PubMed Health⌕ Search

Biomedical subjects

L Cassidy

Publications and source records attributed to L Cassidy.

8 recordsLinked to original sources
PubMed1992

The carotid stump syndrome.

Transient ischaemic attacks (TIAs) following internal carotid artery occlusion are not uncommon. Micro-embolisation from an ipsilateral internal carotid artery stump has been implicated in the pathogenesis of such TIAs. We report six patients who had persistent TIAs in association with an occluded ipsilateral internal carotid artery and a carotid stump. Four patients who underwent surgery and stump exclusion remain asymptomatic at 2 years while of two patients who were treated with antiplatelet therapy, one remains asymptomatic and one died from a cerebro-vascular accident.

Aged↗
PubMed1992

A randomised study comparing standard dose carboplatin with chlorambucil and carboplatin in advanced ovarian cancer.

A total of 161 previously untreated patients with FIGO stage III or IV epithelial ovarian cancer were randomised after surgery to receive six courses of either carboplatin 400 mg m-2 alone (Arm A) or carboplatin 300 mg m-2 with chlorambucil 10 mg day-1 for 7 days (Arm B). The median progression free survival (PFS) was similar: arm A: 45 weeks; arm B: 61 weeks (P = 0.830). Multivariate Cox regression analysis showed that the extent of residual disease and performance status were the most important prognostic factors for PFS. Fifty-two per cent of patients received dose escalations based on nadir blood counts, and 89% of all dose adjustments were made according to protocol. Failure to achieve a significant degree of leucopenia was associated with worse progression free survival (P less than 0.001). A total of 29.4% of patients fall into this category. The median survival was similar in both arms, i.e. 75 weeks. It is unlikely that there is any major clinical advantage to adding chlorambucil to single agent carboplatin for the management of advanced ovarian cancer, but whether used in combination or a single agent, the dose of carboplatin should be sufficient to cause at least grade I leucopenia. This may best be achieved by determining the initial dose based on renal function, and then adjusting subsequent doses according to nadir blood counts.

Adult↗
PubMed1991

Expression of normal and novel glucokinase mRNAs in anterior pituitary and islet cells.

The glucose-phosphorylating enzyme glucokinase likely plays an important role in regulating glucose-stimulated insulin secretion from the islets of Langerhans and has previously been thought to be expressed only in that tissue and in liver. In this study, we demonstrate high levels of glucokinase mRNA in the anterior pituitary cell line AtT20ins, which has been engineered to secrete correctly processed insulin, as well as in primary anterior pituitary tissue. Unlike islet or liver cells, expression of glucokinase mRNA in anterior pituitary cells was not accompanied by expression of the high Km glucose transporter (GLUT-2) mRNA. The glucokinase transcript in anterior pituitary cells was similar in size to islet glucokinase mRNA, which has a unique, elongated 5'-end relative to the liver glucokinase message. Amplification and sequence analysis of the glucokinase mRNA expressed in islets, RIN1046-38 cells, and anterior pituitary cells confirmed that the glucokinase transcripts in these cell types contain the same 5'-sequence. In addition, a novel alternative transcript was identified that contains a 52-nucleotide deletion and that predicts a 58-amino acid peptide as a result of a frame shift. Both the deleted and undeleted transcripts were found in islets, RIN cells, and AtT20ins cells, whereas only the deleted product was identified in primary anterior pituitary tissue. An antibody prepared against a peptide found at the N terminus of the islet isoform of glucokinase easily detected a protein with a size predicted by the undeleted transcript in extracts prepared from islets, RIN1046-38 cells, and AtT20ins cells. Since both the glucokinase protein and mRNA are naturally expressed in AtT20ins and RIN1046-38 cells, we compared the effect of varying concentrations of glucose on insulin secretion from the two lines. Insulin secretion from RIN1046-38 cells was stimulated by glucose in a dose-dependent manner over the range 0-2.5 mM, where it reached a maximum. AtT20ins cells, in contrast, exhibited no response to glucose at any concentration tested, despite the fact that insulin secretion from both cell lines was stimulated by incubation with dibutyryl cAMP. We conclude that glucokinase expression in AtT20ins cells may be necessary, but is not sufficient to confer glucose-stimulated insulin secretion.

Amino Acid Sequence↗
PubMed1990

Estrogen and progesterone receptors in ovarian cancer.

To determine whether steroid hormone receptor expression is clinically relevant in ovarian cancer, cytoplasmic and nuclear estrogen (ER) and progesterone (PR) receptor levels have been measured and their concentration calculated by Scatchard analysis. Of 89 samples from patients with non-pretreated epithelial ovarian cancer, 33% were ER-positive, PR-positive (ER+PR+) and 40% ER-negative, PR-negative (ER-PR-); 20% were ER+PR-, and 7% ER-PR+. There was no correlation between receptor status and patient age, menopausal status, or tumor grade, although serous tumors were more likely to be ER+. The incidence of PR+ tumors was highest in early disease and decreased with increasing International Federation of Gynecology and Obstetrics (FIGO) stage. Survival of patients with advanced disease (FIGO Stages IIC, III, or IV) was significantly prolonged by optimal initial cytoreductive surgery (P = 0.002), platinum therapy (P = 0.003), and tumor expression of PR (P = 0.009). On multivariate analysis, PR positivity was still associated with improved survival, although this did not retain statistical significance (P = 0.09).

Adult↗
PubMed1986

Outcome of pregnancy in insulin-dependent (type 1) diabetic women between 1971 and 1984.

We have looked at the outcome of pregnancy in women with type 1 (insulin-dependent) diabetes mellitus who were confined at Glasgow Royal Maternity Hospital between 1971 and 1984. Of 134 pregnancies, 123 proceeded beyond 28 weeks' gestation and yielded 125 live infants. The perinatal mortality rate was 16/1000, due solely to congenital foetal malformation. Malformations were not related either to the severity of maternal diabetes (as graded by the White classification) or the glycaemic control in the first trimester (as judged by maternal glycosylated haemoglobin concentration). Over the period of study, there has been a marked reduction in the frequency of ketoacidosis during pregnancy and in the delivery of small-for-dates babies; more mature lecithin:sphingomyelin ratios have been obtained by amniocentesis; and better Apgar scores have been demonstrated in the infants at delivery. The Caesarean section rate has fallen from 83 to 30 per cent, and babies now spend less time separated from their mothers in paediatric units. These improvements largely reflect better diabetic treatment (improved insulin regimens and glycaemic control) and closer obstetric assessment. Foetal malformation occurred overall in 11.4 per cent of pregnancies and did not become less frequent over the period of study. Further major improvement in the outcome of diabetic pregnancy will only come from a reduction in the congenital malformation rate, which implies better diabetic control at and around the time of conception.

Adult↗
PubMedDate not supplied

Developing nursing guidelines for the PTCA patient.

Developing guidelines for the care of complicated patients is not an easy task. This article describes how a group of critical care nurses produced guidelines for the nursing care of patients undergoing percutaneous transluminal coronary angioplasty (PTCA). Guidelines are important in guiding nursing actions without the legal restrictions implicit in using standards.

Angioplasty, Balloon, Coronary↗