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Biomedical subjects

R Jones

Publications and source records attributed to R Jones.

At least 775 records · Page 43Linked to original sources
PubMed1987

Self-care and primary care of dyspepsia: a review.

Digestive disorders are common in the community and a frequent reason for consultation in primary care, yet there is considerable uncertainty about their prevalence, natural history and management. This paper reviews knowledge of the epidemiology of dyspepsia and acid-peptic disease and goes on to examine issues in self-care and primary care of these conditions.

Adult↗
PubMed1987

Comparison of high-frequency chest wall compression with conventional mechanical ventilation in cats.

Six anesthetized paralyzed cats with normal lungs were ventilated by high-frequency chest wall compression (HFCWC) at 5 Hz using a single-chamber circumferential cuff enclosing the thorax from the axillae to the xiphisternum. PaCO2 during HFCWC + PEEP (3 cm H2O) was significantly (p less than .0005) lower compared with conventional mechanical ventilation (CMV). End-expiratory lung volume (VL) during HFCWC + PEEP was significantly (p less than .001) lower than VL during CMV + PEEP but was higher than VL during CMV without PEEP. After the cats' lungs were stiffened by repeated saline lavage, CMV + PEEP at a mean airway pressure (Paw) of 10 cm H2O was compared with HFCWC + continuous positive airway pressure (CPAP) at an equal or lower Paw. A significant decrease in PaCO2 (p less than .02) during HFCWC occurred but no significant differences were observed in PaO2, VL, or compliance. Arterial BP and cardiac output were similar between CMV + PEEP and HFCWC + CPAP. In cats with normal lungs, VL can be maintained by applying CPAP during HFCWC, and in those with injured lungs, HFCWC + CPAP produces comparable gas exchange at a Paw equal to or lower than that used during CMV + PEEP.

Animals↗
PubMed1987

Allogeneic, syngeneic and autologous marrow transplantation in the acute leukemias and lymphomas--Baltimore experiences.

Allogeneic bone marrow transplants (BMT) in acute lymphoblastic leukemia following cyclophosphamide (Cy) and total body irradiation (TBI) has resulted in disease-free survival (DFS) for CR1, CR2, and CR3 of 10/18 (56%), 16/30 (53%) and 4/17 (24%), respectively. Median follow-up of survivors was 25-43 months. One relapse was seen in CR1, 1 in CR2, and 6 in CR3. Allogeneic BMT in acute nonlymphoblastic leukemia (ANLL) following busulfan (Bu) resulted in DFS for CR1, CR2 + CR3 + early relapse of 21/47 (45%) and 13/41 (32%), respectively. Median DFS of survivors of all groups together was 36 months. DFS of all patients 20 years or less was 15/27 (56%) and 19/61 (31%) for ages 21-46. Three relapses of 47 (6%) were seen in CR1 and 6/41 (15%) in subsequent remission and early relapse. BMT of autologous BMT with 4-hydroperoxy-cyclophosphamide (4-HC) purged marrow in ANLL in CR1 (5), CR2 (32) and CR3 (9) following Bu + Cy resulted in DFS of 19/46 (41%) for 1-67 months (median 15 months). Twenty patients with prior risk non-Hodgkin's lymphoma received 4-HC-purged marrow following Cy + TBI. DFS was 10/20 (50%) for 1.4-9.5 years (median 2.9 years).

Acute Disease↗
PubMed1987

Age-related development profiles of the antioxidative defense system and the peroxidative status of the pig heart.

The developmental profiles of the antioxidative defense system and the peroxidative status of the heart during growth and development were studied in pigs of three different age groups. A unique age-specific myocardial lipid peroxidation expressed in terms of malonaldehyde formation occurred after incubation of neonatal and adult pig heart homogenates in the absence of any added factors. Very little malonaldehyde release was noticed in the 0- to 2-day age group, while considerably higher activity was found in the 8- to 10-day-old animals. The 2-month-old pig heart again formed very little malonaldehyde. Myocardial injury from lipid peroxidation was highest in the 0- to 2-day age group, as evidenced by the release of oxidized glutathione, lactate dehydrogenase (LDH) and creatine kinase (CK) activities. Release of glutathione, LDH and CK decreased with age and was minimal in the adult group. The antioxidative enzymes, superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase, increased during the first 10 days of neonatal growth and then levelled off. Glucose-6-phosphate dehydrogenase was present in appreciably lower amounts in adult hearts compared to neonatal hearts. Heart weight increased with aging, but myocardial water content decreased. Protein and DNA contents of hearts increased with age, such that the protein/DNA ratio almost doubled from the newborn to adult age. The results indicate that the newborn pig hearts are equipped with the antioxidative defense system, which undergoes significant development during the initial phase of neonatal growth and does not change appreciably thereafter. The results further suggest that the change in activity profile with aging is different for different enzymes, and the peroxidative status of the myocardium is not a function of these enzyme activities.

Aging↗
PubMed1987

Vascular components of ARDS. Clinical pulmonary hemodynamics and morphology.

Mild pulmonary artery hypertension (PAP, 29.6 +/- 10.6 mm Hg, mean +/- SD) due to a 3-fold elevation of pulmonary vascular resistance (PVR, 2.2 +/- 1.1 mm Hg X L/min) is a common finding in severe ARDS. A vasodilator such as nitroprusside (151 micrograms/kg X min) can be administered in early ARDS and will lower PAP and PAOP (capillary wedge pressure) while increasing cardiac output (CO) from 6.9 to 8.75 L/min X M2 and venous admixture from 23% to 31.6%. This suggests diffuse vasoconstriction is present in early ARDS. In 19 patients with severe ARDS, 13 had vascular occlusions on balloon occlusion angiography, and these occlusions correlated with increased post mortem counts of PA thrombi. At autopsy, there was a considerable increase of PA medial thickness and a reduction of lumen diameter. This hemodynamic and morphologic evidence suggests both vasoconstrictor and anatomic changes play major roles elevating the PVR in ARDS.

Acute Disease↗
PubMed1987

Behavioral, psychosocial, and academic correlates of marijuana usage in adolescence. A study of a cohort under treatment.

In 1985 approximately 120,000 American high school seniors smoked marijuana daily. We interviewed 35 middle-class, cannabis-dependent adolescents with a mean age of 16 years who were patients in a drug treatment program. The patients also completed a lengthy self-assessment questionnaire designed to elicit information on drug-related problems. Our results show that family harmony, school attendance, and school achievement deteriorated once these young people began to use marijuana at least 4 days a week. The following behaviors were noted: remaining away from home without permission or parental knowledge for at least 7 consecutive days (29%), a D or F grade average on the last report card before they entered the drug treatment program (43%), involvement in a motor vehicle accident when the driver was under the influence of marijuana (26%), suicide attempts (20%), and convincing a "marijuana-naive" younger sibling to smoke the drug (20%). Despite such seemingly apparent signs of possible drug use by these 35 adolescents, a mean time of 12 months elapsed before parents suspected their children of marijuana abuse. In many cases mental health professionals consulted by a number of the children when they were using drugs were likewise unaware of the marijuana abuse.

Adolescent↗
PubMed1987

Mental health and psychological well-being among the old and the very old living at home.

Using four brief assessment scales, profiles of mental health and psychological well-being were obtained from 507 old (aged 65-74 years) and 535 very old (aged 75+) individuals randomly sampled from the community. Assessments of dementia and depression were subsequently validated against diagnostic ratings made by experienced psychogeriatricians. Levels of agreement between psychometric and clinical ratings of dementia (kappa = 0.83) and depression (kappa = 0.66) were satisfactory. The old and very old groups reported similar levels of anxiety and personal disturbance, and showed a similar prevalence of depression. However, those aged 75+ showed higher levels of dementia and significantly lower levels of social involvement and morale.

Aged↗
PubMed1987

High frequency chest wall compression in cats with normal lungs.

Ten anesthetized, paralyzed adult cats were ventilated by high frequency chest wall compression (HFCWC) at 3, 5, 7, and 9 Hz by means of a single chamber cuff enclosing the thorax from the axillae to the xyphisternum. The effects of HFCWC in terms of gas exchange, end-expiratory lung volume, and respiratory system compliance were compared to conventional intermittent positive pressure ventilation (IPPV) (30 breaths/mn). HFCWC and IPPV were compared at three levels of matched end-expiratory airway pressure [continuous positive airway pressure (CPAP)/positive end-expiratory pressure/(PEEP) of 0, 2, and 5 cm H2O]. In the absence of CPAP, HFCWC resulted in a marked decrease (up to 50%) in end-expiratory lung volume with significantly lower PaO2, lower compliance, and higher alveolar-arterial oxygen gradient than during IPPV. No differences in PaO2 and a-ADO2 were observed when HFCWC was combined to CPAP greater than or equal to 2 cm H2O. At frequencies below 9 Hz, PaCO2 became significantly lower during HFCWC + CPAP than during IPPV. During HFCWC + 2 cm H2O CPAP, lung volume was lower than during IPPV + 2 cm H2O and similar to the volumes observed during IPPV + 0 positive end-expiratory pressure. Additional studies in six cats at HFCWC + 3 cm H2O confirmed that CPAP greater than 2 cm H2O more than adequately compensated the decrease in lung volume associated with HFCWC alone. Peak cuff pressures between 14 and 17 cm H2O generated oscillary tidal volumes between 4.5 and 2.1 ml/kg. The size of the oscillatory volume was significantly affected by increasing frequencies (decrease in tidal volume) and increasing levels of positive airway pressure (increase in tidal volume). We conclude that in cats with normal lungs, HFCWC can provide for normal gas exchange, provided that it is combined with low level CPAP in order to prevent the occurrence of airway closure associated with HFCWC alone.

Animals↗
PubMed1987

Binding of zona pellucida proteins to a boar sperm polypeptide of Mr 53,000 and identification of zona moieties involved.

Experiments have been carried out to identify proteins on boar spermatozoa that bind to components of the zona pellucida. Polypeptides in sodium deoxycholate extracts of boar spermatozoa and in whole seminal plasma have been separated by sodium dodecyl sulphate-polyacrylamide gel electrophoresis, transferred onto nitrocellulose sheet by electroblotting and probed with 125I-labelled heat-solubilized zona pellucida from pig oocytes or ovulated eggs. Zona proteins bound avidly and consistently to a polypeptide of Mr 53,000 on blots of capacitated and noncapacitated sperm and weakly to polypeptides of Mr 67,000, 38,000 and 18,000. On blots of seminal plasma the 125I-labelled probes bound to two polypeptides of Mr 65,000 and 19-24,000. Identification of the zona proteins that were binding to the aforementioned proteins on blots showed that all the major zona pellucida glycoproteins were involved, including those acquired from oviduct secretions. Binding of 125I-ovulated zona pellucida to the polypeptide of Mr 53,000 also occurred in extracts of testicular and epididymal boar spermatozoa. The results are discussed in relation to sperm-egg recognition in the pig.

Animals↗
PubMed1987

Multivariate discriminant analysis of risk factors for operative mortality following isolated coronary artery bypass graft. Loyola University Medical Center experience, 1970 to 1984.

The Loyola Open-Heart Registry is a fully operational database that contains detailed data on approximately 9,000 patients who have undergone coronary bypass or cardiac valve replacement from January 1970 to December 1984. We analyzed the registry data using multivariate discriminant analysis to identify and quantitate those factors that might predict operative mortality (OM) for patients undergoing coronary artery bypass grafts at Loyola University Medical Center: Operative mortality was defined as death within 30 days following surgery. A total of 50 clinical and angiographic variables were analyzed for possible univariate association with operative mortality. Twenty-two variables were found to have significant univariate association with OM, and these 22 variables were subjected to multivariate discriminant analysis. For patients undergoing isolated, elective coronary artery bypass, the factors found to be predictive of OM are age (greater than 70) (F = 11.57), severe (more than six stenoses) coronary artery disease (F = 5.81), diffuse disease (F = 5.54), positive family history (F = 5.17), and number of coronary arteries bypassed (F = 4.78).

Coronary Artery Bypass↗
PubMed1987

Pulmonary vascular obstruction in severe ARDS: angiographic alterations after i.v. fibrinolytic therapy.

IV streptokinase was infused to test the potential reversibility of adult respiratory distress syndrome (ARDS) associated pulmonary vascular thrombosis in five patients suffering from severe ARDS with elevated mean pulmonary artery pressure, increased pulmonary vascular resistance, and angiographically documented pulmonary vascular thrombosis. At 48 hr there was clearance of obstructions in arteries larger than 1 mm in diameter in all patients, increased filling of the microvasculature and small arteries less than 1 mm in diameter in four patients, a fall in pulmonary vascular resistance in all patients, a rise in cardiac output in four patients, improved oxygenation (PAO2/FlO2) in three patients, and variable changes in shunt fraction and ventilator pressures. Expressed as a mean fraction of the preinfusion controls, the postinfusion physiologic values were pulmonary artery pressure = 0.89 mm Hg, pulmonary vascular resistance = 0.68 mm Hg X min/L, cardiac output = 1.36 L/min, central venous pressure = 0.77 cm H2O, pulmonary capillary wedge pressure = 0.92 mm Hg, PAO2/FlO2 = 1.08, and shunt fraction = 0.95. Follow-up angiography showed no evidence of reocclusion. Postmortem studies of the three nonsurvivors confirmed recanalization of thrombosed pulmonary arteries. One documented bleeding episode occurred. We conclude that fibrinolytic infusion can lyse thrombi and possibly improve hemodynamics and oxygenation in ARDS-associated pulmonary vascular thrombosis.

Angiography↗
PubMed1987

Rat pulmonary artery restructuring and pulmonary hypertension induced by continuous Escherichia coli endotoxin infusion.

We have studied the effect of continuous endotoxin infusion on rat pulmonary structure and function (69.4 ng/100 gm body weight/min for 24 hours). After 6 days of endotoxin infusion, lack of filling of pre- and intraacinar arteries was evident on pulmonary arteriograms. Microscopy demonstrated lumen narrowing in preacinar arteries and occlusion of intraacinar arteries. Morphometry of patent intraacinar arteries established dilation and increased wall muscle. Widespread alveolar wall injury was evident. After 24 hours of infusion, pulmonary artery pressure was raised (delta 9 mmHg; p less than or equal to 0.001); it then fell but was again increased by day 6 (delta 6 mmHg; p less than or equal to 0.05). Pulmonary vascular resistance was markedly increased at 24 hours (day 0 = 0.1 +/- 0.011 dyne/sec/cm-5; 24 hours endotoxin = 0.572 +/- 0.102 dyne/sec/cm-5; p less than or equal to 0.02). It remained elevated during the infusion period but was not significant. At day 6 the alveolar-arterial oxygen diffusion gradient (A-aDO2) was increased (day 0 = 19.6 +/- 1.39 mmHg, day 6 endotoxin = 33.8 +/- 0.1 mmHg; p less than or equal to 0.001). The arterial oxygen tension (PaO2) was decreased (day 0 = 86.5 +/- 1.8 mmHg, day 6 endotoxin = 74 +/- 2.52 mmHg; p less than or equal to 0.05), as was the arterial carbon dioxide tension (PaCO2) (day 0 = 36.0 +/- 0.73 mmHg, day 6 endotoxin = 30 +/- 1.9 mmHg; p less than or equal to 0.05). Thrombocytopenia occurred during the first 72 hours of infusion (day 0 = 7.41 +/- 0.41 X 10(5)/mm3, day 1 endotoxin = 2.43 +/- 0.30 X 10(5)/mm3, day 3 endotoxin = 2.32 +/- 0.31 X 10(5)/mm3; p less than or equal to 0.001) but by day 6 the platelet count had returned to basal levels (9.9 +/- 0.65 X 10(5)/mm3). Endotoxin increased the number of leukocytes in peripheral blood (day 0 = 12.8 +/- 1.2 X 10(3)/mm3, day 3 endotoxin = 17.0 +/- 1.86 X 10(3)/mm3, day 6 endotoxin = 22.5 +/- 1.8 X 10(3)/mm3; p less than or equal to 0.01 for day 6). Plasma concentrations of 6-keto-prostaglandin F1 alpha decreased during the first 24 hours of infusion (day 0 = 0.56 +/- 0.076 ng/ml, 24 hours endotoxin = 0.27 +/- 0.026 ng/ml; p less than or equal to 0.05) and thromboxane (TX) B2 in the first 15 hours (day 0 = 0.23 +/- 0.058 ng/ml, 15 hours endotoxin = 0.09 +/- 0.14 ng/ml; p less than or equal to 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)

6-Ketoprostaglandin F1 alpha↗
PubMed1987

An evaluation of the efficacy of arthroscopic synovectomy of the knee in rheumatoid arthritis: 12-24 month results.

Nine patients with rheumatoid arthritis (10 knees) with chronic knee synovitis unresponsive to medical therapy were entered into a prospective study of arthroscopic total synovectomy of the knee. Histopathological examination of the synovium revealed a proliferative synovitis in all knees. Patients were ambulatory and exhibited 90 degrees of knee flexion on the day after surgery and were discharged at 24 to 48 h postoperation. Mean joint tenderness and swelling improved from the preoperative level and was maintained for the initial 12 months of the study. Knee range of movement was improved in all patients (mean 21 degrees). Improvement of joint function in daily activities was also demonstrated, but patients with Grade IV articular cartilage damage failed to show significant improvement. Nine knees were followed for at least 24 months and 4 required repeat surgery. Arthroscopic synovectomy is comparable to synovectomy by arthrotomy in short term reduction of pain and swelling. The chief benefit of arthroscopic synovectomy is a reduction in morbidity, hospital stay and postoperative rehabilitation.

Adult↗
PubMed1987

General practitioner beds in Finland--lessons for the UK?

The Finnish Primary Health Care Act of 1972 aimed to provide comprehensive health care to the population. One consequence was an increase in the number of beds for the use of general practitioners, so that there are now 2.2 general practitioner beds per thousand population. Use of these beds varies with the location of the health station in which they are situated, but in rural areas approximates to that of general practitioner hospitals in the United Kingdom. Despite integration of general practitioner beds into overall planning, some potential benefits of these facilities have not been realized. For the UK, with traditions of personal general practice and continuity of care, the Finnish system offers one model of community care which may have medical and economic advantages.

Beds↗