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Biomedical subjects

M McDermott

Publications and source records attributed to M McDermott.

At least 19 recordsLinked to original sources
PubMed1992

Interrelation of left ventricular ejection fraction, pulmonary congestion and outcome in acute myocardial infarction.

The interrelation of different grades of pulmonary congestion evaluated by chest roentgenogram in the coronary care unit, predischarge left ventricular (LV) ejection fraction (EF) and long-term prognosis was studied in 1,850 surviving patients of acute myocardial infarction (AMI). Pulmonary congestion was categorized as: none, mild or moderate, or severe; LVEF was classified as: greater than or equal to 40%, 25 to 39%, or less than 25%. The majority of patients (1,060; 57%) had an LVEF greater than or equal to 40% and no signs of pulmonary congestion. Severe pulmonary congestion was noted in 63 patients (3.4%), 17 with LVEF less than 25% and 16 with LVEF greater than or equal to 40%. One hundred twenty-five patients (6.8%) had an LVEF less than 25%, 49 of whom had no signs of pulmonary congestion. During a mean 2-year follow-up, cardiac mortality occurred in 212 patients (11.5%). The cardiac mortality rate was related to both predischarge LVEF impairment and severity of pulmonary congestion. Cardiac mortality hazard ratios (95% confidence intervals [CI]) for LVEF less than 25%, and 25 to 39% were 5.32 (CI 3.49, 8.13; p less than 0.0001) and 2.91 (CI 2.10, 4.02; p less than 0.0001), respectively, where a referent hazard ratio of 1 was assigned to patients with LVEF greater than or equal to 40% and to those with no pulmonary congestion. Development of pulmonary congestion during AMI significantly increased the cardiac mortality risk derived from LVEF, with a marked mortality effect in patients with severe pulmonary congestion; (hazard ratio 4.20; 95% CI 2.67, 6.62; p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

Markers of dopamine metabolism in Parkinson's disease. The Parkinson Study Group.

We used two analytic methods (a multichannel coulometric electrode array with high-performance liquid chromatography, and gas chromatography-mass spectrophotometry) to measure CSF dopamine (DA) and its metabolites in mildly affected, unmedicated subjects with Parkinson's disease (PD). The mean (+/- SD) concentration of homovanillic acid (HVA), the most abundant product of DA turnover, was 164.57 +/- 95.05 nM. As sequential aliquots of CSF were collected from the first to 23rd ml, CSF HVA concentration almost doubled. After HVA, 3-O-methyldopa (3-O-MD) was the next most abundant compound. The summed concentrations of 3-O-MD, 3,4-dihydroxyphenylacetic acid, 3-methoxytyramine, DA, DA-3-sulfate, homovanillol, and levodopa (LD) amounted to 12.6% of HVA. Concentrations of the DA metabolites did not correlate to a variety of indices of PD severity. The presence of LD and 3-O-MD may be indicators of DA synthesis and possibly could reflect compensatory processes among surviving dopaminergic neurons of the PD brain.

Aged↗
PubMed1991

Photooxidation of specific residues in alpha-crystallin polypeptides.

Singlet oxygen is a biologically important, photochemically generated species that preferentially oxidizes His, Trp, and Met residues of protein molecules. Calf alpha-crystallin was photooxidized with use of meso-tetra(p-sulfonatophenyl)porphyrin (TPPS) and uroporphyrin (UP) as singlet oxygen generators. The effects of photooxidation were monitored by analyzing the changes in alpha-crystallin peptide maps obtained by reversed-phase HPLC using a photodiode array absorbance detector. The reaction led to the loss of six specific peptides, five of which contained photooxidizable residues. Peptides containing His-97 and His-154 from the A chain and Met-68 from the B chain are preferentially photooxidized, suggesting that those residues have access to singlet oxygen. Trp residues in the N-terminal region are converted to NFK, whereas Trp-60 in the B chain is not photooxidized strongly suggesting that the former are close to the surface of alpha-crystallin while the latter Trp residue is buried. Only one peptide that is lost from the peptide maps does not contain a photooxidizable group; however, this peptide does contain an apparently undigested Lys residue. It is suggested that it forms a cross-link with a photooxidized His residue.

Amino Acid Sequence↗
PubMed1991

Effects of diltiazem on long-term outcome after acute myocardial infarction in patients with and without a history of systemic hypertension. The Multicenter Diltiazem Postinfarction Trial Research Group.

The effect of diltiazem on long-term outcome in patients with acute myocardial infarction with and without a history of systemic hypertension was investigated in 2,466 patients using the Multicenter Diltiazem Postinfarction Trial data-base. The baseline variables were comparable in the diltiazem and placebo-treated patients within the groups with and without hypertension. The initial 60-mg dose of diltiazem was associated with a significant (p less than 0.001) but modest (3%) reduction in blood pressure and heart rate in both groups with and without hypertension. Univariate and multivariate analyses revealed a meaningful overall reduction in first recurrent cardiac events (cardiac death or nonfatal reinfarction, whichever occurred first) and cardiac death in patients with hypertension treated with diltiazem compared with results in those treated with placebo. Similar effects were not observed in patients without a history of hypertension. When first recurrent cardiac events were used as the end point, the diltiazem:placebo hazard ratio (95% confidence limits) was 0.77 (0.58, 1.01) for the total hypertension group, and 0.67 (0.47, 0.96) and 1.32 (0.83, 2.10) for patients with hypertension with and without pulmonary congestion during the acute infarction, respectively. Similar results were observed using cardiac death as the end point. Beta blockers had a negligible effect on the hypertension-diltiazem relation. These findings suggest that diltiazem may exert a long-term beneficial effect in most patients with hypertension who do not have pulmonary congestion during an acute infarction, and a detrimental effect in the minority who have pulmonary congestion.

Adult↗
PubMed1991

Indirect measures of memory in a duration-judgement task are normal in amnesic patients.

Nine amnesic patients of mixed aetiology were studied in a duration-judgement task that allowed three measures of memory to be obtained. On each trial of the task, subjects attempted to read a briefly flashed word and to estimate the duration of the flash. Both word identification and duration estimation differed as a function of prior study. Words that were previously studied were identified more often and were estimated to have been flashed for a longer duration than were words not previously studied. These priming effects were found in young subjects in Experiment 1 and in amnesic patients and age-matched control subjects in Experiment 2. Priming effects were normal in the amnesic patients, whereas these patients were severely impaired at recognizing the same words. Previous results have also shown that amnesic patients can perform normally on certain memory tests, including priming of word identification. These results show that priming of duration judgements can also be included in the category of indirect measures of memory that are spared in amnesia.

Adult↗
PubMed1991

Effects of intraocular irrigants on the preserved human corneal endothelium.

Either a simple balanced salt solution (BSS) or a bicarbonate-buffered, glutathione-containing commercial irrigant (BSS Plus, Alcon Laboratories, Fort Worth, Texas, U.S.A.) may be used during the vitrectomy portion of a corneal transplant procedure. To simulate the conditions present in the anterior chamber during the first few hours after vitrectomy and grafting, we performed in vitro perfusions of stored human corneas using each irrigant and measured corneal thickness over a 3-hour period. Irrespective of the preservation medium used (McCarey Kaufman, Chondroin Sulfate or Dexsol, all from Chiron Ophthalmics, Irvine, California) or duration of storage (2 or 4 days), corneas irrigated with BSS Plus exhibited significantly (p less than .05) decreased thickness compared with their paired mates irrigated with BSS. In ultrastructural studies performed on postperfusion corneas, there was a tendency toward improved surface morphology in the in vitro BSS Plus-perfused tissue. This study shows that in vitro corneal thickness after preservation is significantly irrigant dependent, with BSS Plus providing the essential ingredients to promote the corneal endothelial pump function.

Corneal Edema↗
PubMed1991

Heart disease associated with deletion of the short arm of chromosome 18.

Deletion of the short arm of chromosome 18 provides a highly variable phenotype. Mental retardation, short stature, and abnormal facies are invariably present. About 9 percent of patients with this syndrome have cardiac pathology. An additional case with congenital heart disease has been presented along with a review of the literature concerning the association of congenital heart disease and the 18p- syndrome.

Abnormalities, Multiple↗
PubMed1990

A double-blind, placebo-controlled trial of fluoxetine plus behavior modification in the treatment of obese binge-eaters and non-binge-eaters.

To determine whether fluoxetine is effective in the long-term treatment of obesity and whether it is particularly useful in the treatment of obese binge-eaters, the authors randomly assigned 45 obese subjects (22 with binge-eating problems and 23 without binge-eating) to fluoxetine (60 mg/day) or placebo in a 52-week double-blind trial. The 21 subjects who completed the trial made 13 clinic visits and were taught basic behavior modification strategies. Patients treated with fluoxetine plus behavior modification lost significantly more weight than those treated with placebo plus behavior modification. However, the drug did not appear to have a differential benefit for binge-eaters.

Adolescent↗
PubMed1990

Variable expression of Parkinson's disease: a base-line analysis of the DATATOP cohort. The Parkinson Study Group.

The DATATOP database, which includes clinical information on 800 patients with early untreated Parkinson's disease (PD), is well suited to explore clinical heterogeneity in PD. Patients with early-onset PD (less than or equal to 40 years, N = 33) reached the same level of disability as the late-onset PD (greater than or equal to 70 years, N = 85) group at a significantly slower rate (2.9 vs. 1.7 years). Early-onset PD patients functioned cognitively better than late-onset PD patients. Bradykinesia, and postural instability and gait difficulty (PIGD), were more common at onset in patients with a rapid rate of disease progression ("malignant PD"; duration of symptoms less than 1 year and Hoehn/Yahr stage of 2.5, N = 11) as compared with those with a relatively slow rate of progression ("benign PD"; duration of symptoms greater than 4 years, N = 65). Comparisons of tremor-dominant PD (mean tremor score/mean PIGD score less than or equal to 1.5, N = 441) with the PIGD-dominant type (mean tremor score/mean PIGD score greater than or equal to 1.0, N = 233) provided support for the existence of clinical subtypes. The PIGD group reported significantly greater subjective intellectual, motor, and occupational impairment than the tremor group. Stage II patients had higher depression scores than stage I patients. Among the patients participating in the DATATOP, older age at onset with bradykinesia, or with the PIGD form of PD, is associated with more functional disability than when the symptoms are dominated by tremor or begin at a younger age.

Adult↗
PubMed1990

LPN to ADN.

Explore the source record for details and available documents.

Career Mobility↗
PubMed1990

Variables associated with weight loss and improvements in glycemic control in type II diabetic patients in behavioral weight control programs.

Because weight loss is difficult to achieve, it would be helpful to determine whether there are subgroups of obese type II diabetic patients who benefit most from participation in a behavioral weight loss program. We studied 178 obese patients with type II diabetes, who participated in a 12-20 week behavioral weight loss program and were followed for 1 year after the program to determine whether age, gender, percent overweight, medication, duration of diabetes or fasting glucose were related to weight loss and/or to the magnitude of improvement in glycemic control experienced with weight loss. Gender was the only variable related to weight loss; males lost more weight and had greater decreases in percent overweight than females. The variable most strongly related to improvement in glycemic control was pretreatment fasting glucose level; patients with higher initial glucose levels experienced the greatest improvements in control. There was no evidence to support the belief that patients on insulin have poorer weight losses or that patients with long-duration diabetes benefit less from weight reduction than those with recent-onset diabetes.

Behavior Therapy↗
PubMed1979

Comparison of the new miniature Wright peak flow meter with the standard Wright peak flow meter.

Preproduction and current models of the miniature Wright peak flow meter have been compared with the standard Wright peak flow meter on normal and abnormal subjects. Early problems in production appear to have been overcome, and the current model agrees to within 3% with the standard peak flow meter, which is as close as the agreement between two standard instruments. The new mini-meter may be enclosed in a case, making direct comparisons with other instruments possible.

Humans↗