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Biomedical subjects

P Bean

Publications and source records attributed to P Bean.

At least 37 records · Page 2Linked to original sources
PubMed2000

Self-functioning traits affecting meal compliance in eating disorder patients.

The objective of this study was to measure the extent to which self-functioning traits relate to meal compliance in eating disorder patients by using multiple regression analysis. Compliance was the dependent variable. It was recorded on a meal flowsheet during breakfast, lunch and dinner and compiled for the 8 days immediately preceding each patient's discharge. The independent variables were gender, self-esteem (Rosenberg Scale) and 7 subscales of the Eating Disorder Inventory (EDI-2): drive for thinness, body dissatisfaction, ineffectiveness, perfectionism, interpersonal distrust, interoceptive awareness and maturity fears. A random sample of 30 subjects who completed the above instruments before May 1999 were included in the study. The results suggest that close to 50% of their meal compliance can be explained by variations in four explanatory variables: gender, ineffectiveness, interoceptive awareness and distrust. The adjusted r2 was 0.497 and the significance of the equation, measured by the p-value, was p = 0.0002. We conclude that multiple regression analysis is a valuable tool to identify patients' traits with the strongest effect in meal compliance.

Adolescent↗
PubMed2000

Comparative evaluation of three human immunodeficiency virus genotyping systems: the HIV-GenotypR method, the HIV PRT GeneChip assay, and the HIV-1 RT line probe assay.

Evaluation of drug resistance by human immunodeficiency virus (HIV) genotyping has proven to be useful for the selection of drug combinations with maximum antiretroviral activity. We compared three genotyping methods for identification of mutations known to confer drug resistance in the reverse transcriptase (RT) and protease genes of HIV type 1 (HIV-1). The HIV-GenotypR method (GenotypR; Specialty Laboratories, Inc., Santa Monica, Calif.) with the ABI 377 DNA sequencer (Applied Biosystems Inc.), the HIV PRT GeneChip assay (GeneChip; Affymetrix, Santa Clara, Calif.), and the HIV-1 RT Line Probe Assay (LiPA; Innogenetics, Alpharetta, Ga.) were used to genotype plasma samples from HIV-infected patients attending the University of Wisconsin Hospitals and Clinics and the Mayo Clinic. At the time of analysis, patients were failing combination therapy (n = 18) or were treatment naive (n = 6). Forty codons of the RT and protease genes were analyzed by GenotypR and GeneChip for resistance-associated mutations. LiPA analyzed seven RT codons for mutations. Each sample was genotyped by all three assays, and each assay was subjected to pairwise comparisons. At least 92% of the codons tested (by the three assays) in paired comparisons were concordant. GenotypR and GeneChip demonstrated 96.6% concordance over the 40 codons tested. GenotypR identified slightly more mutations than GeneChip and LiPA; GeneChip identified all primary mutations that corresponded to failing treatment regimens. Each assay identified at least 84% of the mutations identified by the other assays. Mutations that were discordant between the assays mainly comprised secondary mutations and natural polymorphisms. The assays had better concordance for mutations that corresponded to current failing regimens, present in the more predominant viral quasispecies. In the treatment-naive patients, GenotypR, GeneChip, and LiPA mainly identified wild-type virus. Only the LiPA identified K70R, a possible transmitted zidovudine resistance mutation, in the RT gene of a treatment-naive patient. We conclude that although discrepancies in results exist between assays, each assay showed a similar capacity to identify potentially clinically relevant mutations related to patient treatment regimens.

Anti-HIV Agents↗
PubMed2000

The early detection of alcohol consumption (EDAC) score in the identification of Heavy and at-risk drinkers from routine blood tests.

The objective of this study was to use the EDAC score to detect heavy and at-risk drinking in young adults (mean age = 25 years) and compare the results to self-reports. The EDAC score is a linear discriminant function (LDF) derived from the analysis of a combination of up to 35 blood chemistry and hematology analytes ordered routinely in clinical settings. Subjects (N = 150) were recruited from medical care facilities at the University of Missouri, Columbia. Blood samples, obtained from males (N = 66) and females (N = 84), were sent to LabCorp (Burlington, NC) for analysis. The blood chemistry panels were evaluated using a Linear Discriminant Function method available through SPSS software to predict whether each individual was a Heavy Drinker or an At-Risk Drinker. Heavy Drinkers consumed on average > or = 4 drinks daily for males and > or = 3 drinks daily for females. At-Risk Drinkers consumed at least 14 drinks per week or drank more than 4 drinks on any occasion in the last 14 days if male and consumed at least 7 drinks per week or more than 3 drinks on any occasion if female. Not-Heavy Drinkers and Not-At-Risk Drinkers consumed less than the amounts above. The results showed 8/10 (80%) males and 2/2 women identified as Heavy Drinkers by both the EDAC score (prior probability Not-Heavy vs. Heavy Drinker = 0.5:0.5) and self-report. Fifty of 56 (89%) males and 65/82 (79%) of females were identified as Not-Heavy Drinkers by both EDAC score and self-report. There were 6/54 (11%) males and 15/82 (18%) women with false positive results, of these, 14/21 (67%) met dependence criteria by DSM-IV. The EDAC test showed 30% sensitivity and 96% specificity when identifying At-Risk drinking males and 42% sensitivity and 90% specificity when identifying At-Risk drinking females. In females, the EDAC's sensitivity was higher than any single traditional or new laboratory marker previously reported for diagnosis of alcohol abuse such as GGT, MCV and CDT. As a complement or a substitute to an interview, in subjects who are less candid about their drinking, the EDAC is a useful tool to assess heavy and at-risk alcohol consumption in young adults.

Adult↗
PubMed2000

Therapeutic drug monitoring of antiretroviral agents.

HIV+ patients fail antiretroviral therapy due to inadequate drug concentrations reaching the site of viral replication and/or the development of viral resistance to the antiretroviral agents. Adequate drug concentrations may not be reaching the virus due to poor compliance, poor absorption, or other pharmacokinetic factors such as metabolism, elimination, and drug interactions. The most important and most common pharmacokinetic drug interactions involve inhibition of metabolism, induction of metabolism, altered drug absorption, inhibition of renal excretion, and displacement from plasma protein binding sites. If a patient is failing antiretroviral therapy, TDM of antiretroviral agents could help in determining both adequacy of drug concentrations and patients' adherence. Ongoing studies will determine whether total drug concentration or free drug concentration of the protease inhibitors is the best predictor of response. Trough concentrations could prove to be the most important predictor of response, but additional studies are needed to compare trough, peak, and AUC concentrations with response to treatment. Finally, if some patients fail therapy due to inadequate drug concentrations, then increasing the dose could benefit patients' outcome and increase longevity. Clinical trials are needed that compare patients who receive a fixed-dosage regimen with patients who have adjusted dose regimens. Such a study is the best way to determine the true value of TDM of the antiretrovirals.

Anti-HIV Agents↗
PubMed2000

A physician's primer to antiretroviral drug resistance testing.

Evaluating the genetic composition of HIV has evolved from a traditional epidemiologic research tool into a widely used clinical asset in the management of HIV infection. Genotypic and phenotypic testing is designed to identify drugs less likely to be therapeutically effective. Genotypic assays identify specific "gene mutations" or nucleotide substitutions known to confer drug resistance, whereas phenotypic assays measure the amount of drug necessary to inhibit viral replication in vitro. Prospective studies of antiretroviral drug resistance testing have shown its value as an independent predictor of optimal virologic response to drug therapy. Current guidelines recommend use of these tests following treatment failure and during pregnancy; considerations for testing include primary infection and treatment-naive patients. The identification of drug resistance can help the clinician individualize treatment regimens to attain maximal viral suppression and patient longevity.

Anti-HIV Agents↗
PubMed1998

Drug courts and drug treatment.

This paper examines the way in which American Drug Courts operate, and the changes required were they to be introduced into the UK.

Journal Article↗
PubMed1998

The effectiveness of a volunteer appropriate adult scheme.

This paper discusses the first evaluation to be undertaken of a volunteer Appropriate Adult scheme for mentally vulnerable adults. Southampton MIND was granted funding by the Mental Health Foundation to implement a volunteer Appropriate Adult scheme which began in April 1994 and lasted for two years. The Mental Health Foundation required an evaluation from an independent organization, the implications of which are examined here against the background of previous research conducted by the authors on the use of Appropriate Adult protection for mentally vulnerable adults in the police station. We show that a basic Appropriate Adult training programme has been devised and that there are people willing to take on this training and the onerous role for which it prepares them.

Adult↗
PubMed1997

Semiautomated procedures for evaluation of carbohydrate-deficient transferrin in the diagnosis of alcohol abuse.

Carbohydrate-deficient transferrin (CDT) may now be the most valuable biological marker for diagnosis of alcohol abuse. We compared the diagnostic performance of two new CDT tests, Axis %CDT turbidimetric immunoassay (TIA) and Axis %CDT HPLC, against Specialty Laboratories' isoelectric focusing/immunoblotting/laser densitometry (IEF/IB/LD). Both Axis tests include one-half the concentration of trisialotransferrin isoforms in their CDT quantitation schemes. Considering an alcohol abuse prevalence of 7%, Axis %CDT TIA shows a sensitivity of 87% at 98% specificity and a positive predictive value (PPV) of 0.75; %CDT HPLC shows a sensitivity of 87% at 100% specificity for a PPV of 1, and the IEF/IB/LD shows 81% sensitivity at 94% specificity for a PPV of 0.5. All three CDT tests show the same negative predictive value (0.98). Both Axis procedures perform better than IEF/IB/LD in the diagnosis of alcohol abuse; %CDT TIA is available in several semiautomated, cost-effective formats.

Adult↗