Search PubMed⌕ Search

Biomedical subjects

C C Cronin

Publications and source records attributed to C C Cronin.

34 records · Page 2Linked to original sources
PubMed1994

Complications and cardiovascular risk factors in insulin-dependent diabetes--findings in an Irish clinic and in other European centres.

The Eurodiab Insulin Dependent Diabetes (IDDM) Complications Study was a cross-sectional investigation of a stratified random sample of IDDM patients attending 31 clinics in 16 European countries. We compared the findings in the only participating Irish centre (Cork Regional Hospital) with those of the study group as a whole. There were fewer episodes of ketosis but severe hypoglycaemia occurred more frequently in Cork patients, when compared to the full study group. There were no significant differences in the prevalence of background retinopathy, proliferative retinopathy, microalbuminuria, macroalbuminuria or peripheral neuropathy, when the two groups were compared. However, autonomic neuropathy was significantly less common in Cork. The prevalence of cardiovascular disease was slightly lower than the Eurodiab average in Cork patients, and cardiovascular risk factors were more favourable. Waist-hip ratio and total plasma cholesterol were significantly lower than in the full study group. The prevalence of hypertension was similar, but there were fewer smokers in Cork than in most other centres.

Adult↗
PubMed1994

The Jarisch-Herxheimer reaction in leptospirosis.

Three patients with leptospirosis whose condition worsened after initiation of antibiotic therapy are reported. Their clinical deterioration appeared to be due to the development of the Jarisch-Herxheimer reaction rather than to progression of their underlying infection. Relevant aspects of the management of patients with leptospirosis are discussed.

Adolescent↗
PubMed1994

Splenectomy in patients with undiagnosed splenomegaly.

Of splenectomies performed in the Cork Regional Hospital over an 11 year period, ten were undertaken primarily for diagnostic purposes. A definitive histological diagnosis was established in nine patients, seven of whom had lymphoma, two with Hodgkin's disease and five with non-Hodgkin's lymphoma. The weight of the excised spleen in all patients with lymphoma exceeded 1 kg; in all those with a diagnosis other than lymphoma, the spleen weighed less than 1 kg. A majority of patients also had symptomatic improvement from reversal of hypersplenism and from relief of the mechanical pressure effects of an enlarged spleen. Operative mortality was zero. Diagnostic splenectomy is a worthwhile procedure. Most patients will have lymphoma.

Adult↗
PubMed1993

Constrictive pericarditis simulating intestinal lymphangiectasia in a patient with the Noonan syndrome.

A case of constrictive pericarditis with marantic endocarditis in a patient with the Noonan syndrome is reported. Congenital heart defects are often diagnosed in the Noonan syndrome and are undoubtedly the most problematic of its pathologies. Our patient had surgery for pulmonic stenosis at age 10 and 16 years. Over a period of 1-2 years prior to death at age 23 years, he developed elevated jugular venous pressure, hypoproteinaemia, pedal oedema and pleural effusions. The hypoproteinaemia and resulting signs were initially attributed to intestinal lymphangiectasia. The latter, unlike constrictive pericarditis, has been reported in the Noonan syndrome. Post-mortem examination revealed constrictive pericarditis with a marantic endocarditis. There was no evidence of intestinal lymphangiectasia.

Adult↗
PubMed1993

Reversible bilateral ureteric obstruction due to a pancreatic pseudocyst.

An unusual case of bilateral ureteric obstruction and hydronephrosis due to pancreatic pseudocyst formation, after an episode of acute pancreatitis is reported. All abnormalities resolved with conservative management. Possible reasons for such ureteric obstruction include periureteric fat necrosis by pancreatic enzymes and compression by the inflammatory mass.

Acute Disease↗
PubMed1992

Serum ferritin in newly diagnosed and poorly controlled diabetes mellitus.

Serum ferritin was measured in 50 patients at diagnosis of diabetes mellitus (DM) and in 20 patients with established DM and poor metabolic control. Twenty-two patients had hyperferritinemia at diagnosis. Four patients had a recognised cause for their hyperferritinemia. In the remaining 18 patients ferritin levels decreased from a mean of 506 +/- 3.6 (SE) ug/l at diagnosis to 254 +/- 29.2 ug/l seven months later (p < 0.001). Metabolic control improved significantly over the same time. All 20 patients with established DM and poor metabolic control had normal ferritin levels. When compared with the newly diagnosed hyperferritinemic patients no difference was found in levels of glycosylated haemoglobin, but ferritin values differed significantly between the two groups (p < 0.001). These results indicate that transient hyperferritinemia is a feature of newly diagnosed DM but not of established DM with poor control. If used to screen diabetic patients for haemochromatosis, serum ferritin should be measured in established DM rather than at diagnosis.

Adolescent↗
PubMed1991

Long term efficacy of a pen injector.

We assessed the long term efficacy of Novopen as a form of insulin administration. Records were obtained on 48 patients who were treated with Novopen between January '86 and October '88. Six patients were excluded due to insufficient data. The study group of 42 patients comprised 22 females and 20 males of average age 33 years (range 17-66). Mean Hb.A1 rose from 10.6% to 12.1% after Novopen therapy, a rise of 14.1%. This rise is both clinically and statistically significant (p less than 0.001; 99% confidence limits 0.59-2.78). Increases in weight and insulin dose were also noted, but did not reach statistical significance. The majority of patients felt Novopen was superior to twice daily insulin in terms of ease of administration (81%) and flexibility of lifestyle (95%), and all who were using Novopen wished to continue with it. More than 50% of patients admitted to altering their dietary habits while using Novopen. Despite continuing patient satisfaction with this form of insulin administration, its long-term use may be associated with sub-optimal metabolic control.

Adolescent↗
PubMedDate not supplied

Appropriateness of laboratory tests: requests for atypical pneumonia serology in a teaching hospital.

The cost of providing medical care is ever-increasing but the resources available are at best static. Major savings can be made by reducing inappropriate investigations. Using serological testing for organisms causing atypical pneumonia as an example, we examined the appropriateness of requests and also physicians' understanding of the test. Of 119 patients tested, only 3 had titres indicative of acute infection. Most patients were tested within 2 days of hospital admission, before receipt of results excluding more likely diagnoses. Forty-five patients had no current or recent respiratory symptoms, in whom infection was highly unlikely. Titres were most often requested by the least experienced members of the clinical team. Of 70 patients with an acute illness in whom a definitive diagnosis, bacteriological or otherwise, was not made, in only 9 was a convalescent specimen sent for follow-up titres. Most requests for serology for organisms causing atypical pneumonia were inappropriate. Furthermore, in the majority of cases the test was incorrectly used.

Adolescent↗
PubMedDate not supplied

The prevalence of coeliac disease among female subjects having bone densitometry.

BACKGROUND: Osteoporosis frequently complicates coeliac disease but most studies focus on symptomatic patients at the time of diagnosis. Screening tests have revealed that many individuals with coeliac disease have mild, atypical, or absent symptoms. AIM: To evaluate the relationship between coeliac disease and osteopenia or osteoporosis in female subjects attending for bone densitometry. METHODS: We studied 371 female subjects attending for bone densitometry, without secondary causes of osteoporosis and included those with normal and with reduced bone mineral density. Mineral density was measured by dual energy X-ray absorptiometry. Screening for coeliac disease was by measurement of anti-endomysial antibody by indirect immunofluorescence. RESULTS: Two of 115 (1.7%) female subjects with normal bone density and five of 256 (1.9%) female subjects with sub-normal bone density were positive for endomysial antibody. Five subjects who underwent small bowel biopsy had histological changes suggestive of coeliac disease. CONCLUSIONS: In females referred for bone densitometry, endomysial antibody positivity was not more prevalent among those with reduced bone mineral density. Examining only patients with clinically detected coeliac disease may overestimate the frequency of complications. This study does not support population screening for coeliac disease in an area with a high frequency of the condition.

Absorptiometry, Photon↗
PubMedDate not supplied

Are the nutritional recommendations for insulin-dependent diabetic patients being achieved?

Dietary intake was assessed, using a 3-day recorded food diary, in 122 patients with insulin-dependent diabetes. Subjects were selected randomly from patients attending a diabetic clinic and stratified for age, sex, and duration of diabetes. The findings were compared to the dietary recommendations of the European Association for the Study of Diabetes (EASD) and to the findings in a recent Irish National Nutrition Survey. The average daily protein intake among diabetic patients was 18% of the total calories, significantly higher than recommended by EASD and significantly higher than in the age-matched general population. Dietary fat intake was on average 37% of total calorie intake, again significantly higher than recommended and greater than in the general population among older patients. Saturated fat intake was higher than recommended and polyunsaturated fat intake was low. The average carbohydrate intake was 42% of total calories, significantly lower than recommended and similar to that in the general population. Sugar intake was lower and starch intake was higher among patients than in the general population, however. Fibre intake was also lower than recommended, but was higher than in the general population. We conclude that the present dietary targets for diabetic patients are not being fully achieved.

Adolescent↗
PubMedDate not supplied

Concomitant Graves' disease and Hashimoto's thyroiditis, presenting as primary hypothyroidism.

Hypothyroidism in patients with Graves' disease is usually the result of ablative treatment. We describe a 58 year old man with Graves' ophthalmopathy and pre-tibial myxoedema, who presented with spontaneous primary hypothyroidism. Circulating TSH receptor antibody activity was increased, while thyroid microsomal antibody was detectable in titres greater than one in one hundred thousand. It is likely that the TSH receptor antibody of Graves' disease was ineffective in stimulating hyperthyroidism because of concomitant thyroid destruction due to Hashimoto's disease. Alternatively, primary hypothyroidism could have resulted from the effects of a circulating TSH receptor blocking antibody.

Graves Disease↗