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Biomedical subjects

D Barlow

Publications and source records attributed to D Barlow.

At least 73 records · Page 4Linked to original sources
PubMed1996

Gonorrhoea in men: clinical and diagnostic aspects.

AIM: To review the features of gonococcal infection in men in the 1990s. METHODS: A retrospective study of all men with gonorrhoea presenting to an inner city department of genitourinary medicine in the years 1990 to 1992. RESULTS: 1749 cases of gonorrhoea were seen in 1382 men. A high incidence of gonorrhoea was found in attenders of African or Caribbean extraction. In 228 men with a known date of infection, the incubation period, a mean of 8.3 days, was longer than previously described. The mean infectious period was 12.0 days. By 14 days 86.2% of men had developed symptoms. Of 1615 men with urethral infection 81.9% complained of discharge, while dysuria occurred in 52.8%. Discharge with dysuria were present in only 48.1% of patients. In 10.2% episodes of urethral infection the patients had no symptoms referable to their gonorrhoea. Urethral gonorrhoea was diagnosed by microscopy in 94.4% of symptomatic men and in only 81.1% of asymptomatic men. Microscopy of rectal samples were positive in 46.4% of cases. In this population, a dose of 2 g of ampicillin with 1 g of probenecid gave a high cure rate of gonorrhoea as long as infection was not due to penicillinase-producing organisms. CONCLUSIONS: These data suggest that the incubation and infectious period of urethral gonorrhoea has increased compared with previous studies and that symptoms have altered. Only 48.1% of men described the classical symptoms of discharge with dysuria. Microscopy of urethral smears remains useful in symptomatic men but is less sensitive in those without symptoms.

Adolescent↗
PubMed1996

Men with repeated episodes of gonorrhoea 1990-1992.

Patients who acquire repeated infections of gonorrhoea are well described. A study was undertaken of male patients attending a central London clinic in an attempt to identify features of those acquiring repeated infections to facilitate risk reduction strategies. During the 3 years 1990 to 1992, 18.8% of patients contributed 35.8% of episodes with a mean time between episodes of 10.5 weeks. Those with repeat infections were more likely to be black and to have had more than one episode of gonorrhoea prior to the study period. They are also more likely to have had 3 or more recent partners. While those with repeated infections do not form a homogeneous group there are certain characteristics that should enable targeting of a subgroup.

Adult↗
PubMed1996

Hysterosalpingo-contrast sonography (HyCoSy) using Echovist-200 in the outpatient investigation of infertility patients.

This study describes the introduction of hysterosalpingo-contrast sonography (HyCoSy) as a first line outpatient investigation of uterine and tubal factors in two fertility units. 136 infertile women had transvaginal scanning before and during the intrauterine injection of contrast medium (Echovist-200). HyCoSy was successfully completed in 132 cases (97%) within a mean time of 12.6 +/- 8.4 (4-50) min. The uterus and its cavity appeared normal in 108 (82%) women. Uterine abnormalities in the remaining 24 women (18%) included structural abnormality (n = 7), fibroids (n = 12) and endometrial polyps (n = 5). A total of 261 fallopian tubes in 132 women were assessed: 186 (71%) appeared patent and 55 (21%) blocked. The remaining 20 (8%) could not be assessed for technical reasons. Polycystic ovaries and ovarian cysts were diagnosed in eight women. The most common adverse effect was mild/moderate pain, similar to period pain, with 24 (18%) women requiring simple analgesia. HyCoSy is a simple and well tolerated outpatient procedure. The technique provides clinically valuable information about tubal patency, ovarian and uterine abnormalities.

Ambulatory Care↗
PubMed1996

A self-care assessment tool (SCAT) for persons with a spinal cord injury: an expanded abstract.

The purpose of this study was to develop a reliable and valid tool that assesses the cognitive and functional skills needed for self-care in persons with spinal cord injury (SCI). The Self-Care Assessment Tool (SCAT) assesses cognitive and functional skills in eight self-care areas: bathing/grooming, nutritional management, medications, mobility/transfers/safety, skin management, bladder management, bowel management and dressing. The tool was carefully developed and has demonstrated content validity. Using two samples of veterans seen in the SCI clinics of two Southern Veterans Affairs Medical Centers, n = 13 and n = 15, interrater reliabilities computed by Pearson product moment correlations for the cognitive, functional and total scores ranged from .69 to .94. Test-retest reliabilities using Pearson product moment correlations for the cognitive, functional and total scores of two groups (n = 14 and n = 15) ranged from -.06 to .86. Regarding predictive validity, R2 was found to be .61 to .90 for the cognitive, functional and total scores. Although continued reliability and validity studies are needed, the SCAT has potential to measure patient rehabilitation outcomes, to evaluate nursing care approaches and to serve as a quality assurance indicator for nursing care.

Activities of Daily Living↗
PubMed1995

Familial endometriosis.

PURPOSE: The study aimed to identify families with endometriosis and to document disease severity within the families and the clinical characteristics of the affected women. RESULTS: Two hundred and thirty women with surgically confirmed endometriosis in 100 families were identified. The families consisted of 19 mother-daughter pairs, 1 set of cousins and 56 sister pairs. There were 5 families with 3 affected sisters, 1 family with 5 affected sisters, and 18 families with > or = 3 affected members in more than one generation. The mean age at the onset of symptoms and the mean age at surgical diagnosis was 22.1 +/- 8.8 SD (range 10-46) and 31.8 +/- 7.9 SD (range 15-56) years respectively. Seventy-nine women (34.3%) had revised AFS Stage I-II disease, and 151 (65.7%) had revised AFS Stage III-IV disease. CONCLUSION: The study confirms a familial tendency for endometriosis and supports the hypothesis that endometriosis has a genetic basis.

Australia↗
PubMed1995

Cyclical breast pain and swelling in relation to differing patterns of suppression of ovarian activity with the luteinizing hormone-releasing hormone analogue buserelin acetate: case report.

The presenting complaints of an amenorrhoeic (after hysterectomy with ovarian preservation) woman were cyclical breast pain and swelling. These showed synchronicity with fluctuations in E2 levels. Both ovarian activity and symptoms initially responded to (after lag periods of approximately 40 days) daily SC injections of the LH-RH analogue buserelin acetate. After a break in treatment, the interval between reinitiation of therapy and suppression of E2 levels was prolonged markedly, ovarian function being apparently resistant even to very large doses of the analogue.

Breast Diseases↗
PubMed1995

16S rRNA sequence analysis of an isolate of Mycobacterium haemophilum from a heart transplant patient.

Biopsy samples from a heart transplant patient with cellulitis and bursitis yielded an isolate of Mycobacterium haemophilum. The isolate was identified on the basis of a growth requirement for haemin or ferric ammonium citrate, growth at 30 degrees C but not at 37 degrees C, negative catalase test, intracellular growth in McCoy fibroblasts and sequence identify with a portion of the 16S rRNA sequence of the type strain. In comparisons with known 16S rRNA sequences, M. haemophilum grouped with other pathogenic, slow-growing mycobacteria, showing close sequence similarity to M. marinum (98.8%) and lower similarity to M. ulcerans and M. tuberculosis complex organisms. M. haemophilum and M. marium share other features including optimal growth at 30 degrees C and the ability to cause superficial skin lesions in man.

Base Sequence↗
PubMed1994

Subsyndromal ("mixed") anxiety--depression in primary care.

OBJECTIVE: To determine in primary care settings the prevalence, clinical characteristics, and functional status of patients who have anxious and depressive symptoms who did not meet diagnostic criteria for major mood and anxiety diagnoses. DESIGN: Patients were screened with the General Health Questionnaire and interviewed if they exceeded the cutoff score of 5. Also, one patient whose score was below the cutoff was interviewed for every two patients whose scores were above the cutoff. SETTING: Five primary care sites in the United States, France, and Australia. PATIENT: Two hundred sixty-seven patients presenting to their primary care physicians for general medical care and follow-up. METHODS: Structured diagnostic interviews were conducted and ratings of anxiety, depression, and functional impairment were obtained by trained interviewers. RESULTS: After adjustments for sampling, 5% of the patients had symptoms of anxiety, depression, and functional impairment, without meeting formal criteria for a major DSM-III-R mood or anxiety disorder. This was comparable to the prevalence of diagnosable DSM-III-R mood disorders but only one-fourth the prevalence of diagnosable anxiety disorders. These patients who had subsyndromal symptoms had rates of lifetime psychiatric disorders and prior psychiatric treatment comparable to those of patients meeting criteria for major mood and anxiety disorders. CONCLUSION: The comparable rates of symptomatic distress, functional impairment, and prior psychiatric illness and treatment suggest that patients with subsyndromal anxiety and depressive symptoms warrant clinical recognition and possibly specific treatment.

Anxiety↗
PubMed1994

Structure-activity relationships in the formation of amides from substituted N-benzylanilines.

1. The in vitro hepatic microsomal metabolism of certain substituted N-benzylanilines was studied in the male hamster to establish the mechanism(s) and process(es) involved in the formation of the corresponding amides. 2. N-Benzyl-2,4,6-trihalogeno, N-benzyl-4-cyano- and N-benzyl-4-nitroanilines were only metabolized by N-debenzylation. However, N-benzyl-4-methyl- and N-benzyl-2,4,6-trimethylanilines gave rise to both the corresponding amide and nitrone metabolites together with dealkylation products. These latter two substrates also produced hydroxymethyl metabolites as major products. Metabolism of N-(2,4,6,-trimethylbenzyl)aniline also led to the formation of an amide metabolite. The dealkylation products, the corresponding imine and an unknown metabolite, probably an hydroxylated product were also detected with this substrate. 3. N-(2,4-Dichlorobenzyl) and N-(2,6-dichlorobenzyl) anilines yielded the corresponding nitrone metabolites; but no amide metabolite was detected. Oxidative dealkylation leading to the formation of the corresponding primary anilines and aldehydes, together with para hydroxylation of aniline rings, were established as major routes of metabolism for both compounds. Similarly, neither N-(2,4,6-trifluorobenzyl) nor N-(4-nitrobenzyl) anilines produced any amide metabolite although dealkylation products were detected. 4. The pattern of amide formation observed for these N-benzylsubstituted anilines is discussed in terms of the steric and electronic effects of their aromatic substituents.

Amides↗
PubMed1993

Measuring the impact of menopausal symptoms on quality of life.

OBJECTIVE: To examine the impact of menopausal symptoms on the overall quality of life of women. DESIGN: Data collection with a questionnaire administered by an interviewer, incorporating two different quality of life measurement techniques (time trade off and rating scale). SETTING: Specialist menopause clinic and two general practices in Oxford. SUBJECTS: 63 women aged 45-60 years recruited opportunistically during a clinic or appointment with a general practitioner; no exclusion criteria. RESULTS: Subjects gave very low quality of life ratings for health states with menopausal symptoms. The time trade off method of measuring preferences for these health states (on a scale from 0 to 1, where preference for full health is given as 1) yielded utility values of 0.64 for severe menopausal symptoms and 0.85 for mild symptoms. The rating scale measurement technique yielded even lower values: utilities of 0.30 and 0.65 were obtained for severe and mild symptoms respectively. Kappa scores indicated that the two methods produced results that were poorly related but not contradictory. Comparison of quality of life ratings before and after treatment with hormone replacement therapy showed significant improvements: with the rating scale measurement technique mean increases in utility values after the relief of severe and mild menopausal symptoms were 0.56 and 0.18 respectively. CONCLUSIONS: Quality of life may be severely compromised in women with menopausal symptoms, and perceived improvements in quality of life in users of hormone replacement therapy seem to be substantial. This emphasises the need to include quality of life measurements when assessing outcomes of hormone replacement therapy. Several limitations may exist with widely applied measurement techniques, calling for the development of appropriate and well validated instruments for measuring quality of life associated with reduced health states.

Data Collection↗
PubMed1993

Gonorrhoea in men.

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Black or African American↗