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M Geoghegan

Publications and source records attributed to M Geoghegan.

5 recordsLinked to original sources

Non-anticoagulation in atrial fibrillation.

Atrial fibrillation (AF) is an important risk factor for stroke and anticoagulation is now indicated in many patients at increased risk. Studies however have shown that many patients at risk are not anticoagulated for reasons that are not well explored. We identified prospectively the reasons for non-anticoagulation in patients with AF in 94 consecutive hospital patients with cardiac or cerebrovascular disease who had AF. Patients with intermittent or lone AF and < 60 years were excluded n = 16. The remaining group had a mean age of 76 +/- 7 years with a mental test score of 7.4 +/- 2 (normal 10), 31 lived alone and they lived an average of 14 +/- 11 miles from the hospital laboratory. The reasons for non-anticoagulation overlapped and were: medical in 29: cognitive impairment/compliance in 32: and monitoring problems in 50. Anticoagulation for AF in the elderly is a complex enterprise which must take into account social and cognitive as well as medical issues.

Aged

Prevalence and forms of neuropathic morbidity in 800 diabetics.

We prospectively determined the prevalence of morbidity from the various forms of diabetic neuropathy over one year in a population of 800 patients with diabetes mellitus (336 type 1, 464 type 2 DM). Symptoms documented were: pain/paraesthesia in the feet, loss of feeling and the restless legs syndrome. We also documented the prevalence of: neuropathic ulcers, amyotrophy, foot drop, and oculomotor palsy. Autonomic symptoms documented were: impotence, postural hypotension and diarrhoea. The only symptoms reported by 100 non-diabetic control subjects were: loss of feeling in 2% and restless legs syndrome in 7%. In the diabetics; pain/paraesthesia was present in 13%, feeling loss in 7% and neuropathic ulcers in 2%. The prevalence of Diabetic amyotrophy (proximal femoral neuropathy) was 0.8%, oculomotor palsy 0.1% and peroneal nerve palsy 0.1%. Erectile impotence was present in 20%, symptomatic postural hypotension in 1% and diabetic diarrhoea in 1%. Overall; 22.9% of the population was afflicted by one or more problems resulting from neuropathy. Neuropathy was associated with older age (p < 0.001), and serious retinopathy (p < 0.001) in both groups of diabetics and with duration of diabetes, proteinuria (p < 0.02), hypertension (p < 0.01) and ischaemic heart disease (p < 0.02) in type 1 diabetics.

Adult

Incidence, risk factors, and morphology in operating microscope light retinopathy.

A review of 135 consecutive cataract operations identified ten cases (7.4%) of operating microscope light retinopathy. Ophthalmoscopically, these light retinopathy lesions appeared as a focal pigment epithelial change with varying degrees of pigment clumping in the center. Fluorescein angiography accentuated the lesion by demonstrating a sharply demarcated transmission defect, occasionally with multiple satellite lesions. The shape of the lesion matched the shape of the illuminating source of the particular operating microscope used during the surgery. The most significant risk factor associated with the production of these light retinopathy lesions was prolonged operating time. Mean total operating time for the ten patients with light retinopathy was 51 minutes longer than for those without (P less than .0001). Other significant associated factors were the presence of diabetes mellitus (P less than .03), younger age (P less than .05), and the use of hydrochlorothiazide (P less than .04).

Cataract Extraction