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Biomedical subjects

T O'Rourke

Publications and source records attributed to T O'Rourke.

36 records · Page 2Linked to original sources
PubMed1990

Nonpsychiatric consultations within a general hospital psychiatric unit: characteristics and concordance.

Nonpsychiatric consultations to a general hospital psychiatric unit were investigated for concordance with diagnostic testing advice, drug recommendations, and representation of the medical diagnoses in the discharge summary. Those patients who received consultations were older and had less social support but did not have more severe medical illnesses. The level of concordance with medical consultants' recommendations was far greater than previous reports of psychiatric consultants' advice to nonpsychiatric colleagues.

Adult↗
PubMed1990

Travelers' diarrhea among U.S. Navy and Marine Corps personnel during a Western Pacific deployment.

The incidence and etiology of travelers' diarrhea was studied in a crew of 1,914 sailors and marines aboard a U.S. Navy ship during a western Pacific deployment. Questionnaires completed by 301 troops indicated that 52% had at least one episode of diarrhea during the deployment; however, only 5% of the ship's company sought treatment. Enterotoxigenic Escherichia coli was the most commonly identified pathogen (23%), followed by Giardia lamblia (6%), Salmonella (3%), rotavirus (2%), and Shigella, Campylobacter jejuni, and Entamoeba histolytica (1% each). In 66% of the episodes no etiologic agent was found. None of the risk factors thought to be associated with travelers' diarrhea could be statistically associated with the diarrhea group in comparison to questionnaire respondents who denied having had the illness.

Bacterial Infections↗
PubMed1990

Phase II evaluation of recombinant gamma-interferon in patients with advanced pancreatic carcinoma: a Southwest Oncology Group study.

Thirty evaluable patients with advanced carcinoma of the pancreas received treatment with either daily x 5 bolus or continuous infusion x 5 days recombinant gamma-interferon. No responses were noted. Major toxicities included fever, hypotension, and flu-like symptoms. gamma-Interferon does not appear to be an active single agent for patients with advanced pancreatic cancer.

Aged↗
PubMed1988

Clinical usefulness of an algorithm for the early diagnosis of spinal metastatic disease.

We have previously reported an algorithm that invokes several imaging modalities in the early detection of metastatic and benign disease of the spine in patients with cancer (J Clin Oncol 4:576, 1986). The development of new lesions (shown by Tc99m bone scans) in cancer patients with normal neurological examinations is further evaluated with plain radiographs, spinal computed tomography (CT), and CT myelography (CT-M). Of 60 patients in the original study, 28% were diagnosed as having only benign disease and the remainder had spinal metastases. Thecal sac impingement was seen in 47% of patients with metastatic disease and disruption of the posterior vertebral cortex was noted in all patients with epidural compression. We now report the 2-year follow-up of 55 of these patients. Without treatment, the 17 patients diagnosed with benign disease have shown no evidence of local failure in the spine and median survival is greater than 27 months. Thirty-eight patients diagnosed with spinal metastases had a median survival time of 16.9 months. Radiation therapy directed by CT-M findings provided pain relief in 78% of patients with back pain and metastatic disease. No patient, including 19 with thecal sac impingement, developed clinical myelopathy. These results demonstrate the usefulness of an imaging algorithm for the early identification and distinction of spinal metastatic disease and benign disease in patients with cancer.

Algorithms↗
PubMed1986

Spinal computed tomography and computed tomographic metrizamide myelography in the early diagnosis of metastatic disease.

New lesions were shown by Tc99m bone scans to have developed in sixty patients with known metastatic cancer or high-risk primary cancer and normal neurologic examinations; they were further evaluated with plain radiographs, spinal computed tomography (CT), and CT myelography (CT-M) according to an algorithm. Three groups were identified based on plain radiographs: group 1 (normal radiograph), group 2 (compression fracture as indicated by radiograph), group 3 (evidence of metastasis as indicated by radiograph). In group 1 (n = 18), spinal CT revealed that 33% of the patients had benign disease and 67%, metastases; epidural compression was seen in 25% of the patients with metastasis as indicated by CT-M. In group 2 (n = 26), CT-M disclosed that 38% had a benign compression fracture and 62% had metastases and that 63% of the patients with metastases had an epidural compression. In group 3 (n = 16), spinal CT revealed that 15 patients had metastases (one patient had benign disease). Epidural cord compression was seen in 47% of the patients with metastatic disease. In all groups, the presence of cortical bone discontinuity around the neural canal (seen in 31 patients) was highly associated with epidural compression (seen in 20 patients). Our approach allowed the early and accurate diagnosis of spinal metastasis and epidural tumor as well as the diagnosis of benign disease and was useful in planning optimal local therapy.

Bone and Bones↗
PubMed1984

Treatment of Schistosoma mekongi with praziquantel in Cambodian refugees in holding centres in Prachinburi Province, Thailand.

Eighty-four cases of schistosomiasis mekongi among Cambodian refugees in holding centres in Thailand received praziquantel at 30 mg/kg body-weight orally twice in one day. Those treated were admitted to hospital in order to observe side effects for 24 hours. Assessment of the efficacy of praziquantel was based on cure rates. Side effects observed consisted primarily of abdominal pain, anorexia, nausea, emesis and headache. These were generally mild and transient. Physical signs revealed mild hepatomegaly and splenomegaly. The cure rate obtained one month after treatment was 97.5% and by 2 to 12 months after treatment reached 100%.

Adolescent↗
PubMed1984

Health risk attitudes, beliefs and behaviors of students grades 7-12.

The purpose of this study was to identify trends for youths grades seven to 12 with respect to their attitudes, beliefs and behaviors related to smoking and weight. The results of this study indicate that the majority of students believe smoking is a real health problem. However, the strength of this belief decreases with age. The majority of students agree that smoking does not help people relax, however, the strength of this belief also decreases with age. The majority of students also agree that smoking is not socially okay and again the strength of this belief decreases with age. Another interesting finding, differing from the trends previously mentioned, is that of asking permission before smoking. It was consistent that about 75% of students at all grade levels believed that they would ask permission before smoking around others. Another finding consistently supported across the grades more than 80% believed that a separate area should be provided for those who want to smoke in buildings where smoking is permitted. Youths report a significant decline in the percent of their peers that do not smoke as grade level increases. The decline is from 76% at the seventh grade to 39% at the 12th. While students at each grade level report that approximately one-third of their mothers and 43% of their fathers smoke they also indicate that 16% of their fathers and 10% of their mothers have given up the smoking habit. Youths also consistently report that their parents would be upset if they were to smoke.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

The relationship between health risk attitudes and behaviors and parental presence.

The purpose of this study was to assess whether an association exists between a student's attitudes and behaviors about selected health risks, such as weight and smoking behavior, and the presence or absence of one or both parents. Data were collected from 5,411 central Illinois school-age youth in grades 7-12. Physical measurements were taken on all students. Also, a variety of attitudinal, behavioral and behavioral intention questions relative to risk factors including smoking and weight were developed. Comparisons for these areas were made between students identified as having both parents versus those having none or one parent. The data were analyzed using the Statistical Package of the Social Sciences (SPSS). Both a descriptive and chi-square statistical analysis were utilized. Results indicated that students with none or one parent report significantly higher health risk behaviors than students with both parents. Students with none or one parent reported being more overweight and having a significantly higher smoking rate. The students also reported significantly greater unfavorable attitudes about smoking and weight. While these findings do not imply a cause and effect relationship, it does appear that the students missing one or both parents are at much higher risk than students with both parents. This knowledge can be useful to those involved in intervention efforts. Identifying students at risk allows educators to focus their efforts on such groups. Further implications of the specific findings of this study are discussed.

Adolescent↗
PubMed1983

The relative importance of parental attitudes and behavior upon youth smoking behavior.

The purpose of the study was to assess the relative importance of parental attitudes about smoking and parental smoking behavior as factors associated with youth smoking behavior. Knowledge of the relative importance of each variable could enhance antismoking educational efforts. Data were collected from 5,409 central Illinois school-age youth in grades 7-12. Data were analyzed by sex. A variety of attitudinal, behavioral and behavior intention questions relative to risk factors, including smoking, were developed. Specific questions about parental attitudes, parental behavior, and the youth's smoking behavior were included. Descriptive and chi-square statistical analyses were utilized. Results indicate that both factors are significantly associated with youth smoking behavior. However, it appears that parental attitudes may exert a more significant impact than parental behavior. Whereas parental behavior seems to be associated with a doubling of the youth smoking rate, it appears that parental attitude is associated with an approximately fourfold increase. These results need to be interpreted within the larger context that a number of variables, and not just smoking attitudes and parental behavior have been found to be associated with youth smoking behavior. However, within this overall context it appears that parental attitude toward youth smoking is a more significant factor associated with youth smoking behavior than parental behavior. As such, those involved with youth antismoking educational efforts may find it helpful to include this factor.

Adolescent↗
PubMed1981

Representation of providers on health planning boards.

PL 93-641, The National Health Planning and Resources Development Act of 1974, called for broad representation of health care providers, in addition to consumers, on Health Systems Agency (HSA) governing boards. Analysis of data submitted to the U.S. Department of Health, Education, and Welfare by the HSAs indicated that HSA provider board members are not representative of the overall provider work force or general population. Direct providers outnumber indirect providers by roughly seven to one. Physicians and hospital-nursing administrators are overrepresented, and nurses and other provider groups underrepresented, in relation to their numbers in the work force. Evidence also shows that HSA provider board members are mostly white males, although nonwhites and females are significantly represented in the work force and population.

Administrative Personnel↗
PubMed1980

Studies on dengue 2 virus infection in cyclophosphamide-treated rhesus monkeys.

Dengue 2 virus (D2V) replication has been demonstrated in cultured primate mononuclear phagocytes, mitogen treated lymphocytes and lymphoblastoid cells. To determine which of these cell types might play an important role in sustaining infection in vivo, nine rhesus monkeys were immunosuppressed with cyclophosphamide and then infected with D2V. Maintenance dose which held total white blood cell counts to less than 3000/mm3 ablated both primary and secondary antibody responses. Six successfully immunosuppressed animals circulated virus and infected monocytes in blood for prolonged periods. Virus was recovered from lymphatic organs and visualized in tissue mononuclear leukocytes in two subjects dying during the experimental period. The results argue against the hypothesis that lymphoblasts play an important role in dengue virus infection but are consistent with the possibility that mononuclear phagocytes are the site of viral replication in vivo.

Animals↗
PubMed1979

Effect of immune status on dengue 2 virus replication in cultured leukocytes from infants and children.

Cord blood leukocytes from neonates with maternal dengue antibody supported dengue 2 virus replication in vitro; those from neonates without maternal antibody did not. Cord bloods of infants born to dengue-immune mothers contained a potent enhancing factor which gradually decayed with age and which was absent from neonates born to nonimmune mothers. Permissiveness of cultures of washed peripheral blood leukocytes from infants with maternal antibody declined steadily with increasing age in parallel with the decay of maternal antibody, and the leukocytes were no longer permissive after 10 to 12 months. The demonstration of a dengue maternal infection-enhancing factor in human cord blood from dengue-immune mothers supports the hypothesis that severe primary dengue hemorrhagic fever with shock seen in Bangkok infants is related to maternal immune status.

Age Factors↗
PubMed1979

Absence of leukocytes permissive to dengue 2 virus in the acute phase of dengue hemorrhagic fever.

Patients with primary dengue infection developed dengue 2 virus (D2V) permissive peripheral blood leukocytes (PBL) 2--3 weeks after infection. PBL from healthy individuals with dengue antibody were permissive to D2V in vitro, suggesting that immunologically mediated in vitro D2V permissiveness persists for a relatively long time after recovery from dengue infection. However, PBL obtained from second infection dengue hemorrhagic fever patients did not support D2V growth during the acute phase of illness but did so during convalescence. Leukocytes from dengue-immune patients with typhoid fever or non-dengue viral illness were permissive throughout both acute and convalescent phases of illness although there was tendency for increased permissiveness during convalescence. Acute phase PBL from DHF patients synthesized and secreted dengue neutralizing antibody in culture. Absence of D2V replication in these cultures was strongly, but not completely, correlated with antibody production. Other immunological mechanisms, in addition to antibody, may be operating in vitro or in vivo during acute phase dengue hemorrhagic fever to alter the permissiveness of PBL to D2V infection.

Adolescent↗
PubMed1974

Percutaneous needle localization of clustered mammary microcalcifications prior to biopsy.

Mammography occasionally reveals the presence of suspicious appearing clustered microcalcifications without an associated mass. Clinical localization of these microcalcifications within the breast is difficult, even using the 2 dimensional effect of a mammogram. Percutaneous needle localization of these microcalcifications is recommended for its accuracy, patient acceptance, and reduction in size of the biopsy specimen. No complications of this procedure have been encountered.

Biopsy↗
PubMedDate not supplied

AAHE scholar presentation. Boston, April 22, 1989. Reflections on directions in health education: implications for policy and practice.

In summary, this paper has attempted to share some reflections on directions in health education. I have called attention to the issue of "micro myopia," which narrows our perspective, turns us inward, and predisposes us to be less supportive of societal responses. The need for a broader perspective was presented and directions in which we should be going were identified. Attention was directed at the disproportionate and inappropriate emphasis on risk factors. Our limited knowledge base is evident, as are the limitations of an individual behavior approach. Concern was also expressed about the increased phenomenon of the educationalization of health problems and the gradual emergence of a mortality in health education. Finally, the relationship of risk factors to health was challenged. It seems that reduced mortality and increased longevity are driving forces, but are these synonymous with health? Few would argue that they are. Overall, concerns have been raised and suggestions forwarded for consideration, analysis, and debate. Where will we be in the year 2000? I don't know. Hopefully this presentation will provide insight into our current positions and help us reflect on our future directions.

Attitude to Health↗