Biomedical subjects
B McNicholl
Publications and source records attributed to B McNicholl.
Coeliac disease in Galway, Ireland 1971-1990.
Recent studies have reported changes in the incidence of coeliac disease and in its presentation. We carried out a retrospective study looking at the incidence and clinical features of coeliac disease in Galway children over a 20 year period. The study period was divided in two parts. (I) Patients diagnosed between 1971 and 1980 and (II) between 1981 and 1990. Comparison was made between demographic and clinical data in these two periods. There were 97 cases of coeliac disease diagnosed in children resident in Galway over the 20 year period. 71 patients were diagnosed in period I and 26 in period II. The median age at diagnosis in period I was 1.41 years and 4.95 years in period II. There were more females diagnosed in period I. Growth data, histology and enzyme levels were similar in both groups. Diarrhoea and vomiting were the major presenting symptoms in both periods but more patients presented with wasting or abdominal protuberance in the latter period. Our data support the concept that coeliac disease in childhood is declining, and is presenting at a later age.
Fluid resuscitation in traumatic haemorrhage.
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The epidemiology of major trauma in Northern Ireland.
In a one year population based study of major trauma (Injury Severity Score greater than 15) reaching hospitals in Northern Ireland in 1990/91 the incidence was 23.2 per 100,000 of the population or 20.5 per 100,000 excluding terrorist activities. The expected number of patients with major trauma for the province, (population 1.54 million) is 359 patients per annum. Road accidents and falls accounted for 71% of all trauma. Ninetynine patients per annum are expected to require immediate surgery, a laparotomy in 59 instances and neurosurgical procedures in 26. These data facilitate resource allocation and help predict the effects of future changes in the trauma system.
Rammed by a ramp causing low-velocity sternal fractures.
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Guidelines and a proposed audit protocol for the initial management of an acute hot joint.
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Sarcoidosis following B.C.G. vaccination in a lymphopaenic boy.
A case of sarcoidosis in an eleven year-old boy which developed four months following B.C.G. vaccination is presented. This was associated with lymphopaenia of undetermined origin which persisted after the pulmonary lesions subsided.
Ultrasound in diagnosis of infantile hypertrophic pyloric stenosis.
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Decreasing incidence of coeliac disease.
Between 1960 and 1974 the incidence of coeliac disease in children under 12 years in County Galway remained fairly constant, but since 1975 it has fallen by 62% and the lowered incidence seems well established. The number of those who were breast fed and the age at which first gluten feeding took place during the 22 years both increased significantly and from the mid-70s total protein content and osmolarity of proprietary cow's milk formulas were reduced. All three factors may be relevant. A negative correlation with the incidence of gastroenteritis was found.
Compliance with gluten free diet in coeliac disease.
Fifty two children in whom coeliac disease was confirmed by persistent enteropathy while they were taking gluten were monitored to assess the effects of compliance with a gluten free diet (GFD). Between the ages of 17.8 and 18.5 years height (in 45 patients followed up for a mean of 14.9 years) and weight (in 43 followed up for a mean of 15.2 years) were significantly lower in those complying poorly with a GFD compared with those complying well. Of the 37 patients still attending the clinic after a mean of 25 years, having been followed up for a mean of 18.4 years, 16 who had complied well with the diet had normal or only slightly abnormal mucosal morphology whereas all 10 who had not complied had abnormal morphology. In these 10 lactase, sucrase, and alkaline phosphatase activities were significantly less than values in those who complied well. Mucosal sucrase and alkaline phosphatase activities in those who complied well were no different from those in a control population, whereas lactase activity was significantly lower. It is concluded that failure to comply with a GFD during childhood results in decreased adult stature and in persisting active enteropathy with depressed brush border enzyme activity.
Excessive head growth in early infancy: a feature of Sotos' syndrome.
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Coeliac disease: ecology, life history and management.
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Management of coeliac disease.
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Re: Infantile hypertrophic pyloric stenosis.
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Gastroenteritis associated with enterotoxigenic Escherichia coli 078 H12.
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