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Biomedical subjects

M McMahon

Publications and source records attributed to M McMahon.

159 records · Page 9Linked to original sources
PubMedDate not supplied

A case of Resistance to Thyroid Hormone without mutation in the thyroid hormone receptor beta.

BACKGROUND: Resistance to Thyroid Hormone (RTH) is a condition caused by tissue hyposensitivity to the effects of circulating thyroid hormone, and may be misdiagnosed as hyperthyroidism. AIMS: We report the first case of RTH in an Irish patient highlighting the clinical features and the pathophysiological mechanism underlying the characteristic laboratory abnormalities found in the condition. METHODS: We describe an isolated case of RTH initially misdiagnosed as hyperthyroidism, and detail the investigations which ultimately led to the correct diagnosis. Genetic screening of the thyroid hormone receptor beta gene was performed. RESULTS: Thyroid function tests including T3 suppression test and TRH-stimulation test suggested a diagnosis of RTH. Genetic testing failed to demonstrate a mutation in the thyroid hormone receptor. CONCLUSION: RTH is a rare inherited condition that may be misdiagnosed as hyperthyroidism. The case we describe most likely results from a de novo mutation in an as yet undiscovered gene. RTH should be considered in patients with elevated thyroid hormone levels and normal TSH so that unnecessary and potentially harmful treatment can be avoided.

Adult↗
PubMedDate not supplied

Diagnostic utility of tomographic myocardial perfusion imaging with technetium 99m furifosmin (Q12) compared with thallium 201: results of a phase III multicenter trial.

BACKGROUND: Based on physical properties, 99mTc-labeled perfusion agents offer several advantages over 201Tl for myocardial perfusion imaging. The results of in vivo and experimental studies, along with preliminary experience in human subjects, have shown 99mTc-labeled furifosmin to be a promising new perfusion tracer. The purpose of this study was to evaluate the safety of a new myocardial perfusion agent, 99mTc-labeled furifosmin (Q12), and determine the concordance of furifosmin perfusion scintigraphy to 201Tl imaging. In addition, we sought to determine the normalcy rate of myocardial scintigraphy with furifosmin. METHODS AND RESULTS: One hundred fifty patients constituted the study group in this multicenter trial. Patients underwent exercise testing with furifosmin injected at peak exercise, and tomographic imaging was begun 15 to 30 minutes afterward. After a separate injection, resting images were obtained 3 to 4 hours later. Thallium scintigraphy was performed within 2 weeks of the furifosmin scans, after a similar exercise workload. Patients with a low likelihood of coronary artery disease (n = 39) also underwent furifosmin imaging. All images were processed and displayed in uniform manner and interpreted by a panel of readers. No adverse effects or clinically important laboratory alterations were related to furifosmin imaging. Image quality was slightly better with furifosmin than with thallium. The overall concordance between the perfusion studies was 86% (kappa value = 0.669). The normalcy rate for furifosmin scintigraphy was 100%. CONCLUSIONS: 99mTc-labeled furifosmin is a promising new 99mTc-labeled myocardial perfusion agent, providing diagnostic results similar to those obtained with 201Tl.

Coronary Disease↗
PubMedDate not supplied

Parenteral nutrition in patients with diabetes mellitus: theoretical and practical considerations.

It is estimated that there are 11 million diabetics in the United States. Increasing recognition of the importance of nutrition in clinical medicine coupled with the frequent hospitalizations of the diabetic patient has heightened interest in their nutritional therapy. Patients with diabetes mellitus exhibit many abnormalities in the regulation of carbohydrate metabolism which may be accentuated during illness as part of the metabolic response to injury. An understanding of the effect of injury/illness, parenteral nutrition, and diabetes mellitus on carbohydrate metabolism is essential for the development of a rational approach to the initiation and maintenance of nutritional support in the diabetic patient.

Carbohydrate Metabolism↗
PubMedDate not supplied

Regimen compliance two years after myocardial infarction.

Two-years postinfarction, the effect of a nursing intervention at 30 days postinfarction, and intentions, attitudes, and perceived beliefs of others on regimen compliance of myocardial infarction patients was investigated. The sample was comprised of 51 patients (E = 29, C = 22) who participated in a five-phase study over 2 years. No differences were found between experimental and control groups for regimen compliance to activity, stress, and medication prescriptions. The experimental group was significantly more compliant to the diet prescription than the control group. The control group was significantly more compliant than the experimental group with cessation from smoking. Perceived beliefs of others were predictive of compliance for all regimen prescriptions at 2 years. Attitude was also predictive of compliance with the diet, smoking, and stress regimens.

Adult↗
PubMedDate not supplied

Influence of a nursing intervention on regimen adherence and societal adjustments postmyocardial infarction.

One hundred three first-time myocardial infarction (MI) patients were randomly assigned to either an experimental or a control condition. Patients completed a cardiac rehabilitation program during hospitalization and were interviewed to assess intentions to follow regimen prescriptions, attitudes toward the prescriptions, coping methods, and the perceived beliefs of others concerning their intentions. Patients were visited at home 30 days after discharge and reassessed on each of the above variables except that their behavior was substituted for intentions and societal adjustment was assessed. The experimental group was given an intervention program which included a discussion of assessment data, identification of problems, and establishment of goals. The assessment was repeated 60 days after discharge. No differences were found between experimental and control groups for either medical regimen adherence or societal adjustment. There was a significant decrease in mean scores for all variables from hospital to 30 days for both groups, but no change from 30 to 60 days. Attitudes and perceived beliefs of others were predictive of adherence, and it was concluded that these variables need to be included in any rehabilitation program.

Adaptation, Psychological↗
PubMedDate not supplied

Loving the unlovable.

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Emergency Service, Hospital↗
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Challenges and goals.

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Delivery of Health Care↗
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Indicators of medical regimen adherence for myocardial infarction patients.

This study investigated relationships between demographic and medical variables, attitudes, perceived beliefs of others, and intentions toward medical regimen adherence and actual posthospitalization regimen adherence. During hospitalization, attitudes, perceived beliefs of others, and intentions toward prescribed medical regimen were elicited from 112 persons recovering from a first time myocardial infarction (MI). Six to 9 months posthospitalization, attitudes, perceived beliefs of others, and adherence behaviors were assessed. Multiple regression analysis indicated that, during hospitalization, attitudes and perceived beliefs of others were strong indicators of intentions to adhere to the medical regimen, but they were not indicators of actual adherence posthospitalization. Posthospitalization, attitudes and perceived beliefs of others were strong indicators of actual regimen adherence. Findings indicate rehabilitation plans for the MI patient should be individualized for hospital and home and should include data on health belief variables.

Adult↗
PubMedDate not supplied

Development of a health attitude scale.

A tool was developed to assess attitudes of patients with cardiac disease toward performing prescribed behaviors of their medical regimen. Two groups of subjects with heart disease were used to examine validity and reliability of the Miller Attitude Scale. One group included 480 members of Mended Hearts, Inc., and the second group consisted of 35 patients diagnosed with a first myocardial infarction. The second group repeated the attitude scale six months post-hospitalization. Performance of the medical regimen by this group was verified at the six-month follow-up period. Using Spearman Rank Correlation, there was a significant relationship between attitudes and adherence behaviors for three of the five subscales. Alpha reliabilities revealed a high degree of internal consistency of scale items for all five subscales when testing both groups. A factor analysis resulted in eight factors accounting for the majority of the variance. Each of the five behaviors of the medical regimen clearly defined a factor supporting used of the Miller Attitude Scale for assessing attitudes of heart patients toward behaviors of their medical regimen.

Attitude to Health↗