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Biomedical subjects

D J Hole

Publications and source records attributed to D J Hole.

104 records · Page 6Linked to original sources
PubMed1982

Bacteriuria in patients undergoing prostatectomy.

A review of the literature revealed that the reported incidence of bacteriuria arising before and after prostatectomy varied considerably, that there had been little investigation of the organisms isolated, and that the value of chemoprophylaxis at the time of prostatectomy was unproven. Using standard criteria and technical procedures, 248 patients undergoing prostatectomy were studied over a two-and-a-half-year period. Preoperative bacteriuria occurred in 28% of patients. The incidence was significantly increased in patients catheterised before operation (44%) compared with those who had not been catheterised (18%). The incidence of bacteriuria was directly related to the duration of catheter drainage. Postoperatively, 40% of patients with sterile urine at the time of prostatectomy developed bacteriuria. There was an increased prevalence of Enterococcus and coagulase-negative Staphylococcus isolates from postprostatectomy bacteriuria compared with preprostatectomy bacteriuria. Based on this information, suggestions can be made regarding the choice of a suitable chemoprophylactic agent and the optimum timing and duration of its administration.

Anti-Bacterial Agents↗
PubMed1982

Morphological characteristics and distribution patterns of epithelial cells in the cytological diagnosis of gastric cancer.

The morphological features of epithelial cells in gastric biopsy touch smears from 296 cases (248 benign, 48 malignant) were retrospectively reviewed. By subjective criteria no single purely morphological characteristic could be identified that was consistently capable of separating benign from malignant specimens. The value of cell distribution patterns in diagnosis was therefore objectively analysed in the 231 adequate specimens (190 benign, 41 malignant). A score of over 20% for single epithelial cells was found to have a sensitivity of 95.1% and specificity of 99.5% in the diagnosis of carcinoma. Quantitative analysis of cell distribution pattern is a simple test, which does not require special equipment, yet can be helpful in the interpretation of gastric cytology.

Cytodiagnosis↗
PubMed1982

Autologous x-irradiated tumour cells and percutaneous BCG in operable lung cancer.

To determine the value of specific immunotherapy with adjuvant BCG in operable lung cancer, the immunological and clinical results of serial postoperative injections of autologous irradiated tumour cells and BCG were compared with those of a single preoperative injection of BCG in two randomly selected groups of patients undergoing resection of their tumours. There was a significant rise in tuberculin skin reactivity from seven weeks to 11 months after operation in the treated group. Actuarial curves for survival and freedom from tumour recurrence and median survival times showed an advantage for the treated patients who had stage I tumours, but these differences were significant only at the levels p = 0.07 - 0.09. Survival and duration of freedom from tumour recurrence was greater in autograft-treated patients whose skin responded to a weak test dose of dinitrochlorobenzene (DNCB) after sensitisation with 2% DNCB than in control DNCB-positive patients (p = 0.02). There were no significant differences in the actual proportion of patients from each group surviving at two years. The results show that this form of specific immunotherapy with adjuvant may have a beneficial effect in patients with stage I tumours and those who become sensitised to 2% DNCB after the first exposure.

Aged↗
PubMed1980

48-hour cephradine and post-prostatectomy bacteriuria.

In a randomised, controlled trial of intramuscular cephradine given in a dose of 1 g 6-hourly for 48 h, there was a significant reduction in the incidence of significant bacteriuria after transurethral resection. In contrast, the incidence of significant bacteriuria after open prostatectomy was unchanged. Post-operative complications were reduced in patients who received cephradine. The use of short-term cephradine would appear to be justified.

Aged↗
PubMed1979

Cell-mediated immunity in operable bronchial carcinoma: the effect of injecting irradiated autologous tumour cells and BCG.

In 52 patients undergoing tests of cell-mediated immunity before surgical resection of bronchial carcinoma a positive tuberculin test result was found in 71% compared with 68% of age- and sex-matched controls. Sensitisation to DNCB occurred in 52% of 37 patients but in 78% of controls. There was depression of lymphocyte transformation by PPD in 19 patients compared with controls (P=0.001), but there was no difference in lymphocyte transformation by PHA or pokeweed mitogen between 34 patients and controls. In a pilot study patients were randomly allocated to autograft (eight) or non-autograft (seven) groups. The autograft group were given an intradermal injection of a suspension of irradiated autologous tumour-cells mixed with intradermal BCG on the day of operation. Tests of cell-mediated immunity were repeated two weeks after operation. Five patients in each group received a course of radiotherapy to the mediastinum three weeks after operation. There was a rise in cutaneous tuberculin reactivity (P=0.08) and total leucocyte count (P=0.09) in the autograft group postoperatively with a fall in total lymphocyte and T lymphocyte counts in the non-autograft group (P less 0.05). These differences, however, were not followed by any difference in the frequency of tumour recurrence or the survival rate two years after operation. The results show that the immunological surveillance mechanism is impaired even in patients with early bronchial carcinoma and that it is possible to overcome postoperative immunological depression with specific immunotherapy combined with BCG. This treatment did not produce any clinical advantage in this small number of patients and the skin lesions caused the patients considerable discomfort.

Aged↗
PubMedDate not supplied

Mortality amongst patients of the Glasgow Blood Pressure Clinic was high in the 1970s and 80s but has fallen since, why?

Established in 1968 the Glasgow Blood Pressure Clinic has over 11,000 patients on its computer record. Up to 1980, mortality from all-causes and from cardiovascular causes was high: relative risks compared with two local control populations were greater than 2.0. Since 1980, all-cause mortality has decreased to 1.31 (859 deaths, CI 1.23-1.39). Lower mortality from cardiovascular causes, particularly coronary heart disease, contributes to the decrease. Reasons for the decrease are under investigation currently. Referral of patients with slightly lower blood pressure contributes, as may better blood pressure control with newer antihypertensive drugs. ACE inhibitors and calcium channel blockers were introduced in 1980 and during the 16-year period to 1995, all-cause mortality has decreased most in patients taking ACE inhibitor. A decrease also occurred in patients taking antihypertensive drugs other than ACE inhibitor.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Is cancer related to hypertension or to its treatment?

Three questions related to cancer and blood pressure are discussed. (i) Is cancer related in some way to hypertension, or to blood pressure? Several studies show a relation of blood pressure and cancer in populations. However, our own experience, based on a cohort of 15,411 subjects with BP measured in the 1970s and with 1,392 fatal cancers since, shows no relation of cancer risk and diastolic pressure. Nor were cancer numbers (n=72) observed in the 1,078 untreated hypertensives of the Glasgow Blood Pressure Clinic different from those expected (n=71.2) in a control population matched for age, sex and smoking habit. (ii) Do antihypertensive drugs promote cancer? Atenolol and calcium channel blockers have been suspected of this, but evidence of larger studies, including two of our own, is negative: relative risk for cancer in our patients taking CCB was 1.02 (CI 0.82-1.27). (iii) Do antihypertensive drugs protect against cancer? A study of ours based on the Glasgow Clinic raises this possibility: relative risk for incident cancer amongst 1,559 patients taking ACE inhibitor was 0.72 (CI 0.55-0.92).

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Patient compliance: a novel method of testing non-steroidal antiinflammatory analgesics in rheumatoid arthritis.

Patient compliance has been used as a measure of efficacy of non-steroidal antiinflammatory drugs (NSAID) in the treatment of patients with rheumatoid arthritis. A series of studies on various cohorts of patients using different drugs and different prescribing methods has been conducted. The studies have confirmed the absence of long-term placebo response. Indomethacin emerges as the most effective drug regardless of the mode of prescription, but it is clear from the results that the level of compliance varies with the mode of prescription.

Adult↗