PubMed Health⌕ Search

Biomedical subjects

C Conway

Publications and source records attributed to C Conway.

At least 19 recordsLinked to original sources
PubMed2001

Altered subjective appetite parameters in Crohn's disease patients.

BACKGROUND AND AIM: Altered appetite and early satiety may promote anorexia associated with Crohn's disease. The aim of this study was to assess the impact of disease activity on subjective appetite parameters in Crohn's disease patients. METHODS: Seventeen patients with Crohn's disease and 15 healthy controls (8 M: 7 F, 34 (20-35) years) were studied. Subjects rated their hunger, desire to eat, fullness and level of satiety using visual analogue scales after an overnight fast. Subjects were reassessed after ingestion of 500 and 1000 ml water. Anthropometry was used to determine percentage body fat. Serum leptin & TNF- alpha levels were assessed using immunoassay. Disease activity was determined using the Harvey-Bradshaw index. RESULTS: Hunger ratings for active Crohn's disease patients were significantly lower than controls at baseline (P<0.05). Desire to eat was lower in patients with active Crohn's disease than controls both at baseline (95% CI, 0.3 mm, 40.7 mm) and after ingestion of 500 ml water (95% CI, 1.25 mm, 51.9 mm) (P<0.05). Serum leptin concentrations were significantly associated with percent body fat (r=0.57;P<0.001) and, after correcting for body fat status, tended to be higher in patients with active Crohn's disease (mean 0.9 ng/ml/% body fat; SD 0.8 ng/ml/% body fat) compared with either patients with inactive disease (mean 0.4 ng/ml/% body fat; SD 0.3 ng/ml/% body fat) or healthy controls (mean 0.3 ng/ml/% body fat; SD 0.2 ng/ml/% body fat) (P=0.15, ns). Appetite parameters and serum leptin concentrations showed no significant correlation. CONCLUSIONS: Subjective appetite parameters were altered in patients with active Crohn's disease. At baseline, patients with active Crohn's disease were less hungry than healthy controls and had less desire to eat. After ingestion of 500 ml of water, desire to eat was significantly less in patients with active disease as compared with healthy controls. Serum leptin concentration corrected for percent body fat tended to be higher in patients with active Crohn's disease compared with inactive Crohn's disease and healthy controls, but the differences did not reach statistical significance.

Adult↗
PubMed1998

Simple cyst in the postmenopausal patient: detection and management.

The aims of our study were to determine the prevalence of simple ovarian cysts in asymptomatic postmenopausal patients and to investigate the natural history of these cysts by ultrasonographic follow-up examinations. Three thousand five hundred and eighty-five women participated in the volunteer pelvic cancer screening program. Entry criteria were as follows: postmenopausal, no clinical symptoms, and no previous gynecologic pathology. An anechoic, small cyst less than 5 cm in greatest diameter was classified as a simple ovarian cyst. A scoring system to determine malignant potential had been established previously. All simple cysts had a score of 2 or less and had a morphology typical of benign lesions. In the case of a positive finding, the patient would be seen at 3 to 6 month intervals. The decision for surgical intervention was made by a private gynecologist or patient or if an interval change was noted. One thousand seven hundred and sixty-nine postmenopausal women (49.34% of all patients from the screening program) participated in this study. One hundred and sixteen simple cysts were found, with a prevalence of 6.6% in our population. Among those patients, 27 (23.28%) simple cysts resolved spontaneously, 69 (59.48%) have persisted, and 20 (17.24%) have been lost to follow-up study. Eighteen women (26.09%) with persistent simple ovarian cyst underwent surgery. No malignant ovarian conditions were identified. In conclusion, simple ovarian cysts are more common in postmenopausal women than previously was thought. This condition is very unlikely to be malignant and can be followed conservatively.

Adult↗
PubMed1998

Transvaginal color doppler ultrasound in the conservative treatment and surveillance of three ectopic pregnancies.

We evaluated the role of transvaginal color Doppler ultrasound in the treatment and follow-up after transvaginal instillation of methotrexate in ectopic pregnancy. Three patients diagnosed with ectopic pregnancies were treated with a single 50 mg dose of methotrexate, transvaginally instilled, under direct color sonographic guidance. Inclusion criteria required a gestational age of less than 8 weeks, non-ruptured ectopic pregnancy, gestational sac of less than 4 cm, and compliant patient. b-hCG titers, gestational sac sizes, and Doppler flow waveform analyses were followed at regular intervals. All three patients had falling b-hCG titers, shrinkage of the gestational sacs, and normalization of Doppler flow waveform indices. Transvaginal color Doppler ultrasound appears to be an effective adjunct in the treatment and follow-up of ectopic pregnancies treated with transvaginal instillation of methotrexate.

Abortifacient Agents↗
PubMed1995

The use of cervicography in the follow-up of cervical intraepithelial neoplasia treated by CO2 laser.

After treatment for cervical intraepithelial neoplasia (CIN) the follow-up of patients would be simplified if colposcopy could be safely omitted. A study of 50 patients was performed to determine the feasibility of such an approach. Cervical cytology, cervicography and colposcopy, with or without biopsy, was performed in each patient. From the results the following criteria for colposcopy were adopted: (a) patients thought to have CIN on cytology or cervicography, (b) inadequate cervicography picture (vagina covering cervix or poor quality photography), (c) high-risk factors present (immunosuppression, after cone biopsy, postmenopausal). In this study the number of colposcopies would have been reduced from 50 to 11 if these criteria were adopted. Cervical cytology combined with cervicography is a reasonable alternative to colposcopy and we feel this is a technique worth pursuing for the follow-up of patients treated for CIN.

Carbon Dioxide↗
PubMed1994

Prevalence in a volunteer population of pelvic cancer detected with transvaginal ultrasound and color flow Doppler.

Our objective was to find the prevalence of non-symptomatic endometrial and ovarian neoplasms in a volunteer population of women, aged 40 and over. We offered a free volunteer screening program to asymptomatic women for a study using transvaginal ultrasound and color flow Doppler for the detection of pelvic cancer. In the first 2 years, 2117 women were examined, 51.3% post-menopausal. An ovarian cyst was defined as having a maximum diameter of more than 2.4 cm. Color flow was used to identify blood vessels feeding pelvic organs and adnexal enlargements. An abnormal Doppler flow velocity for the ovary was defined as a resistance index of less than 0.41. Ovarian cysts of less than 5 cm with normal Doppler indices were followed up in 6 months to 1 year. An adnexal morphology score was created to quantify the usefulness of this parameter, particularly in postmenopausal women. Indications for surgery were pre-defined as a persistent ovarian cyst of more than 5 cm, a persistent suspicious Doppler and a total endometrial thickness of greater than 0.59 cm in postmenopausal women not taking hormones.A total of 202 women (9.5%) had ovarian cysts. Fourteen women were operated upon because of size criteria, one because of family history and three for persistent abnormal flow. By Doppler study, 15 cysts were predicted to be benign and histology was confirmatory. There were two false positives and one true positive, a stage Ib ovarian cancer. There were no false negatives, although a stage I endometrioid cancer of the ovary was detected 8 months after a negative scan. In those cases in which follow-up data were available, 56% of the cysts regressed in premenopausal women. In postmenopausal women, 28% regressed. Twenty of 1086 postmenopausal women had endometrial biopsies. Three had endometrial cancer, two stage I and one stage IIA. Five had atypical or adenomatous hyperplasia, and seven had benign polyps. So many women have small asymptomatic cysts of the ovary that a major reorientation of physicians' attitudes towards the ovary will have to be introduced to adapt to this new information. In this population, the prevalence of benign epithelial ovarian neoplasms was 7/1000, and of malignancy was 05/1000. In postmenopausal women, the prevalence rate for endometrial cancer was 5/1000, with 5/1000 hyperplasias and 7/1000 benign polyps. When endometrial and ovarian cancer screening are combined, the yield is comparable to that seen in breast and cervical cancer screening.

Journal Article↗
PubMed1993

The costs of returning home.

AIMS: To measure the use, and the financial cost to the patient, of medical and domiciliary services, in an elderly population following discharge from hospital. To estimate the effect of recent changes in Accident Compensation Corporation (ACC), Disabled Persons Community Welfare Act (DPCW) interpretation and user part charges on those costs. METHODS: Elderly patients discharged home from hospital were visited 3 months following their discharge. The use of medical services and pharmaceuticals, receipt of formal domiciliary support services and adaptive equipment was recorded, together with the cost to the patient of each. RESULTS: Ninety-four (88%) of 106 eligible patients were visited. Fifty percent lived alone and 77% were solely reliant on state benefits for income. Forty (42%) received meals on wheels, 64 (68%) domestic help and 42 (45%) district nursing. Most (86%) required the use of a walking aid and 77 (82%) needed further adaptive equipment to return home. The mean cost to the patient was $541.40 for the first 3 months. Changes in the funding of community supports would add an average of $60.38 (11.2%) to this cost. CONCLUSION: Elderly patients recently discharged from hospital are high users of domiciliary support services. Any changes to their funding need monitoring to determine the effects on utilisation, costs and health status for the patient.

Aftercare↗
PubMed1993

Endometrial and myometrial thickness and uterine blood flow in postmenopausal women: the influence of hormonal replacement therapy and age.

The aim of our study was to assess the age and hormonal influence on endometrial and myometrial thickness and uterine blood flow in postmenopausal women. One hundred and nine healthy postmenopausal women were examined by transvaginal ultrasonography and color Doppler ultrasonography. Twenty women (18.4%) were under continuous HRT for at least 1 year. In all patients, full thickness of the endometrium and half thickness of the myometrium was measured. Pulsed Doppler waveforms were used to calculate the RI for the left and right uterine arteries. Endometrium thickness in the groups without HRT did not change as the years of postmenopause progressed. This was also true for myometrial thickness. The resistance to blood flow in the uterine arteries remained the same as the postmenopause progressed, but with each 5 year analysis, the ability to see the uterine arteries decreased. The duration of the therapy did not affect the measured parameters. The thickness of the endometrium was larger in the groups with HRT in comparison with all groups without HRT (P < 0.01). Myometrial thickness and uterine blood flow are not affected and did not show any significant influence from HRT. In conclusion, continuous HRT significantly influences the thickness of the postmenopausal endometrium but not of the myometrium or the uterine artery blood flow.

Aged↗
PubMed1992

Maltose chemotaxis involves residues in the N-terminal and C-terminal domains on the same face of maltose-binding protein.

The periplasmic maltose-binding protein (MBP) of Escherichia coli is the recognition component of the maltose chemoreceptor and of the active transport system for maltose. It interacts with the Tar chemotactic signal transducer and the integral cytoplasmic-membrane components (the MalF and MalG proteins) of the maltose transport system. Maltose binds in a cleft between the globular N-terminal and C-terminal domains of MBP, which are connected by a moveable hinge. The two domains undergo a large motion relative to one another as the protein moves from the open, unbound state to the closed, ligand-bound state. We generated, by doped-primer mutagenesis, amino acid substitutions that specifically disrupt the chemotactic function of MBP. These substitutions cluster in two well-defined regions that are nearly contiguous on the surface of MBP in its closed conformation. One region is in the N-terminal domain and one is in the C-terminal domain. The distance between the two regions is expected to change substantially as the protein goes from the open to the closed form. These results support a model in which ligand binding brings two recognition sites on MBP into the proper spatial relationship to interact with complementary sites on Tar. Mutations in MBP that appear to cause defects in interaction with MalF and MalG are distributed differently from mutations that primarily affect maltose taxis. We conclude that the regions of MBP that contact Tar and those that contact MalF and MalG are adjacent on the face of the protein opposite the hinge connecting the two domains and that those regions are largely, although perhaps not entirely, distinct.

ATP-Binding Cassette Transporters↗
PubMed1992

Aspartate and maltose-binding protein interact with adjacent sites in the Tar chemotactic signal transducer of Escherichia coli.

The Tar protein of Escherichia coli is a chemotactic signal transducer that spans the cytoplasmic membrane and mediates responses to the attractants aspartate and maltose. Aspartate binds directly to Tar, whereas maltose binds to the periplasmic maltose-binding protein, which then interacts with Tar. The Arg-64, Arg-69, and Arg-73 residues of Tar have previously been shown to be involved in aspartate sensing. When lysine residues are introduced at these positions by site-directed mutagenesis, aspartate taxis is disrupted most by substitution at position 64, and maltose taxis is disrupted most by substitution at position 73. To explore the spatial distribution of ligand recognition sites on Tar further, we performed doped-primer mutagenesis in selected regions of the tar gene. A number of mutations that interfere specifically with aspartate taxis (Asp-), maltose taxis (Mal-), or both were identified. Mutations affecting residues 64 to 73 or 149 to 154 in the periplasmic domain of Tar are associated with an Asp- phenotype, whereas mutations affecting residues 73 to 83 or 141 to 150 are associated with a Mal- phenotype. We conclude that aspartate and maltose-binding protein interact with adjacent and partially overlapping regions in the periplasmic domain of Tar to initiate attractant signalling.

ATP-Binding Cassette Transporters↗
PubMed1986

Hospital admission for depression.

Fifty depressed patients in a psychiatric unit were asked in an open-ended and a forced-choice question: 'When you're feeling depressed what sorts of things can make you feel worse in hospital and at home?'. The responses were analysed and compared with a study where non-depressed subjects were asked the same question. Implications of the results of this study for the admission of clinically depressed people to hospital are discussed.

Adult↗
PubMed1979

Effect of age and removable partial dentures on gingivitis and periodontal disease.

The periodontal disease variables manifested in the individuals with partial dentures were more severe, which suggests that the contribution of denture status is significant. Age, while related to increased bone loss, did not appear to be of significance. Common sense suggests that poor oral hygiene in persons wearing removable partial dentures also is a contributing factor.

Adult↗