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Biomedical subjects

J Fitzpatrick

Publications and source records attributed to J Fitzpatrick.

At least 55 records · Page 3Linked to original sources
PubMed1994

Transurethral microwave thermotherapy versus transurethral catheter therapy for benign prostatic hyperplasia.

Transurethral microwave thermotherapy (TUMT) is a single outpatient treatment for benign prostatic hyperplasia. It produces good symptomatic relief but minimal objective improvement in mean flow rates. We wished to evaluate the placebo effect of the transurethral catheter. We evaluated 40 patients with outflow obstruction, 20 had TUMT for 1 h and 20 had a catheter placed in the urethra without treatment for 1 h. Urinary flow rates improved in both groups (12.8-14.6 with TUMT, 10.0-12.4 with catheter). Significant reduction from pretreatment values occurred in symptom scores and postvoid residual urine volume in both groups following treatment. The subjective results of TUMT and the placebo effect seen in the catheter group cast doubt on our understanding of the mechanism of action of TUMT.

Humans↗
PubMed1992

Laparoscopic versus open appendicectomy: a prospective evaluation.

A prospective evaluation of laparoscopic surgery for acute appendicitis over a 6-month period is reported. Sixty-five patients with signs and symptoms of appendicitis necessitating surgery were assigned to open (n = 36) or laparoscopic (n = 29) appendicectomy. Thirty-seven patients were female (22 open) and 28 were male (14 open). The median age was 24 (range 14-64) years for open appendicectomy and 18 (range 14-60) years for the laparoscopic procedure. The mean postoperative stay for open operation was 4.8 (range 1-21) days and for the laparoscopic route 2.2 (range 1-11) days (P < 0.05). Inflammation was confirmed histologically in 72 per cent of the open cases and in 74 per cent of the laparoscopic cases (P not significant). The wound infection rate was 11 per cent (n = 4) for open and 4 per cent (n = 1) for laparoscopic appendicectomy (P < 0.05). The median anaesthesia time was 52 (range 15-90) min for open appendicectomy and 48 (range 20-120) min for laparoscopic surgery (P not significant). After open appendicectomy patients had a median of 5 (range 2-12) intramuscular injections of analgesia compared with a median of 1 (range 0-5) in the laparoscopic group (P < 0.05). Two laparoscopic operations were converted to an open procedure. The results suggest that emergency laparoscopic appendicectomy should be explored further as an alternative to open surgery for acute appendicitis.

Acute Disease↗
PubMed1992

A nursing perspective on advance directives.

The nurse's role in implementing the Patient Self-Determination Act is often unclear. This article describes the clinical use of advance directives, discusses related ethical concepts, and identifies methods nurses could use for initiating discussions about advance directives.

Advance Directives↗
PubMed1991

World Health Organization Consensus Committee recommendations concerning the diagnosis of BPH.

The expert committees, which met in Paris in June 1991 under the patronage of WHO to establish a consensus concerning BPH, adopted the recommendations summarised in this report. Despite certain criticisms which can be made, these recommendations offer the advantage of simplicity and uniformity, thereby constituting a "universal language". This will facilitate comparison of patients and therapeutic results, both in everyday practice and in the course of clinical trials. These recommendations will be periodically re-evaluated in the light of clinical experience and technological progress.

Clinical Protocols↗
PubMed1988

The cerebral origin of the alpha rhythm.

The EEG alpha rhythm was recorded from 8 isolated canine brains in the absence of orbital contents, drug effect, or pulsatile cerebral blood flow. Abrupt shift to hypoxic perfusion, with maintenance of other perfusion variables, resulted in a loss of alpha coincident with a fall in CMRO2 and rise in oxygen deficit. It is concluded that the alpha rhythm reflects neural electrical activity, and that sources in the eye muscles or in cardiac-induced electromechanical properties of the brain may be rejected.

Alpha Rhythm↗
PubMed1988

Nosocomial infection rates at an oncology center.

Nosocomial infection rates were computed for 5,031 patients at an oncology center during a 20-month period. Twelve percent of the patients developed nosocomial infections, accounting for a total of 802 infections. The overall incidence of nosocomial infections during this study period was 6.27 infections per 1,000 patient days. The highest incidence of nosocomial infections was found in patients having acute myelogenous leukemia (30.49 infections per 1,000 patient days); bone and joint cancer (27.27 infections per 1,000 patient days); and liver cancer (26.58 infections per 1,000 patient days). The respiratory tract was the most common site of infection, followed by bloodstream, surgical wound, and urinary tract infections. Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and coagulase-negative staphylococci were most frequently implicated as pathogens. The distribution of specific types of infection according to underlying malignancy was also tabulated. These data provide nosocomial infection rates, common pathogens, and sites of infection for cancer patients, thus assisting in directing appropriate therapy for these patients.

Bone Neoplasms↗
PubMed1987

The relationship between nurse characteristics and perceptions of psychotropic medications in residential facilities for the retarded.

A total of 227 nurses were surveyed regarding their attitudes, perceptions, and knowledge about the use of psychotropic drugs. In general, greater age, male sex, status, and higher qualifications tended to covary and were associated with perception of greater involvement by senior nurses in drug-related decisions, more satisfaction with the level of in-service training, awareness of certain side effects, perception of interdisciplinary decision making as a clinical reality, and the view that psychologists were not influential in medication-related decisions. Those without these characteristics (e.g., females, younger nurses) more often advocated greater use of medical and laboratory tests, ongoing training, and alternatives to drugs. Nurses working in nonambulatory units more often saw senior nursing staff as influential in decisions to stop drug treatment and more often recommended that alternatives to pharmacology be employed. Some tentative conclusions about the dynamics surrounding medication use in these facilities were offered to account for these patterns.

Adolescent↗
PubMed1985

Creatine kinase isoenzyme (CK-BB) by RIA as a follow-up marker in stage D cancer of the prostate: comparison with PAP RIA.

Fifty-nine patients with stage D carcinoma of the prostate under different modalities of treatment were studied for creatine phosphokinase isoenzyme BB (CK-BB) and prostatic acid phosphatase (PAP) levels in serum by radioimmunoassay (RIA) technique, in order to study the possible use of CK-BB as a follow-up marker compared to PAP. Thirty-three patients were in stable, 19 in progressive, and seven in regressive clinical state. CK-BB was above normal level in 52 (88%) out of 59 patients with no statistically significant difference between the three clinical states. On the other hand, PAP was above normal level in only 23 patients (38.98%) with statistically significant difference between the three clinical states (P less than 0.001). The PAP/CK-BB index was below 1 in stable and regressive condition, while it was above 1 in eight out of 19 patients with progressive disease. The PAP/CK-BB index may be of prognostic importance. CK-BB by RIA was abnormal in more cases than PAP. In this way CK-BB reflects the presence of the tumor and may be used for diagnosis; however, it does not reflect the clinical response as PAP does.

Acid Phosphatase↗
PubMed1985

Testicular tumors in subfertile men: report of 4 cases with implications for management of patients presenting with infertility.

We report on 4 men attending our infertility clinic in whom seminomas developed. A review of testicular biopsies performed for investigation of subfertility in 2 patients revealed in situ and early invasive carcinoma. Infertile men have a prevalence of carcinoma in situ in the range of 1 per 100 to 200, with a high risk of progression to invasive germ cell tumor (50 per cent within 5 years of diagnosis). Biopsy is the only method of detection of the in situ lesion and, therefore, is recommended in the investigation of oligospermic and azoospermic male subjects. The surgical approach to and diagnostic sensitivity of testicular biopsy are reviewed, and the management of carcinoma in situ is discussed.

Adult↗