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Biomedical subjects

G McCarty

Publications and source records attributed to G McCarty.

12 recordsLinked to original sources
PubMed2003

Cardiac disease in the antiphospholipid syndrome: recommendations for treatment. Committee consensus report.

The Committee reviewed cardiac involvement in the antiphospholipid antibody syndrome. The Committee's recommendations are: Valve abnormalities: anticoagulation is recommended for symptomatic patients with valvulopathy. Prophylactic antiplatelet therapy may be appropriate for asymptomatic patients (recommended by 13/17 experts in an independent review). Committee members disagreed whether corticosteroid therapy is helpful, but agree that distinguishing among presumptive valvulitis (valve thickening on echocardiogram), valve deformity and vegetations is important, as treatment implications may differ. Occlusive arterial disease (angina, myocardial infarction): the Committee recommends aggressive treatment of all risk factors for atherosclerosis (hypertension, hypercholesterolaemia, smoking) and liberal use of folic acid, B vitamins and cholesterol-lowering drugs (preferably statins). Hydroxychloroquine for cardiac protection in APS patients may be considered. The Committee also recommends warfarin anticoagulation for those who have suffered thrombosis in the absence of atherosclerosis, but recognizes that developing data may support the use of antiplatelet agents instead. Intracardiac thrombi: the Committee recommends intensive warfarin anticoagulation, and consultation with cardiac surgeons when appropriate. Ventricular dysfunction: the Committee has no recommendations on this aspect of cardiac disease. Pulmonary hypertension: the Committee recommends intensive anticoagulation with warfarin and clinical trials of bosentan, epoprostenol and other new agents.

Anticoagulants↗
PubMed2002

The potential of diffuse reflectance spectroscopy for the determination of carbon inventories in soils.

Investigations have shown that near- and mid-infrared reflectance spectroscopy can accurately determine organic-C in soil. Efforts have also demonstrated that both can differentiate between organic and inorganic-C in soils, but the mid-infrared produces more accurate calibrations. Nevertheless, the greatest benefit would come with in situ determinations where factors such as particle size, sample heterogeneity and moisture can be important. While the variations in large (> 20 mesh) particle size can adversely effect calibration accuracy, efforts have demonstrated that the scanning of larger amounts of sample can overcome this, but the effects of moisture have not been fully explored. While under in situ conditions C distribution and sample heterogeneity are a problem for any analytical method, the rapid analysis possible with spectroscopic techniques will allow many more samples to be analyzed. In conclusion, near- and mid-infrared spectroscopy have great potential for providing the C values needed for C sequestration studies.

Calibration↗
PubMed2001

An innovative approach for locating and evaluating subsurface pathways for nitrogen loss.

Fundamental watershed-scale processes governing chemical flux to neighboring ecosystems are so poorly understood that effective strategies for mitigating chemical contamination cannot be formulated. Characterization of evapotranspiration, surface runoff, plant uptake, subsurface preferential flow, behavior of the chemicals in neighboring ecosystems, and an understanding of how crop management practices influence these processes are needed. Adequate characterization of subsurface flow has been especially difficult because conventional sampling methods are ineffective for measuring preferential flow of water and solutes. A sampling strategy based on ground-penetrating radar (GPR) mapping of subsurface structures coupled with near real-time soil moisture data, surface topography, remotely sensed imagery, and a geographic information system (GIS) appears to offer a means of accurately identifying subsurface preferential flow pathways. Four small adjacent watersheds draining into a riparian wetland and first-order stream at the USDA-ARS Beltsville Agricultural Research Center, Beltsville, MD are being studied with this protocol. The spatial location of some preferential flow pathways for chemicals exiting these agricultural watersheds to the neighboring ecosystems have been identified. Confirmation of the pathways is via examination of patterns in yield monitor data and remote sensing imagery.

Agriculture↗
PubMed2001

Indirect institutional revenue generated from an academic primary care clinical network.

BACKGROUND AND OBJECTIVES: As the financial performances of US academic health centers have faltered under managed care and the Balanced Budget Act of 1997, increasing attention has been paid to the costs and benefits of operating primary care networks. This study examines the indirect revenues to a university hospital and faculty group practice that result from such a primary care network using a method of abstracting billing data. METHODS: A primary care patient cohort was identified by selecting all patients who generated at least one charge in any of the 10 primary care clinics in the network over a 15-month period. All charges from the hospital and the faculty practice group for this cohort were then examined during a 6-month period, and the total charges generated in the primary care setting were compared with charges generated elsewhere in the health system. RESULTS: The primary care patient cohort included 56,459 patients and generated a total of $7,243,312 in charges for primary care services, $43,559,741 of charges in the hospital billing system for non-primary care services, and $8,825,611 of charges for services from specialty faculty. This cohort accounted for 18.5% of the gross charges for hospital care and 17.6% of charges generated by the specialty physicians. CONCLUSIONS: Using a simple and replicable methodology, this study estimates a substantial financial benefit to the hospital and specialty practices from a primary care network.

Academic Medical Centers↗
PubMed1995

Clinical comparison of Provisc and Healon in cataract surgery.

This prospective, randomized, multicenter clinical trial compared the safety and efficacy of the Provisc and Healon viscoelastics. Sixty-one eyes of 61 patients had an extracapsular cataract extraction with implantation of a posterior chamber intraocular lens with the aid of Provisc (n = 32) or Healon (n = 29). Mean changes in preoperative versus postoperative corneal thickness and intraocular pressure and the incidence and magnitude of postoperative corneal edema and iritis were not significantly different between the two groups. Observed complications were considered consequences of the surgery and unrelated to viscoelastic use. No adverse medical events occurred. These results indicate Provisc and Healon are clinically equivalent in terms of safety and efficacy when used as surgical aids.

Cataract Extraction↗
PubMed1987

A new method for the cytological analysis of autoantibody specificities using whole-mount, surface-spread meiotic nuclei.

A new method for the cytological analysis of antinuclear antibody binding offers several advantages over conventional techniques. Nuclei in meiosis, prepared by surface-spreading spermatocytes, provide a detailed examination of the constituents of the nucleus--euchromatin, heterochromatin, sex chromatin, nucleoli, centromeres, and dense patches that seem related to RNA metabolism--and each of these structures can be seen to change in morphology and antibody labeling during the course of meiotic prophase. Results using sera from humans and mice with autoimmune disease, and using several mouse monoclonal antibodies, demonstrate the potential of this method for clinical and research applications, both for more common antibody types and for those that bind epitopes which are unique to germ cells.

Animals↗
PubMed1987

Increased plasma free cortisol in ocular hypertension and open angle glaucoma.

Values of plasma free cortisol (not bound to plasma proteins), total plasma cortisol, and percent free cortisol were determined in normal, ocular hypertensive, and open angle glaucomatous subjects. Median total plasma, plasma free, and percent free cortisol levels were higher in ocular hypertensive and glaucomatous individuals. The most significant differences occurred with percent free cortisol values between normal and glaucomatous subjects. There was a significant positive correlation between percent free cortisol and total cortisol levels in normal subjects only. For subjects with glaucoma and hypertension, the percent free cortisol values were independent of the total cortisol values. Multilinear regression analysis also indicated that besides diagnosis and level of total plasma cortisol, male sex, blood sampling late in the day, and increased diastolic blood pressure were the only variables significantly related to increased values of plasma free cortisol and percent free cortisol. Ocular medication for glaucoma and use of beta-blockers were not found to be significant independent variables in the regression models for either plasma free cortisol or percent free cortisol. These observations further suggest that a disorder of the pituitary adrenal axis and/or a binding of plasma cortisol is associated with ocular hypertension and open angle glaucoma.

Adrenergic beta-Antagonists↗
PubMed1987

Phacoemulsification devices: a consumer's update.

This report extends a previous paper on the various characteristics of the most popular phacoemulsification devices. An evaluation of 11 devices by ten different manufacturers was attempted. Only five manufacturers of six devices agreed to critical evaluation or reevaluation. As in the previous report, the devices were compared for level of patient safety, dependability, efficiency, ease of usage, and operating cost for the first 1,000 cases. At the completion of this study, we ranked the nine devices evaluated over the past 17 months as follows: (1) United Surgical (Optikon) Systems Plus, (2) Optical Micro Systems (OMS), (3) United Surgical (Optikon) Phacotron, (4) CooperVision 10,000, (5) Site XTR, (6) CooperVision KCP, (7) CooperVision 9001, (8) Phakosystems CES 4000 and (9) United Sonics. To enhance the usefulness of this consumer's guide, we asked 40 experienced cataract surgeons what they wanted in the "ideal" phacoemulsification device. The opinions of 27 who responded are included.

Cataract Extraction↗
PubMed1981

Absence of lymphocyte glucocorticoid hypersensitivity in primary open angle glaucoma.

The glucocorticosteroid sensitivity of patients with primary open angle glaucoma and normal patients was determined by the quantity of dexamethasone required to reduce concanavalin A-induced lymphocyte blast transformation to 50% of control values (I50). This was performed under culturing conditions employing both serum-free medium and medium supplemented with 10% autologous serum. A comparison of the I50 between normal subjects and those with primary open angle glaucoma did not show a significant difference in steroid sensitivity under either of the two culturing conditions. It is concluded that persons with primary open angle glaucoma do not have a generalized inherited or acquired cellular hypersensitivity to glucocorticoids.

Adult↗
PubMedDate not supplied

Delayed regression of effect in myopic epikeratophakia vs myopic keratomileusis for high myopia.

We compared the effectiveness and stability of our first six consecutive myopic epikeratophakia procedures (mean follow-up 18 months, range 14 to 26) with our first four consecutive cryolathe myopic keratomileusis procedures (mean follow-up 28 months, range 14 to 35). Myopic keratomileusis reduced preoperative myopia (range -8.9 to -12.1 diopters) by 77% to 94% in four patients. Refraction and visual acuity remained stable for over 1 to 3 years. In contrast, only three of the six myopic epikeratophakia procedures had stable results. The remaining three eyes which were within 0.38 D of emmetropia at the time of suture removal showed a loss of effect, resulting in myopia worse than their preoperative values in two eyes and a small correction in one eye. Only one of the six eyes achieved an uncorrected visual acuity better than 20/200. We conclude that myopic keratomileusis may be the procedure of choice for treating individuals with myopia of -8 to -15 D, because the incidence of late regression of effect after myopic epikeratophakia using the techniques in this study is unacceptable.

Adult↗