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Biomedical subjects

A V Taylor

Publications and source records attributed to A V Taylor.

10 recordsLinked to original sources

Detection and quantitation of raw fish aeroallergens from an open-air fish market.

BACKGROUND: IgE-mediated hypersensitivity to fish is a clinically relevant problem, particularly in several European countries. Although most allergic reactions to fish are caused by ingestion, occupational exposures to seafood allergens by inhalation have been correlated with respiratory symptoms. In Madrid, patients with fish allergy have exhibited respiratory symptoms after visits to an open-air fish market. OBJECTIVE: We sought to study the possibility of passively aerosolized fish allergen in an open-air fish market through air sampling and a competitive IgE immunoassay. METHODS: Air samples were collected on polytetrafluoroethylene filters by using air samplers. Samples were collected on 41 different days from both an open-air fish market and an outdoor residential area. Fish allergens were specifically quantified by competitive IgE immunoassay by using pooled sera from fish-sensitive individuals. A raw fish extract (10 mg of dry weight/mL) was used as the reference standard. RESULTS: Allergen was quantified in all 39 fish market air samples (2-25 ng/m(3)). The residential air samples contained no detectable allergen. The analytic limit of detection was 2 ng, allowing detection of 0.4 ng/m(3) for the air volumes collected. A concentrated (30-fold) pool of fish market air samples was tested in serial dilutions and demonstrated an identical regression line to that of the raw fish standard. CONCLUSION: By using air sampling and an immunochemical analytic technique, fish allergen is detectable in the air of an open-air fish market. Avoidance of a food allergen, such as fish, should include preventing exposure to aerosolized particles through inhalation in relevant environments.

Air Pollution↗

Adrenal suppression secondary to inhaled fluticasone propionate.

BACKGROUND: Inhaled glucocorticoids are the medical treatment of choice in many of patients with asthma. Fluticasone propionate is an inhaled glucocorticoid with little systemic bioavailability via the oral route and infrequent association with systemic adverse effects at the recommended dosage. OBJECTIVE: To report a case of adrenal suppression and exogenous glucocorticoid excess from inhaled fluticasone propionate. METHODS: A 9-year-old girl with a previous history of episodic asthma was placed on 550 microg of fluticasone propionate daily for severe labile asthma diagnosed by history and methacholine challenge. The patient returned 6 months later with complaints of increased appetite, nausea, and feeling "hot and flushed." On physical exam she had stigmata of Cushing's syndrome. The patient subsequently developed orthostatic hypotension and moderate dehydration following a viral illness. After a long taper of fluticasone propionate the patient' s adrenal function returned to normal and she had no acute or chronic exacerbations of her asthma. RESULTS: Her 8 AM cortisol was undetectable with an ACTH of 21 pg/mL. The serum prolactin, TSH, free thyroxine, insulin-like growth factor I, and renin activity were all normal. An MRI study of her head was also normal. Repeat methacholine challenges while receiving a much smaller dose fluticasone propionate showed a significant decrease in airway reactivity. CONCLUSION: Adrenal suppression can occur from inhaled fluticasone propionate at a dosage less than has been previously reported.

Administration, Inhalation↗

Treatment of vitamin D deficient osteomalacia may unmask autonomous hyperparathyroidism.

Two cases of vitamin D deficient osteomalacia with secondary hyperparathyroidism are presented. In both cases treatment with vitamin D replacement therapy resulted in elevated calcium levels and a failure of parathormone levels to normalise, indicating autonomous parathyroid activity. Subsequent surgery in one case resulted in removal of a parathyroid adenoma. The importance of osteomalacia and its complications are discussed.

Adult↗

Eating disorders among women receiving treatment for an alcohol problem.

To evaluate the frequency of eating disorder features among women receiving treatment for an alcohol problem, 52 female attenders at an alcohol clinic were assessed using a standardized research clinical interview, and the findings compared with data on a general population sample. The results suggest that eating disorder features are overrepresented among women who present for treatment for an alcohol problem.

Adolescent↗

Prostaglandin metabolite levels during cervical ripening with a controlled-release hydrogel polymer prostaglandin E2 pessary.

Prostaglandin E and F metabolite (PGEM and PGFM) concentrations in peripheral plasma were assayed following the vaginal administration of a controlled release hydrogel polymer pessary designed to release 0.6 mg PGE2 per hour in vivo. A linear relationship between calculated PGE2 release from the pessary and PGEM levels was observed with a correlation coefficient of 0.78. A significant rise in PGEM levels occurred two hours following pessary administration, with significantly higher PGEM levels in patients delivering within the eight hour observation period compared with those delivering later. PGFM levels increased more slowly. The results suggest that PGE2 released by the pessary crosses the vaginal epithelium and may stimulate endogenous prostaglandin production. The controlled rise of metabolites in association with the polymer pessary suggest that it should provide greater control in labour induction than other vehicles we have studied, but this should be confirmed by clinical trials.

Administration, Intravaginal↗

The concurrent in vitro and in vivo release of PGE2 from a controlled-release hydrogel polymer pessary for cervical ripening.

Twenty five patients booked for induction of labour, at 38 weeks or more gestation, were administered a controlled release vaginal polymer pessary containing 10 mg prostaglandin E2 (PGE2), designed to release 0.6 mg per hour in vivo. The release profile from the polymer was linear throughout the eight hour observation period with a correlation coefficient of 0.81, and regression slope of 0.93 mg/hr. with 95% confidence intervals of 0.63 mg/hr. to 1.23 mg/hr. This compared with a concomitant release profile in vitro which was uniform with time for the first five hours, but then continued at a decreasing rate with a correlation coefficient of 0.98. The relationship between PGE2 release and cervical score change was linear, with a correlation coefficient of 0.65. The results show that PGE2 release from the pessary in vivo is predictable, and suggest that the controlled release pessary offers the advantages of greater control of cervical ripening than alternative vehicles currently available.

Cervix Uteri↗

Prostaglandin induced cervical ripening under tocolytic cover in primiparae: results of a double blind placebo controlled trial.

In a double blind trial, 60 nulliparae with a modified Bishop score of less than or equal to 5 requiring induction of labour, received either 8 mg of salbutamol or an identical placebo orally, 30 min before vaginal administration of 2 mg prostaglandin E2 gel. Women in the salbutamol group experienced less uterine activity over the subsequent 12 h compared with those given placebo, and fewer (35%) commenced labour compared with the placebo group (62%). However, the change in cervical score was significantly less in the salbutamol group (mean 3.0, SD 3.1) than that in the placebo group (mean 5.8, SD 3.2), and the prostaglandin treatment to delivery time in the salbutamol group (mean 26.1 h, SD 6.49) was significantly longer than that in the placebo group (mean 19.3 h, SD 7.95). The first stage of labour lasted greater than 10 h in 11 women in the salbutamol group compared with five in the placebo group. Side effects attributable to salbutamol occurred in 10% of the treated women but in none of their fetuses and fetal outcome was satisfactory and similar in both groups. Our findings show that salbutamol can suppress prostaglandin-induced uterine activity during cervical ripening, which could be an advantage in induction of labour where a planned delivery is preferred. However, the poorer outcome of labour in salbutamol-treated women mitigates against this approach.

Administration, Intravaginal↗