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Biomedical subjects

J B Jones

Publications and source records attributed to J B Jones.

203 records · Page 12Linked to original sources
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Treatment of blastomycosis with itraconazole in 112 dogs.

One hundred twelve client-owned dogs with blastomycosis were treated with itraconazole, 5 or 10 mg/kg/d. The first group of 70 dogs treated in 1987 and 1988 received 10 mg/kg/d (group 1), and the second group of 42 dogs treated after October 1988 received 5 mg/kg/d (group 2). Even though the groups were treated at different times, the dogs were similar in age and gender distribution, number of sites involved, and percent and severity of pulmonary involvement. The proportion of dogs cured with a 60-day course of itraconazole was similar for both groups (53.6% versus 54.3%) and for a second historical control group treated with amphotericin B (57%); the recurrence rate was also similar, 20%, 21.4%, and 20%, respectively. Dogs treated with itraconazole had similar mortality rates (25.7% at 5 mg/kg/d; 25% at 10 mg/kg/day) to those treated with amphotericin B (23%). Seventeen of the 23 dogs that died (74%), did so during the first week of treatment; these early deaths were usually attributed to respiratory failure. The only site of infection that was significantly associated with failure (death or recurrence) was the brain. There was a marked difference in survival times between dogs without lung disease or with mild lung disease compared with dogs with moderate or severe lung disease. Serum itraconazole concentrations reached steady state by 14 days of treatment. Dogs receiving 5 mg/kg/d of itraconazole (group 2) had mean serum concentrations of 3.55 +/- 2.81 mg/mL (range, 0.67 to 10.8 micrograms/mL), whereas dogs receiving 10 micrograms/kg/d (group 1) had mean concentrations of 13.46 +/- 8.49 micrograms/mL (range, 1.8 to 28 micrograms/mL) (P < or = .001). There was no association between cure and serum itraconazole concentrations. Dogs in group 1 had significantly more adverse effects than dogs in group 2 (P = .046). Anorexia was the most common adverse effect, occurring in 14.9% of dogs in group 1. Only 8% of dogs in group 2 had adverse effects. Serum concentrations of itraconazole were positively correlated with serum alkaline phosphatase and alanine aminotransferase activities. Our findings indicate that itraconazole administered at a dose of 5 mg/kg/d is the drug of choice for blastomycosis in dogs.

Alanine Transaminase↗
PubMedDate not supplied

Assessment of pain management skills in emergency medicine residents: the role of a pain education program.

A prospective study of Emergency Medicine (EM) residents was conducted over two consecutive 1-month periods at a rural tertiary-care teaching hospital with a residency in EM to evaluate the effect of a 4-h pain management education program on the assessment and management of acute pain in the emergency department (ED). All patients presenting to the ED with an acute, painful condition were eligible to participate in the survey. Patients were excluded if they had taken any pain medication within 4 h of presenting to the ED, or had any condition requiring immediate resuscitation, suspected cardiac pain, or pain from a potential surgical abdomen. Baseline and 30-min pain scores were evaluated using a 100-mm, unnumbered visual analog scale (VAS). A 4-h pain management educational program (EP) aimed toward the EM residents was conducted. Comparisons were made with respect to the overall treatment of pain as evaluated by the change in VAS score between baseline and 30 min as well as the global assessment of treatment. A total of 126 surveys were completed, 54 before (Group 1) and 72 after (Group 2) the EP. The mean deltaVAS score for patients in Group 2 was significantly better than the deltaVAS score for patients in Group 1. Only 65% of the patients studied before the EP had significant reduction in their pain scores after 30 min in the ED; after institution of the EP, 92% had a significant reduction in their pain scores at 30 min. Similarly, a significant improvement was seen in the patients' global evaluation of treatment after the educational program was instituted. It appears that the use of a 4-h educational program on pain assessment and management directed toward EM residents in their training can improve their skills at recognizing and treating painful conditions.

Clinical Competence↗
PubMedDate not supplied

Representations of menopause and their health care implications: a qualitative study.

INTRODUCTION: Menopause is primarily represented as a medical condition with its associated body changes described as symptoms in need of treatment. The purpose of this study was to determine whether women's representations of and responses to menopause reflected this medical perspective. It is based on a secondary analysis of data from an earlier study in which the menopause experience of 17 middle-aged women was examined. METHODS: The original study used a qualitative methodology in which data were collected by means of semistructured interviews and then analyzed for primary categories of meaning. Interview transcripts were reanalyzed for the current study. RESULTS: Findings of the analysis indicate that, although the women were relatively uninformed about menopause, they identified themselves as menopausal on the basis of both positively and negatively defined physical and psychological changes that they associated with it. These changes were also associated with aging in general. Furthermore, although the women responded to menopause as a time-limited physiological event that sometimes required medical attention, they perceived it primarily as a marker or symbol of more general life-stage developmental issues and responded with both lifestyle changes and a search for new meaning. DISCUSSION: These findings indicate that the women's perception of and response to menopause reflected both medical and nonmedical representations. Health care implications include the importance of health care providers supporting menopausal women in their search for both information and meaning, and of researchers investigating both medical and nonmedical approaches to reducing the negative health-related effects of decreased estrogen levels in menopausal women.

Aging↗