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Biomedical subjects

C F McCarthy

Publications and source records attributed to C F McCarthy.

At least 55 records · Page 3Linked to original sources
PubMed1988

Impaired coagulation in accidental hypothermia of the elderly.

Six elderly patients with accidental hypothermia were prospectively evaluated for impaired coagulation. All patients had abnormal coagulation profiles. Three patients with severe coagulopathies and serious underlying conditions died while hypothermic. Despite investigation, no cause for disordered coagulation was found in four patients. We conclude that hypothermia per se contributes to disordered coagulation in the elderly.

Accidents↗
PubMed1988

Three computer models for the calculation of prevalence of peptic ulcer disease during long-term treatment.

At present the effects of maintenance treatment for peptic ulcer disease are usually calculated by using 'life-table' analyses. Whilst these accurately demonstrate the speed with which an initial relapse occurs they make no allowance for the fact that, in clinical practice, a relapse often responds to a further course of full-dose treatment and the patient then returns to maintenance therapy. A further compounding factor is that, in any long-term study, patients will be lost to follow-up for a variety of reasons not all related to failure of the treatment. In this paper we describe the use of 'prevalence rates' to better reflect the outcome of peptic ulcer management. Three 'computer models', which have been developed to address the problems of patients leaving the study for any reason during such a long time-period, are also described, as are the underlying assumptions made. Using the results from a long-term study of continuous treatment with cimetidine, the 'prevalence rates' of ulcer disease over 6 years were calculated. Observed relapse rates appeared to fall with time (from 2.7% for duodenal ulcer (DU) and 2.5% for gastric ulcer (GU) to 1% and 2% respectively). However, on applying the models to the data, prevalence rates tended to rise slowly with time for the first 3 years in each of the models tested. At 6 years, two of the models suggested that the prevalence rate for DU would be about 8%; this is not very different to the reported recurrence rate after surgical treatment by truncal vagotomy and pyloroplasty. It is concluded that 'prevalence rates' should be used to assess long-term medical treatments for ulcer disease. Similar methods could also be used to examine the medical treatment of any other disease where multiple relapses, capable of responding to re-treatment, occur. The use of models proved beneficial in compensating for patients lost during the study.

Computer Simulation↗
PubMed1987

Gait deviations in patients with juvenile rheumatoid arthritis.

The purpose of this study was to describe quantitatively the gait patterns of patients with juvenile rheumatoid arthritis (JRA). Thirty children with JRA and 30 healthy children were evaluated using a computerized gait analysis system. Time-distance characteristics and joint angle excursions were studied. The subjects with JRA walked with significantly decreased velocity, cadence, and stride length. We found no significant difference in step width nor in the percentage of time spent in each phase of the gait cycle. The anterior pelvic tilt of subjects with JRA was significantly increased throughout the gait cycle. Hip extension at the end of single-limb stance and ankle plantar flexion during weight release also were significantly decreased for subjects with JRA. No significant difference between the two groups was noted in knee joint excursion. Areas of emphasis for physical therapy of patients with JRA include increasing velocity, cadence, stride length, hip extension, and ankle plantar flexion and decreasing excessive anterior pelvic tilt.

Adolescent↗
PubMed1987

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.

Age Factors↗
PubMed1987

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.

Body Height↗
PubMed1987

Coeliac proctitis.

An increased association of ulcerative colitis and coeliac disease has been reported, as have the results of several small-bowel biopsy studies in ulcerative colitis. Forty-two patients from a population of 438 patients with coeliac disease had rectal biopsies. Fourteen of these showed inflammation of various degrees of severity, including three compatible with a diagnosis of ulcerative colitis. The presenting complaint in 34 of these patients was diarrhoea or steatorrhoea. Twenty-seven patients had coeliac disease diagnosed at the same time or after their rectal biopsy. The other 15 were previously diagnosed coeliacs. Twelve of the 14 patients with abnormal rectal biopsy specimens were known to have subtotal/total villous atrophy at the time of rectal biopsy. Proctitis as seen in these coeliac patients had no unique features to differentiate it from proctitis caused by other disorders. The diarrhoea/steatorrhoea stopped in all patients on commencement of a gluten-free diet, except in those with ulcerative colitis. Proctitis is common in patients with coeliac disease presenting with diarrhoea/steatorrhoea. This study supports the finding of an increased association of coeliac disease and ulcerative colitis and is, to our knowledge, the first rectal biopsy study of a coeliac population.

Adult↗
PubMed1985

Immunoglobulins in healthy controls: HLA-B8 and sex differences.

Serum immunoglobulins were measured in one hundred and eighty-four healthy controls. One hundred and fifty-nine of these were also HLA typed. IgG levels did not differ with sex or HLA-B8 status. IgM levels did not differ with HLA-B8 status but were significantly higher in females than males. IgA levels were lower in females than males; they were also lower in HLA-B8 positive compared with HLA-B8 negative individuals; the lowest IgA levels were found in HLA-B8 positive females. The IgA variation may be relevant to the higher incidence of certain disorders among HLA-B8 positive individuals and among females.

Adult↗
PubMed1985

Influence of splenectomy and the functional hyposplenism of coeliac disease on platelet count and volume.

Platelet count and volume were measured in 84 splenectomised subjects, 142 patients with coeliac disease and 77 healthy subjects. An inverse, non-linear correlation between platelet count and volume was found in healthy subjects and coeliac patients, but was not present in splenectomised subjects who had higher platelet counts (P = 0.0001) and mean platelet volumes (P = 0.0001) than healthy subjects. Platelet counts correlated with splenic function in patients with coeliac disease and were higher in patients with severe hyposplenism than in normosplenic coeliacs (P = 0.0001). Splenic function did not influence the mean platelet volume (MPV) in coeliac disease but normosplenic coeliacs had higher MPV than normal subjects (P = 0.05). Serum iron and red cell folate were not correlated to MPV in coeliac disease. We conclude that splenic function effects platelet count and volume in non-coeliac subjects and platelet count in coeliac disease. However, other unidentified factor(s) influence the MPV in coeliac disease.

Adolescent↗
PubMed1985

Genetic influences on splenic function in coeliac disease.

Splenic function was assessed using 'pitted' erythrocyte counts in 61 first degree relatives of patients with coeliac disease. 'Pitted' erythrocyte counts were normal in 12 parents, but were raised in 20% of 49 siblings and/or children of coeliac patients. First degree relatives had higher 'pitted' erythrocyte counts than normal controls (p = 0.002). The counts were lower in coeliac relatives than in age matched coeliacs (p = 0.0001), but no difference was present between the relatives and coeliac patients whose small bowel mucosa was morphologically normal. Considerable interfamily variation was found in 'pitted' erythrocyte counts, both in the coeliac patients and first degree relatives, and the pattern tended to 'run true' within families. The genetic factor influencing splenic function in coeliac disease is not HLA-linked but seems to be associated with a second, probably recessive, gene influencing the inheritance of coeliac disease.

Adolescent↗
PubMed1985

Celiac disease: does hyposplenism predispose to the development of malignant disease?

Splenic size and function was assessed in eight patients with celiac disease and coexisting malignancy (six had small bowel lymphoma and two gastric adenocarcinoma). The size of the spleen was reduced in four of seven patients as seen at autopsy or radionucleotide scanning. Splenic function was studied using "pitted" erythrocyte counts, platelet counts, and Howell-Jolly bodies and was impaired in five of eight patients. Malignant disease developed in some celiacs with normal splenic size and function. Splenic function as measured by pitted erythrocyte counts was similar in the celiac patients with malignancy and appropriately matched nonmalignant celiacs. We conclude that hyposplenism in celiac disease does not influence the development of malignant disease.

Adenocarcinoma↗