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Biomedical subjects

C C Murphy

Publications and source records attributed to C C Murphy.

At least 37 records · Page 2Linked to original sources
PubMed1994

Hearing impairment among 10-year-old children: metropolitan Atlanta, 1985 through 1987.

The prevalence of hearing impairment among 10-year-old children in metropolitan Atlanta between 1985 and 1987 was evaluated. Hearing-impaired children were identified by reviewing records at public schools and health and social service agencies. The prevalence was 1.1 per 1000 and was slightly higher among Blacks and boys than among Whites and girls. The most common known causes of hearing impairment were meningitis (0.3 per 1000), genetic and hereditary conditions (0.2 per 1000), and congenital rubella syndrome (0.1 per 1000). For 55% of the children, the etiology of the hearing loss could not be determined. Most (74%) of the children were diagnosed after the age of 2, suggesting that methods of early identification need to be improved.

Child↗
PubMed1993

Mental retardation in ten-year-old children in relation to their mothers' employment during pregnancy.

We conducted a case-control study to examine relationships between potential risk factors in women's prenatal occupational histories and subsequent mental retardation in their 10-year-old children. Children with mental retardation (intelligence quotient less than 71) were identified from special education records maintained by the public school systems in the metropolitan Atlanta area and from records of various medical and social service agencies serving children with special needs. Control children were chosen from the rosters of 10-year-olds who were enrolled in regular education classes in the local public school systems. To obtain occupational histories, sociodemographic data, and other information, we interviewed 352 natural mothers (67%) of 525 case children and 408 natural mothers (64%) of 636 control children. We computed odds ratios for each of 25 selected occupation, industry, and agent categories controlling for maternal education, birth order, and race. Most comparisons yielded odds ratios that were not indicative of unusual risks, but we did find lower than expected risks among children of teachers and health-care professionals. We also found a strong, positive association between mental retardation and maternal employment in the textile and apparel industries. The findings are useful for planning the direction of future studies of childhood cognitive ability to focus on specific parental occupations or industries.

Adult↗
PubMed1993

Prevalence of cerebral palsy among ten-year-old children in metropolitan Atlanta, 1985 through 1987.

The Metropolitan Atlanta Developmental Disabilities Study was a population-based study (1985 through 1987) to determine the prevalence of five developmental disabilities among 10-year-old children. The disabilities included cerebral palsy, mental retardation, visual impairment, hearing impairment, and epilepsy. The prevalence of cerebral palsy (CP) and a description of the children with CP are reported here. Using a record review approach, we identified 204 10-year-old children with CP (resulting in a prevalence of 2.3 per 1000). The rate of CP was significantly higher among boys (prevalence odds ratio = 1.5; 95% confidence interval = 1.1, 2.0), and the rate was also higher among black children than white children (prevalence odds ratio = 1.3; 95% confidence interval = 1.0, 1.7). Thirty-three of the children (16%) acquired CP postnatally; these children were more likely to be black or male. The gender and racial differences found for acquired CP were greater than those for congenital CP. Approximately 75% of the children had one of the other four disabilities studied; 65% of the children were mentally retarded, 46% had epilepsy, and 15% had a sensory impairment. Our multiple-source method of identifying children with CP gave us a population-based sample from which to determine the prevalence of the condition and to study factors that are associated with CP.

Black People↗
PubMed1992

Legal blindness among 10-year-old children in Metropolitan Atlanta: prevalence, 1985 to 1987.

The prevalence of legal blindness in 10-year-olds in metropolitan Atlanta was 6.8 per 10,000 during 1985 to 1987. The prevalence was 8.8 per 10,000 in Black boys, 8.6 per 10,000 in White boys, 6.7 per 10,000 in White girls, and 1.8 per 10,000 in Black girls. Retinopathy of prematurity was the most common known cause (1.0 per 10,000). Of the 61 cases, 40 had other disabilities, including 14 with mental retardation, cerebral palsy, and epilepsy. The low prevalence among Black girls and the frequent occurrence of blindness with other disabilities are noteworthy.

Black or African American↗
PubMed1992

A multiple-source method for studying the prevalence of developmental disabilities in children: the Metropolitan Atlanta Developmental Disabilities Study.

The Metropolitan Atlanta Developmental Disabilities Study is the first US, population-based epidemiologic study of the prevalence of mental retardation, cerebral palsy, hearing impairment, and visual impairment among school-age children. The study population consisted of children who were 10 years of age between 1985 and 1987 and whose mothers were residents of the five Georgia counties of Clayton, Cobb, DeKalb, Fulton, and Gwinnett at the time of the child's birth. Since children with developmental disabilities are identified by and receive services from various health, social service, and education systems, a multiple-source case identification method was used. This study is unique in that individual school records were used to identify children with the four disabilities. Use of a multiple-source method made it possible to confirm specific conditions and to classify subtypes of disabilities. About 95% of the children with one or more of these four disabilities were initially identified through the school systems. This approach is much less costly than conducting medical and psychologic assessments on populations of children. In addition, this method made it possible to estimate accurately the "administrative prevalence" of these disabilities (ie, the number of children previously identified with these disabilities for the purpose of providing services). The prevalence rates found in this study, per 1000 10-year-old children, were as follows: mental retardation, 10.3; cerebral palsy, 2.0; hearing impairment, 1.0; and visual impairment, 0.6.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Palsy↗
PubMed1990

Oral anticoagulation in patients with short-bowel syndrome.

A 55-year-old woman was transferred to our institution from another hospital. The history of her present illness began 17 days earlier with a right-sided cerebral vascular accident (CVA). Three days later she had a superior mesenteric artery (SMA) embolus with infarcted bowel. Her small bowel was resected leaving about 20-25 centimeters of small bowel. A cardiac echo on hospital day 6 documented the presence of a left ventricular embolus, which was considered to be the cause of her CVA and SMA embolus. The cardiologists recommended lifelong anticoagulation, preferably with warfarin when technically feasible. After one month of warfarin therapy, with doses as high as 25 mg/d, the patient's prothrombin times (PTs) were not changed from baseline; however, this was probably due to concomitant therapy with vitamin K. Heparin was incorporated into her total parenteral nutrition (TPN) in preparation for her discharge. Because the TPN was cycled, she required subcutaneous heparin twice daily while off TPN. This patient's clinical course while she was maintained on heparin therapy was complicated by bleeding episodes and extensive thigh and abdominal hematomas, which led to erratic heparin absorption and widely fluctuating partial thromboplastin times. Ten months after the initiation of anticoagulation the patient was again tried on an oral warfarin regimen. She was successfully titrated to achieve the desired PT ratio. This case led to a review of the literature of patients with short-bowel syndrome requiring anticoagulation.

Anticoagulants↗
PubMed1989

Neonatal intensive care admissions: changing profile in Georgia, 1974 to 1982.

Birthweight-specific admission rates were reviewed from 1974 to 1982 for Georgia's five regional perinatal centers. Analysis of birthweight-specific neonatal intensive care unit (NICU) admissions as a proportion of total live births revealed an upward trend for infants weighing 1,000 to 1,499 gm and a downward trend for those weighing 2,000 gm or more. This method revealed no significant trends for infants of weight groups less than 500 gm or 500 to 999 gm. Analysis of birthweight-specific admissions as a proportion of total NICU admissions revealed significant increases for all birthweight groups of less than 2,000 gm, with decreases in admissions for infants weighing more than 2,000 gm. Analysis of mortality data revealed improved survival for infants weighing less than 1,500 gm, but some centers showed increases in neonatal mortality, postneonatal mortality, or infant mortality among infants weighing 2,500 gm or more. During this study, low birthweight infants comprised an increasingly larger proportion of neonatal intensive care admissions. This trend evolved gradually through the process of regionalization and can be directly linked to the cost requirements of regional neonatal intensive care units.

Georgia↗
PubMed1983

Population genetic analyses of insulin dependent diabetes mellitus using HLA allele frequencies.

In order to try to detect heterogeneity within insulin dependent diabetes mellitus (IDDM) and to distinguish a mode of inheritance of IDDM, population genetic analyses were performed using HLA allele frequencies. HLA-A and -B typing performed on 231 IDDM individuals and 268 controls from the southeastern U.S. showed significant increases with IDDM in A2, B8, B15 and B18, and significant decreases in Aw23, B7, B14 and B17. The combination of HLA-B8/B15 showed a greatly increased risk (RR = 25.5). Between the 120 IDDM individuals and 123 controls HLA-DR typed, HLA-DR3 and -DR4 were significantly increased among the IDDM group and DR2 and DR7 were decreased. The risk for DR3/4 was 29.2. It appeared that the B15 association was secondary to the DR4, but the B8/DR3 association showed no difference. Using the method of Curie-Cohen, no significant increases in risk were found for the B8/B15 or DR3/DR4 heterozygotes when compared to the respective homozygotes. Using the method of Thomson and Bodmer, the dominant mode of inheritance was excluded for DR4 only. There was a significant increase in B15 and DR4 in those with onset before age 20. No significant differences were found among the DR phenotypes with respect to season.

Age Factors↗
PubMed1983

Genetic analysis of multiply-affected families of insulin-dependent diabetes mellitus (IDDM) probands.

The present study combines segregation and linkage information on 30 families ascertained through a proband and a first degree relative affected with insulin-dependent diabetes mellitus (IDDM). An autosomal dominant model with incomplete penetrance was much more likely to fit the family data than a recessive model, whether or not linkage to HLA was assumed. The lod scores for linkage to HLA were 2.46 at theta M = theta F = 0.00 for dominant and 1.45 at theta M = theta F = 0.22 for a recessive model. The results are discussed in light of heterogeneity in likelihood and lod scores when the families are grouped by familial types, which indicate that the increase in likelihood of a dominant hypothesis can be attributed to the parent-child families and not the sib-sib families.

Adult↗
PubMed1982

HLA-A, -B, and -DR associations in type I diabetes mellitus with onset after age forty.

It remains to be convincingly demonstrated whether insulin-requiring, ketosis-prone, lean-at-onset, type I diabetics who develop their disease after age 40 have the same disease as the children with similar characteristics. To address this question, we examined the population HLA genetic associations of this group. One hundred forty white, insulin-using diabetics with onset of disease past age 40 yr and 268 normal white controls have thus far been analyzed for HLA type. In the group of patients who were lean-at-onset and/or ketosis-prone (N = 54), there was a significantly increased frequency of DR4 (RR = 4.63; P less than 0.01) and significantly decreased frequency of DR2 (RR = 0.18; P less than 0.05) after correction. DR4 was also significantly increased after correction (RR = 5.72; P less than 0.25) in the subgroup who were both lean and ketosis-prone (N = 23). No significant differences in HLA-DR frequencies were found between the obese and not-ketosis-prone group (N = 69) and controls. No significant associations of HLA-A or-B antigens with either group were observed after correction for the number of antigens tested. To our knowledge, this is the first such study in the United States, and the first demonstrating that late onset diabetics who are lean-at-onset and/or ketosis-prone exhibit HLA-DR antigen associations which are similar to early onset cases.

Adult↗
PubMed1982

Evidence for genetic admixture as a determinant in the occurrence of insulin-dependent diabetes mellitus in U.S. blacks.

In recent years, it has been proposed that genetic admixture may have played a role in the increased frequency of insulin-dependent diabetes mellitus (IDDM) in young U.S. blacks relative to African blacks. In support of this proposal, the similar associations of specific markers of the major histocompatibility complex (MHC) with IDDM in U.S. blacks with respect to U.S. whites have been cited. To determine whether racial admixture was a factor in the increased prevalence, we did three analyses of admixture. In the first we used nine genetic markers (ABO, Rh, Fy, Hp, Gc, Pl, OR, Tfr, and Gm) and determined that there was significantly greater than zero genetic contribution from whites in our sample of U.S. black IDDM patients (9.6 +/- 2.3%, P less than 0.01) when a sample of U.S. blacks without IDDM was used as one "parental" population. In the next two analyses, we estimated the amounts of genetic contribution from whites in the U.S. blacks with and without IDDM using reported gene frequencies for West African blacks for four genetic markers (ABO, Rh, Fy, and Hp). The estimate of admixture (21.4 +/- 2.8%) for the black IDDM sample was greater than that for the U.S. black controls (17.9 +/- 2.3%), although the difference was not significant. Our estimate of genetic contribution from whites, 21.4% for black IDDM patients, supports the assumptions of 20% admixture which MacDonald and Rotter and Hodge used to test their respective models for the inheritance of IDDM. These results support the hypothesis that admixture with the white population is, in part, responsible for the increase in prevalence of IDDM seen in U.S. blacks.

Black People↗
PubMed1981

HLA associations with insulin-dependent diabetes mellitus in a sample of the American Black population.

It has been of considerable interest to determine if the HLA associations with insulin-dependent diabetes mellitus (IDDM) in blacks are the same as in whites in the United States. Seventy-nine black IDDM patients who were under the age of 40 at onset 283 black controls were HLA typed for A, B and C specificities. This is the largest sample of black IDDM patients yet reported. Analysis of HLA antigen frequencies for these samples has revealed an increased frequency of HLA B8 (p less than 0.01), B3 (p less than 0.02) and B15(p less than 0.006), and a decreased frequency of B14 (p less than 0.01). The estimate of relative risks for B8 and B15 was 2.6 and 4.4, respectively. Comparison of a subsample of the black patients (n = 61) and controls (N = 137) revealed increased frequencies of DR3 (p less than 0.0004), DR4 (p less than 0.0002), and DR7 (p less than 0.03) in the IDDM patients. Both HLA DR2 and DR5 were decreased in the diabetic patients (p less than 0.0001 and p less than 0.0002, respectively). All p values were uncorrected. The associations of HLA antigens with IDDM in our black American sample are essentially the same as those found in white IDDM patients. This suggests that the occurrence of IDDM in American blacks may be due to admixture of white genes.

Adolescent↗
PubMedDate not supplied

Contribution of sickle cell disease to the occurrence of developmental disabilities: a population-based study.

PURPOSE: Population-based surveillance of children aged 3-10 years from metropolitan Atlanta was used to determine if stroke-related neurological damage in children with sickle cell disease (SCD) is associated with developmental disabilities (DD). METHODS: School and medical records were reviewed annually to identify eligible children. Observed-to-expected ratios, P values, and population attributable fractions were calculated. RESULTS: Children with SCD had increased risk for DD (O/E = 3.2, P < 0.0001), particularly mental retardation (O/E = 2.7, P = 0.0005) and cerebral palsy (O/E = 10.8, P < 0.0001). This risk was confined to DD associated with stroke (O/E = 130, P < 0.0001; for DD without stroke: O/E = 1.3, P = 0.23). CONCLUSIONS: Children with SCD have increased risk for DD associated with stroke; thus, aggressive interventions are needed to prevent stroke in these children.

Anemia, Sickle Cell↗