Biomedical subjects

A Jones

Publications and source records attributed to A Jones.

At least 415 records · Page 23Linked to original sources

PubMed1994

The social self, body dissatisfaction, and binge eating in obese females.

We examined the relationship of the social self to body dissatisfaction and to binge eating in two clinical samples of obese females. In the first study, with 32 nonbingeing obese females, social self measures of Public Self-Consciousness and Social Anxiety were positively correlated with body dissatisfaction. Self-esteem was negatively correlated with body dissatisfaction. In the second study, 11 obese binge eaters were compared with 11 matched nonbingeing obese females. Binge eaters were characterized by significantly higher levels of social anxiety and body dissatisfaction than the obese nonbingeing controls. These findings support the hypothesized links of social self concerns to body dissatisfaction and to binge eating in obese females.

Adult↗

PubMed1994

Ionspray mass spectrometry of ciguatoxin-1, maitotoxin-2 and -3, and related marine polyether toxins.

A range of marine polyether toxins from dinoflagellates were analysed by ionspray mass spectrometry. Ciguatoxin-1 ([M+H]+ m/z = 1,111.8) purified from several fish species yielded singly charged ions corresponding to the parent ion, sodium and H2O adducts and ions for the loss of up to five H2O molecules. Ciguatoxin-1 was detected to 1 ng; however, interference from fish lipids precluded direct detection of ciguatoxin-1 in crude extracts from fish flesh spiked with ciguatoxin-1 at a level equivalent to 1.5 ng ciguatoxin-1/g of extracted flesh. Maitotoxin-2 yielded doubly and triply charged ions for sodium and potassium salts and likely possessed only one sulphate ester (M(r) = 3,298 for the mono-sodium salt). Maitotoxin-3, a recently isolated small maitotoxin, yielded singly charged ions including ions for the loss of one sulphate and up to four H2O molecules. Maitotoxin-3 is proposed to be a polyether compound possessing two sulphate esters (M(r) = 1,060.5 for the disodium salt). Brevetoxin-A ([M+H]+ m/z = 867.5) and brevetoxin-B ([M+H]+ m/z = 895.5) yielded singly charged ions corresponding to the parent ion, Na+ adducts and the loss of up to four H2O molecules. Okadaic acid ([M+H]+ m/z = 805.5) yielded singly charged ions corresponding to the parent ion and ions for the loss of up to three H2O molecules. A signal for M + 18 Da species that may represent [M+NH4]+ was observed for ciguatoxin-1, brevetoxin-A and -B, and okadaic acid. For all polyethers examined, the orifice potential influenced the relative intensity of the ions detected in a predictable manner.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

Characterization of a single glycosylated asparagine site on a glycopeptide using solid-phase Edman degradation.

The characterization of site-specific glycosylation is traditionally dependent on the availability of suitable proteolytic cleavage sites between each glycosylated residue, so that peptides containing individual glycosylation sites are recovered. In the case of heavily glycosylated domains such as the O-glycosylated mucins, which have no available protease sites, this approach is not possible. Here we introduce a new method to gain site-specific compositional data on the oligosaccharides attached to a single amino acid. Using a model glycopeptide from a mutant human albumin Casebrook, glycosylated PTH-Asn was recovered after sequential solid-phase Edman degradation, subjected to acid hydrolysis and the sugars were identified by high performance anion exchange chromatography with pulsed amperometric detection. The PTH-Asn(Sac) derivative was further characterized by ionspray mass spectrometry. Comparison between an endoproteinase Glu-C glycopeptide and a tryptic glycopeptide showed that the oligosaccharide attached to Asn494 was stable after at least 10 cycles of Edman degradation.

Amino Acid Sequence↗

PubMed1994

Ultrasound evaluation of the inferior epigastric artery.

Color-flow Doppler ultrasound was used to assess the anatomic characteristics of the inferior epigastric artery (IEA) bilaterally in 20 nonatherosclerotic (group I; mean age, 28 years) and 20 atherosclerotic (group II; mean age, 57 years) subjects. Forty-nine percent of the IEAs were located laterally within the rectus sheath with 34% in a mid and 17% in a medial location. Seventeen percent had a large branch within 5 cm of the origin. Average length of the IEA was 10.7 +/- 3.2 cm. Average proximal and distal internal diameters were 3.0 +/- 0.45 and 1.9 +/- 0.35 mm, respectively. Neither length nor vessel diameter showed any correlation with age or body surface area. Sixty-two percent of the IEAs were greater than or equal to 9 cm in length and 1.5 mm in distal diameter. Stenosis of the vessel (more than 50% diameter) was noted at the proximal 1 cm segment in 20% of the IEAs in the atherosclerotic group but none of the IEAs in the nonatherosclerotic group. Beyond this proximal segment, there was freedom from atherosclerotic stenosis as demonstrated by the IEAs' similarity of length and diameter irrespective of age in these atherosclerotic and nonatherosclerotic populations.

Abdominal Muscles↗

PubMed1994

A simultaneous electrocardiogram is important when electroencephalography is used in the evaluation of loss of consciousness.

This study examined the use of electroencephalograms (EEGs) in 2 groups of patients with loss of consciousness (LOC), and the importance of a simultaneous electrocardiogram (ECG). Each group consisted of 75 patients referred for EEG. Group 1 patients (LOC without an established cause) had no clear history of convulsive disorder, while group 2 patients (LOC secondary to epilepsy) did. In all patients, it was ascertained if any previous cardiac investigations had been performed. All patients had an EEG performed with a simultaneous ECG. In addition to reporting the EEG, the neurologist reviewed the ECG rhythm and QRS morphology from the strip recording in an attempt to use this as a cardiac screening test. A cardiologist with the availability of all strip recordings and a subsequent 12 lead ECG reviewed his findings. The ECG was classified as significantly abnormal (potentially capable of causing syncope) in 17% of group 1 patients and 5% of group 2. The neurologist, using the simultaneous ECG strip recording only, correctly identified 14 of the 17 significantly abnormal ECGs (84%) and 127 of the 133 normal cases. In most cases, this was the only ECG evaluation as the EEG was performed without any prior cardiac investigation in 53% of group 1 patients and 92% of group 2. In conclusion, the EEG was often used as an initial investigation in these patients with LOC. A simultaneous ECG strip enabled the neurologist to detect most patients with significantly abnormal ECGs or rhythm. This will allow appropriate early cardiac review of these patients.

Adolescent↗

PubMed1994

Quantitative analysis of two pyridinium metabolites of haloperidol in patients with schizophrenia.

OBJECTIVE: A pyridinium metabolite (HPP+) of the neuroleptic drug haloperidol has been identified in rats and in the urine of patients. The purpose of this study was to measure the steady-state blood and plasma concentrations and daily urinary excretion of HPP+ in patients treated with haloperidol. METHODS: HPP+ was measured by HPLC with fluorescence detection. The chromatograms also revealed the presence of a previously unknown pyridinium species, which was identified in urine by liquid chromatography/mass spectrometry/mass spectrometry as 4-(4-chlorophenyl)-1-4-(4-fluorophenyl)-4-hydroxybutylpyridinium (RHPP+). Concentrations of RHPP+ were then measured by HPLC. RESULTS: The steady-state concentrations of HPP+ or RHPP+ in blood and plasma from 34 patients were virtually identical. The plasma concentrations of each metabolite were related to the daily dose of haloperidol and to its plasma concentrations. Nonlinearity in the elimination of RHPP+ was suggested by the increase in the ratio between RHPP+ and HPP+ plasma concentrations with dose or steady-state concentrations of haloperidol. The concentrations of RHPP+ in plasma and urine generally exceeded those of HPP+; the ratio between them in plasma ranged from 0.9 to 14.1. The daily urinary excretion of HPP+ and RHPP+ accounted for 0.40% +/- 0.18% and 2.3% +/- 1.4% of the haloperidol dose, respectively. The renal clearance of each species was 4.5 +/- 2.5 and 11.3 +/- 5.3 L/hr, respectively. CONCLUSIONS: The presence of these pyridinium species in humans raises the concern that they may be neurotoxic in a manner similar to the dopaminergic pro-neurotoxin, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine.

Adult↗

PubMed1994

Analysis of cerbB2 expression using a panel of 6 commercially available antibodies.

Results are presented of a study comparing cerbB2 (neu or Her2) expression as assessed immunohistochemically in breast neoplasia using a panel of 6 commercially available antibodies. The antibodies were examined utilizing conventional formalin fixed paraffin embedded tissue, and compared with molecular analysis of gene amplification. The aim was to determine the practical utility of each antibody, assessing ease of use, specific and non-specific staining characteristics, and expense, thus allowing a specific recommendation as to antibody of choice for immunohistochemical assessment of cerbB2 expression. Reassuringly, amongst the 38 breast lesions (36 carcinomas, 2 fibroadenomas) subjected to immunohistochemically (IHC) with the panel of 6 antibodies (Ab), no gross discrepancy of staining pattern was seen. Of the 38 cases, 10 were positive (26%), where at least one Ab demonstrated clear cytoplasmic membrane staining. Of a total of 45 breast lesions (43 carcinomas, 2 fibroadenomas), including all those examined by IHC, the total number of cases showing cerbB2 amplification by DNA analysis was 14 (31%). Using the DNA amplification as a base line for comparison, one Ab (No. 4) was found to stain 6 of the 14 cases of breast carcinoma that were assessed as showing amplification at the DNA level. Four Abs (1,3,5,6) stained 5 of these cases. However, Abs 3,4 and 6 displayed artefactual cytoplasmic staining (in the absence of membrane staining) that precluded the practical use of these reagents. Therefore, based on additional considerations of cost and ease of use, Ab No. 1 was finally chosen for recommendation from the 6 Ab panel.

Adult↗

PubMed1994

Benign myocardial uptake of hydroxymethylene diphosphonate.

During 'routine' bone scanning with diphosphonates, 10 elderly men were noted to show prominent myocardial uptake of Tc-hydroxymethylene diphosphonate (HDP) consistently, but no heart activity was seen with Tc-methylene disphosphonate (MDP). None had evidence of recent myocardial injury and the uptake persisted over a period of many months. In some, myocardial uptake defects were noted, analogous to 201Tl- and Tc-methoxyisobutyl isonitrile (MIBI) scans postinfarction. The condition appears to be essentially benign but its aetiology remains obscure. We have not been able to identify its cause; presumably atherosclerosis is one factor.

Aged↗

PubMed1994

Communication skills in palliative care: development and modification of a rating scale.

A complex rating scale has been used to evaluate the verbal communication skills of health professionals before and after training. The scale has been modified in order to decrease the useage time, to improve its accuracy and to develop a rating tool available to teachers. This paper describes the process of the modification and discusses the consequent validation of the scale.

Communication↗

PubMed1994

Strategic activity and financial performance of U.S. rural hospitals: a national study, 1983 to 1988.

This study examines the effect of 13 strategic management activities on the financial performance of a national sample of 797 U.S. rural hospitals during the period of 1983-1988. Controlled for environment-market, geographic-region, and hospital-related variables, the results show almost no measurable effect of strategic adoption on rural hospital profitability and liquidity. Where statistically significant relationships existed, they were more often negative than positive. These findings were not expected; it was hypothesized that positive effects across a broad range of strategies would emerge, other things being equal. Discussed are possible explanations for these findings as well as their implication for a rural health policy relying on individual rural hospital strategic adaptation to environmental change.

Catchment Area, Health↗

PubMed1994

Clinical complaints: a means of improving quality of care.

OBJECTIVES: To establish the reasons for clinical complaints, complainants' feelings about the original incident, and their motivation in complaining. DESIGN: Postal questionnaire survey. SETTING: 24 hospitals in North West Thames region. SUBJECTS: 1007 complainants who had written to 20 hospitals between 1 January 1992 and 30 June 1993 about a complaint involving a clinical incident. MAIN MEASURES: Personal details, the nature of the complaint, the complainant's reaction to the original incident, the quality of the explanation at the time of the incident, the reasons for making a complaint, and what would have prevented the incident. RESULTS: 491 completed questionnaires were received (response rate 49%). Complaints arose from serious incidents, generally a clinical problem combined with staff insensitivity and poor communication. Clinical complaints were seldom about a clinical incident alone (54; 11%); most (353; 72%) included a clinical component and dissatisfaction with personal treatment of the patient or care. In all, 242(49%) complainants reported a need for additional medical treatment, 206(42%) reported that the patient's condition had worsened as a result of treatment, and 175(36%) that side effects had been experienced. In 26(5%) cases the patient had died. Complainants' primary motive was to prevent recurrence of a similar incident. Lack of detailed information and staff attitude were identified as important criticisms. CONCLUSIONS: The emphasis must be on obtaining a better response to complaints at the clinical level by the staff involved in the original incident, not simply on adjusting the complaints procedure. Staff training in responding to distressed and dissatisfied patients is essential, and monitoring complaints must form part of a more general risk management programme.

Attitude of Health Personnel↗

PubMed1994

Asymptomatic bronchial hyperreactivity and the development of asthma and other respiratory tract illnesses in children.

BACKGROUND: It is not clear whether asymptomatic bronchial hyperresponsiveness (BHR) in children is a risk factor for the subsequent development of asthma. A longitudinal study was conducted to determine the predictive value of BHR for the development of asthma in a primary care patient population. METHODS: A standard free running asthma screening test (FRAST) was applied to 956 schoolchildren aged between 4 and 11 years in 1985. Peak expiratory flow (PEF) rates were measured before hard running for six minutes and following a three minute rest period. Children with a fall in PEF of more than 15% were labelled as having a positive FRAST. Clinical data from the patients' notes and from symptom questionnaires were compared with age and sex matched controls for children known to have asthma, and for those with a positive FRAST but no asthma (BHR group). Over the ensuing six years to 1991 further clinical data were gathered to compare the development of asthma and other diseases of the airways in both the BHR groups and their controls. RESULTS: Of the 956 children exercised in 1985, 60 who were not known to have asthma had an abnormal test. Of the 55 of these studied in 1991, 32 (58%) had developed asthma. The sensitivity of a positive FRAST for the development of asthma was 58%, its specificity 97%, and positive predictive value 72%. Hay fever, eczema, otitis media, "bronchitis," and family history of atopy also occurred more commonly in this group. CONCLUSIONS: Asymptomatic BHR, as shown by exercise challenge, can predict the development of clinical asthma. This study has also shown a relation between BHR, asthma, and other diseases of the airways, notably upper respiratory tract infection, "bronchitis," and otitis media.

Asthma↗

PubMed1994

Audit on myocardial infarction in a district general hospital: is there room for improvement in diagnostic accuracy?

The proportion of patients with an acute myocardial infarction (MI) whose diagnosis was missed on admission was accessed. The admitting consultants were then tested to see if they could diagnose the patients correctly when they were shown the admission histories and electrocardiograms (ECGs). Twenty-six per cent of patients with a final diagnosis of MI were not correctly diagnosed on admission. Fifty-one per cent of all patients did not receive thrombolytic therapy (TT) mainly because the diagnosis was not made on admission. A smaller proportion of these patients were admitted to the coronary care unit (CCU). The consultants only correctly diagnosed an average of 7.3 of the 20 patients who were mis-diagnosed on admission and would have prescribed TT to an average of 4.3 of these 20 patients. A significant proportion of patients had a diagnosis of MI missed on admission and therefore did not receive TT. Therefore, another aid to diagnosis such as serum creatinine phosphokinase (CPK) measurement should be available as an emergency test.

Aged↗

PubMed1994

Dynamic external fixation of unstable fractures of the distal part of the radius. A prospective, randomized comparison with static external fixation.

A prospective, randomized study was done to compare the results of dynamic external fixation (the Clyburn device) with those of static external fixation (the AO/ASIF device) in the treatment of fifty unstable fractures of the distal part of the radius. Mobilization of the wrist from neutral to 30 degrees of flexion was begun in the dynamic-fixator group at approximately two weeks, and full motion, allowing 30 degrees of extension, was started at approximately four weeks. The external fixation frames in both groups were kept in place for approximately ten weeks. Mobilization of the wrist in the dynamic-fixator group provided little gain in the mean motion of the wrist at the time of the removal of the fixator or at the one, six, or twelve-month evaluation. The static-fixator group had greater flexion of the wrist and radial deviation at the early and late follow-up examinations, while the dynamic-fixator group demonstrated only greater ulnar deviation one month after the fixator had been removed. Motion of the wrist in the dynamic-fixator group resulted in a statistically significant loss of radial length compared with that in the static-fixator group (four millimeters compared with one millimeter, p < 0.001). Complications were more frequent in the dynamic-fixator group. As evaluated with a modification of the scoring system of Gartland and Werley, 92 percent of the results at one year were excellent or good in the static-fixator group and 76 percent, in the dynamic-fixator group. The results of this study cannot support the concept of early mobilization with a dynamic external fixator for the treatment of unstable fractures of the distal part of the radius.

Adult↗

PubMed1994

Peripatetic and Euclidean theories of the visual ray.

The visual ray of Euclid's Optica is endowed with properties that reveal the concept to be an abstraction of a specific physical account of vision. The evolution of a physical theory of vision compatible with the Euclidean model can be traced in Peripatetic writings of the late fourth and third centuries B.C.

Greece, Ancient↗

PubMed1994

Distribution of hepatitis A antibody over a process for the preparation of a high-purity factor VIII concentrate.

The levels of hepatitis A antibody were studied in factor VIII products manufactured by the Scottish National Blood Transfusion Service. It was found that the current high-purity factor VIII product has no detectable hepatitis A antibody, whereas the superseded intermediate-purity product had significant antibody levels (6,700 mIU/ml). Although the finished high-potency factor VIII product has no detectable hepatitis A antibody, significant levels of antibody are found in the early stages of product manufacture. This antibody may offer some protection against hepatitis A contamination present in very occasional plasma donations. Antibody to parvovirus B19 is also present at intermediate stages in the manufacture of high-potency factor VIII, but its significance is not known. Hepatitis A antibody levels were also measured in normal immunoglobulin. These data indicate that antibody levels in the plasma pools used to manufacture factor VIII are falling.

Consumer Product Safety↗

PubMed1994

Screening for asthma in children.

The primary health care team is at the forefront of asthma management and there is evidence of improved delivery of care via nurse run, audited, general practice clinics. However, hospital admissions for asthma continue to rise. Screening for childhood asthma would appear to have advantages for patient care. This review looks critically at the literature that addresses important issues in screening for childhood asthma, including the problem of defining asthma, its prevalence rate and the importance of dealing with asthma as part of a spectrum of illnesses of the upper respiratory tract. The fundamental principles of screening in relation to asthma are addressed, and five screening procedures are described and debated. Questionnaire studies are concluded to be relatively cheap and reliable, and a compilation of validated questions is described. Such questions could be tailored to individual practice needs and used in the early detection of asthma, giving the potential for early intervention and improved quality of life.

Adolescent↗

PubMed1994

Screening for childhood asthma using an exercise test.

BACKGROUND: Screening for asthma in children in the community could have advantages at a time when prevalence rates of the condition and associated hospital admission rates are rising. AIM: The aim of this study was to assess the usefulness of a standard exercise test as a marker of asthma or potential asthma in children, and to examine the relationship between asthma and other respiratory tract illnesses. METHOD: In 1985 a cross-sectional research study was undertaken in 10 primary schools in West Glamorgan; the children were followed up over six years until 1991. The exercise test involved measuring peak expiratory flow rate before and after the children ran as fast as they could for six minutes. A control group of children with a negative exercise test result were compared with those not known to have asthma who had a positive result (fall in peak expiratory flow rate of 15% or greater), using clinical data. Similar clinical comparisons were undertaken between the children known to have asthma and a control group. RESULTS: Of 864 children not known to have asthma, 60 had a positive exercise result. Of 92 children known to have asthma, 33 had a positive test result and seven were unable to finish the test because of bronchospasm, a sensitivity of 43% and a specificity of 93%. Follow up of 55 of the 60 children not known to have asthma but who had an abnormal response to the test showed that 32 had developed clinically recognizable asthma six years later. There was a significantly higher prevalence of atopic and respiratory illnesses (otitis media, hay fever and eczema) in the group of children with bronchial hyperreactivity demonstrated on exercise than in those without bronchial hyperreactivity. CONCLUSION: This research shows that bronchial hyperreactivity demonstrated by an exercise test can be a marker for childhood asthma. The study has also identified other respiratory tract illnesses which appear to belong to the same spectrum as asthma.

Asthma↗