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Biomedical subjects

C McCarthy

Publications and source records attributed to C McCarthy.

At least 55 records · Page 3Linked to original sources
PubMed1997

Coronary Stenting in Clinical Practice: Patient Profile, Immediate Outcome, Clinical and Angiographic Follow-up in 243 Consecutive Patients.

The purpose of this study is to assess immediate outcome and long term results in unselected consecutive patients (pts) representing a spectrum of clinical and angiographic subgroups and stent designs. RESULTS: From first implantation in November 1989 through to October 1995, 243 pts underwent coronary stent insertion (307 stents, males n=188, females n=55, mean age 57.8 years. Palmaz-Schatz stents were implanted in 210 pts, Wiktor in 30 pts, both in 3. Bailout stenting was performed in 11 patients. Overall procedural success was 97%. Complete revascularization was achieved in 155 (64%) patients. Stenting of an infarct-related artery within 6 hours of an acute myocardial infarction was performed in 6 patients, and for unstable angina in 107. Pre-procedure 223 (92%) pts had class III/IV angina. Stenting of 11 vein grafts and 5 left main arteries was performed. Subacute stent thrombosis occurred in 13 (5%) pts while 6 (2.5%) pts died in hospital, and 8 (3%) had a Q-wave myocardial infarction. At a mean (SD) 7.3 (12.9) months follow-up 233 (96%) pts were alive, 213 (91%) had no or mild angina. Angiographic follow-up in 201 (83%) pts at 19 (30) weeks showed a 13% in stent restenosis rate. CONCLUSIONS: In an unselected, consecutive series of patients undergoing coronary stenting, mortality was low, procedural success was high and late clinical and angiographic results were satisfactory. Subacute stent thrombosis, though uncommon remains a challenge.

Journal Article↗
PubMed1997

[Elaboration and validation of a specific quality of life questionnaire for urination urgency in women].

Urgent micturition interferes with the quality of life (QoL) of women suffering from this symptom. In order to evaluate this disturbance of quality of life and the benefits of treatment, a self-administered questionnaire, specific to the disorders of urgent micturition in women, was developed from a pre-existing scale (Measurement of Urinary Handicap, MUH). The following developmental methodology was adopted: Generation of a first instrument from the patient's descriptions collected by a multidisciplinary group of clinicians: formulation of questions, regrouping of questions into dimensions, choice of reference period and modalities of response. Content validation and test of comprehension in 20 patients. Transverse pilot study (98 patients) designed to reduce the number of questions and analyse the internal reliability and clinical validity. Reproducibility study. The final questionnaire comprises 24 items grouped into 5 dimensions: activities (8 items), emotional repercussions (5), self-image (5), sleep (3), well-being (3). The relevance of regrouping of the questions in their dimension and of calculation of a global score was confirmed by a principal component analysis and multifactorial analysis. The internal reliability and reproducibility of the scores were satisfactory, with a Cronbach alpha of > 0.70 and an intraclass correlation coefficient > 0.80, respectively. The clinical validity of the questionnaire was verified: the QoL scores of patients became significantly lower as the symptoms became more severe. A specific, reliable and clinically valid questionnaire, expressed in the form of a global score and a profile, was able to be developed. The profile of patients suffering from urgent micturition reflects the repercussions of the disease on the major and specific domains of their QoL. This questionnaire presents the required properties to be used in clinical trials designed to evaluate the effects of treatments on the patients' QoL, as a complement to classical clinical evaluations.

Activities of Daily Living↗
PubMed1997

Case costing means, measuring and managing now! The journey traveled by a community hospital.

Funding for health care in Ontario is moving from global funding to equity funding. In the future, hospitals will be reimbursed for how efficiently they care for their various patient populations. The Ontario Case Costing Project (OCCP) was a joint venture by the Ontario Hospital Association and the Ministry of Health. Incentive for participation in this project was based on the need to assess efficiencies in caring for patient populations in surgical suites and to obtain Canadian data. Case Costing has the potential to forecast budgets, identify variances and highlight areas for cost savings. Case Costing can also determine cost per surgeon, cost per service, cost per procedure. The nurses at Markham Stouffville Hospital are empowered to enhance the focus of their practice to include managing human resources, processes and materials. This enhanced focus in the Operating Room maximizes efficiency and effectiveness of processes, and allows the organization to provide better service. This article documents the journey and growth of perioperative nurses toward the destination of case costing. Key to this journey is not only the destination, but the growth and change that occurred and enabled perioperative nurses to effectively champion initiatives such as case costing. Opportunities and Threats, a One Page Plan and our recommended learnings will be shared.

Case Management↗
PubMed1996

A 13-year cytogenetic study of spontaneous abortion: clinical applications of testing.

Chromosome analysis was performed on 1,543 specimens of first trimester miscarriage received between 1982 and 1994. Comparisons with earlier studies show that some findings are absolutely consistent between different years and populations, but some major differences are also found. The results are considered in the light of several recent genetic, environmental and physiological studies. Trisomy 16, and probably trisomy 22, is entirely dependent on maternal age; other trisomies show both maternal age and other environmental or genetic effects. Monosomy X and mosaic aneuploidy arise postzygotically by chromosome loss, a normal control mechanism. Some trisomy, dipaternal triploidy and tetraploidy probably occur because of pre- or postovulatory 'overripeness'; either due to transient or chronic maternal conditions or delayed fertilization. Unbalanced structural abnormalities, most apparently of de novo origin, are markedly increased compared to earlier studies and are possibly due to paternal environmental exposures. It is concluded that when considering histories of abortion, studies of the chromosomes of the aborted products are much more informative and cost-effective than studies of parental bloods. Where available, studies of products should be undertaken for preference, but only by experienced and committed laboratories.

Abortion, Spontaneous↗
PubMed1996

Two comparative endoscopic evaluations of Naprelan.

This paper describes the results of two endoscopic studies of Naprelan (Wyeth-Ayerst Laboratories, Philadelphia, Pennsylvania), a controlled-release formulation of naproxen sodium. In one study, 19 healthy male subjects received either 2 controlled release Naprelan 500-mg tablets once daily or 1 Naprosyn (naproxen; Syntex Laboratories, Inc., Palo Alto, California) 500-mg tablet BID. At baseline, all subjects had gastroduodenal endoscopy scores of 0 on both the Lanza and Euler scales. Although the trend favored Naprelan, differences in Lanza and Euler scale elevations were not statistically significant. Eight of 10 subjects in the Naprelan group and 7 of 9 subjects in the Naprosyn group reported a total of 27 adverse events (AEs). In the second study, healthy subjects received Naprelan 1,000 mg once daily, Naprosyn 500 mg BID, and film-coated aspirin 650 mg QID. In the stomach, there was a significant difference in favor of Naprelan over aspirin (P = 0.0001) and in favor of Naprosyn over aspirin (P = 0.0001). Fewer erosions were seen in the duodenum than in the stomach. In the duodenum, there was a significant difference in favor of Naprelan over Naprosyn (P = 0.0236), and in favor of Naprelan over aspirin (P = 0.0086), but the difference between Naprosyn and aspirin was not significant (P = 0.6643). Of the 23 subjects who received medication, 12 reported AEs: 8 while receiving aspirin, 3 while receiving Naprosyn, and 1 while receiving Naprelan. Differences in the number of erosions and ulcers seen following each of the periods of drug administration favored Naprelan and the Intestinal Protective Drug Absorption System.

Adolescent↗
PubMed1995

Long-term prospective study of Helicobacter pylori in nonulcer dyspepsia.

Helicobacter pylori is present in up to 87% of patients with nonulcer dyspepsia. This study assessed the effect of eradicating Helicobacter pylori infection on the symptoms of nonulcer dyspepsia at four weeks and one year after treatment. Dyspepsia was assessed on the frequency and severity of six symptoms [epigastric pain (night and day), nausea and vomiting, upper abdominal discomfort, and regurgitation] where each symptom was scored from 0 to 4. Helicobacter pylori status was assessed before treatment and four weeks after treatment with histology and microbiology, and at one year with a carbon-13 urea breath test. Eighty-three patients (23 males, 60 females; mean age 56.3 years; mean symptom duration 3.6 months) with nonulcer dyspepsia and Helicobacter pylori infection entered the study. Seventy-five were available at one year follow-up. Four weeks after treatment, the mean symptom score improved in those with eradication (6.95-2.3, P = 0.01, N = 41) or persistent infection (6.69-3.0, P = 0.015, N = 42). At one year, those with persistent Helicobacter pylori infection (N = 38, score 5.24) had a higher score than those remaining clear of infection (N = 24, score 1.4, P < 0.0001) and those with reinfection (N = 13, score 2.2, P < 0.0001). In addition, persistent Helicobacter pylori infection was associated with more additional treatments than those with eradication (34/38 versus 4/37, P < 0.001). These results suggest that Helicobacter pylori plays an important role in the symptoms of nonulcer dyspepsia.

Adult↗
PubMed1995

Establishing baseline data in cancer registration in northern England: implications for Health of the Nation targets.

OBJECTIVE: To assess the completeness and accuracy of cancer surveillance data relevant to Health of the Nation targets. DESIGN: A comparison of locally ascertained data on cancer with recorded cancer registry sources in selected diagnoses. SETTING: The district of South West Durham within the Northern Regional Health Authority. PATIENTS: All patients with lung, skin, and malignant cervical cancer who were resident and diagnosed in the district or identified in the Northern Region Cancer Registry during the calendar period 1989-91. MAIN RESULTS: Of 544 cases of cancer identified from all available sources, 448 (95.8%) were registered, ranging from 93.9% for malignant cervical cancer to 96.7% for skin cancer. In 448 cases which were both identified locally and registered, 53 (11.8%) showed disagreements between local sources and register data, involving classification of site and timing of registration. Twenty three cases were identified locally but were not registered, 22 registered but not identified locally, and 51 registered with the casenotes missing locally. CONCLUSIONS: Any real achievement of Health of the Nation targets may be masked by changes over time in the accuracy and completeness of information systems. In assessing the achievement or otherwise of targets, it is important to be aware of any differences in the completeness and accuracy of the baseline data compared to future measurements.

England↗
PubMed1995

Allogeneic BMT from a donor with fragile X syndrome: cytogenetic and molecular evaluation.

We report the first case of engraftment of bone marrow collected from a donor with Fragile X syndrome with subsequent cytogenetic and molecular evaluation. Engraftment was prompt and stable. Whilst the Fragile X abnormality could be detected initially by molecular techniques in the peripheral blood, it could not be detected cytogenetically while the patient was receiving CsA.

Adult↗
PubMed1995

Evaluation of an interactive multimedia application to learn interpersonal skills.

A multidisciplinary team from Ryerson Polytechnic University in Toronto collaborated to produce an interactive multimedia application to teach interpersonal communication skills. The purpose of this educational prototype was to provide a module to accompany an introductory course in communication skills. Though it is based on a scenario specific to a group of health care professionals, it is hoped that the application would be useful to a variety of learners.

Communication↗
PubMed1994

[Measurement of quality of life in intermittent claudication. Clinical validation of a questionnaire].

OBJECTIVES: Functional limitation in patients with intermittent claudication impairs their quality of life. In order to measure this new evaluation parameter, we developed a self-administered questionnaire: Artemis. METHODS: The questionnaire was composed of a general instrument (SF-36) and a specific one. A cross sectional study was performed in 177 patients with intermittent claudication (mean age 68 +/- 10 years, 77% males) who stated their walking distance was limited within 50 to + 2000 meters. The acceptability, reliability and sensitivity of the questionnaire were tested. RESULTS: In patients who had a walking distance greater than 500 m (n = 96), the scores obtained were significantly higher (better quality of life) than in patients whose walking distance was limited to less than 500 m (n = 81) (p < 0.05). Intermittent claudication had a global effect on the different parameters of the quality of life evaluated by the questionnaire including physical performance and psychological and social aspects. CONCLUSION: The Artemis questionnaire as shown its ability to describe patients with intermittent claudication. It can be used in clinical trials as a tool for measuring quality of life.

Activities of Daily Living↗
PubMed1994

Taping the patella medially: a new treatment for osteoarthritis of the knee joint?

OBJECTIVE: To test the hypothesis that medial taping of the patella reduces the symptoms of osteoarthritis of the knee when the patellofemoral joint is affected. DESIGN: Randomised, single blind, crossover trial of three different forms of taping of the knee joint. Each tape (medial, lateral, or neutral) was applied for four days, with three days of no treatment between tape positions. SUBJECTS: 14 patients with established, symptomatic osteoarthritis of the knee and both clinical and radiographic evidence of patellofemoral compartment disease. MAIN OUTCOME MEASURES: Daily visual analogue scale ratings for pain; patients' rating of change with each treatment; and tape preference. RESULTS: Medial taping of the patella was significantly better than the neutral or lateral taping for pain scores, symptom change, and patient preference. The medial tape resulted in a 25% reduction in knee pain. CONCLUSION: Patella taping is a simple, safe, cheap way of providing short term pain relief in patients with osteoarthritis of the patellofemoral joint.

Aged↗
PubMed1994

Magnetic resonance imaging of hemochromatosis arthropathy.

This study was undertaken to compare plain film radiography and magnetic resonance imaging in the assessment of hemochromatosis arthropathy of the knees of ten patients with a biopsy-proven diagnosis. Both modalities enabled visualisation of bony degenerative changes; magnetic resonance imaging enabled additional visualization of deformity of both cartilage and menisci. Magnetic resonance imaging failed reliably to confirm the presence of intra-articular iron in the patients studied. No correlation was observed between synovial fluid magnetic resonance signal values, corresponding serum ferritin levels, or the severity of the observed degenerative changes.

Adult↗
PubMed1994

Sulphasalazine desensitisation in patients with arthritis.

Skin rash is a common side effect of sulphasalazine. Desensitisation, with a gradual introduction of the drug, may prevent rash. This study reports a 33% (3/9 patients) success rate of desensitisation in patients with arthritis. Desensitisation should only be attempted if sulphasalazine has been efficacious in treating the joint symptoms.

Adult↗
PubMed1994

The predictive role of scintigraphy in radiographic osteoarthritis of the hand.

Sixty-seven patients with symptomatic knee osteoarthritis (OA) (26 male, 42 female, mean age 62.7 years) have been followed prospectively for a mean of 67.3 months (range 60-72 months). Hand radiographs were obtained at entry and at follow-up. Scintigraphic images of the hands were obtained at entry, and the predictive value of scan abnormalities for subsequent radiographic change was examined. Forty-six of 203 scan-positive joints at entry showed radiographic change, compared with 41 of 2075 scan-negative joints (P < 0.0001). The thumb base was more often involved than other joints and scintigraphy was a better predictor of change at this site than at other joints in the hand. This study confirms the predictive value of scintigraphy in hand OA and suggests that thumb base and interphalangeal joint OA behave differently.

Female↗
PubMed1994

[Development and validation of a quality of life scale associated with health status, specific for benign hypertrophy of the prostate and including a sexuality evaluation scale].

In order to develop a quality of life scale related to the state of health, specific for benign prostatic hypertrophy, a group of French specialists constructed a self-administered questionnaire, designed to complete the usual evaluations of the efficacy and safety of new medical treatments for this disease. This questionnaire was well accepted, reliable, clinically valid and sensitive to clinical changes occurring in a given patient. It includes questions concerning sexuality. An abbreviated form of the questionnaire was then developed in order to obtain a tool suitable for use in daily practice, in combination with the International Prostate Symptom Score (IPPS).

Aged↗
PubMed1994

Computed tomography of the retroperitoneum in patients with femoral neuropathy.

The authors illustrate the value of computed tomography (CT) of the retroperitoneum in patients presenting with femoral nerve signs. They describe 28 such patients, examined at a tertiary-care hospital between June 1990 and January 1993, in whom CT of the retroperitoneum contributed significantly to the diagnosis. The patients, 19 males and 9 females, ranged in age from 11 to 81 years. CT showed disease of the psoas compartment in 17 cases; the condition was due to a malignant lesion in 9 cases and was secondary to infection in 5 and to other causes in 3. Disease of the iliacus compartment was shown in 11 cases; it was due to a malignant lesion in 6 cases and was secondary to hemorrhage in 2, to infection in 1 and to a bursa in 1. The diagnostic features of the diseases encountered are discussed, and the importance of performing CT early is stressed.

Adolescent↗
PubMed1993

Long-term quality of life in patients with benign prostatic hypertrophy: preliminary results of a cohort survey of 7,093 patients treated with an alpha-1-adrenergic blocker, alfuzosin. QOL BPH Study Group in General Practice.

In recent years, considerable attention has been paid to the patient's point of view by monitoring medical care outcomes in terms of quality of life (QOL). The objective of this study was to evaluate the QOL of a representative population of patients undergoing medical treatment for symptoms of benign prostatic hypertrophy (BPH). A French BPH-specific QOL scale was constructed by a group of experts to assure content validity. A self-administered questionnaire consisting of 20 visual analogue scales exploring the physical, mental, social and general aspects of QOL was designed and validated. A total of 7,093 patients (mean age 66.7 years) was included in an open, prospective, 1-year study. The evaluation was based on symptoms and QOL questionnaires filled in by the patient at inclusion and after 3 months of treatment with alfuzosin (7.5 mg/day). 6,780 patients (96%) completed the study: 129 (1.8%) dropped out because of intolerance; 53 were or had to be operated on, and 14 had prostate carcinoma. After 3 months, the results of the symptom questionnaire confirmed the efficacy of alfuzosin on symptoms of BPH observed in previous placebo-controlled studies. The irritative symptom score improved by 57% and the obstructive score by 40%. The physical subscore of the QOL questionnaire was most improved (+44%). The mental subscore improved by 29% and the social subscore by 32%. Principal component analysis revealed 3 main components in the QOL of the population: BPH-specific interference with activities; general QOL, and sexuality, a domain which is not usually explored in studies of BPH patients. A reduced QOL score was defined to be used in future studies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic alpha-Antagonists↗