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Biomedical subjects

R Patterson

Publications and source records attributed to R Patterson.

At least 73 records · Page 4Linked to original sources
PubMed1990

Clinical trials: the role of the neuroscience nurse.

Participation in clinical drug trials is becoming a common expectation of many neuroscience nurses. Prior to assuming responsibilities associated with a research study, the roles, rights and responsibilities involved must be thoroughly understood. The effective neuroscience nurse brings to the research arena a thorough knowledge of the drug under study, outstanding skills as a clinician and a commitment to ensure the safety and comfort of the participant as the search is made for better and more effective drug regimens.

Clinical Trials as Topic↗
PubMed1990

A critical review of the use of Rogers' model within a special hospital: a single case study.

This case study presents a problematic patient who has been resident in a special hospital for mentally handicapped people for years due to a gross sexual fantasy disorder, continuous self-injurious behaviour and an array of disordered conducts which resulted in negative nursing reports. The introduction of Rogers' model, with its abstract finer conceptualizations produced an alternative framework by which to assess the patient. This holistic interactive model generated a paradigmatic shift in the nursing perceptions, at a conceptual level, which was manifested in their reporting behaviours. The results appeared to indicate a sudden and dramatic change in the patient's behaviour. However, alternative interpretations proved the more convincing on closer analysis. The use of Rogers' framework proved difficult in its practical application due to its underpinning requirements for role adoption and negotiation, both being problematic in a secure environment.

Adult↗
PubMed1990

Rhesus monkey airway responses to substance P.

The tachykinin, substance P (SP), was used as a model to study airway and cutaneous responses in a group of normal rhesus monkeys or animals with IgE-mediated cutaneous reactions to Ascaris antigen (AA) alone or animals with both IgE-mediated cutaneous and airway responses to AA. Aerosolized SP (10 mg/ml) resulted in airway responses qualitatively similar in duration and pulmonary function abnormalities to AA. These SP airway responses were most closely associated with the presence of IgE antibody to AA and were not increased in animals with airway reactivity to AA. A dose response to aerosolized SP can be established. An enkephalinase inhibitor, thiorphan, did not potentiate SP airway responses but appeared to potentiate SP cutaneous responses in some animals. SP cutaneous reactions could be demonstrated and did not correlate with the IgE-mediated cutaneous dilution titers to AA.

Administration, Inhalation↗
PubMed1990

Human IgE, IgG and IgA antibody responses to T101, a murine monoclonal antibody against human lymphocytes: implications for pathogenesis, risk and avoidance of adverse immunologic reactions.

To study immune responses that may play a role in immediate-type allergic reactions (ITAR) and serum-sickness-like reactions that have been reported with administration of monoclonal antibodies (MAb), we measured by enzyme-linked immunosorbent assay serum levels of IgE, IgG, and IgA human antimurine antibody (HAMA) to T101, a murine IgG2a antibody that has been used in the treatment of cutaneous T cell lymphoma (CTCL) and chronic lymphocytic leukemia (CLL). None of 8 patients (4 with CLL, 4 CTCL) pretreated with T101 had elevated titers of any HAMA class tested as compared to normal control sera. All CTCL patients who had elevated total serum IgE levels, but normal total serum levels of other antibody classes, had significant rises in IgE, IgG, and IgA HAMA to T101 after intravenous MAb infusion. However, the CLL patients who were hypogammaglobulinemic failed to develop significant rises in HAMA. Three patients (2 CLL, 1 CTCL) had ITAR (e.g., urticaria, angioedema, bronchospasm) associated with infusion of T101; prophylactic medication regimens based upon the control of radiographic contrast media reactions were used with apparent benefit in subsequent infusions in these patients. All 8 patients had negative immediate intradermal skin tests (1 microgram/ml) to T101 prior to its infusion. Our data confirm that (1) non-IgE-mediated mechanisms cause ITAR from this MAb, possibly by a mechanism inherent in the action of this MAb against lymphocytes, and (2) that isotypic antibody responses to MAb vary with the type of malignancy being treated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Immunologic hemorrhagic pneumonia caused by isocyanates.

The occurrence of hemoptysis, dyspnea, and bilateral pulmonary opacities progressed to respiratory failure in a 34-yr-old man. Recovery occurred with corticosteroid therapy. In the absence of evidence for an infectious etiology, the possibility of immunologic trimellitic anhydride (TMA) hemorrhagic pneumonitis was considered when the lung biopsy excluded Goodpasture's and other diseases and because the patient was a spray painter. Serologic evaluation for antibodies against TMA was requested. Because the immunologic studies for TMA were negative, and because the patient was a spray painter, immunoassays for three isocyanates conjugated to human serum albumin (HSA) were carried out although there was no specific history of isocyanate exposure at that time. High levels of IgG and IgE antibodies were detected against hexamethylene diisocyanate (HDI)-HSA and toluene diisocyanate (TDI)-HSA. Further investigation documented exposure to spray paint that contained HDI and another isocyanate. The paint was sprayed on warm metal, and subsequently the worker developed an acute illness. Further plant studies were not possible. We propose that the pathogenesis of this case of hemorrhagic pneumonitis is immunologic because of uncontrolled exposure to HDI and TDI, is analogous to the immunologic hemorrhagic pneumonia caused by TMA, and should be considered as a possible cause of a similar acute lung disease after isocyanate exposure.

Acute Disease↗
PubMed1990

Erythema multiforme and Stevens-Johnson syndrome. Descriptive and therapeutic controversy.

Diagnosis and particularly the management of erythema multiforme and Stevens-Johnson syndrome are controversial in medical textbooks and thus in individual cases. In these diseases, fatalities may result from various causes, including secondary infection or visceral organ damage to lung, liver, or kidneys. We present a series of 13 cases managed by one group of physicians which demonstrates the controversy in certain cases, and we review the controversy in the medical literature. Corticosteroid therapy used in this series was considered beneficial in every case by the managing physician and lifesaving in some cases. There were no fatalities in this series. Although the summation may be considered as our opinion only, the frequently suggested "controlled trial of corticosteroid therapy" can probably never be done for ethical reasons, and series such as this will have to establish the standard of therapy.

Erythema Multiforme↗
PubMed1990

Nearly fatal idiopathic anaphylactic reaction resulting in cardiovascular collapse and myocardial infarction.

We report a case of nearly fatal cardiovascular collapse attributable to an idiopathic anaphylactic reaction in a 76-year-old man. The event began with gastrointestinal symptoms of abdominal cramps, diarrhea, nausea, and vomiting as manifestations of IA. The patient subsequently progressed to develop urticaria, flushing, cardiovascular symptoms of chest pain, hypotension, and eventually cardiovascular collapse and myocardial infarction over a five-hour interval. This case emphasizes that the potential for life-threatening cardiovascular events from IA exists in patients without previously defined cardiac risk factors.

Aged↗
PubMed1990

Sitting forces and wheelchair mechanics.

The effects of back angle and leg height on sitting forces in a wheelchair were studied, using a force plate mounted on a wheelchair seat. Readings of both normal force (perpendicular to the seat) and shear force were measured while the chair's back angle and footrest height were changed. Pressure under the ischial tuberosities was also measured during the footrest height adjustments. Five normal subjects sat directly on the plate as well as upon ROHO and Jay cushions placed on the force plate. Returning the back to the upright position after a recline caused the normal force (+/- SD) to increase 5.4 +/- 2.5, 9.5 +/- 4.0, and 10.0 +/- 2.3 kg for the hard surface, Jay cushion, and ROHO cushion respectively, while shear at the plate increased to 5.1 +/- 2.2, 11.6 +/- 2.6, and 12.3 +/- 2.7 kg for the hard surface, Jay cushion, and ROHO cushion respectively. Leaning forward (away from the back) caused all the forces to return to measurements close to the starting values. The results suggest that the wheelchair user should momentarily lean forward after a recline to reduce undesired forces. If a cushion with firm thigh support is used, ischial tuberosity pressure can be reduced by lowering the leg height as much as possible, which causes a levering action by lifting the pelvis.

Biomechanical Phenomena↗
PubMed1990

Insulin allergy: re-evaluation after two decades.

We reevaluated IgE-mediated insulin allergy using sera obtained 16 to 21 years ago and, 1 and 5 years ago. All antibodies had specificity for human and bovine insulin. We reevaluated Prausnitz-Kustner reactivity after 15 years and the IgE antibody and cutaneous reactivity appeared unchanged. IgE-mediated insulin allergy appears to be declining.

Antibodies, Anti-Idiotypic↗
PubMed1990

Evaluation of ketotifen in corticosteroid-dependent idiopathic anaphylaxis.

To study the possible efficacy of ketotifen (K) in the treatment of idiopathic anaphylaxis (IA), K was administered in an open-label trial to six patients with IA who required corticosteroids at doses below which their disease could not be controlled. During the study, patients continued to receive noncorticosteroid medications (eg, antihistamines, oral adrenergic agents) that had been used on a regular basis for treatment of IA before study, but periodic attempts to reduce corticosteroid doses were made. A reduction of prednisone dose with continued control of disease was judged to be evidence for a beneficial effect of K. After 7 to 16 months of K administration, three patients were judged to have had probable benefits from K (reductions in alternate day prednisone dose requirement from 40 mg to none, 35 mg to 15 mg, and 30 mg to none), and one patient had a possible benefit from K (dose reduction from 100 to 120 mg to 77 mg). Two other patients were unable to tolerate major decreases in prednisone without developing symptoms or signs of IA. Within the limitations of this study design, we conclude that K may be efficacious in the treatment of some patients with IA, and that further trials of K in the treatment of IA are indicated.

Adult↗
PubMed1990

Asthma and pregnancy: responsibility of physicians and patients.

The successful management of asthma during pregnancy requires a cooperative approach between the obstetrician, the physician managing the asthma, and the patient. This is emphasized by a case report describing a patient with uncontrolled asthma subsequently managed with appropriate medical and obstetrical care. Concern for maternal and fetal health and reassurance of patients are primary concerns. Guidelines for physicians and patients are outlined as are the safety of drugs and therapy in pregnant patients. Physicians must have knowledge of appropriate use of medications during pregnancy.

Administration, Inhalation↗