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Biomedical subjects

J J Jones

Publications and source records attributed to J J Jones.

At least 55 records · Page 3Linked to original sources
PubMed1987

The management of primary lymphoma of bone.

From October 1962 through April 1982, 21 patients with the diagnosis of primary lymphoma of bone (18 monostotic, stages IE and IIE; 3 polyostotic) were treated with curative intent. A combination of chemotherapy and radiation therapy was used in 11 patients, local treatment alone in 9 patients, and chemotherapy alone in one patient. Overall 5-year survival for the patients treated with curative intent was 56%. Standard work-up has changed over the 20-year study period. Five-year survival for the subset of eight stage I and II patients with full pretherapy staging was 83%. Prognosis was significantly correlated with extent of pretherapy staging. Treatment parameters that also seemed to predict outcome were the aggressiveness of chemotherapy and the use of irradiation or surgery for local-regional disease; the only local failure occurred in the patient who received chemotherapy alone. Complications of radiation therapy alone and in combination with chemotherapy are discussed and correlated with irradiation dose. Radiation therapy techniques are described, and a management approach is recommended.

Adolescent↗
PubMed1986

Letting go.

Explore the source record for details and available documents.

Adolescent↗
PubMed1984

Spontaneous intra-abdominal hemorrhage in hemophilia.

Intra-abdominal hemorrhage in patients with hemophilia is uncommon but represents a major cause of death in hemophiliacs. The manifestations are protean and may mimic other intra-abdominal processes. We present seven episodes of hemophilic intra-abdominal hemorrhage in which the initial diagnoses were incorrect in five of the seven cases. The mean time from seeking medical assistance to correct diagnoses was two days (range, zero to five days). Computed tomography proved useful, particularly when the diagnosis was uncertain or needed to be differentiated from other possibilities, such as aneurysm, tumor, or abscess. Delay in diagnosis and diagnostic and therapeutic misadventures can be minimized only by a knowledge of the nature of such hemorrhage.

Adult↗
PubMed1983

Head injury patients admitted to general hospitals in Merseyside.

During 1975 and 1976, 11837 patients with head injury were admitted to 16 general hospitals serving 2.1 million people. Eight hundred and seventy-five had fractures of the skull, 178 died and 103 were transferred to the regional department of neurosciences. A fall was the cause of injury in 49 per cent, a traffic accident in 24 per cent and assault in 17 per cent. Seventeen per cent of adult patients had taken alcohol and 16 per cent had major extracranial injuries (including fractures of the bones of the face). Sixty-seven per cent stayed in hospital for 0-48 hours and 8 per cent for 8 days or more. The mortality rate and the number of deaths associated with avoidable factors both increased with the patient's ages. After standardization for age and sex, neither of these measures of the effectiveness of the management of head injury in hospital was found to differ significantly amongst the sixteen hospitals; nor were they related to differences in the way in which head injury patients were managed (for example, duration of stay in hospital) or to admission policy, work load (number of patients admitted with head injury per year) or the distance by road to the regional neurosciences department.

Adolescent↗
PubMed1983

Evaluating alcoholism and drug abuse knowledge in medical education: a collaborative project.

A series of six modular examinations, each representing a substance abuse problem, were developed by a National Institute on Drug Abuse task force working with consultants from the National Board of Medical Examiners (NBME). Each examination contained a patient management problem and multiple-choice questions. The examinations were administered to 629 third- and fourth-year U.S. medical students, and the results indicated that students performed less well in this area than on the traditional content of the NBME examinations. Students performed better on items related to pharmacologic effects of drugs of abuse, Alcoholics Anonymous, and the treatment of delirium tremens. Students did less well on items related to metabolic and biochemical areas; emergency room treatment of drug-overdosed, comatose patients; and legal issues in substance abuse. As a result of these data, a syllabus explaining each item in the available modules was developed, score-reporting to participating schools was modified, and the modules were shortened. Implications for medical education in substance abuse are discussed.

Alcoholism↗
PubMed1981

Relative risk of alternative admission policies for patients with head injuries.

During 1975 and 1976, 10 200 patients with head injuries were admitted for observation to sixteen general hospitals serving 2.1 million people. The neurological condition of 60 (0.59%) patients subsequently deteriorated, including 27 (0.26%) who died. The effect of alternative admission policies on outcome and bed occupancy was calculated. If no patients were admitted solely for observation, 35 beds would be released for elective surgery but 30 patients with severe intracranial injuries would be sent home each year. Alternatively, if only patients with a history of loss of consciousness were admitted, 18 beds would be released but 11 patients with severe injuries, including 7 with unrecognised skull fractures, would be sent home. The effect of introducing a standard policy for routine skull radiography has also been determined. If, in England and Wales, post-traumatic skull radiography was restricted to patients with alteration in level of consciousness when examined, with neurological signs, with physical signs (e.g., a palpable fracture), or with a history of loss of consciousness, each year 163 patients with unrecognised skull fractures and potentially lethal intracranial injuries would be sent home and not be admitted for observation. Can the expected annual saving of 3 million pounds on routine skull radiography justify the risk to these patients?

Adolescent↗
PubMed1981

Avoidable factors contributing to the death of head injury patients in general hospitals in Mersey Region.

In 1975 and 1976 190 head injury patients died after admission to 19 general hospitals in Mersey Region or after transfer to the regional department of neurosciences. Their hospital case-notes were examined. Avoidable factors definitely contributing to death were identified in 58 (30%), and those possibly contributing to death in another 45 (24%). Of the avoidable factors 38% occurred in patients who "talked and died" and 77% in patients with intracranial haematomas. The most common avoidable factors were failure to recognise the development of a haematoma, respiratory difficulty leading to hypoxia, hypotension, and convulsions. The following recommendations are made: hospital case-notes of all head injury deaths should be assessed by a panel of senior consultants; all patients unconscious for 4 h in primary surgical wards in general hospitals should be transferred to the regional department of neurosciences; and fewer patients with minor head injuries should be admitted for observation.

Adolescent↗
PubMed1979

Beliefs and anticipated situations influencing intentions to use drugs.

Unique differences between usage segments in beliefs, perceptions, and anticipated situational influences regarding the salient dimensions underlying motivations to use marijuana are described. An extended model of behavioral intention is used for examining and explaining motivations to use marijuana in an attempt to replicate and extend recent research on drugs. Respondents' opinions concerning the interventing influences of external situations on the intentions-behavior relationship are also addressed. Implications for public policymakers concerned with drug-related social issues are also provided.

Adult↗
PubMed1978

A method for comparing endotracheal cuffs. A controlled study of tracheal trauma in dogs.

Damage to the trachea produced in dogs by large and small residual volume cuffs during 6 h of IPPV was compared using a specially designed endotracheal tube. The cuffs under evaluation were adjusted to exert similar average pressures on the tracheal wall, so that many of the variables believed responsible for tracheal injury were controlled. The true compliance of the cuff was measured with the tube inside and outside the trachea of the anaesthetized dogs. The maximum estimated pressure transmitted to the tracheal wall, derived from these compliance curves, was found to equal the peak airway pressure in the presence of a small air leak past each cuff. At various tracheal wall pressures there were only very minor differences in tracheal damage between the large and small residual volume cuffs tested.

Animals↗