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Luimneach, Ireland

Deegan B.M.,National University of Ireland | Cooke J.P.,Clinical Age Assessment Unit | Lyons D.,Clinical Age Assessment Unit | Olaighin G.,National University of Ireland | Serrador J.M.,Medical Center East Orange
2010 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC'10 | Year: 2010

The majority of cerebral autoregulation research has focused on the middle cerebral artery. However, many symptoms of presyncope indicate posterior cerebral hypoperfusion. To address this issue, we measured cerebrovascular reactivity, cerebral blood flow velocity and dynamic cerebral autoregulation in the middle cerebral artery and vertebral arteries during orthostatic stress to presyncope in 9 healthy subjects. There was no significant difference in either the decline in cerebral blood flow velocity or indices of dynamic cerebral autoregulation between the middle cerebral and vertebral arteries prior to or during presyncope. In conclusion, there is no significant difference in regulation of blood flow between the vertebral artery and middle cerebral artery in healthy subjects. Further study is required to determine whether or not a difference exists in syncopal patient populations. © 2010 IEEE.

Pope G.,Clinical Age Assessment Unit | Wall N.,Clinical Age Assessment Unit | Peters C.M.,Clinical Age Assessment Unit | O'Connor M.,Clinical Age Assessment Unit | And 7 more authors.
Age and Ageing | Year: 2011

Objectives: To evaluate specialist geriatric input and medication review in patients in high-dependency continuing care. Design: prospective, randomised, controlled trial. Setting: two residential continuing care hospitals. Participants: two hundred and twenty-five permanent patients. Intervention: patients were randomised to either specialist geriatric input or regular input. The specialist group had a medical assessment by a geriatrician and medication review by a multidisciplinary expert panel. Regular input consisted of review as required by a medical officer attached to each ward. Reassessment occurred after 6 months. Results: one hundred and ten patients were randomised to specialist input and 115 to regular input. These were comparable for age, gender, dependency levels and cognition. After 6 months, the total number of medications per patient per day fell from 11.64 to 11.09 in the specialist group (P = 0.0364) and increased from 11.07 to 11.5 in the regular group (P = 0.094). There was no significant difference in mortality or frequency of acute hospital transfers (11 versus 6 in the specialist versus regular group, P = 0.213). Conclusion: specialist geriatric assessment and medication review in hospital continuing care resulted in a reduction in medication use, but at a significant cost. No benefits in hard clinical outcomes were demonstrated. However, qualitative benefits and lower costs may become evident over longer periods. © The Author 2010. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

Quinn C.,Clinical Age Assessment Unit | Cooke J.,Clinical Age Assessment Unit | O'Connor M.,Clinical Age Assessment Unit | Lyons D.,Clinical Age Assessment Unit
Aviation Space and Environmental Medicine | Year: 2011

Background: Cervical artery dissection is a common cause of stroke in young patients without vascular risk factors and may affect the carotid or vertebral arteries. The risk of spontaneous dissection is higher in those with genetic predisposing factors while other cases may be precipitated by an event involving head or neck movement or associated with direct neck trauma. Case Report: We present the case of a previously well young woman with a history of migraine who developed internal carotid artery dissection following a turbulent short-haul commercial flight while restrained using a seatbelt. Discussion: We propose that repetitive flexion-hyperextension neck movements encountered during the flight were the most likely precipitant of carotid artery dissection in this case and review the therapeutic options available. © by the Aerospace Medical Association, Alexandria, VA.

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