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Articles 1 - 30 of 156
Full-Text Articles in Medicine and Health Sciences
Portal And Systemic Haemodynamic Action Of N-Acetylcysteine In Patients With Stable Cirrhosis, Alison Jones, I Bangash, I.A.D Bouchier, P Hayes
Portal And Systemic Haemodynamic Action Of N-Acetylcysteine In Patients With Stable Cirrhosis, Alison Jones, I Bangash, I.A.D Bouchier, P Hayes
Alison L Jones
The effects of intravenous N-acetylcysteine on hepatic and systemic haemodynamics were investigated in 11 patients with stable cirrhosis (eight alcohol; two primary bilary cirrhosis; one cryptogenic). N-acetylcysteine administration had no effect on the mean heart rate or mean arterial blood pressure despite a significant fall in systemic and pulmonary vascular resistance. Cardiac index increased but estimated liver blood flow and portal venous pressure did not change significantly. Administration of N-acetylcysteine resulted in increased oxygen delivery to the tissues because of the increased cardiac index but this was not accompanied by a rise in either arteriovenous oxygen extraction ratio or mean …
Poisoning & Overdose, Alison Jones
Poisoning & Overdose, Alison Jones
Alison L Jones
Many poisoned patients recover without specific management other than supportive care. A minority have life-threatening toxicity. In assessing the poisoned patient It is important to ensure adequate Airway. Breathing and circulation, take an adequate history and undertake a full clinical examination. Tablets, bonles, syringes, aerosol contai"lers and other items found with or near the patient should be retained, although it Is usually best to analyse biological specimens (usually blood andlor urine) if analytical confirmation of exposure Is required.
Hepatocellular Damage Following Amphetamine Intoxication, Alison Jones, D Jarvie, G Mcdermid, A Proudfoot
Hepatocellular Damage Following Amphetamine Intoxication, Alison Jones, D Jarvie, G Mcdermid, A Proudfoot
Alison L Jones
We report two cases of hepatocellular damage after ingestion of amphetamine in one case and both amphetamine and methylenedioxyamphetamine in another case, and postulate possible mechanisms responsible for this.
Ward Rounds: Developing A Collaborative Best Practice Model Of Interdisciplinary Teaching For Multidisciplinary Practice, Patrea Andersen, Noel Tait, Kenneth Walsh, Pauline Gaetani, Alison Jones, Angela Brown
Ward Rounds: Developing A Collaborative Best Practice Model Of Interdisciplinary Teaching For Multidisciplinary Practice, Patrea Andersen, Noel Tait, Kenneth Walsh, Pauline Gaetani, Alison Jones, Angela Brown
Alison L Jones
Ward rounds are an everyday occurrence in clinical practice. They provide the means for assessing patient care needs and communicating these within a multidisciplinary team. The literature demonstrates poor ward round practice contributes to poor patient care outcomes (O'Hare, 2008). Garling (2008) identifies that there is a need to change current practise and facilitate more effective interdisciplinary communication. This presentation reports collaborative research between The Illawarra Shoalhaven Local Health District (ISL HD) and The University of Wollongong. Using a Practice Development methodology, the aim of the research is to develop and test a best practice model for conducting ward rounds …
Progres Recents Dans Le Traitment Des Intoxications Au Paracetamol, Alison Jones, P Lheureux
Progres Recents Dans Le Traitment Des Intoxications Au Paracetamol, Alison Jones, P Lheureux
Alison L Jones
Au Royaume-Uill et aux EtatsUills, Ie parac~tamol est utilise depuis plus de 40 ans comme antalgique de premiere ligne en raison de sa securite d'emploi a dose tMrapeutique. Au RoyaumeUni, il figure parmi les substances les plus sou vent impliquees dans les tentatives de suicide, seul dans la majorite des cas ou en association avec l' alcoo!. En moyenne, six patients intoxiques par cet antalgique sont admis chaque jour a la Poisons Unit de la Royal Infirmary d'Ectimbourg (incidence annuelle 400/100 000 habitants). Parmi eux, 0,02 % vont developper une Mpatite fulminante. Le parac~tamol en est la cause la plus …
Hepatotoxicity, Alison Jones
Hepatotoxicity, Alison Jones
Alison L Jones
Many potentially toxic substances enter the body via the gastrointestinal tract (gut). As the blood supply from the gastrointestinal tract, through the portal vein, drains into the liver, the liver comes into contact with the potentially toxic substances, and this exposure will often be at a higher concentration than that received by other tissues. The liver is essential for the metabolic disposal of virtually all xenobiotics (foreign substances). This process is mostly achieved without injury to the liver itself or to other organs. A few compounds such as carbon tetrachloride are toxic themselves and/or produce metabolites that cause liver injury …
Long-Term Health And Wellbeing Of People Affected By The 2002 Bali Bombing, Garry J. Stevens, Julie C. Dunsmore, Kingsley E. Agho, Melanie R. Taylor, Alison L. Jones, Jason J. Van Ritten, Beverley Raphael
Long-Term Health And Wellbeing Of People Affected By The 2002 Bali Bombing, Garry J. Stevens, Julie C. Dunsmore, Kingsley E. Agho, Melanie R. Taylor, Alison L. Jones, Jason J. Van Ritten, Beverley Raphael
Alison L Jones
Objective: To examine the physical and mental health status of individuals directly affected by the 2002 Bali bombing, 8 years after the incident. Design, setting and participants: Cross-sectional study of people directly exposed to and/or bereaved by the 2002 Bali bombing who had participated in a New South Wales Health therapeutic support program. Telephone interviews were conducted during July - November 2010. The sample was weighted to reflect the population of interest, registered participants in the program (n = 115). Main outcome measures: Self-rated physical health, personal resilience (Connor-Davidson Resilience Scale), past-month psychological distress and daily functioning (Kessler Psychological Distress …
Multiple-Choice Questions In Clinical Gastroenterology, Malcolm Bateson, R Barton, Denis Burke, P Cann, J Cox, Graham Curry, S Ghosh, W Hislop, D Hopwood, D Johnston, Alison Jones, Sarah Jowett, A Macklon, K Matthewson, J O'Donohue, K Palmer, T Reilly, J Rose, Nurani Sivaramakrishnan, Heather Smith, J Stephen, Peter Trewby, John Wilson, R Wood
Multiple-Choice Questions In Clinical Gastroenterology, Malcolm Bateson, R Barton, Denis Burke, P Cann, J Cox, Graham Curry, S Ghosh, W Hislop, D Hopwood, D Johnston, Alison Jones, Sarah Jowett, A Macklon, K Matthewson, J O'Donohue, K Palmer, T Reilly, J Rose, Nurani Sivaramakrishnan, Heather Smith, J Stephen, Peter Trewby, John Wilson, R Wood
Alison L Jones
In the middle of the twelfth century the Scottish Sovereign's rule extended into England north of the River Tees. The territory of this ancient kingdom of CaledonIa is today an area where the National Health Service functions best and academic medicine flourishes. Gastroenterology is particularly strong and so it is especially appropriate that colleagues from north Britain contribute to this collection of multiple-choice questions (MCQs). These MCQs focus on common clinical problems approached in different ways and on recent advances. Many are based on real patients under the clinical care of the authors. Often detailed explanations of the answers are …
Cognitive Skills Underlying Driving In Patients Discharged Following Self-Poisoning With Central Nervous System Depressant Drugs, Tharaka Dassanayake, Patricia Michie, Alison Jones, Trevor Mallard, Ian Whyte, Gregory Carter
Cognitive Skills Underlying Driving In Patients Discharged Following Self-Poisoning With Central Nervous System Depressant Drugs, Tharaka Dassanayake, Patricia Michie, Alison Jones, Trevor Mallard, Ian Whyte, Gregory Carter
Alison L Jones
Background: Central nervous system–depressant (CNS-Ds) drugs can impair cognitive functions and driving. They are also the most common drugs taken in overdose in hospital-treated episodes of self-poisoning. In Australia most of these patients are discharged within 48 h, while they still have possible subclinical drug effects. We aimed to determine whether patients treated for self-poisoning with CNS-Ds are impaired in the Trail-Making Test (TMT, parts A and B), a neuropsychological test that is known to correlate with driving performance. Methods: This study was a conducted from November 2008 to April 2011 in a referral center for poisonings in New South …
What's Your Poison?, Alison Jones, A Good, A Proudfoot
What's Your Poison?, Alison Jones, A Good, A Proudfoot
Alison L Jones
TOXBASE is the database provided by the National Poisons Information Service of the United Kingdom for use by CPs, hospital pharmacists and hospital doctors to provide information on the toxicity, clinical features and up to date management of acute poisoning. The database provides in/ormation on industrial chemicals, pharmaceuticals, pesticides, houselwld products, plants and 'uenomous animals or insects. The foUoUJing article discusses the database's design and development and some of the information technology involved.
Emergency Room Use Of Opioid Antagonists In Drug Intoxication And Overdose, Simon Clarke, Rob Torok, Paul Dargan, Alison Jones
Emergency Room Use Of Opioid Antagonists In Drug Intoxication And Overdose, Simon Clarke, Rob Torok, Paul Dargan, Alison Jones
Alison L Jones
Opioid receptor antagonists are effective at reversing the clinical features of opioid toxicity; however, if administered overenthusiastically, they can precipitate acute withdrawal symptoms (AWS) in regular opioid users. These symptoms may cause the patients to discharge themselves against medical advice and they are in danger of renarcotization either due to the effect of the antagonists wearing off or because of the patients seek further opioids, often in larger doses, to overcome AWS. Clinicians treating opioid overdose are therefore walking a clinical tightrope between undertreating the patient and precipitating AWS. The three opioid antagonists that have been licensed for clinical use …
Perceived Coping & Concern Predict Terrorism Preparedness In Australia, Garry Stevens, Kingsley Agho, Melanie Taylor, Alison L. Jones, Margo Barr, Beverley Raphael
Perceived Coping & Concern Predict Terrorism Preparedness In Australia, Garry Stevens, Kingsley Agho, Melanie Taylor, Alison L. Jones, Margo Barr, Beverley Raphael
Alison L Jones
Background In the aftermath of major terrorist incidents research shows population shifts towards protective behaviours, including specific preparedness and avoidance responses. Less is known about individual preparedness in populations with high assumed threat but limited direct exposure, such as Australia. In this study we aimed to determine whether individuals with high perceived coping and higher concern would show greater preparedness to respond to terrorism threats. Methods Adults in New South Wales (NSW) completed terrorism perception and response questions as part of computer assisted telephone interviews (CATI) in 2010 (N=2038). Responses were weighted against the NSW population. Multiple logistic regression analyses …
An Olfactory 'Stress Test' May Detect Preclinical Alzheimer's Disease, Peter W. Schofield, Houman Ebrahimi, Alison L. Jones, Grant A. Bateman, Sonya R. Murray
An Olfactory 'Stress Test' May Detect Preclinical Alzheimer's Disease, Peter W. Schofield, Houman Ebrahimi, Alison L. Jones, Grant A. Bateman, Sonya R. Murray
Alison L Jones
Background: The olfactory bulb (OB) receives extensive cholinergic input from the basal forebrain and is affected very early in Alzheimer’s disease (AD). We speculated that an olfactory ‘stress test’ (OST), targeting the OB, might be used to unmask incipient AD. We investigated if change in olfactory performance following intranasal atropine was associated with several known antecedents or biomarkers of AD. Methods: We measured change in performance on the University of Pennsylvania Smell Identification Test (UPSIT) in the left nostril before (20-items) and after (remaining 20-items) intranasal administration of 1 mg of atropine. We administered cognitive tests, measured hippocampal volume from …
Uncertain Etiologies Of Proteinuric-Chronic Kidney Disease In Rural Sri Lanka, N.T.C Athuraliya, T.D.J Abeysekera, P Amerasinghe, R.P.V Kumarasiri, P Bandara, U Karunaratne, Abdul Milton, Alison Jones
Uncertain Etiologies Of Proteinuric-Chronic Kidney Disease In Rural Sri Lanka, N.T.C Athuraliya, T.D.J Abeysekera, P Amerasinghe, R.P.V Kumarasiri, P Bandara, U Karunaratne, Abdul Milton, Alison Jones
Alison L Jones
The global prevalence of chronic kidney disease (CKD) of uncertain etiology may be underreported. Community-level epidemiological studies are few due to the lack of national registries and poor focus on the reporting of non-communicable diseases. Here we describe the prevalence of proteinuric-CKD and disease characteristics of three rural populations in the North Central, Central, and Southern Provinces of Sri Lanka. Patients were selected using the random cluster sampling method and those older than 19 years of age were screened for persistent dipstick proteinuria. The prevalence of proteinuric-CKD in the Medawachchiya region (North Central) was 130 of 2600 patients, 68 of …
Developing A Process Of Continuous Quality Improvement In Medical School Assessment Processes: Lessons From One School, Alison Jones, Ian Wilson, Dorothy Keefe
Developing A Process Of Continuous Quality Improvement In Medical School Assessment Processes: Lessons From One School, Alison Jones, Ian Wilson, Dorothy Keefe
Alison L Jones
Introduction: Setting high quality assessments for medical students can be a resource intensive exercise. This study explored the feasibility of coordinating and rationalising the use of expertise to set assessments and to raise the standard of those assessments. Method: A literature review on staff development for assessment was undertaken and the governance structure for assessment design and monitoring in our institution was explored. A manual was developed to outline issues around assessment and processes for improving assessments and this was distributed to key personnel involved in the assessment setting process. A two-day examination setting workshop was organised and evaluated. A …
Relative Safety Of Hyperinsulinaemia/Euglycaemia Therapy In The Management Of Calcium Channel Blocker Overdose: A Prospective Observational Study, S Greene, I Gawarammana, David Wood, Alison Jones, Paul Dargan
Relative Safety Of Hyperinsulinaemia/Euglycaemia Therapy In The Management Of Calcium Channel Blocker Overdose: A Prospective Observational Study, S Greene, I Gawarammana, David Wood, Alison Jones, Paul Dargan
Alison L Jones
Objective: To examine the clinical safety of hyperinsulinaemia/ euglycaemia therapy (HIET) in calcium channel blocker (CCB) poisoning. Design: A prospective observational study examining biochemical and clinical outcomes of a HIET protocol administered under local poisons centre guidance. Setting: Critical care settings. Patients: Seven patients with significant CCB toxicity [systolic blood pressure (BP) < 90 mmHg] treated with HIET. Interventions: HIET was commenced after correction of any pre-existing hypoglycaemia ([blood glucose]< 65 mg/dl) or hypokalaemia ([K+] < 3.5 mmol/l). A quantity of 50 ml of 50% intravenous dextrose was followed by a loading dose (1 unit/kg) of intravenous short-acting insulin and an insulin maintenance infusion (0.5–2.0 units/kg/h). Euglycaemia was maintained using 5–10% dextrose infusions. Potassium was maintained within low normal range (3.8–4.0 mmol/l). Measurements and results: Six patients survived. All patients received fluids, calcium, and conventional inotropes. Three patients (who all ingested diltiazem) received an insulin-loading dose; all experienced a significant sustained rise in systolic BP (> 10 mmHg) during the first hour of HIET. Systolic BP did not increase significantly in four patients who did not receive insulin loading. Single episodes of non-clinically significant biochemical hypoglycaemia and hypokalaemia were recorded in one and two patients respectively. Hypoglycaemia was not recorded in any patient administered …
Acceptance Of Pandemic (H1n1) 2009 Influenza Vaccination By The Australian Public, K Eastwood, D Durrheim, Alison Jones, Michelle Butler
Acceptance Of Pandemic (H1n1) 2009 Influenza Vaccination By The Australian Public, K Eastwood, D Durrheim, Alison Jones, Michelle Butler
Alison L Jones
To investigate the Australian public’s expectations, concerns and willingness to accept vaccination with the pandemic (H1N1) 2009 influenza vaccine. Design, setting and participants: A computer-assisted telephone interview survey was conducted between 20 August and 11 September 2009 by trained professional interviewers to study issues relating to vaccine uptake and perceived safety. The sample comprised 1155 randomly selected representative adults who had participated in a 2007 national study exploring knowledge and perceptions of pandemic influenza. Main outcome measures: Likely acceptance of pandemic (H1N1) 2009 vaccination, factors associated with acceptance, and respondents’ willingness to share Australian vaccine with neighbouring developing countries. Results: …
Paracetamol Poisoning: Can It Be Prevented? , E Norman, R Dhairiwan, Paul I. Dargan, Craig I. Wallace, Alison L. Jones
Paracetamol Poisoning: Can It Be Prevented? , E Norman, R Dhairiwan, Paul I. Dargan, Craig I. Wallace, Alison L. Jones
Alison L Jones
No abstract provided.
Is Cocaine Use Recognised As A Risk Factor For Acute Coronary Syndrome By Doctors In The Uk?, David Wood, Duncan Hill, Awini Gunasekera, S Greene, Alison Jones, Paul Dargan
Is Cocaine Use Recognised As A Risk Factor For Acute Coronary Syndrome By Doctors In The Uk?, David Wood, Duncan Hill, Awini Gunasekera, S Greene, Alison Jones, Paul Dargan
Alison L Jones
Background: Cocaine is a sympathomimetic agent that can cause coronary artery vasospasm leading to myocardial ischaemia, acute coronary syndrome and acute myocardial infarction (ACS/AMI). The management of cocaine-induced ACS/AMI is different to classical atheromatous ACS/MI, because the mechanisms are different. Methods: Knowledge study—Junior medical staff were given a scenario of a patient with ACS and asked to identify potential risk factors for ACS and which ones they routinely asked about in clinical practice. Retrospective study—Retrospective notes reviews of patients with suspected and proven (elevated troponin T concentration) ACS were undertaken to determine the recording of cocaine use/non-use in clinical notes. …
Mercury Contamination Incident, R Maclehose, G Pitt, S Will, Alison Jones, L Duane, S Flaherty, D Hannant, B Stuttard, A Silverwood, K Snee, V Murray, Q Syed, Ivan House, M Bellis
Mercury Contamination Incident, R Maclehose, G Pitt, S Will, Alison Jones, L Duane, S Flaherty, D Hannant, B Stuttard, A Silverwood, K Snee, V Murray, Q Syed, Ivan House, M Bellis
Alison L Jones
No abstract provided.
Haemodynamic Parameters Predicting Variceal Haemorrhage And Survival In Alcoholic Cirrhosis, A Stanley, I Robinson, E Forrest, Alison Jones, P Hayes
Haemodynamic Parameters Predicting Variceal Haemorrhage And Survival In Alcoholic Cirrhosis, A Stanley, I Robinson, E Forrest, Alison Jones, P Hayes
Alison L Jones
No abstract provided.
Benztropine, Alison Jones, Robert Flanagan
Selective Iga Deficiency, Hypothyroidism And Congenital Lymphoedema, Alison Jones, D Webb
Selective Iga Deficiency, Hypothyroidism And Congenital Lymphoedema, Alison Jones, D Webb
Alison L Jones
The occurrence of selective IgA deficiency and hypothyroidism with congenital lymphoedema has never previously been documented, although the association of hypogammaglobulinaemia with congenital lymphoedema has previously been reported and can result in recurrent respiratory infections. We report a 34 year old woman with congenital lymphoedema who was found to have symptomatic autoimmune hypothyroidism and asymptomatic selective IgA deficiency.
Poisoning And Overdose, Alison Jones
Adverse Drug Reactions To Poison Antidotes: Part 1, Alison Jones
Adverse Drug Reactions To Poison Antidotes: Part 1, Alison Jones
Alison L Jones
Summary: The probability of benefit generally outweighs the risk of adverse reactions for antidotes such as N-acetylcysteine used for treatment of paracetamol (acetaminophen) poisoning, and naloxone used in opioid poisoning. For some antidotes, such as dicobalt edetate in cyanide poisoning, administration carries high risk, and the clinical decision to use the antidote is only taken in severe poisoning. Use of an antidote rarely replaces the need for supportive measures. Except for N-acetylcysteine in paracetamol poisoning, the clinical state and not plasma concentration dictates whether an antidote is used. In pregnancy, it is usually reasoned that treatment of the mother takes …
Severity Scores For Poisoned Patients: Reasons And Rationale, A Proudfoot, Alison Jones
Severity Scores For Poisoned Patients: Reasons And Rationale, A Proudfoot, Alison Jones
Alison L Jones
No abstract provided.
Australian Clinical Toxicology Investigators Collaboration Randomized Trial Of Different Loading Infusion Rates Of N-Acetylcysteine [6], I Gawarammana, S Greene, Paul Dargan, Alison Jones
Australian Clinical Toxicology Investigators Collaboration Randomized Trial Of Different Loading Infusion Rates Of N-Acetylcysteine [6], I Gawarammana, S Greene, Paul Dargan, Alison Jones
Alison L Jones
Adverse reactions to N-acetylcysteine are reported in 6% to 23% of patients who are administered the antidote for treatment of paracetamol poisoning.1 Because paracetamol is the most common pharmaceutical product taken in overdose in many countries, it is essential that attempts be made to prevent or minimize adverse effects caused by N-acetylcysteine. We congratulate Kerr et al2 on their attempt to address this important issue.
Antidotes 5. Antidotes To Organophosphorus And Carbamate Anticholinesterases, Robert Flanagan, Alison Jones
Antidotes 5. Antidotes To Organophosphorus And Carbamate Anticholinesterases, Robert Flanagan, Alison Jones
Alison L Jones
No abstract provided.
Immediate Gp Strategies In Cases Of Poisoning, Alison Jones
Immediate Gp Strategies In Cases Of Poisoning, Alison Jones
Alison L Jones
Poisoning is a common problem for GPs. The challenge is to identify 1-2 per cent of patients who have taken enough toxin to be at serious risk and to start appropriate management as early as possible, especially if there is going to be a significant delay in getting them to hospital.
Antidotes 2. Sulphydryl Donors (N-Acetylcysteine, Methionine), Robert Flanagan, Alison Jones
Antidotes 2. Sulphydryl Donors (N-Acetylcysteine, Methionine), Robert Flanagan, Alison Jones
Alison L Jones
No abstract provided.