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Biomedical subjects

J McCall

Publications and source records attributed to J McCall.

47 records · Page 3Linked to original sources
PubMedDate not supplied

On the nature of the genes influencing the prevalence of Graves' disease.

Burnet's theory that Graves' and other autoimmune diseases are caused by forbidden clones of immunocytes, reactive against host antigens and emerging in post-natal life due to somatic events (somatic mutations of V genes and inter-clonal deletions), remains the most comprehensive and likely concept of the pathogenesis. The MHC antigens, B8 and D/DR3, have a predisposing influence of X 2.5 and X 3.7 respectively, whilst male sex has a protective influence, divided by 6. Family studies testing for associated inheritance of Graves' disease and immunoglobulin allotypes (Gm and Km), by observation of the segregation of known heterozygous allotypes and also by Penrose's sibling pair method, have failed to show involvement of immunoglobulin genes. The H gene theory, prompted by studies on the inheritance of autoimmune diseases in the New Zealand mice, postulates that germline genes influencing the prevalence of Graves' and other autoimmune diseases code for major and minor histocompatibility or other alloantigens. By deleting complementary clones, alloantigens alter the immune response repertoire of each individual and this could alter the chance of emergence of a forbidden clone by the somatic mutations and the inter-clonal deletions envisaged by Burnet and Jerne. The H gene theory is superior to the linkage disequilibrium theory in that it accounts for all the known genetic features of Graves' disease, including the female sex preponderance, which is ascribed to the effect of clonal deletions imposed by the H-Y antigen.

Animals↗
PubMedDate not supplied

Pediatric patients experiencing postoperative nausea and vomiting after burn reconstruction surgery: an analysis.

Nausea and vomiting after a surgical procedure has a significant impact on a patient's hospital course. A perceived increased incidence of postoperative nausea and vomiting (PONV) in pediatric patients undergoing reconstructive scalp surgery had been clinically observed. A chart review to determine if a relationship existed between the surgical procedure and the incidence of PONV was conducted by selecting patients who were 5 to 12 years old and whose surgery fell between April 1995 and August 1995. Thirty-eight patients were evaluated for 46 procedures; 8 patients were evaluated for both insertion and removal of scalp expanders. No differences were identified between groups for previous history of PONV, length of anesthesia, or position during surgery. Data from the retrospective review suggested that pediatric patients with reconstructive surgeries of the scalp experienced PONV at 100% (24 procedures), whereas only 45% (10 procedures) of patients whose surgeries did not involve the scalp experienced PONV. In addition, despite significant earlier return of bowel sounds, episodes of PONV and time to oral intake were also increased in the group of patients whose operations involved the scalp. On the basis of these findings, a prospective study has been initiated to determine if changes in the perioperative protocol will improve patient outcomes and reduce the incidence of PONV.

Burns↗
PubMedDate not supplied

A prospective, randomized comparison of the Volume Diffusive Respirator vs conventional ventilation for ventilation of burned children. 2001 ABA paper.

UNLABELLED: The Volume Diffusive Respirator (VDR) is a high-frequency time cycled pressure ventilator that can ventilate, oxygenate, and promote secretion removal. The VDR provides ventilation at lower airway pressures than those required for conventional ventilation in the pressure control mode (PCV). A prospective, randomized, institutional review board-approved study was conducted comparing the VDR to PCV in burned children with respiratory failure from all causes. METHODS: Pediatric burn patients requiring ventilation were stratified by presence of inhalation injury and ventilated by VDR or PCV to achieve predefined arterial blood gases. RESULTS: Sixty-four patients were prospectively assigned ventilator type; 32 to VDR, 32 to PCV. Data are reported as mean + SEM. Patient age was 7.4 + 0.7 years, TBSA was 56 + 3%, and number of patients with inhalation injuries was 55 (86%). Maximum peak inspiratory pressure with the VDR was significantly less than with PCV (30.9 + 0.8 cm H2O vs 39.5 + 1.8 cm H2O,P < 0.05) and the best PaO2 /FIO2 ratio was significantly higher with the VDR compared with PCV (563 + 15 vs 507 + 13, P < 0.05). No patient in the VDR group had evidence of barotrauma compared with two in the PCV group. Five patients in the PCV group died compared with two in the VDR group. CONCLUSION: Patients ventilated with the VDR required significantly lower peak inspiratory pressure and achieved a significantly higher PaO2 /FIO2 ratio compared with PCV. This demonstrates the VDR is a safe and effective method of ventilation for pediatric burn patients and it offers advantages when compared with conventional ventilation.

Adolescent↗
PubMedDate not supplied

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Attitude of Health Personnel↗