Search PubMed⌕ Search

Biomedical subjects

L Daly

Publications and source records attributed to L Daly.

At least 91 records · Page 5Linked to original sources

Inhibitors and activators of fibrinolysis during and after childbirth in maternal and cord blood.

During normal childbirth profound changes in the fibrinolytic system take place. Tissue plasminogen activator (t-PA), the antigen and its biological activity and, the activity of plasminogen activator inhibitor (PAI): were measured in twenty-two healthy women during and shortly after spontaneous delivery (2nd stage and 3rd stage of labour, 48 and 72 hours post partum). Significant increases of plasma t-PA antigen and activity occurred during childbirth and before delivery of the placenta, while the inhibitor remained unchanged. After delivery the PA inhibitor and t-PA antigen showed a steep decline. The activity of t-PA remained largely unchanged during labour and after delivery. The comparison between the activity levels of PAI in infant cord blood and in maternal peripheral blood, taken simultaneously during the process of placental separation, showed significantly higher PAI activity in the mother. In contrast the levels of t-PA activity were found to be significantly higher in cord blood. Our results demonstrate that during the process of child-birth and separation of the placenta distinct alterations in the fibrinolytic system occur most likely due to placental effects.

Adolescent↗

Acute effects of the Chernobyl nuclear accident on Irish mortality?

This report examines the claim that Irish mortality in the second quarter (April-June) of 1986 increased due to the cloud of radioactive material released by the damaged reactor in Chernobyl. Over the period 1971-1987, based on date of registration, the death rates in the second quarter showed marked year to year variation often exceeding that expected on the basis of chance alone. In 1986 the percentage of annual deaths occurring between April and June, and the death rate itself, were both significantly higher than in most other years between 1981 and 1987. The 1986 figures were not however, significantly higher than those observed in years prior to 1981. Since the distribution of mortality by cause was not consistent with the hypothesis relating low level radiation to immediate mortality, and since causality cannot be inferred from a temporal association per se, the Chernobyl accident cannot be implicated in the excess mortality observed in the second quarter of 1986.

Accidents↗

Prevention of early recurrence of high risk malignant melanoma by coumarin. Irish Melanoma Group.

Coumarin (1,2-benzopyrone) as a daily oral dose of 50 mg was evaluated in a multicentre prospectively randomized, double-blind, placebo-controlled trial to prevent early recurrence of malignant melanoma TNM Stage IB (Breslow thickness greater than 1.70 mm) and Stage II. Intake for the trial started in 1984 and was stopped prematurely, after review, in 1987. There were two recurrences in 13 treated patients and 10 in 14 controls which was significant (P 0.01). The sites of the metastases differed in each group, being local and in bone in the treated group, and in lymph nodes, skin and lung in the control group. There were no toxic effects associated with coumarin treatment and all patients without recurrence are now receiving coumarin.

Adult↗

Analysis of the histologic variation of synovitis in rheumatoid arthritis.

One hundred forty-five synovial biopsy specimens were obtained from 30 procedures performed on the knee joints of 29 patients with rheumatoid arthritis. All patients had clinically active rheumatoid arthritis and none had received slow-acting disease-modifying drugs or intraarticular corticosteroids. Scores were assigned to each biopsy specimen for each of 6 histologic features to quantify variation within each joint. In the majority of knee joint biopsies, there was considerable clustering of scores for all histologic features. Thus, on a scale of 0-10, 82% of the scores for synoviocyte hyperplasia were within 1 point of the median score for a given joint. Similarly, between 69% and 85% of the scores for the remaining features (fibrosis, vessel proliferation, perivascular infiltrates, focal aggregates, and diffuse infiltrates of lymphocytes) were within 1 point of the median values. Multiple biopsies were obtained at arthroscopy in 8 patients. Tissue was selected from areas of apparent maximal and minimal involvement, to enhance the likelihood of regional histologic variation. Of the scores for synoviocyte hyperplasia, 91% were within 1 point of the median values for a given joint, and of the scores for the remaining 5 features, 72-94% fell within 1 point of the median values. In addition, highly significant statistical correlations of the intensity of synovial lining layer hyperplasia, vessel proliferation, mononuclear cell infiltration, fibrosis, and clinical measurements of synovitis were observed.

Arthritis, Rheumatoid↗

Secular changes in mortality among survivors of unstable angina and myocardial infarction.

Seven hundred and ninety-four males under 60 years who survived a first episode of unstable angina or myocardial infarction by 28 days were admitted to St. Vincent's Hospital between 1965 and 1981 inclusive. They were followed for at least 4 years: 1-, 2- and 4-year mortality during the follow-up period did not alter significantly during the 17 years. Significant changes did take place over time in the severity of the coronary attacks and in the risk profile of the patients. A greater number of complicated infarcts occurred in the later years and there were fewer smokers and more hypertensives. There was a significant increase over time in the number of initial cigarette smokers who stopped after the coronary attack. Changing methodology made secular changes in cholesterol levels difficult to interpret.

Adult↗

The fibrinolytic enzyme system in normal menstruation and excessive uterine bleeding and the effect of tranexamic acid.

The fibrinolytic enzyme system of menstrual and peripheral blood was studied in three groups of women: Group 1, 20 subjects (mean age 37.2 years) with normal menstrual loss; Group 2, 20 patients (mean age 39 years) with dysfunctional uterine bleeding studied before treatment, and Group 3, during treatment with a fibrinolytic inhibitor, tranexamic acid (AMCA) (1 g 8-hourly). The fibrinolytic activity (plasminogen activator and plasmin) of menstrual blood was significantly higher than that of peripheral blood in the three groups (p less than 0.001). Both plasminogen activator and plasmin were higher in the menstrual blood of patients with menorrhagia (Group 2) compared with the control subjects (Group 1) (p less than 0.001 and p less than 0.1 respectively). Treatment with AMCA significantly reduced both plasminogen activator (p less than 0.01) and plasmin (p less than 0.05) in the menstrual blood of patients with menorrhagia (Group 3). No significant differences in fibrinolytic activity were found in peripheral blood between Groups 1 and 2; however, both plasminogen activator and plasmin were significantly lower (p less than 0.01) in Group 3 than in Group 2. Plasmin activity was also significantly lower (p less than 0.05) in Group 3 compared to Group 1. These findings confirm the presence of increased fibrinolytic activity in the uterus in excessive (dysfunctional) bleeding.

Administration, Oral↗

Blood coagulation with a combination pill containing gestodene and ethinyl estradiol.

The coagulation effects of oral contraceptives are determined by the interaction of the estrogen and the progestogen components. Serial studies on the coagulation system were carried out in 120 randomly allocated healthy women to compare the effects of (1) triphasic gestodene/ethinyl estradiol and triphasic levonorgestrel/ethinyl estradiol and (2) monophasic gestodene/ethinyl estradiol and monophasic desogestrel/ethinyl estradiol. The triphasic study showed significant increases in factor VII, factor X, fibrinogen, plasminogen, and fibrinolytic activity. No significant differences were noted between levonorgestrel and gestodene except for factor VII, which was higher with gestodene. Antithrombin III and anti-Xa were unchanged, and platelet aggregation was slightly accelerated with gestodene. The monophasic study is still in progress: Significant increases of factor VII, factor X, plasminogen, and fibrinolytic activity and no changes in antithrombin III, anti-Xa, and platelet aggregation have been found with both monophasic gestodene and desogestrel. The results of the triphasic study indicate that the effect of gestodene on the blood coagulation system is similar to that of levonorgestrel and that both formulations increase fibrinolytic activity. The increased coagulation activity would appear to be counteracted by enhanced fibrinolysis, so protecting the dynamic balance between coagulation and fibrinolysis. Further data are required in the monophasic gestodene and desogestrel study before any conclusions can be drawn.

Adolescent↗

Differences in coagulation and haemostatic parameters in normal women of childbearing age from different ethnic groups and geographical locations. Task Force on Oral Contraceptives--WHO Special Programme of Research, Development and Research Training in Human Reproduction.

A comparative study of coagulation and fibrinolytic laboratory parameters was undertaken in four countries (Salvador, Brazil; Singapore; Santiago, Chile and Dublin, Ireland) among apparently healthy women of reproductive age. A continuous external quality control scheme of the laboratory measurements was employed to permit comparison among centres. Significant and consistent differences were found between the four centres. In Dublin, the prothrombin time and activated partial thromboplastin time (APTT) were accelerated, and the specific factor assays showed more activity, whereas the antiprotease levels were higher than in the other centres. In Salvador, a contrasting tendency was found with longer prothrombin times and APTT and lower Factor VII and antiprotease levels. The results from the other two centres were approximately midway between these two extremes. The study has revealed important differences in the coagulation and haemostatic tests between women from widely diverse geographical areas. It is not certain whether these are due to ethnic, nutritional or economic factors but they may be related to the apparent varying incidence of thrombosis in these ethnic groups.

Adolescent↗

Peptic ulcer in rheumatoid arthritis--intrinsic or related to drug therapy?

The reported incidence of peptic ulcer disease (PUD) in patients with rheumatoid arthritis (RA) is higher than that of the general population. Unusual susceptibility to PUD in RA, independent of therapy, has been suggested. To compare RA patients with others who had similar drug exposure but no known predisposition to PUD, 120 patients hospitalized for treatment of severe arthritis (65 with RA, 55 with osteoarthritis) were assessed by questionnaire for PUD history, drug history and other relevant variables. The relationship of PUD to sex distribution, smoking, alcohol consumption and anti-inflammatory therapy followed expected patterns. We found high but similar PUD rates in RA and osteoarthritis (OA) patients (RA 15%, OA 18%). This suggests that a common factor (probably drugs) is responsible. We feel that the documented high incidence of PUD in RA is most probably related to drug therapy. Available methods cannot determine if PUD ever occurs as a primary manifestation of RA.

Aged↗

Diet and 20-year mortality from coronary heart disease. The Ireland-Boston Diet-Heart Study.

In a prospective epidemiologic study of 1001 middle-aged men, we examined the relation between dietary information collected approximately 20 years ago and subsequent mortality from coronary heart disease. The men were initially enrolled in three cohorts: one of men born and living in Ireland, another of those born in Ireland who had emigrated to Boston, and the third of those born in the Boston area of Irish immigrants. There were no differences in mortality from coronary heart disease among the three cohorts. In within-population analyses, those who died of coronary heart disease had higher Keys (P = 0.06) and modified Hegsted (P = 0.02) dietary scores than did those who did not (a high score indicates a high intake of saturated fatty acids and cholesterol and a relatively low intake of polyunsaturated fatty acids). These associations were significant (P = 0.03 for the Keys and P = 0.04 for the modified Hegsted scores) after adjustment for other risk factors for coronary heart disease. Fiber intake (P = 0.04) and a vegetable-foods score, which rose with increased intake of fiber, vegetable protein, and starch (P = 0.02), were lower among those who died from coronary heart disease, though not significantly so after adjustment for other risk factors. A higher Keys score carried an increased risk of coronary heart disease (relative risk, 1.60), and a higher fiber intake carried a decreased risk (relative risk, 0.57). Overall, these results tend to support the hypothesis that diet is related, albeit weakly, to the development of coronary heart disease.

Adult↗