Research & Publications
Dr Kaye Barrett was awarded a Junior Clinical Fellowship by the Arthritis and Rheumatism Council in August 1990, to work with Professor Dame Carol Black, studying the small intestine in systemic sclerosis (scleroderma).
She set up the following studies recruiting patients with small bowel symptomatology.
Permeability and absorptive capacity of the small intestine in systemic sclerosis
This non-invasive test employed the use of sugar probes, with subsequent analysis of the sugars in plasma and urine, using thin layer chromatography at St. Thomas’s hospital. The study found that patients with scleroderma had significantly increased permeability of the small intestine compared to a group of normal subjects. Absorption from the small intestine was also impaired.
Detection of bacterial overgrowth of the small intestine in a group of systemic sclerosis patients with symptoms of malabsorption.
For the purpose of the study, a new catheter system was designed for jejunal aspiration at endoscopy. Following jejunal aspiration, duodenal biopsies were obtained from each patient for routine histology and electron microscopy. Of the patients investigated for bacterial overgrowth, 33% had evidence of this on small bowel aspiration. Eight of the 24 patients in this group had weight loss but no evidence of bacterial overgrowth.
Study of the ultastructure of the small intestine in Systemic Sclerosis
This was a collaborative study with the Department of Electron Microscopy at the School of Hygiene and Tropical Medicine. Collagen cuffing of nerves and blood vessels was demonstrated in addition to neuronal damage and endothelial cell damage.
Study of mucosal blood flow of the stomach and duodenum in systemic sclerosis using a laser Doppler probe
Ten patients and ten normal volunteers were recruited for this study. Mucosal blood flow was measured in the gastric and duodenum via a laser Doppler probe introduced via a gastroscope. There was a 54% reduction in duodenal blood flow and a 61% reduction in gastric mucosal blood flow, compared to a group of normal control subjects.
A study of the oesophagus was also completed in 301 patients with systemic sclerosis using oesophageal scintigraphy, as a non-invasive test, to detect early oesophageal dysfunction.
Subsequent Research
Dr Kaye Barrett obtained a Trustee Research Fellowship in April 1998, for the funding of a clinical research fellow, to study the role of human retrovirus-5 in inflammatory arthritis.
In April 1997, she obtained a ‘Trustees Research Grant’, in conjunction with Dr. Michael Feher, to support collaborative work on “The assessment of a novel urate lowering compound in hyperuricaemia”. She has also carried out clinical research in osteoporosis.
Publications
Original Papers Dr Kaye ( nee O’Mahony)
Oligoarthritis in an elderly woman with diarrhoea and weight loss. Postgrad Med J 2001:77:475-477
Fenofibrate – a new treatment for hyperuricaemia and gout. Ann Rheum Dis 2001:60
Calcium and vitamin D supplementation in women with anorexia nervosa, and low bone density. Rheumatology 2001: 40:109
Long-term remission from gout associated with Fenofibrate therapy. Clin. Rheumatol 2003:22:73-76
Fenofibrate enhances urate reduction in men treated with Allopurinol for hyperuricaemia and gout. Rheumatology 2003:42:321-325
Oesophageal Scinitigraphy in Systemic Sclerosis; A simplified imaging and reporting methods. J Nucl Med Technol 1996; 24; 1-5
Detection of early asymptomatic oesophageal dysfunction in systemic sclerosis using a simplified scintigraphic grading method. J Rheumatol 1995; 23; 297-301
Bacterial overgrowth in systemic sclerosis; Detection and treatment outcome. Br J Rheumatol 1995; 34; 265-269
Malabsorption caused by celiac disease in patients who have scleroderma. Br J Rheumatol 1995; 34; 858-61
Ischaemia of the small intestine in systemic sclerosis; Raynaud’s Phenomenon or chronic vasculopathy? Q J Med 1994; 87; 495-500
Aortic Regurgitation in Crohn’s Disease. Am Heart J. June 1990; 119; 6; 1444-5
The antiphospholipid antibody syndrome in a 77 year old man with digital gangrene. Postgrad Med J. 1989; 65; 837-839
Review Articles
Polymyositis and Dermatomyositis; A review of treatment. Br J. Hosp Med 1994; 53; 463-468
Scleroderma and the Gastrointestinal tract; Up-to-Date.
MD Thesis submitted to the University of Liverpool, June 1998 entitled The Small Intestine in Systemic Sclerosis. The thesis was awarded, after a viva, in November 1998.
