27 results on '"Jones, G."'
Search Results
2. Acute Management of Hypertension Following Intracerebral Hemorrhage.
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Haller, J. Tyler, Wiss, Adam L., May, Casey C., Jones, G. Morgan, and Smetana, Keaton S.
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ADRENERGIC beta blockers ,ACE inhibitors ,CALCIUM antagonists ,CLONIDINE ,THERAPEUTIC use of nitroglycerin ,PHENYTOIN ,METOPROLOL ,SODIUM nitroferricyanide ,VASODILATORS ,HYDRALAZINE ,LABETALOL ,PHENTOLAMINE ,PROPOFOL ,STROKE-related mortality ,ESMOLOL ,ENALAPRILAT ,BLOOD pressure ,CEREBRAL hemorrhage ,CEREBRAL circulation ,HYPERTENSION ,ANTIHYPERTENSIVE agents ,INTRACRANIAL pressure ,DISEASE complications ,THERAPEUTICS - Abstract
Intracerebral hemorrhage (ICH) is responsible for approximately 15% of strokes annually in the United States, with nearly 1 in 3 of these patients dying without ever leaving the hospital. Because this disproportionate mortality risk has been stagnant for nearly 3 decades, a main area of research has been focused on the optimal strategies to reduce mortality and improve functional outcomes. The acute hypertensive response following ICH has been shown to facilitate ICH expansion and is a strong predictor of mortality. Rapidly reducing blood pressure was once thought to induce cerebral ischemia, though has been found to be safe in certain patient populations. Clinicians must work quickly to determine whether specific patient populations may benefit from acute lowering of systolic blood pressure (SBP) following ICH. This review provides nurses with a summary of the available literature on blood pressure control following ICH. It focuses on intravenous and oral antihypertensive medications available in the United States that may be utilized to acutely lower SBP, as well as medications outside of the antihypertensive class used during the acute setting that may reduce SBP. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
3. IL‐27: a double agent in the IL‐6 family.
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Jones, G. W., Hill, D. G., Cardus, A., and Jones, S. A.
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AUTOIMMUNE disease treatment , *INFLAMMATION treatment , *CYTOKINES , *INTERLEUKINS , *NATURAL immunity , *THERAPEUTICS - Abstract
Summary: The cytokine interleukin (IL)‐6 is a major therapeutic target for the treatment of various inflammatory and autoimmune diseases. While IL‐6 receives considerable attention in studies of innate and adaptive immunity, the IL‐6‐related family member IL‐27 is recognized increasingly for its effects on cellular proliferation, differentiation and leucocyte effector functions. Both cytokines activate responses in myeloid and stromal tissue cells, where they direct the transition from innate to adaptive immunity. However, they are identified frequently as lymphokines that control responses in T cells and B cells. In this regard, IL‐27 often opposes the action of IL‐6. Here, we will review the role of IL‐6 and IL‐27 in inflammation, with a particular focus on inflammatory arthritis, and discuss their importance in the diagnosis, stratification and treatment of autoimmune disease. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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4. The assessment of online health videos for surgery in Crohn's disease.
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Marshall, J. H., Baker, D. M., Lee, M. J., Jones, G. L., Lobo, A. J., and Brown, S. R.
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CROHN'S disease ,STREAMING video & television ,GASTROINTESTINAL disease treatment ,INTERNET in medicine ,THERAPEUTICS - Abstract
Abstract: Aim: YouTube™ is an open‐access, nonpeer‐reviewed video‐hosting site and is used as a source of publicly available healthcare information. This study aimed to assess the thematic content of the most viewed videos relating to surgery and Crohn's disease and to explore the viewer interactions with these videos. Method: A search of YouTube™ was carried out using one search string. The 50 most viewed videos were identified and categorized by source and content themes and assessed for viewer interactions. Video comments were used to describe the usefulness of the video content to viewers. Results: The majority of videos were uploaded by patients (n = 21).The remainder were uploaded by individual healthcare professionals (n = 9), hospital/speciality associations (n = 18) and industry (n = 2). The median number of likes for patient videos was significantly higher than for hospital/speciality association videos (P < 0.001). Patient videos received more comments praising the video content (n = 27) and more comments asking for further information (n = 14). The median number of likes for ‘experience of surgery’ (P < 0.001) and ‘experience of disease’ (P = 0.0015) themed videos were significantly higher than for ‘disease management’ themed videos. Conclusion: Crohn's disease patients use YouTube™ as a surgical information source. The content of patient‐sourced videos focused on surgical and disease experience, suggesting that these themes are important to patients. Current patient developed videos provide limited information, as reflected by viewers requesting further information. Storytelling patient‐centred videos combined with clinical evidence may be a good model for future videos. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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- View/download PDF
5. Intranasal packs and haemostatic agents for the management of adult epistaxis: systematic review.
- Author
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IQBAL, I. Z., JONES, G. H., DAWE, N., MAMAIS, C., SMITH, M. E., WILLIAMS, R. J., KUHN, I., and CARRIE, S.
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NOSEBLEED treatment , *HEMOSTATICS , *BANDAGES & bandaging , *NASAL cavity , *SYSTEMATIC reviews , *DISEASE relapse , *ADULTS , *THERAPEUTICS - Abstract
Background: The mainstay of management of epistaxis refractory to first aid and cautery is intranasal packing. This review aimed to identify evidence surrounding nasal pack use. Method: A systematic review of the literature was performed using standardised methodology. Results: Twenty-seven eligible articles were identified relating to non-dissolvable packs and nine to dissolvable packs. Nasal packing appears to be more effective when applied by trained professionals. For non-dissolvable packs, the re-bleed rates for Rapid Rhino and Merocel were similar, but were higher with bismuth iodoform paraffin paste packing. Rapid Rhino packs were the most tolerated non-dissolvable packs. Evidence indicates that 96 per cent of re-bleeding occurs within the first 4 hours after nasal pack removal. Limited evidence suggests that dissolvable packs are effective and well tolerated by patients. There was a lack of evidence relating to: the duration of pack use, the economic effects of pack choice and the appropriate care setting for non- dissolvable packs. Conclusion: Rapid Rhino packs are the best tolerated, with efficacy equivalent to nasal tampons. FloSeal is easy to use, causes less discomfort and may be superior to Merocel in anterior epistaxis cases. There is no strong evidence to support prophylactic antibiotic use. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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6. Minocycline and matrix metalloproteinase inhibition in acute intracerebral hemorrhage: a pilot study.
- Author
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Chang, J. J., Kim ‐ Tenser, M., Emanuel, B. A., Jones, G. M., Chapple, K., Alikhani, A., Sanossian, N., Mack, W. J., Tsivgoulis, G., Alexandrov, A. V., and Pourmotabbed, T.
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CEREBRAL hemorrhage ,CEREBROVASCULAR disease ,MINOCYCLINE ,INTRAVENOUS therapy ,PLACEBOS ,THERAPEUTICS - Abstract
Background and purpose Intracerebral hemorrhage ( ICH) is a devastating cerebrovascular disorder with high morbidity and mortality. Minocycline is a matrix metalloproteinase-9 ( MMP-9) inhibitor that may attenuate secondary mechanisms of injury in ICH. The feasibility and safety of minocycline in ICH patients were evaluated in a pilot, double-blinded, placebo-controlled randomized clinical trial. Methods Patients with acute onset (<12 h from symptom onset) ICH and small initial hematoma volume (<30 ml) were randomized to high-dose (10 mg/kg) intravenous minocycline or placebo. The outcome events included adverse events, change in serial National Institutes of Health Stroke Scale score assessments, hematoma volume and MMP-9 measurements, 3-month functional outcome (modified Rankin score) and mortality. Results A total of 20 patients were randomized to minocycline ( n = 10) or placebo ( n = 10). The two groups did not differ in terms of baseline characteristics. No serious adverse events or complications were noted with minocycline infusion. The two groups did not differ in any of the clinical and radiological outcomes. Day 5 serum MMP-9 levels tended to be lower in the minocycline group (372 ± 216 ng/ml vs. 472 ± 235 ng/ml; P = 0.052). Multiple linear regression analysis showed that minocycline was associated with a 217.65 (95% confidence interval −425.21 to −10.10, P = 0.041) decrease in MMP-9 levels between days 1 and 5. Conclusions High-dose intravenous minocycline can be safely administered to patients with ICH. Larger randomized clinical trials evaluating the efficacy of minocycline and MMP-9 inhibition in ICH patients are required. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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7. Is Unilateral Neck Surgery Feasible in Patients with Sporadic Primary Hyperparathyroidism and Double Negative Localisation?
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Scott-Coombes, D., Rees, J., Jones, G., and Stechman, M.
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HYPERPARATHYROIDISM treatment ,NECK surgery ,PARATHYROID gland diseases ,PARATHYROIDECTOMY ,POSITRON emission tomography ,THERAPEUTICS - Abstract
Introduction: Ultrasound and Tc99mMIBI scans are used to localise parathyroid tumours in sporadic primary hyperparathyroidism (pHPT). Intra-operative PTH (ioPTH) assay facilitates unilateral neck exploration (UNE). When both ultrasound and MIBI are negative, it is our policy to explore the left side of the neck and only proceed to bilateral neck exploration (BNE) when either a tumour is not found or when ioPTH does not fall to >50% of the highest pre-excision value. The aim of this study was to investigate the outcome of our approach to 'double negative' patients. Methods: A retrospective analysis of patients undergoing primary parathyroidectomy for pHPT. Data were obtained from a prospective surgical database and the hospital electronic patient record. Results: Between January 2004 and November 2014, 746 patients underwent a parathyroidectomy for pHPT. Those who did not have both pre-operative scans, ioPTH or a minimum of 6-month follow-up were excluded. Of 552 patients, 111 (20%) had double negative scans (group A), and in 441, either one or both scans were positive (group B). Median age was 61.5 years (range 10-88). Pre-operative PTH level was significantly lower in group A: 11.8 pmol/l (range 3.1-38.8) versus 14.9 pmol/l (range 2.8-101.6; P < 0.01). Median tumour weight was significantly lower in group A: 280 mg (range 50-3710) versus 573 mg (range 10-12,000; P < 0.01). Overall rate of multiple gland disease (MGD) was 11%; 24% in group A and 7% in group B ( P < 0.01). Overall rate of UNE in Group A was 28% and converse to the rate in Group B (76%; P < 0.01). Sensitivity and specificity of ioPTH to detect MGD were 98 and 98% in Group A versus 98 and 100% in Group B. First-time cure rate was 92.7% in group A and 96.8% in group B ( P < 0.05). Conclusion: A double negative scan is associated with small tumours and higher rates of MGD. Despite these challenges, surgery is successful in this group of patients reinforcing the message that negative localisation is not a contraindication for parathyroidectomy. We demonstrated that it is feasible to offer unilateral neck surgery to 28% of patients with double negative scans. A randomised trial is needed to compare BNE with ioPTH/UNE in this select population. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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8. EULAR revised recommendations for the management of fibromyalgia.
- Author
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Macfarlane, G. J., Kronisch, C., Dean, L. E., Atzeni, F., Häuser, W., Fluß, E., Choy, E., Kosek, E., Amris, K., Branco, J., Dincer, F., Leino-Arjas, P., Longley, K., McCarthy, G. M., Makri, S., Perrot, S., Sarzi-Puttini, P., Taylor, A., and Jones, G. T.
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ANTICONVULSANTS ,ANTIDEPRESSANTS ,THERAPEUTIC use of capsaicin ,TREATMENT of fibromyalgia ,MONOAMINE oxidase inhibitors ,NONSTEROIDAL anti-inflammatory agents ,ADENOSYLMETHIONINE ,GAMMA-hydroxybutyrate ,DRUG therapy ,SEROTONIN uptake inhibitors ,HUMAN growth hormone ,ACUPUNCTURE ,PHYSIOLOGICAL control systems ,COGNITIVE therapy ,EXERCISE therapy ,FATIGUE (Physiology) ,FIBROMYALGIA ,HYDROTHERAPY ,HYPNOTISM ,MASSAGE therapy ,MEDICAL protocols ,MEDICAL societies ,MIND & body therapies ,PAIN ,SENSE organs ,SLEEP ,SPINAL adjustment ,EVIDENCE-based medicine ,ACTIVITIES of daily living ,TREATMENT effectiveness ,AMITRIPTYLINE ,MINDFULNESS ,THERAPEUTICS - Abstract
Objective: The original European League Against Rheumatism recommendations for managing fibromyalgia assessed evidence up to 2005. The paucity of studies meant that most recommendations were 'expert opinion'.Methods: A multidisciplinary group from 12 countries assessed evidence with a focus on systematic reviews and meta-analyses concerned with pharmacological/non-pharmacological management for fibromyalgia. A review, in May 2015, identified eligible publications and key outcomes assessed were pain, fatigue, sleep and daily functioning. The Grading of Recommendations Assessment, Development and Evaluation system was used for making recommendations.Results: 2979 titles were identified: from these 275 full papers were selected for review and 107 reviews (and/or meta-analyses) evaluated as eligible. Based on meta-analyses, the only 'strong for' therapy-based recommendation in the guidelines was exercise. Based on expert opinion, a graduated approach, the following four main stages are suggested underpinned by shared decision-making with patients. Initial management should involve patient education and focus on non-pharmacological therapies. In case of non-response, further therapies (all of which were evaluated as 'weak for' based on meta-analyses) should be tailored to the specific needs of the individual and may involve psychological therapies (for mood disorders and unhelpful coping strategies), pharmacotherapy (for severe pain or sleep disturbance) and/or a multimodal rehabilitation programme (for severe disability).Conclusions: These recommendations are underpinned by high-quality reviews and meta-analyses. The size of effect for most treatments is relatively modest. We propose research priorities clarifying who will benefit from specific interventions, their effect in combination and organisation of healthcare systems to optimise outcome. [ABSTRACT FROM AUTHOR]- Published
- 2017
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9. Treatment of Acute Hepatic Encephalopathy.
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Courson, Alesa, Jones, G. Morgan, and Twilla, Jennifer D.
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ANTIBIOTICS , *DISACCHARIDES , *ACADEMIC medical centers , *COMBINATION drug therapy , *HEPATIC encephalopathy , *LENGTH of stay in hospitals , *CIRRHOSIS of the liver , *TREATMENT effectiveness , *RETROSPECTIVE studies , *PATIENT readmissions , *DESCRIPTIVE statistics , *DISEASE complications , *THERAPEUTICS - Abstract
Objectives: Rifaximin is approved for the reduction of hepatic encephalopathy (HE) recurrence in patients with chronic liver disease (CLD); however, few studies have evaluated the benefit of adding rifaximin to lactulose for treatment of acute HE. The aim of this study was to determine the impact of combination therapy with lactulose and rifaximin on hospital length of stay (LOS) and readmission rates. Methods: A retrospective study of patients admitted to an adult hospital within the Methodist LeBonheur Healthcare (MLH) System in Memphis, Tennessee, between 2007 and 2012 was conducted. Patients were identified via International Classification of Diseases, Ninth Revision (ICD-9) coding for liver cirrhosis. Results: Of the 173 patients included, 87 (50%) received lactulose monotherapy and 62 (36%) combination therapy, while 24 (14%) underwent therapy escalation. Median LOS was 6 days in monotherapy group and 8 days in combination group (P = .9). At 180 days, patients receiving combination therapy had fewer readmissions for HE than those receiving monotherapy (2.4% vs 16.2%, P = .02). Conclusion: Addition of rifaximin to lactulose for treatment of acute HE did not reduce hospital LOS; however, it did result in lower readmission rates for HE at 180 days. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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10. Adherence to controller asthma medications: 6-month prevalence across a US community pharmacy chain.
- Author
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Feehan, M., Ranker, L., Durante, R., Cooper, D. K., Jones, G. J., Young, D. C., and Munger, M. A.
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ADRENERGIC beta agonists ,ADRENOCORTICAL hormones ,HORMONE therapy ,DRUG therapy for asthma ,AGE distribution ,COMBINATION drug therapy ,CHI-squared test ,DRUGS ,DRUGSTORES ,PATIENT compliance ,RESEARCH funding ,SEX distribution ,SECONDARY analysis ,DESCRIPTIVE statistics ,THERAPEUTICS - Abstract
What is known and objective Non-adherence to controller asthma medications is an important public health problem. It is estimated to occur in 30-70% of individuals and is a significant risk factor for asthma morbidity and mortality. The aim of this study was to determine the level of adherence, as indicated by refill rates, to controller asthma medications in a community pharmacy setting. Methods Secondary analyses of a community pharmacy dispensing database in 15 locations throughout Utah. Results and discussion The dispensing records of 2193 patients who received controller medications for asthma in a 12-month period, and had a minimum of 6-month potential coverage (180 days) from the date of their first receipt of a controller medication in that period, were examined. Using standard metrics to gauge adherence, the proportion of days covered ( PDC) and the medication possession ratio ( MPR), the average coverage for controller asthma medications across a 6-month period (180 days) was poor, averaging less than 50% of days' availability. Standard cut-offs (≥80% medication availability) indicated that only 14-16% of patients had 'satisfactory' adherence over their 6-month follow-on period. Females and older patients had significantly greater satisfactory adherence. Medication adherence was significantly greater with inhaled corticosteroid ( ICS)-long-acting β
2 -agonist ( LABA) combinations than with ICS alone. What is new and conclusion This study confirms the considerable scope of the asthma therapy non-adherence problem. Therefore, it is imperative to conduct survey-based research linked directly to pharmacy-based dispensing data to derive patient behavioural, attitudinal and environmental factors that may contribute to the issue, and then pilot and evaluate interventions for change. [ABSTRACT FROM AUTHOR]- Published
- 2015
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11. Effects of etomidate on vasopressor use in patients with sepsis or severe sepsis: A propensity-matched analysis.
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Alday, Nerissa J., Jones, G. Morgan, Kimmons, Lauren A., Phillips, Gary S., McCallister, Jennifer W., and Doepker, Bruce A.
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SEPTICEMIA treatment ,BODY weight ,CRITICAL care medicine ,ETOMIDATE ,HOSPITAL emergency services ,EVALUATION of medical care ,DATA analysis ,RETROSPECTIVE studies ,THERAPEUTICS - Published
- 2014
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12. Granulocyte infusion: benefit beyond neutrophils?
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Creasey, T., Jones, G. L., and Collin, M.
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KARYOTYPES , *DAUNOMYCIN , *CANCER chemotherapy , *GRANULOCYTES , *THERAPEUTICS - Abstract
The article presents a case study of a woman of 45 years with acute myeloid leukaemia (AML) blasts and poor karyotype. Topics discussed include her treatment using daunorubicin, reappearance of blasts in peripheral blood after completion of chemotherapy and increase in neutrophil count after granulocyte infusions. Other topics include information that higher amount of lymphocytes are present in buffy coat granulocytes and use of non-engrafting allogeneic cells in granulocyte infusion.
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- 2016
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13. Predictors of Severe Hypotension in Neurocritical Care Patients Sedated with Propofol.
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Jones, G., Doepker, Bruce, Erdman, Michael, Kimmons, Lauren, and Elijovich, Lucas
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PROPOFOL , *HYPOTENSION , *MEDICAL centers , *ARTIFICIAL respiration , *CRITICAL care medicine , *PATIENTS , *THERAPEUTICS , *DISEASE risk factors - Abstract
Introduction: Propofol is used extensively in neurocritical care (NCC) due to its pharmacologic properties allowing for facilitation of serial neurologic examinations. Despite widespread use, few studies have identified risk factors for hypotension in these patients. We aimed to determine predictors of hypotension in NCC patients sedated with propofol. Methods: This retrospective, multicenter study evaluated 237 patients at two academic medical centers, both with dedicated NCC teams led by board-certified neurointensivists. Univariate analyses were performed to determine risk factors associated with severe hypotension during sedation with propofol. Multivariable analysis was performed to determine variables independently associated with hypotension, defined as a mean arterial pressure (MAP) less than 60 mmHg. Results: There was an average maximum reduction in MAP of 28.8 % after propofol initiation in the entire cohort. Severe hypotension developed in 62 (26.2 %) patients to a median nadir MAP of 56 mmHg. Those who developed severe hypotension had a longer median duration of mechanical ventilation (5.0 vs. 3.6 days; p = 0.01) and an increased in-hospital mortality (38.7 vs. 24.0 %; p = 0.03). Multivariable logistic regression analysis identified increasing number of changes to the propofol infusion rate, baseline MAP 60-70 mmHg, and need for renal replacement therapy (RRT) as factors independently associated with hypotension. Conclusions: Multiple factors predicted hypotension in NCC patients receiving propofol. Clinicians should use propofol cautiously in patients with a lower baseline MAP or receiving RRT. Development of protocols related to the frequency of dose titrations is also recommended to prevent this avoidable complication. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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14. Remifentanil, Ketamine, and Fospropofol.
- Author
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Mohrien, Kerry M., Jones, G. Morgan, MacDermott, Jennifer R., and Murphy, Claire V.
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THERAPEUTIC use of narcotics ,FENTANYL ,ANALGESIA ,ANALGESICS ,ANESTHESIA ,CRITICALLY ill ,MEDICAL databases ,INFORMATION storage & retrieval systems ,MEDICAL information storage & retrieval systems ,INTRAVENOUS therapy ,KETAMINE ,MEDICAL cooperation ,MEDLINE ,NARCOTICS ,PATIENTS ,PRODRUGS ,RESEARCH ,SYSTEMATIC reviews ,MECHANICAL ventilators ,RANDOMIZED controlled trials ,PHARMACODYNAMICS ,PROPOFOL ,THERAPEUTICS - Abstract
Sedation and analgesia are integral aspects in the care of critically ill patients admitted to the intensive care unit. In recent years, many of the commonly used sedative agents in the United States have experienced manufacturing and sterility issues leading to decreased availability. In addition, current practice has shifted to providing lighter levels of sedation as clinicians have gained a better understanding of the consequences of prolonged deep sedation. Benzodiazepines have fallen out of favor due to findings including increased delirium and duration of mechanical ventilation. Alterations in end-organ function in critically ill patients may also lead to varied responses to commonly used sedatives. With numerous factors impacting choice of sedation in the intensive care unit, fospropofol, ketamine, and remifentanil have been considered potential alternatives to standard therapy. The purpose of this review was to discuss strategies for the safe and effective use of fospropofol, ketamine, and remifentanil for continuous intravenous sedation in critically ill patients. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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15. Empyema and Respiratory Failure Secondary to Nephropleural Fistula Caused by Chronic Urinary Tract Infection: A Case Report.
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Jones, G. H., Kalaher, H. R., Misra, N., Curtis, J., and Parker, R. J.
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EMPYEMA , *PLEURA diseases , *URINARY tract infections , *CASE studies , *FISTULA , *KIDNEY stones , *CRITICAL care medicine , *THERAPEUTICS ,RESPIRATORY insufficiency treatment - Abstract
We report a case of nephropleural fistula causing empyema and respiratory failure in a 68-year-old gentleman with a long history of urological problems including recurrent nephrolithiasis and urinary tract infections. He was admitted with sepsis, a productive cough, pyuria, and reduced breath sounds over the left hemithorax. Radiological imaging revealed a fistulous connection between a left-sided perinephric abscess and the pleural space. He was commenced on broad spectrum intravenous antibiotics but developed progressive respiratory failure requiring intensive care admission. Urinary and pleural aspirates cultured facultative anaerobic pathogens with identical resistance patterns. Drainage of thoracic and perinephric collections was carried out, allowing him to be extubated after 24 hours and discharged home after 18 days on an extended course of oral antibiotics. Left nephrectomy is now planned after a period of convalescence. Empyema developing in patients with known urolithiasis should alert the treating physician to the possibility that a pathological communication has formed especially if typical urinary tract pathogens are cultured from respiratory sampling. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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16. Oral contraceptive use and bone mass in women aged 26-36 years.
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Wei, S., Jones, G., Thomson, R., Dwyer, T., and Venn, A.
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ORAL contraceptives , *ANALYSIS of variance , *CHI-squared test , *COMPUTER software , *ESTROGEN , *FISHER exact test , *MULTIVARIATE analysis , *PROGESTERONE , *REGRESSION analysis , *ULTRASONIC imaging , *DATA analysis , *EQUIPMENT & supplies , *BONE density , *ADULTS , *THERAPEUTICS - Abstract
Introduction: The association between hormonal contraceptive use and bone mineral density remains controversial. Hypothesis: Hormonal contraceptive use is positively associated with bone mass in young premenopausal women. Methods: Cross-sectional analysis of data collected from women aged 26-36 years ( n = 687) in the Childhood Determinants of Adult Health study-a longitudinal study investigating childhood determinants of cardiovascular disease, diabetes, and other chronic diseases in adulthood. Participants were not currently pregnant or breast-feeding. Contraceptive use was obtained by self-administered questionnaire. Women were categorized as combined oral contraceptive users ( n = 219), progestogen-only contraceptive users ( n = 43), and non-users of hormonal contraceptives ( n = 425). Bone mass was measured by quantitative ultrasound. Results: Compared with women who were not using any hormonal contraceptives, women using combined oral contraceptives had significantly higher values of broadband ultrasound attenuation (BUA), speed of sound, and quantitative ultrasound index. These associations remained after adjustment for confounders. Progestogen-only contraceptive users had higher BUA than non-users, but the differences were not statistically significant in this small group. Conclusion: Combined oral contraceptive use was associated with higher bone mass measured by quantitative ultrasound in this population-based sample of premenopausal women aged 26-36 while progestogen-only contraceptives appeared to have no deleterious effect on bone mass. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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17. Providing a children's palliative care service in the community through fixed-term grants: the staff perspective.
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Beringer, A. J., Eaton, N. M., and Jones, G. L.
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PALLIATIVE treatment ,CHILDREN'S health ,CHILD care services ,CHILD care ,PEDIATRICS ,THERAPEUTICS ,COHORT analysis ,SUSTAINABLE development ,PUBLIC health research - Abstract
Background Children's palliative care services have recently been awarded fixed-term grants, aimed at improving the provision of care for children with life-limiting conditions in the community. We report findings of a qualitative study to investigate the experience of a cohort of community children's nurses from teams involved in setting up or extending community-based children's palliative care services. The purpose of the study was to identify factors that affect service delivery, from the staff perspective, and to suggest ways of promoting their sustainable development. Methods Semi-structured telephone interviews were conducted with 21 nurses from 12 different teams providing palliative care for children at home and in hospices. Participants were questioned about the services they provided and their own roles in that provision.nvivo qualitative data analysis software was used to explore themes arising from the transcribed recorded interviews. Findings Key findings were the importance of physical location in facilitating multidisciplinary communication, the importance of defining role boundaries between existing and new providers of children's palliative care, and the potentially detrimental impact of insecure funding on referral patterns and recruitment to posts. Staff named the opportunity to offer direct ‘hands-on’ care to families, access to work-based support and networking opportunities as important factors in helping them cope with the stresses involved in managing finite resources and the emotional challenges of their work. Conclusions The maintenance of a mixed caseload with a significant proportion of direct care, provision of ongoing support and clearly defined roles are recommended as means of bolstering the ability of staff to develop their services. The deliberate locating of services to enhance communication between staff and guidance on the preparation of funding applications may further contribute to the sustainability of these services. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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18. Persistent and intractable ventriculitis due to retained ventricular catheters.
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Vajramani, G. V., Jones, G., Bayston, R., and Gray, W. P.
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CATHETERS , *CEREBROSPINAL fluid shunts , *CEREBRAL ventricles , *STAPHYLOCOCCAL diseases , *SURGERY , *THERAPEUTICS , *CRANIOTOMY , *HEMORRHAGE - Abstract
It is generally recommended that, in cases of difficulty in removing a ventricular catheter during a shunt revision, it is best left alone to avoid intraventricular haemorrhage. Retained ventricular catheters (RVCs) are usually safe, although in the presence of ventriculitis they may become colonized by organisms and become a source of persistent or recurrent infection. The authors present a case of persistent and intractable ventriculitis due to an old retained ventricular catheter. A 23-year-old female, who had a RVC and a functioning shunt, was admitted for a suspected blocked shunt. At surgery the shunt was found to be infected and external drainage was instituted. Over the next 4 months, she developed intractable and persistent staphylococcal ventriculitis, despite undergoing 10 further surgical procedures, and appropriate intravenous and intrathecal antibiotic therapy. She responded rapidly only after surgical removal of the old RVC via a craniotomy. The staphylococcus cultured from the RVC had an identical antibiogram to the organism responsible for the intractable ventriculitis. This case emphasizes the point that, although RVC are generally considered safe, removal becomes imperative in the presence of concurrent CSF infection that fails to respond quickly to intrathecal antibiotic therapy. [ABSTRACT FROM AUTHOR]
- Published
- 2005
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19. Letters.
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Edwards, Anusha G, Donaldson, Olly, Walsh, Ed, Karantana, Alexia, Elder, Andrew T, Hague, W M, Davoren, P M, Oliver, J, Rowan, J, Jones, Philip, Yate, Paul, Jones, G C, Macklin, J P, Alexander consultant Physician, W D, Martin, Stephen, Smith, Peter C, Walshe, Kieran M J, Hackam, Daniel G, and Ashcroft, John S
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MEDICINE ,DISASTER medicine ,CIVIL defense equipment ,HYPERTENSION ,THERAPEUTICS ,CHILDREN'S health - Abstract
Presents letters related to medicine. Importance of medical staff awareness about major incident planning; Comments about drug treatment of hypertension; Difficulties faced in the identification of malnourished children by the World Health Organization.
- Published
- 2003
20. A modification to the Codman™ Microsensor™ Skull Bolt Kit.
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Jones, G. N. and Barker, J. M.
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PRESSURE transducers , *HEAD injuries , *NEUROSURGEONS , *CRITICAL care medicine , *THERAPEUTICS - Abstract
Presents a modification of Codman Co.'s Microsensor Skull Bolt Kit used to monitor intracranial pressure in treating head injuries. Elongation of the minimum depth where the grub screw is not mounted on the cutting portion of the drill; Improved safety in the use of the equipment by non-neurosurgeons; Relevance to anesthetic practice in the field of intensive care.
- Published
- 2000
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21. Livedo reticularis and cerebrovascular lesions.
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Thomas, S. E., Church, R. E., and Davies-Jones, G. A. B.
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DIAGNOSIS ,SKIN diseases ,DERMATOLOGY ,THERAPEUTICS ,CLINICAL medicine - Abstract
Presents a case report of a thirty-one-year female diagnosed to have the livedo reticularis. History of the medical case; Clinical manifestations; Treatment.
- Published
- 1986
- Full Text
- View/download PDF
22. Recording video worlds for minimal-access surgery techniques.
- Author
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Cooper, J., Jones, G. J. F., Grange, S., and Bunker, T. D.
- Subjects
TELEMEDICINE ,MEDICINE ,THERAPEUTICS ,MEDICAL telematics ,SURGERY - Abstract
This article presents information on the development of methods for recording and playing back images from a minimal-access surgical exploration of a shoulder of lamb. It explains that the system used the images as a resource for computer-based arthroscopic training. It details the procedure of the surgery.
- Published
- 1998
- Full Text
- View/download PDF
23. Increased use of laparoscopy in acute right iliac fossa pain - is it good for patients?
- Author
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Jones, G. E., Kreckler, S., Shah, A., Stechman, M. J., and Handa, A.
- Subjects
- *
LAPAROSCOPY , *APPENDICITIS treatment , *ABDOMINAL diseases , *ULTRASONIC imaging , *SURGICAL excision , *THERAPEUTICS - Abstract
Aim The use of laparoscopy, with or without appendicectomy, is becoming more common in the management of acute right iliac fossa (RIF) pain, but little is known of the 'unintended' consequences of this change. This study aimed to evaluate the impact of increased use of laparoscopy on the number and type of patients treated surgically and on the rate of negative appendicectomy. Method A prospective audit was carried out of admissions to a teaching hospital over two, 3-month periods during 2007 and 2008. The management, investigations and outcome of patients presenting with RIF pain were studied. Results Admissions were stable over the two time-periods. There was a significant increase in the number of laparoscopic operations performed, from 22.5% (14/62) in 2007 to 85.7% (72/84) in 2008 ( P < 0.0001), and the percentage of patients undergoing surgery rose from 55.4% ( n = 62) in 2007 to 71.2% ( n = 84) in 2008 ( P < 0.01). In 2008, female patients were more likely to have surgery, an increase from 37.1% to 66.2% ( P < 0.001), and were more likely to have a laparoscopic procedure, an increase from 50% to 98% ( P < 0.0001). The rate of histologically confirmed appendicitis did not increase significantly (50/122 vs 57/118; P = 0.25), but the number of patients with a normal appendix either left in situ because it was macroscopically normal or found to be histologically normal following excision, increased significantly, from 9.01% in 2007 to 21.2% in 2008 ( P < 0.01). The diagnostic value of pelvic ultrasound decreased from 75.6% of examinations in 2007 to 54.5% in 2008 ( P = 0.039). Conclusion An increase in laparoscopic procedures has resulted in more operations in women, an associated higher negative appendicectomy rate and decreased usefulness of pelvic ultrasound. Increased use of laparoscopy needs to be balanced against the diagnostic benefits of 'negative' laparoscopy. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
24. Effects of dual-chamber pacing in hypertrophic cardiomyopathy without obstruction.
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Seidelin, P H, Jones, G A, and Boon, N A
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- *
CARDIAC pacemakers , *COMPARATIVE studies , *EXERCISE tests , *CARDIAC hypertrophy , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *EVALUATION research , *STANDARDS , *THERAPEUTICS - Published
- 1992
- Full Text
- View/download PDF
25. Self-report of sleep deprivation therapy.
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Jones, Gareth and Jones, G
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LETTERS to the editor ,SLEEP deprivation ,MENTAL depression ,THERAPEUTICS - Abstract
A letter to the editor is presented on sleep deprivation therapy.
- Published
- 1979
- Full Text
- View/download PDF
26. Impact of Moderate Hyperchloremia on Clinical Outcomes in Intracerebral Hemorrhage Patients Treated With Continuous Infusion Hypertonic Saline: A Pilot Study.
- Author
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Riha, Heidi M., Erdman, Michael J., Vandigo, Joseph E., Kimmons, Lauren A., Goyal, Nitin, Davidson, K. Erin, Pandhi, Abhi, and Jones, G. Morgan
- Subjects
- *
HEMORRHAGE , *MORTALITY , *CRITICALLY ill , *HYPERTONIC saline solutions , *HOSPITALS , *PATIENTS , *CEREBRAL hemorrhage treatment , *CATASTROPHIC illness , *ACADEMIC medical centers , *CEREBRAL hemorrhage , *CHLORINE , *COMPARATIVE studies , *INTRAVENOUS therapy , *RESEARCH methodology , *MEDICAL cooperation , *PROBABILITY theory , *RESEARCH , *WATER-electrolyte imbalances , *PILOT projects , *EVALUATION research , *RETROSPECTIVE studies , *HOSPITAL mortality , *ODDS ratio , *THERAPEUTICS - Abstract
Objectives: Hyperchloremia has been associated with increased morbidity and mortality in critically ill patients. While previous research has demonstrated an association between hypertonic saline and hyperchloremia, limited data exist in neurocritical care patients. The objective of this study is to determine the impact of moderate hyperchloremia (chloride ≥ 115 mmol/L) on clinical outcomes in intracerebral hemorrhage patients treated with continuous IV infusion 3% hypertonic saline.Design: Multicenter, retrospective, propensity-matched cohort study.Setting: Neurocritical care units at two academic medical centers with dedicated neurocritical care teams and comprehensive stroke center designation.Patients: Intracerebral hemorrhage patients discharged between September 2011 and September 2015 were evaluated and matched 1:1 based on propensity scoring.Interventions: Continuous IV infusion 3% hypertonic saline.Measurements and Main Results: A total of 219 patients were included in the unmatched cohort (143 moderate hyperchloremia and 76 nonhyperchloremia) and 100 patients in the propensity-matched cohort. In-hospital mortality was significantly higher in those who developed moderate hyperchloremia in a propensity-matched cohort (34% vs 14%; p = 0.02). Moderate hyperchloremia independently predicted in-hospital mortality in multivariable logistic regression analysis (odds ratio, 4.4 [95% CI, 1.4-13.5]; p = 0.01).Conclusions: We observed higher rates of in-hospital mortality in patients who developed moderate hyperchloremia during treatment with continuous IV infusion 3% hypertonic saline, with moderate hyperchloremia independently predicting in-hospital mortality. These results suggest that chloride values should be monitored closely during hypertonic saline treatment as moderate elevations may impact outcomes in intracerebral hemorrhage patients. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
27. A Novel Retro-Inverso Peptide Inhibitor Reduces Amyloid Deposition, Oxidation and Inflammation and Stimulates Neurogenesis in the APPswe/PS1ΔE9 Mouse Model of Alzheimer’s Disease
- Author
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Vadivel Parthsarathy, Elisa Salvati, Christian Hölscher, David Allsop, Mark Taylor, Paula McClean, Claire Tinker, Oleg Kolosov, Glynn Jones, Massimo Masserini, Maria Gregori, Parthsarathy, V, Mcclean, P, Holscher, C, Taylor, M, Tinker, C, Jones, G, Kolosov, O, Salvati, E, Gregori, M, Masserini, M, and Allsop, D
- Subjects
Male ,Mouse ,Long-Term Potentiation ,Beta-Sheet Conformation ,Plaque, Amyloid ,Bioinformatics ,medicine.disease_cause ,Biochemistry ,Amyloid beta-Protein Precursor ,Mice ,Drug Discovery ,Neurobiology of Disease and Regeneration ,Cells, Cultured ,Multidisciplinary ,Microglia ,Chemistry ,Neurodegeneration ,Neurogenesis ,Neurodegenerative Diseases ,Animal Models ,medicine.anatomical_structure ,Neurology ,Blood-Brain Barrier ,Oligomer ,Cerebral cortex ,Medicine ,Female ,In-Vivo ,Alzheimer's disease ,Oxidation-Reduction ,Protein Binding ,Research Article ,Biotechnology ,Amyloid ,Drugs and Devices ,medicine.medical_specialty ,Drug Research and Development ,Curcumin ,Science ,Mice, Transgenic ,Therapeutics ,Blood–brain barrier ,Permeability ,Cell Line ,Aggregation ,Model Organisms ,Alzheimer Disease ,Internal medicine ,medicine ,Animals ,Biology ,Inflammation ,Amyloid beta-Peptides ,Protein ,Dentate gyrus ,Fibrillogenesi ,medicine.disease ,Disease Models, Animal ,Oxidative Stress ,Endocrinology ,Dementia ,Fibril Formation ,Protein Multimerization ,Peptides ,Oxidative stress ,Neuroscience - Abstract
Previously, we have developed a retro-inverso peptide inhibitor (RI-OR2, rGffvlkGr) that blocks the in vitro formation and toxicity of the Aβ oligomers which are thought to be a cause of neurodegeneration and memory loss in Alzheimer's disease. We have now attached a retro-inverted version of the HIV protein transduction domain 'TAT' to RI-OR2 to target this new inhibitor (RI-OR2-TAT, Ac-rGffvlkGrrrrqrrkkrGy-NH2) into the brain. Following its peripheral injection, a fluorescein-labelled version of RI-OR2-TAT was found to cross the blood brain barrier and bind to the amyloid plaques and activated microglial cells present in the cerebral cortex of 17-months-old APPswe/PS1ΔE9 transgenic mice. Daily intraperitoneal injection of RI-OR2-TAT (at 100 nmol/kg) for 21 days into 10-months-old APPswe/PS1ΔE9 mice resulted in a 25% reduction (p
- Published
- 2013
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