Biomedical subjects
J H Boyles
Publications and source records attributed to J H Boyles.
Allergic rhinitis: clinical practice guideline. Committee on Practice Standards, American Academy of Otolaryngic Allergy.
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Autoimmune ear disease.
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Efficacy of alternative tests for delayed-cyclic food hypersensitivity.
With the oral challenge food test (OCFT) used as the standard for delayed-cyclic food hypersensitivity diagnosis, blinded comparison studies were accomplished with 175 in vitro food specific IgE and 180 IgG radioallergosorbent tests, 180 food enzyme-linked immune complex assays, and 155 in vivo Multi-Test prick tests. The study was multi-centered, eight physicians and 37 patients participating. All of the compared tests were shown to be approximately 50% efficient when compared with the OCFT results, and, thus, nonefficacious.
Provocation-neutralization: a two-part study. Part I. The intracutaneous provocative food test: a multi-center comparison study.
This study investigated the clinical usefulness of the intracutaneous provocative-neutralization food test (IPFT). Thirty-seven patients were tested for five identical food allergies by eight physicians in different geographical locations. Throughout the study, comparison was made between the IPFT when interpreted by skin response (IPFT SK) and when interpreted by symptom provocation (IPFT PR). Double-blind IPFT results were compared with those of previously accomplished oral challenge food tests (OCFT). IPFT reliability was determined by a double-blind comparison of the initial IPFT, with two subsequent IPFTs performed 7 days apart. Correlation of the IPFT SK and IPFT PR with the OCFT provided validity coefficients of 0.78 and 0.61 respectively, both significant beyond the 0.01 level of confidence. Reliability of the IPFT SK and IPFT PR was shown to be 0.68 and 0.40, respectively. The IPFT SK was significant beyond the 0.01 level of confidence and the IPFT PR was significant beyond the 0.05 level of confidence.
Provocation-neutralization: a two-part study. Part II. Subcutaneous neutralization therapy: a multi-center study.
Presented is a triple-blind crossover study that investigates the efficacy of subcutaneous neutralization food hypersensitivity therapy. Seven physicians and thirty-three patients from various parts of the country participated. Each patient underwent three 2-week treatment sessions, with 1 week off treatment between each session. During each treatment session, one injection a day was given. The injection consisted of a placebo for one 2-week session, and the active allergen during the other two sessions. The active dose was determined by earlier intracutaneous provocative food testing. The diet during the study period was not varied. Medication-symptom diaries were maintained and treatment result evaluations for both individual complaints and overall results were detailed on a standard form at the end of each treatment session. While the number of foods treated per patient varied from 1 to 13, the majority were treated with 3 to 5 foods. Treatment with the active medication was more efficacious than with placebo. A few patients' symptoms were aggravated with the active medication. This indicates a correct diagnosis, but incorrect treatment dose. In the clinical setting such adverse response should be reversed. Overall, neutralization subcutaneous treatment should be beneficial approximately 75% of the time, and further enhanced by supplemental diet manipulation.
Food allergy. Diagnosis and treatment.
The problem of food sensitivity causing chronic disorders of the ear, nose, and throat has been a known fact for many years. Diagnosis and management of the problem are well within the abilities of any concerned otolaryngologist. Precise means of laboratory diagnosis are currently being developed and should aid us in the treatment of this disorder.
Chemical sensitivity. Diagnosis and treatment.
The cases of chemical sensitivity causing chronic disorders of the ear, nose, and throat are becoming increasingly severe. Recognition of this problem is increasing; however, laboratory diagnosis is almost nonexistent. Continued research into this important area of otolaryngologic care is vital.
Allergy testing in otology.
The allergic etiologic factors in many otologic diseases are becoming increasingly apparent. Recent advances in the understanding of mechanisms in atopic allergic reactions have resulted in the development of highly accurate diagnostic tools. The development of the radioallergosorbent test (RAST) for determining specific IgE has lead to very effective techniques of immunotherapy. Unfortunately, the mechanisms involved in nonatopic sensitivity, such as that found in food and chemical allergies, are still poorly understood. It is hoped that research will reveal the mechanisms of nonatopic disease and lead to effective in vitro diagnosis and treatment. Regardless of which techniques are used in diagnosis and treatment, education of the allergy patient is imperative to ensure that long-lasting good results are obtained.
Can private practice survive ... or does anybody care?
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The validity of using the cytotoxic food test in clinical allergy.
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