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Biomedical subjects

C F McCarthy

Publications and source records attributed to C F McCarthy.

At least 19 recordsLinked to original sources
PubMed1992

HLA class II frequencies in celiac disease patients in the west of Ireland.

Restriction fragment length polymorphism analysis, using a single restriction enzyme TaqI-multiple-probe system for HLA-DRB1-DQB1 and -DQA1, was used to determine HLA-DR and -DQ frequencies in 56 unrelated celiac patients and 47 unrelated controls from the west of Ireland. In addition, HLA-DPB1 allelic frequencies were determined in the same group of patients and controls by using the technique of enzymatic DNA amplification of the polymorphic second exon of HLA-DPB1 genes in conjunction with sequence-specific oligonucleotide probing. The results suggest that HLA-DQ rather than HLA-DR is more important in conferring susceptibility to celiac disease. Furthermore, no association between HLA-DP and celiac disease was found in this study.

Adolescent↗
PubMed1991

Evidence for a dominant gene mechanism underlying coeliac disease in the west of Ireland.

Although coeliac disease (CD) is strongly associated with the HLA alleles B8 and DR3, the genetic basis of this illness remains obscure. Recent studies show that at least two unlinked loci are involved. Most studies agree on recessivity at the HLA-unlinked locus but differ with respect to dominance or recessivity at the HLA-linked disease susceptibility locus. To address this controversy, we examined the association of CD with HLA in 39 families from the West of Ireland. Previous studies have shown that the prevalence of CD and the frequencies of the HLA antigens associated with it are higher in this population than in most others. Analysis of the data revealed a significant excess of concordant sib-pairs with two HLA haplotypes in common and an excess of discordant pairs with no haplotype in common. Chi-square tests confirmed a highly significant association between HLA-B8 and CD. Both heterozygotes and homozygotes for B8 had a significantly increased risk of CD. The risk for homozygotes was slightly higher than for heterozygotes, although not significantly so. The segregation ratio for disease occurrence among sibs of probands was estimated to be 0.185 when neither parent is affected. We estimated a gene frequency of 0.003 for the disease allele (C) at the HLA-linked locus and of 0.648 for the disease allele (d) at the HLA-unlinked locus. Assuming that CCdd homozygotes are always affected and that only carriers of C who are homozygous dd can be affected, the disease was found to be completely penetrant in Ccdd heterozygotes. These results support dominance at the HLA-linked locus conferring susceptibility to CD. Possible reasons for the discrepancy between the West of Ireland and other populations are discussed.

Alleles↗
PubMed1991

Gm typing of Irish coeliac patients and controls does not help locate the "second" coeliac gene.

A two gene model has been proposed to explain the inheritance of coeliac disease (CD). One gene is on chromosome 6 in the MHC complex (HLA associated). It has been suggested the second gene is located on chromosome 14, in or near the region encoding for immunoglobulin heavy chain allotypes (Gm types). In a study of 102 unrelated Irish coeliacs and a group of ethnic controls, we have failed to show an association of CD with any particular Gm type or types. There is no evidence to confirm that a gene on chromosome 14 is implicated in the inheritance of CD.

Adolescent↗
PubMed1990

Lung cavities in patients with coeliac disease.

The clinical, radiological and pathological features of 7 patients with coeliac disease (CD) who developed lung abscesses or cavities are described. These patients were seen during a 20-year period during which time approximately 600 coeliacs were seen and 50 died. Six of the coeliac patients with lung abscess died. The patients were middle aged. Staphylococcal infection, Klebsiella pneumoniae, bronchial carcinoma and previous pulmonary tuberculosis accounted for the cavities in 4 patients. In the 3 other patients a definite cause could not be identified. Hyposplenism and malnutrition were common. Next to malignancy pulmonary abscess was the commonest cause of death in the coeliac population. The development of respiratory symptoms should be regarded as a potentially serious and a life-threatening event in the middle-aged coeliac patients. Lung abscess should be added to the list of respiratory diseases associated with coeliac disease.

Adult↗
PubMed1989

Ulcerative enteritis--atypical features.

A 40 year old man with two month history of vomiting and weight loss, was found to have multiple strictures in his small bowel. Investigations outruled known causes of small bowel ulceration, and the flat bowel mucosa did not respond to a gluten free diet. Treatment with steroids conferred a temporary benefit, however, small bowel ulceration persisted.

Adult↗
PubMed1989

Medical services for the elderly.

The percentage of acute medical beds in Galway Regional Hospital, occupied by patients over 65 years old is more than 50%. This use of acute medical services by elderly, will increase over the next three decades, in line with population projections. Further development of the geriatric service, and more emphasis on training in geriatric medicine is necessary.

Aged↗
PubMed1988

Impaired coagulation in accidental hypothermia of the elderly.

Six elderly patients with accidental hypothermia were prospectively evaluated for impaired coagulation. All patients had abnormal coagulation profiles. Three patients with severe coagulopathies and serious underlying conditions died while hypothermic. Despite investigation, no cause for disordered coagulation was found in four patients. We conclude that hypothermia per se contributes to disordered coagulation in the elderly.

Accidents↗
PubMed1988

Three computer models for the calculation of prevalence of peptic ulcer disease during long-term treatment.

At present the effects of maintenance treatment for peptic ulcer disease are usually calculated by using 'life-table' analyses. Whilst these accurately demonstrate the speed with which an initial relapse occurs they make no allowance for the fact that, in clinical practice, a relapse often responds to a further course of full-dose treatment and the patient then returns to maintenance therapy. A further compounding factor is that, in any long-term study, patients will be lost to follow-up for a variety of reasons not all related to failure of the treatment. In this paper we describe the use of 'prevalence rates' to better reflect the outcome of peptic ulcer management. Three 'computer models', which have been developed to address the problems of patients leaving the study for any reason during such a long time-period, are also described, as are the underlying assumptions made. Using the results from a long-term study of continuous treatment with cimetidine, the 'prevalence rates' of ulcer disease over 6 years were calculated. Observed relapse rates appeared to fall with time (from 2.7% for duodenal ulcer (DU) and 2.5% for gastric ulcer (GU) to 1% and 2% respectively). However, on applying the models to the data, prevalence rates tended to rise slowly with time for the first 3 years in each of the models tested. At 6 years, two of the models suggested that the prevalence rate for DU would be about 8%; this is not very different to the reported recurrence rate after surgical treatment by truncal vagotomy and pyloroplasty. It is concluded that 'prevalence rates' should be used to assess long-term medical treatments for ulcer disease. Similar methods could also be used to examine the medical treatment of any other disease where multiple relapses, capable of responding to re-treatment, occur. The use of models proved beneficial in compensating for patients lost during the study.

Computer Simulation↗
PubMed1987

Gait deviations in patients with juvenile rheumatoid arthritis.

The purpose of this study was to describe quantitatively the gait patterns of patients with juvenile rheumatoid arthritis (JRA). Thirty children with JRA and 30 healthy children were evaluated using a computerized gait analysis system. Time-distance characteristics and joint angle excursions were studied. The subjects with JRA walked with significantly decreased velocity, cadence, and stride length. We found no significant difference in step width nor in the percentage of time spent in each phase of the gait cycle. The anterior pelvic tilt of subjects with JRA was significantly increased throughout the gait cycle. Hip extension at the end of single-limb stance and ankle plantar flexion during weight release also were significantly decreased for subjects with JRA. No significant difference between the two groups was noted in knee joint excursion. Areas of emphasis for physical therapy of patients with JRA include increasing velocity, cadence, stride length, hip extension, and ankle plantar flexion and decreasing excessive anterior pelvic tilt.

Adolescent↗
PubMed1987

Decreasing incidence of coeliac disease.

Between 1960 and 1974 the incidence of coeliac disease in children under 12 years in County Galway remained fairly constant, but since 1975 it has fallen by 62% and the lowered incidence seems well established. The number of those who were breast fed and the age at which first gluten feeding took place during the 22 years both increased significantly and from the mid-70s total protein content and osmolarity of proprietary cow's milk formulas were reduced. All three factors may be relevant. A negative correlation with the incidence of gastroenteritis was found.

Age Factors↗
PubMed1987

Compliance with gluten free diet in coeliac disease.

Fifty two children in whom coeliac disease was confirmed by persistent enteropathy while they were taking gluten were monitored to assess the effects of compliance with a gluten free diet (GFD). Between the ages of 17.8 and 18.5 years height (in 45 patients followed up for a mean of 14.9 years) and weight (in 43 followed up for a mean of 15.2 years) were significantly lower in those complying poorly with a GFD compared with those complying well. Of the 37 patients still attending the clinic after a mean of 25 years, having been followed up for a mean of 18.4 years, 16 who had complied well with the diet had normal or only slightly abnormal mucosal morphology whereas all 10 who had not complied had abnormal morphology. In these 10 lactase, sucrase, and alkaline phosphatase activities were significantly less than values in those who complied well. Mucosal sucrase and alkaline phosphatase activities in those who complied well were no different from those in a control population, whereas lactase activity was significantly lower. It is concluded that failure to comply with a GFD during childhood results in decreased adult stature and in persisting active enteropathy with depressed brush border enzyme activity.

Body Height↗