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Biomedical subjects

G M McCarthy

Publications and source records attributed to G M McCarthy.

67 records · Page 4Linked to original sources
PubMed1991

The mitogenic response to stimulation with basic calcium phosphate crystals is accompanied by induction and secretion of collagenase in human fibroblasts.

Synovial fluid basic calcium phosphate (BCP) crystals are associated with severe destructive arthropathies that are characterized by synovial proliferation and digestion of articular collagenous structures. BCP crystals are potent mitogens, which may account for this proliferation. The role of collagenase in articular degradation is controversial because, despite the massive loss of collagen, no studies have confirmed collagenolytic activity in synovial fluid, as originally reported. We investigated collagenase messenger RNA induction and enzyme activity in human foreskin fibroblasts proliferating in response to stimulation with BCP crystals, and analyzed the associated secreted proteins. Northern blots revealed a dose-dependent accumulation of collagenase message, evident by 4 hours and continuing to at least 36 hours, in BCP-stimulated cultures. One- and 2-dimensional polyacrylamide gel electrophoresis of conditioned media from BCP crystal-stimulated cultures revealed the selective induction of 2 proteins with molecular weight and pI values consistent with those of collagenase. Increased enzyme activity was also found. Thus, the mitogenic response of fibroblasts to BCP crystals is accompanied by collagenase induction and secretion, supporting the hypothesis that they act as a mediator of joint destruction in BCP crystal-associated arthropathies.

Calcium Phosphates↗
PubMed1991

Influence of antihyperuricemic therapy on the clinical and radiographic progression of gout.

Ten years ago, we studied the clinical and radiographic manifestations of gout in 60 patients and described 3 patterns of disease. To determine the consequences of management over a 10-year period, we recently reassessed the 39 available patients of this population. We found that although reduced tophaceous deposition on physical examination correlated with normalization of the serum urate concentration, no correlation existed between radiographic changes and mean serum urate concentrations. Progression of gouty changes on radiography reflected progressive deformity on physical examination. We have described the radiographic changes that occurred in a well-characterized population of subjects with gout over 10 years and determined that serum urate concentrations alone may not provide an effective means of monitoring the progression of tophaceous disease in bone.

Aged↗
PubMed1991

Factors associated with increased frequency of HIV-related oral candidiasis.

HIV-related oral candidiasis was investigated in 71 HIV-seropositive patients who received interviews, oral examinations and hematologic investigation. Diagnosis of candidiasis was based on clinical signs and examination of PAS-stained smears. The frequency of candidiasis was 24/71 (34%). The clinical presentations were pseudomembranous 8 (11%), erythematous 14 (20%), angular cheilitis 3 (4%). Twenty-six patients (37%) had candidiasis or were receiving antifungal treatment for recurrent pseudomembranous type. Twelve of 13 (92%) patients with AIDS and 14/58 (24%) without AIDS were affected. Bivariate analyses showed significant associations with AIDS, the use of zidovudine, low T4-count, xerostomia; marital status (sometime married), restricted performance status and age of greater than 35 yr. Multivariate logistic regression analysis showed that the presence of xerostomia was an independent and statistically significant predictor of HIV-related oral candidiasis. T4-count and restricted performance status were the second and third most important predictors.

Acquired Immunodeficiency Syndrome↗
PubMed1991

A prospective cohort study of the orofacial effects of vincristine neurotoxicity.

Neurotoxicity is the dose-limiting side effect of vincristine sulfate. This study was designed to investigate neurotoxicity affecting the head and neck in a population of cancer patients receiving vincristine. Forty patients were given baseline interviews and oral examinations, and these were repeated weekly for the first 7 wk of treatment. Twenty-six patients (65%) developed symptoms of neurotoxicity: orofacial pain, 22/40 (55%); numbness 1/40 (2.5%); paresthesia 4/40 (10%); difficulty with mastication 1/40 (2.5%); involuntary movements 3/40 (7.5%); and voice changes, 4/40 (10%). Most symptoms occurred in the first week except voice changes (hoarseness and weakness) which did not occur until the third week of treatment. Using Fisher's exact test, neurotoxicity affecting the orofacial area was found to be significantly associated with younger age and single marital status indicating that psychosocial factors may affect susceptibility to the neurotoxic effects of vincristine. This prospective cohort study confirms previous anecdotal reports of vincristine neurotoxicity affecting the head and neck.

Adult↗
PubMed1991

Age-related changes in protein concentrations in serum and respiratory tract lavage fluid obtained from cats.

Total protein concentrations was determined in serum, bronchoalveolar lavage (BAL) fluid, and nasal flush fluid obtained from specific-pathogen-free cats from birth to maturity and from adult conventionally raised cats. Protein components were analyzed by immunoelectrophoresis and isoelectric focusing. Albumin, and alpha-, beta-, and gamma-globulins were among the proteins identified in BAL fluid, and their isoelectric point ranged from 3.1 to 5.1. gamma-Globulin was not detected in serum or BAL fluid of newborn kittens before they had ingested colostrum. By day 3 after ingestion of colostrum, IgG was detected in high concentration in serum and was the predominant immunoglobulin in serum and BAL fluid of older cats. Nasal flush fluid from cats greater than 6 months old contained albumin, and alpha-, beta-, and gamma-globulins, with IgA being the predominant immunoglobulin. Total protein concentration in nasal flush fluid increased progressively with increasing age, and albumin was the predominant protein. Protein concentration was significantly (P less than 0.01) higher in BAL fluid from conventionally raised adult cats than in that from specific-pathogen-free cats.

Age Factors↗
PubMed1989

Immune complex disease and gynecomastia.

A man with arthritis, gynecomastia and a rash histologically showing leukocytoclastic vasculitis, dermatitis herpetiformis and immunoglobulin G deposits at the dermoepidermal junction is reported. In contrast to cases of systemic lupus erythematosus (SLE) associated with vesiculobullous eruptions and similar histological features, our patient had neither bullae nor serological evidence of SLE. Conversely, no men already reported had evidence of feminization. Thus, our case appears to be unique.

Adult↗
PubMed1989

Bronchoalveolar lavage in the cat: cytological findings.

Cells recovered by bronchoalveolar lavage from the lungs of specific pathogen-free (SPF) cats from birth to maturity and from adult conventional cats were enumerated and identified. The predominant cell type recovered was the pulmonary alveolar macrophage from all ages of both SPF and conventional cats. Other cell types included eosinophils, neutrophils and lymphocytes. Lavage of conventional cats yielded significantly more eosinophils and neutrophils than were recovered from SPF cats.

Aging↗
PubMedDate not supplied

Primary care-based dermatology practice: internists need more training.

OBJECTIVE: To evaluate the ability of teachers in an internal medicine clinic to appropriately diagnose, treat, and refer for specific dermatologic disorders. DESIGN: Prospective study. SETTING: Medical school-affiliated primary care clinic. PATIENTS/PARTICIPANTS: Case presentations of 20 patients who had dermatologic problems were prepared in the form of photographs with accompanying histories. All cases were presented to 17 of 21 available faculty internists who answered questions concerning diagnosis and management of the cases on a questionnaire. The responses of three board-certified faculty dermatologists were used as a reference standard. MEASUREMENTS AND MAIN RESULTS: The internists had had an average of three weeks' total formal dermatology training. Overall, 60% of cases were correctly diagnosed by the internists and 89% of these were either treated appropriately or referred to dermatologists. In 40% of incorrectly diagnosed cases, internists failed to refer and the majority of these were treated inappropriately. Of referrals deemed appropriate by dermatologists, only 62% were made. Conversely, 33% of referrals were deemed unnecessary. CONCLUSIONS: Faculty internists were able to diagnose many common skin diseases despite having received little dermatology training. However, errors in diagnosis occurred frequently and when diagnoses were incorrect there was a tendency to mismanage. These data suggest that the current amount of dermatology training is inadequate to prepare future primary care physicians for their increased role in the management of skin disorders.

Adult↗
PubMedDate not supplied

An unusual case of Behçet's syndrome: triggered by typhoid vaccination?

A case of Behçet's syndrome in a 32-year-old woman occurring shortly after her third vaccination against typhoid fever is described. Scleritis and pyoderma gangrenosum were unusual manifestations of BS that occurred in this case. Treatment benefit was provided by mycophenolate mofetil and etanercept. As bacterial antigens have been proposed as potential triggers for the onset of BS, it is possible that the syndrome was precipitated by typhoid vaccination in this patient.

Adult↗
PubMedDate not supplied

Geographic differences in the attitudes, knowledge and infection control practices of Ontario dentists.

Geographic differences in the HIV related attitudes, knowledge and behaviours of 5,997 dentists in Ontario were investigated using mailed questionnaires (response rate 70%). Proportionately more respondents from larger population centres reported that they knowingly treated HIV-infected patients (p < 0.00001), they were unwilling to treat HIV-infected patients (p < 0.05), they had an exaggerated perception of the risk of HIV infection after a needlestick injury (p < 0.01), they were concerned about personal risk (p < 0.01) and staff fears (p < 0.05) related to HIV/AIDS, and that patients with HIV or AIDS should be treated in hospitals/specialized practices (p < 0.001). Multiple logistic regression analysis controlling for age, sex, and specialty, showed that respondents who practised in smaller population centres were significantly more willing to treat HIV-infected patients ( < 10,000, odds ratio = 1.6; 10,000-49,999, odds ratio = 1.3). Significantly fewer respondents in the Central West, and Central East Health Planning Region, where AIDS is most prevalent, reported that they were willing to treat HIV patients.

Adult↗