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Biomedical subjects

D Baxter

Publications and source records attributed to D Baxter.

At least 19 recordsLinked to original sources
PubMed2006

A qualitative investigation of changes in the belief systems of families of children with autism or Down syndrome.

BACKGROUND: There have been few reports of the world views, values and priorities of families of children with autism or Down syndrome, despite the fact that family belief systems are considered to be among the most important factors affecting the adaptation and resilience of families. METHODS: Transcripts from three focus groups involving 19 key informants (15 parents of children with autism or Down syndrome, and 4 service providers) were analysed using qualitative methods. RESULTS: The themes indicated that raising a child with a disability can be a life-changing experience that spurs families to examine their belief systems. Parents can come to gain a sense of coherence and control through changes in their world views, values and priorities that involve different ways of thinking about their child, their parenting role, and the role of the family. Although parents may grapple with lost dreams, over time positive adaptations can occur in the form of changed world views concerning life and disability, and an appreciation of the positive contributions made by children to family members and society as a whole. Parents' experiences indicate the importance of hope and of seeing possibilities that lie ahead. CONCLUSIONS: The information from this study may be used to provide families with an advance understanding of the changes in beliefs that they might undergo, and assists service providers in providing individualized and family-centred services and supports to families.

Adaptation, Psychological↗
PubMed2004

Process control in municipal solid waste incinerators: survey and assessment.

As there is only rare and scattered published information about the process control in industrial incineration facilities for municipal solid waste (MSW), a survey of the literature has been supplemented by a number of waste incineration site visits in Belgium and The Netherlands, in order to make a realistic assessment of the current status of technology in the area. Owing to the commercial character, and therefore, the confidentiality restrictions imposed by plant builders and many of the operators, much of the information collected has either to be presented in a generalized manner, and in any case anonymously. The survey was focused on four major issues: process control strategy, process control systems, monitors used for process control and finally the correlation between the 850 degrees C/2 s rule in the European waste incineration directive and integrated process control. The process control strategies range from reaching good and stable emissions at the stack to stabilizing and maximizing the energy output from the process. The main indicator to be monitored, in cases in which the focus is controlling emissions, is the oxygen content in the stack. Keeping the oxygen concentration in a determined range (usually between 8 and 12 vol.%) ensures stable and tolerated concentrations of the gaseous emissions. In the case for which stabilization of energy production is the principal aim, the main controlled parameter is the steam temperature and flow-rate, which is usually related to the fuel energetic input. A lot of other parameters are used as alarm criteria, the most common of which is the carbon monoxide concentration. The process control systems used most commonly feature partially automated classical proportional integral derivative (PID) controllers. New and innovative process control systems, such as fuzzy-logic control systems, are still unknown to most plant managers while their performance is reported to be unsatisfactory in plants in which such systems have been tested or are in use. Monitoring components used in process control are still based on classical tools such as thermocouples. The use of modern and more reliable sensors is very limited due to the high initial investment cost or simply the fear of using non-standard technologies. Complying with the 850 degrees C/2 s rule in the European waste incineration directive generally is seen to be a handicap for the process control, either in terms of cost, or flexibility of reaction, or both, particularly in old incineration facilities where such restrictions were not planned in the design.

Belgium↗
PubMed2003

Measurement and interpretation of pneumococcal IgG levels for clinical management.

The detection of pneumococcal IgG antibodies is helpful for the evaluation of response to pneumococcal vaccination and need for revaccination. Results generated by the clinical assay which is currently used, in which the 23 valent polysaccharide vaccine is the antigen, were compared to those obtained by a capsular polysaccharide serotype-specific assay that measures IgG antibodies to 9 common serotypes causing invasive disease. Discrepancies in 21/47 (45%) of the results were observed in a direct comparison between the two assays. In each case a positive titre was obtained on the clinical assay but IgG levels on the serotype-specific assay were below the putative protective level of 0.2 micro g/ml for at least one of the 9 serotypes assayed. The generation of false positives by the current clinical assay is due to its lack of specificity. Antibodies to C-polysaccharide and all of the 23 serotypes included in the pneumococcal polysaccharide vaccine are incorporated into the final titre whereas the serotype-specific assay adsorbs out noncapsular polysaccharide antibodies. The discrepancies between the two assays highlight the importance of standardized assays that measure putative correlates of protection and demonstrate the need to re-evaluate the current clinical assay. A tool that allows the interpretation of the results of the serotype-specific assay is provided and its potential for assessing individual susceptibility levels to vaccine preventable pneumococcal infection is discussed.

Adolescent↗
PubMed2003

Survey of general practitioner satisfaction with a district communicable disease control service.

General practitioners (GPs) have an important role in disease surveillance and control, and are therefore a key target audience for a district communicable disease control (CDC) service. The feedback of surveillance information, and the provision of policies, guidance and specialist advice, are essential functions of a CDC service. This survey was undertaken to assess how well a CDC service was meeting the needs of GPs. Satisfaction with the service was assessed using a questionnaire survey of 166 GPs. The response rate was 42%. GPs reported a high level of overall satisfaction. The service was valued and it influenced GP practice. The service was valued more for responses to requests for information and assistance than for communicable disease control policies. The highest satisfaction was expressed for communication and for immunisation advice. Several areas of need were identified, including the need for surveillance information on antibiotic resistance and for sexually transmitted infections. The survey tool is recommended as a way of auditing standards for Good Public Health Practice, as identified by the Faculty of Public Health Medicine.

Attitude of Health Personnel↗
PubMed2002

The use and reported effects of mobilization with movement techniques in low back pain management; a cross-sectional descriptive survey of physiotherapists in Britain.

Manual therapy is the most commonly used approach in the management of low back pain (LBP) and encompasses a wide range of techniques. The aims of this study were to investigate the current use of mobilizations with movement (MWM) for LBP management in Britain and to inform future clinical research exploring their effects.A postal survey of a random sample of 3295 practising physiotherapists in Britain was conducted. A response rate of 72.1% (n=2357) was obtained. Of these, 48.2% (n=1136) reported treating LBP, of whom 41.1% (n=467) reported using MWMs in LBP management. Therefore, the sample applicable for analysis consisted of these 467 therapists currently treating LBP and using MWMs. Most respondents (51.4%) worked in a national health service setting. Over half of the respondents used MWMs on at least a weekly basis, with 61.9% using MWMs primarily for mechanical LBP. The most commonly reported changes seen immediately after the application of MWMs were increases in range of movement (ROM) (54.4%) and pain relief (27.5%). This was also reflected in the outcomes chosen to evaluate improvement. On average, two spinal levels were mobilized using 2-3 sets of 4-5 repetitions. The lower lumbar levels were treated more often. Most therapists indicated using a combination of other treatment approaches together with MWMs when treating LBP patients. In conclusion, this study is the first to describe the current practice of MWMs by physiotherapists in Britain, and the results will be used to inform the design of a clinical trial exploring the effects of MWMs for LBP.

Clinical Competence↗
PubMed2001

Dietary fiber showed no preventive effect against colon and rectal cancers in Japanese with low fat intake: an analysis from the results of nutrition surveys from 23 Japanese prefectures.

BACKGROUND: Since Fuchs' report in 1999, the reported protective effect of dietary fiber from colorectal carcinogenesis has led many researchers to question its real benefit. The aim of this study is to evaluate the association between diet, especially dietary fiber and fat and colorectal cancer in Japan. METHODS: A multiple regression analysis (using the stepwise variable selection method) was performed using the standardized mortality ratios (SMRs) of colon and rectal cancer in 23 Japanese prefectures as objective variables and dietary fiber, nutrients and food groups as explanatory variables. RESULTS: As for colon cancer, the standardized partial correlation coefficients were positively significant for fat (1,13, P = 0.000), seaweeds (0.41, P = 0.026) and beans (0.45, P = 0.017) and were negatively significant for vitamin A (-0.63, P = 0.003), vitamin C (-0.42, P = 0.019) and yellow-green vegetables (-0.37, P = 0.046). For rectal cancer, the standardized partial correlation coefficient in fat (0.60, P = 0.002) was positively significant. Dietary fiber was not found to have a significant relationship with either colon or rectal cancers. CONCLUSIONS: This study failed to show any protective effect of dietary fiber in subjects with a low fat intake (Japanese) in this analysis, which supports Fuchs' findings in subjects with a high fat intake (US Americans).

Colonic Neoplasms↗
PubMed2001

Physiotherapy based on the Bobath concept in stroke rehabilitation: a survey within the UK.

PURPOSE: The Bobath concept is one of the most widely used approaches in stroke rehabilitation within Europe. This survey aimed to provide an expert consensus view of the theoretical beliefs underlying current Bobath practise in the UK. METHOD: Questionnaires (with sections related to: therapist background, physiotherapy management, theoretical beliefs and gait re-education strategies used) were posted to all senior level physiotherapists working in stroke care (n = 1,022). RESULTS: The majority of respondents had more than 10 year's experience overall and at least 5 years experience in stroke care. The Bobath concept was the preferred approach (n = 67%) followed by an 'eclectic' approach (n = 31%). Despite a high level of consensus between groups, there were 13 significant differences highlighted between Bobath and 'eclectic' groups related to recovery, control of tone, the analysis and facilitation of normal movement and function. In summary. Bobath therapists considered that patients needed to have normal tone and use normal movement patterns in order to perform functional tasks. They would delay patients from performing tasks independently if abnormal tone and movement would be reinforced by task practice. They were not opposed to the use of walking aids and orthotics. CONCLUSIONS: This survey has raised several issues for debate within physiotherapy such as the automatic translation of movement into function, carry over outside therapy, and the way in which tasks should be practiced. The dominance of the Bobath concept needs to be justified by establishing that it is both effective and efficient at achieving its treatment aims of: normalizing tone, improving intrinsic recovery of the affected side and function within everyday tasks.

Humans↗
PubMed2001

Low intensity monochromatic infrared therapy: a preliminary study of the effects of a novel treatment unit upon experimental muscle soreness.

BACKGROUND AND OBJECTIVE: The current study (for which ethical approval was obtained) sought to assess the effect of low intensity monochromatic infrared therapy (LIMIRT) on experimentally induced delayed onset muscle soreness (DOMS). STUDY DESIGN/MATERIALS AND METHODS: Healthy volunteers were recruited (n = 24, 12M:12F) and randomly allocated under strict double blind conditions to one of three experimental groups (n = 8, 4M:4F): Control, Placebo, or Treatment (840 nm; 3.0 J cm(-2), pulse frequency 1 kHz). DOMS was induced in a standardised manner in the biceps brachii of the nondominant arm. Subjects attended on 5 consecutive days during which the degree of pain and functional impairment was assessed. RESULTS: Analysis of results by using nonparametric Freidman and Kruskal-Wallis H tests (with relevant post hoc tests) revealed significant differences (P < 0.05) between Control and LIMIRT treatment groups for pain and tenderness scores. Despite trends in favour of the Treatment group, analysis failed to show any significant differences between the LIMIRT treatment and Placebo groups for all variables except mechanical pain threshold points 3-6 on day 2. CONCLUSION: The results of the current study suggest that LIMIRT is ineffective in the management of DOMS at the parameters investigated.

Female↗
PubMed2001

Health and exposures of United Kingdom Gulf war veterans. Part I: The pattern and extent of ill health.

OBJECTIVES: To assess the health of United Kingdom Gulf war veterans, to compare their health to that of similar personnel not deployed, to describe patterns of ill health in both groups, and to estimate their extent. METHODS: Main Gulf (n=4795) and validation Gulf (n=4793) cohorts were randomly selected within strata from the population deployed to the Gulf and a non-Gulf cohort (n=4790) from those who were not sent. Seven years after the war subjects completed a questionnaire about their health in the past month, including 95 symptom questions and two manikins on which to shade areas of pain or numbness and tingling. Responses were subjected to a principal component analysis with rotation and to a cluster analysis within each cohort. Mean symptom score was used as a measure of severity. Areas shaded on the manikins were coded to indicate widespread pain and possible toxic neuropathy. RESULTS: A response of 85.5% was achieved. Those who had been to the Gulf were more troubled by every symptom with a mean severity score (3.0) substantially greater than in the non-Gulf cohort (1.7). Seven factors were extracted accounting for 48% of the variance. The scores on five factors (labelled psychological, peripheral, respiratory, gastrointestinal, and concentration) were significantly worse in those who had been to the Gulf. Symptoms suggestive of peripheral neuropathy were found more often (12.5%) in the Gulf than the non-Gulf (6.8%) cohorts. Widespread pain was also found more often (12.2% Gulf; 6.5% non-Gulf). Those who had been to the Gulf were found disproportionately (23.8%) in three clusters with high mean severity scores; only 9.8% of non-Gulf respondents were in these clusters. There was no evidence of an important excess in the use of alcohol, tobacco, or referral to hospital specialists by those who had been to the Gulf. For the same level of reported ill health those who had been to the Gulf were less likely to be referred to specialists than non-Gulf veterans. CONCLUSION: 7 Years after the war, the Gulf war veterans were more troubled about their health than those who had not been sent, with a substantial subgroup reporting a pattern of symptoms suggestive of a significant decline in health.

Adult↗
PubMed2001

Health and exposures of United Kingdom Gulf war veterans. Part II: The relation of health to exposure.

OBJECTIVES: To investigate whether, in personnel who served with the United Kingdom forces in the Gulf war, self reported exposures were related to symptoms in a way that was consistent, specific, and credible. METHODS: Responses to symptom and exposure questionnaires, completed 7 or more years after the war, were collected from 7971 subjects deployed in the Gulf, from two exposed cohorts, in a study with an overall response rate of 85.5%. Exposures were considered in three groups, those outside the control of the subjects, the use of prophylaxis, and indicators of susceptibility. Health indices derived from symptom questionnaires were related to reports of 14 exposures in these three groups in a series of multiple regression analyses to allow for confounding. The relation of exposure to complaints of widespread pain and to symptoms suggesting peripheral neuropathy were examined by logistic regression. RESULTS: Consistent but weak correlations between exposures and with health effects were found in independent analyses of the two (main and validation) cohorts. Three exposures outside the control of the subject, the number of inoculations, the number of days handling pesticides, and the days exposed to smoke from oil fires, were consistently and independently related to severity. The number of inoculations was also associated with higher scores on a factor weighted on symptoms associated with skin and musculoskeletal complaints. The number of days handling pesticides related particularly to scores on a neurological factor and to symptoms consistent with toxic neuropathy. CONCLUSION: The relations between exposures and ill health were generally weak. Consistent, specific, and credible relations, warranting further investigation, were found between health indices and two exposures, the reported number of inoculations and days handling pesticides.

Adult↗
PubMed2001

Relationship between mineral and trace element concentrations in drinking water and gastric cancer mortality in Japan.

It is well known that the incidence and mortality from gastric cancer in Japan are the highest in the world. This is thought to be due, in part, to dietary habit, including a high salt intake. There are, however, no epidemiological reports to describe the relationship between ingestion of mineral and trace elements and gastric carcinogenesis. In this study, we determined the concentrations of 14 elements in drinking water from 34 water treatment plants in Aomori Prefecture, Japan, and studied how element concentrations were geographically associated with gastric cancer mortality rate. Gastric cancer mortality was calculated from the data of the Annual Aomori Health Report. Multiple regression analysis (stepwise method of decreasing the number of variables) was performed by using age-adjusted mortality of gastric cancer by gender as objective variables and each element concentration as an explanatory variable. The standardized partial regression coefficient was significant in men for zinc (-0.59, P = 0.004), lead (1.01, P = 0.013), strontium (1.23, P = 0.007), and selenium (-1.62, P = 0.004), whereas it was significant in women for lead (-0.65, P = 0.022), strontium (0.51, P = 0.035), and gold (0.70, P = 0.019). It is suggested that selenium and zinc may aid in the prevention of gastric carcinogenesis. However, the significant relationship of sodium (a component of salt) to gastric carcinogenesis was not observed, although many previous epidemiological studies in Japan have shown this relationship.

Adult↗
PubMed2000

Absorption of ferulic acid from low-alcohol beer.

Flavonoids and monophenolic compounds have been well-described over recent years for their properties as antioxidants and scavengers of reactive oxygen and nitrogen species. A number of epidemiological studies implicate a role for flavonoids in reducing the risk of coronary heart disease. In particular, the focus has been on flavonol-rich fruit and vegetables and flavonoid-rich beverages, especially tea and red wine. Mechanisms of protection are unclear since the absorption, distribution, metabolism and elimination of dietary phenolics have not yet been extensively investigated. Here we report the bioavailability of ferulic acid, 4-hydroxy-3-methoxy-cinnamic acid, the major hydroxycinnamate in beer. Studies of the pharmacokinetics of urinary excretion of ferulic acid from low alcohol beer consumption in humans have been undertaken. The results show that ferulic acid is absorbed with a peak time for maximal excretion of ca. 8 h and the mean cumulative amount excreted is 5.8 +/- 3.2 mg. These findings are consistent with the uptake of ferulic acid from dietary sources, such as tomatoes, and suggest that ferulic acid is more bioavailable than individual dietary flavonoids and phenolics so far studied.

Adult↗
PubMed1999

Respiratory sinus arrhythmia of brainstem lesions.

In this pilot study we investigated the hypothesis that intrinsic and extrinsic brainstem lesions situated within the pontomedullary region would effect the integrity of respiratory sinus arrhythmia. The study sample consisted of three patients with anatomic brainstem abnormalities associated with isolated Chiari I malformation, Chiari II malformation with syringobulbia, and achondroplasia with cervicomedullary compression. They were compared to an age- and sex-matched control group of nine patients. Each subject's electrocardiogram was recorded in a quiet room and digitized by a personal computer during five 1-minute periods. R-R intervals within each 1-minute period were converted to heart rate in 120 successive 0.5-second intervals. The resultant heartrate time series was converted to its underlying frequency composition by a fast Fourier transform and averaged across minutes. Respiratory sinus arrhythmia was defined as the variability in the time series over a frequency range (0.096 to 0.48 Hz) corresponding to a range of respiratory rates from 6 to 30 breaths per minute. Analysis revealed a significant reduction in respiratory sinus arrhythmia (P < .05), defined as the summated area under the curve, with a mean for controls of 35.42+/-28.13 SD and for subjects of 17.20+/-11.50 SD. There was a gradient of abnormality noted, with the mildest deviation in respiratory sinus arrhythmia for the patient with isolated Chiari I malformation and maximum deviation seen in the patient with extrinsic cervicomedullary compression.

Achondroplasia↗
PubMed1999

Case register study of suicide risk in mental disorders.

BACKGROUND: There have been few large-scale studies of long-term suicide risk in mental disorders in the UK. AIMS: To estimate the long-term risk of suicide in psychiatric patients. METHOD: A sample of 7921 individuals was identified from the Salford Psychiatric Case Register. Mortality by suicide or undetermined external cause during a follow-up period of up to 18 years was determined using the NHS Central Register; suicide risks were estimated as rate ratios. RESULTS: Suicide risk was increased more than ten-fold in both genders: the rate ratio for males was 11.4; for females it was 13.7. The risk was highest in young patients, but high risk continued into late life. The diagnoses with the highest risk were schizophrenia, affective disorders, personality disorder and (in males) substance dependence. Risk was also associated with recent initial contact and number of admissions but not comorbidity. CONCLUSIONS: The suicide risks estimated in this study are generally higher than those previously reported, notably in schizophrenia and personality disorder, and in previous in-patients. Patients with these high-risk diagnoses, an onset of illness within the previous 1-3 years, or more than one previous admission should be regarded as priority groups for suicide prevention by mental health services.

Adolescent↗
PubMed1998

Design, synthesis, and pharmacological evaluation of conformationally constrained analogues of N,N'-diaryl- and N-aryl-N-aralkylguanidines as potent inhibitors of neuronal Na+ channels.

In the present investigation, the rationale for the design, synthesis, and biological evaluation of potent inhibitors of neuronal Na+ channels is described. N,N'-diaryl- and N-aryl-N-aralkylguanidine templates were locked in conformations mimicking the permissible conformations of the flexible diarylguanidinium ion (AS+, AA+, SS+). The resulting set of constrained guanidines termed "lockamers" (cyclophane, quinazoline, aminopyrimidazolines, aminoimidazolines, azocino- and tetrahydroquinolinocarboximidamides) was examined for neuronal Na+ channel blockade properties. Inhibition of [14C]guanidinium ion influx in CHO cells expressing type IIA Na+ channels showed that the aminopyrimidazoline 9b and aminoimidazoline 9d, compounds proposed to lock the N,N'-diarylguanidinium in an SS+ conformation, were the most potent Na+ channel blockers with IC50's of 0.06 microM, a value 17 times lower than that of the parent flexible compound 18d. The rest of the restricted analogues with 4-p-alkyl substituents retained potency with IC50 values ranging between 0.46 and 2.9 microM. Evaluation in a synaptosomal 45Ca2+ influx assay showed that 9b did not exhibit high selectivity for neuronal Na+ vs Ca2+ channels. The retention of significant neuronal Na+ blockade in all types of semirigid conformers gives evidence for a multiple mode of binding in this class of compounds and can possibly be attributed to a poor structural specificity of the site(s) of action. Compound 9b was also found to be the most active compound in vivo based on the high level of inhibition of seizures exhibited in the DBA/2 mouse model. The pKa value of 9b indicates that 9b binds to the channel in its protonated form, and log D vs pH measurements suggest that ion-pair partitioning contributes to membrane transport. This compound stands out as an interesting lead for further development of neurotherapeutic agents.

Animals↗
PubMed1998

Respiratory sinus arrhythmia in children with severe cyanotic and pallid breath-holding spells.

In this study we investigated centrally mediated parasympathetic regulation of modulated cardiac vagal tone among children with severe cyanotic and pallid breath-holding spells by examining respiratory sinus arrhythmia. Respiratory sinus arrhythmia was evaluated in 41 children; 17 subjects with cyanotic breath-holding spells (6 boys, 11 girls; mean age 37.1 months), 7 subjects with pallid breath-holding spells (2 boys, 5 girls; mean age 33.0 months), and 17 controls (8 boys, 9 girls; mean age 41.2 months). Subjects had recurrent (more than 3) severe breath-holding spells. Each subject's electrocardiogram was recorded in a quiet room and digitized by an 80386 personal computer during five 1-minute periods. R-R intervals within each 1-minute period were converted to heart rate in 120 successive 0.5-second intervals. The resultant heart rate time series was converted to its underlying frequency composition by a fast Fourier transform and averaged across minutes. Respiratory sinus arrhythmia was defined as the variability in the time series over a frequency range (0.096 Hz to 0.48 Hz) corresponding to a range of respiratory rates from 6 to 30 breaths per minute. ANCOVA adjusting for age and sex was conducted with the subject group as the independent measure. There were no significant differences between subjects with cyanotic breath-holding spells and controls. Pallid breath-holding spell subjects had a marked difference in respiratory sinus arrhythmia from either controls or subjects with cyanotic breath-holding spells, demonstrating less variability in respiratory sinus arrhythmia (P < .042) This study supports the hypothesis that there exists autonomic dysregulation in pallid breath-holding spells, caused by a primary central parasympathetic disturbance distinct from the dysregulation found in cyanotic breath-holding spells.

Apnea↗
PubMed1998

Lymphoid markers, activation markers, and adhesion molecules in cutaneous biopsy specimens from HIV+ patients with disease progression. The Military Medical Consortium for the Advancement of Retroviral Research.

BACKGROUND: One important factor in understanding the pathogenesis of human immune deficiency virus (HIV) disease is documenting the patterns of immune dysregulation present in HIV-positive patients. The cells which home to skin are mainly certain subsets of T cells and, as opposed to the peripheral blood, where circulating factors may inhibit terminal phenotypic differentiation, the cutaneous environment potentiates differentiation during cutaneous eruptions. OBJECTIVE: The authors' aim was to characterize the inflammatory dermatoses in biopsy specimens from HIV-positive patients with immunohistochemical stains for lymphoid markers, activation markers, and adhesion molecules and to determine if there was any correlation with the type of dermatosis and the HIV-disease stage. METHODS: Lymphoid and activation markers as well as adhesion molecules were studied on cutaneous biopsy specimens from 96 inflammatory dermatoses in HIV-positive patients. The dermatoses included psoriasiform dermatoses with and without a lichenoid component, perivascular lymphoid dermatoses, perivascular and periadnexal inflammatory dermatoses, spongiotic dermatoses, granulomatous dermatoses, and neutrophilic dermatoses with and without vasculitis. RESULTS: Although there was a decrease in CD4/CD8 ratios in the cutaneous inflammatory dermatoses with progression of the disease, the ratios of CD4/CD8 cells were far higher than those in the peripheral blood. There were also increasing numbers of CD23+ cells and increased E-Selectin expression on endothelial cells from the early stages of disease, with no consistent pattern of ICAM-1 expression on epithelial cells with disease progression. CONCLUSIONS: The expression of lymphoid markers, activation markers, and adhesion molecules in the skin with progression of HIV disease, is consistent with a T helper (Th)1 to Th0/Th2 cytokine pattern of immune dysregulation. This cytokine pattern may be modified by the cytopathic effects of HIV on lymphoid and dendritic populations and by effects of other concurrent infections. Significant numbers of CD4+ T cells in skin infiltrates, with low peripheral CD4 T-cell counts, suggest that the cutaneous T-cell populations may be distinctive.

Antigens, CD↗