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Biomedical subjects

P Jones

Publications and source records attributed to P Jones.

At least 127 records · Page 7Linked to original sources
PubMed1999

The melanocyte stimulating hormone receptor polymorphism: association of the V92M and A294H alleles with basal cell carcinoma.

Allelic variants in the melanocyte stimulating hormone receptor (MC1R) gene are susceptibility/outcome candidates for cutaneous basal cell carcinoma (BCC). We identified the val92met (V92M) and asp294his (A294H) alleles in 311 cases and 190 controls. The cases included four homo- and 53 heterozygotes for V92M and 12 heterozygotes for A294H and two compound heterozygotes (V92M/A294H). Allele frequencies were similar in controls. In the cases, we found no association between the alleles and skin type though A294H was more common in those with red hair (4/19) than with other hair colours (6/163) (P = 0.012). V92M was not associated with BCC numbers. Cases with A294H had fewer BCC in comparison with those without the allele though the difference was not significant. After inclusion of red hair in the model, A294H was significantly associated with fewer tumours. While MCIR alleles are attractive candidates for BCC, the variants studied did not influence susceptibility. The association with outcome was relatively weak. The large number of MC1R alleles and their low frequency, make assessment of the importance of this gene in the pathogenesis of skin cancers difficult.

Alleles↗
PubMed1999

When the cradle falls: the treatment of postnatal depression in a psychiatric day hospital compared with routine primary care.

BACKGROUND: Postnatal depression affects one in ten women within 6 months of childbirth. The most effective treatment strategy for postnatal depression is not clear. METHODS: This prospective, naturalistic study of the treatment of postnatal depression compared 30 women treated at a specialised psychiatric day hospital with 30 women treated using routine primary care (RPC). Clinical, marital and social adjustment were assessed on three occasions over 6 months using: the Edinburgh Postnatal Depression Questionnaire (EPDS); the Clinical Interview schedule (CIS); the Anxiety Subscale of the Hospital Anxiety and Depression Scale; the Dyadic Adjustment Scale (DAS); and the Work Leisure and Family Life Questionnaire-Modified (WLFLQ-M). RESULTS: There were no significant differences between the two groups at baseline. However, there were significant differences in outcome at 3 and 6 months follow-up for all outcome measures except the DAS. At 6 month follow-up 21 of the PBDU group were no longer depressed compared with 7 of the RPC group. CONCLUSIONS: A specialised day hospital is a more effective treatment setting for postnatal depression than routine primary care. LIMITATIONS OF THE STUDY: The study is not an RCT, so systematic bias is possible. The sample size is relatively small and the duration of follow-up relatively short.

Adolescent↗
PubMed1999

Patient factors and compliance with asthma therapy.

Compliance by patients to prescribed treatment regimens can be considered as the interface between effective therapy and effective disease management. Compliance can be affected by the nature of the relationship between the practitioner and the patient, and their attitudes towards each other. It has also been suggested that practitioner behaviour can influence patient behaviour and health status. However, each individual patient is influenced in his or her attitudes, and reactions to disease and its management, by a wide variety of patient-related factors. These include psychological variables such as mood, beliefs, and the knowledge, motivation and ability of the patient. Social factors may also play a role: these include age, marital and socioeconomic status and level of education. Results from a range of studies in patients with pulmonary or other diseases show that the psychosocial determinants of compliance are only poorly understood, and suggest that compliance cannot be predicted from patients' health status and that social factors are weak indicators only. Furthermore, it appears from available data that patients' beliefs about health issues are not as useful as indicators of likely compliance as was previously believed.

Adult↗
PubMed1999

Inoculum effect leads to overestimation of in vitro resistance for artemisinin derivatives and standard antimalarials: a Gambian field study.

Artemisinin (QHS) and its derivatives are new antimalarials which are effective against Plasmodium falciparum parasites resistant to chloroquine (CQ). As these drugs are introduced it is imperative that resistance is monitored. In this paper we demonstrate that the inoculum size used in in vitro testing influences the measured in vitro susceptibility to QHS and its derivative dihydroartemisinin (DHA) and to mefloquine (MEF) and CQ over the range of parasitaemias routinely used in testing with the WHO in vitro microtest. An increase in parasitaemia and/or haematocrit was accompanied by a decrease in the measured sensitivity of 2 laboratory lines. In the context of a field study testing in vitro susceptibility of parasite isolates from patients with uncomplicated malaria in Fajara, The Gambia we demonstrate that failure to control for inoculum size significantly overestimates the level of resistance to QHS and DHA as well as MEF, halofantrine (HAL) and quinine (QUIN). When controlling for the inoculum effect, cross-resistance was observed between QHS, MEF and HAL suggesting the presence of a multidrug resistance-like mechanism. These studies underline the importance of inoculum size in in vitro susceptibility testing.

Animals↗
PubMed1999

Studies on amino acid metabolism in the brain using 15N-labeled precursors.

The transfer of label from 15N-alanine and 15N-glutamate into amino acids in incubated brain slices has been followed using gas chromatography/mass spectrometry (GC/MS). 15N from alanine appeared in both amino and amide groups of glutamine more rapidly than into aspartate, glutamate and GABA, which were all labeled at similar rates. Maximum labelling of approx. 50% enrichment of these three metabolites was achieved in 3 hr. The 15N present in doubly-labeled glutamine exceeded that in the singly-labelled after 30 min. 15N from glutamate was rapidly transferred to aspartate and to alanine, with slower incorporation into glutamine and GABA. As was seen with labeling from alanine, doubly-labeled glutamine was higher than the singly-labeled species, also reaching some 50% enrichment in 3 hr. Depolarisation with 40 mM extracellular K+ caused a considerable reversal of the ratio of doubly- to singly-labeled glutamine species from both alanine and glutamate. The results are discussed in terms of the effects of depolarization on the glutamate/glutamine cycle.

Alanine↗
PubMed1999

Biochemical and neurotoxicological effects of L-2-chloropropionic acid on rodent brain.

L-2-Chloropropionic acid (L-CPA) is selectively toxic to cerebellar granule cells; necrosis is first observed in rats 36 h after L-CPA administration (750 mg/kg p.o.) and becomes marked by 48 h. L-CPA has also been shown to activate the mitochondrial pyruvate dehydrogenase (PDH) complex in fasted adult rats, resulting in reduced blood glucose and lactate levels. This study aimed to investigate the biochemical and neurotoxicological effects of L-CPA on the brain. Extracts, prepared from guinea-pig cerebellar and cerebral cortex slices incubated in the presence of L-CPA, were analysed using 1H magnetic resonance spectroscopy, 31P magnetic resonance spectroscopy, and amino acid analysis. Glucose metabolism was studied by monitoring the metabolism of [1-(13)C]glucose using gas chromatography/mass spectrometry. Increased glucose metabolism and decreases in the pool sizes of lactate and alanine were observed in both tissues, demonstrating activation of the PDH complex. Extracts were also prepared from the forebrain and cerebellum of animals that had been treated in vivo with L-CPA and analysed as described for the in vitro studies. Similar evidence for PDH activation was demonstrated at 2 and 24 h after dosing in both tissues. At 48 h after dosing, when signs of toxicity are observed, an increase in the lactate concentration and a decrease in N-acetylaspartate in the cerebellum but not in the forebrain confirmed the selective neurotoxic action of L-CPA. These results suggest that activation of the PDH complex does not directly lead to the delayed selective neurotoxicity of L-CPA.

Alanine↗
PubMed1999

Operative vaginal delivery rates in the United Kingdom.

Operative vaginal delivery with the vacuum extractor or forceps is integral to the practice of obstetrics worldwide. The rates at which obstetricians in different countries intervene vary enormously. The wide range of operative vaginal delivery rates reported in the United Kingdom has been noted as a cause for concern. At a Royal College of Obstetricians and Gynaecologists consultants' conference, the participants of a discussion group were surveyed regarding their 'actual' and perceived 'optimal' operative vaginal delivery rate. The 'actual' operative vaginal delivery rate was 10.5% and the perceived 'optimal' was 8.7%. Given that there are approximately 600 000 births per annum in the UK, if the optimal delivery rate was achieved over 10 000 operative vaginal deliveries could be avoided, with significant reductions in maternal morbidity. Reductions could be achieved by examining practice at a number of points in the care pathway. Individual units should examine their practice to establish whether their guidelines and continuing education programmes reflect current knowledge of best practice.

Journal Article↗
PubMed1999

Acute inflammatory (non-purulent) arthritis concomitant with a developing breast abscess.

A 34 year old female presented 7 weeks post-partum with acute diffuse arthritic manifestations and pyrexia. Extensive investigations (grossly raised erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], normal serology and others) were performed to pursue a diagnosis. Subsequently a breast abscess was diagnosed. Surgical treatment of this led to almost immediate resolution of the joint complaints and return of ESR/CRP to normal levels. This was considered a hitherto unreported case of acute non-purulent inflammatory arthritis concomitant to an existing infection elsewhere in the body. The pathogenic mechanism is unclear but speculatively toxin-mediated.

Abscess↗
PubMed1999

Can excellent school performance be a precursor of schizophrenia? A 28-year follow-up in the Northern Finland 1966 birth cohort.

OBJECTIVE: Poor scholastic performance is known to pre-date adult schizophrenia. We studied the 1966 North Finland general population birth cohort (n = 11017) in order to determine whether excellent school performance was a risk or protective factor. METHOD: Data on school marks at the age of 16 years were linked to data on psychiatric morbidity. In total, 89 subjects (58 boys) developed DSM-III-R schizophrenia between the ages of 16 and 28 years. RESULTS: Six (11%) of the pre-schizophrenic boys (6/54) had excellent mean school marks, compared to only 3% (166/5245) of the comparison group (OR 3.8; 95% CI 1.6-9.3, adjusted for parental social class, place of residence and birth order). CONCLUSION: These results may be a chance phenomenon and require replication. However, adult schizophrenia may be linked to excellent school performance. This result may be relevant both to the preservation of schizophrenia in the population, and to mechanisms of developing schizophrenia.

Achievement↗
PubMed1999

Contributory and exacerbating roles of gaseous ammonia and organic dust in the etiology of atrophic rhinitis.

Pigs reared commercially indoors are exposed to air heavily contaminated with particulate and gaseous pollutants. Epidemiological surveys have shown an association between the levels of these pollutants and the severity of lesions associated with the upper respiratory tract disease of swine atrophic rhinitis. This study investigated the role of aerial pollutants in the etiology of atrophic rhinitis induced by Pasteurella multocida. Forty, 1-week-old Large White piglets were weaned and divided into eight groups designated A to H. The groups were housed in Rochester exposure chambers and continuously exposed to the following pollutants: ovalbumin (groups A and B), ammonia (groups C and D), ovalbumin plus ammonia (groups E and F), and unpolluted air (groups G and H). The concentrations of pollutants used were 20 mg m-3 total mass and 5 mg m-3 respirable mass for ovalbumin dust and 50 ppm for ammonia. One week after exposure commenced, the pigs in groups A, C, E, and G were infected with P. multocida type D by intranasal inoculation. After 4 weeks of exposure to pollutants, the pigs were killed and the extent of turbinate atrophy was assessed with a morphometric index (MI). Control pigs kept in clean air and not inoculated with P. multocida (group H) had normal turbinate morphology with a mean MI of 41.12% (standard deviation [SD], +/- 1. 59%). In contrast, exposure to pollutants in the absence of P. multocida (groups B, D, and F) induced mild turbinate atrophy with mean MIs of 49.65% (SD, +/-1.96%), 51.04% (SD, +/-2.06%), and 49.88% (SD, +/-3.51%), respectively. A similar level of atrophy was also evoked by inoculation with P. multocida in the absence of pollutants (group G), giving a mean MI of 50.77% (SD, +/-2.07%). However, when P. multocida inoculation was combined with pollutant exposure (groups A, C, and E) moderate to severe turbinate atrophy occurred with mean MIs of 64.93% (SD, +/-4.64%), 59.18% (SD, +/-2.79%), and 73.30% (SD, +/-3.19%), respectively. The severity of atrophy was greatest in pigs exposed simultaneously to dust and ammonia. At the end of the exposure period, higher numbers of P. multocida bacteria were isolated from the tonsils than from the nasal membrane, per gram of tissue. The severity of turbinate atrophy in inoculated pigs was proportional to the number of P. multocida bacteria isolated from tonsils (r2 = 0.909, P < 0.05) and nasal membrane (r2 = 0.628, P < 0.05). These findings indicate that aerial pollutants contribute to the severity of lesions associated with atrophic rhinitis by facilitating colonization of the pig's upper respiratory tract by P. multocida and also by directly evoking mild atrophy.

Air Pollution, Indoor↗
PubMed1999

Study of the relationship between premorbid urinary incontinence and stroke functional outcome.

OBJECTIVE: To examine functional outcome in stroke patients with premorbid incontinence of urine. METHOD: Comparative study in stroke patients between premorbidly incontinent and continent groups. Both groups were subjected to structured interview, clinical examination and functional assessment at one week post stroke. Functional assessment was repeated six months later. SUBJECTS: Eighty-six patients with first-time stroke younger than 80 years of age admitted to hospital, were divided into two groups according to their continence status. OUTCOME MEASURE: The 20-point Barthel Index. SETTING: Medical wards at North Staffordshire Teaching Hospitals. RESULTS: Of 86 stroke patients (46 continent and 40 premorbidly incontinent), 19 died before six-month assessment, of whom 15 (79%) were premorbidly incontinent. Premorbid incontinence was the most significant variable predicting poor functional outcome (Barthel Index score <15) at six months, with a sensitivity of 82.6% and specificity of 86.4% and with age-corrected p-value of <0.001. CONCLUSIONS: This study shows a significant relationship between premorbid incontinence and functional outcome at six months. However, other causes that could have contributed to the premorbid incontinence were not excluded. This point needs to be considered in future studies, which should also examine whether premorbid incontinence per se reflects an underlying predisposition for stroke.

Aged↗
PubMed1999

Evaluating the Health of the Nation Outcome Scales. Reliability and validity in a three-year follow-up of first-onset psychosis.

BACKGROUND: The HoNOS has been developed as a routine measure of outcomes in mental health. AIMS: To explore the validity and interrater reliability of HoNOS in a first-onset psychosis follow-up study. METHOD: Between 1992 and 1994 we ascertained a cohort of all persons with first-onset psychosis. We re-assessed these people at 3 years (n = 166) with several outcome scales, including HoNOS. Patients' keyworkers also completed the HoNOS. We estimated concurrent validity by calculating correlations between HoNOS and other scales, and interrater reliability. RESULTS: Researcher HoNOS correlated highly with other scales (0.46 < p < 0.86; P < 0.001). Keyworker HoNOS correlations were lower (0.41 < p < 0.51; P < 0.05), but still significant for all scores except the HoNOS-social subscale (0.12 < p < 0.28). Agreements between researcher and keyworker HoNOS were modest (0.47 < ICC < 0.85). CONCLUSIONS: In this research cohort HoNOS correlates well with established outcome scales. Keyworker ratings show similar, but weaker, relationships; its use in routine settings may require further training for calibration of severity.

Adult↗
PubMed1999

Outcome of psychosis in people of African-Caribbean family origin. Population-based first-episode study.

BACKGROUND: An increased incidence of psychotic disorders has repeatedly been reported among African-Caribbeans in the UK. AIMS: To test whether the increased incidence of psychotic disorders in first- and second-generation African-Caribbeans in the UK could be caused by a relative excess of affective-related psychoses with good prognosis. METHOD: Thirty-three patients of African-Caribbean family origin identified in a population-based study of first-episode psychoses were compared with the remaining cases. Three-year outcomes and patterns of course were compared. RESULTS: There was a trend for better outcomes in African-Caribbean patients for symptoms and social disability, but patterns of course were similar (odds ratio = 0.9 (0.50 to 2.00)) [corrected]. Pattern of course improved after adjustment for confounding by gender, social class, age, diagnosis and duration of untreated illness (odds ratio = 0.59 (0.21 to 1.66)) [corrected]. Diagnostic profiles were similar, with no evidence of greater diagnostic instability in the African-Caribbean group. CONCLUSION: Pattern of course of psychosis did not differ significantly by ethnic family background. An excess of good-prognosis affective psychoses is an unlikely explanation for increased rates of psychosis in African-Caribbeans.

Adolescent↗
PubMed1999

Infant pulmonary hemorrhage in a suburban home with water damage and mold (Stachybotrys atra).

The American Academy of Pediatrics recently issued guidelines regarding the potential toxic effect of indoor molds. We now report another case of an infant with pulmonary hemorrhage whose residential environmental assessment revealed the presence of the toxigenic mold Stachybotrys atra. We used a questionnaire to identify environmental factors that could predispose the home to fungal contamination. We collected air samples from multiple locations in the home that we felt would reflect areas of relevant exposure. Surface samples were collected with a piece of transparent tape for semiquantitative measurement of spores present. We classified spores into their respective genera based on shape, size, and color. We also measured mycotoxin levels. Air sampling revealed significantly elevated total spore counts in the patient's bedroom and in the attic. Aspergillus/Penicillium species were predominant. Stachybotrys spores were found in the air sampled in the patient's bedroom, as well as from surfaces sampled in the patient's closet and the attic ceiling. Additionally, a small patch of Stachybotrys-contaminated area in the closet ceiling was sent for mycotoxin analysis. This material proved to be highly toxigenic. As the link between the presence of Stachybotrys in the home and pulmonary hemorrhage in infants increases, further efforts should be made to educate physicians, health care providers, and new parents about the potential toxic effects of this mold.

Air Pollution, Indoor↗
PubMed1999

Knowledge of laws regulating issues related to HIV and AIDS: development of the HIV/AIDS and the law scale.

42 middle-aged and older adults, ranging in age from 51 to 85 years, completed 10 items dealing with the assessment of knowledge regarding laws regulating issues related to HIV and AIDS. Participants also completed 40 items involving knowledge of risks for HIV infection. The Cronbach coefficient alpha and test-retest reliability coefficient on the HIV/AIDS and the Law Scale were .74 and .83, respectively. Over-all, the grand mean for correct answers was 46.9%, whereas the grand means for incorrect answers and "don't know" responses were 13.6% and 39.5%, suggesting substantial lack of knowledge of laws regulating issues related to HIV and AIDS. Women (50%) and younger participants (51 to 66 years old; 48.2%) showed more of this knowledge (50%) than men (43.0%) and older participants (46.2%). The sample reported a substantial amount of knowledge regarding HIV transmission assessed with factual (92.2% correct) and misconception (87.5% correct) items. The correlation between this knowledge and knowledge of laws regulating issues related to HIV and AIDS was .42 (p < .01). Research with this scale using adolescents and young adults as well as the utility of the scale in areas of clinical, legal, and policy development are discussed.

AIDS Serodiagnosis↗
PubMed1999

[Evaluation of daily activity in patients with COPD].

BACKGROUND: Recently we could show that the daily activity in patients with hypercapnic respiratory failure as judged by the total amount of movements per day increased by 120% after 3 months of non-invasive mechanical ventilation. This study was designed to evaluate the reproducibility of the result of a movement detector in measuring daily activity of patients with COPD. PATIENTS AND METHODS: 25 outpatients (11 females, 56 +/- 12 years old) with stable non-hypercapnic COPD (FEV1 = 47 +/- 9% predicted) were examined twice during a 7 days lasting interval, one month apart using a pedometer. RESULTS AND CONCLUSIONS: The repeatability of the activity counts in the non-hypercapnic COPD patients was high (1st study period: 3,781 +/- 2,320 movements/d, 2nd study period: 3,626 +/- 2,149 movements/d) and in these patients activity correlated significantly with FEV1 (r = 0.54, p = 0.006).

Activities of Daily Living↗