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Biomedical subjects

A Riley

Publications and source records attributed to A Riley.

At least 19 recordsLinked to original sources
PubMed2006

Treatment of premature ejaculation.

Premature ejaculation (PE) is a common problem, the treatment of which has received an increasing interest in recent years. Traditional management continues to be psychotherapy, with techniques such as the 'squeeze' and 'stop-start' most commonly employed. The application of local anaesthetics to the glans to delay ejaculation, first described over 60 years ago, continues to be used both in medical practice and as an 'over-the-counter' remedy. Over the years, a variety of psychopharmacological agents, especially antidepressants, have been described as treatments for PE. At the present time, the selective serotonin re-uptake inhibitors, licensed for other indications, emerge as the most effective agents to delay ejaculation, but none are licensed for the treatment of PE. There appears to be a high relapse rate irrespective of the mode of therapy used.

Anesthetics, Local↗
PubMed2005

Premature ejaculation: presentation and associations. An audit of patients attending a sexual problems clinic.

The diagnostic register and case summaries of all male and female patients who attended the clinic on account of one or more sexual symptoms or relationship problems between 1 January 1992 and 31 December 1997 were reviewed. The index symptom or problem was considered the complaint that caused the patient most concern. When patients or couples were experiencing more than one sexual problem, the concomitant problems were tabulated against the index symptom. During this period, 1,056 (440 men and 616 women) patients with sexual symptoms were seen and 131 couples attended primarily with relationship problems. Overall, 18.2% of men referred to the clinic with sexual problems had premature ejaculation (PE), but this was the index symptom in only 11.6% of men. There was a high occurrence of PE in the partners of women presenting with sexual symptoms. Among couples presenting with relationship dissatisfaction or conflict, 18.3% of the male partners had ongoing PE.

Ejaculation↗
PubMed2004

[Cross-cultural adaptation of the Spanish version of the Child Health and Illness Profile, Child Edition (CHIP-CE)].

OBJECTIVES: To obtain a Spanish version of the CHIP-CE semantically and culturally equivalent to the original version. METHOD: The methodology used was based on the forward-backward method. Two translations into Spanish were performed. After the first reconciled version, 44 cognitive interviews were carried out with children aged 6-11 years old, selected from two schools in Barcelona. The interviews were recorded and transcribed. A qualitative content analysis of the textual data was carried out. A panel of experts developed the second reconciled version taking into account the children's comments. A back-translation into English was carried out and was compared with the original version. RESULTS: Of a total of 45 items induced in the first reconciled version, 21 were considered equivalent, 23 required changes and 1 was considered not equivalent. Comprehension of abstract concepts differed according to age. Older children differentiated among concepts and gave different examples of experiences related to these concepts, while younger children (6 to 7-year olds) provided similar examples for different concepts. The children's comments were used in the reformulation of the items. An illustrative figure reinforced understanding. Children aged 7 or more started to use an adequate recall period and used the response options correctly. CONCLUSIONS: The Spanish version of the CHIP-CE seems appropriate for children aged 6-11 in Spain. The present study shows that children from the age of 6 years onwards are able to describe the health concepts included in the CHIP-CE.

Child↗
PubMed2003

Timing of menopause and patterns of menstrual bleeding.

Age at menopause is associated with a variety of health outcomes. Menstrual histories, both as markers of physiologic function and through their potential association with age at menopause, have also been investigated for their links to health outcomes. This study used data from a cohort of women from the United States who provided prospectively recorded data on their menstrual cycles for many years. Dr. Alan Treloar (University of Minnesota) originally recruited the women in the 1930s; the authors used data reported by these women from 1930 through 1977. They identified nuanced characteristics of menstrual histories that were strongly predictive of the onset of menopause, focusing on measures of central tendency (the mean), variability (standard deviation), and serial irregularity (approximate entropy), the last of which quantifies a continuum that ranges from totally ordered to completely random. They controlled for other characteristics known to affect age at menopause, including use of exogenous hormones, number of births, and extent of breastfeeding. Although cycle length and variability increased with the approach of menopause, the authors found that serial irregularity decreased and was a strong predictor of its onset. This finding constitutes an important piece of information not attainable with conventional statistical summaries of menstrual histories.

Adolescent↗
PubMed2002

Characterisation of the expression of a novel constitutive maize promoter in transgenic wheat and maize.

A novel constitutive promoter from the maize histone H2Bgene was recently identified. In this study, we characterised H2B promoter activity in both wheat and maize tissues using the gusA reporter gene and two synthetic versions of the pat (phosphinothricin acetyl transferase) selectable marker gene, namely mopat and popat. Analyses of transgenic plants showed that the H2B promoter is able to drive the expression of gusA to strong, constitutive levels in wheat and maize tissues. Using an H2B:mopat construct and phosphinothricin selection, we recovered transgenic wheat plants at efficiencies ranging from 0.3% to 7.4% (mean 1.6%), and the efficiency of selection ranged from 40% to 100% (mean 77.7%). In another application, H2B was combined with the maize Ubi-1 or the maize Adh-1 intron to drive the expression of mopat and popat. Transformation efficiencies with the Ubi-1 intron were between 1.4- to 16-fold greater than with the Adh-1 intron. However, the use of either of the introns was necessary for the recovery of transgenic plants. Mopat gave higher transformation efficiencies and induced higher levels of PAT protein in maize tissues than popat.

Acetyltransferases↗
PubMed2002

Antidepressant medications: a review of the evidence for drug-induced sexual dysfunction.

BACKGROUND: Sexual dysfunction is recognised as a potential side effect of antidepressant therapy. However, there is little detailed information on the prevalence of drug-induced sexual dysfunction or the differences, if any, between available drugs. This article is a critical review of the literature in the area. METHODS: English-language studies on sexual dysfunction and depression or antidepressant treatments were identified by searching Medline and supplemented by manual review of their reference lists and recent journal issues available in a library. Trials of antidepressant use in anxiety disorders were identified from a Medline search and their adverse events tables scanned for data on sexual dysfunction. All trials were assessed according to predefined criteria. RESULTS: Sexual dysfunction is widespread in the healthy non-depressed population and is a recognised symptom of depression and/or anxiety disorders. Sexual dysfunction has been reported with all classes of antidepressants (MAOIs, TCAs, SSRIs, SNRIs and newer antidepressants) in patients with depression and various anxiety disorders. Numerous studies have been published, but only one used a validated sexual function rating scale and most lacked either a baseline or a placebo control or both. None met all of the pre-defined assessment criteria. LIMITATIONS: The search techniques may have missed some studies and publication bias cannot be ruled out. CONCLUSIONS: The existing literature confirms sexual dysfunction as a possible adverse event of all antidepressants, but it is not sufficiently robust to support claims for differences in the incidence of drug-induced sexual dysfunctions between existing antidepressant therapies. Prescribing decisions should be based on a careful assessment of the benefits and risks of therapy in the individual patient.

Adult↗
PubMed2002

The role of the partner in erectile dysfunction and its treatment.

Advances in pharmacological, mechanical, and surgical treatment for erectile dysfunction (ED) now allow erectile function to be re-established in most men who experience this problem. However, re-establishing erectile function and re-establishing a satisfying sexual interaction with a partner are totally different objectives, and when the latter is not met, the man may re-present with treatment failure or withdraw from treatment altogether. All nontalking therapies focus on the penis as the dysfunctional element, and all too often clinicians fail to appreciate that ED can result from problems in the patient's partner and/or difficulties in their relationship. This article examines the role of the partner in the etiology, assessment, and treatment of ED.

Erectile Dysfunction↗
PubMed2002

A systematic approach to erectile dysfunction in the cardiovascular patient: a Consensus Statement--update 2002.

Sexual activity is no more stressful to the heart when compared with a number of other natural daily activities, e.g. walking one mile on the level in 20 minutes. The cardiac risk of sexual activity in patients diagnosed with cardiovascular disease is minimal in properly assessed and advised patients. Erectile dysfunction (ED) is extremely common, affecting over half of men aged 40-70 years, and increases in frequency with age. ED and cardiovascular disease share many of the same risk factors and commonly coexist. ED in the otherwise asymptomatic man may be a marker for underlying coronary artery disease. ED in the diagnosed cardiovascular patient should be identified by routine questioning in general practice. Modern therapies can restore a sexual relationship in the majority of patients with ED and can lead to a substantial improvement in quality of life. The majority of patients assessed to be at low or intermediate cardiac risk, as defined later in this paper, can be effectively managed in primary care. Primary care treatment for ED in patients defined as high risk can be initiated following a specialist opinion and/or confirmation that the patient's cardiovascular condition is stabilised. There is no evidence that currently licensed treatments for ED add to the overall cardiovascular risk in patients with or without diagnosed cardiovascular disease. If one form of therapy is not effective, follow-up will identify the need for alternative approaches. The pro-active management of ED in the cardiovascular patient provides an ideal and effective opportunity to address other cardiovascular risk factors and improve treatment outcomes.

Activities of Daily Living↗
PubMed2001

The effects of regular source of care and health need on medical care use among rural adolescents.

OBJECTIVE: To examine those factors associated with the use of different types of ambulatory health services in a rural adolescent population. METHODS: The student bodies of 2 middle schools and 2 high schools in rural areas in a mid Atlantic state (N = 1615) were surveyed using a self-administered health status and health services use instrument. Logistic regression was used to assess factors predicting receipt of (1) preventive services, (2) problem-focused services, and (3) emergency services. RESULTS: One third of the rural youth reported having received preventive services within the previous 3 months; 41% received problem-focused care, and 18% received emergency services. Having the same provider for both preventive and illness care was the most consistent and significant predictor of receipt for all types of ambulatory services. Of special note is the greater use of emergency services when subjects did not have a consistent provider for both preventive and illness care. Health need variables, measured across a wide range of domains, were additionally predictive, and their significance varied according to the type of services received. CONCLUSIONS: This study provides compelling evidence that for rural adolescents, having a regular source of care and medical need are the most important predictors of use across a variety of types of ambulatory care.

Adolescent↗
PubMed2001

Epidemiological investigation of the central Scotland outbreak of Escherichia coli O157 infection, November to December 1996.

On Friday, 22 November 1996, the microbiologist at a hospital in Lanarkshire, Scotland, identified presumptive Escherichia coli O157 in faecal specimens submitted by three patients with bloody diarrhoea, and confirmed its presence in one. Over the next 6 h, 12 more potential cases were identified. Investigations first indicated then confirmed a single food premises as the source of infection. Effective control measures were applied promptly. The outbreak was declared over on 20 January 1997, by which time 512 cases had been identified, and infection with the outbreak strain confirmed in 279. Twenty deaths occurred in cases during the outbreak and there were two more in cases during 1997. Seventeen of these deaths resulted from the outbreak. This paper describes the outbreak's epidemiological investigation, referring to other investigations, and control measures, where appropriate.

Adolescent↗
PubMed2001

Elementary school-aged children's reports of their health: a cognitive interviewing study.

There are no standard methods for assessing the quality of young children's perceptions of their health and well-being and their ability to comprehend the tasks involved in reporting their health. This research involved three cross-sectional studies using cognitive interviews of 5-11-year-old children (N = 114) to determine their ability to respond to various presentations of pictorially illustrated questions about their health. The samples had a predominance of children in the 5-7-year-old range and families of lower and middle socio-economic status. The research questions in Study 1 involved children's ability to convert their health experiences into scaled responses and relate them to illustrated items (n = 35); Study 2 focused on the type of response format most effectively used by children (n = 19); and Study 3 involved testing children's understanding of health-related terms and use of a specific recall period (n = 60). The results of Study 1 showed that children identified with the cartoon drawing of a child depicted in the illustrated items, typically responding that the child was at or near their own age and of the same gender, with no differences related to race. Study 2 results indicated that children responded effectively to circles of graduated sizes to indicate their response and preferred them to same-size circles or a visual analogue scale. Tests of three-, four-, and five-point response formats demonstrated that children could use them all without confusion. In Study 3, expected age-related differences in understanding were obtained. In fact, the 5-year-old children were unable to understand a sufficient number of items to adequately describe their health. Virtually all children 8 years of age and older were able to fully understand the key terms and presentation of items, used the full five-point range of response options, and accurately used a 4-week recall period. Six- and seven-year-olds were more likely than older children to use only the extreme and middle responses on a five-point scale. No pattern of gender differences in understanding or in use of response options was found. We conclude that children as young as eight are able to report on all aspects of their health experiences and can use a five-point response format. Children aged 6-7 had difficulty with some health-related terms and tended to use extreme responses, but they understood the basic task requirements and were able to report on their health experiences. These results provide the guidance needed to develop and test a pediatric health status questionnaire for children 6-11 years old.

Analysis of Variance↗
PubMed2001

Procedures allowing the transformation of a range of European elite wheat (Triticum aestivum L.) varieties via particle bombardment.

Ten current European wheat varieties were transformed at efficiencies ranging from 1-17% (mean 4% across varieties) following modifications in particle bombardment and tissue culture procedures. All plants surviving phosphinothricin selection were screened for uidA and bar gene activity, and for the presence of marker gene sequences by PCR analysis. A minimum of 35% plant 'escape' frequency was achieved with selection on 4 mg l(-1) gluphosinate ammonium after shoot initiation. Mean co-transformation frequency with various genes-of-interest was 66%. The estimated number of insertions of the uidA gene in 25 lines were; 1-2 in 32%, 3-5 in 52%, and 6-8 in 16% of lines. In T(1) progenies, marker genes segregated in a Mendelian fashion in 50% of 39 lines analysed, as determined by transgene activity assays. Based on PCR analysis, it appeared that in some lines the occurrence of distorted segregation was due to poor transmission of the transgenes.

Base Sequence↗
PubMed2001

The use of telepsychiatry in the brief counselling of non-psychotic patients from an inner-London general practice.

Brief counselling of 13 non-psychotic patients was carried out using an interactive television link, in order to assess patient satisfaction with this technique. Informed consent was obtained from all patients before the videoconferencing sessions, which were conducted at 128 kbit/s. Over the four-month study period, 11 men and two women participated in a total of 29 sessions. A total of 28 questionnaires were completed. After the sessions, 93% of patients agreed that they would like to use this medium for communication again, 75% stated that they were able to see everything that they needed to see and 86% agreed that they were able to hear everything they needed to hear. Overall, these findings indicate that patients were happy with the standard of care they received.

Female↗
PubMed2000

Sequence and analysis of chromosome 5 of the plant Arabidopsis thaliana.

The genome of the model plant Arabidopsis thaliana has been sequenced by an international collaboration, The Arabidopsis Genome Initiative. Here we report the complete sequence of chromosome 5. This chromosome is 26 megabases long; it is the second largest Arabidopsis chromosome and represents 21% of the sequenced regions of the genome. The sequence of chromosomes 2 and 4 have been reported previously and that of chromosomes 1 and 3, together with an analysis of the complete genome sequence, are reported in this issue. Analysis of the sequence of chromosome 5 yields further insights into centromere structure and the sequence determinants of heterochromatin condensation. The 5,874 genes encoded on chromosome 5 reveal several new functions in plants, and the patterns of gene organization provide insights into the mechanisms and extent of genome evolution in plants.

Animals↗
PubMed2000

Behavioural and clinical findings in couples where the man presents with erectile disorder: a retrospective study.

Relevant data were extracted from the case records of a consecutive series of 128 men (median age 57 years) who presented with erectile disorder and whose partners (median age 54 years) attended on the first or second consultation. The case records included responses to questionnaires addressing issues relating to sexual behaviour, used routinely in the clinic. Of these partners, 123 agreed to be clinically examined, including pelvic examination. The duration of erectile disorder ranged from less than one year to 40 years. Only about 10% of couples had experienced sexual kissing and/or caressing in the four weeks before presentation. Almost half the couples had not experienced any sexual activity for about 2.5 years. While 83.7% of men considered intercourse to be important to themselves, only 20.2% of the women rated intercourse somewhat or very important. Clinical evidence of urogenital atrophy was present in 33.3% of women over the age of 46 years. Three women had a vaginismic response to examination in the clinic and one of these women reported long term vaginismus pre-dating the onset of her partner's erectile disorder. One case of malignant ovarian tumour was identified. The observations from this study demonstrate the need to involve the partner in the assessment process of men presenting with erectile disorder.

Adult↗