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Biomedical subjects

S D Jones

Publications and source records attributed to S D Jones.

At least 19 recordsLinked to original sources
PubMed2002

Effect of hormone replacement therapy on inflammation-sensitive proteins in post-menopausal women with Type 2 diabetes.

AIMS: To test the effect of oral hormone replacement therapy (HRT) on plasma C-reactive protein (CRP), soluble vascular cell adhesion molecule-1 (VCAM-1), soluble intercellular adhesion molecule-1 (ICAM-1) and IL-6 concentrations and leucocyte count in post-menopausal women with Type 2 diabetes. METHODS: Post-menopausal women with Type 2 diabetes (n = 61) were randomized in a double-blind fashion to receive either continuous combined hormone replacement therapy (n = 29) with conjugated equine oestrogen (0.625 mg/day) plus medroxyprogesterone acetate (2.5 mg/day) or placebo (n = 32) for 6 months. Study variables were measured at baseline and at the end of the study. RESULTS: Eight women randomized to hormone replacement therapy and four women assigned to placebo group dropped out of the study. Plasma CRP increased (2.2 mg/l, 95% confidence interval 0.3-4.1 mg/l) significantly (P = 0.02) in women treated with HRT (n = 21) compared with placebo (n = 29) taking baseline CRP, body mass index (BMI) and smoking status into account. Plasma levels of cell adhesion molecules, IL-6 and leucocyte count did not change significantly during the study. CONCLUSIONS: These findings indicate that oral HRT with conjugated equine oestrogen plus medroxyprogesterone acetate increases plasma CRP levels but not necessarily global inflammatory activity in post-menopausal diabetic women. An increase in plasma CRP may potentially increase risk of a cardiovascular event.

Administration, Oral↗
PubMed2002

Management of life-threatening autonomic hyper-reflexia using magnesium sulphate in a patient with a high spinal cord injury in the intensive care unit.

We report the successful use of i.v. magnesium sulphate to control life-threatening autonomic hyper-reflexia associated with chronic spinal cord injury in the intensive care environment. A 37-yr-old, male was admitted to the intensive care unit with a diagnosis of septic shock and acute renal failure secondary to pyelonephritis. He had been found unresponsive at home following a 2-day history of pyrexia and purulent discharge from his suprapubic catheter. He had sustained a T5 spinal cord transection 20 yr previously. Initial management included assisted ventilation, fluid resuscitation, vasopressor support, and continuous veno-venous haemofiltration. The sepsis was treated with antibiotic therapy and percutaneous nephrostomy drainage of the pyonephrosis. On the fifth day, the patient developed profuse diarrhoea. This was associated with paroxysms of systemic hypertension and diaphoresis, his arterial pressure rising on occasion to 240/140 mm Hg. A diagnosis of autonomic hyper-reflexia was made and a bolus dose of magnesium sulphate 5 g was administered over 15 min followed by an infusion of 1-2 g h(-1). There was an almost immediate decrease in the severity and frequency of the hypertensive episodes. There were no adverse cardiac effects associated with the administration of magnesium, only a slight decrease in minute ventilation as the plasma level approached the upper end of the therapeutic range (2-4 mmol litre(-1)). In view of the beneficial effects observed in this case we advocate further research into the use of magnesium sulphate in the treatment or prevention of autonomic hyper-reflexia secondary to chronic spinal cord injury in the intensive care unit.

Adult↗
PubMed2001

Hormone-replacement therapy increases serum paraoxonase arylesterase activity in diabetic postmenopausal women.

The paraoxonase (PON1) enzyme is associated with high-density lipoproteins (HDL) in the blood and is low in patients with type 2 diabetes. Hormone-replacement therapy (HRT) can increase HDL cholesterol levels, but its effect on serum PON1 arylesterase activity is uncertain. The aim of the present study was to determine the effect of 6 months' HRT with conjugated equine estrogen and medroxyprogesterone acetate on serum PON1 arylesterase activity in postmenopausal women with type 2 diabetes. Serum PON1 activity was measured immediately before and at the end of the second arm of a randomized, placebo-controlled, crossover with washout study originally designed to test the effect of HRT on plasma lipids in diabetic postmenopausal women. Baseline serum PON1 arylesterase activity was significantly (P <.001) lower in the postmenopausal diabetic women (149 +/- 38 micromol/mL/min; n = 47) than values in healthy postmenopausal women (173 +/- 32 micromol/mL/min; n = 51). Serum PON1 activity increased (10%) significantly (P =.009) in diabetic women treated with HRT compared with placebo. A significant (P =.02) interaction between baseline PON1 activity and treatment indicated a greater increase in PON1 activity during HRT in women with lower baseline activities. At baseline, serum PON1 arylesterase activity was correlated significantly with plasma HDL cholesterol levels in diabetic women (r = 0.333, P =.01, n = 47), and the increase in serum PON1 activity was correlated significantly with the change in plasma HDL cholesterol during HRT (r = 0.659, P =.0001, n = 28). These data suggest that serum PON1 activity is abnormally low in postmenopausal women with type 2 diabetes and increases during HRT, particularly in women with lower baseline levels and in those who show a concomitant increase in HDL cholesterol.

Aged↗
PubMed2000

Gender and veterinary medicine: global historical perspectives.

This essay will suggest research methodologies for historians interested in the history of gender and veterinary medicine over the past 200 years. This topic is a very timely one, because we are currently living through a transition in the interactions between gender and veterinary medicine. Traditionally male-dominated, veterinary medicine has recently experienced a world-wide increase in the number of women entering veterinary schools and practicing in all areas of the profession. Understanding this transition requires us to ask historical, cultural, and sociological questions in order to illuminate the roles of gender ideologies and the participation of women in the development of modern veterinary medicine. The following paragraphs outline three specific methodological strategies that historians have used to study the interactions between gender and science and gender and medicine. I will propose ways that we veterinary historians can use these strategies to study gender and veterinary medicine. It is beyond the scope of this paper to summarize the literature on women and veterinary medicine; but it will nonetheless highlight a few studies from nations around the world to illustrate the methodological strategies that I propose. I hope to provide scholars with ideas for future studies in the history of gender and veterinary medicine.

Gender Identity↗
PubMed1998

Genomic organization of the human alpha 3 integrin subunit gene.

The alpha 3 beta 1 integrin is a receptor for various laminin isoforms and plays an important role in the maintenance of tissue integrity. We have characterized the genomic structure of the complete gene for the human alpha 3 integrin subunit. The gene contains 26 exons spanning a region of 36.3 kb of genomic DNA. Its structure closely resembles that of alpha 6, another of the three integrin alpha-subunits that are part of laminin receptors, except that it lacks the corresponding exon 5A, which encodes an X1 region in the extracellular domain of alpha 6. However, the alpha 3 gene contains the equivalent of an exon 5B for an X2-like region, which in alpha 6 and alpha 7 is present only in certain tissue-specific alternative transcripts. The two A and B cytoplasmic variants of alpha 3, which are common to the three laminin receptor integrin alpha-subunits, are encoded by separate exons.

Alternative Splicing↗
PubMed1997

Predicting survival from out-of-hospital cardiac arrest: a multivariate analysis.

From 954 attempts to resuscitate patients from out-of-hospital cardiac arrest two datasets were derived, namely 861 cases of cardiac arrest and 906 cases of either cardiac or primary respiratory arrest. For each dataset, multivariate analysis was performed by fitting a number of explanatory variables with respect to the outcomes of admission to hospital and discharge home in logistic regression models. There were numerous interactions between these variables. Being conscious at the time of the arrival of the ambulance crew and subsequently having cardiac arrest strongly predicted survival, as did both the presence of a witness to the arrest and the initiation of cardiopulmonary resuscitation (CPR) by a bystander; this latter effect was a marker for early CPR. The strongest predictor of a poor outcome was delay to CPR or delay to advanced cardiac life support.

Age Distribution↗
PubMed1997

Outcome of out-of-hospital cardiorespiratory arrest in south Glamorgan.

During 138 weeks an emergency medical service (EMS) of mixed skill-level attempted to resuscitate 954 patients from prehospital cardiac arrest (883 attempts per million population per year); 75% of the arrests were of cardiac cause. This paper is one of the first analyses from europe to use the 'Utstein template' to report outcomes of such arrests. In cases where an arrest rhythm could be recorded, 38.4% were ventricular fibrillation (VF), 45.5% were asystolic, and the remainder were either electromechanical dissociation or respiratory arrests. Using univariate analysis factors associated with a greater likelihood of survival include the presence of a witness, bystander-initiated cardiopulmonary resuscitation (CPR), early CPR and VF as the arrest rhythm. Twenty of 155 cases (13%) survived where VF arrest was witnessed by non-EMS personnel.

Aged↗
PubMed1997

The use of electrolyte solutions for reducing transport stress.

The transport and handling procedures imposed on beef cattle during the normal course of marketing can be a significant stressor. Factors including time off feed, water deprivation, mixing and the resulting behavioral problems, transport movement, unfamiliar noise, inclement weather, and so forth are often present and collectively result in live weight and carcass losses as well as degraded meat quality. In addition, a growing public concern regarding animal welfare in such situations is evident. Understanding how cattle adapt to and are influenced by these factors is a necessary first step in being able to reduce these stresses and a major research effort globally has been directed toward this end. Studies at the Lacombe Research Center have focused on understanding the role of electrolytes in attenuating transport and handling stress. Apparent in this research has been the consistent observation that transport and handling reduce blood pH, glucose concentration, and interstitial water space (P < .05), and increases in serum chloride. hemoglobin, urine sodium, and urine osmolality (P < .05) are evident. These changes are also accompanied by significant increases in the neutrophile/lymphocyte ratio. The application of oral electrolyte therapy, especially if similar in constituents to interstitial fluid, seems to attenuate these physiological changes. Resulting improvements in both live and carcass weights (less shrink) of up to several percent in treated animals as well as a reduction in meat quality degradation (reduced dark cutting) is evident in such trials. These studies suggest that the use of electrolyte therapy may be an effective means of reducing stress in transported cattle.

Animal Welfare↗
PubMed1997

Juvenile onset ankylosing spondylitis--more girls than we thought?

OBJECTIVE: To define the sex ratio of juvenile onset ankylosing spondylitis (AS) among a large population. METHODS: Using a standard questionnaire, data were collected from 3362 subjects, members of the National Ankylosing Spondylitis Society and patients at a tertiary referral center. RESULTS: Of 3362 patients, 2461 (73%) were male; male:female sex ratio was 2.7:1. Of the total, 379 (11%) had disease onset between the ages of 5 and 16 years. Of these, 278 were boys and 101 girls, giving an overall male:female ratio, in juvenile AS, of 2.6:1. For those with onset ages 5-13 years there was a ratio of 2.1:1, while for those aged over 14 years at onset, the ratio was 3.2:1. CONCLUSION: Older published ratios, ranging from 4.5:1 to 6:1, used smaller samples, focusing only on subjects who were juveniles at the time of the study. Our data collection method, which recruits from 2 sources and includes adults with juvenile onset, attempts to avoid these methodological problems. The data suggest a higher incidence of juvenile AS among females than previously described.

Adolescent↗
PubMed1997

Low dose amitriptyline in ankylosing spondylitis: a short term, double blind, placebo controlled study.

OBJECTIVE: To define the effect of low dose amitriptyline on fatigue, pain, and stiffness in patients with ankylosing spondylitis (AS). METHODS: One hundred consecutive patients with AS were randomized to receive low dose amitriptyline up to 30 mg nightly or placebo for 2 weeks. Patients were assessed by the Bath Ankylosing Spondylitis Disease Activity (BASDAI) and Functional (BASFI) Indices pre and post-treatment. RESULTS: Eighty-eight patients (44 amitriptyline, 44 placebo) completed the study. Eight (5 amitriptyline, 3 placebo) stopped treatment because of side effects (e.g., drowsiness, dryness of mouth) and 4 provided insufficient data. Compared to placebo, the patients taking amitriptyline showed significantly greater improvement in restful sleep (66 vs 20%; p < 0.001) and their disease activity scores [BASDAI amitriptyline 1.18 (23%) vs placebo 0.52 (10%); p = 0.024]. All other variables showed a trend to greater improvement by amitriptyline, although the differences were not statistically significant. CONCLUSION: (1) In a 2 week study, low dose amitriptyline significantly improved sleep in AS and was well tolerated; (2) as defined by BASDAI, there was a significant reduction in disease activity with amitriptyline; (3) compared to placebo, there was a nonsignificant trend toward improvement in function; and (4) in spite of improvement in pain, fatigue, and sleep with amitriptyline, stiffness was not increased.

Adult↗
PubMed1997

Which patients with ankylosing spondylitis derive most benefit from an inpatient management program?

OBJECTIVE: To evaluate the benefit achieved from an inpatient management program by testing the hypothesis that more mobile, younger patients on their first course show the most improvement. METHODS: We assessed 236 patients over an 18 month period. Patients were assessed at the beginning and end of the course by 4 indices, 3 of which were self-administered (disease activity, functional ability, and global well being) and one administered by a trained physiotherapist (metrology). Paired t tests and ordinary least squares regression analysis were used to compare pre and postcourse results for each index. RESULTS: The wide range of disease duration (0-53 years) and disease severity [0.69-9.39 (on a 0-10 scale)] reveal that patients are from a wide spectrum of disease. Results revealed a mean improvement of 18-27% over baseline in the 4 indices. Significant predictors of greater improvement over the 2 week course were found for each index. CONCLUSION: Our results confirm the benefit of an intensive regime of inpatient physiotherapy. Although the original hypothesis cannot be accepted or rejected as the results were different for the 4 indices, the following general conclusions may be drawn: (1) there is a trend for females to improve more than males; (2) patients who have attended fewer courses tend to achieve more improvement; (3) younger patients do better than older patients; and (4) age of disease onset has little effect.

Adult↗
PubMed1996

A mutation in the lipoprotein lipase gene is the molecular basis of chylomicronemia in a colony of domestic cats.

Members of a domestic cat colony with chylomicronemia share many phenotypic features with human lipoprotein lipase (LPL) deficiency. Biochemical analysis reveals that these cats do have defective LPL catalytic activity and have a clinical phenotype very similar to human LPL deficiency. To determine the molecular basis underlying this biochemical phenotype, we have cloned the normal and affected cat LPL cDNAs and shown that the affected cat has a nucleotide change resulting in a substitution of arginine for glycine at residue 412 in exon 8. In vitro mutagenesis and expression studies, in addition to segregation analysis, have shown that this DNA change is the cause of LPL deficiency in this cat colony. Reduced body mass, growth rates, and increased stillbirth rates are observed in cats homozygous for this mutation. These findings show that this LPL deficient cat can serve as an animal model of human LPL deficiency and will be useful for in vivo investigation of the relationship between triglyceride rich lipoproteins and atherogenic risk and for the assessment of new approaches for treatment of LPL deficiency, including gene therapy.

Amino Acid Sequence↗