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Biomedical subjects

A Forsyth

Publications and source records attributed to A Forsyth.

At least 19 recordsLinked to original sources

A controlled study of gold contact hypersensitivity.

1203 patients attending for routine patch testing at 3 hospitals and 105 volunteers were tested with 0.5% and 0.05% gold sodium thiosulfate (GST). 38 patients (3.2%) and 5 volunteers (4.8%) had positive patch tests to GST. There were no significant differences between volunteers and patients with respect to age, sex, atopy or exposure to gold in dental restorations, jewellery or through occupation. There were no significant differences in prevalence of GST hypersensitivity in the 3 hospitals, or between patients and controls. This is the 1st controlled study of hypersensitivity to GST, and suggests that routine patch testing to gold is of limited clinical benefit.

Adolescent

Effects of temperature on phrenic nerve and diaphragmatic function during cardiac surgery.

We have studied the effects of whole body cooling on phrenic nerve and diaphragmatic function in 26 patients using magnetic stimulation of the phrenic nerves with a pair of Magstim 200 HP stimulator coils during cardiopulmonary bypass. The diaphragmatic electromyogram in response to magnetic pulses was recorded with needle electrodes at two temperatures, approximately 31 degrees C (cold) and approximately 36 degrees C (warm) during the cooling or rewarming phase of hypothermic cardiopulmonary bypass. This 5 degrees C temperature change was associated with clear changes in the evoked electromyographical response of the diaphragm. Median latency between stimulus and electromyographic response was 10.1 (range 8.0-11.8) ms during cold and 8.3 (5.9-10.2) ms during warm stimulation (P < 0.001). Median duration of the muscle compound action potential was prolonged and its amplitude reduced in cold compared with warm stimulations (P < 0.01). These effects were enhanced by application of ice slush to the heart. We conclude that diaphragmatic function may be affected by mild hypothermia after cardiac surgery.

Adult

Prevalence of gold contact hypersensitivity in the west of Scotland.

373 patients attending for routine patch testing were tested with 0.5% and 0.05% gold sodium thiosulfate (GST). 8 (2.1%) patients had a positive patch test, and a further 4 (1.0%) patient reactions which were interpreted as irritant 2 out of 8 patients with a positive patch test to GST suspected gold allergy prior to testing, and both of these patients reported that their eczema resolved if they avoided gold jewellery. This is the lowest prevalence of hypersensitivity to GST reported and suggests that gold contact allergy may not be as widespread as has been recently proposed.

Adolescent

Patch testing in discoid eczema.

We report a retrospective study of patch testing in patients with discoid eczema. 48 patients with persistent or severe discoid eczema were patch tested. The mean age of patients was 45 years and the median duration of symptoms was 6 months. 24 patients (50%) had positive patch tests, and 16 of these (33%) were considered to be clinically relevant. The most common allergens implicated were rubber chemicals, formaldehyde, neomycin, chrome, nickel (5, 2, 2, 2, 2, 2 reactions, respectively). 13 of 16 patients were followed up by telephone in 1996, and 8/13 (61%) stated they had benefited from patch testing. This study suggests allergic contact dermatitis is relatively common in persistent discoid eczema, and allergen avoidance may be of benefit. We recommend patch testing should be considered for all patients with severe or persistent discoid eczema.

Adolescent

Patch testing in children.

92 children (45 girls, 47 boys), mean age 9.3 years (3-14.75), were referred to the Contact Dermatitis Investigation Unit, Belvidere Hospital, Glasgow, for patch testing during the period 1979-93 for the investigation of allergic contact dermatitis (ACD). The diagnoses at the time of referral were atopic dermatitis (45), non-atopic with localized dermatitis (26), juvenile plantar dermatosis (15), orofacial granulomatosis (2), vaccination reaction (2) and atypical psoriasis (2). In total, there were 55 positive reactions in 30 children. The commonest allergens were metals (18), fragrances (11) and rubber compounds (6). The patient groups with the highest yield of positive patch tests were those patients with atopic dermatitis who had a good history of a precipitating contact factor (4/5), and non-atopic patients with dermatitis of hand and/or feet (7/14). Our findings suggest that allergic contact dermatitis is more common in children than generally appreciated and that patch testing is a practicable and clinically worthwhile procedure in children.

Child

Contact sensitivity to menthol and peppermint in patients with intra-oral symptoms.

We report 12 cases of contact sensitivity to the flavouring agents menthol and peppermint oil in patients presenting with intra-oral symptoms in association with burning mouth syndrome, recurrent oral ulceration or a lichenoid reaction. The patients were referred from the Glasgow Dental Hospital over a 4-year period for assessment of the possible contribution of contact sensitivity to their complaints. 5 patients with burning mouth syndrome demonstrated contact sensitivity to menthol and/or peppermint, with 1 patient sensitive to both agents, 3 positive to menthol only and 1 to peppermint only. 4 cases with recurrent intra-oral ulceration were sensitive to both menthol and peppermint. 3 patients with an oral lichenoid reaction were positive to menthol on patch testing, with 2 also sensitive to peppermint. 9 of the 12 cases demonstrated additional positive patch test results. After a mean follow-up of 32.7 months (range 9-48 months), of the 9 patients that could be contacted, 6 patients described clearance or improvement of their symptoms as a consequence of avoidance of menthol/peppermint.

Adult

Diets for disease? Intraurban variation in reported food consumption in Glasgow.

A recent official report on the Scottish Diet reviews evidence for poor health and poor diets among the Scots, and makes extensive and specific recommendations about dietary change. This paper examines the extent to which reported consumption of fifteen of the food groups discussed in that report vary among four neighbourhoods in Glasgow City. Some foods appear to be typical of a wider Glaswegian (or Scottish) diet and show little variation among neighbourhoods (e.g. semi-skimmed milk, white fish, confectionery, cakes and pastries, savoury snacks). Other foods however show marked differences between neighbourhoods after controlling for sex, age and social class; these include fruit, vegetables, meat (particularly processed meat products), bread, spreading fats, sugar, natural fruit juice and alcohol. This suggests that such intraurban variations in food consumption cannot be explained simply by socio-demographic or socio-economic factors in individuals and that cultural and supply factors also need to be taken into account.

Adult

Type 3 burning mouth syndrome: psychological and allergic aspects.

A subgroup of patients with burning mouth syndrome was investigated. The clinical history of these patients differed from the norm in that symptoms were intermittent and affected unusual sites. In addition, routine investigations were supplemented with a more detailed psychological evaluation than reported previously and also a possible allergic component was studied by patch testing. The study has shown that this subgroup differs from burning mouth syndrome patients overall in that emotional instability and allergic reactions, particularly to food additives, are of etiological significance and require to be taken into consideration in terms of patient management.

Aged

Predicting initiation to and cessation of buprenorphine and temazepam use amongst adolescents.

Two interviews separated by 12 months (mean) were conducted with a purposive sample of Glaswegian adolescent drug misusers. Across that interval, beginning to use buprenorphine and temazepam were predictable by prior extent of other substance use, especially cannabis and tobacco, and by the Drug Misuse Scale, using selected MMPI items. About 50% of those who had been using either drug prior to first interview did not use at all between first and second interview. For temazepam, this cessation was not predictable, but ceasing to use buprenorphine was more likely the less time subjects had used this drug and if they had never injected. It is concluded that personality and frequent substance use predispose to drug misuse, but that additional factors must lead to dependence.

Adolescent

Allergic contact dermatitis in atopic dermatitis.

Of 73 adult patients attending a clinic specially provided to treat patients with atopic dermatitis, 31 (42%) showed one or more positive patch reaction on contact testing. There was a striking female preponderance in the patch test positive group (26F:5M) in contrast to those with negative test results (9F:17M). The commonest allergens identified were fragrances in 13 patients, nickel (7), rubber (5), lanolin (4) and formaldehyde (3). In 21 patients, topical preparations, cosmetic or medically prescribed, could be implicated. Contact sensitivity seems to be relatively common in adult patients who have a continuing problem with their atopic dermatitis. Recognizing this sensitization may be important in their management.

Adolescent

Scottish cocaine users: wealthy snorters or delinquent smokers?

Ninety-two cocaine users were interviewed in Scotland. Most were middle-class nasal users, also used other drugs and generally gave cocaine a positive rating. One half of them had at some time used cocaine more than once a week. For some, this period lasted some months, when as much as 30 'lines' of cocaine were used per day of cocaine use. More of these heavy users reported adverse effects of cocaine than was the case for light users. Nonetheless, most heavy users had reduced their use by themselves to the point that their current cocaine use was no different from that of light users. Possible explanations for this apparently spontaneous reduction are discussed.

Adolescent

A short scale for predicting drug misuse using selected items from the MMPI.

The Minnesota Multiphasic Personality Inventory (MMPI) was administered to 210 young people who either used no drugs, used non-opioids, used opioids but did not inject and drug injectors. From the data collected a short scale of 37 items was derived which distinguished between non-users and drug users. Validation was then attempted using 214 subjects who were either in drug treatment programmes or alcohol treatment programmes as well as appropriate control groups. The Drug Misuse Scale was able to distinguish between these groups. The MacAndrew Scale proved better at distinguishing subjects in alcohol treatment programmes. However, the Drug Misuse Scale proved to be significantly better at distinguishing the drug misusers. It is suggested that the Drug Misuse Scale may prove a valuable clinical tool.

Adolescent