Search PubMed⌕ Search

Biomedical subjects

B A Jones

Publications and source records attributed to B A Jones.

At least 73 records · Page 4Linked to original sources
PubMed1985

The prevalence of appendiceal fecaliths in patients with and without appendicitis. A comparative study from Canada and South Africa.

Appendicitis is more common in developed than in developing societies and appendiceal fecaliths are thought to have an etiologic role in the disease. The geographic distribution of appendiceal fecaliths was investigated by systematic, intraoperative palpation of the appendix in patients in Toronto, Canada and Johannesburg, South Africa. The incidences of fecaliths found on pathologic sectioning of the appendix in appendicitis patients in both societies were compared. In the Canadian population, the prevalence of fecaliths in patients whose appendices were palpated incidentally was 32% versus 52% for those with appendicitis (p less than 0.01). In the African population, the prevalence of fecaliths in patients whose appendices were palpated incidentally was four per cent versus 23% for those with appendicitis (p = 0.04). The difference in prevalence of incidental appendiceal fecaliths in the two populations was statistically significant (p less than 0.005). The prevalence of fecaliths is higher in developed countries, such as Canada, than in developing countries, such as Africa, and is also higher in patients with than in those without appendicitis. These data support the theory that the low-fiber diets consumed in developed countries lead to fecalith formation, which then predisposes to appendicitis.

Adolescent↗
PubMed1985

Transluminal angioplasty: results in high-risk patients with advanced peripheral vascular disease.

The role of percutaneous transluminal angioplasty in treating advanced peripheral vascular disease is unknown. The authors therefore reviewed the experience of Sunnybrook Medical Centre in Toronto with 85 consecutive patients who had rest pain, ulceration, pregangrene or gangrene as a result of peripheral vascular disease and who underwent percutaneous transluminal angioplasty. Seventy-four percent were smokers and 91% were at increased risk due to one or more of the following: coronary or cerebral ischemic disease, diabetes mellitus, obesity and hypertension. Thirty-six patients underwent dilatation of iliac lesions, 46 of superficial femoral or popliteal and 3 of more distal lesions. In nine patients angioplasty was repeated on the same lesion. In 16 patients, the procedure was technically unsatisfactory. The morbidity and 30-day mortality were 5% and 2%, respectively. When the procedure was technically satisfactory, surgery was avoided and the limb was salvaged at 1, 2 and 5 years in 69%, 62% and 54% of cases, respectively (life-table analysis). The authors conclude that percutaneous transluminal angioplasty is acceptable treatment for patients with advanced peripheral vascular disease, because the morbidity and mortality are low and the long-term results are good.

Adult↗
PubMed1983

Bromine levels in tissue lipids of rats fed brominated fatty acids.

Rats have been fed diets containing either 0.8% brominated corn oil or 0.5% of the ethyl ester of 9,10-dibromostearate or 9,10,12,13-tetrabromostearate. The brominated compounds were incorporated into semisynthetic diets and animals were observed after feeding periods of 5 days to 3 months. With the exception of adipose tissues, the highest concentration of lipid-bound bromine was observed after 5 days on the experimental diets. It was also observed that feeding of the dibromostearate resulted in the highest levels of lipid-bound bromine in heart, whereas the tetrabromostearate tended to result in higher levels of lipid-bound bromine in liver. Brominated corn oil produced more substantial changes than the brominated fatty acid esters, inducing fatty livers and enlarged yellow hearts. Microscopic examination indicated myocardial degeneration and occasional early necrosis.

Animals↗
PubMed1983

Toxicology of brominated fatty acids: metabolite concentration and heart and liver changes.

Rats were fed for 35 days diets containing 2% of either brominated corn oil (BCO), monoglyceride of dibromostearate (DBS), monoglyceride of tetrabromostearate (TBS) or a mixture of the two monoglycerides (BMG) which provided proportions of brominated acids comparable to that of the BCO. Hearts from all animals fed BCO were yellow colored and firm in texture. Myocardial cellular degeneration, mild to moderate edema and occasional small necrotic foci were observed. Hearts from animals fed DBS showed moderate edema and some slight necrosis. All diets produced an increase in lipid content of heart. Animals fed the experimental diets developed enlarged livers and showed elevated liver lipid content. The tetrabromostearate appeared to be the more active in producing these changes, in particular a severe intracellular fatty degeneration. Shorter-chain (C-16, C-14) metabolites of di- and tetrabromostearate were identified and the concentration of brominated fatty acids in heart, liver and adipose tissue determined and found to account for 80% of the bromine detected in these tissues by neutron activation analysis. TBS accumulated in liver while the highest concentration of DBS was observed in heart lipids. Although the concentrations of brominated acids in heart and liver lipids were comparable in rats fed BCO or BMG, BCO produced the more pronounced effects. This differential could be due to additional active components in BCO or to a variation in response associated with changes in the location of the fatty acid on the glycerol molecule.

Adipose Tissue↗
PubMed1983

Early diagnosis and thyroidectomy in multiple endocrine neoplasia, type 2b.

Medullary thyroid carcinoma is a feature of multiple endocrine neoplasia, type 2b (MEN 2b). The cancer frequently gives rise to metastases in early life and is therefore often incurable by age 4 years. Because MEN 2b frequently appears as a spontaneous mutation, and because the characteristic phenotypic features are absent in the early life of most affected patients, both MEN 2b and its medullary thyroid cancer may elude diagnosis for years. Total thyroidectomy is the only established treatment for medullary thyroid carcinoma. The timing of thyroidectomy must take into account risks and benefits in small children, but the operation may well not cure after age 4 years. Thyroidectomies in two of our patients were accomplished at ages 2 and 2 1/2 years; no complications were encountered, and no metastatic disease was found in either child. Feeding difficulties--poor suck to the point of failure to thrive--were present in the neonatal periods of seven of our nine patients who had MEN 2b. Infants with feeding difficulties should be examined periodically for the onset of pathognomonic features of MEN 2b, particularly the ganglioneuromas, which usually appear before age three years.

Adolescent↗
PubMed1983

Healing factors of psychiatry in light of attachment theory.

Bowlby's attachment theory is an evolutionary biological model of human affectional bonding. Secure attachment to a parental figure has survival value and is necessary for normal development of the young. When secure attachment was lacking during formative years, the adult remains anxious about the availability of attachment figures in time of need. Persons seeking psychotherapy usually have such anxious attachment. Frank has pointed out features common to all psychotherapies. These common features describe a relationship which has the characteristics of a secure attachment. Strupp notes that specific technical skills are necessary for the success of psychotherapy. The therapist directs these techniques toward changing the patient's anxious attachment to a secure one. In the context of a secure attachment, the patient is able to change his attitudes, try new behaviors, and find fresh meaning in his world.

Adolescent↗
PubMed1978

Depression: a new approach to an old syndrome.

Depression is a medical illness related to an interplay of genetic, biochemical and environmental/experiential factors. Careful diagnosis, using contemporary psychiatric criteria, simplifies treatment by the family physician. Awareness of these criteria may lead to improved selection of candidates for drug treatment and early intervention in recurrent illness. The new nosology in psychiatry avoids much confusion and should take some of the guesswork out of psychiatric treatment in the family physician's office.

Antidepressive Agents, Tricyclic↗
PubMedDate not supplied

Psychosocial predictors of mortality in 83 women with premature acute myocardial infarction.

This was an exploratory investigation of psychosocial risk factors for mortality in women with premature acute myocardial infarction (AMI). Subjects were 83 female participants in the Recurrent Coronary Prevention Project, who were between the ages of 30 and 63 in 1978, nonsmoking, nondiabetic, and at least 6 months beyond their index AMI. Follow-up ranged from 8 to 10 years, with an average of 8.5 years. Six deaths occurred in the 83 women over the follow-up. Univariate predictors of these deaths were arrhythmias on ECG (RR = 7.83, p = .003), being divorced (RR = 6.9, p = .003), being employed without a college degree (RR = 6.8, p = .03), and the inverse of Type A behavior, time urgency, and emotional arousability (p = .03; .005; .006, respectively). Multivariate stepwise logistic regression analysis produced a solution that included as independent predictors: arrhythmias on ECG (RR = 4.01, p = .004), being divorced (RR = 3.43, p = .01), and the inverse of time urgency (RR = 0.35, p = .02). In the multivariate model, "divorced" was interchangeable with "employed without a college degree" and "time urgency" was interchangeable with "emotional arousability." This small sample precludes firm conclusions, but provides a basis for hypothesis development.

Adult↗
PubMedDate not supplied

Scene schemata and scripts in children's understanding of hospital.

In a first study, 90 children (aged 3-5 years) were shown a photograph of a hospital scene, and then asked to identify which of 12 separate items were present in the original scene. Children made more plausible than implausible errors, suggesting that they had well-organized schemata for hospital scenes. In a second study, we investigated children's knowledge of hospital-related routines and activities. A total of 152 children (aged 3-5, 6-8 and 9-10 years) were shown five photographs of hospital and five photographs of school, and asked to arrange each set to 'tell a story'. Children in different age groups showed relatively high agreement in their orderings, and also in selecting the 'most important photograph'. The data suggest that children's knowledge of hospital is organized around rudimentary schemata and scripts, which enable them to make very plausible inferences about hospital scenes and activities.

Child↗
PubMedDate not supplied

Quality assurance/control issues. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial.

ISSUES: General definitions of quality assurance and quality control (QA/C) have existed in many forms for decades, and a new discipline guides their application to diverse industrial and recently medical processes without much fanfare. However, in the field of cervical cytology screening, the range of QA/C options has recently broadened and become controversial. With the advent of new systems of terminology, larger-scale laboratories and new technologies--plus strong governmental and legal pressures in some nations--the range of extremely difficult and sometimes expensive QA/C choices our community faces is greater than ever. CONSENSUS POSITION: At our conference, the basic definitions of QA/C posed little difficulty. Presentation of the range of methods in use today and of those based on new technologies where use is proposed or has just begun also was achieved with little or no dispute. However, there was lack of consensus on exactly how QA/C methods are to be assessed. Indeed, there was little consistency in the use of different outcome measures with which we can judge success or failure of specific QA/C options. In addition, the tension between pressure to adopt sometimes uncertain or expensive method enhancements and pressure to maintain affordability and the widest possible access for populations that most need cervical cytology screening is greater than ever. ONGOING ISSUES: More data are required that would enable assessment of QA/C options with the clearest possible understanding of cost/benefits and current or new assumptions of risk. Other task forces, such as medicolegal, cost/benefit and those devoted to new technologies, are our essential partners in meeting the challenges described above.

Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

False positive cervicovaginal cytology. A follow-up study.

OBJECTIVE: To determine what percentage of cervical cytologic diagnoses initially classified as false positives (based on a negative cervical biopsy within three months of the cervical cytologic smear) are recategorized as histologic false negatives when subsequent studies reveal abnormalities. STUDY DESIGN: A three-year review of 1,242 cervicovaginal biopsies with corresponding cytology in the preceding three months revealed 68 cases (5.5%) where the cytology was positive for a squamous intraepithelial lesion but the biopsy was within normal limits or showed benign cellular changes. Follow-up cytologic and/or histologic diagnoses were obtained for 53 of the 68 cases from the patients' hospital and physician office records. RESULTS: Of the 53 cases with follow-up, 24 (45%) were found to have a subsequent squamous intraepithelial lesion (indicating a sampling error at the time of the initial biopsy), and 9 showed atypical squamous cells of undetermined significance. In addition, 9 of the 20 patients (45%) who had negative follow-up studies had benign abnormalities on the initial, noncorrelating biopsy that may have contributed to the discrepancy. CONCLUSION: This study emphasized the importance of diligent follow-up of patients with noncorrelating studies since they represent a population at high risk for the subsequent detection of premalignant conditions.

Biopsy↗