Biomedical subjects
Publications and source records attributed to S Jones.
The Premature Infant Home Intervention Program, a collaborative effort of the Visiting Nurse Association of Cleveland and Rainbow Babies and Children's Hospital of Cleveland, is designed to provide family support and medical surveillance for high-risk premature infants, to ensure post-discharge wellbeing, and improve survival outcome during the first years of life.
A number of reports have suggested that the incidence of deliberate self-harm has been declining since the late 1970s. Most of these findings have emerged from studies of hospital inpatients, but a large proportion of patients are sent home directly from Accident and Emergency Departments. This study, based in the Nottingham Accident and Emergency Department, looked at attendances for deliberate self-poisoning over four separate years in the period between 1981 and 1988. The findings show a slight reduction over time in the number of attendances and overall rates, with age-specific rates holding steady for the younger age-group (15-34 years), but diminishing as age increases. It is argued that age-specific trends, based on inpatient statistics, could be distorted by Accident and Emergency discharges. It is recommended that future epidemiological studies of deliberate self-harm include patients who progress no further than the Accident and Emergency Department.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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The effects of irrigation with sterile and infected saline after acute ureteric dilatation by graded Teflon dilators were evaluated renographically and histologically in minipigs. The minipig ureter was dilated from its normal calibre of 4 F to 10 F, and 100 ml of sterile or infected saline were then introduced from a height of 60 cm under gravity. One week after irrigation and dilatation the ipsilateral kidney was either functioning less than 10% or there was an obstructive nephropathy. Histology at 3 months suggested that extravasation of infected irrigating fluid was the most likely cause of ureteric stricture formation.
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Two patients are described in this article who developed fractures of transvenous endocardial pacing leads at the point of passage across the tricuspid valve. In one case life-threatening asystole occurred, emphasizing the potential seriousness of this complication.
Morphology of the carotid body and the ventilatory response to hypoxia were compared in New Zealand genetically hypertensive rats and 'normotensive' control rats from the same genetic stock. Hypertensive rats grew more slowly, had higher blood pressure from 6 weeks of age and developed left ventricular hypertrophy. Carotid bodies of both groups were similar in size but larger than those of a common Wistar strain. Intimal damage and proliferation were seen in 1st- and 2nd-order branches of the carotid body artery in hypertensive rats and point-counting showed that the volume proportion of Type 1 cell nuclei and vascular lumen was reduced and vascular wall increased. In age-matched anaesthetized rats, minute ventilation per 100 g was greater in hypertensives than 'normotensive' when inspiring O2 concentrations of 30, 21, 18, 15, 12, 10 and 8%. However, at each inspired O2 concentration, arterial Pa.O2 was higher and Pa.CO2 lower in hypertensive than in 'normotensive' rats. Hypertensive rats were hyperventilating. The shape of the ventilation/O2 tension curve was similar in hypertensive and 'normotensive' rats; thus carotid body sensitivity to hypoxia was probably unchanged. Possible causes of hyperventilation and the relation of carotid body morphology to hypertension are discussed.
Two cases of occupational asthma due to soft corrosive soldering fluxes used in metal jointing are described in which the diagnosis was based on work related deterioration in daily peak expiratory flow rate and positive responses in bronchial provocation tests. Both fluxes contained ammonium chloride and zinc chloride. Occupational asthma provoked by these agents has not previously been reported.
Patients with Wegener's granulomatosis have autoantibodies to a neutrophil cytoplasmic antigen. As these patients often present with severe glomerulonephritis we investigated whether the same autoantigen was expressed in glomeruli by using both cultured human glomerular cells and frozen normal human kidney sections. Glomeruli were isolated from normal human kidney cortex by differential sieving and plated on to coverslips in growth medium containing various supplements. Cell types were identified by a series of markers and designated either epithelial, endothelial or mesangial. In single and double staining experiments, glomerular cells were incubated with a monoclonal antibody to the neutrophil cytoplasmic antigen (MCAW8), control mouse monoclonal IgG, sera from patients with Wegener's granulomatosis and control normal human serum. MCAW8 and Wegener's patient sera bound specifically to cultured epithelial and endothelial cells. MCAW8 was also found to bind to the glomerular epithelium in frozen sections. We conclude that autoantibodies to glomerular antigens are present in serum of patients with Wegener's granulomatosis and may be important in the pathogenesis of rapidly progressive glomerulonephritis.
A questionnaire was sent to those practices known by the Royal College of General Practitioners to have produced annual reports. Practices were asked what data they included, to whom the report was circulated, what problems and benefits they encountered, and their opinion of the government's proposal to encourage such reports. The data most frequently included in reports related to practice workload, and the main benefit which respondents mentioned was facilitation of planning within the practice. Few practices used data derived from outside the practice and several commented on the difficulty of obtaining good quality data from the practice. Although annual reports are useful as internal documents, standardization of definitions and format, with support from family practitioner committees and health authorities is essential if more practices are to be encouraged to produce such documents and if the information obtained from them is to have a broader role in planning for primary health care.
The effects on self management of asthma of a specially prepared book and audiocassette tape with similar contents were observed in a controlled study of 177 patients with asthma in general practice. After a run in period of six months patients were randomly given the book, the tape, both the book and tape, or neither. Patients' knowledge of the use of drugs, perceptions of their disability, skill in using an inhaler, consumption of drugs, consultations with their general practitioners, morbidity (from patients' entries on diary cards), and use of the educational material were measured. Knowledge about the use of drugs was significantly increased in the groups who received the material after three months and persisted after 12 months. Patients who had been given the tape or the book and tape increased their scores of knowledge of drugs more than patients given the book alone. Patients in all groups given the material considered that their disability was reduced. There were no other significant changes. Patients given both the book and the tape preferred the book. Patients with asthma can obtain useful information from such material. The paradoxical result whereby patients learnt more from the tape but preferred the book suggests that a distinction can be made between information that patients need, which may be acquired better from an audiocassette, and information that they want, which may be acquired better from a book.
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We studied the cardiac uptake of 2-14C-D-deoxyglucose (14C-DG) in 6 dogs subjected to a 15 min left anterior descending coronary artery (LAD) occlusion followed by 30 min reflow. Coronary arterial flows during occlusion were determined with 46Sc microspheres. After 30 min reflow, 50 microCi 14C-DG were given intravenously to determine cardiac uptake. The animal was killed 45 min later and 46Sc counts/min were determined in gamma and beta counters. Quenching was determined with non radioactive blood for both isotopes in the beta counter. Contribution of 46Sc counts/min to the 14C channel was subtracted. 14C uptake was in DPM/g and was higher in the cardiac ischemic regions of four of the six dogs. In three of the six animals there was an inverse curvilinear relation between 14C-DG cardiac uptake and occlusion flow. This observation was further confirmed by high resolution autoradiography, indicating that enhanced cardiac uptake of radiolabeled DG may be a useful positron emission tomographic marker for reversible myocardial ischemia.
Twenty patients with secondary liver tumours, predominantly from colorectal carcinoma, were treated with oral urea at a daily dose of 8 gm-2. Treatment was well tolerated without side-effects. No objective responses were seen. It is concluded that oral urea is ineffective in the treatment of liver metastases from colorectal cancer.
The in-vitro activity of a new macrolide antibiotic CP-62,993 (Pfizer Ltd) was determined for 420 bacterial isolates, comprising 150 Haemophilus influenzae, 48 Branhamella catarrhalis, 50 Staphylococcus aureus, 50 coagulase negative staphylococci, 50 beta-haemolytic streptococci, 50 Streptococcus pneumoniae and 22 oral streptococci. CP-62,993 was compared with erythromycin and penicillin (ampicillin in the case of H. influenzae). The MICs of CP-62,993 were found to be lower than those of erythromycin for the two Gram-negative species tested: this was particularly marked in the case of H. influenzae where a ten-fold difference in the MIC50 was observed (CP-62,993, 0.25 mg/l, erythromycin 2 mg/l). In general MICs of CP-62,993 were two-fold higher than those of erythromycin for the Gram-positive species studied, with the exception of the oral streptococci which were equally susceptible (MIC50 0.03 mg/l) to both macrolides. Activity similar to that of erythromycin was observed against Str. pneumoniae (MIC values 0.015-0.12 mg/l), Staph. aureus (MIC 0.12-1 mg/l) and beta-haemolytic streptococci (MIC 0.06-4 mg/l). Incubation in a CO2 enriched atmosphere decreased activity of both erythromycin and CP-62,993. The effect was more marked for CP-62,993, the MIC50s of all groups of organisms being increased four-fold when they were incubated in the presence of 5 or 10% CO2.