PubMed Health⌕ Search

Biomedical subjects

B McCarthy

Publications and source records attributed to B McCarthy.

At least 19 recordsLinked to original sources
PubMed1996

Molecular IDDM epidemiology: international studies. WHO DiaMond Molecular Epidemiology Sub-Project Group.

The WHO DiaMond Molecular Epidemiology Sub-Project is testing the hypothesis that the geographic differences in IDDM incidence reflect population variation in the frequency of IDDM susceptibility genes (i.e., DQA1 and DQB1 alleles with sequences coding for arginine (R) in position 52 of the DQ alpha-chain, and an amino acid other than aspartic acid (ND) in position 57 of the DQ beta-chain, respectively) using a standardized case-control design. Data from twelve populations which have completed (or have nearly completed) recruitment and HLA molecular analyses are presented. There was an approximate 2-fold increase in the frequencies of DGA1*0301, DQB1*0201 and DQB11*0302 among IDDM cases compared to non-diabetic controls in most populations. Interestingly, DQA*0301 was more common in low versus moderate-high incidence countries. DQB1*0201 and DQB1*0302 were more prevalent in the moderate-high incidence areas. DQA1*R and DQB1*ND were both consistent markers of IDDM risk, with stronger associations in moderate-high versus low incidence areas. In general, individuals homozygous for both DQA1*R and DQB1*ND had the highest genotype-specific IDDM incidence rates, which approximated risk estimates for first degree relatives in several countries. These data revealed considerable variation in the frequencies of DQB1 and DQA1 alleles across countries, which likely contribute to the global patterns of IDDM incidence.

Alleles↗
PubMed1996

The low prevalence of immunogenetic markers in Korean adult-onset IDDM patients.

OBJECTIVE: IDDM is an autoimmune disease that occurs among genetically susceptible individuals. In Asian populations, it is not uncommon for adult patients with NIDDM to eventually lose beta-cell function and develop IDDM. These individuals may be characterized by autoantibodies to GAD and high-risk HLA-DQ alleles, which are unlikely to be prevalent among patients with true NIDDM or in the general population. The objective of the present study was to evaluate and compare the prevalence of these immunogenetic markers in NIDDM patients and healthy nondiabetic individuals from Korea. RESEARCH DESIGN AND METHODS: The prevalences of anti-GAD antibodies and HLA-DQA1 and DQB1 alleles among 121 patients with newly diagnosed NIDDM identified from a population-based study in Yonchon, Korea, and 100 matched healthy control subjects were evaluated and compared. RESULTS: The overall prevalence of anti-GAD antibodies was 1.7% (2 of 121) in patients with previously undiagnosed NIDDM, whereas 1 of 100 control subjects had a positive test for antibodies. Among those who tested positive, titers of antibodies to GAD were not high. No statistically significant differences in the distributions of either mean levels of anti-GAD antibodies or DQA1 and DQB1 alleles were found comparing NIDDM patients with control subjects. Interestingly, the frequency of DQB1*non-Asp-57 and DQA1*Arg-52 alleles in the Korean adult control population was similar to that in the U.S. white population (DQB1*non-Asp-57: 0.431 vs. 0.475; DQA1*Arg-52: 0.492 vs. 0.463). CONCLUSIONS: The low prevalence of anti-GAD antibodies and HLA-DQA1 and DQB1 susceptibility alleles among recent-onset NIDDM patients, which was similar to observations in control subjects, suggests that diabetes in Korean adults is unlikely to have an autoimmune component to its pathogenesis.

Adult↗
PubMed1994

Continuously improving primary care.

BACKGROUND: This article describes efforts to understand and improve the daily work processes of primary care within the Henry Ford Health System, where continuous quality improvement (CQI) has been a key business strategy since 1988. We began a pilot project in 1990 that attempted to accelerate the implementation of continuous improvement in primary care. The clinical site was the general internal medicine (GIM) ambulatory clinic, which has 50,000 patient visits annually. STRATEGIES FOR IMPROVEMENT: For four key elements--physicians as leaders, prevention and primary care, patient access, and innovation and team work--we planned and implemented continuous improvement based on three questions: What were we trying to accomplish? What can we change that would lead to an improvement? How would we know a change is an improvement? EXAMPLE: Prevention and Primary Care. In our primary care setting, an appropriate clinical process to improve would include preventive medicine, specifically Pap-smear performance. In our partnership with the department of obstetrics/gynecology, GIM physicians wanted to improve the rate of adequate Pap smears. To reduce variation in the rates with which physicians collected specimens that were adequate for cytologic examination, the team recommended use of a specific tool, a cervi-brush, which should be more effective in producing adequate specimens. As cervi-brush use increased, rates of inadequate Pap smears dropped from 20%-25% in 1989 to less than 10% for the first six months of 1991. CONCLUSIONS: By focusing attention and resources on a limited number of improvement teams, our initial success built enthusiasm and commitment within GIM and accelerated changes that were incorporated into strategic planning for the Henry Ford Health System as a whole.

Female↗
PubMed1993

A partnership to save children's lives--the school nurse/Medic Alert kids program.

The Medic Alert Foundation, in a soon-to-be-launched national program, seeks to educate families about Medic Alert and how its emergency information service helps prevent emergencies from becoming tragedies. This report discusses the role the school nurse plays in determining which children are at risk, what needs to be done, and how Medic Alert can provide the needed protection.

Child↗
PubMed1992

Streetlife and delinquency.

The correlation between class and delinquency often observed in areal studies and assumed in prominent sociological theories is elusive in studies of individuals commonly used to test these theories. A restricted conceptualization of class in terms of parental origins and the concentration of self-report survey designs on adolescents in school have removed from this area of research street youth who were once central to classic studies of delinquency. We argue that street youth experience current class conditions that cause serious delinquency, and that life on the street is an important intervening variable that transmits indirect effects of control and strain theory variables, including parental class origins. Data gathered from nearly 1000 Toronto school and street youth are analyzed with important implications for the conceptualization of class and delinquency, testing and integrating sociological theories of delinquency, the measurement of delinquency, and the use of cross-sectional and longitudinal research designs. Our findings especially encourage incorporation of street-based samples into research on class-based aspects of theories of delinquency.

Adolescent↗
PubMed1991

New technique for Hartmann's reconstruction.

Since the introduction of Hartmann's operation and its broader applications, restoration of intestinal continuity has posed technical challenges and significant morbidity. We describe a technique for Hartmann's reconstruction, utilizing a circular anastomotic stapling device that is simple and fast and that minimizes the potential for contamination, in which the bowel lumen remains closed at all times.

Anastomosis, Surgical↗
PubMed1990

Pubic osteolysis. A benign lesion of the pelvis closely mimicking a malignant neoplasm.

Pubic osteolysis is now recognized as a distinct diagnostic entity. It is characterized by roentgenographic findings of rapidly progressing destructive changes in the pubic rami, pubis, or pubic symphysis. A soft-tissue mass with calcification may be present. Overlapping roentgenographic and even histopathologic features with chondrosarcoma may lead to erroneous diagnosis and over-treatment. Each of the six new cases of pubic osteolysis in this report involved middle-aged to elderly females. Three out of six cases had no antecedent trauma. The pathologic findings were extensive reparative changes that included metaplastic cartilage, bone formation, and granulation tissue with myxoid and angiomatoid patterns. Four of the six cases were initially diagnosed after biopsy as low-grade malignancies. One of these was treated with a partial pelvectomy. The follow-up period in the cases was from one to 41 months. In all cases, the initial complaints of pain about the pelvis gradually subsided with conservative therapy. Differentiating pubic osteolysis, osteitis pubis, and pubic osteomyelitis should not be difficult; pertinent differential features are discussed.

Aged↗
PubMed1989

International collaborative effort (ICE) on birth weight, plurality, perinatal, and infant mortality. III: A method of grouping underlying causes of infant death to aid international comparisons.

Underlying causes of infant death, as coded in the ninth revision of the International Classification of Diseases, have been grouped into a system of seven functional categories plus one additional group of "other and unclassifiable" diagnoses. The groups comprise congenital anomalies, asphyxia related conditions, immaturity related conditions, infections, sudden death, deaths due to external causes, and other specific conditions. The groups were constructed by using a frequency distribution of underlying cause of death in 200,000 infant deaths in 1980-84 in the U.S.A. When analysed according to age at death and according to birth weight, the distribution of the functional groups had patterns which corresponded to what might be expected clinically. Each functional group has common features which require intervention at a specific time for prevention and treatment. We propose that it is used as a tool in epidemiological surveillance and to guide health authorities in priorities for disease control. International comparisons of time trends will be undertaken.

Asphyxia Neonatorum↗
PubMed1989

International Collaborative Effort (ICE) on birthweight; plurality; and perinatal and infant mortality. I: Methods of data collection and analysis.

This paper describes the collection and analysis of data by a group of international collaborators (International Collaborative Effort on Perinatal and Infant Mortality) interested in comparative studies on birthweight distributions and reproductive outcome. This is the first of a series of reports on the results of these studies. It gives an account of the countries or states involved, and the collection and characteristics of the data. The countries and states included sixteen of the United States, plus England and Wales, Denmark, Bavaria and North Rhine-Westphalia from the Federal Republic of Germany, Israel, Japan, Norway, Scotland, and Sweden. The data comprised birthweight distributions in 500-gram groups for all births and for singletons separately, for livebirths, stillbirths, first week deaths and, where available, late neonatal and infant deaths, from 1970 up to 1985.

Birth Weight↗
PubMed1989

Management of multiple enterocutaneous fistulas.

Enterocutaneous fistulas present a difficult management problem in the intensive care unit. Although some patients require surgical intervention for fistula control, key elements to good clinical management include mechanical control and vigorous nutritional support. This approach includes eradication of malnutrition, support of the hypercatabolic state, and maintenance or replacement of protein loss from fistula drainage. Good mechanical control involves integument protection and a mechanism of drainage collection. The patient we describe taxed the ingenuity and creativity of all those concerned with his care. Modification of a previously described technique to protect surrounding skin and collect fistula output served as a simple and inexpensive approach to eliminate infection potential, improve the patient's comfort, and decrease the nursing time that would have been required for frequent, complex dressing changes.

Aged↗
PubMed1988

Iodine concentrations in milk of dairy cattle fed various amounts of iodine as ethylenediamine dihydroiodide.

Due to concerns about high I in milk, the dairy industry has proposed a voluntary standard of 500 micrograms of I/L as the maximum allowable I in milk sold for processing and human consumption. This study was undertaken to determine the amount of ethylenediamine dihydroiodide that could be fed to dairy cattle without exceeding this standard. Various amounts (0 to 45 mg/head per d) of the I compound were fed to a commercial dairy herd for 50 wk. Individual and bulk milk samples were analyzed for total iodine. Milk I in herd bulk milk was directly correlated (r = .92) with the amounts fed. However, the correlation of milk I of individual cows was not as high (r = .66), indicating some individual variation in metabolism and secretion of the I into the mammary gland. Milk production and number of lactations did not correlate with I in milk. Regression analysis indicated that 25 to 30 mg of ethylenediamine dihydroiodide per day can be fed to dairy cattle receiving a diet otherwise low in I without exceeding a 500 micrograms concentration in milk.

Animals↗
PubMed1987

[High postneonatal mortality of infants in North Rhine Westphalia].

Infant mortality in North-Rhine Westphalia was increased above the national average throughout the postwar period until today. To clarify the underlying causes the official death certificates of infants who died during their first year were linked to their respective birth certificates. Thus, the amount of data about each individual case was increased considerably. The information collected was then evaluated. An especially high mortality was associated with the maternal risk factors illegitimacy, age below 20 and Turkish nationality. Perinatal mortality was high in the groups of Turkish nationals, and unmarried mothers. Socially underprivileged groups on the whole proved to contribute a high amount of postneonatal mortality. Predominant causes of postneonatal mortality were infections, injuries and the diagnosis "sudden infant death syndrome".

Birth Weight↗
PubMed1981

The risk of childbearing re-evaluated.

To determine the completeness of reporting of maternal deaths after live born deliveries in Georgia for 1975 and 1976, we matched death certificates with corresponding birth certificates for women of reproductive age. For these two years, more intensive searching led to our finding a minimum of a 27 per cent higher number of maternal deaths than that found by routine death certificate surveillance. When the delivery-death interval was not restricted to 42 days, use of the record linkage method led to a 50 per cent increase in reporting of maternal deaths. We recommend that special efforts be made to obtain more complete reporting of all pregnancy-related deaths and that completeness of reporting be periodically evaluated for all states.

Adolescent↗
PubMed1976

Toxic megacolon of ulcerative colitis in infancy.

A 12-week-old white male infant with ulcerative colitis and toxic megacolon is described. His diarrhea and rectal bleeding responded to prednisone. He subsequently developed toxic dilatation of the transverse colon while on salicylazosulfapyridine and one week after discontinuation of prednisone. His toxic megacolon disappeared during close medical observation, readministration of prednisone, and avoidance of repeated abdominal examinations. One year later sigmoidoscopy showed only friable mucosa and the barium enema showed the presence of ulcerative colitis but with improvement from the initial study. Currently he is taking 375 mg of salicylazosulfapyridine daily. Growth and development are normal and he is asymptomatic.

Colitis, Ulcerative↗