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Biomedical subjects

C McCullough

Publications and source records attributed to C McCullough.

35 records · Page 2Linked to original sources
PubMed1994

The functional and psychological outcomes of juvenile chronic arthritis in young adulthood.

The functional and psychological outcome of 43 patients with polyarticular juvenile arthritis was assessed in order to evaluate the impact of disease on their quality of life. Mean disease duration was 19.7 yr (range 10-39 yr), mean age 26.7 yr (range 18-54 yr) with sex ratio 1:3 (male:female). Severe disability was present in 8% of systemic onset, 34% of RF negative (Rh-P), 38% of RF positive (Rh+P) and 86% of extended pauci-articular (ExP) juvenile arthritics-this last high percentage was due to ocular impairment. The Rh+P had more hip (100% of the group) and knee prostheses (31%) compared with Rh-P (77 and 11% respectively). The Rh+P and ExP groups were the most disabled with the highest proportions of patients with currently active disease (85 and 71% respectively). Psychological testing showed that 21% of the patients were clinically depressed and the rate increased (P = 0.06) with the degree of disability. The proportion of patients demonstrating an anxious preoccupation with their disease increased (P = 0.002) with the degree of disability. Despite this, 66% of patients were employed and 38% felt that their arthritis had no effect on their ability to form relationships.

Adult↗
PubMed1994

Active-phase labor arrest: a randomized trial of chorioamnion management.

OBJECTIVE: To determine whether leaving the membranes intact in active-phase arrest would affect the cesarean delivery rate or the incidence of maternal morbidity secondary to infection. METHODS: We conducted a randomized trial of healthy, spontaneously laboring women at term with an intact chorioamnion and active-phase arrest (defined as 1 cm or less of cervical change over 2 hours in the active phase of labor). Patients were assigned to either oxytocin augmentation with intact chorioamnion or oxytocin augmentation with amniotomy and internal monitoring of the fetal heart rate and uterine contractions. RESULTS: The intact group (n = 58) and the amniotomy group (n = 60) were similar with respect to maternal age, race, parity, labor epidural usage, gestational age, cervical dilatation at randomization, number of vaginal examinations, and infant birth weight. Four patients in the intact group and five in the amniotomy group underwent cesarean delivery (P = 1.0). No patient in the intact group and three in the amniotomy group were diagnosed with chorioamnionitis (P = .24). Endometritis did not occur in the intact group, whereas four cases occurred in the amniotomy group (P = .12). There were no cases of maternal infection in the intact group, versus seven in the amniotomy group (P = .01). The interval between randomization and vaginal delivery was 44 minutes longer in the intact group than in the amniotomy group (P = .11). CONCLUSION: In women with active-phase arrest of labor and intact membranes, oxytocin augmentation with elective amniotomy and internal monitoring increases maternal infectious morbidity.

Adult↗
PubMed1989

Cellular fatty acid composition of Campylobacter pylori from primates and ferrets compared with those of other campylobacters.

The cellular fatty acid profiles of newly described campylobacters were determined on a polar, capillary column. Six isolates of the gastric spiral organism, Campylobacter pylori subsp. mustelae, from ferrets from Australia, England, and the United States were all found to have a similar fatty acid profile which was different from that of C. pylori from humans; C. pylori subsp. mustelae did not have 3-hydroxyoctadecanoic acid (3-OH C18:0) and had much less tetradecanoic acid (C14:0) and much more hexadecanoic acid (C16:0). Inasmuch as Lambert et al. (M.A. Lambert, C.M. Patton, T.J. Barrett, and C.W. Moss, J. Clin. Microbiol. 25:706-713, 1987) have proposed that campylobacters can be grouped by cellular fatty acid composition, we propose this organism should be in a new gas-liquid chromatography (GLC) group, group J. Seven isolates of gastric spiral organisms from macaque monkeys and baboons, including three from Macaca nemestrina, and one isolate from a pig were found to have fatty acid profiles very similar to that of C. pylori; but a second type of organism (type B) from M. nemestrina had a unique profile without 19-carbon cyclopropane fatty acid (C19:0 cyc) but with 3-hydroxy tetradecanoic acid (OH C14:0), which is not present in other gastric spiral bacteria. We propose that this organism (nemestrina type B) should be in a new GLC group, group K. The cellular fatty acid profile of seven isolates of C. jejuni subsp. doylei was found to be similar to that for C. jejuni, but with possibly significant differences in that the former did not have 3-OH C14:0 but did have 3-hydroxyhexadecanoic acid (3-OH C16:0) and had more C14:0 than did C. jejuni. Two strains of urease-positive thermophilic campylobacters were found to have a profile similar to that of "C. cinaedi" and thus should be included with them in GLC group D. We confirm that C. sputorum has a unique cellular fatty acid composition and suggest that it should be in a new group, group H.

Animals↗
PubMed1989

Approaches to rehabilitation of patients with ventilatory insufficiency.

Multi-disciplinary rehabilitation programmes are popular in Europe and North America in the management of patients with chronic respiratory disease. Patients experience an increase in exercise tolerance, a decrease in dyspnoea and spend fewer days in hospital after completing the programme. Criteria for admission often include a well motivated nonsmoking patient with severe but stable disease of the ventilatory system. Although most patients have chronic airflow limitation, we have received a number of referrals concerning patients with non-obstructive ventilatory insufficiency, particularly thoracic restrictive disease and neuromuscular disease. Such patients frequently have hypercapnic respiratory failure, easily aggravated by increased activity or respiratory tract infection. Therefore, they cannot engage in a supervised exercise training programme unless we can stabilize their clinical state. We consider elective mechanical ventilatory support a valuable tool in their rehabilitation. Such support is often required only at night. By preventing the sleep-related alterations in arterial blood gases the clinical course of the disease is stabilized, functional level is increased and patients are then protected from episodes of acute respiratory failure which may be life-threatening.

Aged↗
PubMed1988

A comparison of teicoplanin and cefuroxime as prophylaxis for orthopaedic implant surgery: a preliminary report.

The relative merits of different antibiotic regimens for prophylaxis in orthopaedic implant surgery are difficult to evaluate because of the low frequency of infection. Factors other than infection prevention may influence choice. We have compared 400 mg teicoplanin given intravenously on induction of anaesthesia with three perioperative injections of cefuroxime, in 146 patients undergoing total hip or total knee replacement. These interim results suggest that cefuroxime selects for increased extraintestinal carriage of faecal streptococci and teicoplanin for Proteus species. There were no significant differences between the regimen in the acquisition of coagulase-negative staphylococci or Clostridium difficile, post-operative diarrhoea, wound healing or wound infection. Both regimens were equally safe.

Adult↗
PubMedDate not supplied

Triamcinolone into the knee joint in juvenile chronic arthritis.

Sixty children aged less than 10 years with pauci-articular onset juvenile chronic arthritis and knee joint involvement received local injections with triamcinolone hexacetonide into the knee (total 83 knees). One year after injection, 77% of knees were excellent with no soft tissue swelling, no deformity and full range of movement, or good with slight swelling or deformity, but functioning well. Eleven knees which had relapsed within one year improved after a second injection and 2 after a third. Complications were limited to small areas of subcutaneous tissue atrophy in 2 patients. Intra-articular injection of long-acting steroids is a useful means of controlling disease activity in the knee joints of young children with pauci-articular juvenile chronic arthritis.

Arthritis, Juvenile↗
PubMedDate not supplied

The impact of alcohol and other drugs on the child welfare system.

The Child Welfare League of America surveyed its member agencies on the impact of alcohol and other drugs (AOD) on the delivery of child welfare services. It discovered that the impact is profound and adversely affects the system by compounding problems, such as personnel shortages and shortages in the availability of foster homes, which existed before AOD was identified as a major social problem. Research is needed that more accurately describes the number and characteristics of children and families who enter the child welfare system, that contributes to improved screening and assessment, and that explicates the systemic changes and stresses that result from the impact of alcohol and other drug abuse.

Adolescent↗