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Biomedical subjects

J C Selner

Publications and source records attributed to J C Selner.

At least 37 records · Page 2Linked to original sources
PubMed1990

Neuropsychophysiology during relaxation in generalized, universal 'allergic' reactivity to the environment: a comparison study.

Comparisons were made among a group of patients presenting with universal 'allergic' intolerance to environmental chemicals (universal reactor, n = 58), a group of control subjects without psychologic symptoms (control, n = 55) and a group of outpatients from a psychology practice (psychologic, n = 89) on neuropsychophysiological measures during relaxation. The measures were electroencephalographic (EEG) spectral category for frequencies below 15 Hz, EEG beta activity, scalp electromyography (EMG), peripheral temperature (TEMP), and skin resistance level (SRL). The distributions of subjects in each group across eight EEG spectral categories were significantly different, with the distribution for universal reactors the same as that of the psychologic patients (p = 0.22), and both different from the distribution of controls (p less than 0.001). High levels of EEG beta activity were observed in more universal reactors and psychologic patients than in controls (p = 0.04). High levels of EMG scalp activity were observed in a greater number of universal reactors than in subjects in the other two groups (p less than 0.001). The three groups did not differ in TEMP and SRL. Implications of neuropsychophysiologic stress profiling for the diagnosis and treatment of psychosomatic illness are discussed.

Adult↗
PubMed1990

Anaphylaxis to piñon nuts.

A 21-year-old white male developed life threatening systemic anaphylaxis within seconds of ingesting a small amount of a cookie containing piñon nuts. Skin testing, ELISA, and basophil histamine release studies demonstrated piñon nut-specific IgE. Electrophoresis of the piñon nut extract demonstrated 30 bands, three of which (in the 66 to 68,000 dalton range) bound IgE in the patient's serum in an immunoblot. Ingestion challenge was not performed due to the severity of the patient's reaction. Although used for centuries in certain cultures, piñon nuts are now being eaten more frequently in the American diet. Physicians should be aware of the potential for anaphylactic reactions following ingestion of this food.

Adult↗
PubMed1990

The hidden tonsils of Waldeyer's ring.

The visible and the hidden tonsils of Waldeyer's ring merit attention from specialists in allergy and clinical immunology not only because they are sites of antigen recognition and synthesis of antibody, including IgE, but also because they may produce a wide range of symptoms in the upper airway. Ordinarily, such symptoms may be differentiated from those of classic allergic rhinitis, but allergists commonly see patients with a variety of upper airway complaints that on investigation prove not to have an allergic basis. Use of flexible fiberoptic upper airway endoscopy, a simple office procedure that permits direct inspection of the recessed areas of the upper airway, will result in timely evaluation and treatment of pathology of these upper airway lymphatic structures, and identification of patients requiring referral to another specialist.

Humans↗
PubMed1989

Evaluation of nasal patency by fiberoptic rhinoscopy.

A novel method of assessing anterior nasal patency by flexible fiberoptic rhinoscopy was evaluated in two centers by comparison with active anterior rhinomanometry. Rhinoscopy and rhinomanometry were performed 20 times on each of 14 subjects during 14 to 26 minutes. The procedure was videotaped, and nasal airway area was measured from a video monitor. The mean coefficients of variation for rhinoscopy and rhinomanometry were 14% and 19%, respectively. Another investigator examined five subjects by rhinoscopy 30 times in 15 minutes; the mean coefficient of variation was 9%. These means were not significantly different. Rhinoscopy and rhinomanometry were performed at 30-minute intervals for a 6-hour period in 13 subjects. Three investigators independently evaluated results for changes in nasal function characteristic of the nasal cycle. Rhinoscopy detected the nasal cycle in an average of 72% of subjects and rhinomanometry in 49%. Both methods detected the response to topically applied oxymetazoline and methacholine. Results indicate that, whereas the two procedures evaluate different aspects of nasal function, their precision is similar. Rhinoscopy additionally permits evaluation of nasal mucosal changes occurring from disease or treatment.

Airway Resistance↗
PubMed1989

Loratadine-pseudoephedrine combination versus placebo in patients with seasonal allergic rhinitis.

Two hundred sixty-four patients with moderate to severe seasonal allergic rhinitis were treated with loratadine 5 mg plus pseudoephedrine 120 mg twice a day or placebo in a 28-day multicenter study. Four nasal and four non-nasal symptoms were evaluated for efficacy. At the last evaluable visit, the active treatment group had significantly lower (P = .05) mean combined nasal and non-nasal symptom scores than the placebo group. Also, the physician's rating of overall therapeutic response was significantly better in the active-treatment group (P = .03). Dry mouth, insomnia, and nervousness were reported by a significantly greater proportion (P less than or equal to .04) in the active-treatment group. Sedation occurred in 7% of patients in each treatment group and 6% of patients in each group discontinued the study because of adverse experiences. Loratadine plus pseudoephedrine was safe and significantly more effective than placebo in relieving the symptoms of allergic rhinitis.

Adolescent↗
PubMed1988

Visualization techniques in the nasal airway: their role in the diagnosis of upper airway disease and measurement of therapeutic response.

Flexible fiberoptic rhinopharyngolaryngoscopy permits the examination of most areas of the upper airway that heretofore have not been easily visualized with other available techniques. Use of the flexible fiberscope is safe, convenient, quick, and cost efficient. Abnormalities can be easily seen relating to the septum, turbinates, and mucosa, as well as the nasopharynx, adenoids, eustachian orifice, tonsils, posterior tongue, epiglottis, glottis, and vocal cords. The origin of nasal polyps can also be identified. Furthermore, effects of treatment can be followed with the fiberscope as well. For example, when flunisolide is given to a patient with allergic rhinitis, the reduction of nasal obstruction and edema can be easily visualized.

Endoscopy↗
PubMed1988

Sensitivity to sulfited foods among sulfite-sensitive subjects with asthma.

Eight individuals with asthma who had been diagnosed as sulfite sensitive on the basis of double-blind capsule-beverage challenges were subjected to challenges with various sulfited foods, including lettuce, shrimp, dried apricots, white grape juice, dehydrated potatoes (as mashed potatoes), and mushrooms. Four of these patients failed to respond to challenges with any of the sulfited foods. The other four patients experienced a decrease in pulmonary function on double-blind challenges with sulfited lettuce. Two of three of these patients reacted to challenges with dried apricots and white grape juice; the fourth patient has not yet been challenged with these products. Only one of these four patients reacted to challenges with dehydrated potatoes and mushrooms, and, in this case, the response to double-blind challenges with dehydrated potatoes was not consistent. None of the sulfite-sensitive subjects with asthma responded to challenges with sulfited shrimp. It is concluded that sulfite-sensitive subjects with asthma will not necessarily react after ingestion of sulfited foods. The likelihood of a reaction is dependent on the nature of the food, the level of residual sulfite, the sensitivity of the patient, and perhaps on the form of residual sulfite and the mechanism of the sulfite-induced reaction.

Adult↗
PubMed1988

Comparison of parallel line skin test assay (PLST) and ELISA inhibition (EI) methods for determination of relative potency of polymerized grass and ragweed antigenic extracts.

Relative potency estimates were performed by parallel line skin test assay (PLST) and ELISA inhibition methods for three polymerized allergen extracts (Bermuda grass, orchard grass, and a copolymer of short and giant ragweed) versus four unmodified RAST standardized reference extracts (Bermuda grass, orchard grass, and giant and short ragweed) in nine subjects. One subject experienced a systemic reaction, requiring treatment at the end of the PLST assay. Another subject had a systemic reaction during limited skin testing performed approximately 72 hours after completion of PLST. Relative potency values for the polymerized extracts obtained by PLST were much lower than those obtained by ELISA inhibition, but results were significantly (r = 0.95; p less than 0.01) correlated. Because polymerized allergen extracts are designed to be hypoallergenic, a skin test assay may underestimate their potency relative to an unmodified reference extract.

Binding, Competitive↗
PubMed1987

Vocal cord dysfunction: the importance of psychologic factors and provocation challenge testing.

We present three case reports involving patients with vocal cord dysfunction. The onset of symptoms in one case was coincident with a generalized cutaneous reaction to penicillin with laryngeal involvement. The other cases had been misdiagnosed as food allergy and chemical sensitivity. We describe the psychologic factors in these cases in terms of the primary and secondary gain operative in the somatoform disorder of conversion reaction and emphasize the importance of belief and learned sensitivity in the induction of symptoms. The necessity of considering psychologic factors and the use of blinded, controlled, provocation challenges to evaluate subjective symptomatology is underscored. This study emphasizes the heterogenicity of clinical presentations involving vocal cord dysfunction and illustrates the value of fiberoptic-assisted examination of laryngeal function in conjunction with provocation challenge testing in establishing causal relationships for specific clinical symptoms.

Adult↗
PubMed1986

A group comparative study of the safety and efficacy of nedocromil sodium (Tilade) in reversible airways disease: a preliminary report.

Nedocromil sodium in a dose of 4 mg b.i.d. or q.i.d. by inhalation was used to treat asthmatic patients in a double-blind, placebo-controlled, randomized, parallel study. 80 patients (39 active drug and 41 placebo) received q.i.d. dosage and 87 patients (45 active drug and 42 placebo) received b.i.d. dosage. The patients selected were not on oral or inhaled steroids but required oral sustained-release theophylline with or without an inhaled beta-agonist aerosol. There was a significant reduction in daytime asthma symptoms (p = 0.04) and asthma severity (p less than 0.01) 6 weeks after the onset of therapy in the nedocromil sodium q.i.d. treated group as compared with placebo. In the nedocromil sodium b.i.d. treated group, the following variables showed statistically significant improvements compared with placebo: daytime and night-time asthma (p = 0.002 in both instances), wheezing assessed by auscultation (p = 0.03) and overall asthma severity (p less than 0.01). All these variables showed improvements within 2 weeks of the onset of therapy and became statistically significant at 6 weeks. Side-effects were minor and occurred only in a small number of patients. It can be concluded from this study that nedocromil sodium is a safe and effective drug in the management of asthma.

Adrenal Cortex Hormones↗
PubMed1985

Cromolyn sodium in seasonal allergic conjunctivitis.

A formulation of 2% cromolyn sodium (CS) ophthalmic solution without the preservative, 2-phenylethanol, was compared with placebo in 58 patients with seasonal allergic conjunctivitis. Selection was based on history and positive skin tests. Neither immunotherapy nor use of antihistamines was allowed. This study was double-blinded and stratified by RAST scores to assure comparable groups. Either CS or placebo was used six times daily. Patients were observed weekly for 5 weeks during the peak of the fall weed-pollen exposure. Nasal symptoms were treated as required with beclomethasone nasal spray, and uncontrolled ocular symptoms were treated with boric acid and ephedrine solution. Nasal and ocular symptoms were recorded. There was a significant suppression of eye symptoms in the group receiving CS ophthalmic solution (p less than 0.02) during weeks 2, 4, and 5. There was a trend for nasal symptoms and the requirement for nasal beclomethasone to be less in patients receiving CS.

Adolescent↗
PubMed1985

Viral contamination of intradermal skin test syringes.

Intradermal skin tests are often performed using a common syringe with multiple needles. Bacterial contamination of intradermal skin test syringes can occur as a result of apparent siphoning caused by needle changing. The bacterial contamination of the syringe can be prevented by flushing the contaminated needle prior to changing. In this study, two different needle changing techniques were examined using a polio virus contaminant. Viral contamination of the syringe was not prevented by flushing the infected needle prior to removal. All syringes were contaminated with virus regardless of needle changing technique. We, therefore, cannot recommend the continued use of a common syringe for intradermal skin tests between patients regardless of needle changing technique.

Equipment Contamination↗
PubMed1985

Inhaled metabisulfite sensitivity.

Sensitivity to an inhaled sulfite-containing solution was evaluated in 13 asthmatics and ten nonasthmatic controls. Three of the 13 asthma patients were known to be sensitive to ingested sulfite and ten were not sensitive. All three sulfite-sensitive patients developed bronchospasm following sulfite inhalation challenges. Four of the ten asthmatics not sensitive to ingested sulfite developed bronchospasm following sulfite inhalation. The control subjects showed no reaction to inhaled sulfite. This study demonstrated that all asthmatics sensitive to ingested sulfite developed bronchoconstriction with inhaled sulfite. Furthermore, sensitivity to inhaled sulfite was more common than sensitivity to ingested sulfite in asthmatic patients. Possible reasons for this difference are discussed.

Administration, Oral↗
PubMed1985

Rhinolaryngoscopy in the allergy office.

Rhinolaryngoscopy is a valuable diagnostic and treatment assessment tool for the allergist. We present a method for office use of the rhinolaryngofiberscope and review our experience with 400 consecutive examinations.

Endoscopes↗
PubMed1985

The practical approach to the evaluation of suspected environmental exposures: chemical intolerance.

The purpose of this article is to encourage allergists to expand their interest in environmental intolerance to include chemicals found in everyday exposure. By incorporating controlled challenge procedures into outpatient practice capabilities, the practicing allergist can expand both clinical interest and practice potential. By merging scientific principles of toxicology and psychology with the traditional investigative skills of the well-trained clinical allergist, we believe that discipline of allergy/immunology can realize a rather remarkable new dimension.

Bronchial Provocation Tests↗