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Biomedical subjects

R C Barry

Publications and source records attributed to R C Barry.

7 recordsLinked to original sources
PubMed2000

Poison prevention counseling: a comparison between family practitioners and pediatricians.

OBJECTIVES: To compare the current opinions and practices of family practitioners with those of pediatricians regarding poison prevention anticipatory guidance (PPAG) and to further assess which factors, if any, are associated with providing counseling on this topic. DESIGN: Cross-sectional mail survey. PARTICIPANTS: Family practitioners and pediatricians throughout the United States and Puerto Rico, randomly selected from the membership list of the American Medical Association. MAIN OUTCOME MEASURE: Reported frequency of providing parents with PPAG. RESULTS: Of the 1000 physicians surveyed, 975 were eligible and 500 returned surveys that could be analyzed (227 family practitioners and 273 pediatricians), for a response rate of 51.3%. The majority of physicians in each field (family practice, 81.9%; pediatrics, 87.2%) reported that they believe it is their responsibility to provide PPAG to parents (P = .08). Family practitioners, however, were less likely than pediatricians to provide parents with PPAG (66.5% vs 91.9%; P<.001). When adjusted for other variables, such as age and sex, family practitioners were 5.4 times less likely than pediatricians to provide parents with PPAG (odds ratio, 0.19; 95% confidence interval, 0.09-0.37). Family practitioners, more often than pediatricians, cited lack of training on poisoning prevention as a reason for not providing parents with PPAG (46.1% vs 18.2%; P = .02). Among all physicians, those who received postresidency training on PPAG were more likely to provide PPAG than those who had not received postresidency training on this topic (odds ratio, 3.21; 95% confidence interval, 1.44-7.18). Having received residency training on poisoning prevention, however, did not increase the likelihood of providing PPAG (odds ratio, 1.69; 95% confidence interval, 0.86-3.30). CONCLUSIONS: Although it is currently recommended to include PPAG as part of the routine preventive pediatric care, this study shows that one third of family practitioners do not provide parents with PPAG. Family practitioners should increase their efforts aimed at poisoning prevention. Those involved with training residents in family practice and pediatrics should place greater emphasis on this topic to increase the impact of this training on actual PPAG practices.

Adult↗
PubMed1998

In vivo acetylation identified at lysine 70 of human lens alphaA-crystallin.

Posttranslational modification of protein lysyl residues that change the net charge of the molecule may alter the protein conformation. Such modifications are of particular significance among lens proteins, because conformational changes are associated with the development of cataract. A previously unidentified acetylated form of alphaA-crystallin has been isolated from the water-soluble portion of human lenses. The alphaA-crystallins were fractionated by anion exchange HPLC into seven peaks, each containing more than one form of alphaA-crystallin. The previously reported deamidated and phosphorylated forms were identified by their molecular masses, determined by electrospray ionization mass spectrometry. In addition to these modifications, approximately 5% of alphaA-crystallin had a modification that decreased the charge by one and increased the molecular mass by 42 u. This modification, identified as acetylation, was located uniquely at Lys 70. Like any modification that alters the surface charge, acetylation may affect protein conformation and intermolecular interactions, thereby altering the solubility or chaperone properties of alphaA-crystallin. Acetylation of lysine 70 is potentially significant since it is located in a region that has been implicated in the chaperone activity of alphaA-crystallin.

Acetylation↗
PubMed1997

An analysis of morning report at a pediatric hospital.

The purpose of this study was to determine the types of cases residents select for morning report discussion and the educational value of postdischarge follow-up of unknown cases. Between April and December of 1994, at Cardinal Glennon Children's Hospital in St. Louis, Missouri, random, resident, and group-selected patients listed at morning report were followed up throughout hospitalization. Patients were categorized based upon whether or not their morning report and discharge diagnoses were the same or different. Patients discharged without a diagnosis were followed up by chart review at 6 months to determine whether a diagnosis had been made. Data were analyzed by Chi-square analysis with Bonfferoni adjustment factor for multiple comparisons. Residents were more than two times more likely to select cases for discussion in which the diagnosis changed during hospitalization (P < 0.01). The 6-month follow-up yielded new diagnoses in only 21% of previously unknown cases. We concluded that residents do an exceptional job of selecting difficult diagnostic cases for discussion at morning report. Postdischarge follow up of unknown cases adds little new information for discussion at morning report.

Child↗
PubMed1994

A modified Apt test: a new look at an old test.

This study was designed to verify the applicability of a modified Apt test to blood stains on cloth and to determine whether the time of testing affects the accuracy of the results. We collected cord blood samples from full-term newborns (n = 35) and venous blood samples from gravid females (n = 30) and applied them in a random fashion with a cotton swab to standard cloth diapers. A blinded investigator applied an alkali solution to each stain and recorded either color change or no color change. In addition, a time course was performed by applying infant (n = 4) and adult (n = 4) samples to a cloth diaper at an initial starting point and varying the time of the performance of our modified test in intervals up to four hours. Thirty-four of 35 infant samples had no color change, and 29 of 30 adult samples had an easily identified color change. The time course revealed that the samples were indistinguishable after 30 minutes had elapsed. Therefore, a modified Apt test can be used successfully to differentiate between adult and infant blood stains of nonstool origin, only if performed within 30 minutes of the time the stain is produced. This restriction is significant in the emergency department setting.

Adult↗
PubMed1990

A comparison of three formulations of TAC (tetracaine, adrenalin, cocaine) for anesthesia of minor lacerations in children.

A randomized, prospective, double-blind study comparing three formulations of the topical anesthetic solution TAC for laceration repair was undertaken in 250 children. The children's wounds were anesthetized with either TAC I (original formulation--0.5% tetracaine, 1:2000 Adrenalin, 11.8% cocaine), TAC II (1.0% tetracaine, 1:4000 Adrenalin, 7.0% cocaine), or TAC III (1.0% tetracaine, 1:4000 Adrenalin, 4.0% cocaine) prior to repair. The solutions were compared with respect to efficacy, acceptability, wound complications, and side effects. We found comparable efficacy of the three formulations, with similar efficacy to 1% lidocaine infiltration for facial and scalp wounds. Anesthesia for extremity wounds was adequate in only 39.9% of cases, regardless of TAC strength. Wound complications and side effects were within expected and acceptable limits. Our findings support use of TAC for face and scalp lacerations and a change to a less concentrated TAC preparation, such as our "TAC III," which is presumably safer for widespread use.

Adolescent↗
PubMed1987

Removal of cactus spines from the skin. A comparative evaluation of several methods.

The removal of very fine cactus spines from the skin is particularly distressing for the pediatric patient. We describe two typical patients and a study in experimental animals comparing the effectiveness of several previously described methods for removal. The most effective method involved using tweezers to remove clumps of spines followed by a thin layer of glue covered with gauze, which was allowed to dry and then peeled off to remove individual spines. Attempts to use adhesive tape or a thin layer of a commercial facial mask to aid in removal of the spines produced more retention and inflammation three days after removal than no treatment.

Animals↗