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Biomedical subjects

G Jackson

Publications and source records attributed to G Jackson.

At least 163 records · Page 9Linked to original sources
PubMed1996

Extra-articular features of benign joint hypermobility syndrome.

To define the phenotype of patients with benign joint hypermobility syndrome (BJHS), we studied 58 consecutive patients (mean age 37 yr) presenting to a rheumatology clinic and 30 controls. Patients underwent rheumatological and ophthalmic examination, hypermobility scoring, echocardiography, measurement of bone mineral density (BMD), and skin thickness, elasticity and light transmissibility. The median hypermobility score was 5/9 Beighton and 31/56 Contompasis. Eighteen (31%) patients complained of significant arthralgia. Six (10%) patients and two (7%) controls had mitral valve prolapse (MVP) (chi(2) = 0.27, P = NS). Neither MVP nor aortic diameters showed a correlation with hypermobility score. There was no significant reduction in BMD. There was a significant correlation between hypermobility and light transmissibility of the skin (r = 0.71, P < 0.0001 Contompasis; r = 0.47, P < 0.05 Beighton) and skin stretchiness (r = 0.49, P < 0.05 Contompasis; r = 0.39, P < 0.05 Beighton). On ophthalmic examination, 14 (41%) patients had upper eyelid laxity. Thus, patients with BJHS do not have an increased prevalence of significant cardiac, bone, skin or eye abnormalities, helping differentiate BJHS from other more serious hereditary disorders of connective tissue.

Adolescent↗
PubMed1996

The latex dilemma: an actual case.

Health care institutions across the country are dealing with a relatively new phenomenon: staff sensitivity to latex. This article presents the issues involved through an actual case and the response of one institution.

Adult↗
PubMed1996

Risk factor management: the cardiologist's perspective.

Risk factors are associated with disease and are not necessarily causative; as they are additive they should not be judged in isolation. Thus, 'mild blood pressure' does not imply a 'mild' risk in a cigarette-smoking, hypertensive diabetic. Cardiologists are usually fortunate, in that they see patients when there is already evidence of disease (ie, when secondary prevention is the issue, which is much less contentious than primary prevention). In the 'whizz-bang' specialty of cardiology, a balloon can remove in a matter of seconds what a lipidologist has toiled over for years. Attention to detail may not come easily in a stressful world: it is the detail of prevention that is likely to slow the progression of disease and induce regression rather than angioplasty or bypass surgery. In the presence of coronary artery disease, the essence of management is the team approach, the patient being the most important member of the team. Furthermore, the factors that need the most concentrated effort include cigarette smoking, hypertension, and hyperlipidaemia. As risk factors are additive, treatment of one should not make another one worse. Some drugs for hypertension can exacerbate hyperlipidaemia or impair glucose tolerance (eg thiazides), while ACE inhibitors can beneficially decrease insulin resistance in diabetes. Therapy must be tailored to the individual, but the overall prognostic benefits of drugs that might have slightly adverse metabolic profiles (such as beta-blockers) must not be ignored. Science is often a loser when faced with the power of marketing. When one risk factor (eg hypertension) is present, it is important to be vigorous in treating other factors (eg hyperlipidaemia) with general advice and support, as well as with specific drug therapy if indicated. There are two individuals that tend to lack education in risk factors--the patient and the cardiologist. The patient is a victim of poor investment in prevention, while the cardiologist is put off by a perceived lack of balance from the medical protagonists.

Adult↗
PubMed1996

Local government reorganisation in Scotland and Wales.

This article describes the new local authority structure that comes into effect in Scotland and Wales on 1 April 1996. The relationship between the new 'unitary' authorities and other administrative areas is discussed briefly and some key demographic data are presented. References are given to other sources of statistical information.

Adolescent↗
PubMed1996

A study of lipid profile before and after coronary artery bypass grafting.

This study was undertaken to establish the variability in the levels of total cholesterol (TC), total triglyceride (TG), low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol before and after coronary artery bypass graft (CABG) surgery, in order to determine postoperatively when an accurate assessment can be made of the lipid status. During a prospective study over 4 months, fasting venous samples were taken pre- and postoperatively on day 5, and in the 4th, 8th and 12th weeks. Ninety-six patients admitted to the cardiothoracic and cardiac wards for CABG were recruited to the study. The mean preoperative levels were: TC 5.94 (+/- 0.1 mmol/l), LDL cholesterol 4.02 (+/- 0.09mmol/l) and HDL cholesterol 1.00 (+/- 0.03mmol/l). These were significantly different (p < 0.01) from the levels on the 5th postoperative day when the mean level of TC was 4.14 (+/- 0.084mmol/l), LDL cholesterol was 2.45 (+/- 0.07mmol/l) and HDL cholesterol was 0.74 (+/- 0.03mmol/l). By the 4th postoperative week, mean TC (5.73 +/- 0.13mmol/l), LDL cholesterol (3.79 +/- 0.14mmol/l) and HDL cholesterol (1.03 +/- 0.04mmol/l) did not vary significantly from the mean preoperative values. There was no significant difference in the mean TG levels pre- and postoperatively. The mean TC, LDL cholesterol and HDL cholesterol rise to preoperative levels by the 4th week after CABG. Thus, an accurate assessment of patients' lipid status can be made from this period. An earlier postoperative assessment may be falsely reassuring.

Adult↗
PubMed1995

Signal-averaged electrocardiography of the sinus and paced P wave in sinus node disease.

The detection of paroxysmal atrial fibrillation (AF) in patients requiring a permanent pacemaker for sinus node disease may influence the choice of both pacemaker and programmed mode. While signal-averaged ECG of the P wave (SAEP) during sinus rhythm may detect patients with paroxysmal AF, the value of SAEP in the presence of sinus node disease is unknown. We therefore evaluated SAEP in patients with sinus node disease during sinus rhythm and atrial pacing. We investigated 10 patients with sinus node disease alone (SND), 10 with sinus node disease and paroxysmal AF (SND-PAF), and 20 normal controls (NC) using a P wave specific, signal-averaging system. In sinus rhythm, duration and energy were greater in SND-PAF than in SND and NC (mean [SEM] duration: 153 [4] msec, 140 [4] msec, and 134 [2] msec, P < 0.001; energy from 20-150 Hz: 76 [18] muV2.sec, 48 [7] muV2.sec, and 36 [3] muV2.sec, P = 0.006). Atrial pacing in SND-PAF produced an 11% prolongation of atrial activation but little further abnormality in P wave characteristics. In SND, atrial pacing caused a 20% prolongation of the P wave and increased P wave energy to a greater extent than in SND-PAF. We conclude that in patients with SND, atrial activation appears similar to normal controls during sinus rhythm but changes significantly on pacing. In patients with SND-PAF, atrial activation is abnormal during sinus rhythm with little further change when the atrium is paced. SAEP may be useful in detecting a predisposition to paroxysmal AF in the presence of sinus node disease and might help optimize pacemaker prescription.

Adult↗