PubMed Health⌕ Search

Biomedical subjects

Kevin J Keen

Publications and source records attributed to Kevin J Keen.

6 recordsLinked to original sources
PubMed2005

The effect of injection immunotherapy on mucociliary clearance in allergic patients.

OBJECTIVE: To assess the effect of injection immunotherapy on mucociliary clearance in allergic patients with the use of the saccharin test. METHODS: In this prospective cohort study, mucociliary clearance in 42 allergic patients treated with injection immunotherapy was determined with the saccharin test. Of these patients, 23 were retested 1 year later to assess changes in mucociliary clearance times. Mean results for historical controls were determined in a review and meta-analysis of the existing literature. RESULTS: Saccharin clearance times (SCTs) were initially prolonged in allergic patients who received injection immunotherapy when compared to historical controls (one-sided P value < 0.05). However, after 1 year of immunotherapy, there was a significant reduction in SCTs in our patient population. This finding was independent of other evaluated patient characteristics, with the exception of nasal steroid use, which was also significantly associated with a decrease in SCT. CONCLUSIONS: After 1 year of injection immunotherapy, there was a significant reduction in mean SCT in our patient population. Of the other factors studied, only nasal steroid was associated with decreased mucociliary clearance times. To our knowledge, this is the first report in the literature documenting the beneficial effect of injection immunotherapy on mucociliary clearance as measured by saccharin clearance times. Nevertheless, further research is warranted, given the confounding effect of nasal steroid use.

Adolescent↗
PubMed2004

Prevalence of allergy in patients with chronic rhinosinusitis.

OBJECTIVES: The purpose of this study was to provide further evidence that allergic rhinitis is an important factor in chronic and recurrent acute rhinosinusitis. Specifically, this study shows that perennial allergens play a more significant role than seasonal allergens. STUDY DESIGN AND SETTING: Census by chart review of patients with chronic and recurrent acute rhinosinusitis presenting to the Department of Otolaryngology at the MetroHealth Medical Center, Cleveland, OH. METHODS: All participants had allergy testing done either by RAST or intradermal skin endpoint titration utilizing a battery of seasonal and perennial antigens. RESULTS: Of the 48 voluntary participants analyzed in this study, 57.4% had a positive allergy test. Most patients in the study were sensitive to more than one allergen. Of the patients with a positive allergy test, 92% demonstrated sensitivity to one or more perennial allergens-most prominently, molds and dust mites. CONCLUSIONS: Perennial allergy has a statistically significant association with chronic and recurrent acute rhinosinusitis. SIGNIFICANCE: The diagnosis and management of perennial allergies may be beneficial when treating chronic sinus disease.

Acute Disease↗
PubMed2003

Genome-wide linkage analysis of the tracking of systolic blood pressure using a mixed model.

BACKGROUND: Elevated blood pressure in middle age is a major risk factor for subsequent cardiovascular complications. An important longitudinal characteristic of blood pressure is the "tracking phenomenon". Tracking is defined as the persistence of the rank of a person's blood pressure level in a group over a long period of time. In this analysis, we used the Framingham data to investigate whether there are some genes responsible for this phenomenon. RESULTS: Both two-point and multipoint linkage analyses were applied to family members with complete data only and to all family data with missing values imputed by a Gaussian model. The results of two-point linkage analysis indicated that two loci for linkage with the intercept were on chromosomes 10 and 13, and two loci for linkage with both slope and intercept were on chromosomes 1 and 3. Multipoint linkage analysis indicated only one region, 200-240 cM on chromosome 1, to be linked with both intercept and slope. For the intercept of SBP, the highest LOD (4.43) was found at 214 cM when missing data were imputed, and the highest LOD (2.81) was at 231 cM for the complete case data. For the slope of SBP, the highest multipoint LODs were 3.63 at 227 cM and 2.02 at 234 cM for the complete case data and imputation data, respectively. CONCLUSION: One or more genes in the range of 200-240 cM on chromosome 1 may be related to the tracking phenomenon of SBP.

Adult↗
PubMed2003

Analysis of metabolic syndrome phenotypes in Framingham Heart Study families from Genetic Analysis Workshop 13.

Twelve teams of investigators constituted a group which analyzed phenotypes related to metabolic syndrome, making use of the available longitudinal measurements from the family component of the Framingham Heart Study or the simulated data, as distributed by Genetic Analysis Workshop 13 (GAW13). Body mass index, obesity, lipid abnormalities, glucose, or combinations of these traits were analyzed by this group. A wide variety of approaches were taken to construct phenotypes from the longitudinal measurements, including considering single or multiple cross-sectional time points, single ages, minimum values, maximum values, means, other lifetime values, ever/never dichotomy, or age at onset of some threshold value. Approaches also differed in the family structures utilized (sib pairs to full extended pedigrees), the genetic data considered (two-point or multipoint), and the statistics calculated (model-free and parametric), and led to a diverse set of analyses being performed. Inferences were made about heritability, and attempts were made to map underlying genes. Over 40 genome-wide linkage analyses were conducted. Despite the broad range of approaches, several regions of the genome were repeatedly identified across multiple analyses.

Cardiovascular Diseases↗
PubMed2003

The role of sequential and concurrent sexual relationships in the risk of sexually transmitted diseases among adolescents.

PURPOSE: To explore whether patterns of sexual relationships, such as sequential (nonoverlapping in time) or concurrent (overlapping in time), are more important indicators of sexually transmitted disease (STD) risk among adolescents than number of sexual partners. METHODS: Data from 4,707 sexually active adolescents from the National Longitudinal Study of Adolescent Health were analyzed based on reported heterosexual relationships during the past 18 months. Adolescents were categorized as engaging in single, sequential, or concurrent sexual relationships. Demographic, behavioral, and social characteristics of each group were compared and multivariate logistic models were fit to determine STD risk associated with sexual relationship patterns and overall number of sexual partners during this same time period. RESULTS: Thirty-five percent of sexually active teens had more than one partner in the past 18 months, and 40% of these multiple partnerships were overlapping or concurrent in time. Teens in sequential and concurrent relationships reported lower condom use and a higher degree of regret of having sex owing to alcohol use than those in single relationships. Teens in concurrent relationships also reported the lowest self-efficacy to use contraceptives. Teens in sequential or concurrent relationships were more likely to report an STD than single-relationship teens (odds ratio 2.3 and 3.9, respectively); however, they were not statistically different from each other. Number of sexual partners during this same time period was not associated with STD risk once relationship pattern was considered. CONCLUSIONS: Adolescents who engage in sequential or concurrent sexual relationships differ in some important demographic, behavioral, and social characteristics and, when compared with those who engage in single relationships, have a significantly greater risk for STDs over and above the number of sexual partners.

Adolescent↗