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Biomedical subjects

M Callaghan

Publications and source records attributed to M Callaghan.

At least 19 recordsLinked to original sources
PubMed2004

Short migraine attacks of less than 2 h duration in children and adolescents.

We studied the duration of migraine attacks among children and adolescents who reported headache attacks lasting <2 h. Among the 720 children who attended our specialist headache clinic, over a period of 6 years, 231 children had migraine with or without aura fulfilling the International Headache Society (IHS) criteria for the diagnosis of migraine. A further 15 children reported headache attacks typical of migraine, but of duration <2 h. They were asked to fill prospective headache diaries in order to determine with accuracy the duration of their headache attacks. Ten (67%) of these children provided prospective fully analysable headache diaries and recorded a total of 120 headache attacks, 66 attacks (55%) lasting for <1 h each, 30 attacks (25%) lasting between 1 and 2 h, and 24 attacks (20%) lasting >2 h. Patient-based analysis of the headache diaries showed that only three children consistently had headache attacks lasting <1 h. Seven children had some of their headache attacks lasting for at least 1 h and four had some of their headache attacks lasting at least 2 h. This study shows that headache attacks in children with migraine can be variable, and brief attacks are rare. A combination of short (<1 h) and long (>2 h) attacks of headache can coexist in the same patient. The IHS diagnostic criteria of 1988 for migraine in children should therefore acknowledge such variation and allow reduction of the duration of migraine attacks to 1 h.

Adolescent↗
PubMed2001

Chronic posttraumatic headache in children and adolescents.

Little is known about chronic posttraumatic headache (PTH) in children and adolescents. In this study we report on symptoms, clinical findings, and management of all children seen in our headache clinic who presented with recurrent headache following head injuries. A total of 23 children were identified over a period of 4 years. Twenty-one children (13 male, eight female; mean age 11.2 years, age range 3.3 to 14.9 years, median 12.1 years) fulfilled the International Headache Society's clinical criteria for the diagnosis of chronic PTH. Mean duration of headache was 13.3 months (range 2 to 60 months, median 7 months). Children were followed up for a period of 5 to 29 months (mean 12.5 months, median 9 months). Head injuries were classified as serious in four patients and minor in 17. Clinical variables were compared between children with PTH and those without a history of head injury. The headaches were migraine in five patients, tension type in 13, and mixed in three patients. Tension-type headache was significantly more common in children with chronic PTH than in those with no history of head injury, but the clinical course was comparable in the two groups.

Adolescent↗
PubMed1999

Homozygosity mapping and linkage analysis demonstrate that autosomal recessive congenital hereditary endothelial dystrophy (CHED) and autosomal dominant CHED are genetically distinct.

BACKGROUND: Congenital hereditary endothelial dystrophy (CHED) is a corneal dystrophy characterised by diffuse bilateral corneal clouding resulting in impaired vision. It is inherited in either an autosomal dominant (AD) or autosomal recessive (AR) manner. The AD form of CHED has been mapped to the pericentromeric region of chromosome 20. Another endothelial dystrophy, posterior polymorphous dystrophy (PPM), has been linked to a larger but overlapping region on chromosome 20. A large, Irish, consanguineous family with AR CHED was investigated to determine if there was linkage to this region. METHODS: The technique of linkage analysis with polymorphic microsatellite markers amplified by polymerase chain reaction (PCR) was used. In addition, a DNA pooling approach to homozygosity mapping was employed to demonstrate the efficiency of this method. RESULTS: Conventional genetic analysis in addition to a pooled DNA strategy excludes linkage of AR CHED to the AD CHED and larger PPMD loci. CONCLUSION: This demonstrates that AR CHED is genetically distinct from AD CHED and PPMD.

Chromosome Mapping↗
PubMed1998

The 77-kDa echinoderm microtubule-associated protein (EMAP) shares epitopes with the mammalian brain MAPs, MAP-2 and tau.

Previous work has shown that the echinoderm microtubule-associated protein (EMAP) was a unique MAP with little sequence similarity with the brain MAPs. The purpose of this study was to determine whether there were any small domains within EMAP that were shared by the mammalian brain MAPs, MAP-2, and tau. It is reported here that EMAP and the heat-stable MAP-2 and tau share antigenic determinants. A polyclonal antisera, raised against SDS-PAGE denatured EMAP, reacted strongly with both MAP-2 and tau on Western blots. In addition, a detailed sequence comparison, using a window of 5 amino acids at a time, revealed several short domains with approximately 20 residues that shared sequence similarity. The regions of sequence similarity were all located in regions implicated in microtubule binding, suggesting that EMAP and the mammalian brain MAPs may share short structural and functional domains.

Amino Acid Sequence↗
PubMed1998

Non-invasive assessment of bleeding pulmonary artery aneurysms due to Behçet disease.

Because of its ability to depict intravascular, intramural, and extramural pathology, non-invasive imaging is well suited to assessing life-threatening hemoptysis that may complicate Behçet disease. We made exclusive use of CT angiography supplemented by MR to identify pulmonary thromboembolism, mediastinal lymphadenopathy, and bilateral pulmonary artery aneurysms with signs of previous unilateral rupture. Two-dimensional reformatted CT images provided surgeons with a road map of upstream and downstream vascular relationships prior to aneurysm resection. Imaging findings were confirmed by surgery and pathology. Non-invasive imaging proved to be a useful alternative to standard catheter arteriography in the preoperative assessment of hemoptysis in this patient with Behçet disease.

Adult↗
PubMed1998

Hodgkin's disease.

OBJECTIVES: To review current approaches to the diagnosis and treatment of Hodgkin's disease (HD). DATA SOURCES: Review articles, research studies, and book chapters related to HD. CONCLUSIONS: The treatment of HD has progressed to be one of the most successful therapies in oncology. Researchers currently seek to improve the positive outcomes of therapy while decreasing the toxicity associated with therapy. IMPLICATIONS FOR NURSING PRACTICE: Nursing care of the patient with HD requires physical, educational, and psychological support. Within this scope of nursing care, the patient receives essential information to participate as a partner in care.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

Complications associated with central venous catheters used for the collection of peripheral blood progenitor cells to support high-dose chemotherapy and autologous stem cell rescue.

The purpose of this study was to review the incidence and type of complications associated with the insertion and use of central venous catheters for leukapheresis and high-dose chemotherapy with stem cell rescue. One hundred sixty-seven central venous catheters placed either at the transplant center or by various community surgeons were studied for insertion complications, inability to perform leukapheresis and incidence of infection. The overall incidence of hemo- or pneumothorax was 3.6%. Inability to pherese occurred in 13% of catheters placed by outside surgeons and 6.5% of catheters inserted at the transplant institution. Most often, these were due to malposition of the catheter too high in the superior vena cava or in other veins. Deep venous thrombosis was often related to this malposition and occurred in 4.8% of all patients. Pulmonary embolism was not seen in these patients despite the fact the catheters were often left in place during the thrombotic episode. Early or late-onset infections occurred in 6.5% of patients and were most often exit site infections. The incidence of complications of pheresis catheters is high but might be reduced by more attention to proper placement of the catheter closer to the right atrial/superior vena cava junction, and limiting insertion to a cadre of surgeons familiar with leukapheresis requirements.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

Outpatient high-dose chemotherapy with autologous stem-cell rescue for hematologic and nonhematologic malignancies.

PURPOSE: A prospective study to determine the feasibility of high-dose chemotherapy (HDC) and autologous stem-cell rescue (ASCR) in the outpatient setting. METHODS: One hundred thirteen consecutive patients underwent 165 cycles of HDC/ASCR for a variety of malignancies. HDC regimens were disease-specific. Initially, patients were hospitalized for HDC, discharged on completion, and maintained as outpatients unless toxicities required rehospitalization (subtotal outpatient transplantation [STOT]). Once this was established as safe, a total outpatient transplant (TOT) program was developed in which patients received all of the HDC, as well as supportive care, as outpatients. Patients who declined the outpatient programs received the same HDC and supportive care as inpatients. RESULTS: In 140 of 165 (85%) HDC cycles, patients agreed to participate in one of the outpatient transplant programs. Five patients in the STOT program could not be discharged from the hospital because of toxicities that developed during HDC; thus, 135 patients were monitored the outpatient setting, 95 (70%) of whom were never readmitted. The mean +/- SEM total hospital length of stay (LOS), including all readmissions and excess days after chemotherapy, was 18.33 +/- 5.06 days for patients who refused the outpatient program, 8.22 +/- 5.76 days for patients in the STOT program, and 2.81 +/- 7.66 days for those in the TOT program (P < .001). One treatment-related death occurred in each treatment setting: day 120 inpatient, day 17 STOT, and day 110 TOT. CONCLUSION: Outpatient management of HDC/ASCR is safe and acceptable for the vast majority of patients. The STOT program resulted in significant reduction in hospital LOS, while the TOT program appears equally safe and further reduces LOS. Hospitalization for HDC/ASCR is unnecessary in most patients.

Adult↗
PubMed1993

Radionuclide migration through the genital tract in infertile women with endometriosis.

The migration of radionuclide through the genital tract was observed, comparing 20 patients with endometriosis and infertility with a control group of 23 infertile patients who had a normal pelvis. All patients had patent tubes at laparoscopy and chromopertubation, performed in both groups for the investigation of infertility and to diagnose the presence and extent of endometriosis. A radionuclide tubal test, using human albumin microspheres labelled with 99m-technetium (99mTc) was subsequently undertaken to observe the extent of genital tract migration of radionuclide to uterus, Fallopian tube and peritoneal cavity. The results show that radionuclide migration to the peritoneal cavity was impaired in patients with endometriosis, compared with the control group (30 versus 83%, respectively; P < 0.001). There was no relationship between migration and the severity of endometriosis. We conclude that impaired tubal function may be a cause of infertility in some patients with endometriosis.

Adult↗
PubMed1993

Spontaneous in vitro production of rheumatoid factor during infectious exacerbations of cystic fibrosis: correlation with circulating immune complex levels.

Rheumatoid factor (RF) production has been demonstrated during infections, including infectious exacerbations of cystic fibrosis (CF). The aim of this study was to evaluate the relationship of RF production to infection, and examine the mechanisms involved. Serial peripheral blood mononuclear cell (PBMC) cultures with measurement of spontaneous production of IgM RF, IgA RF, total IgM and IgA, and measurement of serum levels of immune complexes were carried out during exacerbations of CF. The percentage of B cells expressing CD5 was examined in a second cohort of acutely infected CF patients, and related to IgM RF production. IgM RF production was significantly elevated during acute infection compared with convalescence (P < 0.05), stable CF subjects (P < 0.005) and normal controls (P < 0.05). IgM RF production did not correlate with total IgM production in the majority of patients, but was closely related to circulating immune complex levels in 8/10 subjects. IgA RF production did not increase significantly during infection, and did not correlate with total IgA or IgM RF production, or with circulating immune complex levels. CD5+ B cells were not increased in the CF group, and the percentage of CD5+ B cells did not correlate with IgM RF synthesis. These observations suggest that RF production during infection is specifically induced, possibly by immune complex autoimmunization, and is not simply the result of polyclonal B cell activation. Different patterns of IgM RF and IgA RF synthesis suggest different mechanisms of induction.

Acute Disease↗
PubMed1993

IL-2 enhances polyclonal IgM but not IgM-rheumatoid factor synthesis by activated human peripheral blood B cells.

IgM-rheumatoid factor (RF) is thought to be involved in the pathogenesis of rheumatoid arthritis (RA). Several cytokines are known to regulate immunoglobulin synthesis. In this study the effects of IL-2 on polyclonal IgM and IgM RF synthesis were compared. Cytokines were added to peripheral blood B cells from normal subjects and patients with RA after activation by Staphylococcus aureus Cowan 1 (SAC). The addition of IL-2, but not IL-4 or IL-6, resulted in significant enhancement of IgM synthesis in cultures from both healthy subjects and patients with RA. Similar degrees of enhancement were seen in both peripheral blood mononuclear cell and highly purified B cell cultures. IgM-RF was synthesized after activation in cultures from healthy subjects and spontaneously in cultures from RA patients. In contrast to polyclonal IgM synthesis, IL-2 failed to augment IgM-RF synthesis in cell cultures from either healthy subjects or RA patients. This study demonstrates different effects of IL-2 on IgM and IgM-RF synthesis.

Adult↗
PubMed1993

A severity index designed as an indicator of acuity in palliative care.

Patients who are facing terminal illness frequently experience changes in health care settings which are necessitated by acute events during palliative care. This pilot study evaluates the reliability, criterion validity, and appropriateness of the San Diego Severity Index (SDSI) in a population of advanced cancer patients in different care settings. The SDSI includes diagnostic, acuity, and psychosocial assessments. Cancer patients were evaluated in an outpatient oncology clinic (SCRF), a hospice home care (HC) program, and an acute care hospital/hospice centre (ACC). Scores were lowest for SCRF (9.51 +/- 3.7), HC was intermediate (24.04 +/- 8.8), while patients at the ACC scored the highest (29.33 +/- 7.0). Patients admitted to the ACC were significantly more acute, as assessed by the SDSI, than those utilizing outpatient services. This instrument may be useful as an indicator of appropriate transitions between health care settings.

Acute Disease↗
PubMed1991

Immunodominant carbohydrate determinants in the multicellular stages of Dictyostelium discoideum.

Two families of glycoprotein are defined in Dictyostelium discoideum by the presence of different glycoconjugates, both of which are highly immunogenic in mice. The previously described monoclonal antibodies MUD50 and MUD62 recognize the glycoconjugates and identify the respective glycoprotein families. Both types of glycosylation occur on vegetative and developmentally regulated glycoproteins. The immunodominant components of both families are reportedly O-linked sugars, but Western blots do not identify any glycoprotein that has both O-glycans, suggesting that there are two independently processed types of O-linked glycosylation in D. discoideum. The synthesis of the two O-glycan families is affected by glycosylation-defective mutations. Strains with a mutation at the modB locus lack one of these glycosylation types (that recognized by MUD50) and this mutation alters the size of two minor glycoproteins in the second family. Two new mutants, HU2470 (mod-352) and HU2471 (mod-353), lack the epitope recognized by MUD62. The two mutations map to different chromosomes. The mod-353 mutation also affects the size of PsA, a cell surface glycoprotein carrying the modB-dependent O-glycan.

Animals↗
PubMed1983

Alpha(human leukocyte)-interferon as treatment for non-small cell carcinoma of the lung: a phase II trial.

Thirty-eight patients with advanced measurable non-small cell carcinoma of the lung (20 adenocarcinoma, 13 epidermoid carcinoma, 5 large cell anaplastic carcinoma) were treated with alpha(leukocyte)-interferon. Patients received 3 X 10(6) units intramuscularly 5 days out of 7. Patients were treated for 12 weeks or as modified for disease progression or positive response to therapy. In 37 patients evaluable for response, one partial response was observed (adenocarcinoma). Toxicity included fever and malaise, leukopenia, thrombocytopenia, nausea-vomiting, and hepatic toxicity. One additional patient with previous cardiac and pulmonary disease had a cardiorespiratory arrest several hours after his first interferon injection. The relationship between those events is not clear. As administered, alpha-interferon showed no meaningful activity as therapy for non-small cell carcinoma of the lung.

Adenocarcinoma↗