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Biomedical subjects

J L Baldwin

Publications and source records attributed to J L Baldwin.

At least 19 recordsLinked to original sources
PubMed2001

Identification of carmine allergens among three carmine allergy patients.

BACKGROUND: There have been several reports of carmine allergy; however, identification of the responsible carmine allergens has not been widely documented. METHODS: Three female patients presented with a history of anaphylaxis and/or urticaria/angioedema after ingestion of carmine-containing foods. All three patients had 4+ skin prick tests to carmine. Among them, two patients were confirmed to have carmine allergy by blinded, placebo-controlled food challenges to carmine. SDS-PAGE of cochineal insects and carmine, immunoblotting for IgE antibody with sera from all three patients, and immunoblotting inhibition with carmine were performed. RESULTS: SDS PAGE of minced cochineal insects revealed several protein bands of 23-88 kDa. Several of these bands were variably recognized by our three patients' sera, and this reactivity was inhibited by carmine. Although no protein bands could be visualized on SDS-PAGE of carmine in Coomassie brilliant blue staining, three protein bands were recognized by two of the three patients' serum. CONCLUSIONS: These results suggest that commercial carmine retains protein-aceous material from the source insects. These insect-derived proteins (possibly complexed with carminic acid) are responsible for IgE-mediated carmine allergy. Patient reactivity to these proteins may vary.

Administration, Oral↗
PubMed1997

Popsicle-induced anaphylaxis due to carmine dye allergy.

BACKGROUND: IgE-mediated hypersensitivity is a suggested mechanism to explain adverse reactions from carmine-containing products. OBJECTIVE: To describe a patient who experienced anaphylaxis after ingestion of a popsicle colored with carmine and to provide additional evidence that the adverse reaction was IgE-mediated. METHODS: The patient and her husband underwent skin prick tests to the popsicle and carmine. The patient also received skin prick tests and/or open oral challenge to each of the other components of the incriminated food. Topical application of cosmetics with and without carmine to the patient's forearm was also performed. To confirm carmine-specific IgE, a Prausnitz-Kustner (P-K) test was performed using the patient's husband as recipient. Twenty control subjects also were tested to carmine by skin prick test. RESULTS: The patient showed 4+ skin prick test responses to the popsicle and carmine. Skin prick tests and/or open oral challenge to each of the other components of the popsicle were negative. The patient's husband's and 20 control subjects' skin prick tests to carmine were negative as was the patient's husband's skin prick test to the popsicle. Skin prick test reactivity to the popsicle and carmine were successfully transferred to the patient's husband in P-K format. Cosmetics applied to the patient's forearm elicited no immediate response. CONCLUSION: The positive skin prick tests to the popsicle and carmine and the successful (P-K) transfer of skin prick test reactivity support a carmine-specific, IgE-mediated mechanism in explaining our patient's popsicle-induced anaphylaxis.

Adult↗
PubMed1996

Uncemented total knee arthroplasty: report of 109 titanium knees with cancellous-structured porous coating.

One hundred twenty-three uncemented total knee arthroplasties were performed between November 1986 and November 1989. The implants were pure titanium with porous coating for bony ingrowth. One hundred nine of these knees were followed for 2 to 5 years (average: 31.5 months). Clinical evaluation of the results, using the Hospital for Special Surgery Knee Rating Scale, revealed an increase in the average knee score from 62.9 preoperatively to 92.5 postoperatively, with excellent or good results in 94.5% of the cases. Thirteen knees (12%) had 26 radiolucent lines or areas. There was no complete lucency underneath any implant, and no knees were revised for loosening. One knee required replacement of the tibial insert for instability. While titanium implants were successful in achieving secure fixation and high knee scores in the short term, longer follow up will be necessary for more definitive conclusions, especially in regard to the potential problems with titanium wear debris.

Adult↗
PubMed1996

The effect of bone quality on the outcome of ingrowth total knee arthroplasty.

Bone quality generally is felt to be an important consideration when planning total knee arthroplasty (TKA). This prospective study was conducted to see if bone quality, as assessed intraoperatively in 346 knees, affects the outcome of ingrowth TKA. Group A consisted of 272 knees with good or excellent bone quality in all areas and Group B consisted of 74 knees with fair or poor bone in at least one area. The average follow-up was 48 months, with 301 knees (87%) available for follow-up. Group A knees had more males, were heavier, had fewer patients with rheumatoid arthritis, and exhibited more varus. Preoperatively, Groups A and B had modified Hospital for Special Surgery (HSS) knee scores that averaged 55 and 48, respectively. At 4 years post-surgery, Groups A and B had HSS scores of 92 and 90, respectively. Fluoroscopic radiographs of the bone-prosthesis interfaces showed 13% incomplete radiolucencies in Group A and 7% in Group B. A complete radiolucency was seen in one patient in Group A. Based on these results, it can be concluded that bone quality as determined by gross intraoperative inspection had little effect on the 4-year outcome of this ingrowth TKA.

Aged↗
PubMed1995

How patients determine when to replace their metered-dose inhalers.

BACKGROUND: One factor that has been suggested as a possible contributing factor to the rise in asthma morbidity and mortality in the United States is utilization of metered-dose inhalers after the canister has reached its specified maximum number of actuations. METHODS: We surveyed patients using inhalers as to their awareness of the manufacturer's listed maximum number of actuations for the inhalers they were using, their methods for determining when to replace their inhalers, and the replacement methods they thought were best. We also determined the number of actuations existing in inhalers beyond the specified maximum number listed by the manufacturer, and determined the flotation status of the inhalers after that listed number had been actuated. RESULTS: Fifty-four percent of patients surveyed were unaware of the specified maximum number of actuations listed by the manufacturer for the inhalers they were currently using. Only 8% reported tallying the number of actuations used. All canisters tested contained a greater number of total actuations than the number listed by the manufacturer. There was no universal flotation status that accurately reflected when these canisters had reached their respective specified maximum number. CONCLUSIONS: Both lack of knowledge and inhaler replacement practices likely cause patients to extend the use of their metered-dose inhalers beyond the specified maximum number of actuations. This practice may well contribute to the documented rise in asthma morbidity and mortality.

Asthma↗
PubMed1992

Factors that influence passive transfer of immunoglobulins in foals.

Effects of farm management, breed, mare age, gestation duration, and climatologic factors on colostral specific gravity, colostral IgG concentration, and foal serum IgG concentration were evaluated. Climatologic variables measured were daily maximal, minimal, and mean air temperature, precipitation, average relative humidity, and total solar radiation. Presuckle, postpartum colostrum samples were collected from 140 Standardbred, 94 Thoroughbred, and 59 Arabian mares from January through June during 1985 and 1986. Thoroughbred (farm A, n = 61; farm B, n = 33) and Arabian (farm C, n = 45; farm D, n = 14) mares were located in Ocala, Fla; Standardbred mares (farm E) were in Montgomery, NY. Mares from farms A, B, D, and E foaled in box stalls, and mares from farm C foaled in sand paddocks. Mares with premature lactation greater than 12 hours were not included in the study. Foals were clinically normal at birth and suckled colostrum without assistance within 2 hours of parturition. Specific gravity of presuckle colostrum samples was measured by use of an equine colostrometer. Blood samples were collected 18 hours after parturition from 253 of the 293 foals (n = 45, 25, 32, 13, 138 on farms A through E, respectively) to determine serum concentration of IgG. The IgG concentrations in colostrum and serum were measured by single radial immunodiffusion. Data were analyzed by multiple regression or chi 2 analysis. The most important determinants of foal serum IgG concentration were the IgG content and specific gravity of presuckle colostrum samples (P less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Husbandry↗
PubMed1991

Prevalence (treatment days) and severity of illness in hypogammaglobulinemic and normogammaglobulinemic foals.

Serum samples for determination of IgG concentration were obtained between postpartum hours 18 and 48 from 132 Standardbred foals. Results of the IgG assay were not known to farm personnel. None of the foals was given plasma IV for treatment of hypogammaglobulinemia. Foal health records were examined retrospectively to determine prevalence of infectious-type illness (foal treatment days [FTD]), prevalence of life-threatening infectious illness (foal treatment days-serious condition [FTD-SC]), and number of diseases (NOD) per foal. Values for FTD, FTD-SC, and NOD per foal were compiled for the first 21 days of life and for the first 90 days of life. The FTD, FTD-SC, and NOD per foal values were compared for foals with less than 400 mg of IgG/dl and for foals with greater than or equal to 400 mg of IgG/dl; the same variables were compared for foals with less than 800 mg of IgG/dl and for foals with greater than or equal to 800 mg of IgG/dl. Statistical analysis indicated that IgG concentration was not associated with FTD, FTD-SC, or NOD in foals of any of the groups. Also, despite a large subpopulation of hypogammaglobulinemic foals (13.6% with less than 400 mg of IgG/dl and 44.7% with less than 800 mg of IgG/dl), the 21-day and 90-day overall survival rates were 100 and 99.2%, respectively. The data strongly suggest that serum IgG concentration was not related to prevalence or severity of illness or to survival rate in this population of foals.

Agammaglobulinemia↗
PubMed1987

Early pregnancy loss in brood mares.

During 1985, linear-array ultrasonography was used to study early pregnancy loss in commercial brood mares: 600/1115 (54%) of the cycles resulted in detected pregnancy at Week 2 after ovulation and 80 (13%) of these pregnancies resulted in early pregnancy loss. The pregnancy loss rate was significantly higher (P less than 0.05) for twin pregnancies (10/41) than for singleton pregnancies (70/559). The pregnancy loss rate was significantly higher (P less than 0.05) at 2-4 weeks (29/60) than at 6-8 weeks (12/60). The pregnancy rate was significantly less (P less than 0.05) for post-partum mares inseminated at the foal heat (157/302) than for those inseminated at a subsequent oestrus (203/334). Mares with a history of endometritis had a significantly higher (P less than 0.05) per cycle pregnancy loss rate (7/26) than did mares with a history of not having endometritis (64/498). When mares that had lost pregnancies were re-mated, 37/75 (49%) detectable pregnancies resulted and 7 (19%) of these pregnancies were again lost. The per cycle pregnancy rate was 56% (153/273), 55% (177/319), 60% (130/216), 51% (72/142), 45% (34/76) and 33% (12/36) for mares aged 2-5, 6-9, 10-13, 14-17, 18-21 and greater than 21 years, respectively. The corresponding per cycle pregnancy loss rates were 12%, 14%, 9%, 14%, 24% and 33%.

Animals↗
PubMed1977

Bone marrow transplantation in patients with gold-induced marrow aplasia.

Aplastic anemia is a rare but usually fatal complication of gold salt therapy for rheumatoid arthritis. This report describes 3 patients who developed aplastic anemia while receiving gold salts, and a fourth patient who developed aplastic anemia after receiving gold and then cytotoxic agents. These patients failed to respond to conventional therapy for aplastic anemia and subsequently received bone marrow transplants from HLA-matched siblings. Engraftment occurred in all 4 patients. One patient is alive 2 years after transplantation, and 3 patients died of complications following transplantation.

Adult↗
PubMedDate not supplied

Allergen-induced inflammation and the role of immunoglobulin E (IgE).

The prevalence of common allergic disorders such as asthma, allergic rhinitis, and atopic dermatitis has increased significantly in the past 30 years. The impact of these atopic diseases on the patient and the health care system is considerable: Allergic disorders are associated with a high degree of morbidity, which can profoundly impact patient quality of life and health care resource use. Existing strategies to treat allergic disorders beyond simple allergen avoidance focus on diminishing or eliminating the recurrent and/or persistent signs and symptoms that characterize the allergic response. A new strategy has been developed that uses antibodies directed against immunoglobulin E (IgE) to prevent it from binding to cells bearing its receptors and thus neutralizing the allergic response before it begins. These new agents reduce allergic responses in atopic individuals and improve their symptoms while reducing rescue medication and corticosteroid use in patients with allergic asthma or seasonal allergic rhinitis. Thus, anti-IgE antibodies represent proof that IgE plays a central role in allergic reactions and that anti-IgE therapy is a potentially effective treatment for allergic disease.

Anti-Allergic Agents↗