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Biomedical subjects

T M Bell

Publications and source records attributed to T M Bell.

At least 19 recordsLinked to original sources
PubMed1999

Low-titre auto-antibodies predict autoimmune disease during interferon-alpha treatment of chronic hepatitis C.

BACKGROUND: In this study, we determined whether low-titre auto-antibodies are a risk factor for the development of autoimmune disease during interferon-alpha (IFNalpha) therapy for chronic hepatitis C (CHC) infection. METHODS: Eighty-three patients with circulating hepatitis C virus RNA and chronic viral hepatitis on liver biopsy, who had not received IFNalpha, were assessed for serum auto-antibodies (anti-nuclear antibodies (ANA), anti-smooth muscle antibodies, thyroid microsomal antibodies, thyroglobulin antibodies) and thyroid function tests. RESULTS: Thirty-five patients had one or more pre-existing auto-antibody. The majority were low titre ANA. Seven of the 35 patients had clinical autoimmune disease or immune-mediated disorders, predominantly thyroid disease. Twenty patients with low titre auto-antibodies received treatment with IFNalpha and of these 20 patients, six patients developed adverse effects with a possible auto-immune basis. In comparison, only five of the 48 patients without auto-antibodies had immune-mediated disorders and no patient developed autoimmune complications during therapy with IFNalpha. CONCLUSIONS: These results suggest that the presence of low-titre auto-antibodies may be a risk factor for the development of autoimmune dysfunction during IFNalpha therapy for chronic hepatitis C. Patients with no detectable auto-antibodies have a low risk for developing autoimmune complications during treatment with IFNalpha.

Adult↗
PubMed1999

Assessment of two 'low-tech' genetic health care procedures performed by prenatal care providers in Washington state: implications for future policy development activities.

Equity in health care demands that patients be treated fairly, impartially and with justice. Health care professionals and others have long been aware of the concept of equity, and the many inequities that exist in our health care system. As part of our analysis of postpartum data collected between 1993 and 1996 by the Washington Pregnancy Risk Assessment Monitoring System (PRAMS) from self-administered patient surveys, we explored equity as it pertains to two 'low-tech' prenatal genetic health care procedures: (1) whether or not prenatal care providers asked their patients about a family history of birth defects/genetic disorders, and (2) whether or not prenatal care providers talked to their patients about prenatal testing for birth defects/genetic disorders. Overall, about 80% of pregnant women reported that they had been asked about their family history of birth defects/genetic disorders, and about 85% said that their prenatal care provider(s) had talked to them about prenatal testing. Maternal characteristics associated with a lower likelihood of receiving these two low-tech genetic health care procedures appeared to be young maternal age, and low education and income levels, regardless of where women with these attributes received their prenatal care (e.g. community, migrant, health department or military health care clinics, private physicians, or health maintenance organizations).

Journal Article↗
PubMed1988

Viral etiology and epidemiology of acute respiratory infections in children in Nairobi, Kenya.

Acute respiratory infection (ARI) is the most common cause of illness and death in young children worldwide. Because of inadequate laboratory facilities and financial resources the etiological agents responsible for most cases in developing countries remain unknown, thus obviating appropriate management. Therefore, an ARI program was commenced at the Kenyatta National Hospital, Nairobi, Kenya in 1981 with the objectives of establishing the microbial causes, clinical presentations, and diagnoses of ARI in children under 5 years of age and of developing simple, rapid, and inexpensive diagnostic techniques. Viruses were demonstrated in 54% of the 822 children studied, but over half of the viruses identified were types not commonly associated elsewhere with the causation of severe ARI. Respiratory syncytial, parainfluenza, and adenoviruses occurred in the same age groups and during similar weather conditions as elsewhere. Measles virus occurred most frequently in those 7 to 9 months old. Herpes simplex, rhino-, and enteroviruses play causative roles in some cases of severe ARI in Kenyan children. A combination of immunofluorescent and cell culture techniques were shown to be essential for the detection of viruses.

Acute Disease↗
PubMed1985

Investigation of the effectiveness of measles vaccination in children in Kenya.

Laboratory studies were performed on 128 children clinically diagnosed as measles when seen at the Infectious Diseases Hospital, Kenyatta National Hospital (IDH), Nairobi (86 cases) and the Rural Health Training Centre, Maragua, Central Province (42 cases) between 9 July and 31 August 1984. A concurrent measles infection was confirmed in 95% of the children seen at IDH and in 85% of those seen at Maragua, with similar proportions of confirmations in children who had, and who had not, received measles vaccine. No differences in the number of sero-conversions nor in the absolute levels of acute or convalescent HI antibody titres could be detected between vaccinated and unvaccinated children. Analysis of the cases seen at Maragua indicates that about two thirds of the children who had received vaccine were protected. A pilot study of vaccinating children at 8 months and again at 12-13 months is suggested in an attempt to eradicate measles.

Age Factors↗
PubMed1985

Detection of rotavirus by a latex agglutination test, Rotalex: comparison with electron microscopy, immunofluorescence, polyacrylamide gel electrophoresis, and enzyme linked immunosorbent assay.

A commercially available latex agglutination test, Rotalex (Orion Diagnostics, Finland), for detecting rotaviruses was evaluated in comparison with four other tests (electron microscopy, immunofluorescence, polyacrylamide gel electrophoresis, and enzyme linked immunosorbent assay) routinely used in our laboratories. Although Rotalex was the least complex method, it showed lack of specificity and sensitivity when carried out according to the manufacturer's instructions. Four basic modifications of Rotalex are described. These include the use of Hank's balanced salt solution, increasing the incubation time to 20 min, reading the agglutination result by an experienced observer, and the use of 50 mm square glass plates. The modified procedure gave results which were comparable with those obtained by electron microscopy, immunofluorescence, polyacrylamide gel electrophoresis, and enzyme linked immunosorbent assay. The latter techniques, when used to detect rotavirus, all gave similar results.

Electrophoresis, Polyacrylamide Gel↗
PubMed1984

The association of extrahepatic bile duct atresia and neonatal Epstein-Barr virus infection.

An infant with uncorrectable extrahepatic bile duct atresia was found to have evidence of Epstein-Barr virus infection during the neonatal period. It is probable that the infection was acquired in utero. In view of the association of hepatitis with the Epstein-Barr virus in later life, it is possible that this infection was responsible for the development of bile duct obstruction.

Antibodies, Viral↗
PubMed1976

Application of immunofluorescence to a study of measles.

A new and rapid method for the laboratory diagnosis of measles, using the fluorescent antibody technique applied to nasopharyngeal secretions is described. The reliability of the method was best shown by correlation with clinical diagnosis, which gave an overall agreement of 95% in 53 cases of typical clinical measles and 72 control children. Correlation with results of tissue culture and serology was also good, though these methods are in practice too infrequently successful to be used as the main standards of reliability. The antiserum used for immunoflorescence showed no cross-reactivity with other viruses. Viruses could be identified by the fluorescent antibody technique from 4 days before to 10 days after the onset of the rash in a high proportion of cases. The wider applications of this method include rapid diagnosis of measles before the rash has appeared; in cases where clinical diagnosis is in doubt, especially in dark-skinned children, or when the illness has been modified by previous vaccination; prevention of cross-infection by early detection of measles; and investigation of the immune response and its relationship to nutritional status.

Antigens, Viral↗