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Biomedical subjects

J L Barr

Publications and source records attributed to J L Barr.

7 recordsLinked to original sources

Effect of systemic matrix metalloproteinase inhibition on periodontal wound repair: a proof of concept trial.

BACKGROUND: The adjunctive use of matrix metalloproteinase (MMP) inhibitors with scaling and root planing (SRP) promotes new attachment in patients with periodontal disease. This pilot study was designed to examine aspects of the biological response brought about by the MMP inhibitor low dose doxycycline (LDD) combined with access flap surgery (AFS) on the modulation of periodontal wound repair in patients with severe chronic periodontitis. METHODS: Twenty-four subjects were enrolled into a 12-month, randomized, placebo-controlled, double-masked trial to evaluate clinical, biochemical, and microbial measures of disease in response to 6 months therapy of either placebo capsules + AFS or LDD (20 mg b.i.d.) + AFS. Clinical measures including probing depth (PD), clinical attachment levels (CAL), and bleeding on probing (BOP) as well as gingival crevicular fluid bone marker assessment (ICTP) and microbial DNA analysis (levels and proportions of 40 bacterial species) were performed at baseline and 3, 6, 9, and 12 months. RESULTS: Patients treated with LDD + AFS showed more potent reductions in PD in surgically treated sites of >6 mm (P<0.05, 12 months). Furthermore, LDD + AFS resulted in greater reductions in ICTP levels compared to placebo + AFS. Rebounds in ICTP levels were noted when the drug was withdrawn. No statistical differences between the groups in mean counts were found for any pathogen tested. CONCLUSIONS: This pilot study suggests that LDD in combination with AFS may improve the response of surgical therapy in reducing probing depth in severe chronic periodontal disease. LDD administration also tends to reduce local periodontal bone resorption during drug administration. The use of LDD did not appear to contribute to any significant shifts in the microbiota beyond that of surgery alone.

Adult↗

Creating a vision for your medical call center.

MCC technologies and applications that can have a positive impact on managed care delivery are almost limitless. As you determine your vision, be sure to have in mind the following questions: (1) Do you simply want an efficient front end for receiving calls? (2) Do you want to offer triage services? (3) Is your organization ready for a fully functional "electronic physician's office?" Understand your organization's strategy. Where are you going, not only today but five years from now? That information is essential to determine your vision. Once established, your vision will help determine what you need and whether you should build or outsource. Vendors will assist in cost/benefit analysis of their equipment, but do not lose sight of internal factors such as "prior inclination" costs in the case of a nurse triage program. The technology is available to take your vision to its outer reaches. With the projected increase in utilization of call center services, don't let your organization be left behind!

Computer Communication Networks↗

Interference with testing for lysergic acid diethylamide.

We found a high rate (4.2%) of positive results for lysergic acid diethylamide (LSD) by Emit in 1898 urine samples that were submitted primarily from psychiatric patients for drugs-of-abuse (DOA) testing. Specimens that tested positive for LSD by Emit subsequently tested negative for LSD with two RIAs. Furthermore, LSD was not detected in randomly selected Emit-positive urine samples by gas chromatography-mass spectrometry. Normal urine samples tested positive for LSD by Emit when they were supplemented with therapeutic medications that were prescribed for patients with positive urine LSD results by Emit. These therapeutic drugs interfered specifically with the Emit assay for LSD, since other Emit DOA tests were not affected by these medications at the tested concentrations.

Enzyme Multiplied Immunoassay Technique↗

Familial carriage of methicillin-resistant Staphylococcus aureus and subsequent infection in a premature neonate.

During routine surveillance of patients in a Neonatal Intensive Care Unit (NICU), an alert infection-control practitioner confirmed the relationship of the index patient (sibling 3) who had a methicillin-resistant Staphylococcus aureus (MRSA) infection to an infant sibling (sibling 2) who had been admitted to the hospital 7 months previously with an MRSA infection. Cultures of nasal specimens obtained from the index patient's parents and two other siblings also yielded MRSA for two of the family members, the mother and sibling 1. The strains were typed by antibiogram, plasmid analysis, and genomic DNA typing. The isolates from sibling 1, sibling 2, the mother, and one isolate from sibling 3 were found to be identical by all techniques. The other isolates from sibling 3 shared the same genomic type but had no detectable plasmids. These findings suggest that transmission of this strain occurred at least three times within this family and that at least one family member was colonized with the same strain for 7 months or more. Recognition that family members may serve as reservoirs for nosocomial infections with MRSA raises important issues for infection control.

Adult↗

Drug findings in 'Driving Under the Influence of Drugs' cases: a problem of illicit drug use.

Drug findings in 137 drug positive cases of Driving Under the Influence of Drugs (DUID) occurring in St. Louis, Missouri, U.S.A. from June 1983 through May 1986 are presented. Thirty-two different drugs were detected. A single agent was detected in only 34% (47/137) of cases. The most frequently encountered drugs, expressed as percent of positive cases, were: phencyclidine, 47%; marijuana, 47%; benzodiazepines, 22%; barbiturates, 15%; opiates, 11%; and cocaine, 9%. Most multiple drug cases involved popular illicit drug mixtures, such as cocaine and morphine (speedballs) or phencyclidine on marijuana (whack). All the drivers in this survey had displayed inappropriate or impaired operation of a motor vehicle to the extent that a law enforcement officer had stopped and charged them for DUID. In at least 81% of the drug positive cases, persons impaired in the operation of a motor vehicle from a drug or drugs other than alcohol, were impaired not as the result of side effects of therapeutic drug use, but as the result of deliberate self intoxication with illicit or controlled substances.

Automobile Driving↗

Tissue disposition of cocaine in man: a report of five fatal poisonings.

The disposition of cocaine in five cases of fatal poisoning are presented. The highest concentrations of cocaine were found in urine, kidney, spleen, brain, lung and skeletal muscle. Cocaine concentrations in these organs far exceeded those in blood. Cocaine was detected in all other specimens tested including: bile, heart, liver, vitreous and adipose tissue. These results are in agreement with limited, previously reported, tissue data, and indicate that when urine is not available, kidney, spleen, brain and/or lung should be the specimen of choice for cocaine detection.

Adult↗