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Biomedical subjects

R A Barbee

Publications and source records attributed to R A Barbee.

50 records · Page 3Linked to original sources

Reversibility of severe bleomycin-induced pneumonitis.

The use of bleomycin sulfate as an antineoplastic agent has been limited by its substantial pulmonary toxic effects. The exact incidence and prognosis of bleomycin-pneumonitis is unresolved. Although bleomycin pulmonary toxicity is thought to be dose-related, recent reports have emphasized severe reactions at low doses. Furthermore, severe pulmonary toxicity has been suggested to be progressive, irreversible, and ultimately, fatal. We report clinical, roentgenographic, and pathophysiologic recovery after severe, bleomycin-induced pneumonitis.

Bleomycin↗

The absence of a relationship between serum precipitins and pulmonary disease in a community.

To study the role of serum precipitins in respiratory illness in a community, sera obtained from 3,047 residents of Tucson, Ariz., were tested for the presence of precipitating antibody to a battery of antigens. Positive reactions were obtained in 54 subjects (1.8 percent), a lower incidence than has been reported previously. The majority of these subjects were older than 54 years of age, an age distribution significantly older than the entire sample (P less than 0.01). Pulmonary function among the subjects with positive precipitin reactions was not significantly different from that of the asymptomatic nonsmokers of the entire sample. None of the subjects who were lifelong residents of Arizona had serum precipitins to any of the thermophilic actinomycetes antigens which were used in the testing. These antigens have been found in association with extrinsic allergic alveolitis, most frequently among patients living in the north central United States and were derived from strains of Micropolyspora faeni, Thermoactinomycetes candidus and vulgaris. Each subject with precipitins to one or more of the tested antigens was matched by age, sex, and socioeconomic class with two subjects from the sample who had negative precipitin reactions. The groups did not differ in their prevalence of respiratory symptoms or abnormalities of pulmonary function. We conclude that the presence of precipitating serum antibodies among subjects in a community is not indicative of the presence of immunologic pulmonary disease but merely reflects previous exposure to the tested antigen. In addition, individuals whose sera contain precipitating antibody appear to have no increased tendency to develop other types of pulmonary disease.

Adolescent↗

Nitrogen dioxide-induced pulmonary disease: five new cases and a review of the leterature.

Twenty-three patients exposed to nitrogen dioxide in agriculture or industry were referred to the University of Wisconsin Medical Center. Eighteen experienced a transient upper respiratory tract syndrome; five developed pulmonary edema or bronchiolitis obliterans. This latter group responded to steroid therapy but all demonstrated evidence of persistent pulmonary dysfunction on follow-up studies. Combining our findings with those in the literature we concluded: (1) exposure to NO2 is more common than generally appreciated; (2) case fatality is high--29% for silo-filler's disease; (3) steroids are effective therapy and should be continued for at least eight weeks; (4) although the majority recover without significant sequelae, some individuals may develop persistent functional abnormalities; (5) there is no evidence that long-term exposure to low concentrations of NO2 leads to chronic airway obstruction; and, (6) NO2-induced pulmonary disease could be elminated with appropriate preventive measures.

Adult↗

Student decision-making and performance in a flexible-time curriculum.

Three consecutive classes (213 students) entering the University of Arizona College of Medicine under a flexible-time three-year curriculum were provided the option of extending their program by a year or more. Of the 30 percent who availed themselves of this option, a majority did so because they desired a better personal or academic "life-style" rather than for specific academic reasons. Most continued to pursue medical interests during the free time which became available to them. Through none of the usual admission data was it possible to predict which students would choose to extend their program. At the time of graduation students completing the curriculum in three years achieved scores on the Part II examination of the National Board of Medical Examiners comparable with those earned by students who extended for a four-year program. Nonacademic factors may be of greater importance than academic factors in student acceptance of accelerated curricula.

Arizona↗

Immediate skin-test reactivity in a general population sample.

To assess the prevalence and distribution of allergic skin-test reactions in a general population sample, allergy prick tests were applied to 3101 subjects older than 2 years of age. Test materials included allergens common to the Tucson environment, and subjects were randomly stratified by age, sex, and socioeconomic status. No difference in the prevalence of measurable reactions was found among male subjects versus female subjects. A definite age relation was apparent, however, with the peak prevalence of reactivity (more than 40%) occurring during the third decade, and falling rapidly past age 50. When present, reactions tended to be multiple, highly reproducible, and more frequent among those in the higher socioeconomic strata. The prick test was judged to be a useful tool for the assessment of atopy.

Age Factors↗

Respiratory disorders and allergy skin-test reactions.

This study examines the relations of allergy skin-test reactivity, assessed by prick testing, to a variety of respiratory symptoms, findings, and diagnoses in a general population sample consisting of more than 3000 subjects. The independent and combined relations of skin-test reactivity and cigarette smoking are reported. Prevalences of asthma and allergic rhinitis are closely related to the severity of skin-test reactions; all of the 39 subjects with the largest skin-test reactions observed have had one or both of these conditions. A variety of other respiratory findings, not generally considered allergic in nature, are also related to skin-test reactivity, especially in children and in young to middle-aged adults. In subjects 15 to 54 years of age, an atopic predisposition, as manifested by reactions to allergy skin tests, appears to be associated with an increased susceptibility to the bronchoconstrictor effects of cigarette smoking and to recurrent chest infections. It is suggested that an atopic predisposition relatively early in life may be a risk factor for the later development of chronic obstructive lung diseases.

Adolescent↗

Respiratory tract disease from thermosetting resins. Study of an outbreak in rubber tire workers.

An outbreak of upper and lower respiratory tract inflammatory disease and conjunctivitis among synthetic rubber tire workers occurred. The outbreak began after the introduction of a new thermosetting resin, containing resorcinol and a trimere of methylene aminoacetronitrile, into the rubber tire carcass stock formulation. Two hundred ten workers were affected. Characteristically, symptoms improved during periods of sick leave or vacation, recurring upon the workers' return to the plant. Chest radiograms disclosed pneumonic infiltrates in about one fourth of the cases. Pulmonary function studies detected abnormal airways dynamics as well as abnormal diffusing capacity in more than one third of the workers tested. Lung biopsy showed evidence of focal interstitial fibrosis and peribronchiolar and perivascular chronic inflammatory reaction. The illness was ascribed to volatile products released during the manufacture of synthetic rubber tires. The exact chemical nature of these products is unknown.

Adult↗