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Biomedical subjects

L Daly

Publications and source records attributed to L Daly.

At least 109 records · Page 6Linked to original sources
PubMed1985

Is a family history of coronary heart disease an independent coronary risk factor?

The importance of a positive family history as a primary risk factor for coronary heart disease was examined in a case history study. Of 792 consecutive male patients aged under 60 years who survived a first episode of unstable angina or myocardial infarction, 326 had a negative family history, 298 had a positive history, and in 168 a family history could not be established with certainty. There was no significant difference in the distribution of the three primary coronary risk factors--cigarette smoking, hypertension, and hypercholesterolaemia--between those with and those without a positive family history. The 133 subjects with a positive family history of premature coronary heart disease (occurrence in near relatives under 60 years) were significantly younger than those with a negative family history. It is concluded that there is little evidence to confirm a positive family history as an important independent risk factor for coronary heart disease, although there may be familial aggregation of subjects with a high susceptibility to the effects of the three primary risk factors, cigarette smoking, hypertension, and hyperlipidaemia.

Cholesterol↗
PubMed1984

Variable clinical and hormonal manifestations of hyperandrogenemia.

This study was undertaken to contrast the hormonal profiles in patients with various hyperandrogenemic states in an attempt to correlate clinical manifestations with specific hormonal abnormalities. Patients with idiopathic hirsutism, polycystic ovaries, and a syndrome recently described by us, amenorrhea with cryptic hyperandrogenemia, ie, without hirsutism, participated. Total testosterone, the testosterone: sex-hormone-binding globulin (SHBG) ratio, and androstenedione levels were elevated in each group of patients. SHBG levels were suppressed in patients with idiopathic hirsutism and in patients with polycystic ovaries. In patients with polycystic ovaries or cryptic hyperandrogenemia, plasma estrone levels were elevated and the luteinizing hormone (LH) responses to luteinizing-hormone-releasing hormone (LH-RH) were exaggerated. Estrone is derived from androstenedione under the influence of the enzyme, aromatase. While elevated androstenedione occurred in both patients with polycystic ovaries or idiopathic hirsutism, estrone levels were only elevated in patients with polycystic ovaries. Reduced aromatase activity may have protected patients with idiopathic hirsutism from elevated estrone values and, thereby, from menstrual disturbances. The hormonal profiles in polycystic ovary syndrome and in patients with amenorrhea with cryptic hyperandrogenemia were very similar, with the exception that SHBG levels were high normal in three of five patients with cryptic hyperandrogenemia while estrone values were markedly elevated in these patients. Elevated estrone levels may explain the normal SHBG values, which are usually suppressed in hyperandrogenemic states. While each of the hyperandrogenemic disorders studied has a characteristic hormonal profile, the various clinical manifestations cannot be accounted for solely by abnormalities in circulating hormonal levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Mortality from coronary heart disease-trends for the Republic of Ireland.

A study of certified mortality between 1968 and 1981 indicates that mortality from all causes commenced to decline from the mid 1970s in the Republic of Ireland. This trend was apparent for both sexes and for all ages except for men aged 55-64 years. A similar trend of lesser magnitude is suggested for coronary heart disease mortality in males, but not in females. The decrease in the percentage of male cigarette smokers in the population which is also reflected in a marked decline of smoking among male coronary patients, may be related to the trends in mortality.

Adult↗
PubMed1984

Prolactin in hirsute women: possible roles for androgens in suppressing basal levels, and for oestrogens in enhancing TRH-induced responses.

Hyperprolactinaemic patients occasionally demonstrate hirsutism and elevated levels of DHA-S, a weak androgen of adrenal origin. Abnormal adrenal function is frequently observed in hirsute patients. These observations prompted speculation that prolactin may modulate normal adrenal secretion and that derangements of adrenal androgen secretion may be due to abnormalities in prolactin. In this study we examined the possibility that elevated prolactin levels may be involved in the pathogenesis of hyperandrogenaemia in hirsute patients. However, basal prolactin levels in hirsute women, with or without menstrual disturbances, 201 +/- 24.3 mU/l (mean +/- SE) and 192 +/- 24.3 mU/l respectively, were significantly suppressed below levels in normal women, 289 +/- 12.2 mU/l. The prolactin responses to stimulation with TRH and to suppression with L-dopa were also studied in hirsute patients. The prolactin response to TRH (maximum increment or integrated response) was exaggerated significantly in hirsute women with menstrual disturbances when compared to normal women, to hirsute women with normal menses or to normal men. This abnormal response may have been due to elevated oestrone levels present in patients with oligomenorrhoea (318 +/- 49.5 pmol/l compared to 191 +/- 12.1 pmol/l in normal women and 161 +/- 15.5 pmol/l in hirsute women with normal menses, P less than 0.05). There were no abnormalities detected in the suppression of prolactin in response to L-dopa in any of these groups. These findings do not support a role for prolactin in the pathogenesis of hyperandrogenaemia in hirsute patients. However, elevated androgen levels in women may bring about suppression of basal prolactin levels to values seen in normal men. (ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Glands↗
PubMed1983

Natural history of coronary heart disease: a study of 586 men surviving an initial acute attack.

A total of 586 men who survived an initial attack of unstable angina or myocardial infarction have been followed for up to 15 years. A policy of early mobilization and sustained risk factor advice was employed. A conservative approach to treatment was adopted during the acute and follow-up stages. Drugs were employed only for symptomatic reasons, and only two patients proceeded to coronary artery bypass surgery. Survival at 5, 10, and 15 years was 80%, 61%, and 43%. Older patients and those with more severe initial attacks had a higher mortality, but these factors did not relate to combined fatal and nonfatal recurrence of myocardial infarction. Of 22 studies reviewed, 18 report a higher mortality than does our study. Four studies, none strictly comparable, report a similar 5-year mortality. A conservative approach to management does not appear to be harmful and may be beneficial.

Age Factors↗
PubMed1983

Cigar and pipe smoking related to four year survival of coronary patients.

Six hundred and thirty-four male patients under 60 years who survived a first attack of unstable angina or myocardial infarction were followed for a period of four years. Details of initial and follow-up smoking habits were examined. Patients who continued to smoke cigarettes or cigars had an excess mortality compared with non-smokers, with those who stopped smoking, and with cigarette smokers who changed to pipe smoking. Pipe smokers who continued smoking the pipe had an observed mortality which was greater than that of the non-smokers, but the numbers were small and the results were not statistically significant. The effect of smoking habit on mortality was not influenced by two other determinants of prognosis: age and severity of initial attack. These results confirm that the long-term prognosis of patients after unstable angina or myocardial infarction may be significantly influenced by smoking habits. They are consistent with the hypothesis that cigar and pipe smoking may have an adverse effect after myocardial infarction but further studies are needed to corroborate the association between cigar and pipe smoking and prognosis of coronary heart disease.

Adult↗
PubMed1983

Controlled studies of nutritional intake in patients with malignant disease undergoing treatment.

Ninety-seven patients with cancer, undergoing radiation treatment, were studied. Forty-two were given special dietary counseling and supplements of Sustagen or Isocal; 42 controls received no special advice or supplements. Thirteen patients were excluded because of poor prognoses and the ethical need for food supplements. Nutrient intake of all groups was assessed by 3-d diet records in household measures in the first and the last week of treatment. Intake was significantly higher in the adjunctive than the control group. The excluded group, despite supplementation, had intakes similar to the control group. No difference was observed between the control and adjunctive groups in clinical status at the end of treatment or in long-term outcome.

Abdominal Neoplasms↗
PubMed1982

Association of cold weather with testicular torsion.

A retrospective study of 46 patients who presented with proved testicular torsion over five years at two Dublin hospitals showed that in 40 cases torsion had occurred when the temperature was under 2 degrees C; the incidence of torsion was higher during the cold months of the year. Both of these findings were statistically significant. These and other results suggest that the ambient temperature may have some role in the incidence and aetiology of testicular torsion.

Adolescent↗