Showing papers by "N. Franklin Adkinson published in 1999"
TL;DR: Examination of the recruitment experiences of the centers with and without delays did not indicate any single recruitment strategy that was certain to be successful, and the most commonly cited factors for success were a cohesive staff, endorsement of participation by the child's primary care provider, and ability of the staff to be flexible and honest in assessing progress and the value of recruiting methods being used.
Abstract: The Childhood Asthma Management Program (CAMP), a multicenter clinical trial sponsored by the Division of Lung Diseases of the National Heart, Lung, and Blood Institute (NHLBI), is the largest outcome study of mild to moderate asthma in children to be undertaken, with eight clinical centers in the United States and Canada participating. The initial recruitment goal was 960 children within an 18-month recruitment period. Recruitment was extended to 23 months, with 1041 children randomized from late December, 1993, to early September, 1995. In this time interval each of the eight centers met the recruitment goal of 120 using a variety of self-selected recruitment strategies. The goal for minority recruiting was 33%, or 320 of the planned 960 children to be recruited. CAMP achieved the overall goal for the number of minorities, with 330 patients. Three centers recruited at or above the expected rate from the beginning. The other five centers had significant delays in recruitment. Examination of the recruitment experiences of the centers with and without delays did not indicate any single recruitment strategy that was certain to be successful. The most commonly cited factors for success were a cohesive staff, endorsement of participation by the child's primary care provider, and ability of the staff to be flexible and honest in assessing progress and the value of recruiting methods being used.
36 citations
TL;DR: The diagnosis of latex allergy depends primarily on a clinical history in which latex exposure is associated with clinical allergy symptoms, and confirmatory skin tests and serologic tests that have been developed to measure specific anti-latex IgE often have reduced sensitivity and specificity.
Abstract: INTRODUCTION Allergic sensitivity to the plant protein constituents of natural rubber latex has become a major occupational hazard for health care workers and for certain patients with repetitive latex exposures.1,2 Epidemiologic studies from Europe indicate that between 2.2% and 10.7% of health care workers and between 1% and 2% of laboratory personnel are latex allergic.3–5 More recently, Brown et al studied a group of anesthesiologists and found the prevalence of latex allergy with clinical symptoms to be 2.4% and the prevalence of asymptomatic latex sensitization to be 10.1%.6 The prevalence of latex sensitization in children with spina bifida approaches 45%, possibly due to prolonged or repeated latex allergen exposure due to multiple surgical procedures and/or chronic indwelling catheters.7–9 Contact urticaria is the most common manifestation of latex allergy. The clinical sequelae of latex allergy also include other rashes, rhinoconjunctivitis, asthma, and systemic anaphylaxis.2 These allergic reactions are elicited in sensitized individuals by exposure to a group of allergenic latex proteins. Some allergen attaches to cornstarch particles and becomes airborne when powdered latex gloves are used.10 Latex proteins can also be absorbed through repeated contact with the skin (especially after abrasion) or mucosal surfaces. The diagnosis of latex allergy depends primarily on a clinical history in which latex exposure is associated with clinical allergy symptoms. Confirmatory skin tests and serologic tests that have been developed to measure specific anti-latex IgE often have reduced sensitivity and specificity.11–13 When the clinical history and anti-latex IgE tests are discordant, natural provocational procedures are useful to adjudicate the patients’ true latex sensitivity status.
18 citations