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Ian Jones

Publications and source records attributed to Ian Jones.

51 records · Page 3Linked to original sources
PubMed2003

Variation in the coding sequence and flanking splice junctions of the estrogen receptor alpha (ERalpha) gene does not play an important role in genetic susceptibility to bipolar disorder or bipolar affective puerperal psychosis.

Genes involved in estrogen pathways have been proposed as possible candidates influencing susceptibility to bipolar disorder and the affective symptoms suffered by many women during the puerperal period. The estrogen receptor alpha (ERalpha) gene in particular has been a subject of interest and has recently been intensively screened for variations of potential relevance to psychiatric disorders, resulting in the identification of four mutations in individuals with bipolar disorder or puerperal psychosis. We have examined the frequency of these four ERalpha variations in a case control study using a group of mixed gender bipolar individuals (N = 231), further classified into subsets of parous bipolar females with (N = 112) and without (N = 50) puerperal psychosis, and a non-psychiatric comparison group (N = 110). We have also investigated the families in which the variations were initially detected, for evidence of co-segregation of the variants with mood disorder. We found no evidence in our case control sample to support the involvement of any of the ERalpha variations in either the aetiology of bipolar disorder or puerperal triggering of bipolar episodes. Nor did we find co-segregation of ERalpha variants and disease in any of the four families examined. We conclude that variation in the coding sequence and flanking splice junctions of the ERalpha gene does not play an important pathogenic role in the majority of cases of Bipolar Disorder or Bipolar Affective Puerperal Psychosis.

Adult↗
PubMed2003

Antibiotic concentrations in serum and wound fluid after local gentamicin or intravenous dicloxacillin prophylaxis in cardiac surgery.

One important aim of antibiotic prophylaxis in cardiac surgery is preventing mediastinitis and thus it would appear to be relevant to study the antibiotic concentrations in pericardial/mediastinal fluid. Local administration of gentamicin in the wound before sternal closure is a novel way of antibiotic prophylaxis and could be effective against bacteria resistant to intravenous antibiotics. This study measured dicloxacillin concentrations in 101 patients in serum and wound fluid following intravenous administration of dicloxacillin. Similarly, concentrations of gentamicin in serum and wound fluid were determined in 30 patients after administration of 260 mg gentamicin in the wound at sternal closure. Median dicloxacillin concentrations in serum and wound fluid at sternal closure were 59.4 and 55.35 mg/l, respectively. Gentamicin levels in the wound were very high (median 304 mg/l), whereas serum concentrations were low (peak median 2.05 mg/l). Dicloxacillin, 1 g given intravenously, according to the clinical protocol, resulted in levels in serum and wound fluid at sternal closure likely to prevent Staphylococcus aureus infections. Locally administered gentamicin resulted in high local concentrations, potentially effective against agents normally considered resistant.

Adult↗
PubMed2003

Acute coronary syndromes: identification and patient care.

Acute coronary syndromes comprise acute ST-elevation myocardial infarction, non-ST-elevation myocardial infarction and unstable angina. These three conditions share a very similar pathology, although treatments differ. This paper examines the pathophysiology, identification, classification and management of these conditions.

Angina, Unstable↗
PubMed2003

Overcoming barriers to better care.

Pharmacological developments and the shift of emphasis to primary care are just two developments that make it possible to widen access to cardiac services to more patients.

Community Health Services↗
PubMed2002

Triplet repeats and bipolar disorder.

Anticipation, the phenomenon of a disease becoming more severe or having earlier onset as it is transmitted down the generations, was originally described in families with psychiatric illness but was thought due to ascertainment bias and became forgotten. Interest was rekindled when a number of neurodegenerative disorders that show this phenomenon, were found to be due to a novel form of mutation--unstable triplet repeats showing intergenerational expansion. Some recent studies of anticipation are consistent with its occurrence in bipolar disorder but are still associated with methodological problems making interpretation difficult. A number of case-control studies employing the repeat expansion detection (RED) technique have found longer repeats in bipolar probands but other studies have found no such association. Despite a large number of studies examining the role of various repeat containing candidate genes, a pathogenic triplet repeat has yet to be found for bipolar disorder. It is likely that the controversy surrounding anticipation and the existence of triplet repeats will only finally be resolved with the demonstration of such a mutation in the aetiology of bipolar disorder.

Bipolar Disorder↗
PubMed2002

Attitudes towards future testing for bipolar disorder susceptibility genes: a preliminary investigation.

The discovery of susceptibility genes for the major psychiatric illnesses may lead to the development of presymptomatic and prenatal tests. In a preliminary study we assessed the attitudes of 147 bipolar patients, 90 attendees at their family doctor (GP) and 32 psychiatrists to the possible development of genetic tests for bipolar disorder susceptibility genes. Our results suggest that patients and the public will look favourably on the development of presymptomatic (but not prenatal) testing for bipolar disorder susceptibility genes. Psychiatrists, who will have to administer such tests, appear significantly more cautious.

Adult↗
PubMed2002

Colon trauma: Royal Melbourne Hospital experience.

BACKGROUND: Recent studies from the USA and South Africa suggest that primary repair or resection and primary anastomosis have become the recommended treatment for most traumatic colon injuries. The aim of the present review is to determine the applicability of these studies to the urban Australian setting. METHODS: All patients with colon injuries operated on at the Royal Melbourne Hospital from March 1989 to March 1999 were identified. Data were collected by a retrospective chart review. RESULTS: A total of 20 patients sustained 26 injuries to the colon. Blunt injuries were more common than penetrating injuries (14 vs 6). Significant other injuries occurred in 15 patients. Colostomies were performed in four patients. The overall mortality rate was 10%. There were no anastomotic leaks. Primary repair or resection and primary anastomosis were not associated with any increase in intra-abdominal complications. CONCLUSION: Evidence from large trauma centres supporting primary repair or resection and primary anastomosis is also applicable to regions that have a low rate of traumatic colon injury.

Adolescent↗
PubMed2002

Do puerperal psychotic episodes identify a more familial subtype of bipolar disorder? Results of a family history study.

Bipolar women have a marked vulnerability to puerperal psychosis, an episode of mania or psychosis following childbirth. We have conducted a family history study to examine the question of whether a vulnerability to puerperal episodes of illness is a marker for a more familial form of bipolar disorder. A consecutive series of 103 bipolar disorder probands were recruited in a lithium clinic and given a semi-structured interview, including a detailed family history. For the 52 female probands, information was also obtained about the relationship of episodes to childbirth. The morbid risk of affective disorder in first-degree relatives of bipolar women who had suffered an episode of mania, hypomania or schizoaffective mania with onset within 6 weeks of childbirth was significantly higher than that in relatives of parous bipolar women with no episodes in relation to childbirth (P = 0.0077). Despite relatively small numbers, this study provides evidence to support the hypothesis that puerperal episodes identify a more familial subtype of bipolar disorder.

Bipolar Disorder↗
PubMed2002

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Difficult intubation, the bougie and the stylet.

A short cut review was carried out to establish whether a gum elastic bougie is more effective than a stylet at improving the success rate in difficult intubation. Altogether 32 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of this best paper are tabulated. A clinical bottom line is stated.

Evidence-Based Medicine↗
PubMed2002

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. To stab or slash: the percutaneous dilatation or standard surgical approach to cricothyroidotomy in prehospital care.

A short cut review was carried out to establish whether surgical or percutaneous dilatation techniques offer better success rates in emergency cricothyroidotomy. Altogether 114 papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Cricoid Cartilage↗
PubMed2002

Effect of fasting on diarrhoea in collagenous colitis.

BACKGROUND/AIM: Diarrhoea in collagenous colitis has been considered as secretory though the pathophysiology has been studied thoroughly in only a few patients. The result of fasting is one way to distinguish between secretory and osmotic diarrhoea. Our aim was to investigate the effect of fasting on diarrhoea in collagenous colitis. METHODS: Fourteen patients with collagenous colitis were admitted to the hospital for investigation. All were female. Five of these did not have diarrhoea during admission and were excluded. Stools were examined for weight, electrolytes, pH, fat and osmolality during a period on a normal diet and during fasting. RESULTS: During the fasting period the faecal weight was significantly reduced from median 757 (440-3,198) to 191 (22- 2,197) g. The faecal sodium concentration was also reduced, though not significantly, during fasting from median 65 (29-85) to 45 (19-88) mmol/l. The osmotic gaps varied according to the method of calculation applied. CONCLUSIONS: The data indicate that the cause of the diarrhoea in collagenous colitis could be multifactorial. In some patients an osmotic factor dominates and in others a secretory factor, while in some patients a combination of both seems to exist.

Aged↗
PubMed1999

A functional polymorphism in the promoter of monoamine oxidase A gene and bipolar affective disorder.

The genes encoding for the enzymes monoamine oxidase (MAO) A and B are good candidates to investigate bipolar affective disorder. A 30 bp repeat in the MAOA promoter was recently demonstrated to be polymorphic and to affect transcriptional activity. In a family-based association design we found that none of the different repeat copies was preferentially transmitted from mothers (n = 131) to their children affected with bipolar disorder (chi(2) = 2.75, 4 d.f., p = 0.6). Following on our previous finding of an excess of low-activity genotypes of catechol-O-methyltransferase in patients with a rapid cycling form of illness, we examined for a similar trend with MAOA alleles. In an extended sample we found a non-significant trend for patients with an ultra-rapid cycling form of illness (n = 29) to have a higher frequency of low-activity alleles compared with 92 bipolar patients with a non-rapid cycling course of illness (chi(2) = 2.37, 1 d.f., p = 0.13).

Journal Article↗
PubMedDate not supplied

Percutaneous coronary intervention.

Symptoms associated with coronary heart disease include chest pain, dyspnoea, palpitations and collapse (Delahaye, 1999). Percutaneous transluminal coronary angioplasty (PTCA) has been found effective for relieving some of these symptoms (RITA-2 trial participants, 1997). The National Service Framework for Coronary Heart Disease (Department of Health, 2000) identified a need to double the number of these procedures carried out per year by 2010 to provide a service comparable with the rest of western Europe.

Aftercare↗