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Biomedical subjects

P A Barr

Publications and source records attributed to P A Barr.

At least 19 recordsLinked to original sources

Neosporosis in a young dog presenting with dermatitis and neuromuscular signs.

A 16-week-old, male boxer dog developed multifocal nodular dermatitis followed by rapidly progressive and fatal neuromuscular disease. Protozoal tachyzoites were demonstrated by aspiration and biopsy of dermal lesions. Necropsy and histology revealed necrotising inflammation associated with intralesional protozoal organisms in various organs including the brain, heart, skeletal muscle and skin. Serology suggested active infection with Neospora caninum. Immunohistochemistry provided a definitive diagnosis. Dermatitis is a finding rarely associated with juvenile neosporosis. The possible role of immunosuppression is discussed.

Animals↗

Informed consent for population-based research involving genetics.

Bridging the gap between gene discovery and our ability to use genetic information to benefit health requires population-based knowledge about the contribution of common gene variants and gene-environment interactions to the risk of disease. The risks and benefits associated with population-based research involving genetics, especially lower-penetrance gene variants, can differ in nature from those associated with family-based research. In response to the urgent need for appropriate guidelines, the Centers for Disease Control and Prevention formed a multidisciplinary group to develop an informed consent approach for integrating genetic variation into population-based research. The group used expert opinion and federal regulations, the National Bioethics Advisory Commission's report on research involving human biological materials, existing consent forms, and literature on informed consent to create suggested language for informed consent documents and a supplemental brochure. This language reflects the premise that the probability and magnitude of harm, as well as possible personal benefits, are directly related to the meaning of the results for the health of the participant and that appropriate disclosures and processes for obtaining consent should be based on an assessment at the outset of the likelihood that the results will generate information that could lead directly to an evidence-based intervention. This informed consent approach is proposed to promote discussion about how best to enable potential participants to make informed decisions about population-based research involving genetics and to suggest issues for consideration by research sponsors, institutional review boards, and investigators.

DNA↗

Efficacy of lamotrigine in refractory neonatal seizures.

A newborn infant with seizures of unknown etiology that were refractory to treatment with phenobarbitone, phenytoin, midazolam, clonazepam, and vigabatrin is reported. The introduction of the new antiepileptic drug lamotrigine was followed by rapid and sustained control of the seizures.

Anticonvulsants↗

The reliability and validity of a brief diabetes knowledge test.

OBJECTIVE: To examine the reliability and validity of a brief diabetes knowledge test. The diabetes knowledge test has two components: a 14-item general test and a 9-item insulin-use subscale. RESEARCH DESIGN AND METHODS: Two populations completed the test. In one population, patients received diabetes care in their community from a variety of providers, while the other population received care from local health departments. Cronbach's coefficient alpha was used to calculate scale reliability for each sample. To determine validity, patient group differences were examined. It was hypothesized that test scores would be higher for patients with type 1 diabetes, for patients with more education, and for patients who had received diabetes education. RESULTS: The coefficient alpha s for the general test and the insulin-use subscale indicate that both are reliable, alpha > or = 0.70. In the community sample, patients with type 1 diabetes scored higher than patients with type 2 diabetes on the general test and the insulin-use subscale. In the health department sample, patients with type 1 scored higher than patients with type 2 on the insulin-use subscale. For both samples, scores increased as the years of formal education completed increased, and patients who received diabetes education scored higher than patients who did not. CONCLUSIONS: Although the samples differed demographically, the reliability and validity of the test were supported in both the community and the health department samples. This suggests that the test is appropriate for a variety of settings and patient populations.

Adult↗

Learning to empower patients. Results of professional education program for diabetes educators.

The patient empowerment approach to diabetes education is intended to enable patients to make informed decisions about their own diabetes care and to be fully responsible members of the health-care team. Facilitating patient empowerment requires a specific set of skills and attitudes on the part of diabetes educators. A professional education program designed to facilitate the acquisition and enhancement of the requisite skills and attitudes was designed, implemented, and evaluated. The program involved adhering to a simulated diabetes care regimen for 3 days followed by a 3-day intensive skills-based workshop. The 23 educators who participated in the first two offerings of this program made significant gains in their counseling skills and demonstrated a positive change in attitude.

Attitude↗

Role of renin and aldosterone in establishment of electrolyte balance in very low birthweight neonates.

Urine sodium, potassium and chloride excretion, plasma renin activity (PRA) and urine aldosterone excretion (UAE) were measured in seven very low birthweight (VLBW) infants during the first 6 weeks after birth. Hyponatraemia was most common, and major changes in urine electrolyte excretion occurred, during the first 2 weeks. These changes in urine electrolyte excretion appeared to relate to improvement in distal tubular function. PRA did not correlate with urine excretion of either aldosterone or electrolytes. However, UAE correlated significantly with fractional sodium-potassium exchange in the distal tubule in a non-linear fashion (P less than 0.001) which suggested a threshold of aldosterone responsiveness between 70 and 100 nmol/24 h per 1.73 m2 UAE. We conclude that in VLBW infants the distal tubule can respond to aldosterone during the first 2-3 weeks, but that the threshold for responsiveness appears to be higher than it is in fullterm infants.

Aldosterone↗

Effect of diazoxide on the antepartum cardiotocograph in severe pregnancy-associated hypertension.

Intravenous diazoxide was given to 8 patients with severe pregnancy-associated hypertension (diastolic pressure greater than or equal to 110) in the antepartum period. Maternal hypertension was rapidly controlled in all patients; the diastolic blood pressure fell to less than or equal to 100 in all patients and to less than or equal to 85 in 7. Diazoxide had no significant effect on the basal fetal heart rate (FHR) or on the latency period or amplitude of late decelerations in the 3 patients with abnormal (positive) stress cardiotocographs (SCTG) and abnormal (unreactive) non-stress cardiotocographs (NSCTG). In the 5 patients with reactive NSCTGs, diazoxide had no significant effect on the basal FHR or on the frequency of fetal movement-induced FHR accelerations. Thus, diazoxide did not adversely affect fetal well-being in these patients with severe pregnancy-associated hypertension as assessed by cardiotocography.

Blood Pressure↗

Teaching of neuroanatomy by means of self-instructional laboratory stations.

Neuroanatomical laboratory material was presented to first-year medical students in a series of six self-instructional stations. Each station was designed to emphasize one major objective and to be completed without reference to any other station. Upon completion of a station the students filled out a response questionnaire. Five weeks later, short examinations testing both station content and application of the neuroanatomical principles were administered to volunteers from the class. Student response to this teaching format was highly favourable for all areas questioned. Results of the tests indicated a mastery of station material as defined by the objectives and an ability to use the material in applied problems. The laboratory station concept is economical of both student and instructor time and allows flexibility in the design of neuroanatomical laboratory experiences.

Education, Medical, Undergraduate↗