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Biomedical subjects

D Ferguson

Publications and source records attributed to D Ferguson.

157 records · Page 9Linked to original sources
PubMedDate not supplied

Supra-aortic arterial stenoses: management with Palmaz balloon-expandable intraluminal stents.

PURPOSE: The authors report on the use of Palmaz balloon-expandable intraluminal metallic stents to supplement conventional balloon angioplasty and to primarily treat a variety of supra-aortic arterial atherosclerotic lesions manifested by claudication or embolic phenomena. PATIENTS AND METHODS: Results from a series of seven patients are reported. Five patients received stents following percutaneous balloon angioplasty (PTA): four patients received five stents for suboptimal initial result of PTA and one patient received one stent for early restenosis following successful PTA. Two patients received three stents primarily: one patient had one stent placed for a highly eccentric innominate lesion and the other patient had two stents placed for an ulcerated nonocclusive subclavian lesion causing blue digits. RESULTS: Treatment produced immediate angiographic or hemodynamic improvement in all seven patients. Clinical follow-up was obtained on all patients (mean, 10 months; range, 3-18 months). One patient had an episode of vertigo after PTA of a right subclavian lesion that resolved after thrombolytic therapy and stent placement. CONCLUSION: The placement of metallic stents in supra-aortic arteries represented an effective adjunct to PTA of atherosclerotic stenoses in these vessels. Primary stent placement may be an effective treatment for selected lesions.

Aged↗
PubMedDate not supplied

Percutaneous transluminal stent placement in the abdominal aorta.

PURPOSE: To retrospectively review and to report the results of stent placement for focal mid-abdominal aortic stenoses. MATERIALS AND METHODS: During a 4-year period, 10 focal mid-abdominal aortic stenoses were treated with stent placement in nine patients (six women and three men; mean age, 61 years; range, 49-73 years). All of the stenoses were atherosclerotic in nature except for one at the proximal anastomosis of an aortobi-femoral graft, which may have been from fibrointimal hyperplasia. Seven of the 10 stenoses were treated with primary stent placement, whereas three were treated with stent placement after suboptimal angioplasty. RESULTS: The technical success rate was 100%. Clinical success, defined as complete elimination or improvement of symptoms present before stent placement, was achieved in eight of the nine patients with a mean duration of follow-up of 1.6 years (range, 0.2-3.0 years). CONCLUSION: In view of the excellent technical and clinical success, the authors believe that stent placement should be considered as an adjective therapy to angioplasty or as a primary method of treatment in properly selected patients with focal mid-abdominal aortic stenoses.

Aged↗
PubMedDate not supplied

The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function.

This article presents the development of a brief, self-report measure of female sexual function. Initial face validity testing of questionnaire items, identified by an expert panel, was followed by a study aimed at further refining the questionnaire. It was administered to 131 normal controls and 128 age-matched subjects with female sexual arousal disorder (FSAD) at five research centers. Based on clinical interpretations of a principal components analysis, a 6-domain structure was identified, which included desire, subjective arousal, lubrication, orgasm, satisfaction, and pain. Overall test-retest reliability coefficients were high for each of the individual domains (r = 0.79 to 0.86) and a high degree of internal consistency was observed (Cronbach's alpha values of 0.82 and higher) Good construct validity was demonstrated by highly significant mean difference scores between the FSAD and control groups for each of the domains (p < or = 0.001). Additionally, divergent validity with a scale of marital satisfaction was observed. These results support the reliability and psychometric (as well as clinical) validity of the Female Sexual Function Index (FSFI) in the assessment of key dimensions of female sexual function in clinical and nonclinical samples. Our findings also suggest important gender differences in the patterning of female sexual function in comparison with similar questionnaire studies in males.

Adult↗
PubMedDate not supplied

Topical alprostadil in the treatment of Female Sexual Arousal Disorder: a pilot study.

This study evaluated the efficacy and safety of three doses of topical alprostadil USP (prostaglandin E1) cream in 8 patients with Female Sexual Arousal Disorder (FSAD). Each patient was administered a single intravaginal dose of placebo followed by escalating intravaginal doses of the active drug at 2-week intervals. Alprostadil's effectiveness in enhancing subjective and physiological arousal during visual sexual stimulation was supported by patient ratings and physician assessments of vaginal erythema and transudate volume. Photoplethysmography measurement of vaginal pulse amplitude was not able to demonstrate treatment sensitivity in the present study. Adverse events included mild cases of vaginal itching and burning. The data support further investigation of the use of alprostadil for FSAD.

Administration, Topical↗
PubMedDate not supplied

Eco-maps: facilitating insight in learning-disabled sex offenders.

The assessment of risk in relation to men who have learning disabilities and who sexually offend can be difficult as innovative means for eliciting information or presenting it to them require careful consideration. A risk assessment model has been designed which introduces an interactive tool called an 'eco-map' as a means of gathering important information from the offender as well as presenting the identified risks. The author explores the use and development of the eco-map from its crude beginnings to its use in practice. The tool enables offenders to rationalize and understand the often complicated concepts which contribute to their behaviour and allows them to be actively involved in the risk assessment process.

Adult↗
PubMedDate not supplied

Breast cancer metastatic phenotype as predicted by histologic tumor markers.

PURPOSE: Two clinical characteristics of the metastatic cancer phenotype are virulence-which reflects the pace of disease growth, clinical manifestation, and dissemination-and metastagenicity, the ultimate likelihood of distant metastasis. Molecular markers may allow distinguishing between these two cancer phenotypes. The purpose of this study is to determine whether proliferating cell nuclear antigen (PCNA) and tumor nuclear grade are markers of virulence or metastagenicity. PATIENTS AND METHODS: PCNA and tumor nuclear grade were determined in patients with extensive follow-up, treated only with mastectomy, for whom archival paraffin-embedded tissue was available. RESULTS: There is no significant difference in long-term disease-free survival (DFS) as a function of PCNA, but after only 5 years of analysis there are significant differences that gradually disappear with further follow-up, reflecting differences in virulence. While the likelihood of recurrence is the same, in patients with high PCNA 80% of disease recurrences become evident in the first 2 to 3 years, whereas in patients with low PCNA it takes more than 10 years for 80% of metastases to become clinically detectable. There was a significant difference in 20-year DFS for nuclear grade 1 compared with nuclear grade 2 and 3 tumors, indicating a difference in metastagenicity. The differences in DFS between nuclear grade 2 and 3 tumors decrease as the length of follow-up increases; thus, like PCNA, these grade differences are also a marker of virulence. Eighty percent of the metastasis became evident within 4 years in grade 3 tumors and within 12 years in grade 2 tumors. DISCUSSION: PCNA and nuclear grade (2 vs 3) are markers of virulence. We have previously shown angiogenesis to be a marker of metastagenicity as is, in this study, the difference between nuclear grade 1 and nuclear grades 2 and 3. Both phenotypic characteristics, virulence and metastagenicity, are important to understanding the natural history of the tumors and may influence the nature of the therapy.

Adult↗