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Biomedical subjects

E Jones

Publications and source records attributed to E Jones.

At least 109 records · Page 6Linked to original sources
PubMed1998

Ninety-six-hour infusional paclitaxel as salvage therapy of ovarian cancer patients previously failing treatment with 3-hour or 24-hour paclitaxel infusion regimens.

PURPOSE: To test the hypothesis that prolonged infusion of paclitaxel (96 hours) might overcome resistance to shorter infusion schedules (3 or 24 hours) in ovarian cancer. PATIENTS AND METHODS: A total of 30 patients with advanced ovarian cancer (24 patients), primary carcinoma of the peritoneum (four patients), or fallopian tube cancer (two patients) who previously had received paclitaxel administered on either a 3-hour or 24-hour schedule were treated with the agent delivered as a 96-hour infusion (30 to 35 mg/m2/d x 4 days) on an every 3-week program. RESULTS: Although the regimen generally was well tolerated, no objective responses were observed. CONCLUSION: In patients with ovarian cancer who have shown resistance to shorter paclitaxel infusion schedules, ninety-six hour infusional paclitaxel is an inactive treatment strategy. This makes it less likely that protracted infusion of paclitaxel will improve outcome when used as part of primary therapy of ovarian cancer. An ongoing randomized study will answer that question.

Adult↗
PubMed1998

Lipid formulations of amphotericin B.

Amphotericin B has long been the mainstay in the treatment of systemic fungal infections, but its nephrotoxicity limits the dosage that can be used. New lipid-based forms may allow higher dosing with less nephrotoxicity. Unfortunately, these new forms are substantially more expensive, and data from randomized clinical trials of their relative efficacy are as yet limited.

Amphotericin B↗
PubMed1998

Surgical excision of a pharyngeal pouch.

A pharyngeal pouch usually occurs in people over 70. This Update examines symptoms, management, surgical treatment and the postoperative care of patients, focusing on nutrition, care of the nasogastric tube and mouth care.

Aged↗
PubMed1998

[End-stage renal insufficiency associated with Chinese herbal consumption in France].

In May 1994 in Toulouse, there were two cases of end-stage renal failure (ESRF) related to Chinese herbs similar to those incriminated in the case series reported in Belgium in 1992-93, they led to an epidemiologic investigation aimed at evaluating the risk linked to these plants in France. Studies carried out by the Pharmacy Inspection showed that powders labelled Stephania Tetrandra, but consisting instead of Aristolochia Fangji and containing aristolochic acid, were sold in France between 1989 and May 1994. A systematic attempt to ascertain cases of ESRF associated with ingesting Chinese herbs was carried out by analysing data from the ERA-EDTA Registry of ESRF as well as from the French adverse drug reaction monitoring system. Registry data showed no significant increase over previous years in the number of new ESRF cases caused by tubulo-interstitial nephritis (TIN) between 1990 and 1993. In eight regions of France, the files of 85 ESRF cases were examined, and all patients whose nephropathy began after 1989 were interviewed using a very detailed questionnaire. No association with Chinese herb use was found in any of these cases. In 1996, two new ESRF cases were reported in Nice; the regional adverse drug reaction monitoring center considered the relationship with Aristolochia Fangji to be as possible (I2) for one case and dubious (I1) for the other. Despite a lack of sensitivity of the methods used to detect cases, it seems clear that no phenomenon as extensive as that observed in Belgium occurred in France, although the same drugs prescribed at the same doses have been widely distributed in our country. A possible explantation for the difference in the number of cases in Belgium and France is that of an unrecognised factor, promoting the toxicity of aristolochic acid or peculiar to the Belgian clinic and causative. The precautionary principle led the authorities to ban Stephania Tetrandra and Aristolochia Fangji from the market permanently.

Adult↗
PubMed1997

The application of various protic acids in the extraction of (1-->3)-beta-D-glucan from Saccharomyces cerevisiae.

Glucans are (1-->3)-beta-linked glucose polymers which have immune-stimulating capability. The extraction of water-insoluble (1-->3)-beta-D-glucan form Saccharomyces cerevisiae employs hydrochloric acid. Hydrochloric acid is difficult to employ in the large-scale pharmaceutical extraction of glucans due to its corrosive nature and toxicity. To address these concerns, we determined whether acetic, formic or phosphoric acid can be substituted for hydrochloric acid in the process for the isolation of (1-->3)-beta-D-glucan. The resulting microparticulate glucans were employed as the starting material for the production of (1-->3)-beta-D-glucan phosphate. 13C NMR analysis of the glucan phosphates derived from the acetic, formic or phosphoric acid-extracted microparticulate glucan show excellent correspondence to hydrochloric acid extracted glucan and laminarin, a (1-->3)-beta-D-glucan standard, indicating that the primary structure is not altered by the acid used for extraction. Glucan phosphate prepared from hydrochloric acid had a Mw of 7.2 x 10(4) g/mol, rmsz of 17.7 nm, of 1.50 and (eta) of 49.0 mL/g. Glucan phosphate prepared from acetic acid had a primary polymer peak with a Mw of 1.4 x 10(6) g/mol, rmsz of 23.6 nm, I of 1.93 and (eta) of 62.4 mL/g. Glucan phosphate prepared from formic acid had a main polymer peak with a Mw of 1.2 x 10(6) g/mol, rmsz 27.1 nm, I of 1.56 and (eta) of 89.0 mL/g. Glucan phosphate prepared from phosphoric acid had a primary polymer peak with a Mw of 6.6 x 10(5) g/mol, rmsz of 32.3 nm, I of 2.70 and (eta) of 91.3 mL/g. These data indicate that the molecular mass, size, polydispersity and intrinsic viscosity of the glucan phosphate obtained is influenced by the pKa of protic acid employed to extract the microparticulate glucan. However, the primary structure and side-chain branching are not substantially altered regardless of the acid employed.

Acetic Acid↗
PubMed1997

Comparison of quantitative HCV RNA assays in chronic hepatitis C.

We compared the relative sensitivities of first-and-second generation branched nucleotide assays (Quantiplex HCV RNA 1.0 and 2.0, respectively, Chiron, Emeryville, Calif) for the detection of hepatitis C virus (HCV) RNA to that of a commercially available quantitative reverse transcriptase polymerase chain reaction (RT-PCR) method (Monitor, Roche Molecular Systems, Nutley, NJ) in 53 patients with chronic hepatitis C. The sensitivities of the second-generation branched DNA (bDNA) and RT-PCR assays were similar (91% and 92%, respectively), and both were significantly more sensitive (P < .001) than the first-generation method. Moreover, both assays detected HCV RNA in all 11 patients with type 2a, 2b, or 3a genotypes vs 45% with the HCV RNA 1.0 bDNA assay. We examined 174 serum samples by the bDNA 2.0 and RT-PCR assays. Major quantification differences were noted on a given specimen with the RT-PCR method reporting values an average 41-fold lower (range, 0-703-fold) than those obtained with the bDNA assay. We conclude that both methods can be used to detect HCV RNA in patients who are infected with the genotypes that are most commonly encountered in the United States. The HCV RNA 2.0 bDNA assay may offer advantages when attempting to quantify high-level viremia.

Chronic Disease↗
PubMed1997

Industrial Genotoxicology Group collaborative trial to investigate cell cycle parameters in human lymphocyte cytogenetics studies.

Human lymphocyte cultures have been used for many years for assessing the in vitro clastogenic potential of test substances. In these assays the harvest time should be based on the cell cycle time in order to ensure that cells are sampled at an appropriate time for the detection of clastogenic effects. The sources of variation in the cell cycle time in routine cytogenetic assays have not been well studied. Consequently 13 laboratories, all members of the Industrial Genotoxicology Group, participated in a collaborative study to measure the variation in cell cycle time in cultured human peripheral blood lymphocytes under various conditions. The study was performed in two phases, spaced 6 months apart. The average generation time (AGT) was measured by the incorporation of bromodeoxyuridine. Very similar AGTs were found in the presence and absence of S9 mix. The mean AGT (mean of four donors) in each laboratory varied from 11.2 to 17.1 h, indicating there is significant variability in cell cycle times of human peripheral blood lymphocytes between laboratories. There was greater variation between laboratories than within laboratories. A comparison of AGT values at 72 h performed in experiments at least 6 months apart indicated good reproducibility in most laboratories. The study indicates that a 24 h post-treatment harvest may result in the analysis of very few first division cells unless very significant cell cycle delay is induced by the test substance. It was also found that a post-harvest time equivalent to 1.5 cell cycles will result in an approximately equal mixture of first and second division cells and therefore should by suitable for assessing both the induction of chromosome aberrations and polyploidy.

Animals↗
PubMed1997

Body habitus and coronary heart disease in men. A review with reference to methods of body habitus assessment.

Table 1 is a synopsis of the major findings from an extensive literature on the association between human body habitus and coronary heart disease. Whilst some studies have used quite sophisticated laboratory procedures to quantify body fat most have relied upon anthropometric measurements to determine some component of body habitus. Of these, body weight and height are the simplest measurements and are, therefore, well-suited to large-scale prospective studies. Height and weight are highly reproducible measurements, although in the short term, weight can have considerable physiological variation associated with gastric emptying and state of hydration. Less reliable measurements than height and weight are skinfolds and body circumferences, both of which have been used extensively in cross-sectional and prospective analyses. For skinfolds, both the inter and intra-observer variability is affected by the measurement technique, location of the skinfold site, the skinfold caliper used and skinfold compressibility. As measurement error has been shown to be a function of skinfold thickness, accurate and repeatable skinfold measurements are particularly difficult to make in the obese. In these subjects, it is not always possible to locate a specific anatomical bony landmark or to pull a parallel skinfold away from the underlying tissue. Furthermore, in the extremely obese it is sometimes possible for a skinfold to be thicker than the jaws of the currently available commercial calipers. Alternately, body circumferences are obtainable in all subjects and have greater reproducibility than skinfolds. They are, therefore, the preferred method in obese subjects. However, there is considerable work to be done to establish their association with body fatness. The evidence examined in this review suggests that body weight is a poor predictor of coronary heart disease. Some studies have reported no difference in the body weight of coronary heart disease patients compared to subjects free of the disease, others found the body weight of subjects with coronary heart disease to be slightly greater, and one found the body weight of cardiac patients to be less than controls. Height, however, is associated with coronary heart disease in prospective studies with long-term and shorter-term follow-up periods and case-control designs. Fetal, infant and childhood under-nutrition may link shorter adult height and susceptibility to cardiovascular disease. Many researchers have studied the relationship between overweight and coronary heart disease by using a surrogate measurement of body fatness such as relative weight or a weight-for-height index. In general, results produced by these studies suggest weight-for-height indices, particularly the often used body mass index, are not strong predictors of coronary heart disease. Indeed case-control designs have consistently failed to show a relationship between body mass index and coronary heart disease. Inconsistent results from prospective studies, however, are difficult to interpret. To further confuse the situation, the body mass index has been examined in relation to different coronary heart disease end-points and adjusted for different confounding variables. Explaining the inconsistent results on the basis of length of follow-up is also not straightforward. When follow-up periods exceed 20 years, and sample size is small, however, this closer association has not been found, even with a long follow-up period. Whilst some studies have found no association after 15, 13 and 12 years others have reported a relationship after 8.5, 10, 12, 10 and 7 years. The 22 year follow-up evidence from the Framingham Study shows the strongest 'independent' association between body mass index and coronary heart disease. (ABSTRACT TRUNCATED)

Adult↗
PubMed1997

The effect on 24 h blood pressure control of an angiotensin converting enzyme inhibitor (perindopril) administered in the morning or at night.

OBJECTIVE: To determine the clinic and ambulatory blood pressure when the same dose of perindopril (4 mg) is administered in the morning (0900 h), or at night (2100 h), in particular, to determine whether the early morning blood pressure rise, the duration of effect and the pattern of response differed. METHODS: Twenty male patients with diastolic blood pressure 95-110 mmHg when seated and 24 h mean ambulatory diastolic blood pressure > 85 mmHg after 4 weeks' placebo were allocated randomly to be administered 4 mg perindopril at 0900 h or at 2100 h. Clinic blood pressure (with the patient seated and erect) was measured 2 and 4 weeks after the therapy had been started and ambulatory blood pressure monitoring with a SpaceLabs device was performed for 26 h during week 4. The patients then crossed over to the other time of dosage and the measurements were repeated. The study was conducted from a hospital clinic. RESULTS: The clinic analysis concerned all 20 patients but the ambulatory analysis concerned 18 patients because the ambulatory blood pressure monitor data sets were inadequate for two patients. Compliance was high (97 +/- 3%), with a suggestion that it was better with the 0900 h dose. Clinic blood pressure (with the patient seated and erect) was lower under both regimes and the blood pressure with night-time administration of perindopril tended to be lower than that with daytime administration (P = 0.05-0.10). Twenty-four-hour mean, daytime and night-time means were lower with both doses than they were with placebo and did not differ. Both regimes reduced the early morning peak blood pressure rise and the effect tended to be greater with the 2100 h dose (P = 0.05-0.10). The 0900 h dose had an effect that persisted for > 24 h but the effect of the 2100 h dose had dissipated 18 h after the dose. There was no excessive night-time fall in blood pressure with the 2100 h dose. The trough : peak ratio with the 0900 h dose was 0.86 for systolic and 0.70 for diastolic blood pressure. CONCLUSION: The early morning blood pressure rise is reduced more when 4 mg perindopril is administered at 2100 h. However, the 2100 h dose regime does not reduce blood pressure over 24 h whereas 24 h control is achieved with the 0900 h dose. In clinical practice the 2100 h dose would have been titrated to the next dose range in more patients. This study indicates that the response profile obtained with an angiotensin converting enzyme inhibitor cannot be transformed from one dose time to another automatically and that chronobiology has important effects on a drug's action.

Adult↗
PubMed1997

Delusion, the overvalued idea and religious beliefs: a comparative analysis of their characteristics.

BACKGROUND: The study sought to investigate the form of the delusion in schizophrenia and the overvalued idea in anorexia, employing a range of belief characteristics to discover whether differences could be detected between them, and how they stood in general relationship to the religious beliefs of normals. METHOD: A belief rating scale was devised with 12 characteristics, and completed by 20 schizophrenics, 20 anorectics, and 20 normal controls. Comparisons were drawn between populations using the Mann-Whitney test, and different types of belief were contrasted within diagnostic groups using each subject as their own control by repeated-measures MANOVA. RESULTS: The schizophrenic delusion was differentiated from the overvalued idea in anorexia by a number of variables, which also served to distinguish both phenomena from religious beliefs held by normals. The schizophrenic delusion exhibited many of the qualities of an initial (or observational) belief, when its content suggested that it should manifest those of a derived belief. The anorectic overvalued idea, although occasionally an initial belief in terms of its content, was typically held in the form of a derived belief. CONCLUSIONS: A wider range of characteristics is required to define all the differences between delusion and the overvalued idea, and these have implications for belief modification programmes.

Adult↗
PubMed1997

Social support for elderly patients with chronic wounds.

Few attempts have been made to measure the social support received by elderly patients with chronic wounds. To focus research on these issues, an established model integrating the various roles played by social support in the adaptation of patients to stressful situations was applied. Two questionnaires were used to measure perceived social support and coping in a sample of patients with leg ulcers (N = 15, mean age 70.4 years) or diabetic foot ulcers (N = 15, mean age 63.6 years) at two time-points over a four-month period. The results indicate that there were no statistical differences between the groups. The overall levels of social support were low, with emotional support recorded most frequently. The standardised scores for types of coping indicate no unusual patterns, although the scores for logical analysis were low. However, there was considerable variation in the types of coping strategies used by individuals.

Adaptation, Psychological↗
PubMed1997

Comparative genomic hybridization and molecular cytogenetic characterization of two prostate cancer xenografts.

Conventional cytogenetic analysis of two prostate tumor xenografts, LuCaP 23.1 and RP22090, was unsatisfactory for comprehensive genetic evaluation of the cell lines. Fluorescence in situ hybridization (FISH) for chromosome enumeration and comparative genomic hybridization (CGH) for numerical imbalance detection were performed and resulted in a more complete molecular cytogenetic characterization of these lines. Both xenografts were hypertriploid and had significant numerical imbalances. For example, LuCaP 23.1 had gain of all or part of chromosomes 3, 5, 6, 7, 8, 11, and 12 and the X chromosome and loss of all or part of chromosomes 2, 3 6, 8, 9, 10, 17, and 18. In RP22090, gain of all or part of chromosomes 5, 7, 8, 9, 10, 12, 14, and 15 was seen, whereas loss was seen for all or part of chromosomes 4, 6, 8, 15, 16, 17, 19, 20, and 22. Both xenografts reflect the high frequency of chromosomal changes seen in some late-stage prostate cancers, including many novel changes and some changes such as the loss of 8p and gain of 8q, which have been reported previously in primary and metastatic prostate cancers. Consistent changes in both lines, such as loss of chromosomes 6 and chromosome arm 8p and gain of chromosome 7 and chromosome arm 8q, may represent genetic events specific for prostate cancer development, but imbalances on other chromosomes such as 3, 9, 19, and 20, not frequently reported in prostate cancers, may reflect potentially important changes that should also be examined.

Adenocarcinoma↗
PubMed1997

Drug-nutrient interactions in enteral feeding: a primary care focus.

Drug and nutrient interactions are complex and can take many forms, including malabsorption of either the drug or the nutrient component. Some drugs can stimulate or suppress appetite, whereas others can cause nausea and vomiting resulting in inadequate nutritional intake. Absorption of drugs is a complex process that can be affected by the physical characteristics of the gastrointestinal tract (GIT) as well. Depending on the physical properties of a drug, it may be absorbed in a limited area of the GIT or more diffusely along much of the entire length. Many diseases and conditions are also known to affect the GIT either directly or indirectly. Dietary factors also need to be considered when the "food" is an enteral formula. The widespread use of enteral tubes requires that consideration be given to patients receiving both enteral feedings and medication concurrently. The location of a tube in the gastrointestinal tract, as well as the problems involved in crushing and administering solid dosage forms, creates a unique set of problems.

Biological Availability↗