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Biomedical subjects

B Jones

Publications and source records attributed to B Jones.

At least 145 records · Page 8Linked to original sources
PubMed1999

The treatment of negative symptoms: a clinical and methodological study.

The primary objective of this study was to evaluate the efficacy, safety and tolerability of remoxipride (controlled release) versus haloperidol in patients with negative symptoms. The study comprised a multicentre, randomised, double-blind, parallel-group clinical trial. Two hundred and five patients were randomised to either remoxipride or haloperidol. Patients eligible for this study were aged 18-65 years, met the DSM-III-R diagnosis for chronic schizophrenia and the Positive and Negative Symptoms Scale (PANSS) criteria for predominant negative symptoms. There was a statistically significant reduction in the PANSS scores of at least 20% from baseline to last rating for 39 remoxipride (49.4%) and 45 haloperidol (47.6%) treated patients. There were no statistical differences found between the two treatment groups with respect to improvement of negative symptoms and adverse events. The PANSS data suggest that both remoxipride and haloperidol improve the cluster of negative symptoms concerned with social functioning. In addition, the design of the study provides a methodology that is appropriate to the study of primary negative symptoms in schizophrenia.

Adult↗
PubMed1999

Experimental approaches to the development of a recombinant hookworm vaccine.

Hookworm infection is a major parasitic cause of morbidity in the developing nations of the tropics. Development of a genetically engineered vaccine would be a useful tool in the control of this infection in highly endemic areas. Recombinant polypeptides belonging to the Ancylostoma secreted protein (ASP)-1 family have shown promise for reducing hookworm burdens after larval challenge infections in mice. Typically, these polypeptides are expressed in Escherichia coli and administered as an alum precipitate. Vaccine protection is antibody dependent. It is anticipated that a cocktail of different recombinant hookworm antigens may be required in order to effectively prevent heavy hookworm infections and disease. The progress of this work has been hampered by the absence of both a convenient laboratory animal with which to study hookworm infections resembling human infection, as well as the lack of easy availability of native hookworm antigens. In addition, useful human serologic correlates of antihookworm immunity are still poorly defined.

Ancylostoma↗
PubMed1999

Determination of tumour regression rates during radiotherapy for cervical carcinoma by serial MRI: comparison of two measurement techniques and examination of intraobserver and interobserver variability.

Tumour regression rates of 11 patients with cervical carcinoma were estimated during external beam radiotherapy (EBRT) using serial MRI (average time interval 7 days; range 3-15 days). An average of five investigations (range 4-8) was performed per subject. Tumour volume was measured by two observers using the Cavalieri method of modern design stereology in combination with (a) planimetry and (b) point counting. The mean precision of all the volume estimates obtained by manually tracing the outline of the tumour was 6.6%. The mean precision obtained by counting an average of 176 points per investigation on the same transects was 6.7%. The intraobserver repeatability of planimetry, interobserver reproducibility of planimetry and point counting were excellent with no significant difference between the volume estimates obtained using either technique. Based on the planimetry measurements, initial tumour volumes ranged from 6.5 to 222 cm3 (mean 63 cm3, median 44 cm3). Based on the point counting measurements, initial tumour volumes ranged from 7.2 to 235 cm3 (mean 68 cm3, median 46 cm3). Tumour regression began within a few days of commencing EBRT and showed an exponential relationship with time (p < 0.01). There was good agreement between the regression rates obtained by planimetry and those obtained by point counting. No significant correlation was found between initial tumour volume and tumour regression rate for either planimetry or point counting. Planimetry measurements were, on average, obtained in about half the time taken for point counting (i.e. 30 min and 50 min, respectively). Although point counting is generally likely to be the more efficient approach, planimetry may be the preferred approach for estimating tumour volume when a purpose built track ball is available and the tumour morphology is relatively simple. Volume measurement should be obtained using the Cavalieri method to ensure that the estimates are unbiased and that their precision can be predicted. The measured tumour regression rates may have important implications for improving local tumour control, optimum timing of brachytherapy and minimizing the risk of radiation damage.

Adult↗
PubMed1999

High dose rate brachytherapy practice for the treatment of gynaecological cancers in the UK.

A summary of UK high dose rate brachytherapy practice in gynaecological cancer is presented. There appears to be relatively good uniformity in dose prescription and biological effective doses, which represents a considerable improvement from the findings of a previous report of UK low dose rate brachytherapy practice in 1991. Individual details of the dose schedules used at each treatment centre are presented.

Brachytherapy↗
PubMed1999

Enhanced normal tissue doses caused by tumour shrinkage during brachytherapy.

Published data concerning shrinkage rates of low-grade gliomas implanted with 125I seeds have been used to determine the likely influence of such shrinkage on normal tissue doses. It is demonstrated that a tumour volume shrinkage of 50% over 6 months can bring about a 30% increase in the dose delivered to tissues which shrink centripetally towards the implanted volume. The use of radionuclides with a half-life shorter than that of 125I would substantially reduce shrinkage-induced dose increments.

Brachytherapy↗
PubMed1999

Contrast enhanced dynamic MRI of cervical carcinoma during radiotherapy: early prediction of tumour regression rate.

This prospective study investigated the relationship between changes in the MRI dynamic enhancement of cervical carcinoma early during radiotherapy, and tumour regression rate throughout radiotherapy. A total of 36 MRI examinations was performed in seven patients with cervical carcinoma, including a T2 weighted sequence weekly during radiotherapy and also a multislice dynamic Gd-DTPA enhanced sequence before and after the first 2 weeks of radiotherapy. Tumour enhancement was determined on dynamic images using a region of interest and signal-to-noise ratio method. Serial tumour volumes over time on T2 weighted images were estimated using the Cavalieri method of modern design-based stereology to obtain tumour regression rate. It was found that peak and mean enhancement prior to radiotherapy ranged from 3.0 to 13.3, and from 1.9 to 12.2, respectively. After 2 weeks of radiotherapy, peak and mean enhancement ranged from 7.5 to 13.0, and from 6.3 to 10.6, respectively. The change in peak and mean tumour enhancement between dynamic scans ranged, respectively, from -2.0 to 8.4 and from -4.5 to 8.5. Tumour volume decreased exponentially with time (p < 0.01). Tumour regression rates ranged from 2.0% to 15.2% per day, and correlated positively with changes of both peak and mean tumour enhancement (p < 0.01). It is concluded that MRI dynamic enhancement during the first 2 weeks of radiotherapy may provide early prediction of tumour regression rate, and therefore be of value in designing treatment schedules for cervical carcinoma.

Adult↗
PubMed1999

Primary care physicians' training and their community involvement.

BACKGROUND AND OBJECTIVES: Physicians who incorporate a community perspective into their clinical practice can provide more effective care, but little is known about the type of training that helps physicians include this perspective. This study examines associations between physicians' current level of involvement in their communities and a range of prior educational experiences. METHODS: We obtained data from 247 recently graduated primary care physicians through a nationwide mail survey. Physicians described their community-related training experiences during medical school and residency. They also described their current involvement in each of 4 domains of community work. Associations between different training experiences and physicians' current community involvement were examined. RESULTS: Subjects generally reported limited community-related training. Physicians who did receive training in content relevant to a given community domain were significantly more involved in that domain as practicing physicians. Rotating in rural locations and having a mentor active in the community also were associated with greater current community involvement. CONCLUSIONS: These data provide evidence that formal training experiences can influence how actively physicians will later interact with their communities. We should provide medical students and residents with educational content in all 4 domains of community work, place them in carefully selected locations, and arrange mentor relationships.

Community Health Services↗
PubMed1999

Overcoming multidrug resistance: valspodar as a paradigm for nursing care.

PURPOSE/OBJECTIVES: To review the mechanisms of multidrug resistance (MDR) in human cancer and the clinical use of MDR modulators to overcome or reverse P-glycoprotein (P-gp)-mediated MDR. DATA SOURCES: Current literature, ongoing clinical trials, and clinical experience. DATA SYNTHESIS: Agents, such as valspodar, that block the activity of P-gp can reverse or overcome MDR caused by overexpression of P-gp. The MDR modulator valspodar (PSC 833; Novartis Pharmaceuticals Corporation, East Hanover, NJ) is examined as a model for establishing nursing guidelines for this new class of therapeutic agents. CONCLUSIONS: The dose of some chemotherapy agents must be modified with concurrent valspodar administration. Studies examining the safety and efficacy of valspodar as a prototype of MDR modulators provide the basis for establishing nursing care guidelines. IMPLICATIONS FOR NURSING PRACTICE: Nursing care for the administration of valspodar includes understanding patient selection, criteria, dosing, and administration; side-effect management; patient monitoring and follow-up; and patient education.

ATP Binding Cassette Transporter, Subfamily B↗
PubMed1999

No waiting.

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Commerce↗
PubMed1999

Neonatal nurse practitioners--a model for expanding the boundaries of nursing culture in New Zealand.

The development and terminology of what constitutes advanced practice nursing roles in New Zealand has been the subject of recent debate within nursing. This article outlines the development of the neonatal nurse practitioner role in New Zealand as an example of one advanced practice nursing role. A model of how nursing culture changes to include roles that incorporate components that historically have been considered the domain of other health professionals is proposed. This article outlines some of the issues surrounding the neonatal nurse practitioner role, including the educational requirements for this role in New Zealand.

Humans↗
PubMed1999

Improving preventive practice. An educational intervention using chart audit.

OBJECTIVE: To assess if the impact of teaching preventive medicine can be increased by supplementing conventional teaching with a practice based preventive audit undertaken by general practice registrars and their supervisors. METHOD: A practice based medical record audit of preventive activities was undertaken by 30 general practice registrars and 27 of their supervisors. Items recorded were based on the RACGP's Guidelines for Preventive Activities in General Practice. Participants were also asked to identify or target areas identified by the audit which they specifically wished to improve. Following an educational program on preventive medicine for both groups, the audit was repeated to assess changes made. RESULTS: Both registrars and supervisors increased their level of prevention in most parameters measured. Registrars' scores were lower than supervisors' for all items in the initial audit but they made greater improvements by the repeat audit (p < 0.02 for all items). There was great variability between the level of recording of preventive data--from rubella immunity (which was recorded in only 22% of cases) to blood pressure (which was recorded in 94% of cases). There was also variability between practices. Items specifically targeted for improvement by participants did not improve more than other items. CONCLUSION: Supplementing conventional teaching with a practice-based audit improved the level of preventive medicine undertaken in teaching practices, by both registrars and supervisors.

Adolescent↗