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Biomedical subjects

C McDonough

Publications and source records attributed to C McDonough.

7 recordsLinked to original sources

Fatal warm autoimmune hemolytic anemia resulting from IgM autoagglutinins in an infant with severe combined immunodeficiency.

Autoimmune diseases are rare in patients with severe combined immunodeficiency (SCID). The authors describe an 11-month-old infant girl with SCID with fatal warm autoimmune hemolytic anemia (AIHA) resulting from IgM autoagglutinins. Serologic evaluation revealed IgM autoantibodies that caused in vitro hemagglutination at 37 degrees C. The patient had clinical evidence of ongoing hemolysis and agglutination despite aggressive treatment. She had three strokes and died 6 weeks after unsuccessful bone marrow transplantation. Autoimmune disease is an unexpected complication of SCID. The presence of warm reactive IgM autoagglutinins in AIHA confers a dismal prognosis.

Anemia, Hemolytic, Autoimmune↗

Identification of MK-944a: a second clinical candidate from the hydroxylaminepentanamide isostere series of HIV protease inhibitors.

Recent results from human clinical trials have established the critical role of HIV protease inhibitors in the treatment of acquired immune-deficiency syndrome (AIDS). However, the emergence of viral resistance, demanding treatment protocols, and adverse side effects have exposed the urgent need for a second generation of HIV protease inhibitors. The continued exploration of our hydroxylaminepentanamide (HAPA) transition-state isostere series of HIV protease inhibitors, which initially resulted in the identification of Crixivan (indinavir sulfate, MK-639, L-735,524), has now yielded MK-944a (L-756,423). This compound is potent, is selective, and competitively inhibits HIV-1 PR with a K(i) value of 0.049 nM. It stops the spread of the HIV(IIIb)-infected MT4 lymphoid cells at 25.0-50.0 nM, even in the presence of alpha(1) acid glycoprotein, human serum albumin, normal human serum, or fetal bovine serum. MK-944a has a longer half-life in several animal models (rats, dogs, and monkeys) than indinavir sulfate and is currently in advanced human clinical trials.

Animals↗

Risk factors for sarcoidosis hospitalization among U.S. Navy and Marine Corps personnel, 1981 to 1995.

Sarcoidosis has been associated with various demographic risk factors, yet findings may be falsely influenced by effects such as socioeconomic status. We used univariate and multiple logistic regression to compare demographic data from military sarcoidosis hospitalizations with similar data from the general military population from 1981 to 1995. A total of 626 first hospitalizations for sarcoidosis were identified. After adjusting for pay grade, blacks had seven-fold increased odds of sarcoidosis hospitalization compared with whites. The oldest age group had five times the odds of the youngest age group. A southeastern United States home of record was associated with increased risk. Multivariate modeling permitted us to determine independent risk factors for sarcoidosis hospitalization, in contrast to previous studies that focused mainly on unadjusted rates. These findings are useful in identifying populations at high risk for sarcoidosis.

Adolescent↗

Goldenhar syndrome among infants born in military hospitals to Gulf War veterans.

Reports in the popular press described the occurrence of Goldenhar syndrome among children of Persian Gulf War veterans (GWVs). The objective of this investigation was to compare the birth prevalence of Goldenhar syndrome among infants born in military hospitals to GWVs and to military personnel who were not deployed to the Gulf War (NDVs). Computerized hospital discharge data were reviewed for infants conceived after the war and born prior to the 1st of October, 1993, in medical treatment facilities (MTFs) operated by the U.S. Department of Defense. Medical records were evaluated for infants diagnosed at birth with at least one abnormality that might be related to Goldenhar syndrome. Two pediatricians, blinded to the parental Gulf War status of each infant, reviewed records. An estimated 75,414 infants were conceived after the Gulf War and born in MTFs during the study period (34,069 GWV infants and 41,345 NDV infants). Seven infants fulfilled the case criteria (five GWV infants and two NDV infants). All infants had fathers who served in the military at the time of their conception and birth. The birth prevalence was 14.7 per 100,000 live births among GWV infants (95% confidence interval [CI]: 5.4-36.4) and 4.8 per 100,000 live births (95% CI: 0.8-19.5) among NDV infants (relative risk: 3.03; 95% CI: 0.63-20.57; P values: [2-tailed] = 0.26, [1-tailed] = 0.16). The few affected cases and the broad confidence intervals surrounding the relative risk require that these results be interpreted with caution and do not exclude chance as an explanation for these findings.

Adolescent↗

An evaluation of three approaches to the teaching of a behavioral therapy.

Evaluated the relative efficacy of three approaches to teaching mental health professionals how to do social skill training (SST). All three conditions received a minimal of a common reading package and videotaped modeling of competent SST. Ss in a structured learning format (SLF) as well receive instructions, rehearsal and feedback for a total of 20 hours (N = 39). Therapists in a seminar format (SF) condition discussed topics associated with SST raised by the readings and films for 20 hours. In addition to modeling and the readings, Ss in the workshop format (SF) condition received concise instructions on how to carry out SST during 6 hours of training. All three conditions showed equivalent and significant pre- to posttraining improvement on a questionnaire measure of familiarity with SST; however, only the SLF and CW conditions improved significantly on a test of the therapists' evaluative skills. Finally, on a measure of therapist behavior during a simulated SST session, the three groups showed roughly equivalent improvement. The results were interpreted in terms of the particular ingredients present in each condition, and directions for future research were discussed.

Adult↗