to as self-determination theory, to explain this effect and suggest alternative strategies for facilitating patient motivation. Empirical tests of the theory have shown that people will accept more responsibility for behavior change when motivated internally rather than externally. In the doctor-patient relationship, this internal motivation for change can be facilitated when doctors allow choice, provide relevant information, and acknowledge the patient's perspective. We propose a simple, three-question model, consistent with self-determination theory, for physicians to use with patients who smoke and are not yet ready to try quitting.

Counseling↗
PubMed1991

Severe fetal hydrops resulting from ABO incompatibility.

Severe fetal hydrops was diagnosed at 34 weeks' gestation. Funipuncture revealed a normal 46,XX karyotype and a hematocrit of 20%. Cesarean delivery was performed. Neonatal blood testing showed blood type B positive, positive direct and indirect Coombs, and an anti-B antibody titer of 1:64. The maternal blood group was O positive with a titer of 1:65,536 immunoglobulin G (IgG) anti-B antibody (after inactivation of IgM anti-B antibody). This report documents a rare case of fetal hydrops resulting from ABO incompatibility with neonatal survival.

ABO Blood-Group System↗
PubMed1990

Ligmaject system for local anaesthesia in otology.

The Ligmaject syringe for local anaesthetic injection incorporates a pistol-grip handle and a ratchet system designed to inject a very tiny aliquot of anaesthetic per 'click'. This instrument was used to provide local anaesthesia for 22 otological procedures on consenting adults. The performance of the Ligmaject syringe compared favourably with that of the conventional dental syringe in terms of patient acceptability and user convenience.

Adult↗
PubMed1990

Self-perceptions, motivation, and adjustment in children with learning disabilities: a multiple group comparison study.

This study examined the self-perceptions, motivational orientations, and classroom adjustment of children with learning disabilities (LD), matched-IQ non-LD, randomly selected non-LD, and low achieving children. Elementary-age children (N = 148; 37 from each group) completed domain-specific measures of their self-concepts, perceptions of control, and motivation. Teachers rated children on motivational and competence indices and classroom behavioral adjustment. Comparisons among groups indicated that children with LD were lower in perceived cognitive competence and academic self-regulation relative to the nondisabled control groups, but were comparable to the low achieving children. Children with LD were most likely to perceive academic outcomes as controlled by powerful others. No group differences were found for general self-perceptions of control or competence. Teacher ratings of children with LD were more discrepant from those of comparison groups than were self-ratings of children with LD. The results suggest the need for matched-IQ and low achieving control groups in research on children with LD. The origin and role of both environmental inputs and self-perceptions in the adjustment of students with LD are discussed.

Adaptation, Psychological↗