PubMed Health⌕ Search

Biomedical subjects

A Jones

Publications and source records attributed to A Jones.

At least 19 recordsLinked to original sources
PubMed2007

Management of septic arthritis: a systematic review.

OBJECTIVE: To evaluate the existing evidence on the diagnosis and management of septic arthritis in native joints. DESIGN: Systematic review. DATA SOURCES: Cochrane Library, Medline, Embase, National Electronic Library for Health, reference lists, national experts. REVIEW METHODS: Systematic review of the literature with evaluation of the methodological quality of the selected papers using defined criteria set out by the Clinical Effectiveness and Evaluation Unit of the Royal College of Physicians. RESULTS: 3291 citations were initially identified. Of these, 189 full text articles were identified for potential selection. Following review of these full text articles, 80 articles were found to fulfil the inclusion criteria and were included in the final list. CONCLUSIONS: were drawn on the diagnosis, investigation and management of septic arthritis. DISCUSSION: Little good quality evidence exists to guide the diagnosis and management of septic arthritis. Overall, no investigation is more reliable in the diagnosis of septic arthritis than the opinion of an experienced doctor. Aspiration and culture of synovial fluid is crucial to the diagnosis, but measurement of cell count is unhelpful. Antibiotics are clearly required for a prolonged period, but there are no data to indicate by which route or for how long. Key unanswered questions remain surrounding the medical and surgical management of the infected joint.

Anti-Bacterial Agents↗
PubMed2006

Limits on the high-energy gamma and neutrino fluxes from the SGR 1806-20 giant flare of 27 December 2004 with the AMANDA-II detector.

On 27 December 2004, a giant gamma flare from the Soft Gamma-Ray Repeater 1806-20 saturated many satellite gamma-ray detectors, being the brightest transient event ever observed in the Galaxy. AMANDA-II was used to search for down-going muons indicative of high-energy gammas and/or neutrinos from this object. The data revealed no significant signal, so upper limits (at 90% C.L.) on the normalization constant were set: 0.05(0.5) TeV-1 m;{-2} s;{-1} for gamma=-1.47 (-2) in the gamma flux and 0.4(6.1) TeV-1 m;{-2} s;{-1} for gamma=-1.47 (-2) in the high-energy neutrino flux.

Journal Article↗
PubMed2006

The relationship between access and quality of urban green space with population physical activity.

OBJECTIVES: This study examined the association between access to quality urban green space and levels of physical activity. STUDY DESIGN: A cross-sectional examination of the relationship between access to quality urban green space and level of recreational physical activity in 4950 middle-aged (40-70 years) respondents from the European Prospective Investigation into Cancer and Nutrition (EPIC), who resided in Norwich, UK. METHODS: Using geographic information systems (GIS), three measures of access to open green space were calculated based on distance only, distance and size of green space and distance, size and quality of green space. Multiple regression models were used to determine the relationship between the three indicators of access to open green space and level of recreational physical activity. RESULTS: There was no evidence of clear relationships between recreational activity and access to green spaces. Non-significant associations were apparent for all variables, and there was no evidence of a clear trend in regression coefficients across quartiles of access for either the distance, size adjusted, and quality and size-adjusted models. Furthermore, the neighbourhood measures of access to green spaces showed non-significant associations with recreational physical activity. CONCLUSIONS: Access to urban green spaces does not appear to be associated with population levels of recreational physical activity in our sample of middle-aged adults.

Adult↗
PubMed2006

Methods used in veterinary practice to maintain the temperature of intravenous fluids.

To determine the methods used in veterinary practice to maintain the temperature of intravenous fluids, and the users' impression of their efficacy, data were collected from a survey of 150 veterinary practices. Of the 99 per cent of the practices that warmed intravenous fluids, the use of a heat retention bag cover was most popular and was considered most effective. In a laboratory experiment, four methods of maintaining the temperature of intravenous fluids were compared. The results showed that there was a significant loss of heat through the giving set. A heat retention cover was an effective device for maintaining the temperature of the prewarmed fluid in its bag. The use of ;hot hands' (a sealed surgical glove containing warmed water) was most effective in reducing heat loss from the delivered fluid, and was aided by prewarming the giving set.

Animals↗
PubMed2006

HER2-positive breast cancer brain metastases: multiple responses to systemic chemotherapy and trastuzumab--a case report.

Brain metastases from metastatic breast cancer typically occur in 10-15% of patients and are associated with survival of 3-6 months. Recent series have shown that women with HER2-positive metastatic breast cancer receiving the drug trastuzumab develop brain metastases more frequently than this, but also that continuation of trastuzumab after diagnosis of brain metastases in such patients is associated with extended survival. Authors have speculated that this is due to improved systemic control of disease; however, a possibility is that trastuzumab may have a beneficial effect on cerebral metastases themselves. We report the case of a woman with HER2-positive metastatic breast cancer who developed multiple brain metastases while on trastuzumab, in whom the addition of systemic chemotherapy to continued trastuzumab has produced multiple treatment responses associated with prolonged survival. This is the first report of its kind.

Adult↗
PubMed2006

Is screening for tuberculosis acceptable to immigrants? A qualitative study.

BACKGROUND: Screening of immigrants has been a widespread response to the global resurgence of tuberculosis but has been criticized as discriminatory and stigmatising. Acceptability is an essential but neglected ethical prerequisite of screening programmes, particularly those targeting vulnerable groups such as refugees. No data exist concerning acceptability of tuberculosis screening. We therefore examined the responses of immigrants to screening for tuberculosis in a range of settings. METHODS: We carried out a qualitative interview study of a maximum diversity sample of 53 immigrants offered screening for tuberculosis in east London. We recruited people screened in three settings: a social service centre for asylum seekers, a hospital clinic for new entrants and primary care. We confirmed validity of our findings at a focus group of asylum seekers. RESULTS: The opportunity to be screened for tuberculosis was valued highly by recipients. Moreover, many saw being screened as a socially responsible activity. Of the minority raising concerns, few mentioned the possibility of discrimination. Acceptability was high irrespective of setting, with respondents expressing preference for their chosen place of screening. CONCLUSION: Screening for tuberculosis was highly acceptable to recipients in these settings. Screening should be offered in a range of settings.

Adolescent↗
PubMed2006

Diazinon toxicity in sheep and cattle arising from the misuse of unlicensed and out-of-date products.

Two incidents involving the misuse of unlabelled or out-of-date diazinon products are described. In the first incident, 81 of a group of 210 five-month-old lambs died within 12 hours of being dipped with the contents of a partly used tin of 15-year-old sheep dip. Analysis showed that the diazinon had decomposed by hydrolysis into a range of breakdown products, including tetraethyldithiopyrophosphate (sulfotepp) and monothiono-tetraethylpyrophosphate (monothiono-TEPP), which are much more toxic to mammals than diazinon. In the second incident, four yearling bulls were affected within 48 hours of being treated with a liquid that the farmer believed to be a lice treatment but was actually old diazinon sheep dip. Three of the bulls recovered but one died four days after the treatment. Analysis of the dip confirmed the presence of diazinon but in this incident no breakdown products were detected.

Animal Husbandry↗
PubMed2006

Quantitative analysis of residual protein contamination on reprocessed surgical instruments.

'Ready-for-use' instruments from surgical instrument trays were examined after routine cleaning and sterilization in a blinded study. These reprocessed instruments originated from five National Health Service hospital trust sterile service departments in England and Wales. Determination of residual protein and peptide contamination was carried out by acid stripping of the instrument surfaces, hydrolysis of the constituent amino acids and quantitative total amino acid analysis. One hundred and twenty instruments were analysed, and the median levels of residual protein contamination per instrument for the individual trays were 267, 260, 163, 456 and 756 microg. Scanning electron microscopy and energy dispersive X-ray spectroscopic analyses of the instruments showed that tissue deposits were localized on surfaces, but there was no significant correlation between overall protein soiling and instrument complexity. The highest levels of residual contamination were found on instruments used for tonsillectomy and adenoid surgery.

Amino Acids↗
PubMed2006

Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis.

BACKGROUND: Chest physiotherapy is widely prescribed to assist the clearance of airway secretions in people with cystic fibrosis (CF). Positive expiratory pressure (PEP) devices provide constant back pressure to the airways during expiration. This may improve clearance by building up gas behind mucus via collateral ventilation. Given the widespread use of PEP devices, there is a need to determine the evidence for their effect. OBJECTIVES: To determine the effectiveness and acceptability of PEP devices compared to other forms of physiotherapy as a means of improving mucus clearance and other outcomes in people with CF. SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising of references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. The electronic database CINAHL was also searched from 1982 to 2001. Most recent search of the Group's register: February 2006. SELECTION CRITERIA: Randomised controlled studies in which PEP was compared with any other form of physiotherapy in people with CF. DATA COLLECTION AND ANALYSIS: Two authors independently applied the inclusion and exclusion criteria to publications and assessed the quality of the included studies. MAIN RESULTS: Forty studies were identified and twenty-five studies involving 507 participants met the review inclusion criteria. Most included studies had low scores on a scale of study quality. Twenty of these studies involving 300 participants were cross-over in design. Data were not published in sufficient detail in most of these studies to perform meta-analysis.Forced expiratory volume in one second (FEV1) was the most frequently measured outcome. Single interventions or series of treatments continued for up to three months demonstrated no significant difference in effect between PEP and other methods of airway clearance on FEV1. Long-term studies had equivocal or conflicting results regarding the effect on FEV1. Participant preference was reported in nine studies. In all studies with an intervention period of at least one month, measures of participant preference were in favour of PEP. The results for the remaining outcome measures were not examined or reported in sufficient detail to provide any high level evidence. AUTHORS' CONCLUSIONS: There was no clear evidence that PEP was a more or less effective intervention overall than other forms of physiotherapy. There was limited evidence that PEP was preferred by participants compared to other techniques, but this finding is from studies of low quality.

Cystic Fibrosis↗
PubMed2006

Prenatally diagnosed pulmonary atresia with ventricular septal defect: echocardiography, genetics, associated anomalies and outcome.

OBJECTIVE: To assess the accuracy of prenatal diagnosis, the association with genetic and extracardiac anomalies, and outcome in fetuses with isolated pulmonary atresia with ventricular septal defect (PA-VSD). DESIGN AND SETTING: Retrospective study in a tertiary centre for fetal cardiology. PATIENTS AND OUTCOME MEASURES: Echocardiographic video recordings of 27 consecutive fetuses with PA-VSD were reviewed for: (1) intracardiac anatomy; (2) presence of confluence and size of the branch pulmonary arteries; (3) source of pulmonary blood supply; and (4) side of the aortic arch. Postmortem and postnatal data were added. Karyotyping was performed in 25 patients and, in 23 of these, fluorescent in situ hybridisation to identify 22q11.2 deletion. RESULTS: PA-VSD was correctly diagnosed in 19 of 21 patients (90%) with postnatal or autopsy confirmation of diagnosis. Central pulmonary arteries were correctly identified in 79% (15/19), the source of pulmonary blood supply in 62% (13/21) and major aortopulmonary collateral arteries in 44% (4/9). Aneuploidy was detected in 4 of 25 patients (16%) and 22q11.2 deletion in 6 of 23 patients (26%). Five of 27 patients (19%) had extracardiac anomalies. Eleven pregnancies were interrupted. Eleven of 16 liveborn babies survived. Neonatal survival was 15 of 16 (94%, 95% confidence interval (CI) 70 to 100), one-year survival was 9 of 12 (75%, 95% CI 43 to 95) and two-year survival was 5 of 9 (56%, 95% CI 21 to 86). CONCLUSION: PA-VSD can be diagnosed by fetal echocardiography with a high degree of accuracy. However, it can be difficult to determine the morphology of the central pulmonary arteries and to locate the source of pulmonary blood supply. In most liveborn infants, complete surgical repair can be achieved.

Echocardiography↗
PubMed2006

The development of mental state attributions in women with X-monosomy, and the role of monoamine oxidase B in the sociocognitive phenotype.

We hypothesized that women with Turner syndrome (45,X) with a single X-chromosome inherited from their mother may show mentalizing deficits compared to women of normal karyotype with two X-chromosomes (46,X). Simple geometrical animation events (two triangles moving with apparent intention in relation to each other) which usually elicit mental-state descriptions in normally developing people, did not do so to the same extent in women with Turner syndrome. We then investigated the potential role in this deficit played by monoamine oxidase B enzymatic activity. MAO-B activity reflects central serotonergic activity, and by implication the functional integrity of neural circuits implicated in mentalizing. Platelet MAO-B was substantially reduced in Turner syndrome. However, contrary to prediction, in this (relatively small) sample there was no association between MAO-B enzymatic activity and mentalizing skills in participants with and without Turner syndrome.

Adult↗
PubMed2006

Termination of pregnancy in South Tyneside.

We evaluated prospectively, compliance with the Royal College of Obstetricians and Gynaecologists (RCOG) guidelines on termination of pregnancy (TOP) in a cohort of 340 women referred for termination of pregnancy in 2003 at South Tyneside Foundation Trust. The number of referrals represented one-fifth of all births in our unit during the study period. Teenagers were the largest single group of women requesting termination of pregnancy and the majority were nulliparous. There were 85 women who were seeking a repeat termination of pregnancy. The RCOG minimum referral standard was met in 80% of cases. A good number of women were unsure of their menstrual dates and only 5% had used emergency contraception. A total of 96% were either not using contraception, using condoms or taking oral contraceptives irregularly. A total of 50% of the women attended hospital without a Certificate A being completed by the referring practitioner. Surgical termination was preferred over medical termination in the cohort of women who could exercise a choice. It is possible to comply with the RCOG Termination of Pregnancy guidelines to a large extent in a District General Hospital, with some innovation. Close liaison between General Practitioners, Family Planning Clinics and Acute Hospitals is required. The adoption of agreed referral requirements and pathways would help in the delivery of a high quality service as advocated by the guideline.

Abortion Applicants↗
PubMed2006

Differentiation and immune function of human dendritic cells following infection by respiratory syncytial virus.

RSV causes annual epidemics of bronchiolitis in winter months resulting in the hospitalization of many infants and the elderly. Dendritic cells (DCs) play a pivotal role in coordinating immune responses to infection and some viruses skew, or subvert, the immune functions of DCs. RSV infection of DCs could alter their function and this could explain why protection after natural RSV infection is incomplete and of short duration. In this study, this interaction between DCs and RSV was investigated using a human primary culture model. DCs were generated from purified healthy adult volunteer peripheral blood monocytes. Effects of RSV upon DC phenotype with RSV primed DCs was measured using flow cytometry. Changes to viability and proliferation of cocultured DCs and T-cells were determined using microscopy with fluorescent dyes (Hoechst 33342 and propidium iodide). DC maturation was not prevented by the RSV challenge. RSV infected a fraction of DCs (10-30%) but the virus replicated slowly in these cells with only small reduction to cell viability. DCs challenged with RSV stimulated T-cell proliferation less well than lipopolysaccharide. This is the first study to demonstrate RSV infection of human monocyte derived DCs and suggests that the virus does not significantly interfere with the function of these cells and potentially may promote cellular rather than humoral responses.

Adult↗
PubMed2006

Early immunological changes associated with laryngeal transplantation in a major histocompatibility complex-matched pig model.

Laryngeal transplantation is an increasingly viable proposition for patients with irreversible diseases of the larynx. One human transplant has been performed successfully, but many questions remain before routine transplantation can begin. In order to measure the immunological changes in mismatched transplants, it is first necessary to know the immediate combined effects of ischaemia-reperfusion injury (IRI) plus the added insult of major surgery in a fully matched setting. We measured the changes in immunologically active mucosal cells following 3 h of cold ischaemia and 8 h of in situ reperfusion in a major histocompatibility complex (MHC)-matched minipig model (n = 4). Biopsies were prepared for quantitative, multiple-colour immunofluorescence histology. The number of immunologically active cells was significantly altered above (supraglottis) and below (subglottis) the vocal cords following transplantation and reperfusion (P < 0.05, P < 0.001, respectively). However, the direction of the change differed between the two subsites: cell numbers decreased post-transplant in the supraglottis and increased in the subglottis. Despite the statistical evidence for IRI, these changes were less than the large normal inter- and intrapig variation in cell counts. Therefore, the significance of IRI in exacerbating loss of function or rejection of a laryngeal allograft is open to question. Longer-term studies are required.

Animals↗
PubMed2006

Group-format clinical supervision for hospice nurses.

This paper discusses the aspects of a small research study, which used mixed research methods. The study concerned group-format supervision as a means of helping five hospice nurses, four women and one man, discuss their work experiences. An aim of the study was to understand something of the professional work of hospice nurses and how they might best be supported. Ethical considerations and some benefits derived by group members from clinical supervision are summarized in the context. The research method entailed 12 sessions of group-format clinical supervision. The discussion explores the forming, management and dynamics of a small clinical supervision group. Hospice work is emotionally demanding of nurses. Nurses throughout this small study thought over issues concerning serious illness, death and bereavement, as well as working together as a supervision group. Group-format supervision is potentially helpful to nurses examining professional practice. However, group work can be as challenging to participants as it is helpful. The discussion concludes with an appraisal of the potential gains for nurses from clinical supervision in group-format. This paper proposes that supervision groups could help hospice nurses to identify and explore issues related to professional practice. Adequate preparation of nurses, organizational support and the competency of group facilitators should be considered critical to safe and effective management of professional groups.

Adaptation, Psychological↗