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Biomedical subjects

E McNally

Publications and source records attributed to E McNally.

29 records · Page 2Linked to original sources
PubMed1990

Treatment of osteoporosis with human parathyroid peptide and observations on effect of sodium fluoride.

OBJECTIVE: To evaluate the need for a randomised study of treatment of spinal osteoporosis with human parathyroid peptide in the secondary prevention of crush fractures; to study the effect of human parathyroid hormone peptide 1-34 plus sex hormones on vertebral body cancellous bone; and, separately, to determine the effect of relatively low doses of sodium fluoride plus calcium on spinal bone mineral density. DESIGN: Open study of patients with primary or postmenopausal osteoporosis. All patients had serial bone densitometry of the spine by quantitative computed tomography and dual photon absorptiometry as well as serial densitometry of the radial midshaft (cortical) and radial distal (trabecular) bone by quantitative computed tomography. Changes in the spinal bone not forming the spongiosa of the vertebral bodies ("cortical" bone) were determined from the difference between the two axial measurements, after correction to the same units of measurement. SETTING: Northwick Park Hospital and Medical Research Council Clinical Research Centre. PATIENTS: 24 Patients who fulfilled the conventional criteria for type 1 (vertebral) osteoporosis not secondary to recognised causes other than sex hormone deficiency and with at least one crush or wedge vertebral fracture and a spinal bone density (quantitative computed tomography) less than 80 mg/cm3 or two or more fractures. Twelve patients received human parathyroid peptide and 12 sodium fluoride; they were not randomised. MAIN OUTCOME MEASURES: Trends in axial and peripheral bone mass values determined by linear, time dependent regression analyses. RESULTS: The patients receiving the peptide showed a substantial increase in vertebral spongiosa (mean 25.6 mg/cm2 two years after the start of treatment). No significant changes were seen in spinal cortical or radial bone density. The patients receiving sodium fluoride showed roughly equal increases in cancellous and cortical bone over the same period (mean increase in vertebral spongiosa 16.1 mg/cm3). No significant changes were seen in radial bone. CONCLUSIONS: Treatment of postmenopausal women with human parathyroid peptide selectively increases spinal cancellous bone density by amounts that may prove useful in secondary prevention. Peptide treatment should now be tested in a randomised study in which the important end point is prevention of fractures as the usefulness of sodium fluoride in this context is doubtful.

Bone Density↗
PubMed1990

Testing a policy for skull radiography (and admission) following mild head injury.

There has been, and continues to be, conflicting advice regarding skull radiography following an apparently uncomplicated head injury. Policies on admission are often ill defined. In 1983, representatives of the Royal College of Radiologists met neurosurgeons at a seminar in Harrogate organized by the DHSS and laid down clear, but little publicized, joint recommendations: "The Harrogate Criteria". The survey described here evaluated an existing liberal policy for skull radiography (and a loose policy for admissions) against these recommendations, and it was concluded that the number of patients having skull radiography (74% of head injury attenders) was excessive. Measured against the "Harrogate Criteria", requests for 36% of the adult and 47% of children's skull radiographs did not fulfil these criteria. As a corollary, it was also concluded that loose admissions policies could usefully be altered to comply more closely with the Harrogate recommendations. This would not necessarily reduce the numbers admitted, but would provide casualty officers with a framework on which to base this crucial aspect of clinical decision making, where presently there is often very little structure at all. The authors suggest that all the options have not been fully explored, and that a simple but important alteration to the Harrogate guidelines would provide an even closer link between policy on skull radiography and patient admission. Specifically, most patients who are to be admitted do not need skull radiographs.

Adult↗
PubMed1990

The ossification of the costal element of the seventh cervical vertebra with particular reference to cervical ribs.

During 16 years of study at Northwick Park Hospital 715 fetuses were radiographed to determine the incidence of skeletal malformations. A technique using low kV and industrial film provided higher resolution radiographs than would have been possible in live births because of dose considerations. Gestational age calculated from LMP and ultrasound findings ranged from less than 18 weeks to 42 weeks. A separate costal element of C7, the possible precursor of a cervical rib, could be identified in 63% of fetuses. Males outnumbered females 403:311 but there was no intersex difference in the presence of such rudimentary cervical ribs with 63 and 64% respectively in each group. Of the 452 cases with separate costal elements, 73% were bilateral. Of the unilateral group 60% occurred on the right and 40% on the left. There was no significant difference in the incidence between the gestational age groups from 20 weeks onwards, confirming that the disappearance of the separate element occurs predominantly after birth, 394 cases (87%) of fetuses had an otherwise normal skeleton.

Cervical Rib Syndrome↗
PubMed1983

Isolation and characterization of human myosin heavy chain genes.

We have isolated four unique human sarcomeric myosin heavy chain (MHC) genomic clones using rat MHC cDNA clones as probes. Three of these clones contain adult skeletal muscle-specific DNA sequences, whereas one clone contains embryonic skeletal muscle-specific sequences. This developmental and tissue specificity was determined by hybridization of each of the human clones to MHC mRNA from different muscle tissues. Cross-hybridization studies indicate that certain sequences of the human MHC genes have been conserved through evolution while other portions have diverged considerably. Preliminary evidence demonstrates that the MHC gene family is polymorphic in human populations. Each of the human MHC genes was shown to have repetitive sequences in multiple positions, both within the gene and in adjacent flanking DNA sequences. We have shown that, in contrast, four rat MHC genes have far fewer repetitive sequences even though two of the four genes contain the same muscle specificity as the human genes. Therefore, these genes may be useful to study gene evolution and repetitive sequence transposition.

Animals↗
PubMed1983

Therapeutic recreation for long-term care patients.

The present study evaluates the impact of a therapeutic recreation program on the life satisfaction and activity level of hospitalized geropsychiatric patients. Sixty-one inpatients from a VA Medical Center were randomly assigned to participate either in a community recreation program for ten consecutive Saturdays or to engage in the regularly scheduled hospital program. Data from four observational instruments established a baseline of activities and confirmed that the study group's life satisfaction appears quite comparable to previously published reports. While the results showed no significant differences among pre-post measures, the clinical staff who accompanied the recreation group reported many unsolicited patient responses indicating consistently high and uniform expressions of satisfaction throughout the trial period. A discussion clarifies how therapeutic evaluation procedures could be made more appropriate for a geropsychiatric population.

Activities of Daily Living↗