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Biomedical subjects

R McCoy

Publications and source records attributed to R McCoy.

32 records · Page 2Linked to original sources
PubMed1989

Stroke in the Lehigh Valley: combined risk factors for recurrent ischemic stroke.

We used the Lehigh Valley Stroke Register and a logistic regression model for the odds ratio to study the relative contribution of several factors, considered jointly, to the risk of recurrent ischemic stroke. The factors were hypertension (HT), transient ischemic attack (TIA), myocardial infarction (MI), other heart diseases (OHD), diabetes mellitus (DM), age, and sex. Among these factors MI, OHD, and TIA constituted significantly greater risk than HTN, DM, age, or sex for ischemic stroke recurrence.

Cerebrovascular Disorders↗
PubMed1985

Seasonal variation of acute anterior uveitis: differences between HLA-B27 positive and HLA-B27 negative disease.

One hundred and seventy-five consecutive patients with acute anterior uveitis (AAU) were examined over a 24-month period. There was a significantly increased incidence of AAU during the months August to December (p less than 0.05). This increase was confined predominantly to the HLA-B27 negative group of patients (p less than 0.01). There was no significant monthly difference in incidence between males and females, between patients with first or recurrent attacks, or between patients with and without arthritis. These results suggest that seasonal environmental factors may play a role in the production of HLA-B27 negative AAU.

Australia↗
PubMed1984

Progressive multifocal leukoencephalopathy in a renal transplant recipient. Increased diagnostic sensitivity of computed tomographic scanning by double-dose contrast with delayed films.

A progressive, deteriorating neurologic disorder developed in a 28-year-old white man 10 years after he successfully received a living related donor kidney transplant. An extensive neurologic evaluation was unrevealing, including normal results of computed tomographic scanning of the brain with and without contrast medium. Repeated computed tomographic scanning after a double dose of radiocontrast medium in conjunction with delayed imaging revealed multiple areas of abnormal enhancement. This technique helped to direct brain biopsy, which led to the early diagnosis of progressive multifocal leukoencephalopathy and the institution of specific therapy.

Adult↗
PubMed1984

A search for gram-negative enteric micro-organisms in acute anterior uveitis: association of klebsiella with recent onset of disease, HLA-B27, and B7 CREG.

Faecal samples obtained from patients with acute anterior uveitis (AAU) and healthy controls unconnected with hospitals were examined for the presence of Gram-negative micro-organisms reported to be associated with AAU. There was an increased recovery of Klebsiella spp. from AAU patients seen in the first and in the second week after onset of symptoms when compared with patients presenting three to four weeks after onset of symptoms (p less than 0.025 and p less than 0.05 respectively) or with healthy control subjects (p less than 0.005 and p less than 0.05 respectively). By the third to fourth week there was no difference in klebsiella recovery between AAU patients and controls. The increased faecal recovery of klebsiella in the first two weeks was predominantly in HLA-B27 positive patients or patients possessing antigens which cross-react with B27, namely, HLA-B7 CREG. The patients with faecal cultures positive for klebsiella had a higher mean ESR than patients with negative faecal cultures (p less than 0.05). Although there was an increase in recovery of faecal klebsiella from AAU patients with spondylarthritis when compared with AAU patients without arthritis, the difference was not statistically significant. These results suggest that some klebsiella micro-organisms may play a role in the aetiopathogenesis of AAU associated with HLA-B27 or HLA-B7 CREG.

Acute Disease↗
PubMed1984

Serum immunoglobulins in acute anterior uveitis.

Serum levels of immunoglobulin A, G, and M were examined in 99 patients with acute anterior uveitis (AAU). The mean level of serum IgA was raised (p less than 0.001) in AAU patients when compared with healthy control subjects. The levels of serum IgG and IgM were not significantly different from those in the control group. The raised levels of serum IgA were found to occur predominantly in the HLA-B27 positive group of patients (p less than 0.001) and were highest in HLA-B27 positive patients with sacroiliitis or associated spondylarthritic diseases (p less than 0.001). The HLA-B27 negative group of AAU patients did not have a significantly raised mean serum IgA. The raised level of serum IgA in HLA-B27 positive AAU patients suggests that there has been a response to an environmental or infectious agent(s) acting across a mucosal tissue in these patients. This agent could be responsible for the initiation of the acute ocular inflammation.

Acute Disease↗
PubMed1984

Digital tomosynthesis: technique modifications and clinical applications for neurovascular anatomy.

Digital tomosynthesis studies (DTS) using a linear tomographic motion can provide good quality clinical images when combined with subtraction angiotomography. By modifying our hardware system and the computer software algorithms, we were able to reconstruct tomosynthesis images using an isocentric rotation (IR) motion. Since this is the motion used by C-arm and U-arm angiographic units, these modifications allow for the use of DTS studies in most modern angiographic suites at a reasonable cost. Applying a combination of linear tomographic and IR techniques in clinical cases, we performed DTS studies in six patients, five with aneurysms and one with a hypervascular tumor. The results showed detailed definitions of the pathologic entities and the regional neurovascular anatomy. Based on this early experience, DTS would seem to be a useful technique for the preoperative surgical planning of vascular abnormalities.

Brain Neoplasms↗
PubMed1975

Membranoproliferative glomerulonephritis. Progression from the pure form to the crescentic form with recurrence after transplantation.

Described are the clinical course and renal morphologic findings in a patient with membranoproliferative glomerulonephritis. intially, the patient had a pure form of membranoproliferative glomerulonephritis but after a 3 year course, it became crescentic. After a renal allograft was performed, membranoproliferative glomerulonephritis recurred within 1 month in a pure form and subsequently developed into the crescentic form. This change occurred in the host kidney as well as in the allograft immediately after immunosuppressive and steroid therapy was discontinued.

Adult↗
PubMedDate not supplied

Distress, coping, and social support among rural women recently diagnosed with primary breast cancer.

This study examined distress, coping, and group support among a sample of rural women who had been recently diagnosed with breast cancer. We recruited 100 women who had been diagnosed with primary breast cancer at one of two time points in their medical treatment: either within a window up to 3 months after their diagnosis of breast cancer, or within 6 months after completing medical treatment for breast cancer. Their mean age was 58.6 years (SD = 11.6), and 90% were of white/European American ethnicity. Women completed a battery of demographic and psychosocial measures prior to being randomized into a psychoeducational intervention study, and then again 3 months later at a follow-up assessment. The focus of this article is on the women's self-reported psychosocial status at baseline. Many of the women experienced considerable traumatic stress regarding their breast cancer. However, this distress was not reflected in a standard measure of mood disturbance that is frequently used in intervention research (the Profile of Mood States). The average woman considered her diagnosis of breast cancer to be among the four most stressful life events that she had ever experienced. Also, women on average reported a high level of helplessness/hopelessness in coping with their cancer. On average, women felt that they "often" (but not "very often") received instrumental assistance, emotional support, and informational support. Women varied considerably in which kind of social group provided them with the most support, with as many reporting that they found the greatest support in spiritual/church groups or within their family units as with breast or general cancer groups. These results suggest that among these rural women with breast cancer, distress with the diagnosis of breast cancer must be carefully assessed, as women who are highly distressed about their breast cancer may not report general mood disturbance. Furthermore, the kinds of groups that rural women with breast cancer experience as most supportive need to be identified so that psychosocial interventions can be matched to breast cancer patients' individual needs.

Adaptation, Psychological↗
PubMedDate not supplied

Stroke in the Lehigh Valley: seasonal variation in incidence rates.

We investigated the seasonal pattern of stroke using the Lehigh Valley Stroke Register. This register includes all patients hospitalized with stroke or transient ischemic attack (TIA) from among the 600,000 Lehigh Valley residents. Meterological data were obtained from the National Oceanic and Atmospheric Administration. The study, which uses 18 months of data, included 1,944 cases. Using single harmonic regression analysis, the seasonal pattern of TIA and infarction, but not hemorrhage, fit a sine-cosine wavefunction with a 12-month period (R2 = 41% and 36%, respectively). For infarction, the strongest seasonal pattern was exhibited for women of all ages and for both sexes in the age groups 65-74 and 75-84, but only the sine component was significant. The peak months for TIA were June-August, while the peak months for infarcts were February-April. Correlations between ambient temperature and each type of stroke were computed. A significant positive correlation for TIA was found (r = 0.57, p = 0.01). After adjusting for a 2-month lag between the low for infarction and the peak for temperature, a significant negative correlation was found (r = -0.64, p = 0.01). No significant correlation was found for hemorrhage. Possible reasons for the opposite relations of TIA and infarct are discussed.

Age Factors↗
PubMedDate not supplied

Acute stroke, hematocrit, and blood pressure.

A population-based study of the relation between hematocrit and stroke subtype was carried out among 2,077 individuals using the Lehigh Valley Stroke Register. This register identifies all stroke patients admitted to the 8 acute care hospitals serving the Lehigh Valley area of eastern Pennsylvania-western New Jersey. The mean hematocrit was higher in patients with lacunes than with thrombotic or embolic strokes (p = 0.02). However, when blood pressure was also considered the increase in hematocrit in patients with lacunar stroke was significant only when systolic hypertension (greater than or equal to 150 mm Hg) was also present (p = 0.029); no significant difference in hematocrit was found between stroke subtypes in normotensive individuals. Therefore, we cannot exclude the possibility that hypertension interacts with hematocrit in accounting for the observed association with lacunar infarcts. There was no trend for increased in-hospital mortality for stroke patients in either the low (less than or equal to 30, 30-36%) or high (greater than or equal to 47%) hematocrit groups.

Acute Disease↗