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Biomedical subjects

A M Griffin

Publications and source records attributed to A M Griffin.

At least 19 recordsLinked to original sources
PubMed1996

When the diagnosis is cancer: patient communication experiences and preferences.

BACKGROUND: Discrepancies exist between reported experiences of patients when they have been given a diagnosis of cancer, published guidelines for telling a diagnosis, and patterns of communication patients rate as favorable. Several studies have identified what happened and what is important to cancer patients when told their diagnosis, but no studies have addressed subsequent communications concerning the implications of the diagnosis and treatment choices. This study extended previous research by investigating the experiences and preferences for communication about diagnosis, prognosis, and treatment of patients diagnosed with breast cancer or melanoma. METHODS: A self-report questionnaire was designed for this study based on previous research and qualitative data generated from focus groups. Patients with breast cancer or melanoma answered questions about their experiences with communication at the time of diagnosis and concerning prognosis, treatment and related issues. Comparisons were made between patient experiences, preferences and published guidelines. Differences between the experiences of breast cancer and melanoma patients were tested and the relationship between communication and subsequent psychological adjustment to cancer was assessed. RESULTS: Patient preferences for communication during diagnostic consultation were not always consistent with published guidelines. Type of cancer did not significantly affect patient preferences. Psychological adjustment was related to patient ratings of the quality of doctor discussion about treatment options, but not about the diagnosis of cancer and its implications. Patients who wanted more emotional support at the time of diagnosis subsequently experienced poorer psychological adjustment. CONCLUSIONS: The differences in patient preferences show that a list of prescriptions for how to disclose a cancer diagnosis is too simplistic. Guidelines for clinicians should be derived from patient-based data rather than be limited only to clinical opinion. Guidelines concerning communication at the time of diagnosis also need to address discussions concerning the implications of the diagnosis and making treatment decisions.

Adult↗
PubMed1996

Giant cell tumor of the proximal fibula: surgical management.

Five patients with giant cell tumor of the proximal fibula were treated with intralesional excision of the lesion, preservation of the peroneal nerve, and reconstruction of the lateral collateral ligament. At minimum 24-month follow-up there have been no local recurrences. Four patients exhibit normal function of the peroneal nerve and one has grade 4 strength of the muscles innervated by this nerve. No patient demonstrated varus instability. Marginal excision with nerve preservation and reconstruction of the ligament is a worthwhile procedure for treatment of this relatively uncommon lesion.

Adult↗
PubMed1996

On the receiving end. V: Patient perceptions of the side effects of cancer chemotherapy in 1993.

BACKGROUND: A study conducted in 1983 to identify and rank the symptoms experienced by patients receiving cancer chemotherapy reported that vomiting and nausea were the most important symptoms experienced. With the advent of new antiemetic regimens and changes in cancer chemotherapy, it was anticipated that changes may have occurred in patient perception of symptoms. The study was therefore repeated in 1993. PATIENTS AND METHODS: One hundred and fifty-five cancer patients receiving chemotherapy at a large urban teaching hospital participated in the study. Patients selected from cards listing symptoms all those experienced and the five most troublesome. RESULTS: Patients reported experiencing an average of 20 symptoms (13 physical and 7 psychosocial). Nausea was reported as the most severe symptom followed by tiredness and loss of hair. Vomiting which was the most severe symptom in 1983, now ranked 5th. Differences were detected in the symptoms experienced and reported as most severe, between chemotherapy regimens, between older and younger patients and between males and females. CONCLUSIONS: The results suggest a reduction in the severity of some symptoms experienced while receiving chemotherapy and a shift from concerns about physical to psychosocial issues.

Adult↗
PubMed1995

The effect of intramedullary cement on intercalary allograft reconstruction of bone defects after tumour resection: a pilot study.

OBJECTIVE: A pilot study to evaluate the surgical and functional results of resection and reconstruction of diaphyseal bone tumours with cemented and uncemented intercalary allografts. DESIGN: A retrospective case series. SETTING: A quaternary care unit within a teaching hospital. PATIENTS: Twenty-two patients with diaphyseal bone tumours treated between 1988 and 1992, with mean follow-up of 38 months (range from 20 to 70 months). INTERVENTIONS: Diagnostic biopsy in all patients. Preoperative and postoperative chemotherapy in patients with high-grade sarcoma. En-bloc excision of all tumours. Reconstruction of the defect with cemented (15 patients) or uncemented (7 patients) intercalary allografts. MAIN OUTCOME MEASURES: Nonunion at one or both osteosynthesis sites, death from systemic disease, amputation. RESULTS: Six of the 22 patients died of systemic disease with the graft intact, and 3 subsequently had amputation for either local recurrence (2 patients) or failure of free tissue transfer (1 patient), leaving 13 patients alive with the allograft in situ at an average of 36 months (range from 24 to 64 months). There were no revision procedures to remove or replace the original allograft. Five patients had nonunion at one or more osteosynthesis sites on plain radiographs 9 months after resection. Four patients with nonunion were in the cemented group of 13 patients available for assessment at 9 months, and 1 was in the uncemented group of 5 patients available for assessment at 9 months. There were two graft fractures, both in the uncemented group. CONCLUSION: The results of this pilot study offer guarded support for the use of pressurized cement in allografts prior to reconstruction of intercalary defects.

Adolescent↗
PubMed1994

Genetic analysis of the acetan biosynthetic pathway in Acetobacter xylinum.

We have identified, cloned and sequenced an 8422 base pair fragment of Acetobacter xylinum genomic DNA containing part of the acetan biosynthetic gene cluster. Computer analysis of the nucleotide sequence data generated revealed the presence of six open reading frames. Comparison of the translated sequences of putative genes to the amino acid sequences of genes from other organisms was used to assign functions to the aceA, aceC and manB genes. These genes were predicted to encode a UDP-glycosyl transferase, a GDP-mannosyl transferase and a phosphomannose isomerase/GDP-mannose pyrophosphorylase, respectively.

Bacterial Proteins↗
PubMed1994

The take-home message: patients prefer consultation audiotapes to summary letters.

PURPOSE: Despite reports of poor patient understanding and recall after cancer consultations, few doctors provide communication aids. We conducted a randomized trial comparing an audiotape of the consultation versus individualized summary letters to patients after their first consultation with a medical oncologist. METHODS: One hundred eighty-two cancer patients were randomized to receive either (1) the audiotape followed 7 to 10 days later by the letter or (2) the letter followed by the audiotape. Outcome measures included patient recall, anxiety and depression, satisfaction with and use of the communication aids, and patient preferences for six communication options. Demographic and disease variables and information and involvement preferences were documented. RESULTS: Eighty percent of patients wanted all information and 72% wanted to participate in treatment decisions. Patients listened to the tape on average 2.3 times and read the letter 2.8 times over 4 weeks, and 90% showed the tape or letter to a friend, relative, or doctor. Satisfaction with the tape and letter were uniformly high and they did not differentially affect recall, anxiety, or depression. When asked to rank six communication options, 46% of patients gave the highest rank to the tape and 21% to the letter. CONCLUSION: Patients use audiotapes of their cancer consultation and individualized letters to review the information given and communicate information to relatives and friends. They prefer audiotapes to letters. Clinicians should consider installing audiotape-recording facilities that could be used to tape new-patient consultations.

Adult↗
PubMed1994

Diagnosis and management of sacral bone tumours.

OBJECTIVE: To evaluate the efficacy of current treatment in patients with sacral bone tumours. DESIGN: Retrospective case series. SETTING: A quaternary care unit within a teaching hospital. PATIENTS: Twenty-nine patients with sacral tumours referred to the unit between 1983 and 1991. Follow-up was a minimum of 18 months. INTERVENTIONS: Diagnostic biopsy in all patients. Plain radiography, ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI) and bone scanning. Sacral resection in patients with malignant or aggressive primary bone tumours. MAIN OUTCOME MEASURES: The accuracy of biopsy and local and systemic recurrence of the disease. RESULTS: Symptoms were present for a mean of 12 months to the time of presentation. Low-back pain was present in 28 of 29 patients. Radicular pain and sacral nerve dysfunction were found more often in patients with malignant tumours. Only three patients had altered bowel habits. On rectal examination a mass was palpable in 61% of patients. The sacral abnormality was demonstrated by plain radiography in 6 of 9 cases, by ultrasonography in 2 of 7 cases, by bone scanning in all of 17 cases, by CT in 24 of 25 cases and by MRI in 17 of 18 cases. Fine-needle aspiration biopsy provided the correct diagnosis in only one of four patients. Transrectal biopsy resulted in tethering of the rectum to the tumour in two patients. Core needle biopsy gave an accurate diagnosis in eight of nine patients. Open biopsy was repeated to obtain adequate tissue in 3 of 19 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Neoplasms↗
PubMed1993

DNA sequencing.

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Automation↗
PubMed1993

Plasmid sequencing.

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Bacteriophage M13↗
PubMed1991

Retrospective review of chemotherapy for small cell lung cancer in the elderly: does the end justify the means?

Between 1978 and 1983, 72 patients aged 70 years or older (median 72, range 70-80) were treated for biopsy-proven, small cell lung cancer (SCLC). Intercurrent disorders were common, including ischaemic heart disease, peripheral vascular disease, chronic airflow limitation and second malignancies. 26 patients (36%) had limited extent of disease, and 46 (64%) had extensive disease. "Intensive" chemotherapy incorporating vincristine, cyclophosphamide and doxorubicin (OCA regimen) was administered to 32 patients [complete response (CR) + partial response (PR) = 84%]; less rigorous regimens (e.g. single agent chemotherapy, planned dose reductions, radiotherapy only) were used in 34 cases (CR + PR = 52%); and 6 received no active treatment. In the intensively treated group, there were 3 treatment-related deaths and 26 episodes of WHO grade 3-4 toxicity. In the less intensively treated group, there were no treatment-induced deaths and only 1 episode of severe toxicity. The overall median survival was 25 weeks (36 weeks for intensive treatment, 16 weeks with less intense treatment). For patients with limited disease only, the median survival in each group was 43 and 26 weeks, respectively. Intensive treatment for elderly patients with small cell lung cancer is associated with substantially increased toxicity and higher response rates than for gentle treatment, but without a major survival benefit.

Age Factors↗
PubMed1991

The nucleotide sequence of the glycoprotein gB gene of infectious laryngotracheitis virus: analysis and evolutionary relationship to the homologous gene from other herpesviruses.

A 3698 bp region of the genome of infectious laryngotracheitis virus (ILTV) was sequenced and found to contain the entire glycoprotein gB gene and the C-terminal region of a gene homologous to the ICP 18.5 protein gene of herpes simplex virus type 1. The ILTV gB gene encoded a protein with an Mr of 100K possessing all the characteristics of a transmembrane glycoprotein. Alignment of the ILTV gB sequence with homologous sequences from six other herpesviruses revealed that 10 cysteine residues on the surface of the molecule were completely conserved and that the positions of several N-linked glycosylation sites were largely conserved. Evolutionary trees based on the gB amino acid sequences from a total of 13 herpesviruses were constructed and the relationships among these herpesviruses were examined.

Amino Acid Sequence↗
PubMed1991

Cloning and DNA sequence analysis of the serC-aroA operon from Salmonella gallinarum; evolutionary relationships between the prokaryotic and eukaryotic aroA-encoded enzymes.

The serC-aroA operon of Salmonella gallinarum was isolated from a gene library using a labelled oligonucleotide probe and by complementation of an aroA Escherichia coli strain. The nucleotide sequence of a 2.6 kbp fragment was determined. The predicted amino acid sequence of the aroA gene product was compared to the equivalent sequence from ten other organisms. Computer-generated evolutionary trees clearly divide the eleven sequences into four different groups: Gram-negative bacteria, Gram-positive bacteria, fungi and plants. These trees depict a close evolutionary relationship between the sequences from Gram-negative bacteria and higher plants.

3-Phosphoshikimate 1-Carboxyvinyltransferase↗