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Biomedical subjects

L Jones

Publications and source records attributed to L Jones.

At least 289 records · Page 16Linked to original sources
PubMed1991

Integrating research activities, practice changes, and monitoring and evaluation: a model for academic health centers.

A study undertaken by the Joint Commission in 1986 proposed that some research activities at academic health centers (AHCs) be used to fulfill monitoring and evaluation requirements. This paper presents a framework for such use of research activities. To fulfill the monitoring and evaluation standards, AHCs and their medical staff departments must conduct planned and systematic quality assurance activities, and research and subsequent practice changes must be documented. In addition, particular research activities should correspond to the ten steps of the Joint Commission model of the monitoring and evaluation process. It is critical that research result in specific actions to improve care, along with follow-up monitoring and, when necessary, follow-up action.

Academic Medical Centers↗
PubMed1991

The pneuPAC hyperbaric variant HB: a ventilator suitable for use within a one-man hyperbaric chamber.

We describe the performance of the pneuPAC hyperbaric variant HB, a ventilator designed for use in a one-man hyperbaric chamber. The ventilator delivered minute volumes of 11-23 litre at 1 atm abs to 7.6-16 litre at 2.5 atm abs. The delivered minute volume may be controlled easily from outside the chamber by manipulation of the ventilator rate, 11.5-31 b.p.m.

Evaluation Studies as Topic↗
PubMed1991

Formation of C8-modified deoxyguanosine and C8-modified deoxyadenosine as major DNA adducts from 2-nitropyrene metabolism mediated by rat and mouse liver microsomes and cytosols.

2-Nitropyrene, the geometric isomer of the most studied nitropolycyclic aromatic hydrocarbon (nitro-PAH), 1-nitropyrene, is an environmental contaminant detected in ambient air and a potent direct-acting mutagen. Its metabolic activation leading to the formation of DNA adducts was studied. The activated metabolite, N-hydroxy-2-aminopyrene, was prepared and reacted with calf thymus DNA. Upon enzymatic hydrolysis of the DNA, the resulting nucleosides were separated by HPLC, and the adducts were characterized by mass and proton NMR spectral analysis. Both N-(deoxyguanosin-8-yl)-2-aminopyrene and N-(deoxyadenosin-8-yl)-2-aminopyrene, in a 5:2 ratio, were identified. These adducts were then utilized as standards to identify the DNA adducts formed from reaction of [3H]2-nitropyrene with DNA mediated by liver microsomes and cytosols of mouse and rat. In all cases, both adducts were formed. The quantities of the two adducts formed in each system were: mouse liver microsomes (11.3 pmol [3H]2-nitropyrene/mg DNA), rat liver microsomes (23), mouse liver cytosol (11.4) and rat liver cytosol (5.1). Thus, these adducts were formed in highest yield from rat liver microsomes and the lowest from rat liver cytosol. The deoxyguanosine/deoxyadenosine adduct ratio was higher from rat and mouse liver microsomes (7.8:9.2) than from rat and mouse liver cytosols (2.5:3.1). Our results represent the first direct demonstration of a C8-deoxyadenosine adduct being formed as a major product from the reaction of a nitro-PAH metabolite with DNA.

Animals↗
PubMed1991

Microangiopathic haemolysis associated with occult carcinoma.

Microangiopathic haemolytic anaemia (MAHA) is a well recognized complication of disseminated carcinoma and its treatment. It is however, rarely seen with localized carcinoma. The case presented here is a previously unreported association of a patient, who having been successfully treated for MAHA, was found to have occult breast carcinoma on a routine screening mammogram six months after the haemolytic episode.

Adenocarcinoma↗
PubMed1991

Pathology of the lung in leukaemia and lymphoma: a study of 87 autopsies.

Histopathological findings in the lungs in a series of autopsies on 87 patients suffering from various types of leukaemia or lymphoma who had received no treatment, or various combinations of radiotherapy, chemotherapy and bone marrow transplantation were reviewed. Thirteen untreated patients showed neoplastic infiltration (4), thromboembolism (4), infection (5) or amyloidosis (1). Seventy-two treated cases showed malignant infiltration (14), vascular damage (21), infections (32) and/or diffuse alveolar damage (47). One patient treated with local irradiation for myeloma had acute bronchopneumonia alone and another treated with [32P] for polycythaemia rubra vera had extensive thrombo-embolism of the large pulmonary vessels. Clinical and autopsy evidence of infection correlated very poorly. Non-infective pulmonary disease was a frequent finding. Bacterial, fungal or pneumocystis pneumonia particularly affected the chemotherapy and radiotherapy groups, while cytomegalovirus infection was seen only in the bone marrow transplant group. This study shows that diffuse alveolar damage is a common and important problem in patients treated with radiotherapy and chemotherapy.

Antineoplastic Agents↗
PubMed1991

Sports insurance and national governing bodies.

A postal survey was conducted of the attitudes and advice of Welsh governing bodies of amateur sports and their Cardiff-based clubs towards personal sports insurance. Information on 36 of the 39 sports surveyed (92%) was sufficient for analysis. Twenty-two of these 36 sports (61%) organized insurance at a national level, one at club level (3%) and 13 (36%) provided no insurance advice. Only 12 sports (33%) insisted on mandatory insurance cover. Many sportsmen and women are left to search for an appropriate insurance cover themselves or remain uninsured. Owing the lack of advice in 36% of cases it was decided to survey Cardiff-based insurance brokers to establish what type of policy they would recommend. Only 41% of the brokers were able to offer a suitable policy. Club policies recommended by the Central Council for Physical Recreation provide individuals with the same sports cover (but at a lower premium) as is available from a personal accident policy. However, cover is somewhat inadequate and may provide a false sense of security. Sports with mandatory sports insurance are not necessarily those with the highest risk of disabling injury.

Athletic Injuries↗
PubMed1991

Mood disorders in the year after first stroke.

An unselected community sample of 128 patients were studied over the 12 months after their first stroke, and compared with a control sample of subjects from the general population. Psychiatric status was assessed using the PSE and BDI. Symptoms of mood disorder were commoner in the stroke patients than the controls, but the differences were not substantial and had largely disappeared by 12 months. Psychiatric problems encountered included agoraphobia, social withdrawal, apathy and self-neglect, irritability and pathological emotionalism. While there was a high cumulative incidence of psychiatric disorder, little of it persisted: only two cases of major depression were present for the whole 12 months. We believe undue emphasis has been placed in the recent literature on major depression as a specific syndrome following stroke.

Adolescent↗
PubMed1991

The health consequences of economic recessions.

Unemployment has been demonstrated to be a stressful life event with severe health consequences. This paper reviews the literature on the relationship between unemployment and health. Specific risks and the mechanisms that lead to adverse outcomes are identified. Suggested social work interventions to reduce health risks during economic downturns are discussed.

Economics↗
PubMed1991

Text telecommunication for people who are deaf: assessing the use of a text-relay service.

This study investigated the pattern and frequency of telephone use by people with a profound or severe hearing impairment. The main purpose was to assess the benefits of text telecommunication for making calls by typing rather than speaking and listening. Data on 169 adults were obtained by personal interview. The sample was stratified between subscribers to an experimental text-relay service and non-subscribers: a minority of respondents in both groups used a text telephone for direct telecommunication. Access to the relay service increased independent use of the telephone significantly above that of other respondents, whether for social contact, conducting personal business, or in paid work. The text-relay service was less than satisfactory for urgent calls and apparently did not encourage reciprocal contact. Nearly all respondents, subscribers and non-subscribers alike, relied on other people making or receiving calls on their behalf via an ordinary telephone. Direct text telecommunication was as important as the text-relay service for social contact, especially with friends. The costs of telephone text equipment were substantially more than those normally incurred by hearing people. The implications for improving deaf people's access to the telephone are discussed.

Deafness↗
PubMed1991

Integrating HIV/AIDS policies and curricular content into baccalaureate nursing programs.

A model used by one school of nursing to implement HIV/AIDS policies, sequenced instructional opportunities, and a research-based evaluation process is described. In the evaluation phase, a study was undertaken to measure students' retention of HIV/AIDS knowledge and their application of universal precautions (U.P.). Findings revealed that 59% of junior baccalaureate nursing students and 75% of seniors retained knowledge about HIV/AIDS and U.P. Seniors indicated that in their role as nursing student or technician/extern, supplies and equipment were readily available and that they had sufficient time to implement U.P. However, only 64% admitted to following correct procedures, even though 96% acknowledged feeling confident in their ability to do so. Knowledge about HIV/AIDS and consistent application of U.P. protects nursing students, prevents legal problems, and promotes the quality of patient care.

Clinical Competence↗
PubMed1991

The natural history of low grade non-Hodgkin's lymphoma and the impact of a no initial treatment policy on survival.

The natural history of low grade lymphoma and the influence of a 'no initial treatment' policy on survival were studied retrospectively in a group of 153 patients with stage II-IV low grade non-Hodgkin's lymphoma. The median follow-up was 85 months (range 45-229 months) and median survival of 50 months (range 14-220 months). Favourable outcome was significantly associated with the absence of B symptoms and a centroblastic/centrocytic (cb/cc) diffuse and follicular histological subtype and was inversely associated with increasing age. No significant differences in survival were found according to patient gender, site or stage of disease or whether the patients were participants in a clinical trial. Importantly, there was no survival disadvantage amongst the 56 patients who were initially untreated compared to those receiving other treatment modalities: initially untreated patients had a median survival of 75 months; 56 per cent were alive at 5 years and the median treatment free interval was 33 months. This favourable outcome persisted even after adjustment for other important prognostic variables. Further studies are needed to identify the characteristics of those patients with indolent disease in whom treatment may be deferred without adversely affecting survival.

Adult↗
PubMed1991

Early deposition trends on group I (Polymacon and Tetrafilcon A) and group III (Bufilcon A) materials.

One of the problems with hydrophilic contact lenses is that they are susceptible to spoilage. This study investigated the degree of spoilage associate with lenses of various surface changes during the early stages of wear and the effect of surfactant cleaning of lenses at this stage. Ten patients wore a control HEMA lens on one eye and either an ionic (Bufilcon A) or non-ionic (Tetrafilcon A) lens on the other for one week and used a peroxide system for disinfection. The lenses were then replaced with identical lenses, which were also worn for 1 week, with surfactant cleaning added to the care regimen. The lenses then were examined by fluorescence spectroscopy in order that the extent of lipid and protein deposition could be assessed. The results indicate that protein accumulation is highly material dependent, whereas lipid deposition is primarily patient dependent. Also the term "ionic" does not necessarily indicate equally enhanced deposition in all lenses so termed. Surfactant cleaning appears to be of little benefit in reducing deposits during the early stages of wear, its benefit in the long-term being of much greater significance.

Adult↗
PubMed1991

A survey of psychiatric patients' views of outpatient clinic facilities.

Psychiatric services have been slow to solicit the views of their patients about quality. This study asked attenders at an outpatient clinic at a large psychiatric teaching hospital about their opinions on the referral process, waiting time, access, waiting within the clinic, consultations, and overall satisfaction. Response rates were 86% and 70% for the two parts of an interviewer-administered, structured questionnaire. A range of criticisms and concerns were identified, some of which have since been addressed by practical measures. Overall satisfaction was related to the quality of communication within the consultation and to the length of waiting time from referral to appointment. The study confirms the practicality of consumer studies in a psychiatric setting.

Attitude to Health↗
PubMed1990

IL-2-PE40 prevents the development of tumors in mice injected with IL-2 receptor expressing EL4 transfectant tumor cells.

A number of different immunotherapeutic reagents are currently being developed to target IL-2R for the treatment of leukemia, graft rejection, and certain autoimmune diseases. Previously, we have shown that IL-2-PE40, a chimeric protein composed of human IL-2 linked to the N-terminus of a truncated form of Pseudomonas exotoxin (PE), could effectively kill a variety of cell lines in vitro expressing either low, intermediate, or high affinity IL-2R. Here, we demonstrate that IL-2-PE40 can successfully retard or prevent the growth of a lethal ascites tumor or a solid tumor composed of EL4J murine thymoma cells transfected with the p55 murine IL-2R. The transfected line, EL4J-3.4, expresses 1,000 to 3,000 high affinity IL-2R. Survival extension in the ascites model was achieved by initiating treatment either after 4 to 6 h or within 5 days post-tumor injection in both athymic nude and C57BL/6 mice. Similarly, the growth of an aggressive s.c. solid tumor could also be inhibited. Extension of survival was not achieved either by using the truncated toxin alone not attached to IL-2 or by using an IL-2-PE40Asp553 mutant lacking a functional toxin. Survival extension was not caused by IL-2 activated NK or other host effector mechanisms as IL-2-PE40 was unable to prevent the receptor-negative EL4J parental line from forming a lethal ascites or a solid tumor. Thus, IL-2-PE40 is a potent, specific cytolytic reagent that may prove useful in the arsenal of anti-IL-2R immunotherapeutics.

ADP Ribose Transferases↗
PubMed1990

Lipid screening: is it enough to measure total cholesterol concentration?

OBJECTIVES: To determine whether measurement of total cholesterol concentration is sufficient to identify most patients at lipoprotein mediated risk of coronary heart disease without measurement of triglyceride and high density lipoprotein (HDL) cholesterol concentrations. DESIGN: Cross sectional screening programme. SETTING: Six general practices in Oxfordshire. PATIENTS: 1901 Men and 2068 women aged 25-59. MAIN OUTCOME MEASURE: Cardiovascular risk as assessed by fasting venous plasma concentrations of total cholesterol, triglyceride, and HDL cholesterol. RESULTS: 2931 Patients (74% of those screened) had a total cholesterol concentration of less than 6.5 mmol/l. If the triglyceride concentration had not been measured in these patients isolated hypertriglyceridaemia (greater than or equal to 2.3 mmol/l) would have remained undetected in 185. Among these 185 patients, however, 123 were overweight or obese and only 18 (0.6% of those screened) had an increased risk associated with both a raised triglyceride concentration (greater than or equal to 2.3 mmol/l) and a low HDL cholesterol concentration (less than 0.9 mmol/l). Conversely, in the 790 patients with predominant hypercholesterolaemia (cholesterol concentration greater than or equal to 6.5 mmol/l and triglyceride concentration less than 2.3 mmol/l) measurement of HDL cholesterol concentration showed that 348 (9% of those screened) had only a moderately increased risk with a ratio of total to HDL cholesterol of less than 4.5 and 104 had a low risk with a ratio of less than 3.5. CONCLUSIONS: Fasting triglyceride and HDL cholesterol concentrations identify few patients at increased risk of coronary heart disease if the total cholesterol concentration is less than 6.5 mmol/l. HDL cholesterol and triglyceride concentrations should, however, be measured in patients with a total cholesterol concentration exceeding this value. Total cholesterol concentration alone may overestimate risk in a considerable number of these patients, and measurement of HDL cholesterol concentration allows a more precise estimate of risk. Measurement of the triglyceride concentration is required to characterise the lipoprotein abnormality. A patient should not be started on a drug that lowers lipid concentrations without having had a full lipoprotein assessment including measurement of HDL cholesterol concentration.

Adult↗