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Biomedical subjects

T M Jones

Publications and source records attributed to T M Jones.

At least 55 records · Page 3Linked to original sources
PubMed1997

Butenafine 1% cream in the treatment of tinea cruris: a multicenter, vehicle-controlled, double-blind trial.

BACKGROUND: Butenafine hydrochloride, a potent antifungal agent related to the allylamines, has been used in Japan for treating various cutaneous mycoses including tinea cruris. OBJECTIVE: We compared the safety and efficacy of butenafine hydrochloride and its vehicle when used once daily for 2 weeks to treat tinea cruris. METHODS: Patients (n = 93) with tinea cruris and a positive potassium hydroxide examination and mycologic culture were enrolled. Of the 76 patients assessed for efficacy, 37 applied butenafine and 39 applied vehicle once daily for 2 weeks. Assessments were made at the end of the 2-week treatment period and 4 weeks after the end of treatment. RESULTS: Patients in the butenafine group had a higher mycologic cure rate by day 7 (66% vs 13%, p < 0.0001), with marked improvement 4 weeks after the end of treatment (81% vs 13%, p < 0.0001). They also had a higher rate of effective treatment at day 7 (29% vs 5%, p < 0.01) and at 4 weeks after treatment (73% vs 5%, p < 0.0001). Adverse events definitely related to butenafine treatment were limited to one case of burning sensation after application. CONCLUSION: Butenafine applied once daily for 2 weeks is effective in treating tinea cruris. The proportion of patients cured increased between the end of treatment and 4 weeks after treatment.

Administration, Topical↗
PubMed1996

Alzheimer's disease and apolipoprotein E genotype in Western Australia: an autopsy-verified series.

OBJECTIVE: To determine the relationship between the apolipoprotein E epsilon 4 allele and autopsy-verified Alzheimer's disease (AD) in an Australian population. DESIGN: Retrospective case-control study. SETTING: Royal Perth Hospital, Perth, Western Australia (a tertiary referral hospital). SUBJECTS: 50 subjects with "definite" AD (according to the histological and clinical criteria of the Consortium to Establish a Registry for Alzheimer's Disease [CERAD]) and 30 control subjects who had died from a non-neurological disease were randomly selected from the hospital's neuropathology register. OUTCOME MEASURES: Histological grading of brain sections stained with the modified Bielschowsky stain according to the criteria of CERAD; number (burden) of neuritic plaques; apolipoprotein E genotype (APOE). RESULTS: Frequency of the epsilon 4 allele was significantly higher in the AD group (37%) than in the control group (2%) (chi 2 = 25.8; P < 0.00001). In the AD group, 50% of subjects were heterozygous for the epsilon 4 allele and 12% were homozygous, while in the control group one subject was heterozygous for the allele and none were homozygous. No association was seen between the epsilon 4 allele and neuritic plaque burden in the hippocampus, entorhinal cortex, middle frontal gyrus or inferior parietal lobule in subjects with AD. CONCLUSIONS: Our findings confirm an association between the epsilon 4 allele and autopsy-verified AD. The epsilon 4 allele may be an important risk factor for susceptibility to AD in the general Australian population.

Aged↗
PubMed1996

Spontaneous retropharyngeal haematoma attributable to Epstein-Barr virus infection.

Life-threatening sequelae of Epstein-Barr virus infection are uncommon but may present as: local pharyngeal manifestations, splenic rupture, neurological and haematological disorders and altered hepatic function. We present a case of retropharyngeal haematoma with posterior hypopharyngeal wall necrosis, thrombocytopenia and altered clotting function as a result of Epstein-Barr virus infection. A review of the literature on retropharyngeal haematoma reveals this to be the only recorded case which can be directly attributed to Epstein-Barr virus infection.

Adult↗
PubMed1995

Zidovudine as an immunomodulatory agent.

In view of the increase of HIV infection in women, and of transplacental infectivity, 3'-azido-3'-deoxythymidine (zidovudine) is being explored to control infection in offspring. Zidovudine toxicity in humans and experimental animals is well documented. However, information on immunotoxicity in pregnant females and their offspring is lacking. We exposed pregnant female mice to zidovudine to provide data, and perhaps baseline evaluation, on zidovudine immunotoxicity in primiparous females and their progeny. In pregnant mice exposed to zidovudine (0.2 mg/ml) in drinking water, enhancement of the mixed lymphocyte response (MLR) occurs; suppression is not seen until the 7th month. Profound, persistent suppression is seen in their progeny first detected at one week of age. Suppression in virgin females occurs 1 month after treatment, which persists through the seventh month. The antibody forming cell response is enhanced in primiparous females and their offspring, but is not affected in virgin females. After weekly alternation of oral treatment with two 0.5 ml intravenous injections at 0.2 mg/ml, MLR suppression occurs after 1 month in primiparous females, while in their progeny and in virgins enhancement is seen first; in progeny suppression is observed at 3 months. Thus, zidovudine is immunosuppressive for T-cell mediated immunity and the kind of modulation is a function of treatment regimen.

Administration, Oral↗
PubMed1994

Psychology of computer use: XXXI. Relating computer users' stress, daily hassles, somatic complaints, and anxiety.

The relation of computer users' stress, measured by the Computer Hassles Scale, and global stress, measured by the Daily Hassles Scale, with stress reactions, measured by the somatization-anxiety items of the SCL-90, was investigated in a college sample (N = 101). Computer hassles ratings were correlated .54 with daily hassles ratings and .57 with somatization-anxiety ratings. Daily hassles ratings were correlated .74 with somatization-anxiety ratings. These results provide important evidence on convergent validity for the Computer Hassles Scale as a measure of computer users' stress.

Adult↗
PubMed1994

Building Internet accessible medical education software using the World Wide Web.

We describe work to enhance existing software protocols and develop a suite of new software utilities based upon a set of standards known as the World Wide Web (WWW). Specifically, we have developed an effective X-windows based WYSIWYG WWW browser/editor and a prototype for integrated wide-area authentication and authorization support for delivery and maintenance of WWW service. These software development activities, along with parallel work in content development, are empowering individuals to better use the Internet as a resource to easily author, publish, and access materials. As an illustrative application, we describe one Web-based self-instructional unit designed to increase users' knowledge of hazardous substances in the environment. This on-line monograph was adapted from a series of paper-based case studies developed by the Agency for Toxic Substances and Disease Registry of the U.S. Department of Health & Human Services. The on-line version illustrates many of the innovative features provided by the Web, and demonstrates how such materials can significantly impact medical education at all levels.

Computer Communication Networks↗
PubMed1993

Selection of human anti-hapten antibodies from semisynthetic libraries.

Semisynthetic human Fab libraries were constructed, displayed on the surface of filamentous phage and selected for binding to three hapten conjugates. A number of Fabs were isolated and characterized with respect to affinity and specificity. Fabs exhibited affinities of between 80 and 29 nM, as determined by surface plasmon resonance, for the conjugate on which they were selected. Conservation of Asp101 in the third heavy-chain complementarity determining region (HCDR3) appears to be important in the construction of synthetically diverse repertoires.

Amino Acid Sequence↗
PubMed1993

Molecular profile of an antibody response to HIV-1 as probed by combinatorial libraries.

A large number (33) of human Fab fragments reacting with HIV-1 surface glycoprotein gp120 have been generated by selection from a combinatorial IgG1 kappa library displayed on the surface of phage. The library was prepared from a long term asymptomatic HIV-seropositive donor. Analysis of the sequences from these Fabs shows the heavy chains can be placed in groups, many of which contain intraclonal variants, almost certainly corresponding to chains used in vivo. Further variants can be accessed via chain shuffling experiments in which a given light chain is recombined with a library of heavy chains. Heavy chain promiscuity, i.e. the ability of heavy chains to pair with different light chains with retention of antigen binding, is dependent on the particular heavy chain considered and probably excludes the identification of in vivo light chain partners. The antibodies examined here are primarily to the CD4 binding site on gp120 and broadly reflect the serum profile of the donor. The antibodies show evidence of extensive somatic modification indicative of an antigen-driven response. The heavy chain CDR3 regions of the antibodies show a remarkably conserved extended length. A number also show strong sequence conservation in CDR3 against a background of considerable diversity in the rest of the VH gene supporting a central role for this region in antigen recognition.

Amino Acid Sequence↗
PubMed1993

Psychology of computer use: XXIX. Measuring computer users' stress: the Computer Hassles Scale.

Measurement of computer users' stress was based on the Computer Hassles Scale. 65 questionnaires were returned from 113 mailed to users of accounting information systems who worked for manufacturing companies. Correlations were calculated for the total sample and subsamples divided by gender. The analysis indicated that persons with college degrees experienced greater computer users' stress than those who were without. Those persons who reported more computer hassles experienced more somatic complaints which indicated that the computer hassles were stressful. There were no significant mean differences between women and men on computer hassles or somatic complaints. The correlations of computer hassles with somatic complaints differed by gender. Women's computer hassles were significantly correlated .61 with somatic complaints, but men's computer hassles were not significantly correlated (r = .18) with somatic complaints. The gender differences suggest that there is a complex relationship between stressors (computer hassles) and stress reactions (somatic complaints).

Adult↗
PubMed1993

The Centennial Patient Care Program: binding patient, student, and clinician-teacher in a learning triad.

The University of Chicago is building a technology-based clinical environment to provide a longitudinal experience for patients and medical students. This environment uses an open systems, computer communication and information support network to forge an interactive education and care relationship between patient, medical student, and clinical faculty mentor. The project proactively addresses some of the most important activities required to reform both the health care and medical education systems: anchoring patient care in a generalist setting; educating medical students in outpatient medicine; fostering primary care as a career choice; and using medical informatics as a tool rather than as an end in itself. Moreover, the project effectively deploys concepts such as patient-centered education, student-based learning, and mentored teaching experiences. This paper reports the curricular, pedagogical, and technological motivations and framework under which the project was designed, and describes the process that a patient-student-clinician/teacher triad will experience as participants in this program.

Ambulatory Care Facilities↗
PubMed1992

Human monoclonal Fab fragments derived from a combinatorial library bind to respiratory syncytial virus F glycoprotein and neutralize infectivity.

Respiratory syncytial virus (RSV) is the most important cause, throughout the world, of severe viral lower respiratory tract illness in young children. Antibodies are known to mediate resistance to RSV infection and illness. We have isolated a number of human monoclonal Fab fragments to RSV F glycoprotein from a combinatorial antibody library expressed on the surface of phage. One of these neutralized a wide range of virus isolates, 10 subgroup A and 9 subgroup B isolates, with a titer (60% neutralization) of approximately 0.1-1.0 micrograms/ml. Another Fab neutralized diverse isolates at a concentration somewhat higher. These human Fab fragments show great promise for use in the prophylaxis or therapy of serious RSV lower respiratory tract disease. For intramuscular or intravenous administration, whole antibodies will be required, whereas for aerosol application, F(ab')2 or Fab fragments may suffice.

Amino Acid Sequence↗
PubMed1992

Recombinant human Fab fragments neutralize human type 1 immunodeficiency virus in vitro.

A panel of 20 recombinant Fab fragments reactive with the surface glycoprotein gp120 of human type 1 immunodeficiency virus (HIV-1) were examined for their ability to neutralize MN and IIIB strains of the virus. Neutralization was determined as the ability of the Fab fragments to inhibit infection as measured in both a p24 ELISA and a syncytium-formation assay. One group of closely sequence-related Fab fragments was found to neutralize virus in both assays with a 50% neutralization titer at approximately 1 micrograms/ml. Another Fab neutralized in the p24 ELISA but not in the syncytium assay. The other Fab fragments showed weak or no neutralizing ability. The results imply that virion aggregation or crosslinking of gp120 molecules on the virion surface is not an absolute requirement for HIV-1 neutralization. Further, all of the Fab fragments were shown to be competitive with soluble CD4 for binding to gp120 and yet few neutralized the virus effectively, implying that the mechanism of neutralization in this case may not involve receptor blocking. The observation of a preponderance of high-affinity Fab fragments with poor or no neutralizing ability could have implications for vaccine strategies.

Amino Acid Sequence↗
PubMed1992

Attitudes and education of pediatric house staff concerning breast-feeding.

Pediatricians are expected to offer information and advice on breast-feeding to expectant and lactating mothers, but the educational experience for pediatric residents may not adequately prepare them for this responsibility. To examine knowledge and confidence regarding breast-feeding gained by pediatric house staff during their residency, a survey was administered to pediatric residents in a large, hospital-based training program. Of 108 program residents, 87 (81%) participated. Forty-one percent of the respondents were postgraduate level I (PL-I), 29% were PL-II, and 30% were PL-III. There was no evidence that PL-III residents were more competent or comfortable with routine breast-feeding counseling or intervention than their PL-I counterparts. Residents who had breast-fed, those with spouses who had breast-fed, and those with children of their own had the greatest knowledge and confidence base in several areas, such as their ability to teach breast-feeding techniques and to treat cracked nipples. They were also more familiar with different types of breastpumps. There were no significant differences among those who were or were not breast-fed as a child nor among men versus women. Residency programs must provide comprehensive education on breast-feeding to prepare future pediatricians to meet the needs of patients and their parents.

Attitude of Health Personnel↗
PubMed1991

Antibody redesign by chain shuffling from random combinatorial immunoglobulin libraries.

A number of experiments on the shuffling of heavy and light chains from antibodies of defined specificity for the transition-state analogue hapten nitrophenyl phosphonamidate are described. The experiments report on the promiscuity of heavy and light chains in binding antigen and the feasibility of antibody redesign by this shuffling process. The concepts of incestuous and extraclonal promiscuous association are described. Shuffling opens the possibility of generating panels of antibodies with related specificity but of distinct idiotypic composition that may have significance in the use of human monoclonal antibodies in therapy.

Animals↗
PubMed1991

Psychology of computer use: XXIII. Validating a measure of computer-related stress.

Prediction of the final grade in a computer course using the Computer Technology Hassles Scale, a measure of computer-related stress, was investigated. A sample of 154 university students enrolled in computer courses completed questionnaires covering demographic data, information on computer use, the Computer Technology Hassles Scale, and somatic complaint items of the Hopkins Symptom Checklist. Pearson correlations indicated scores on the Computer Technology Hassles Scale were significantly associated .27 with somatic complaints, -.24 with computer-course grades, and -.18 with self-rated computer knowledge. Regression analysis indicated that self-rated computer knowledge and scores on the Computer Technology Hassles Scale significantly predicted computer-course grade.

Adult↗
PubMed1989

Temperature response to acetaminophen and risk of occult bacteremia: a case-control study.

A case-control study of 34 children with occult bacteremia was conducted to test the hypothesis that nonresponse to acetaminophen (decrease less than or equal to 0.8 degrees C) is a risk factor for occult bacteremia. Febrile children visiting the emergency center from May 1986 to October 1987 were monitored for occult bacteremia. Inclusion criteria were age 2 months to 6 years, temperature greater than or equal to 38.9 degrees C, and having a blood culture. Exclusion criteria were serious acute or chronic illness, sponging for fever reduction, current therapy with antibiotics or steroids, and admission to the hospital. Records of 3892 febrile children were reviewed. Of these, 2101 (54%) had a blood culture and 1028 (26%) were eligible. All patients (positive blood culture) were matched with two control subjects (negative blood culture). Patients and control subjects had similar age, gender, ethnicity, height of initial temperature, time to second temperature, and dose of acetaminophen. The estimated risk of occult bacteremia for nonresponders was 9.2 (95% confidence interval 2.7, 32.0). We conclude that children who do not respond to acetaminophen by at least a 0.8 degrees C decrease in temperature have an increased risk of occult bacteremia. However, achieving a response to acetaminophen does not eliminate the possibility that the child has occult bacteremia.

Acetaminophen↗
PubMed1989

Putting a premium on medical staffs. A novel way to insure physician liability (and loyalty).

The physician malpractice insurance crisis is having an adverse financial impact on both hospitals and their medical staffs. Innovative hospitals are exploring ways to create insurance arrangements to cover the professional liability of their medical staffs. Hospital risk managers often have theorized that if the same insurer covered both hospitals and their staff physicians, providers and their patients would benefit. These programs--often referred to as "channeling" or "channeled programs"--use a common risk management program, common claims administration, and a common claims defense for insured hospitals and their medical staffs, reducing costs, unfavorable verdicts, and, thus, premiums. Unfortunately only a few commercial carriers now offer such a program. Some hospitals and systems have therefore turned to "captive" insurance companies to provide the benefits of a channeled program. Hospitals or systems and their medical staffs can establish a captive (i.e., a controlled insurance company designed to insure its owners and their affiliates) either offshore (typically in a tax-free jurisdiction such as the Cayman Islands, Barbados, or Bermuda) or onshore (typically in a state with facilitating legislation). The Tax Reform Act of 1986, together with the Liability Risk Retention Act of 1986, generally tips the regulatory balance in favor of onshore captives by allowing these entities to operate as risk retention groups (RRGs).

Financial Management↗