Biomedical subjects

D Jones

Publications and source records attributed to D Jones.

At least 55 records · Page 3Linked to original sources

PubMed2005

Inadequacies in the first aid management of burns presenting to plastic surgery services.

Burn injury is a significant cause of mortality and morbidity in Ireland. Simple first aid measures such as immediate wound cooling and removal of the source of injury can significantly improve clinical outcome. We conducted a six-month study, investigating the first aid measures taken by both patients and their primary carers following burn injury. Of the 63 patients referred to the plastic surgery services, only 23.2% had employed the correct first aid principles. Only 20% of patients who sustained burns at work reported that first aid was available in the workplace. This study illustrates that knowledge regarding the initial management of burn injury is very poor. We suggest that a national public health education campaign could have a positive effect on the outcome of burn injury.

Adolescent↗

PubMed2005

Approaches to treatment of HIV facial lipoatrophy.

HIV-associated facial lipoatrophy has become epidemic among the greater than 1 million HIV-infected individuals living in the United States. Those affected usually have well-controlled HIV disease, and are most often healthy and living productive lives. However, their facial appearance often suggests the opposite and frequently serves as a stigma and psychological burden. Treatment approaches may be divided into three categories: 1) Surgically placed alloplastic, autologous, or synthetic implants; 2) Injection of temporary fillers; 3) Injection of permanent fillers, including liquid injectable silicone. Salient aspects of each treatment are reviewed, along with new techniques and pearls on the correct use of liquid injectable silicone.

Anti-Retroviral Agents↗

PubMed2004

Genome-wide survey of protein kinases required for cell cycle progression.

Cycles of protein phosphorylation are fundamental in regulating the progression of the eukaryotic cell through its division cycle. Here we test the complement of Drosophila protein kinases (kinome) for cell cycle functions after gene silencing by RNA-mediated interference. We observed cell cycle dysfunction upon downregulation of 80 out of 228 protein kinases, including most kinases that are known to regulate the division cycle. We find new enzymes with cell cycle functions; some of these have family members already known to phosphorylate microtubules, actin or their associated proteins. Additionally, depletion of several signalling kinases leads to specific mitotic aberrations, suggesting novel roles for familiar enzymes. The survey reveals the inter-digitation of systems that monitor cellular physiology, cell size, cellular stress and signalling processes with the basic cell cycle regulatory machinery.

AMP-Activated Protein Kinase Kinases↗

PubMed2004

Video-assisted thoracic surgery: state of the art in trauma care.

The majority of chest-injured patients are managed with resuscitation and placement of chest tubes. Further interventions are required for complications or missed injuries. Video-assisted thoracic surgery (VATS) has become standard in elective surgery. Our purpose was to review the use of VATS in trauma. The literature and our experience support the use of VATS for specific indications. These indications are: (1) management of retained haemothorax; (2) management of persistent pneumothorax; (3) evaluation of the diaphragm in penetrating thoraco-abdominal injuries and management; (4) management of infected pleural space collections; and (5) diagnosis and management of on-going bleeding in haemodynamically stable patients. VATS for specific indications in trauma is associated with improved outcomes and decreased length of stay. VATS provides diagnostic and therapeutic benefit and should be included in the trauma surgeon's clinical armamentarium.

Diaphragm↗

PubMed2004

The N-glycan glucosidase system in Trypanosoma brucei.

Reactions involving removal and addition of glucose to N-glycans in the ER (endoplasmic reticulum) are performed in higher eukaryotes by glucosidases I and II and the UDP-glucose:glycoprotein glucosyltransferase respectively. Monoglucosylated N-glycan structures have been implicated in glycoprotein folding or ER quality control. Components of the system appear across a range of organisms; however, the precise combination differs between organisms. We have identified putative components of the system in the protozoal organism Trypanosoma brucei by local alignment searching. The function of one of these components, a glucosidase II alpha-subunit homologue, has been confirmed by phenotyping a null mutant, and an ectopic expression cell line. A combination of MS, methylation linkage analysis, exoglycosidase digestion and partial acetolysis have been used to characterize three novel N-glycan structures on the variant surface glycoprotein of the null mutant. On the basis of our results, we propose that two N-glycan precursors are available for transfer to variant surface glycoprotein (variant 221) in the ER of T. brucei; only one of these precursors is glucosylated after transfer.

Animals↗

PubMed2004

The activation profile of tumour-associated reactive T-cells differs in the nodular and diffuse patterns of lymphocyte predominant Hodgkin's disease.

AIMS: To compare the activation profile of T-cells in reactive lymphoid follicles with that of tumour-associated T-cells in lymphocyte predominant Hodgkin's disease (LPHD) with a nodular pattern (n = 21), LPHD with partial diffuse growth pattern (n = 11) and T-cell-rich large B-cell lymphoma (TCRLBCL, n = 8). METHODS AND RESULTS: Reactive germinal centres showed sparse numbers of T-cells positive for CD134, a transient/early T-cell activation marker, and only scattered T-cells in the interfollicular areas positive for CD38, a marker of persistent activation. Lymphoid follicles showing progressive transformation of germinal centres (PTGC) had more numerous CD134+ T-cells which were negative for CD38. Tumour-associated T-cells in nodular LPHD were frequently positive for CD134 (15 of 16 cases, 94%), but negative or only focally positive for CD38 (three of 21 cases, 14%). LPHD with diffuse areas, however, showed increased CD38+ T-cells in the diffuse component in 10 of 11 (90%) cases, with CD134+ T-cells being more prominent in the nodular tumour component. TCRLBCL showed strong, uniform CD38 expression in T-cells and histiocytes in eight cases. CONCLUSIONS: T-cells in nodular LPHD express markers of transient/early T-cell activation. By contrast, T-cells in the diffuse form of LPHD, similar to those in TCRLBCL, have an immunostaining profile consistent with persistent cellular activation. T-cell activation may precede or accompany histological progression in nodular LPHD and immunostaining for these markers, in small samples or in difficult cases, may be useful in highlighting those cases of LPHD undergoing histological progression.

ADP-ribosyl Cyclase↗

PubMed2004

Sensitivity and specificity of serology in determining recent acute Campylobacter infection.

BACKGROUND: The measurement of serum antibodies to Campylobacter spp. has been used to investigate links between prior Campylobacter infections and the development of Guillain-Barre syndrome and its variants. Little is known of the serum antibody response to acute infections in the short- or long-term. AIMS: The aims of the present study were to investigate the normal serum response to an acute Campylobacter infection and the sensitivity and specificity of anti-Campylobacter antibodies in determining recent Campylobacter infection. METHODS: An enzyme-linked immunosorbent assay (ELISA) method was used to measure serum anti-Campylobacter immunoglobulin G (IgG), IgA and IgM antibodies. Controls consisted of 420 blood donors without recent gastroenteritis, 25 patients with other gastrointestinal infections, 24 patients with neurological conditions not affecting the peripheral nerves and 19 patients with autoimmune disorders. Three patient groups were assessed: 99 patients with acute Campylobacter infections, all of whom were tested 3 weeks post-infection; 69 of these patients tested 3-6 months later; and 74 additional patients tested >20 months post-infection. Western blot analysis was performed on controls and patients with high titre anti-Campylobacter antibodies to assess for cross-reactivity and specificity. RESULTS: Following acute infections, all antibody classes rose in the majority of but not in all patients, followed by decreasing titres that did not return to baseline levels. Sixteen per cent of enteritis cases did not demonstrate a rise in titres and 9% of cases had significant levels of antibodies >20 months post-infection. The ELISA used was shown to be highly specific for the detection of Campylobacter antibodies. CONCLUSION: The use of Campylobacter-specific antibody levels as the sole marker of prior infection is an unreliable method of determining the association between Campylobacter infection and neurological disease.

Acute Disease↗

PubMed2004

Establishing a plastic surgery trauma clinic.

Trauma is an increasing burden on resources both in terms of personnel, operating time and bed occupancy. We describe the introduction of a plastic surgery trauma clinic. This clinic was established in an effort to streamline the increasing number of trauma referrals. Under the previous system inappropriate admissions were occurring using up a valuable resource. This audit was performed to see if the "see and treat" plastic surgery trauma clinic has made an impact on the service offered and provided by our unit. One of the aims in establishing this clinic was to ensure a more efficient bed occupancy rates. The "see and treat" aspect of this clinic has been very effective with regard to this as 21% of patients were treated in the minor operations area within the clinic. A further 26% of patients assessed in the clinic did not require admission or a surgical procedure. Prior to the establishment of this clinic both these groups of patients would have been admitted to the hospital and perhaps because of the delay to admission would have been managed in their own hospitals. From this audit we have proven that establishing a trauma clinic has enabled us to triage these patients in an effective manner, within a satisfactory time period and if appropriate, treat them at the time of review in the adjacent theatre.

Adolescent↗

PubMed2004

Firework injuries presenting to a national burn's unit.

The sale to the general public of fireworks is illegal in Ireland. However, many fireworks are readily available on the black market from illegal traders. The number of firework injuries presenting to our unit during the three week run-up to Hallowe'en October 2001 was recorded. In addition, each patient was contacted to determine how the fireworks were obtained, the average amount of money spent, and the level of adult supervision present at the time of injury. A total of 19 patients presented, 18 from the local catchment area, with a mean age of 16 yrs (range 5-46 yrs). Thirteen patients required admission. Sixteen patients sustained hand injuries including burns, and three sustained burns to other body areas. The amount of money spent varied between adults and children, the average amount among the paediatric group was Euro 2-4, but Euro 45 in the adult group. None were willing to identify the local source of their fireworks, but most fireworks originated in Northern Ireland. This small review highlights an ongoing problem in Ireland; fireworks are illegal, yet they are easily and cheaply available without quality or safety controls. Our public awareness campaign has failed to reach its target audience, and the illegal traders who sell these often inferior products are seldom charged. Children and adults will continue to sustain serious injuries as a result.

Adolescent↗

PubMed2004

A pilot study of the effect of altering airway pressure on systolic pulse pressure variation in the systemic and pulmonary arterial circulations.

OBJECTIVE: Systolic pressure variation results from cyclical fluctuation in the intra-thoracic pressure associated with mechanical ventilation and has been used as a measure of relative hypovolemia in mechanically ventilated patients. The impact of the magnitude of the tidal volume and airway pressure on systolic pressure variation, however, has not been examined in mechanically ventilated patients. METHODS: Two patients underwent monitoring following elective cardiac surgery. Tidal volume was randomly varied between 3 and 11 mL/kg over a two minute interval, and the corresponding airway pressure was monitored, as were the effects on the systolic pressure variation of the systemic and pulmonary circulations. RESULTS: There was a strong correlation between increasing tidal volume and peak airway pressure (p<0.0001). In addition, peak airway pressure strongly correlated with the systolic pressure variation of both the systemic and pulmonary circulations (p<0.0001). The increase in diastolic pulmonary arterial pressure induced by insufflation correlated well with the associated increase in systolic blood pressure (p<0.0001). Similarly, the increase in systolic pulmonary artery pressure (PAP) correlated with the associated decrease in systolic blood pressure induced by insufflation (p<0.0001). CONCLUSIONS: Systolic pressure variation in the systemic and pulmonary circulations is affected by tidal volume and peak airway pressure. This should be considered when using systolic pressure variation as a marker of intravascular volume status. Our findings regarding the correlations between changes in the pulmonary arterial pressure and the systemic arterial pressure induced by mechanical ventilation are consistent with the proposed physiological mechanisms of systolic pressure variation.

Journal Article↗

PubMed2004

A technique for the determination of systolic pressure variation in the systemic and pulmonary arterial circulations.

INTRODUCTION: Systolic pressure variation has previously been used to detect the presence of hypovolemia in mechanically ventilated patients but remains difficult to measure. METHODS: We describe the application of a commercially available physiological data acquisition system, PowerLab (ADI Instruments Castle Hill, NSW, Australia), to acquire and graphically display simultaneous recordings of the airway pressure, as well as systemic and pulmonary arterial pressures. The technique involves the use of standard pressure transducers to record each pressure reading and has been used to obtain measurements in patients undergoing elective cardiac surgery. RESULTS: The technique permits calculation of systolic pressure variation of both the systemic and pulmonary arterial pressure waveforms. In addition it is possible to estimate plateau airway pressure and perform expiratory hold maneuvers to determine its constitutive components delta-up and delta-down. Waveforms can be exported into MS-windows Paint and saved in JPEG or bitmap format. CONCLUSIONS: The technique described will permit future analysis of the factors affecting the systolic pressure variation for the systemic and pulmonary arterial pressure waveforms in the clinical context.

Journal Article↗

PubMed2003

Statistical shape analysis of neuroanatomical structures based on medial models.

Knowledge about the biological variability of anatomical objects is essential for statistical shape analysis and discrimination between healthy and pathological structures. This paper describes a novel approach that incorporates the variability of an object population into the generation of a characteristic 3D shape model. The proposed shape representation is a coarse-scale sampled medial description derived from a fine-scale spherical harmonics (SPHARM) boundary description. This medial description is composed of a net of medial samples (m-rep) with fixed graph properties. The medial model is computed automatically from a predefined shape space using pruned 3D Voronoi skeletons. A new method determines the stable medial branching topology from the shape space. An intrinsic coordinate system and an implicit correspondence between shapes is defined on the medial manifold. Several studies of biological structures clearly demonstrate that the novel representation has the promise to describe shape changes in a natural and intuitive way. A new medial shape similarity study of group differences between monozygotic and dizygotic twins in lateral ventricle shape demonstrates the meaningful and powerful representation of local and global form.

Algorithms↗

PubMed2003

Higher blood pressure in middle-aged American adults with less education-role of multiple dietary factors: the INTERMAP study.

Extensive evidence exists that an inverse relation between education and blood pressure prevails in many adult populations, but little research has been carried out on reasons for this finding. A prior goal of the INTERMAP Study was to investigate this phenomenon further, and to assess the role of dietary factors in accounting for it. Of the 4680 men and women aged 40-59 years, from 17 diverse population samples in Japan, People's Republic of China, UK, and USA, a strong significant inverse education-BP relation was manifest particularly for the 2195 USA participants, independent of ethnicity. With participants stratified by years of education, and assessment of 100+ dietary variables from four 24-h dietary recalls and two 24-h urine collections/person, graded relationships were found between education and intake of many macro- and micronutrients, electrolytes, fibre, and body mass index (BMI). In multiple linear regression analyses with systolic BP (SBP) and diastolic BP (DBP) of individuals the dependent variables (controlled for ethnicity, other possible nondietary confounders), BMI markedly reduced size of education-BP relations, more so for women than for men. Several nutrients considered singly further decreased size of this association by > or =10%: urinary 24-h Na and K excretion, Keys dietary lipid score, vegetable protein, fibre, vitamins C and B6, thiamin, riboflavin, folate, calcium, magnesium, and iron. Combinations of these dietary variables and BMI attenuated the education-SBP inverse coefficient by 54-58%, and the education-DBP inverse coefficient by 59-67%, with over half these effects attributable to specific nutrients (independent of BMI). As a result, the inverse education-BP coefficients ceased to be statistically significant. Multiple specific dietary factors together with body mass largely account for the more adverse BP levels of less educated than more educated Americans. Special efforts to improve eating patterns of less educated strata can contribute importantly to overcoming this and related health disparities in the population.

Adult↗

PubMed2003

Brain injury and violent crime.

PRIMARY OBJECTIVE: To test the hypothesis that TBI is associated with violent crime, the prevalence and characteristics of traumatic brain injury (TBI) were compared between men convicted of domestic violence and a matched comparison group. METHODS AND PROCEDURES: Participants were 20 African American men convicted of domestic violence and 20 African American men without criminal convictions matched for age and socioeconomic status. Participants completed a questionnaire regarding health and behaviour history. MAIN OUTCOMES AND RESULTS: More than half of the participants in both groups had sustained a TBI, although injuries in the offender group were significantly more severe. There were significantly more reports of problems with anger management in the offender group. CONCLUSIONS: Published epidemiological data regarding TBI may underestimate the prevalence in urban populations, which may have confounded earlier studies of TBI and domestic violence. The reported prevalence in this sample of defendants suggests implications for the justice system.

Adult↗

PubMed2003

Process water treatment at the Ranger uranium mine, Northern Australia.

The conceptual development and piloting of an innovative water treatment system for process water produced by a uranium mine mill is described. The process incorporates lime/CO2 softening (Stage 1), reverse osmosis (Stage 2) and biopolishing (Stage 3) to produce water of quality suitable for release to the receiving environment. Comprehensive performance data are presented for each stage. The unique features of the proposed process are: recycling of the lime/CO2 softening sludge to the uranium mill as a neutralant, the use of power station off-gas for carbonation, the use of residual ammonia as the pH buffer in carbonation; and the recovery and recycling of ammonia from the RO reject stream.

Australia↗

PubMed2002

Multivariate approach for selecting sets of differentially expressed genes.

An important problem addressed using cDNA microarray data is the detection of genes differentially expressed in two tissues of interest. Currently used approaches ignore the multidimensional structure of the data. However it is well known that correlation among covariates can enhance the ability to detect less pronounced differences. We use the Mahalanobis distance between vectors of gene expressions as a criterion for simultaneously comparing a set of genes and develop an algorithm for maximizing it. To overcome the problem of instability of covariance matrices we propose a new method of combining data from small-scale random search experiments. We show that by utilizing the correlation structure the multivariate method, in addition to the genes found by the one-dimensional criteria, finds genes whose differential expression is not detectable marginally.

Algorithms↗

PubMed2002

Design, production and testing of PMN-PT electrostrictive transducers.

Lead magnesium niobate ceramics (PMN) are promising materials for application in the field of high power transducers. The advantage of PMN materials are the large strains generated under moderate electric field and the low hysteresis. The electrostrictive effect is non-linear, the corresponding physical constants depend on temperature and frequency and a DC electrical bias is required. These difficulties must be considered at the design stage. A finite element model has been developed and validated in the ATILA code for non-linear static and time-domain analyses. These numerical modelings are used to design and test two Langevin-type electrostrictive transducers. The first transducer is made of PMN-PT-La (90-10-1%) ceramics (TRS Ceramics), the second one of ESCI ceramics (Morgan Matroc). For given static mechanical prestresses, resonance frequencies and effective coupling coefficients are measured at different DC electric fields and temperatures.

Journal Article↗

PubMed2002

The prevalence and predictors of psychological distress in patients with early localized prostate cancer.

OBJECTIVE: To determine the level of psychopathology, traumatic distress and quality of life in men with newly diagnosed clinically localized prostate cancer, the effect on these of a consultation in a combined-specialist early-prostate clinic, and predictors of psychopathology. PATIENTS AND METHODS: Eighty-eight patients were recruited from the combined clinic; they completed a battery of questionnaires including the Hospital Anxiety and Depression Scale (HADS), the revised Impact of Event Scale (IES) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, before their first appointment. Two weeks later they completed the HADS, IES and a patient-satisfaction survey. RESULTS: The overall level of psychopathology varied among the questionnaires used, from 0% on the HADS depression scale, 8% on the HADS anxiety scale and 14% on the IES. Anxiety and traumatic stress symptoms were commoner than depressive symptoms. The quality-of-life scores showed a relatively good level of functioning. Pre-morbid factors and disease status did not predict psychological distress. Younger age was mildly predictive of poorer psychological functioning. Anxiety symptoms reduced slightly after a joint clinic appointment, whereas depressive symptoms showed a slight increase. CONCLUSION: This study suggests that men with early localized prostate cancer have low levels of psychopathology overall. However, some men experience distressing psychological symptoms and it is important that future research is conducted to help develop clear guidelines on the optimal methods of detecting and managing men with prostate cancer who have mental health difficulties.

Aged↗