Showing papers by "Michael P. Jones published in 1990"

Coronary artery disease is the major late complication of successful cadaveric renal transplantation

Abstract: The mortality and morbidity due to coronary artery disease (CAD) were determined in a cohort of successful renal transplant recipients. In 133 cadaveric renal allograft recipients who survived at least 10 years (range 10.0-19.4, mean 14.0) from transplantation, 32 subsequently died. The commonest cause of death was myocardial infarction (37.5%), followed by sepsis (25%) and malignancy (16%). The age- and sex-adjusted increase in mortality rate from CAD was 6.76 times that of a normal population

What rate of infusion of intravenous nutrition solution is required to stimulate uptake of amino acids by peripheral tissues in depleted patients

Abstract: We examined the effect of varying the quantities (0, 0.1, 0.2, 0.3, and 0.4 gN.kg-1.[day]-1) of nitrogen input on N balance, 3-methylhistidine (3MH) excretion, plasma amino acid concentration and the net flux of amino acids across the leg in depleted patients requiring parenteral nutrition. The calorie-to-nitrogen ratio was 140 to 1 (kcal:1 gN) and consequently the patients received varying amounts of calories (8, 14, 28, 42, and 56 kcal.kg-1.[day]-10. There was negative nitrogen balance and net loss of amino acids from the limb during fasting. An infusion of 0.2 gN.kg-1.[day]-1 of IVN reversed the net catabolic process and resulted in equilibrium of peripheral total amino acid flux and of tyrosine flux without a decrease in 3MH excretion. Net uptake of total amino acids and tyrosine in peripheral tissues was achieved with 0.4 gN.kg-1.[day]-1 and 56 kcal.kg-1.[day]-1. This was associated with a fivefold increase in 3MH excretion (p less than 0.01), indicating that net anabolism occurred with increased protein turnover. Fifty per cent of the amino acids taken up by peripheral tissues during infusions of 0.4 gN.kg-1.[day]-1 was due to the uptake of glutamate (Glu) and 20% was due to the uptake of branched chain amino acids (BCAA). Plasma Glu concentration, [Glu], did not increase with increasing IVN infusion, but BCAA concentrations did. Although the mean plasma [Glu] did not change with IVN infusion, there was an independent effect of plasma [Glu] (p less than 0.0001) and of N input (p less than 0.0001) on Glu flux, indicating that even at high infusion rates the maximal capacity of peripheral tissues to take up Glu had not been reached.

Magnetic resonance imaging in clinically-definite multiple sclerosis.

Abstract: Forty-two patients with clinically-definite multiple sclerosis were examined by magnetic resonance imaging using a 1.5-T instrument. Magnetic resonance imaging detected an abnormality in 90% of patients. In four patients, no lesions were demonstrated. The number, size and site of the lesions by magnetic resonance imaging were compared with the patients' clinical status and other variables. The Kurtzke disability status scale score increased in patients with corpus callosum atrophy, and brainstem and basal ganglia lesions, and correlated with the total number of lesions. No correlation was shown between the findings of magnetic resonance imaging and disease duration, age, sex or pattern-reversal visual-evoked potentials. This article highlights the variety of magnetic resonance images that is obtained in patients with clinically-definite multiple sclerosis.

The cycling of combination antirheumatic drug therapy in rheumatoid arthritis

Abstract: In this open pilot study a combination of hydroxychloroquine, prednisolone and alternating months of treatment with sulphasalazine or oral weekly pulse methotrexate has been investigated in 16 patients with rheumatoid arthritis (RA) refractory to a total of 67 disease suppressive medications. Results at 3 months indicated significant improvements in visual analogue score for pain, joint count, Ritchie index, scale of disability related to activities of daily living, ESR, rheumatoid factor and C-reactive protein. This degree of improvement, however, was not maintained 6 and 12 months after commencement of treatment. Pain score, Ritchie index and ESR were the only parameters demonstrating significant improvement at 12 months. Therapy was terminated in eight patients, half due to lack of efficacy and half because of side effects.

Is there AH Inhibitor of Na+, K+ ATPase in the Plasma of Normal Pregnant Women, or in those with Pregnancy-Associated Hypertension?

Abstract: Erythrocyte intracellular sodium [Na]i and potassium [K]i concentrations, maximum specific ouabain binding (OBmax), and Na+, K+ ATPase-dependent (ouabain-sensitive) rubidium influx (OSRb influx) were measured in women with pregnancy-associated hypertension (P-AH, pre-eclampsia) and compared with values for normotensive women in the third trimester of pregnancyOBmax was significantly lower in women with P-AH compared with normotensive pregnant women, with a trend to higher [Na]i There was a significant (p < 0001) inverse relationship between OBmax and [Na]i Although mean values for ouabain-sensitive rubidium influx in buffer were slightly lower in women with P-AH, this difference was not statistically significant Lowest values were observed in women with proteinuric P-AH There was no inhibition of OSRb influx by homologous plasma in groups of women with any severity of P-AH Such inhibition was seen only in normotensive women with peripheral oedemaP-AH is associated with an abnormality of cellular N

Bereavement And Long Term Morbidity : An Australian Project

Abstract: Spouse-bereaved subjects who had participated in earlier bereavement studies volunteered to allow investigation of their health up to eleven years after the death of their spouse. Re-enrolled controls were also studied over a similar period. Short-term morbidity after bereavement has been researched at intervals since the 1950’s. These reports have generally included non-specific complaints. For the data analysis, morbidity level was assessed by using a derived illness score. Calculating morbidity rates as the number of illnesses incurred during the time of the study ignores the duration of the illness(es) and hence neglects an entire dimension to morbidity. Only five bereaved and six control subjects had died. The small number of deaths precluded a formal analysis of mortality rates. Morbidity results presented in this part pertain to both physical and psychiatric morbidity. Differences were found between bereaved and non-bereaved subjects for their distribution of occupational, financial and medication-related variables.

Femoropopliteal Laser Angioplasty: Initial Clinical Results with Large Probes as "Sole Therapy"

Abstract: Laser-assisted balloon angioplasty has been shown to be effective in the treatment of superficial femoral artery (SFA) occlusive disease.In order to avoid the inherent trauma of balloon angioplasty, 30 patients underwent laser angioplasty of the SFA as "sole therapy." Laser angioplasty was performed using a laser coupled to a 600 micron fiber and a 3.5 mm probe (22-28 watts). Fourteen patients had laser angioplasty for claudication and 16 for limb salvage. The initial success rate was 83% (25/30) (lesion length 2-14 cm). In follow-up extending to nine months, 84% (21/25) of laser angioplastied SFAs have remained patent.By avoiding the disruptive effect on the arterial wall architecture caused by balloon angioplasty, while at the same time ablating and vaporizing more atheromatous material with larger laser probes, the long-term patency rates of laser angioplasty as sole therapy may prove to be superior to those of laser- assisted balloon angioplasty.