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Biomedical subjects

S O'Connor

Publications and source records attributed to S O'Connor.

At least 109 records · Page 6Linked to original sources
PubMed1984

Child health and maltreatment.

Children who are abused have been said to have more illnesses than children who are not maltreated. The relationship between abuse and illness has been hypothesized to function in 2 ways: (1) that abuse precedes the illnesses and children from abusive homes become ill because of the damaging environment they endure, or, conversely, (2) that the illnesses precede the abuse, with the fussy behavior of ill children eliciting abuse. This study was intended to clarify the temporal relationship between illnesses and maltreatment. Health data were collected on a sample of 80 children: 11 from abusive families, 31 with nonorganic failure to thrive (NOFT), 14 from neglectful families, and 24 from control families. Hospital records (both inpatient and outpatient) for these children from the time of birth until they were 3 years old were searched by data collectors unaware of the child's classification. Children from abusive families or with NOFT appeared to be ill more often than control children, particularly during the first few months after birth, before abuse had been reported, but not necessarily before NOFT had been discovered. Health records of neglected children were not significantly different from those of controls. In addition to the abused. These 6 children also had more illnesses than control children, again particularly during the first few months after birth. Having ill children is described as a source of stress that may trigger abuse in an already stressed family.

Accidents↗
PubMed1983

Concerns of mothers seeking care in private pediatric offices: opportunities for expanding services.

A surplus of general pediatricians has been predicted for 1990. This surplus could provide both opportunity and need for practitioners to identify areas of maternal concern that might guide expansion of marketable physician services. For this purpose, maternal concerns were assessed by interviewing 207 mothers seeking care in private pediatric offices. Only 30% of mothers were most worried about their child's physical health. The remaining 70% were most concerned about problems falling into six categories of parenting, behavior, and development (psychosocial concerns): personality/social development, discipline, mental development, mother-child interaction time, adjustment to divorce and other life changes, and adolescent transition. Although the majority of these concerns conceivably could be handled in private offices, only 28% of these mothers had discussed their greater psychosocial concern with their pediatrician. A search for explanations of this failure to communicate indicated mothers often were not aware that their pediatrician could help, or they questioned his ability or interest in assisting them. Characteristics that correlated significantly with communication were higher family socioeconomic levels, and greater physician self-perceived ability and interest in these psychosocial problems. Parenting, behavior, and development concerns represent an opportunity for expanding services if some of these obstacles can be overcome.

Attitude of Health Personnel↗
PubMed1982

Antecedents of child abuse.

The qualities of parents who batter their children have been determined by interviewing known abusers. Because most studies lack controls and because family characteristics may be changed by abuse, a prospective study was instituted. Fourteen hundred low-income mothers were interviewed in a prenatal clinic, and the characteristics of 23 reported for abuse within two years were compared to the characteristics of the remaining mothers. The predominant antecedents of child abuse were: unwanted pregnancy, aggressive tendencies, and aberrant childhood nurture in which disturbed family relationships were more important than outright abuse. Abusive mother had slightly less self-esteem. Factors which increased exposure between parents and children seemed to increase risk for abuse. In contrast to retrospective findings, abusive mothers did not differ in support available from others, age, education, isolation, family alcohol or drug problems, and expectations of child development.

Aggression↗
PubMed1982

Mother-infant interaction and child development after rooming-in: comparison of high-risk and low-risk mothers.

One hundred and seventy-two low-income women were interviewed prenatally to determine risk for later mistreatment of their children. High-risk and low-risk women were then randomly assigned at delivery to either limited or extended postpartum contact with their newborns over the first two days after birth. Mother-infant interaction observations were performed at 48 hours and at one, three, six, twelve and eighteen months postpartum. Infants were tested at nine months with the Bayley Scales of Infant Development. Results indicated that outcome following extended mother-infant postpartum contact varies with maternal risk status and measures employed for evaluation. Low-risk extended-contact mother-infant pairs differed from low-risk controls in observed interaction while high-risk extended-contact and controls did not differ from each other in interaction. High-risk extended-contact infants were more advanced in motor development than control infants at nine months, however, while low-risk extended contact and control infants did not differ in development.

Child Abuse↗
PubMed1982

Increased child abuse in families with twins.

Large families and inadequate spacing of children increase the risk of abuse. Twin births incorporate both of these factors, yet the association of twinning with subsequent abuse has not been explored. Forty-eight families with twins from St Vincent Hospital and Medical Center and Nashville General Hospital were compared with 124 single-birth families, matched for hospital of delivery, birth date, maternal age, race, and socioeconomic status. Three control (2.4%) and nine twin (18.7%) families were reported for maltreatment (P less than .001). Mothers of twins experienced greater previous parity than did control subjects (P less than .001). Twins also had significantly longer nursery stays (P less than .001), lower birth weights (P less than .001), and lower Apgar scores at one (P less than .01) and five (P less than .05) minutes. A regression analysis incorporating all of these variables, however, showed that twin status was most predictive of subsequent abuse.

Adult↗
PubMed1981

Management of febrile outpatient neonates.

To determine whether all febrile outpatients below the age of two months should be routinely hospitalized and given parenteral antibiotics because of the possibility of occult sepsis or meningitis, 147 such admissions were reviewed over four years. None of the neonates had occult bacterial meningitis, while one may have had occult sepsis. Because serious infections may have been missed in outpatients not hospitalized, the outcome of all such illnesses seen in the clinic during a subsequent six months was monitored; none of 17 hospitalized or 20 followed as outpatients experienced sepsis or meningitis. If our findings are confirmed in other studies, febrile outpatient neonates with a well appearance, normal cerebrospinal fluid and physical examination, and dependable follow-up may not require universal hospitalization and antibiotics.

Ambulatory Care↗
PubMed1980

Reduced incidence of parenting inadequacy following rooming-in.

Low-income mother-infant pairs were randomly assigned to rooming-in (N = 143) or to routine (N = 158) postpartum contact to determine whether rooming-in affects subsequent adequacy in parenting. At mean age 17 months, two rooming-in and ten control children had experienced inadequate parenting. One rooming-in and eight control children were hospitalized for these problems. One rooming-in and five control families were reported to Protective Services for mistreatment of the study child; five control and no rooming-in children were in the care of adults other than their parents at the time of data analysis. In this study, rooming-in correlated with fewer subsequent cases of parenting inadequacy.

Adolescent↗
PubMed1978

Enzymatic modification of aminoglycoside antibiotics: 3-N-acetyltransferase with broad specificity that determines resistance to the novel aminoglycoside apramycin.

Examination of a number of R-plasmid-containing bacterial isolates of animal origin has revealed the presence of a new aminoglycoside acetyltransferase (3-N) with a broad substrate range that includes all the disubstituted 2-deoxystreptamine antibiotics and also the novel monosubstituted antibiotic apramycin. Antibiotic derivatives acylated with hydroxyaminobutyric acid at the 1-amino position were not modified by the enzyme.

Acetyltransferases↗
PubMed1978

Antimotility and antisecretory activity of some aryl substituted amidinoureas.

A number of aryl substituted amidinoureas have been prepared and examined for their gastrointestinal spasmolytic, antimotility, antidiarrheal and antisecretory effects. In general, antisecretory and antimotility effects have been found to be associated with each other in these compounds. The structure-activity relationships found show that substitution of the aromatic ring in positions other than 2 and 6 correlates poorly with potency, and potency of such compounds is low. In contrast to this, 2,6-disubstitution confers high potency. The potency of 2,6-disubstituted compounds declines sharply with increasing weight of substitution of the amidinourea chain, with the important exception of the N-alkoxyamidinoureas. Increasing the molecular weight of an N-alkoxy substituent has a much less profound effect than the corresponding increase has in an N-alkyl substituent. High potency in an amidinourea may well be related to low basicity (or a high pKa value for its conjugate salt) but there is insufficient data to support this hypothesis fully. The actual tautomeric structure of an amidinourea probably affects its potency and this is discussed briefly.

Amidines↗
PubMed1977

Impairment severity in seizure disorders: some suggestions for reliable assessment.

Severity of impairment in seizure disorders is typically difficult to assess because of the existence of seizure-free intervals of varying duration, often in the absence of neurological or other clinical signs. For purposes of determining degree of severity, clear documentation and description of seizures, as well as of any associated phenomena such as loss of sphincter control and the side effects of medication, are needed. Differentiation between primary and secondary seizure disorders is also important because the latter frequently are associated with other impairments. The approach to assessment advocated is based on the incidence and intensity of seizures remaining after maximum therapeutic control has been achieved. An assessment form has been developed which concisely summarizes salient case features. A composite case report is appended for the purpose of demonstrating use of the form. Instructions are in the Appendix.

Adult↗
PubMed1976

Changes in the pituitary-testicular system with age.

In order to provide a comprehensive account of pituitary-testicular function in man, 466 subjects, ranging in age from 2 to 101 years, were studied to examine blood levels of the pituitary gonadotrophins (LH and FSH), the sex steroids testosterone and oestradiol, the binding capacity of the sex hormone binding globulin (SHBG), the free testosterone and oestradiol fractions, and the transfer constant for the peripheral conversion of testosterone to oestradiol. The results were compared with clinical indices of testicular size, sexual function and secondary sex hair distribution. Serum LH and FSH were low before puberty, increased in pubertal adolescents to levels somewhat above those of adults and subsequently increased progressively over the age of 40 years. Testosterone levels fell slowly after the age of 40, while there was a slight rise in plasma oestradiol with increasing age. FSH and testosterone showed small seasonal variations in young adult men, the lowest values being seen in winter. SHBG binding capacity was high in two prepubertal boys, fell in adult men, but increased in old age. Free testosterone and oestradiol levels fell in old age. The metabolic clearance rates (MCR) of testosterone and oestradiol also fell in old age, while the conversion of testosterone to oestradiol was increased. Many correlations were observed between various hormonal and clincial measurements. The evidence is consistent with a primary decrease in testicular function over the age of 40 years.

Adolescent↗
PubMed1976

A study of the endocrine manifestations of hepatic cirrhosis.

The clinical features and hormonal abnormalities were surveyed in 117 men with cirrhosis of the liver. Compared with healthy men of similar ages, the patients had significantly lower metabolic clearance rates, plasma production rates and total and free levels of testosterone, reduced testosterone responses to human chorionic gonadotrophin stimulation, higher oestradiol, luteinizing hormone and follicle stimulating hormone levels and higher binding capacities of sex steroid binding globulin. The peripheral conversion of testosterone to oestradiol was also found to be significantly increased. However, the metabolic clearance and plasma production rates of oestradiol were not significantly different from those of healthy men. Patients who were severely ill with liver failure and one with haemochromatosis had low levels of luteinizing hormone and follicle stimulating hormone and sub-normal responses to clomiphene and luteinizing hormone-releasing hormone. Higher plasma oestradiol levels were found in patients with gynaecomastia and spider naevi than in those without these signs. However, the clinical features of androgen deficiency--that is, testicular atrophy, impotence and loss of secondary sex hair--were only poorly related to the low testosterone levels, and production rates and longtitudinal studies indicated that the hormonal levels, endocrine features and severity of the liver disease could change independently. It is concluded that the clearance of oestradiol from plasma is not limited by liver disease in all patients, and that reduced degradation of oestrogens is not the initial event in the sequence leading to the hormonal abnormalities of cirrhosis. While gonadotrophin deficiency occurs with liver failure and in some patients with haemochromatosis, the more usual findings are of elevated gonadotrophin levels and a poor Leydig cell response to chorionic gonadotrophin. These suggest that the hypogonadism is primary in most patients with cirrhosis. The causes of the high oestradiol levels were not discovered. Increased peripheral conversion of precursors to oestradiol or increased testicular secretion of oestradiol are possibilities. The high binding capacities of sex steroid binding globulin were not significantly correlated with either the low testosterone or high oestradiol level and the cause of this abnormality remains uncertain. The low metabolic clearance rates of testosterone appeared to result from the increased plasma protein binding of testosterone. The discrepancies in the expected relationships between the hormone and clinical changes suggest that factors other than those studied are also involved in the genesis of the endocrine features of hepatic cirrhosis.

Adult↗