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Biomedical subjects

R Jackson

Publications and source records attributed to R Jackson.

At least 37 records · Page 2Linked to original sources
PubMed2004

Motor vehicle driver injury and marital status: a cohort study with prospective and retrospective driver injuries.

OBJECTIVE: To investigate the association of marital status with risk of motor vehicle driver injury. DESIGN: A cohort study with prospective and retrospective outcomes. SETTING: New Zealand. PARTICIPANTS: A total of 10,525 adults (a volunteer sample of a multi-industry workforce, n = 8008; and a random sample of urban electoral rolls, n = 2517). EXPOSURE VARIABLE: Self reported marital status, assessed from a questionnaire administered in 1992-93 (baseline). MAIN OUTCOME MEASURE: Motor vehicle driver injury resulting in admission of the driver to hospital and/or the driver's death, during the period 1988-98; hospitalisation and mortality data were obtained by record linkage to national health databases. RESULTS: During 108 741 person-years of follow up, 139 driver injury cases occurred (85 before baseline, 54 after). After adjustment for age, sex, and study cohort, never married participants had twice the risk of driver injury (hazard ratio [HR] 2.06, 95% confidence interval [CI] 1.35 to 3.16) as married participants (HR 1.00). The relative risk for never married participants was slightly higher (HR 2.29), though less precise (95% CI 1.39 to 3.76), after further adjustment for alcohol intake, driving exposure, area of residence, body mass index, and occupational status. CONCLUSIONS: After taking age, sex, and other variables into account, never married people had a substantially higher risk of driver injury than married people. While requiring corroboration, these findings imply that it may be appropriate for driver injury countermeasures to be targeted to never married people.

Accidents, Traffic↗
PubMed2004

Interdigitating dendritic cell sarcoma of salivary gland associated lymphoid tissue not associated with HHV-8 or EBV infection.

Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare malignancy derived from professional antigen presenting cells. This report describes a case of IDCS arising in the salivary gland associated lymphoid tissue of the parotid gland of a 51 year woman, presenting with a painless neck swelling. Histologically, sheets of S100(+)/Ccd68(+)/CD45(+)/CD34(-)/CD1a(-) spindle cells were surrounded with an inflammatory infiltrate with no evidence of B or T cell clonal proliferations. No evidence of either human herpesvirus 8 or Epstein-Barr virus could be detected by quantitative polymerase chain reaction in the tumour cells with serological evidence of previous Epstein-Barr virus infection. The patient remains well and disease free 24 months after presentation without specific treatment.

DNA, Viral↗
PubMed2003

Co-existent primary cutaneous anaplastic large cell lymphoma and lymphomatoid papulosis.

We describe the case of a 37-year-old female with a history of psoriasiform dermatitis who presented with multicentric primary cutaneous CD30-positive anaplastic large T cell lymphoma (ALCL). Despite aggressive systemic therapy, the patient suffered multiple relapses and the lymphoma spread to cervical and inguinal lymph nodes. Later in her clinical course it was appreciated that she was also suffering from lymphomatoid papulosis (LyP). The case illustrates the overlapping clinical, histological and immunophenotypic features of ALCL and LyP, conditions which represent a spectrum of CD30-positive lymphoproliferative disease. A multidisciplinary approach between dermatologist, oncologist and pathologist is essential for the optimal management of these complex conditions.

Adult↗
PubMed2003

Journal standards.

Despite its many imperfections, the peer review process is a firmly established quality control system for scientific literature. It gives readers some assurance that the work and views that are reported meet standards that are acceptable to a journal. Maureen Revington's editorial in a recent issue of the Australian Veterinary Journal (Revington2002) gives a good concise warts and all overview of the process and is well worth reading. I have some concerns about several articles in the December 2002 issue of the New Zealand Veterinary Journal (Volume 50, Number 6), devoted to the health and welfare of farmed deer, that relate to extensive citing of non-peer reviewed papers. I can understand the need for information to flow from researchers to the wider community but that need is already satisfied by publications such as the proceedings of the Deer Branch of the New Zealand Veterinary Association and Proceedings of the New Zealand Society of Animal Production. Non-peer reviewed papers have been cited in the Journal in the past but never to the extent displayed in this particular issue. It degrades the peer-review process and creates an added burden for reviewers who are forced to grapple with the uncertainties of the science in non-peer reviewed citations. One of my fears is that this process allows science from non peer reviewed articles to be legitimised by its inclusion in a peer reviewed journal and perhaps go on to be accepted as dogma. This is a real danger given the difficulties associated with tracing back to original citations and the increasing volume of scientific literature. It also affords opportunities for agencies to pick up questionable and doubtful science and tout it as support for their products or particular points of view. If deer researchers choose to publish most of their work in proceedings then so be it. However this approach, which seems to becoming increasingly prevalent in the deer sector, is questionable from an established science point of view. For my part, I am increasingly reluctant to spend time reading non-peer reviewed material, despite its appeal. At present there are two distinct baskets for scientific literature, one for non-reviewed articles and another for peer reviewed information. I would sincerely hope that we are not going to need another basket as a halfway house for issues that fall in between that classification.

Journal Article↗
PubMed2003

Motor vehicle driver injury and socioeconomic status: a cohort study with prospective and retrospective driver injuries.

STUDY OBJECTIVE: To investigate the association between motor vehicle driver injury and socioeconomic status. DESIGN: Cohort study with prospective and retrospective outcomes. SETTING: New Zealand. PARTICIPANTS: 10 525 adults (volunteer sample of a multi-industry workforce, n=8008; and a random sample of urban electoral rolls, n=2517). OUTCOME MEASURE: Motor vehicle driver injury resulting in admission of the driver to hospital or the driver's death, or both, during the period 1988-98; hospitalisation and mortality data were obtained by record linkage to national health databases. MAIN RESULTS: After adjustment for age and sex, driver injury risk was inversely associated with both occupational status (p for linear trend <0.0001) and educational level (p for linear trend =0.007). Participants in the lowest approximate quartile of occupational status were four times as likely (HR 4.17, 95% CI 2.31 to 7.55) to have experienced a driver injury during follow up as participants in the highest approximate quartile. Participants who had been to secondary school for less than two years were twice as likely (HR 2.26, 95% CI 1.34 to 3.81) to have experienced a driver injury as those who had been to university or polytechnic. There was little evidence that driver injury risk was associated with neighbourhood income (p for linear trend =0.12) CONCLUSIONS: Occupational status and educational level seem to be important determinants of driver injury risk. Driver injury countermeasures should be targeted to people in low status occupations, as well as to people with comparatively little formal education.

Accidents, Traffic↗
PubMed2003

Comparison of peripheral and central venous pressures in critically Ill patients.

We conducted a prospective study to determine the relationship between central (CVP) and peripheral (PVP) venous pressures in critically ill patients. CVP and PVP were measured on five different occasions in 20 critically ill patients in the intensive care unit. Results showed that the mean difference between PVP and CVP was 4.4 mmHg (95% CI = 3.7 to 5.0). However, PVP might be 1.9 mmHg below (95% CI = 0.7 to 3.1) or 10.6 mmHg above (95% CI = 9.4 to 11.8) the CVP. The mean difference between changes in PVP and corresponding changes in CVP was 0.3 mmHg (95% CI = -0.1 to 0.7). The actual change in PVP could be 3.0 mmHg below (95% CI = 2.3 to 3.7) or 3.6 mmHg above (95% CI = 2.9 to 4.3) the change in CVP. Overall, the direction of change in PVP (rise or drop) predicted a same direction of change in CVP with an accuracy of 78%. Changes in PVP > or = 2 mmHg predicted a change in same direction of CVP with an accuracy of 90%. The direction of changes in CVP > or = 2 mmHg were predicted by the direction of change in PVP with an accuracy of 91%. We conclude that PVP measurement does not give an accurate estimate of the absolute value of CVP in individual patients. However, as changes in PVP parallel, in direction, changes in CVP, serial measurements of PVP may have a value in determining volume status and guiding fluid therapy in critically ill patients.

Adult↗
PubMed2002

Is routine splintage following primary total knee replacement necessary? A prospective randomised trial.

It was hypothesised that routine splintage following primary total knee replacement has no affect on flexion deformity and offers no benefit over simple wool and crepe. Fifty-five patients undergoing primary total knee replacement were entered into a prospective study. The patients were randomly assigned to two groups: The first group was rehabilitated without a splint and the second received an adjustable semi-rigid extension splint (Richards splint) for the first 48 h after surgery. Range of motion measurements were recorded pre-operatively and at 2 days, 1 week and 3 months post-operation by a research nurse blinded to the allocation. No statistically significant difference in flexion deformity was found at any stage (P>0.5). No difference was found in general or wound complications, or requirement for blood transfusion, and the post-operative stay was equal in the two groups. We conclude that routine use of a semi-rigid splint following primary total knee replacement has no advantage over simple wound dressings.

Aged↗
PubMed2002

World War I may have allowed the emergence of "Spanish" influenza.

The 1918 influenza pandemic caused 40 million deaths, and so dwarfed in mortality and morbidity the preceding pandemic of 1889 and the 1957 and 1968 pandemics. In retrospect, much can be learnt about the source, the possible subterranean spread of virus, and the genetic basis of virulence. The World Health Organization has urged every nation to prepare a pandemic plan for the first global outbreak of the 21st century. We present an appraisal of epidemiological and mortality evidence of early outbreaks of respiratory disease in France and the UK in the years 1915 to 1917. Certain of these earlier focal outbreaks--called epidemic bronchitis rather than influenza--occurred during the winter months when influenza was known to be in circulation, and presented with a particular heliotrope cyanosis that was so prominent in the clinical diagnosis in the world pandemic outbreak of 1918-1919 (the Great Pandemic). The outbreaks in army camps at Etaples in France and Aldershot in the UK in 1916-1917 caused very high mortality in 25-35 year olds. Increased deaths from bronchopneumonia and influenza were also recorded in England. We deduce that early focal outbreaks of influenza-like disease occurred in Europe and on the balance of probability the Great Pandemic was not initiated in Spain in 1918 but in another European country in the winter of 1916 or 1917. We suggest that the pandemic had its origins on the Western Front, and that World War I was a contributor.

Disaster Planning↗
PubMed2002

Effect of aged garlic extract on caspase-3 activity, in vitro.

In neurodegeneration, such as Alzheimer's disease (AD), apoptosis results in the loss of valuable neurons. A key mechanism in apoptosis is the activation of caspase-3. Caspase-3 activity first becomes detectable early in apoptosis, continues to increase as cells undergo apoptosis, and rapidly declines in late stages of apoptosis. Its activity is an early marker of cells undergoing apoptosis. Caspase-3 catalyzes the formation of beta-amyloid peptide, a hallmark of AD. The purpose of the study was to determine whether dietary aged garlic extract (AGE), with known antioxidant properties and neuroprotection against Alzheimer's beta-amyloid cytotoxicity, inhibits the caspase-3 activity in vitro. Caspase-3 activity was assayed according to the prescribed protocol and incubated overnight at ambient temperature. We report that AGE inhibits caspase-3 in dose dependent manner. Caspase-8 was not inhibited by AGE. As a caspase-3 inhibitor, AGE may be effective in reducing apoptotic death of neurons since caspase inhibitors have been shown to inhibit neuronal cell death. We propose a scheme for the ameliorative effect of AGE on deleterious effects of beta-amyloid and possibly uncontrolled caspase-3 activity.

Amyloid beta-Peptides↗
PubMed2002

Primary T cell lymphoma of salivary gland: a report of a case and review of the literature.

Lymphoma of the salivary gland accounts for 5% of cases of extranodal lymphoma and 10% of malignant salivary gland tumours. Most primary salivary gland lymphomas are B marginal zone lymphomas arising on a background of sialadenitis associated with autoimmune disorders such as Sjorgen's syndrome. Primary T cell lymphoma of the salivary gland is rare. This report describes a case of primary T cell lymphoma arising in the parotid gland of an elderly white man, which was notable for its striking resemblance to a B cell extranodal marginal zone lymphoma. Immunohistochemistry and gene rearrangement studies confirmed the clonal T cell nature of the tumour. There was no molecular evidence of Epstein-Barr virus (EBV) infection of neoplastic or surroundings cells. Only 14 cases of primary T cell lymphoma of the salivary glands have been recorded in the literature, most being from the Orient and having extremely variable prognosis. Those with a T/natural killer cell phenotype are associated with EBV infection. This case highlights the fact that T cell lymphoma in the salivary gland can mimic closely the morphological features of B cell extranodal marginal zone lymphoma.

Aged↗
PubMed2001

Community-acquired pneumonia in Christchurch and Waikato 1999-2000: microbiology and epidemiology.

AIMS: To prospectively record current epidemiology and microbiology of community-acquired pneumonia in two New Zealand centres. METHODS: Between July 1999 and 2000 all adults admitted to Christchurch and Waikato Hospitals with community-acquired pneumonia were screened for study inclusion. All those enrolled had their medical history, clinical variables, inpatient management and clinical outcomes recorded and standardised microbial diagnostic testing carried out. RESULTS: 474 participants were enrolled with a mean age of 64 years and a microbial diagnosis was made in 197 cases (42%). Streptococcus pneumoniae (14%), Haemophilus influenzae (10%) and Influenza A virus (7%), Legionella spp (4%) and Mycoplasma pneumoniae (3%) were the most commonly isolated organisms. An 'atypical' organism was diagnosed in 8% of cases compared to 30% and 23% in previous Christchurch and Waikato studies respectively. Fourteen of the 67 S pneumoniae isolates (21%) had reduced susceptibility to penicillin, all with a MIC < or = 2 microg/mL, a level of reduced susceptibility not associated with worse patient outcomes. Clinical outcome included a mean hospital stay of 6.7 days and a 6 week mortality of 6%. CONCLUSION: Although S pneumoniae was the most commonly isolated organism in this study there have been significant changes in the prevalence of atypical organisms since previous surveys. Ongoing surveillance of antibiotic resistance and variations in the prevalence of organisms causing community-acquired pneumonia is required to guide clinicians' empiric antibiotic use.

Adult↗
PubMed2001

Prevalence of driver sleepiness in a random population-based sample of car driving.

STUDY OBJECTIVES: To obtain reliable estimates of the prevalence of driver sleepiness. DESIGN: A two-stage cluster sampling technique was employed to obtain a sample of car drivers representative of time spent driving on public roads in a geographically defined region. Data were collected by interviewer-administered questionnaire, and analysed in accordance with the sampling design. SETTING: The Auckland region of New Zealand, between April 1998 and July 1999. PARTICIPANTS: 588 drivers of cars and other light vehicles recruited at 69 roadside survey sites. MEASUREMENTS AND RESULTS: Of 746 eligible participants, 79% were interviewed, 12% refused, 8% were untraceable, and 1% were unable to give informed consent. From this sample we estimated that 58.7% of driving was undertaken by men. The vast majority of driving (90.8%) was undertaken by drivers with Epworth Sleepiness scores in the normal range (<10), but a significant minority was undertaken by drivers with one or more characteristics likely to impair alertness. 3.1% had < or = 5 hours sleep in the previous 24 hours, and 21.9% had < or = 4 full nights sleep in the previous week. The triad of symptoms associated with sleep apnea (snoring, choking, and breathing pauses while sleeping) was present in 1.6%; and 8.1% worked a pattern of shifts likely to interfere with normal sleep. CONCLUSION: The prevalence of sleepiness amongst a random sample of New Zealand car driving was low, and less than suggested by previous studies.

Adolescent↗