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M C McCarthy

Publications and source records attributed to M C McCarthy.

60 records · Page 4Linked to original sources

The value of SPECT-thallium scanning in screening for myocardial contusion.

In this prospective study of 40 patients sustaining blunt chest trauma, the value of single-photon-emission computed tomography (SPECT)-thallium scanning in the prediction of morbidity due to cardiac contusion was examined. Twelve patients developed cardiac complications--arrhythmias, ventricular conduction defects, and pericarditis. The sensitivity of SPECT-thallium scans was 55.6%, and the specificity was 32.1%, with an accuracy of 37.8%. Accuracy of the initial electrocardiogram (ECG) was 85%, with a sensitivity of 91.7% and a specificity of 82.1%. Patients with a normal ECG on admission rarely developed cardiac complications. It is concluded that SPECT-thallium is not a useful screening tool in this patient population.

Adolescent↗

Hepatitis B and C in Juba, southern Sudan: results of a serosurvey.

To compare the epidemiology of hepatitis B virus (HBV) with hepatitis C virus (HCV) in a southern Sudanese population, 666 out-patients attending 6 public clinics in the city of Juba were enrolled in a serosurvey. The average age of subjects was 16 years; 54% were female. Of the 651 samples tested for hepatitis B markers, HBsAg was found in 26% and anti-HBc in 67%. In contrast, only 21 (3%) of the 666 samples were positive for anti-HCV using a second generation immunoblot assay (RIBA-2). Seventeen (81%) of the 21 anti-HCV-positive subjects were positive for anti-HBc, compared to 66% (418/630) of subjects negative for anti-HCV (P = 0.07). None of the anti-HCV-positive subjects reported receiving a prior blood transfusion and only 5 subjects reported a history of jaundice. Nine of the 21 (43%) anti-HCV-positive subjects reported a history of scarification, compared to 23% (148/645) of anti-HCV-negative subjects (P = 0.01). Hepatitis B infection was also associated with scarification by univariate analysis. However, after adjustment for age a history of scarification was not significantly associated with hepatitis C infection, but it was with HBV infection (odds ratio = 1.5, 95% CI 1.0-2.5; P = 0.05). The findings of this study indicate that HCV infection is not highly endemic in this population and that the epidemiology of HCV differs from that of HBV.

Adolescent↗

Prospective evaluation of single and triple lumen catheters in total parenteral nutrition.

The recent introduction of triple lumen catheters has facilitated the care of seriously ill patients by providing multipurpose central venous access through a single percutaneous 7 French catheter. This prospective study was performed to examine the complications associated with the use of these catheters in patients receiving long-term total parenteral nutrition (TPN). Seventy-five patients undergoing catheterization were randomly separated into two groups: 36 patients underwent placement of a single lumen catheter (SLC), and 39 patients, a triple lumen catheter (TLC). The two groups were comparable with respect to concomitant infections, treatment with antibiotics, and need for intensive care. Patients in the SLC group received TPN for a mean of 9.7 days and in the TLC group, for a mean of 8.5 days (p = 0.427). However, after 5 days of catheterization, there was a marked increase in the number of TLC removed because of skin entry site infections. SLC were more likely to be used for the full duration of TPN administration (p = 0.025). Catheter tips were cultured by semiquantitative techniques. A higher incidence of catheter sepsis was seen with TLC, 12.8% vs 0% with SLC (p = 0.055). TLC used for TPN are associated with higher rates of catheter entry site infections and systemic sepsis. SLC should be used for TPN administration.

Bacterial Infections↗