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Biomedical subjects

C W Bailey

Publications and source records attributed to C W Bailey.

At least 19 recordsLinked to original sources
PubMed2001

T cell epitope mapping of the Smith antigen reveals that highly conserved Smith antigen motifs are the dominant target of T cell immunity in systemic lupus erythematosus.

B cell and T cell immunity to the Smith Ag (Sm) is a characteristic feature of systemic lupus erythematosus (SLE). We have shown that T cell immunity against Sm can be detected in SLE patients, and that T and B cell immunity against Sm are linked in vivo. TCR usage by Sm-reactive T cells is highly restricted and characteristic of an Ag-driven immune response. Sm is a well-characterized complex Ag consisting of proteins B1, B2, D1, D2, D3, E, F, and G. A unique feature of all Sm proteins is the presence of homologous motifs, Sm motif 1 and Sm motif 2. We used limiting dilution cloning and synthetic peptide Ags to characterize the human T cell immune response against Sm in seven SLE patients. We sought to determine the precise antigenic peptides recognized, the common features of antigenic structure recognized, and the evolution of the T cell response against Sm. We found there was a highly restricted set of Sm self-peptides recognized by T cells, with three epitopes on Sm-B and two epitopes on Sm-D. We found that T cell immunity against Sm-B and Sm-D was encoded within the highly conserved Sm motif 1 and Sm motif 2, and that immunity against these epitopes appeared stable. The present study supports the concept that T cell immunity to Sm is an Ag-driven immune response directed against a highly restricted set of self-peptides, encoded within Sm motif 1 and Sm motif 2, that is shared among all Sm proteins.

Alanine↗
PubMed2001

Candida dubliniensis in radiation-induced oropharyngeal candidiasis.

Candida dubliniensis is a recently described species that has been shown to cause oropharyngeal candidiasis in patients with HIV. We present a detailed evaluation of a patient undergoing head and neck radiation for oral cancer who developed oropharyngeal candidiasis from a mixed infection of C dubliniensis and Candida albicans. To our knowledge, this is the first described case of C dubliniensis contributing to oropharyngeal candidiasis in this patient population.

Adult↗
PubMed1999

Epidemiology of oropharyngeal Candida colonization and infection in patients receiving radiation for head and neck cancer.

Oral mucosal colonization and infection with Candida are common in patients receiving radiation therapy for head and neck cancer. Infection is marked by oral pain and/or burning and can lead to significant patient morbidity. The purpose of this study was to identify Candida strain diversity in this population by using a chromogenic medium, subculturing, molecular typing, and antifungal susceptibility testing of clinical isolates. These results were then correlated with clinical outcome in patients treated with fluconazole for infection. Specimens from 30 patients receiving radiation therapy for head and neck cancer were cultured weekly for Candida. Patients exhibiting clinical infection were treated with oral fluconazole. All isolates were plated on CHROMagar Candida and RPMI medium, subcultured, and submitted for antifungal susceptibility testing and molecular typing. Infections occurred in 27% of the patients and were predominantly due to Candida albicans (78%). Candida carriage occurred in 73% of patients and at 51% of patient visits. Yeasts other than C. albicans predominated in carriage, as they were isolated from 59% of patients and at 52% of patient visits. All infections responded clinically, and all isolates were susceptible to fluconazole. Molecular typing showed that most patients had similar strains throughout their radiation treatment. One patient, however, did show the acquisition of a new strain. With this high rate of infection (27%), prophylaxis to prevent infection should be evaluated for these patients.

Antifungal Agents↗
PubMed1999

Avoiding malpractice in private practice and the hospital setting.

An overview of very real considerations for the practicing plastic surgeon with regards to potential areas of risk and liability have been presented. As one can see, the hospital environment presents many potential sources of liability that can involve the attending or consulting plastic surgeon.

Health Personnel↗
PubMed1999

Doctor-patient relationship. The consultation.

This article deals primarily with the office consultation involving a new patient. The consultation lays the groundwork for the physician/patient relationship in a number of ways. The authors consider the objective and subjective assessments which take place between the doctor and the patient and offer advice on how to decide on a course of treatment with the patient.

Humans↗
PubMed1998

The fibronectin type III domain as a scaffold for novel binding proteins.

The fibronectin type III domain (FN3) is a small autonomous folding unit which occurs in many animal proteins involving in ligand binding. The beta-sandwich structure of FN3 closely resembles that of immunoglobulin domains. We have prepared a phage display library of FN3 in which residues in two surface loops were randomized. We have selected mutant FN3s which bind to a test ligand, ubiquitin, with significant affinities, while the wild-type FN3 shows no measurable affinity. A dominant clone was expressed as a soluble protein and its properties were investigated in detail. Heteronuclear NMR characterization revealed that the selected mutant protein retains the global fold of FN3. It also has a modest conformational stability despite mutations at 12 out of 94 residues. These results clearly show the potential of FN3 as a scaffold for engineering novel binding proteins.

Amino Acid Sequence↗
PubMed1995

Escherichia coli O157:H7 restriction pattern recognition by artificial neural network.

An artificial neural network model for the recognition of Escherichia coli O157:H7 restriction patterns was designed. In the training phase, images of two classes of E. coli isolates (O157:H7 and non-O157:H7) were digitized and transmitted to the neural network. The system was then tested for recognition of images not included in the training set. Promising results were achieved with the designed network configuration, providing a basis for further study. This application of a new generation of computation technology serves as an example of its usefulness in microbiology.

Animals↗
PubMed1995

Reducing postneonatal mortality in West Virginia: a statewide intervention program targeting risk identified at and after birth.

OBJECTIVES: Excessive postneonatal mortality in West Virginia has been associated with inadequate health care. This paper describes two interventions aimed at those infants at greatest risk of dying. METHODS: Two systems of risk-related intervention were simultaneously introduced and funded statewide from 1985 through 1987. Risk status was determined by a multifactorial score at birth or clinical risk factors later. At-risk infants were linked with physicians who provided specified care plans. All infants were followed for 1 year for mortality. RESULTS: Of 4570 infants with a high Sheffield Birth Score, 45%, together with 1003 infants with clinical risk factors, received specified care plans. High-risk infants constituted 7.6% of total resident births. Odds ratios for overall postneonatal mortality and sudden infant death syndrome in high-birth-score infants compared with low-birth-score infants were 6.2 (95% confidence interval [CI] = 4.2, 9.3) and 11.2 (95% CI = 5.4, 23.2), respectively. The relative risks of postneonatal mortality were similarly significant for infants with most clinical risk factors. During the program there was a 21.4% reduction in the trend of yearly standardized mortality ratios, which differed markedly from the trend in surrounding states. The data suggest that 33 lives were saved at a cost of $36,363 per infant. CONCLUSION: Ensuring affordable, available, accessible, and acceptable care for a small group of at-risk infants was associated with a dramatic drop in overall postneonatal mortality in West Virginia.

Adult↗
PubMed1994

How to avoid being dropped from managed care plans.

Unexplained, arbitrary termination of doctors from managed care plans is becoming more common in the United States. The action often has substantial financial impact on a medical practice and ends established doctor-patient relationships with very little notice. Can you do anything to minimize your risk of being dropped without cause? Dr Bailey, a plastic surgeon and attorney, offers some tips that may help you avoid a "Dear Doctor" letter.

Adaptation, Psychological↗
PubMed1989

Infant mortality in West Virginia. Identifying risk factors for public health intervention.

Because infant death rates vary within populations, it is important for program managers and planners to identify high-risk subgroups for whom effective interventions can be targeted. Matching infant death certificates with birth records permits us to describe infant mortality and calculate risks by a variety of maternal and infant characteristics recorded at birth. In this paper, we illustrate how several variables are associated with infant death, and show how analysis of a recent birth cohort in West Virginia can assist health officials in determining appropriate strategies for risk reduction. While efforts need to focus on reducing social and economic barriers to maternal and infant health, different strategies are required to address separately the neonatal and postneonatal components of infant mortality. Matched records can be used in a variety of ways to develop support for, and highlight the needs of, West Virginia's Maternal and Child Health programs, to monitor trends over time, to evaluate program achievements, and to modify program goals.

Cause of Death↗