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Biomedical subjects

A O'Connor

Publications and source records attributed to A O'Connor.

18 recordsLinked to original sources

Comparison between MAGIC LITE- and CAP-system: two automated specific IgE antibody assays.

The MAGIC LITE system, a newly developed immunochemiluminometric assay for specific and total IgE antibody using paramagnetic particles coupled with standardized allergens as solid phase, was compared to the CAP system, a recently introduced immunoassay based on a cellulose polymer encased in a capsule. A total of 357 serum samples of patients with suspected inhalant allergies and a positive skin prick test (SPT) to common allergens (birch, timothy-grass, mugwort, cat dander, Dermatophagoides pteronyssinus, Alternaria) were investigated. Fifty SPT negative subjects served as controls (total number of tests in each assay = 1600). Both assays were highly precise (overall intra-assay and inter-assay coefficients of variation were 2.9% and 4.5% in MAGIC LITE, 4.7% and 5.5% in CAP) and showed excellent linearity (mean r2 of eightfold log2 serum dilutions were 99.7% and 99.3% in MAGIC LITE and CAP). Good correlations were found between the absolute specific IgE antibody values detected by both methods (correlation coefficient r: birth 0.86, grass 0.93, mugwort 0.96, cat 0.91, D. pteronyssinus 0.73, Alternaria 0.90). Excellent specificity (greater than or equal to 98%) occurred in both assays and with all allergens, and sensitivity was related to the allergen (MAGIC LITE/CAP): birch 91%/89%, grass 83%/90%, mugwort 50%/69%, cat 83%/83%, D. pteronyssinus 72%/78%, Alternaria 75%/81%. Our results indicate that both in vitro tests are useful tools for the detection of specific IgE antibody.

Allergens

Comparison of the Phadebas RAST with the Pharmacia CAP system for insect venom.

Determination of specific IgE by RAST is a well-established method in the diagnosis of immediate allergic reactions. In this study, we have compared the RAST with the ImmunoCAP, a novel test system which is based on a new type of solid phase. A total of 123 sera from 111 insect venom-allergic patients (74% female) were investigated. All patients had their diagnosis confirmed on the basis of their history and skin tests with insect venom. The patients' age showed a mean +/- S of 44.2 +/- 14.6 years. The total serum IgE levels ranged from 4-1712 kU/l, with a median of 108 kU/l. The results of specific IgE, as determined by RAST and CAP, showed a significantly higher sensitivity, by almost one class, with the CAP compared with the RAST system. The quotient of specific IgE to total IgE, determined with the CAP system, could not be shown to be an expression of sensitization, compared with the severity of sting reactions (Müller classification (16)). A conversion factor for vespid venom RAST to CAP was calculated from the present data by subtracting the RAST from the CAP values. The mean delta value +/- SD was found to be 0.9 +/- 0.65, with a range from -0.8 to 2.7 and a median of 0.9. The data clearly show the differences between RAST and CAP-RAST classes, indicating that the CAP-system has a higher sensitivity and that patients with a low level sensitization are missed by the RAST method.

Adolescent

XYY genotype and crime: 2 cases.

The presence of 47, XYY genotype has stimulated much debate as to whether these men are more likely to indulge in criminal and violent behaviour than 46, XY males. Two cases of XYY men who had committed murder are described, and the current literature regarding criminality and psychopathology in XYY males is reviewed. It is important that Forensic Psychiatrists with XYY patients are aware of these issues as the link between XYY genotype and criminality may be raised in court.

Adult

Blunted prolactin responses to d-fenfluramine in sociopathy. Evidence for subsensitivity of central serotonergic function.

Using a neuroendocrine probe we studied nine male offenders in a forensic hospital, convicted of murder, with a diagnosis of antisocial personality disorder, who had been behaviourally 'quiescent' for varying periods and who had not recently been abusing drugs. Nine healthy age-matched men also participated. All subjects received 30 mg d-fenfluramine (d-FEN), a 5-HT releasing agent, orally, after an overnight fast, and serial samples for prolactin estimation were taken hourly for five hours. Responses were significantly impaired in the patients, suggesting a subsensitivity of certain 5-HT systems in antisocial personality disorder, regardless of recent or ongoing behavioural disturbance.

Adult

IgE-mediated inhalant allergy in inhabitants of a building infested by the rice weevil (Sitophilus oryzae).

The rice weevil (Sitophilus oryzae) is known as a stored product pest. Occupants living in a factory used previously as a granary and known to be contaminated by the rice weevil developed rhinitis and asthma. To study the role of the potential insect allergens, extracts were prepared from whole body and a grain dust of the rice and grain weevil (Sitophilus granarius). The extracts were coupled to cyanogen bromide-activated paper disks. Skin prick tests (SPT) were performed using common inhalant allergens as well as the insect allergen preparations. In cases of a positive SPT, specific serum IgE to the insect products was measured. Histamine release studies with peripheral leukocytes (HR) and studies using immunoblot techniques were performed. Fifteen of 39 subjects living in the infested rooms demonstrated positive SPT to the extracts of insect origin. Histamine equivalent wheal size induced by the whole body extract of the rice weevil required 3-160 micrograms protein/mL. Five of 15 subjects (with positive SPTs) had elevated specific IgE-levels to the insect material. RAST-inhibition studies indicated cross allergenicity between rice and grain weevils, and also between the frass of both beetles. Five of 15 subjects were positive in the HR assay (Ag30, allergen concentration for 30% HR for the whole body extract: range, 10(-3) to 400 micrograms protein/mL, maximum release: 26% to 89%). IgE binding was detected after SDS-PAGE by immunoblot techniques at different locations: 35-38, 54, 67, 70, and > 94 kD.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation

Community health service utilisation and needs in an elderly population.

This study was carried out to determine community health service utilisation and needs of an elderly population living in a geographically defined area of Dublin. A random sample of 208 persons was taken from the 11,852 elderly persons living in the area. Activities of daily living and cognitive function were assessed in the person's own home. Whilst the community health services provided were less than comprehensive, they were targeted to those most in need; the very elderly, those living alone, and persons with a mental or physical disability. Objectively assessed need for further services far outweighed the demand for such services. Studies such as this are essential if the elderly are to receive their fair share of services in a demand based health service.

Aged

Concentrations of immunoactive inhibin in serum during human pregnancy: evidence for an ovarian contribution.

Immunoactive inhibin (ir-inhibin) concentrations in maternal serum during normal human pregnancy have been established in two separate studies employing cross-sectional and longitudinal sampling regimes. Ir-inhibin concentrations rose from the mid-luteal phase (geometric mean + 95% confidence intervals 1.490 (1.086-2.028) U mL-1) to peak at week 11 of gestation (3.77 (3.26-4.35) U mL-1), declined to a plateau from 14 to 25 weeks with means ranging from 1.8 to 2.3 U mL-1, and subsequently rose slowly to a peak of 6.53 U mL-1 at 41 weeks. In the longitudinal study, similar results were obtained and no differences were found in maternal inhibin levels in women carrying male or female fetuses. Paired cord blood and maternal samples showed no significant difference in ir-inhibin concentrations irrespective of the sex of the fetus. However, in all such pregnancies amniotic fluid ir-inhibin levels were 2-3 fold greater than maternal or fetal levels raising the possibility that the amnion may secrete inhibin. In 12 women without functional ovaries in whom a singleton pregnancy was achieved by donation of oocytes and in vitro fertilization, the ir-inhibin levels showed a similar pattern in the first trimester of pregnancy but the concentrations achieved were markedly lower (peak 1.1 U mL-1 at 9 weeks). In five women from the group in whom samples were available late in gestation, three showed greater than normal levels and two had subnormal levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Amniotic Fluid

Circulating immunoreactive inhibin, gonadotropin, and prolactin levels during pregnancy, lactation, and postweaning estrous cycle in the rat.

Serum inhibin levels were measured by heterologous RIA during pregnancy, lactation, and the post-weaning estrous cycle in the rat and correlated with changes in serum FSH and LH and prolactin. Blood was serially collected by cardiac puncture under light ether anesthesia from adult Sprague-Dawley rats on alternate days throughout the experimental period. For the first 8 days of pregnancy, immunoreactive inhibin levels remained high, then gradually decreased to reach a nadir at Day 16, and subsequently rose steeply until parturition. The pattern of serum immunoreactive inhibin levels during early pregnancy does not support a corpus luteum source and the dramatic rise from Day 16 to Day 22 correlates with the recommencement of follicular development in the ovary. Inhibin levels decreased rapidly on the day after birth and were suppressed until Day 8 of lactation, slowly increasing thereafter to reach a plateau from Day 14 until weaning (Day 22.5 of lactation). These changes in inhibin levels positively correlated with LH and FSH and negatively with prolactin, and are consistent with an ovarian source for inhibin associated with the recommencement of follicular development resulting from the diminution of the suckling stimulus. Immediately after weaning, serum immunoreactive inhibin levels showed a 4-day cyclic pattern corresponding to the estrous cycle identified by vaginal smear. Inhibin levels peaked on the day of proestrus, reached a nadir on the day of estrus, and rose slowly during metestrus and diestrus to a new peak at proestrus. Serum FSH levels showed an inverse correlation to inhibin levels consistent with a feedback relationship with inhibin.

Animals

Second opinions.

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Referral and Consultation

Smoking: a decision-making dilemma for the vascular patient.

This descriptive study examined the differences in beliefs and social influences between patients who decided to quit or to continue smoking following diagnosis of chronic peripheral vascular disease. A consecutive quota sample of 20 patients who had quit smoking (quitters) and 22 who had continued smoking (continuers) agreed to participate in the study. There were no statistically significant differences between quitters and continuers in demographic characteristics, clinical variables and perceived social influences. Statistically significant differences were found between groups in beliefs about and attitudes towards the risk of continued smoking. These findings underline the need to investigate more fully the factors which influence patients' decisions to quit or to continue smoking. Further investigation may also provide detailed information on the role of risk perception in influencing this decision-making process.

Amputation, Surgical

Women who kill their parents.

The literature on parricide is reviewed with special reference to women. Seventeen female parricides (14 matricides, 3 patricides) were identified: in a remand prison (11), a Special Hospital (5), and a Regional Secure Unit (1). Six were schizophrenic, five had psychotic depression, three had personality disorders, and one was alcoholic. Two of the patricides had no psychiatric disorder but retaliated against violent fathers. Regardless of psychiatric diagnosis, matricides were mostly single, socially isolated women in mid-life, living alone with a domineering mother in a mutually dependent but hostile relationship. Similar characteristics are found in male matricides, who are predominantly schizophrenic. It is suggested that these features are of greater significance in matricide than the specific form of psychiatric disorder. Compared with filicides, matricides were significantly older, were single, and more often suffered from mental illness and substance abuse. Attention is drawn to the possible homicidal risk associated with delusions of poisoning and hypochondriacal delusions.

Adult

Smoking--the effects on cerebral vascular circulation. A variable in patient decision making.

Stroke, caused by either infartion or subarachnoid haemorrhage, can have devastating and debilitating effect on its victims. Traditional therapy has focused on the risk factors of hypertension, hyperlipidemia, atherosclerotic heart disease and diabetes milletus. More recently, the literature has focused on smoking and the short and long term effects of cerebral blood flow. The purpose of this paper will be to review the most recent research literature on both the chronic and acute effects of smoking on the cerebral vascular system. More specifically, there will be an examination of the effect of smoking on the outcome of a carotid endarterectomy, subarachnoid haemorrhage and the progression of atherosclerosis. Smoking is harmful and its cumulative effects, along with additive effects must be recognized. Despite increased risk, people continue to smoke affecting disease progression and treatment. Two models will be discussed--the health belief model and the health decision model. These models can provide a basis for nursing to develop and assess comprehensive smoking cessation programmes.

Carotid Artery Diseases

Helminth infestations in Asian women attending an antenatal clinic in England.

Asian women attending an antenatal clinic in England were studied to determine the infestation rates with intestinal helminths. An overall rate of 9% was found, rising to 18% in those women resident for less than 7 years. Indians had a carriage rate of 3%, Pakistanis 7.3% and Bangladeshis 45%. Species detected were hookworm, whipworm (Trichuris trichiura), dwarf tapeworm (Hymenolepis nana) and roundworm (Ascaris lumbricoides).

Adult

Hunger strikers.

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Fasting

The mentally handicapped criminal offender. A 10-year study of two hospitals.

With mentally handicapped people now being moved into the community, information on mentally handicapped criminal offenders is valuable. A group of such offenders was examined by reviewing the case-notes of 92 patients referred on hospital order to two mental-handicap hospitals over 10 years. Compared with the general criminal population, these offenders' ages were higher, the ratio of male to female offenders was similar, and the proportion of married people was lower. The offences committed were for the most part serious, with a greater number of offences against property and public order in the subgroup whose intelligence were in the mentally handicapped range. Their tested intelligence fell almost entirely into the normal and mild mental-handicap range, suggesting that factors other than intelligence testing, such as social skills, were considered in their admission to the hospitals.

Adult

Subjective recording of fetal movement.

A group of 137 patients, 113 of whom had obstetric complications, recorded fetal movements by a subjective method. Low fetal movement counts were associated with maternal cigarette smoking and prolongation of pregnancy and high counts with maternal ingestion of sedatives or tranquillizers, abnormal fetal heart rate in labour and a true knot in the umbilical cord. The absence of fetal movement during four consecutive 20-minute counting-sessions was not associated with poor fetal outcome. Further investigations to assess the usefulness of fetal movement counting are recommended. Such investigations should take into account the limitations imposed by the methods and the obstetric population for study.

Birth Weight

Menopause in rhesus monkeys: model for study of disorders in the human climacteric.

Hormonal and menstrual patterns were studied in rhesus monkeys 22 years of age or older. Sustained elevations of serum gonodotropins, low circulating levels of estradiol and progesterone, associated with oligomenorrhea or amneorrhea, were similar to changes reported for peri- and postmenopausal women. During the menopausal transition, pituitary FSH appears to be modulated independently of LH. These observations suggest that the rhesus monkey may be a suitable model for study of disorders afflicting women in the climacteric.

Animals