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Biomedical subjects

E Jones

Publications and source records attributed to E Jones.

At least 325 records · Page 18Linked to original sources
PubMedDate not supplied

HIV-1 drug resistance in newly infected individuals.

CONTEXT: There is concern that the widespread use of antiretroviral drugs to treat human immunodeficiency virus 1 (HIV-1) infection may result in the increased transmission of drug-resistant virus. OBJECTIVE: To determine the prevalence of drug resistance-conferring mutations and phenotypic resistance to antiretroviral agents in a cohort of individuals newly infected with HIV-1. DESIGN: Case series with genetic analyses of the HIV-1 plasma-derived pol gene using reverse transcriptase polymerase chain reaction followed by direct sequencing of polymerase chain reaction products. Phenotypic analysis was performed with a recombinant virus assay. SETTING AND PATIENTS: Eighty individuals referred, on average, 1.7 months after infection with HIV-1 to the Aaron Diamond AIDS Research Center between July 1995 and April 1999. Subjects were from large urban areas (65 from New York, NY; 11 from Los Angeles, Calif); 60 (75%) were white, and 75 (93.8%) were homosexual men. MAIN OUTCOME MEASURES: Prevalence of known resistance-conferring genotypes and reduced susceptibility to individual antiviral agents by phenotype. RESULTS: Thirteen individuals (16.3%) had genotypes associated with drug resistance to any antiretroviral agent. Virus with known resistance-conferring mutations to any nucleoside reverse transcriptase inhibitors was found in 10 individuals, to any nonnucleoside reverse transcriptase inhibitors in 6 subjects, and to any protease inhibitors in 2 cases. Multidrug-resistant virus was identified in 3 individuals (3.8%). Extensive polymorphism in the protease gene was identified. Interpretation of genotypes and phenotypes was concordant in 57 (85%) of the 67 cases in which both studies were performed. CONCLUSION: The prevalence of HIV-1 variants with known resistance-conferring genotypes to any antiretroviral agent in this cohort of 80 newly infected individuals is 16.3%. These data support expanded use of resistance testing in the setting of primary HIV-1 infection. Clinical trials should be initiated to establish whether therapy guided by resistance testing, compared with the use of empirical triple combination antiretroviral therapy, provides additional virological and immunological benefit when treating primary HIV-1 infection. Further efforts to expand the study of transmission of drug-resistant HIV-1 variants, particularly in cohorts with different epidemiological profiles, are indicated.

Adult↗
PubMedDate not supplied

Betamethasone valerate in foam vehicle is effective with both daily and twice a day dosing: a single-blind, open-label study in the treatment of scalp psoriasis.

BACKGROUND: Psoriasis is a chronic relapsing skin disorder that affects about 2% of the U.S. population and involves the scalp approximately 50% of the time. Topical corticosteroids, including betamethasone valerate, have been used effectively in the treatment of corticosteroid-responsive dermatoses of the skin and scalp. Betamethasone valerate (BMV) in foam vehicle (Luxiq) is designed to improve patient compliance with topical therapy. Superior efficacy over a BMV lotion preparation has been demonstrated with twice-daily use. Even greater compliance would be expected if the drug is effective with once-daily application. PURPOSE: To compare the efficacy of the betamethasone valerate foam (Luxiq) in the treatment of scalp psoriasis following once-daily versus twice-daily dosing. METHODS: Seventy-nine patients with moderate to severe scalp psoriasis from seven centers were enrolled and treated with BMV foam either once a day or twice a day for four weeks. The physician-grader was blinded to the treatment regimen, and the subjects were randomly assigned to either once-daily or twice-daily dosing in a 1:1 ratio. RESULTS: The signs of psoriasis (plaque thickness, scaling, and erythema) were assessed before and after treatment. The investigator's and the patients' global assessments were also evaluated. The composite score improved from 7.7 +/- 2.1 to 3.0 +/- 2.2 with twice-a-day use and from 8.1 +/- 2.2 to 3.9 +/- 2.8 with once-daily use (p > 0.05 for the difference between groups). DISCUSSION: BMV foam is effective for scalp psoriasis with both once-a-day and twice-a-day use. This feature of the BMV foam is encouraging for expected improvement in clinical use.

Administration, Topical↗
PubMedDate not supplied

Use of oral metronidazole in pregnancy. Risks, benefits, and practice guidelines.

Metronidazole is the recommended treatment for trichomoniasis and bacterial vaginosis in nonpregnant women. Reluctance to use this drug in pregnancy is related to concerns about possible adverse effects on the fetus. However, recent literature suggests associations between these infections during pregnancy and risk of preterm delivery; if such associations are causal and preterm birth is shown to be prevented by effective treatment, the risk-benefit equation may be altered. This article reviews the literature on the carcinogenic and teratogenic potential of metronidazole and discusses the evidence that associates trichomoniasis and bacterial vaginosis with perinatal outcomes. Current practice recommendations are summarized.

Clinical Protocols↗
PubMedDate not supplied

The assessment of the mutagenic potential of vehicle engine exhaust in the Ames Salmonella assay using a direct exposure method.

A method for the assessment of the mutagenic activity of vehicle engine exhaust in the Ames assay is described in which the bacterial strains used (TA98 and TA98/DNP) are exposed to the freshly produced engine exhaust using a "Cassella' slit sampler. The method is found to be effective both in the presence and absence of metabolic activation, using Aroclor-1254-induced rat liver S9 fractions. A comparison is made between the direct exposure method and the standard methods involving the collection of particulate samples on glass fibre filters and the testing of various extracts of these samples. Possible uses of the direct exposure testing method are suggested and the effect of sampling techniques on the results obtained in the Ames assay is also discussed.

Biotransformation↗
PubMedDate not supplied

The effectiveness of staff support: evaluating active support training using a conditional probability approach.

Active Support, a package of procedures which includes activity planning, support planning, and training on providing effective assistance, was introduced in five community residences serving 19 adults with severe mental retardation following a multiple baseline design. Real-time observational data were collected on the level of assistance residents received from staff and their engagement in activity. Active Support was shown in a companion paper (Jones et al., 1999) to increase the levels of assistance residents received and their engagement in activity. Increased assistance was particularly experienced by the behaviorally less able and the disparity in activity between the more and less able was reduced. In the analysis presented here, the effectiveness of assistance was evaluated before and after Active Support training by calculating the likelihood of engagement occurring given the occurrence of assistance. This likelihood was represented by the statistic, Yule's Q. Yule's Q significantly increased following Active Support training, an increase that was maintained at follow-up. The increased effectiveness of assistance was related to other research findings on the relationship between staff: resident interaction patterns and resident behavior.

Activities of Daily Living↗
PubMedDate not supplied

Counterpoint: test the value of hyperthermia in patients with carcinoma of the cervix being treated with concurrent chemotherapy and radiation.

Major advances in the treatment of locally advanced cervical carcinoma were reported in 1999-2000 in five studies from the Gynecologic Oncology Group, Radiation Therapy Oncology Group and Southwestern Oncology Group. Collectively these trials reported a decrease in the risk of recurrence or death from cervical cancer ranging from 30-50% with the use of concurrent chemoradiation, as compared with radiation alone. On the basis of these trials the National Cancer Institute in 1999 issued a clinical alert concluding 'Strong consideration should be given to the incorporation of concurrent cisplatin-based chemotherapy with radiation therapy in women who require radiation therapy for treatment of cervical cancer.' Concurrently with these publications there appeared the publication in the Lancet in 2000 of the Dutch Deep Hyperthermia Group trial of radiotherapy alone versus combined radiation and hyperthermia for locally advanced pelvic tumors including carcinoma of the cervix. This multi-center phase III trial demonstrated an approximate doubling of the three year survival from 27 to 51% for the addition of hyperthermia to radiotherapy in patients with locally advanced cervical carcinoma. Additional trials to test the value of hyperthermia in patients with cervical carcinoma treated with concurrent chemotherapy and radiation are imperative and take precedence over a trial to investigate the value of chemotherapy in patients treated with hyperthermia and radiation.

Antineoplastic Agents↗
PubMedDate not supplied

Intake of dietary fibre and the age of menarche.

The relationship between menarchial age and estimated dietary fibre intake in 46 countries/communities was examined. There was a highly significant positive correlation (r = 0.84) between dietary fibre (g/1000 k calories nutrient energy) and menarcheal age. The nutritional and physiological significance of this relationship is discussed.

Adolescent↗
PubMedDate not supplied

Pediatric oncology and hematology in Manchester, England.

The Manchester pediatric oncology unit is the third largest unit in the United Kingdom, with approximately 120 new referred cases per annum (10% of the U.K. total). Research activities include a gene therapy program, peripheral blood stem cell studies, the genetic epidemiology of childhood cancer, late-effects research (growth, body composition, pulmonary, quality of life), psychosocial studies, and clinical trial organization. Both the clinical oncology service and research activities involve close team coordination and collaboration with scientists both within and outside Manchester. A comprehensive pediatric hematology service is provided. The unit contains the second largest children's hemophilia service in the United Kingdom, serving 200 patients with congenital blood disorders. Twenty-five bone marrow transplants are performed each year (allogeneic, unrelated donor, autologous, and peripheral stem cell) for malignant and nonmalignant disorders. These activities are closely related to local, national, and international research groups.

Child↗