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D O'Shea

Publications and source records attributed to D O'Shea.

67 records · Page 4Linked to original sources

Absence of correlations among three putative in vivo probes of human cytochrome P4503A activity in young healthy men.

In vitro studies with human liver microsomes have shown that erythromycin N-demethylation, dapsone N-hydroxylation, and the 6 beta-hydroxylation of cortisol are all primarily mediated by P4503A4. Trait measurements to assess the in vivo level of activity of these separate oxidations have also been developed previously. This study investigated the relationships among the three phenotypic trait measurements in 30 young healthy white men. The frequency distributions of the trait values were all unimodal, with a twofold range for the erythromycin breath test and the urinary dapsone recovery ratio; the urinary 6 beta-hydroxycortisol/cortisol ratio was more variable, with a 17-fold range of values. No statistically significant correlations were observed among any of the trait measurements (dapsone recovery ratio versus erythromycin breath test: r = -0.07, p = 0.7; urinary 6 beta-hydroxycortisol/cortisol ratio versus erythromycin breath test: r = -0.12, p = 0.6; urinary 6 beta-hydroxycortisol/cortisol ratio versus dapsone recovery ratio: r = 0.13, p = 0.5. This lack of any relationship was unexpected and the reason(s) is unknown; however, it is possible that factors such as route of administration and extrahepatic metabolism in the intestinal epithelium and kidney are involved. Further studies are required to identify and validate the use of an appropriate in vivo probe of P4503A4 in humans.

Adult↗

Growth hormone therapy in Turner's syndrome.

Girls with Turner's Syndrome respond to growth hormone therapy. In combination with anabolic steroids, studies show a synergistic effect that does not cause an undue increase in bone age. As studies progress, patients are growing taller than their predicted final heights. Whether the increase in linear growth velocity will be sufficient to bring the Turner's Syndrome patient in to the normal range (greater than 150cms) and remove short stature as a necessary stigma for these unfortunate patients remains to be seen.

Body Height↗

Management of children with short stature.

325 patients referred to an endocrine clinic with short stature were reviewed, 32 (9.8%) were above the third centile for height and maintained normal growth velocities, fourteen (4.3%) have not had assessment completed. Of 279 children in whom the cause of short stature was established, 140 (50%) had constitutional short stature/delayed puberty (CSS/DP). Seventy-three (26%) had idiopathic growth hormone deficiency (GHD), complete in 23, while 66 patients (34%) had short stature due to other causes. Girls presented earlier (mean age 11.9) than boys (mean age 13.3) and GHD patients earlier than CSS/DP patients with bimodal peaks at 12 and 16 years. Male CSS/DP patients reached their mid pubertal point later than normal at 16.06 +/- 1.19 years (p less than .05) while in GHD males the mid pubertal age was 16.6 years (p less than .05). In female patients with short stature no significant pubertal delay was observed. The average growth velocity of complete GHD patients pre treatment was 3.7 cms/year. Velocity rose to 6.2 cms/year on human growth hormone (HGH) extract and rose further to 8.1 cms/year on biosynthetic HGH. In partial GHD patients the average pre-treatment velocity of 4.3 cm/year rose to an average of 6.0 cm/yr on HGH extract and maintained this velocity on biosynthetic HGH.

Adolescent↗

Into the 80s.

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Economics↗

Assessment and management of transient ischaemic attack--the role of the TIA clinic.

BACKGROUND: As the risk of early stroke following transient ischaemic attack (TIA) is increasingly recognised, the management of patients presenting with symptoms suggestive of TIA presents a clinical challenge. METHODS: Analysis of prospectively collected data on patients referred to a TIA clinic in St. Vincent's University Hospital, between January 2003 and July 2004. RESULTS: One-hundred-and-seventeen (117) patients (mean age 75.5 years) were assessed. The majority (79%) were referred from Accident and Emergency and 61% were seen within one week of referral. Seventy-two patients (62%) had a final diagnosis of cerebrovascular disease (56 TIA, 16 completed strokes), of whom five (7%) and four (5.5%) had severe (> 70%) and moderate (> 50%) symptomatic carotid artery stenosis, respectively, whilst seven patients (10%) had newly diagnosed atrial fibrillation, five of whom were anticoagulated. Non-cerebrovascular diagnoses were made in twenty-seven patients (24%). CONCLUSION: A TIA clinic, in co-ordination with Accident and Emergency Services, provides a safe and efficient alternative to hospital admission for patients with TIA symptoms and a low early stroke risk.

Aged↗