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Biomedical subjects

B P Jones

Publications and source records attributed to B P Jones.

At least 19 recordsLinked to original sources
PubMed2000

Anesthesia for Cesarean section in a patient with paraplegia resulting from tumour metastases to spinal cord.

PURPOSE: Spinal cord injured patients present multiple unique challenges to the anesthesiologist. These include choice of muscle relaxant and management of autonomic hyperreflexia. We report the anesthetic management for Cesarean delivery in a patient who was paraplegic due to spinal canal metastases. Preeclampsia and fever complicated this case. CLINICAL FEATURES: The patient presented at 29 wk gestation with progressive paraplegia at the T10 level due to metastatic osteosarcoma. She had a decompressive laminectomy without improvement in her paralysis. She subsequently developed preeclampsia at 31 wk gestation, and underwent Cesarean delivery for breech presentation under general anesthesia. Anatomical concerns left us unsure of the efficacy or safety of neuraxial anesthesia. CONCLUSIONS: Preeclampsia and autonomic hyperreflexia are generally indications for regional anesthesia for Cesarean section. Tumour in her spinal canal and laboratory abnormalities including thrombocytopenia and a potential urosepsis dissuaded us from this option. Additionally, rapid sequence induction and intubation were not preferred due to paraplegia, leading us to secure the airway fibreoptically.

Adult↗
PubMed1998

An investigation into changes in lung function and the subjective medical benefits from breast reduction surgery.

The aim of this study was to assess the respiratory changes following reduction mammaplasty in women presenting for elective surgery; In addition, to assess whether these changes might be related to any symptomatic improvement. This was a prospective study examining women attending for breast reduction surgery over a 3-month period. Preoperative pulmonary function studies (PFTs) and a symptom questionnaire were completed before operation. These were repeated 6-8 weeks after surgery. Pulmonary function testing was carried out in all cases by the same operator. The study was carried out within a sub regional centre for plastic and reconstructive surgery. Local Ethics committee approval was obtained. Nineteen healthy women mean age 34.9 years and with a mean Body Mass Index of 27.62 were recruited. The mean weight of excised breast tissue was 1546 g. All preoperative pulmonary function tests were within normal limits. Six of the women smoked, none changed their smoking habits over the course of this study. Changes in pulmonary function studies were analysed using the paired t-test. A 'P' value of < 0.05 was considered to be significant. Seventeen women had a post operative improvement in PFTs. Statistically significant improvements were obtained for changes in peak expiratory flow rate (PEFR, P = 0.005) and peak inspiratory flow rate (PIFR, P < 0.0001). The 'P' values for changes in FEV1 (forced expired volume in 1 second) and FEV1/FVC (forced vital capacity) did not reach significance, whilst the 'P' value for the change in FVC was statistically significant (P = 0.01), although the actual mean change was small (0.07 litres). The study sample was too small to relate these changes to mass of excised tissue or BMI. All women taking part claimed an increased confidence and a cessation in analgesic use. Other reported benefits included an improved exercise tolerance (12/19), reduced sleep disturbance (4/19) and reduced breathing difficulties (1/19).

Adult↗
PubMed1993

Repression: the evolution of a psychoanalytic concept from the 1890's to the 1990's.

The author presents a summary of Freud's concept of repression, including modifications of the concept from 1894 to 1932. Several more recent treatments are examined, including those of Piaget; Rosenblatt and Thickstun; Galin; Kissin; Shapiro and Perry; Schwartz; the cognitive and experimental psychologists, including Kihlstrom and Erdelyi; the "connectionists"; and Edelman. Finally, the author delineates several different types of repression, outlining how the different models might apply to the different types of repression.

Affect↗
PubMed1992

On familial factors in the attentional deficit in schizophrenia: a review and report of two new subject samples.

We review the literature on attentional impairment in schizophrenics and their first-degree relatives and present new information from ongoing family studies of the disorder in Ireland and Israel. Subjects were administered a neuropsychological test battery (the NIMH Attention Battery) intended to measure four different elements of attention: encode, focus/execute, sustain, and shift. Results from both samples indicated that schizophrenic subjects performed most poorly on the tests, the control subjects performed best, and the scores of the relatives fell somewhere between the other two groups. Separation among subject groups was most significant for those tests comprising the focus/execute and sustain elements. Some of the results indicate, as well, that tests of auditory sustained attention may be the most discriminating of all. Overall comparison of the Irish and Israeli cohorts revealed striking differences. While within cohort differences remained, subjects from the Irish sample performed more poorly on many of the tests than Israeli subjects. This between-cohort difference was not found in the sustain element, as measured by the Continuous Performance Test. The socio-cultural implications of these findings are discussed with respect to future neuropsychological studies of schizophrenia.

Adult↗
PubMed1991

Cognition in eating disorders.

Cognitive functions were investigated in four groups of women: 30 underweight anorexics, 38 normal-weight bulimics, 20 long-term weight-restored anorexics, and 39 normal controls. A MANOVA was used to examine performance on five neuropsychological domains derived from prior principal components analyses of a comprehensive neuropsychological battery. Underweight anorexics performed more poorly than normal controls in four of five neuropsychological domains (focusing/execution, verbal, memory, and visuospatial), while normal-weight bulimics showed poorer performances only in focusing/execution. The absolute differences in scores between eating disorder groups and normal controls were for the most part small, suggesting subtle rather than frank cognitive difficulties. Poorer neuropsychological test performance was associated with anxiety but not depression as measured by the Tryon, Stein, and Chu Tension scale and scale 2 of the MMPI respectively. The findings support previous reports of attentional difficulties in eating disorders but do not support the hypothesis of differential right-hemisphere dysfunction in eating disorders.

Adult↗
PubMed1990

A patient-powered treadmill--a simple alternative means of assessing heart failure and treatment in family practice.

A patient-powered treadmill was compared with the covered corridor walking test as assessments of exercise capacity in heart failure patients, and used to investigate their sensitivity in discriminating between the effects of xamoterol and placebo. The two methods were comparable, and sufficiently sensitive to demonstrate improvements in exercise capacity on xamoterol. The treadmill was more sensitive and could be useful as an assessment of treatment of heart failure in family practice.

Adrenergic beta-Agonists↗
PubMed1988

Executive functions in unipolar depression before and after electroconvulsive therapy.

A neuropsychological investigation of executive functions in patients with unipolar depression was conducted. Ten patients with unipolar depression were tested before, 48 hours after, and 3 months after ECT. Control subjects were tested at similar intervals. Measures included 10 executive and related tasks (20 variables) on which frontal lobe lesion patients have been previously shown to be differentially impaired, and 1 "nonexecutive" task. Patients were significantly inferior to controls on 9 of the executive and related variables before treatment and performed slightly worse 48 hours after treatment. Significant improvement after 3 months was absent. Depressed patients were not impaired on the "nonexecutive" task.

Depressive Disorder↗
PubMed1987

Incidence and clinical significance of protein-bound vitamin B12 malabsorption.

Patient records from January 1975 to December 1984 were analysed to assess the possible incidence of protein-bound vitamin B12 malabsorption. This condition is characterised by a low serum vitamin B12 level and a normal Schilling test but impaired absorption of vitamin B12 bound to protein. We found that 48 (25%) patients with a low serum cobalamin level unexplained by other causes had a normal Schilling test. Megaloblastic haemopoiesis was found in 25 of these. From this group, all 10 patients who had a test of protein-bound vitamin B12 absorption showed impaired absorption. Protein-bound vitamin B12 malabsorption may represent an early phase of pernicious anaemia when hypochlorhydria precedes intrinsic factor deficiency and should be tested for when the serum vitamin B12 level is decreased and the Schilling test is normal.

Adult↗
PubMed1984

Legionella pneumophila in aerosols from shower baths.

Routine examination of the water system in an establishment where showers were used by staff after work or leisure activities revealed the presence of Legionella pneumophila. Descaling and steaming cleared the system but six months later recolonization was found to have occurred. L. pneumophila was isolated from air samples collected in the shower room whilst the shower was in operation. No clinical cases have occurred. Serological examination of those using the showers throughout the six month period together with a control group showed no evidence of infection.

Aerosols↗
PubMed1984

A note on the temperature tolerance of Legionella.

A strain of Legionella pneumophila serogroup 1 isolated from the environment had a decimal reduction time in water at 50 degrees C (D50) of 111 min, a D54 of 27 min and a D58 of 6 min. There was little loss of viability at 46 degrees C. Other environmental organisms, a Pseudomonas sp., a Micrococcus sp. and a coliform survived less well at these temperatures. A species of Sarcina had a survival time greater than the L. pneumophila at all the temperatures tested. Other strains of legionellas were tested at 50 degrees C and decimal reduction times calculated. These ranged from 80 min for another strain of L. pneumophia serogroup 1 to 216 min for L. bozemannii . Legionella micdadei did not survive well at 50 degrees C.

Legionella↗