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Biomedical subjects

P Bean

Publications and source records attributed to P Bean.

At least 19 recordsLinked to original sources
PubMed2005

Gender differences in the progression of co-morbid psychopathology symptoms of eating disordered patients.

This study examined the utility of the Personality Assessment Inventory (PAI) in screening for comorbid psychopathology in eating disordered males and females undergoing residential treatment. The PAI, a self-administered screening tool containing 344 items to provide information on 11 clinical constructs, was administered at admission and discharge to 181 patients, 154 females and 27 males. Average age was 26.88 years (SD=9.35) and average length of stay was 58.31 days (SD=39.94). The results showed that both male and female patients exhibit several comorbid disorders at admission to residential treatment and the severity of these symptoms was statistically significantly reduced over the course of treatment. When comparing differences among genders, the results show that females present with more psychopathology symptoms at the start of treatment but make better progress than males in reducing these symptoms over time. When comparing patients across eating disorder diagnoses, subjects with bulimia displayed more severe comorbid symptomatology as compared to those with anorexia or other eating disorders. A thorough clinical assessment of eating disordered patients including comorbid psychopathology disorders is relevant for clinical diagnosis, treatment planning, and perhaps ultimately the outcome of treatment.

Adolescent↗
PubMed2003

Protease inhibitor drug levels in the management of human immunodeficiency virus-1 antiretroviral therapy.

In order to evaluate the relationship between protease inhibitor (PI) plasma concentrations and viral suppression in individuals receiving highly active antiretroviral therapy (HAART), plasma concentrations and area under the time concentration curve (AUC(0.5-4)) for 35 HIV-infected adults receiving their initial (or first salvage) nelfinavir- (NFV) or indinavir (IDV)-based HAART were studied. Two groups were evaluated: those who had achieved HIV-RNA suppression (HIV-RNA <500 copies/mL, group 1, n=21) and those who had achieved incomplete HIV-RNA suppression (HIV-RNA>500 copies/mL, group 2, n=14) at the time of study entry. NFV one-hour pre-dose concentrations were significantly higher in group 1 compared to group 2 (P=0.023). The NFV AUC(0.5-4) for group 1 approached significance (P=0.068). No significant differences in IDV concentrations or AUC(0.5-4) were found between group 1 and group 2. It is feasible to use PI drug level monitoring in the outpatient setting.

Adult↗
PubMed2001

Evolution of symptom severity during residential treatment of females with eating disorders.

OBJECTIVES: The overall objective of this study was to measure the evolution of symptom severity in a residential programme based on a multidimensional approach to treatment that includes cognitive-behavioural, interpersonal, experiential and family therapies. The specific aims of the study were: 1) to evaluate changes in symptom severity in bulimic and anorexic patients between admission and discharge; 2) to compare the severity of these symptoms with those of non-patient college females (control group); and 3) to monitor the progression of symptom changes six months after discharge. METHODS: The evolution of symptom severity was measured by comparing the mean raw scores of the Eating Disorder Inventory (EDI original inventory, 1983 version), which was administered at the beginning and end of the residential treatment. A subgroup of patients was also administered the EDI six months after discharge. The study involved 99 females: 47 with bulimia and 52 with anorexia as diagnosed by means of a clinical interview using DSM-IV criteria. The mean raw EDI scores in the control group (FC1, female college students) were obtained from the EDI manual. The population means were compared using the t-test for paired data (Microsoft Excel, version 2000). RESULTS: The overall results for the population as a whole show that the eight subscales of the EDI improved significantly with treatment (<0.001). The subscales with the largest numerical improvements were drive for thinness, ineffectiveness and interoceptive awareness. When divided on the basis of diagnosis, the mean feelings of perfectionism score of the bulimic patients was less than that of the control female college sample; the symptoms of bulimia in the anorexic patients were similar to those found in the control group. The fact that the mean follow-up scores for a number of the ED1 subscales remained similar to those recorded at the time of discharge suggests that some of the improvements in symptoms remained for at least six months. CONCLUSIONS: The results of our study show that multidimensional residential treatment leads to statistically significant changes in the severity of the symptoms manifested by females with eating disorders.

Adolescent↗
PubMed2001

Identification of heavy drinkers by using the early detection of alcohol consumption score.

BACKGROUND: The objective of this study was to evaluate the use of routine blood chemistry and hematology tests to detect heavy drinkers among ambulatory subjects. Heavy drinkers were defined as subjects who consumed an average of four or more standard drinks per day if male and an average of three or more standard drinks per day if female, for at least 1 month before sample collection (1 standard drink = 15 ml of absolute ethanol). METHODS: A routine blood chemistry panel and the demographic factors of age, sex, and ethnicity were evaluated by using linear discriminant function (LDF) analysis to classify subjects as heavy drinkers or light drinkers. The classification was validated by comparison with drinking patterns established by standardized questionnaire and interview. Subjects (n = 807) were males and females with known drinking patterns recruited from 25 centers that included detoxification and rehabilitation institutions, churches, and community groups in the Milwaukee and Boston areas. RESULTS: With LDF, 88% of the heavy drinkers and 92% of the light drinkers were correctly identified by the Early Detection of Alcohol Consumption test. The LDF performed the best when used to identify heavy drinking in ages 40 and above, a group that showed 84% (120 of 143) sensitivity at 97% (152 of 157) specificity. Performance in females showed 73% (76 of 104) sensitivity at 94% (129 of 137) specificity, rates higher than obtained with any single biochemical marker previously examined. Receiver operating characteristic plot analysis showed areas under the curve of 0.94 for females and 0.95 for males (p < 0.0001). CONCLUSIONS: The Early Detection of Alcohol Consumption score is a practical laboratory screen for detecting heavy drinking based on blood constituents ordered routinely in clinical settings.

Adult↗
PubMed2001

Innovative technologies for the diagnosis of alcohol abuse and monitoring abstinence.

This article summarizes the proceedings of a workshop presented at the 2000 RSA Meeting in Denver, Colorado. The aim of this workshop was to discuss the basic methodologies, diagnostic performance, and clinical utility of three technologies: carbohydrate-deficient transferrin, the "Early Detection of Alcohol Consumption" score, and whole blood associated acetaldehyde. Each method adopts a different strategy to identify heavy alcohol consumption and offers a unique approach to determine alcohol abstinence and relapses. Appropriate application of these technologies can lead to early intervention for alcohol problems before significant tissue damage occurs. To date these methodologies have yet to be formally contrasted and compared. Sensitivity, specificity, predictive value, availability, ease of use, and interpretation of tests results are important aspects to consider when selecting the most appropriate and cost-effective system. Critical evaluation of these methodologies can enable research and clinical laboratories to choose the system that best meets their particular needs in terms of assay feasibility, budget, and goals.

Acetaldehyde↗
PubMed2001

Point mutation detection technology for the new-century laboratory.

The READIT system represents the newest contribution to point mutation detection technology. Specifically, the system involves hybridizing DNA or RNA probes using phosphorylation chemistry and luciferase as the detection method. The two primary features that distinguish the READIT technology from the competition are its versatility and the ability of users to design its own probes. The automated genotype assignment and statistical analysis simplify the use of this system even more. In the year 2002 more than a million tests will be performed in molecular diagnostics with significant contributions from both research and private laboratories.(1) The most important attributes for laboratorians when reviewing a new technology are cost, accuracy, automation, and ease of use. The advent of unique point mutation detection technologies will certainly assist the role of the laboratory in demonstrating the positive impact of testing on future applications of these technologies. Cost savings, accuracy, simplicity, and flexible throughput are the must-have features of successful point mutation detection technologies for the new-century laboratory.

Journal Article↗
PubMed2001

Update on HIV patient management: latest trends in laboratory testing, immune cell reconstitution, and vaccine development.

HIV patient management requires the close interaction of clinicians and laboratorians to integrate the results obtained by emerging methodologies. Evaluation of drug susceptibility to screen for specific mutations in the HIV genome can avoid needless treatment with ineffective drugs, maximizing the benefits of costly triple-drug therapy. In addition, providing a scientific basis for the effective use of genotyping and therapeutic drug monitoring is a valuable role that laboratorians can play in optimizing patient care. The clinical utility of HIV genotyping has been defined more clearly during the last year, and pharmacokinetic profiles of the antiretrovirals are beginning to emerge in the clinical laboratory as a tool to periodically assess adherence to and efficacy of the drug regimens. However, much more work is required in this area. Switching to simpler regimens is perceived as a means to improve medication adherence, manage drug toxicity, and reduce the potential for interaction among different drugs. HIV affects the function of both cytotoxic T-cells and neutralizing antibodies. The ability to identify and quantify HIV-specific immunity may allow us to target and expand specific deficient cell clones as a means of correcting immune deficiencies and strengthening the effects of drug therapy. One such example is IL-2, shown to increase CD4 cell counts at various stages of HIV disease. Additional studies of IL-2 therapy and newer immune modulators are ongoing. Combination vaccines are being tested as a worthwhile approach to optimize induction of both CTLs and antibodies. The role of the laboratory to determine the potency of HIV vaccine candidates awaits further developments evaluating the relative importance of neutralizing and mucosal antibodies versus CTL responses and the degree of immunogenicity needed to contain the spread of infection. The Center for Disease Control and Prevention aims to reduce new HIV infections by 50% per year in the next five years, and this goal is to be achieved through selected strategies put together by the plethora of experts in this arena. The aim of this article is to update the reader on the latest trends in HIV patient management and motivate collaborations to assist in the prompt implementation of improved medical care.

Journal Article↗
PubMed2001

Molecular principles underlying hepatitis C virus diagnosis.

Although the rate of new cases of HCV infection has decreased as a result of public health policies related to intravenous drug users, the overall rate of infection in the U.S. is still high. With an estimated 3.9 million people infected nationwide, combined with the observation that, for over 50% of all cases of HCV infection, a route of infection is unknown, HCV will continue to be a major cause of infectious disease related morbidity and mortality for years to come. The benefit of molecular assays resides in providing for more effective treatment of HCV-infected patients, which will certainly justify the expense.

DNA, Viral↗
PubMed2001

A new century approach for alcohol screen in the insurance industry.

Several recent studies point to the value of using combinations of biochemical markers for the identification of alcohol abuse. The Early Detection of Alcohol Consumption (EDAC) test uses a statistical method that combines the results of several routine laboratory tests to form a metabolic fingerprint for each subject. In this study, we evaluated the use of the EDAC test as a screening tool to assess heavy drinking in insurance applicants. The EDAC was calculated by linear discriminate function analysis using the results of 14 routine tests including liver enzymes, lipids, proteins, and blood sugars. We collected and analyzed 1680 random samples at Heritage Laboratories (Olathe, Kan). Alcohol Detection Services (Brookfield, Wis) and Millennium Strategies (Madison, Wis) collaborated in the data analysis and interpretation of laboratory tests results. Ninety-three percent of applicants showed a negative EDAC test. The 7% (n = 134) who screened positive for the EDAC test were then reflexed to carbohydrate deficient transferin (CDT) and whole blood associated acetaldehyde (WBAA). Sixteen percent (22/134) showed a positive confirmatory test. Among these 16% of subjects, 41% (9/22) showed no elevations in liver enzymes or HDL-C results. Four of these subjects were among the top one third with the highest elevations for the CDT test in the entire group and one of them was positive for both the CDT and WBAA tests. These results suggest that the EDAC screen may provide an efficient alternative screening tool for the identification of heavy alcohol consumption not HBA as it identifies applicants with both normal or abnormal liver enzymes and HDL-C.

Adult↗