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Biomedical subjects

L Jones

Publications and source records attributed to L Jones.

At least 379 records · Page 21Linked to original sources
PubMed1984

Prescribing psychotropic drugs in general practice: three year study.

A three year longitudinal study of psychotropic drug prescribing in one inner city general practice showed that there was a greater use of such drugs among women and elderly men and women. Repeat prescriptions without consultation accounted for 44% of prescriptions written. We think that any attempt to reduce the volume of prescriptions for psychotropic drugs should take into account the prescribing habits and attitudes of doctors as well as the problems and needs of patients.

Adolescent↗
PubMed1984

Phase-II trial of 1,2-diaminocyclohexane (4-carboxyphthalato) platinum (II) (DACCP) in non-small cell lung cancer.

A phase-II trial of the second-generation platinum analog 1,2-diaminocyclohexane (4-carboxyphthalato) platinum (II) (DACCP) was performed in 33 patients with non-small cell lung cancer. The compound was studied because of its lack of cross resistance in vitro and decreased nephrotoxicity in both preclinical testing and in a phase-I trial. The starting dose was 640 mg/m2 IV every 3 weeks, with escalations to 720 mg/m2 in the absence of toxicity. Myelosuppression and nephrotoxicity were uncommon. Allergic reactions and neurotoxicity were seen in five and three patients, respectively. Of 28 patients evaluable for response, one partial remission of 3 months' duration was noted in a patient who had previously responded but subsequently progressed during cisplatin and vindesine medication. No responses were seen in 11 adequately treated patients who had received no prior therapy. DACCP has only minimal activity in non-small cell lung cancer. No further studies are planned in this disease.

Adult↗
PubMed1984

Effect of hypoxia on the normal and ischemic myocardium.

This study investigated the effect of hypoxia on global and regional myocardial function in the normal heart and in the heart with a critically constricted coronary artery. Eight dogs under halothane anesthesia were subjected to progressive degrees of hypoxia while global and segmental heart function as well as general hemodynamics were evaluated. In the control phase of the experiment, the coronary circulation was undisturbed. A decrease in the inspired oxygen fraction from 0.3 to 0.1 was associated with significant increases in the heart rate, cardiac output, left ventricular minute work and coronary blood flow, and significant decreases in systemic vascular resistance. regional myocardial function (measured by endocardial fiber shortening) did not change. In dogs with a critical constriction applied to the left anterior descending coronary artery (LAD), hypoxia significantly increased heart rate and decreased stroke volume. Indices of global myocardial function did not change, but regional function in the area supplied by constricted LAD was depressed during severe hypoxia. This study implies that measured indices of global heart function bear little relation to regional function when a compromised segment of the myocardium is subjected to hypoxia.

Animals↗
PubMed1984

Foreign bodies of the upper gastrointestinal tract: current management.

The popularity of the flexible esophagogastroduodenoscope prompted us to reevaluate our management of foreign bodies. In this paper we report our experience and update treatment guidelines. In our series (from December 1975 to May 1982), 74 foreign bodies were removed: 12 with the rigid endoscope, 60 with the flexible endoscope, and two surgically. There was no morbidity or mortality. In the age group 1 to 10 years, there were 15 patients, while the age group 11 to 88 years had 59 patients. Although the rigid endoscope is less expensive and has a larger operating channel, the advantages of the flexible instrument are numerous. Foreign bodies of the pharynx and at the level of the cricopharyngeus muscle are best managed with a rigid endoscope; foreign bodies of the esophagus can be managed with rigid or flexible instruments, but are more easily managed with the latter. Foreign bodies of the stomach and duodenum that require removal can be managed only with the flexible panendoscope.

Adolescent↗
PubMed1984

Sleep disorders among psychiatric outpatients.

Mental health clinics, particularly the ones serving middle-aged and elderly patients, are usually confronted with serious problems of insomnia, which could trigger or aggravate physical or emotional ailments. It could also lead to drug dependence or contribute to polypharmacy. In this study, we have attempted to make a profile of the insomniacs of a VA Mental Hygiene Clinic and to correlate several variables found in common among the patients. Our work indicated that certain drugs such as benzodiazepines were more effective than others. It also indicated that certain types of insomnia, such as that with frequent awakenings, were more amenable to treatment.

Ambulatory Care↗
PubMed1984

A randomized controlled trial of cervical cerclage in women at high risk of spontaneous preterm delivery.

The effect of cervical suture on pregnancy outcome was studied in 194 women with a high risk (approximately 30%) of having a late abortion or a preterm delivery. The women were randomly allocated either to have a cervical suture inserted (n = 96) or to be managed without a suture (n = 98). There was no evidence that cervical cerclage either prolonged gestation or improved survival. Patients allocated to receive cerclage spent significantly longer in hospital, even when the period of admission for insertion was excluded. The patients in the cerclage group were more likely to receive tocolytic drugs, and more of them experienced puerperal pyrexia, although these differences between the groups were not statistically significant.

Adolescent↗
PubMed1984

A critical evaluation of the Incapacity Status Scale.

The Incapacity State Scale (ISS) of the research version of the Minimal Record of Disability in Multiple Sclerosis has been tested in parallel with Assessment of the Activities of Daily Living (ADL) Index. Reliance of the ISS scoring on the use of aids and adaptive devices was found to be a major source of variation. It is suggested that the general scoring of the proposed ISS scale should be modified so that it employs that of the ADL method, i.e. measuring only independence (irrespective of the use of side and adaptive devices), partial and total dependence.

Activities of Daily Living↗
PubMed1984

The effect of hypocapnia on coronary blood flow and myocardial function in the dog.

The effect of hypocapnia on global and regional myocardial function and coronary blood flow (CBF) was studied in dogs anesthetized with halothane before and after critical constriction of the left anterior descending (LAD) coronary artery. Coronary blood flow decreased 29% (P less than 0.05) when hypocapnia was induced in dogs with a normal LAD artery. Critical constriction reduced CBF by 42% (P less than 0.05). In the critically constricted LAD artery, hypocapnia did not reduce CBF. During hypocapnia and with a normal LAD artery, oxygen extraction by the myocardium increased 16% (P less than 0.01) and oxygen tension in the coronary sinus was reduced by 19% (P less than 0.001). After critical constriction of the LAD, hypocapnia was associated with an increase in oxygen extraction of 14% (P less than 0.01) and the coronary sinus oxygen tension was reduced by 21% (P less than 0.001). CBF of the left circumflex coronary artery (LC) increased 36% (P less than 0.05) after critical constriction to the LAD when compared with control values of the preconstriction phase. However, LC flow did not change during hypocapnia when critical stenosis had been applied to the LAD artery. Although oxygen supply (product of CBF and arterial oxygen content) to the myocardium was reduced during hypocapnia, regional myocardial function did not change from control values. Regional function was similarly maintained during hypocapnia and critical constriction of the LAD.

Anesthesia, General↗
PubMed1984

The use of endoscopy in assessment and treatment peptic strictures of the esophagus.

In the 1960s, evaluation of peptic strictures of the esophagus was a significant and difficult clinical problem. The use of rigid esophagoscopes and general anesthesia resulted in high complication rates. Most peptic esophageal strictures were managed surgically. The 1970s brought a dramatic change in the management of peptic strictures of the esophagus. With the introduction and widespread use of the forward-viewing, flexible panendoscope for upper gastrointestinal (GI) endoscopy, general anesthesia is no longer needed; evaluation of the peptic stricture has become one of the most common procedures in GI endoscopy. From December 1975 to October 1982, 1000 dilations were performed with a morbidity of 0.2 per cent and a mortality of 0.1 per cent. Initially, radiographic evaluation proximal to, distal to, and at the stricture is conducted. Endoscopic evaluation of the same three areas is then performed with emphasis on determining whether the stricture is benign or malignant. Malignancy can be determined visually in more than 90 per cent of the patients and in more than 95 per cent of the patients with multiple biopsies and cytology. Immediate dilation, using rubber (Maloney) dilators (Pilling Medical Co., Fort Washington, PA) or Eder-Puestow dilators (Eder Instrument Co., Chicago, IL), is then performed. The personality of the stricture determines which dilator can be used with greatest safety.

Biopsy↗
PubMed1984

Endoscopic evaluation of dysphagia in two hundred and ninety-three patients with benign disease.

A total of 538 dilations were performed upon 293 patients evaluated at our unit. Of these, 4.8 per cent had cervical webs, 3.0 per cent had cricopharyngeal dysfunction, 9.2 per cent had undetermined cause, 3.4 per cent had achalasia, 65.5 per cent had peptic strictures, 3.8 per cent had Schatzki's ring, 2.4 per cent had esophagitis, 6.1 per cent had postoperative strictures, 0.3 per cent had caustic stricture and 1.4 per cent had extrinsic compression. True dysphagia should always be investigated through a careful history, physical examination, barium study, endoscopy and, infrequently, esophageal manometry.

Adolescent↗