Biomedical subjects

D Barrett

Publications and source records attributed to D Barrett.

At least 55 records · Page 3Linked to original sources

PubMed1995

Evaluation of dust and dust mite nasal provocation.

BACKGROUND: The relevance of positive epicutaneous tests to dust mite in patients with perennial rhinitis is often not apparent clinically. OBJECTIVE: We attempted to assess and compare intranasal challenges with both dust and dust mite allergens in skin test positive patients with perennial symptoms. METHODS: Thirteen patients allergic to both dust and dust mite by prick testing were challenged intranasally with each allergen at 2-week intervals. Nasal provocation was performed stepwise to a maximum dose of 2,000 pnu (dust) and 500 pnu (mite). The control group was composed of seven symptomatic patients with negative skin tests. RESULTS: Control patients were uniformly clinically unresponsive to maximum dose. Allergic patients varied considerably in sensitivity but all reacted clinically to at least the final dose with an early response. There were no obvious late phase reactions. Both dust and mite provoked an early phase increase of eosinophil cationic protein in the nasal secretions of control patients. For allergic patients there were early increases of eosinophil cationic protein, prostaglandin D2 and leukotriene C4. Late phase elevations were not observed. CONCLUSION: Dust and mite skin test-positive patients with perennial rhinitis had similar early phase responses to intranasal challenge both clinically and with elevations of inflammatory mediators. Clinically unresponsive control patients did show elevated eosinophil cationic protein levels suggesting a possible nonspecific, non-IgE mediated affect of both dust and mite allergens on the nasal mucosa.

Adult↗

PubMed1994

Issues in the development of subject recruitment strategies and eligibility criteria in multisite trials of matching.

Decision-making in selecting and recruiting subjects for treatment matching research is a complex process involving conceptual, methodological and practical considerations. In selecting clients, concerns arise about whether the criteria will produce a subject population that is (1) relevant to the dimensions associated with the treatment matching, (2) representative of persons typically seen in alcohol treatment settings and, for practical purposes, (3) able or willing to comply with the requirements of the study protocol. Also, in order to fulfill sampling requirements, it may be necessary to employ a variety of creative outreach methods. However, these recruitment mechanisms can pose additional logistical and methodological problems for the research. This article focuses on various issues arising in the selection and recruitment of subjects in matching research. Project MATCH serves to highlight issues related to client eligibility and recruitment and to discuss effective strategies for resolving these matters.

Adult↗

PubMed1994

Older people. 3. Watching your language.

Speech is the most important form of human expression; language is perhaps the most distinctive of all human attributes. During community care assessments, David Barrett examines how health professionals both hear and interpret what is being said by older people.

Aged↗

PubMed1994

Nonspecific nasal reactivity and smoking.

Twenty-three smoking and twenty-four nonsmoking patients both with and without symptomatic rhinitis and/or atopy were challenged intranasally with histamine. Histamine sensitivity was measured by changes in flow rates assessed by anterior rhinomanometry. The median threshold for both smokers and nonsmokers was 0.4 mg histamine. Small numbers limited the analyses of the subgroups. The data did not suggest that cigarette smoke increases nonspecific nasal reactivity as measured by histamine challenge.

Administration, Intranasal↗

PubMed1994

Effects of intensity of early response to allergen on the late phase of both the nose and skin.

Thirty-seven asymptomatic ragweed-sensitive patients and ten controls were challenged both epicutaneously and intranasally with ragweed. Clinical assessments of both early (20 minutes) and late (six hours) phase reactions of skin (mm) and nose (clinical score) were performed. A positive routine nasal challenge was defined as a clinical score 5 (0-12). Augmented nasal challenges were 10-fold higher than routine for each patient. Nasal lavage was performed at baseline, after positive challenge, one, two, and six hours postchallenge. Mediators assayed included histamine, eosinophil cationic protein (ECP), leukotrine C4 (LTC4), and prostaglandin D2 (PGD2). All 37 patients had an early skin reaction. Only 28/37 had a late response correlating with the early. Twenty-one patients had routine nasal challenges; 14 then volunteered for an augmented challenge. The remaining 16 had augmented challenges only. All had a nasal clinical early response, but late responses were infrequent (9). The early phase PGD2 was higher in augmented compared with routine challenges (P < .05) as were the late histamine (P < .05) and ECP (P < .05). The early skin test correlated with early LTC4 (P < .001) and PGD2 (P < .05). The early and late LTC4 (P < .05) and PGD2 (P < .01) were also related. In summary, late phase reactions of both the nose and skin are related to the intensity of the early response.

Adolescent↗

PubMed1993

One-piece stockinet for a spica cast.

A spica cast is still used for many procedures in surgery, usually on pediatric patients. One of the biggest problems with these is skin care. The authors present an easy, sure way of finishing off the perineal area of a spica cast.

Casts, Surgical↗

PubMed1992

O2- production by B lymphocytes lacking the respiratory burst oxidase subunit p47phox after transfection with an expression vector containing a p47phox cDNA.

The respiratory burst oxidase of phagocytes and B lymphocytes is a complicated enzyme that catalyzes the one-electron reduction of oxygen by NADPH. It is responsible for the O2- production that occurs when these cells are exposed to phorbol 12-myristate 13-acetate or other appropriate stimuli. The activity of this enzyme is greatly decreased or absent in patients with chronic granulomatous disease, an inherited disorder characterized by a severe defect in host defense against bacteria and fungi. In every chronic granulomatous disease patient studied to date, an abnormality has been found in a gene encoding one of four components of the respiratory burst oxidase: the membrane protein p22phox or gp91phox, or the cytosolic protein p47phox or p67phox. We report here that O2- production was partly restored to phorbol 12-myristate 13-acetate-stimulated Epstein-Barr virus-transformed B lymphocytes from a patient with p47phox-deficient chronic granulomatous disease by transfection with an expression plasmid containing a p47phox cDNA inserted in the sense direction. No detectable O2- was produced by untransfected p47phox-deficient lymphocytes or by p47phox-deficient lymphocytes transfected with an antisense plasmid. The finding that O2- can be produced by p47phox-deficient B lymphocytes after the transfer of a p47phox cDNA into the deficient cells suggests that this system could be useful for studying the function of mutant p47phox proteins in whole cells.

Amino Acid Sequence↗

PubMed1992

Comparison of dream content of depressed vs nondepressed dreamers.

Dreams of 20 college women classified as depressed by scores on the Beck Depression Inventory were compared with those of 21 nondepressed college women. The depressed group recalled fewer dreams, had significantly shorter dream length, and displayed less anger in their dreams. They also had fewer characters in their dreams and especially fewer strangers.

Adult↗

PubMed1992

Fantasizers and dissociaters: data on two distinct subgroups of deep trance subjects.

This study delineated two subgroups of highly hypnotizable subjects. The first (n = 19) entered trance rapidly, scored high on absorption, and described hypnosis as much like their rich and vivid waking fantasy life. The second subgroup of 15 took time to achieve a deep trance, saw hypnosis as very different from any prior experiences, and were more likely to exhibit amnesia for both hypnotic experience and waking fantasies.

Adult↗

PubMed1992

Does nasal provocation play a role in the diagnosis and management of ragweed-induced allergic rhinitis?

Twenty-seven patients with ragweed allergic rhinitis were evaluated before the season by allergen-induced nasal reactivity. Symptom scores were recorded during the season, and repeat nasal challenges performed at the end. Nasal response to ragweed insufflation did not predict seasonal symptoms. No change in threshold reactivity occurred at the end of the season, once peak symptoms had passed. In the evaluation of patients with allergic rhinitis, specific nasal challenge did not help predict seasonal clinical symptoms.

Double-Blind Method↗

PubMed1992

A comparison of younger and older gay men's HIV risk-taking behaviors: the Communication Technologies 1989 Cross-Sectional Survey.

Data from the 1989 Communication Technologies cross-sectional survey of gay men in San Francisco indicate that both levels and correlates of sexual risk are different between younger and older gay men. Gay men under the age of 30 report higher risk behavior for human immunodeficiency virus (HIV) infection than do gay men who are 30 years of age or older. Further, the set of correlates of unprotected anal intercourse are different between younger and older gay men. Both young and old gay men report that having a primary partner and a lower perceived impact of the AIDS epidemic on their sexual behavior are associated with risk. However, among young gay men, reporting a lower attributed risk for HIV infection to unprotected anal intercourse, higher concern about AIDS risks, and shorter length of residence in San Francisco are positively correlated with risk-taking behavior. These associations were not statistically significant among gay men 30 years of age or older. It appears that the circumstances and/or reasons for taking sexual risk are different between older and younger gay men. Prevention programs must be designed so that they are sensitive to the needs of each generation of gay men.

Adolescent↗

PubMed1991

Viral and bacterial infection in childhood: the value of C reactive protein.

In 199 children with acute infections admitted to an acute general paediatric ward, the serum C reactive protein (CRP) level, using a simple latex agglutination kit, was compared with standard haematological parameters in distinguishing children with viral and bacterial infections. CRP levels proved superior to any haematological parameters singly or in combination in distinguishing these groups. A CRP level of 1:4 identified all but 13% of children with viral infections and excluded all but 15% of children with bacterial infections. The sensitivity of the test was 87%, the specificity 85%. The positive and negative predictive values were 95% and 74% respectively. Combined haematology, using total white cell count, total neutrophil count and percentage neutrophils, misclassified 26% of patients. CRP estimation could potentially help reduce unnecessary antibiotic prescription and shorten hospitalisation in febrile children. Its use in a general practice setting deserves further study.

Acute Disease↗

PubMed1991

Effects of high doses of topical steroids on both ragweed and histamine-induced nasal provocation.

Patients with ragweed-induced seasonal allergic rhinitis were assigned randomly to be challenged intranasally either with ragweed or histamine while asymptomatic before the ragweed season. After initial challenge, all were treated either by placebo (P), beclomethasone dipropionate (BE), 400 micrograms daily, or budesonide (BU), 1200 micrograms daily, intranasally for 14 days. Repeat challenge was then compared with the previous ones in order to assess the effects of both usual (400 micrograms) and high doses (1200 micrograms) of topical steroids on both allergen-induced and nonspecific (histamine) nasal reactivity. Incremental doses of either histamine or ragweed were insufflated intranasally until a positive response defined the threshold reactivity. Reactions were assessed by a combination of changes in flow rates (rhinomanometry), secretions (mL), and sneezes with ten minutes of challenge. There was no difference in initial threshold reactivities among the treatment groups. Neither BE nor BU changed reactivity to ragweed. There were no adverse reactions except epistaxis in two BU patients. Histamine challenges disclosed a change in threshold reactivity, BU (P much less than .01) greater than BE (P much less than .05), compared with placebo. In summary, even high doses (1200 micrograms) of topical steroids had minimal effects on the early response to intranasal ragweed challenge. In contrast, both usual and high doses affected nonspecific histamine reactivity; this may contribute to some of the clinical improvement noted in symptoms of allergic rhinitis.

Administration, Topical↗

PubMed1991

Guidelines for hemophilia care.

The patient with hemophilia has a multitude of medical and psychosocial concerns. The HIV epidemic has drastically exacerbated his needs. Physicians must continue to educate themselves to keep apace of the rapidly changing treatments for hemophilia and for HIV detection and treatment. These recommendations highlight changes that have taken place in the past several months and are up-to-date as of July 1990. It is likely that they will change, however, as more information becomes known about current factor products and better care for HIV infections.

AIDS Serodiagnosis↗

PubMed1990

Immunophenotyping of acute leukemias using paraffin-embedded tissue sections.

In a study of 55 patients with either acute lymphoid leukemia (ALL; 25 cases) or acute myeloid leukemia (AML; 30 cases), paraffin-embedded bone marrow particle sections were examined with a panel of monoclonal and polyclonal antibodies reactive toward lymphoid and myeloid-associated antigens, using the alkaline phosphatase-anti-alkaline phosphatase (APAAP) technique. All cases were previously classified according to the French-American-British (FAB) Co-operative Group, and cases of ALL were immunophenotyped by flow cytometry. Results indicated that myeloid-associated antibodies (Mac 387, KP 1 [CD68], antielastase, antilactoferrin, and antilysozyme) did not react with any case of ALL, M1-AML, or M6-AML, whereas at least one of these antibodies reacted with 20 of 21 (95%) cases of M2, M3, M4, and M5-AML. Anti-glycophorin C marked cases of M6-AML, whereas anti-CD3 labeled T-cell ALL. None of the antibodies tested specifically identified cases of B-cell ALL. The authors conclude that use of a selected panel of antibodies on paraffin-embedded bone marrow particle sections may be of value in the diagnosis and immunophenotypic classification of many cases of acute leukemias.

Acute Disease↗

PubMed1990

Vitamin E in the treatment of tardive dyskinesia.

Eight subjects with persistent tardive dyskinesia were treated with vitamin E and placebo in a randomized, double-blind crossover study. Their mean score on the Abnormal Involuntary Movement Scale (AIMS) was significantly lower after treatment with vitamin E than after placebo administration.

Adolescent↗

PubMed1990

Self-report of right-left confusion in college men and women.

Self-report questionnaires of difficulty in right-left discrimination and handedness were given to 575 male and 607 female undergraduates. Significantly more men and lefthanders reported having right-left confusion frequently or all the time. The validity of such self-report measures in predicting actual performance on right-left discrimination tasks is questioned since the results, at least as a function of handedness, depended on the question asked.

Adult↗

PubMed1990

Relationships among ragweed skin tests and both allergen specific and nonspecific nasal provocation.

Twenty-six patients with ragweed-induced allergic rhinitis were evaluated prior to the onset of seasonal symptoms. Ragweed skin tests and nasal challenges were performed 2 weeks after histamine nasal provocation. A correlation between ragweed skin tests and nasal challenges was detected (r = .4867, P much less than .01). Histamine challenges did not correlate with either of the other variables. A properly performed skin test predicts nasal reactivity to the same allergen. A clinical role for nonspecific nasal provocation could not be determined.

Adult↗