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Biomedical subjects

E Barton

Publications and source records attributed to E Barton.

At least 19 recordsLinked to original sources
PubMed2007

Avian blood parasites in an endangered columbid: Leucocytozoon marchouxi in the Mauritian Pink Pigeon Columba mayeri.

There is increasing evidence that pathogens can play a significant role in species decline. This study of a complete free-living species reveals a cost of blood parasitism to an endangered host, the Pink Pigeon Columba mayeri, endemic to Mauritius. We investigated the prevalence and effect of infection of the blood parasite, Leucocytozoon marchouxi, in the free-living Pink Pigeon population. Overall, L. marchouxi infection prevalence detected was 18.3%. Juveniles were more likely to be infected than older birds and there was geographical variation in infection prevalence. Survival of birds infected with L. marchouxi was lower than that of uninfected birds to 90 days post-sampling. This study suggests that while common haematozoa are well tolerated in healthy adults, these parasites may have greater pathogenic potential in susceptible juveniles. The study is unusual given its completeness of species sampling (96%) within a short time-period, the accurate host age data, and its focus on blood parasites in a threatened bird species. Species for which long-term life-history data are available for every individual serve as valuable models for dissecting the contribution of particular pathogens to species decline.

Animals↗
PubMed2006

LRRK2 mutations in a clinic-based cohort of Parkinson's disease.

In the last decade, major breakthroughs in the understanding of genetic contributions to Parkinson's disease (PD) have been achieved. Recently, mutations in LRRK2, encoding dardarin, have been found to be responsible for an autosomal dominant parkinsonism (OMIM 607060). We screened 311 subjects (cases: n = 202, controls: n = 109) for the three previously reported LRRK2 mutations. Our investigation revealed a sporadic case of PD with a heterozygous mutation G2019S (c.6055G>A). Here, we present the clinical phenotype of this patient and discuss the implications of genetic testing for the G2019S mutation in patients with sporadic PD.

Adolescent↗
PubMed2001

HLA-DRB3*0101 is associated with Graves' disease in Jamaicans.

OBJECTIVES: Graves' disease is associated with different human leucocyte antigen (HLA) genes in different populations. This studywasdesigned to examinethe HLA class II associations with Graves' disease in Jamaicans. PATIENTS: One hundred and six Jamaicans with Graves' disease and 104 controls. DESIGN: Oligotyping for HLA-DRB1, DRB3, DQA1 and DQB1 alleles was performed using the polymerase chain reaction sequence specific oligonucleotide probe (PCR-SSOP) technique. RESULTS The frequency of HLA-DRB3 *0101 was increased significantly in the patients compared to controls (38.7% vs. 19.2%; RR = 2.72; Pc < 0.015). The protective alleles for Graves' disease were DRB1 *0901 (0.9% vs. 20.2%; RR = 0.04; Pc < 0.001), DRB1*1001 (0.0% vs. 11%; RR = 0.0%; Pc < 0.01) and DRB4 *0101 (0.0% vs. 12.5%; RR = 0.0; Pc < 0.05). A high female to male ratio of Graves' disease, 25 :1, was observed. Other associated autoimmune diseases were rare and no significant HLA class II associations were found with clinical markers of disease. CONCLUSIONS: Jamaican patients with Graves' disease share the DRB3 *0101 susceptible allele and the DRB4 *01 protective allele but not the susceptible haplotype DRB1 *0301, DRB3*0101, DQA1*0501 with Caucasians.

Adolescent↗
PubMed1999

Risk factors for injury to women from domestic violence.

BACKGROUND: Domestic violence is the most common cause of nonfatal injury to women in the United States. To identify risk factors for such injuries, we examined the socioeconomic and behavioral characteristics of women who were victims of domestic violence and the men who injured them. METHODS: We conducted a case-control study at eight large, university-affiliated emergency departments. The 256 intentionally injured women had acute injuries resulting from a physical assault by a male partner. The 659 controls were women treated for other conditions in the emergency department. Information was collected with a standardized questionnaire; no information was obtained directly from the male partners. RESULTS: The 256 intentionally injured women had a total of 434 contusions and abrasions, 89 lacerations, and 41 fractures and dislocations. In a multivariate analysis, the characteristics of the partners that were most closely associated with an increased risk of inflicting injury as a result of domestic violence were alcohol abuse (adjusted relative risk, 3.6; 95 percent confidence interval, 2.2 to 5.9); drug use (adjusted relative risk, 3.5; 95 percent confidence interval, 2.0 to 6.4); intermittent employment (adjusted relative risk, 3.1; 95 percent confidence interval, 1.1 to 8.8); recent unemployment (adjusted relative risk, 2.7; 95 percent confidence interval, 1.2 to 6.5); having less than a high-school-graduate's education (adjusted relative risk, 2.5; 95 percent confidence interval, 1.4 to 4.4); and being a former husband, estranged husband, or former boyfriend (adjusted relative risk, 3.5; 95 percent confidence interval, 1.5 to 8.3). CONCLUSIONS: Women at greatest risk for injury from domestic violence include those with male partners who abuse alcohol or use drugs, are unemployed or intermittently employed, have less than a high-school-graduate's education, and are former husbands, estranged husbands, or former boyfriends of the women.

Acute Disease↗
PubMed1999

Interscorer reliability of the MMPI-2: should TRIN and VRIN be computer scored?

Some clinicians and researchers hand score their MMPI-2 protocols. Graham (1990) noted that TRIN and VRIN involve complex scoring that is best done by a computer. We examined the interscorer reliabilities of TRIN and VRIN and compared these results to the reliabilities of the other validity and clinical scales. Despite the high reliabilities (.97 to 1.00), clerical errors were common (i.e., 7% of the scales were scored inconsistently). Graham's caution about the inherent difficulty of scoring VRIN, but not TRIN, was supported. There were three times as many scoring disagreements for VRIN than any other scale (i.e., 27% of the protocols were in disagreement).

Adult↗
PubMed1998

Acute right lower quadrant pain in a patient with leukemia.

Typhlitis or neutropenic enterocolitis is a life-threatening, necrotizing process of the cecum whose incidence is increasing. It is usually encountered in patients with leukemia who have recently undergone chemotherapy. Neutropenic enterocolitis presents as fever, abdominal pain, and diarrhea in neutropenic patients. As the incidence of neutropenic enterocolitis increases, emergency physicians must be aware of this rapidly progressive and potentially fatal disease.

Abdominal Pain↗
PubMed1998

Occult deep venous thrombosis complicating superficial thrombophlebitis.

PURPOSE: To determine whether superficial thrombophlebitis (STP) can extend into the deep venous system (DVS) and whether this may result in pulmonary embolization. METHODS: All venous duplex ultrasound examinations performed in our vascular laboratory to rule out deep venous thrombosis from June 1, 1994, to June 24, 1996, were reviewed. RESULTS: Of 8313 limbs studied by duplex scanning in 6148 patients, 1756 limbs (21.1%) had a positive result for deep venous thrombosis. STP was demonstrated in 232 limbs (213 patients), of which 20 (8.6%) extended into the DVS. Fourteen (70%) were noted on the initial scan, and six (30%) were detected on serial follow-up scans. Eighteen (90%) originated in the proximal greater saphenous vein and extended across the saphenofemoral junction into the common femoral vein. Nine demonstrated "free-floating" thrombus with a "tongue" extending into the common femoral vein while still attached proximally to the greater saphenous vein. Extension of thrombus from the lesser saphenous vein into the popliteal vein was noted in two cases (10%). One pulmonary embolization was directly observed to occur in real time during scanning. No pulmonary embolization was seen when STP did not involve the DVS. CONCLUSIONS: STP can extend into the DVS. In this series STP of the proximal greater saphenous vein extended into the common femoral vein in 8.6% of the cases, of which 10% embolized to the lungs. When the DVS is involved, standard deep venous thrombosis treatment (heparin, warfarin, bed rest) should be instituted. We recommend duplex imaging for STP involving the greater saphenous vein in the thigh to rule out occult deep venous thrombosis. STP is not always benign and self-limiting as previously described.

Femoral Vein↗
PubMed1994

[Injection therapy of bleeding peptic ulcer with fibrin or polidocanol].

The effectiveness of injecting fibrin (group 1; with adrenalin: n = 11; without adrenalin: n = 29) or polidocanol (with [n = 17] or without adrenalin [n = 8]) or adrenalin alone (n = 15) (group 2) in the arrest of bleeding from peptic ulcers was compared in a prospective randomized study of 80 patients (61 males, 19 females; mean age 66.7 [28-92] years). Both groups were comparable regarding age, sex distribution, ulcer site and haemoglobin concentration. The amount of fibrin injected per patient at the first session averaged 2.9 +/- 1.8 ml, that of polidocanol 3.1 +/- 1.9 ml. The initial injection was successful in all but one patients (40 and 39, respectively). Primary definitive haemostasis was achieved in 59 patients (73.8%), with recurrence of bleeding in 20 (9 and 11: 25%). Recurrent bleeding was always treated with fibrin injection. Definitive haemostasis was achieved by a second application of fibrin in eight patients (10%), so that the definitive haemostasis rate was 83.8%. A second recurrence of bleeding was noted in eight patients, requiring surgical treatment. Four patients died during the second recurrence. It is concluded that injection of fibrin is an effective method of treatment of bleeding ulcer. There was no evidence that fibrin was better than polidocanol with or without adrenaline.

Adult↗
PubMed1994

Thyroid disease in the elderly. Part 1. Prevalence of undiagnosed hypothyroidism.

BACKGROUND: The purpose of this study was to examine the prevalence of previously unrecognized hypothyroidism in elderly patients. METHODS: The study was conducted in a primary care geriatrics clinic. Three hundred seventy elderly patients (287 women, 83 men) between 60 and 97 years of age were included in the study. Medical records of patients were reviewed retrospectively. Serum thyroid-stimulating hormone (TSH), free thyroxine (T4), height, weight, demographic variables, clinical signs and symptoms of hypothyroidism, history of thyroid diseases and treatment with thyroid medications, comorbidities, and current medications were obtained from the medical records. Patients who had both elevated TSH levels (5.0 to 14.9 microU/mL) and normal free T4 levels (0.7 to 2.0 ng/dL) met the criteria for "subclinical hypothyroidism." The criteria for "overt hypothyroidism" were TSH levels > or = 15 microU/mL and low free T4 levels (< 0.7 ng/dL). RESULTS: At the initial visit to the clinic, 18.1% of the patients (62 female and 5 male) had an established history of past or current thyroid disease. Another 20 women (5.4%) had a history of thyroid surgery. Of the remaining 283 patients with no history of thyroid disease, 14.6% of the women and 15.4% of the men had subclinical hypothyroidism. Overt hypothyroidism was discovered and subsequently treated in two female patients and one male patient (1.0% and 1.3%, respectively). Thyroid status was not significantly related to age group (60 to 64 years; 65 to 74; 75 to 84; 85 and older). Comorbidities typically associated with hypothyroidism were no more prevalent in hypothyroid patients than in euthyroid patients. CONCLUSIONS: We found a high prevalence of newly diagnosed subclinical hypothyroidism in both elderly male and female patients. Thyroid status was not related to age or to coexisting diseases. The clinical significance of treating subclinical hypothyroidism merits investigation.

Aged↗
PubMed1994

Thyroid disease in the elderly. Part 2. Predictability of subclinical hypothyroidism.

BACKGROUND: The purpose of this study was to determine how well hypothyroidism could be predicted from clinical signs and symptoms in elderly patients with no known history of thyroid disease. METHODS: This retrospective study was conducted in a primary care geriatrics clinic. Two hundred eighty-three patients (205 women, 78 men), who were between the ages of 60 and 97 years of age and had no history of thyroid disease, were included in the study. Medical records of patients were reviewed for data obtained at their first visit to the clinic: serum thyroid-stimulating hormone (TSH), free thyroxine (T4), height, weight, demographic variables, clinical signs and symptoms of hypothyroidism, previous history of thyroid disease and treatment with thyroid medications, and current medications. RESULTS: Of the 283 patients with no previous history of thyroid disease, 15.4% of men and 14.6% of women had subclinical hypothyroidism (TSH levels of 5.0 to 14.9 microU/mL, and normal free T4 levels [0.7 to 2.0 ng/dL]). Overt hypothyroidism (TSH > or = 15.0 microU/mL, low free T4 < 0.7 ng/dL) was discovered and subsequently treated in one male and two female patients. There were no significant differences (P > .05) in the frequencies of any of the clinical signs and symptoms of hypothyroidism between euthyroid and hypothyroid patients. There was no significant relationship between TSH levels and the total number of hypothyroid symptoms experienced by all patients (r = -.004, P = .99). Logistic regression analyses determined that clinical signs and symptoms were poor predictors of subclinical hypothyroidism in these elderly patients. CONCLUSIONS: Thyroid status could not be predicted from clinical signs and symptoms in this sample of elderly community-dwelling patients. This finding substantiates the difficulty of diagnosing subclinical hypothyroidism in the elderly based solely on clinical features.

Aged↗
PubMed1992

Renal acidosis, thyroiditis, hemolytic anemia: an autoimmune link?

Distal renal tubular acidosis (DRTA) is characterized by a urine of inappropriately high pH in the presence of a metabolic acidosis. Female patients with DRTA may have associated autoimmune disorders. We have described a patient with DRTA, followed by acute thyroiditis and autoimmune hemolytic anemia within 2 years. This combination of autoimmune diseases has not been described previously. These conditions are likely linked by an autoimmune pathogenesis. Clinicians are advised that some patients with DRTA may subsequently have features of any autoimmune disorder as the natural history of the disease.

Acidosis, Renal Tubular↗
PubMed1990

Compartment pressure in the foot. Analysis of normal values and measurement technique.

This clinical trial was carried out to verify the validity of the current objective compartment pressure parameters described in the forearm and leg for use in the foot. The authors evaluated the compartment pressures of the central plantar compartment in 25 normal volunteers (94 separate measurements). In addition to determining an average normal foot compartment pressure, two methods of measurement were compared. Results showed no significant difference in normal values through the use of an arterial line monitor technique (5.98 +/- 2.78 mm Hg [SD]) as compared with a Stryker intracompartmental pressure monitor (4.69 +/- 2.62 mm Hg [SD]). It was found that pedal edema caused a statistically significant increase in pressures. The authors propose a standard technique for pedal compartment pressure measurement and discuss diagnosis and management of compartment syndrome in the foot.

Adolescent↗
PubMed1988

Hepatitis update.

Explore the source record for details and available documents.

Carrier State↗
PubMed1987

Influence on patient management of general practitioner direct access to radiological services.

We have looked at the effect of open radiological access on patient management during a 2-year prospective study in the radiology department of a teaching hospital and two general practices. Five hundred and thirty consecutive requests for radiological examination were studied. Chest radiographs (29.8%) and barium meals (17.4%) were the investigations most commonly requested. At the time of referral general practitioners indicated that if open radiological access had not been available, 78% of the patients would have been referred to specialist clinics. They also indicated that with a normal initial radiological examination only 12% would need referral to a specialist department. Open access appears to save outpatient consultations.

Ambulatory Care↗