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J Van Der Meulen

Publications and source records attributed to J Van Der Meulen.

9 recordsLinked to original sources
PubMed2003

The fear of prostate cancer in men with lower urinary tract symptoms: should symptomatic men be screened?

OBJECTIVE: To explore the concerns and worries in men with uncomplicated lower urinary tract symptoms (LUTS, but no evidence of prostate cancer) relating to their symptoms. PATIENTS AND METHODS: There is no current prostate cancer screening programme in the UK. Evidence suggests that men with LUTS have the same risk of prostate cancer as aged-matched asymptomatic men. However, most men with LUTS are 'screened' with a digital rectal examination (DRE) and prostate specific antigen (PSA) testing as part of routine assessment. Whether this screening offers any benefit to patients and whether national screening for prostate cancer and subsequent early treatment offer any long-term survival or quality of life benefit is uncertain. Thus 30 men with uncomplicated LUTS were qualitatively interviewed to explore their concerns and worries about their symptoms. Interviews were transcribed verbatim and subjected to content analysis using validated techniques. RESULTS: Of the 30 men, 22 (73%) expressed a fear of prostate cancer at the time of their initial presentation. This fear was independent of race, social class and symptom severity; older men were less worried. Of the 22, 15 (68%) stated that after reassurance their symptoms were less bothersome and easier to cope with. CONCLUSIONS: These findings suggest there is a considerable gain in health by explicitly addressing the concerns of prostate cancer in men with uncomplicated LUTS. Informing these men of their true risk of prostate cancer (before or after a DRE and PSA estimate) may alleviate much of the bother associated with their symptoms. Despite no evidence of any greater risk of prostate cancer than in asymptomatic men, symptomatic men should continue to be screened after appropriate counselling.

Decision Making↗
PubMed2003

Lifestyle and behavioural interventions for men on watchful waiting with uncomplicated lower urinary tract symptoms: a national multidisciplinary survey.

OBJECTIVE: To determine the use of lifestyle and behavioural interventions in the UK for symptom control in men with uncomplicated lower urinary tract symptoms (LUTS) on watchful waiting (WW). METHOD: Semi-structured interviews with urologists, nurse practitioners and continence advisors were used to obtain a list of lifestyle and behavioural interventions used in men with LUTS. From the 18 interventions identified, a survey was constructed asking how often these interventions were used in routine practice. The survey was sent to 100 consultant urologists (British Association of Urological Surgeons), 100 nurse practitioners (British Association of Urological Nurses), and 100 continence advisors (International Continence Society) with an interest in male urology, all randomly selected. RESULTS: Of 248 (83%) responses, 236 were suitable for analysis; 193 (82%) of the respondents reported using lifestyle or behavioural interventions in men on WW with uncomplicated LUTS. The most frequently used interventions were education about the prostate and bladder, avoiding caffeine, urethral milking and reassuring men that they do not have prostate cancer. The use of lifestyle and behavioural interventions showed an 'all-or-none' pattern. Respondents used either few or many of the 18 interventions identified. There was considerable variation in the extent to which these interventions were used among the survey groups (P < 0.01); urologists used these interventions the least and continence advisors the most. CONCLUSIONS: Lifestyle and behavioural interventions are advised by many medical professionals to men on WW with uncomplicated LUTS. However, the use varies considerably, with some medical professionals advising many of these interventions and some a few or none at all. Further research is required to define and test the effectiveness of these interventions in reducing LUTS.

Aged↗
PubMed2001

Thirty minutes transport causes small intestinal acidosis in pigs.

Long duration (>10 hours) transport has been described as having either adverse or no effects on porcine health. However, the effect of short duration transport on porcine health is unknown. In the present paper, pigs fed ad libitum (n = 6) were transported for 30 minutes, anaesthetised, instrumented, and cardiovascular and gastrointestinal parameters were measured. Non-transported pigs (n = 6) served as controls. No significant differences between groups were found concerning blood flow in the arteria mesenterica cranialis, heart rate, cardiac output, pulmonal blood pressure, haemoglobin content and haematocrit value. Systolic systemic blood pressure was higher (though not significant), and diastolic systemic blood pressure was significantly higher in the transported pigs than in the controls. Small intestinal pH was significantly lower in transported pigs than in control pigs. We conclude that a 30-minute transport of fed pigs results in small intestinal acidosis. As small intestinal acidosis predisposes to bacterial translocation, even short duration transport should be avoided when possible.

Acidosis↗
PubMed1998

[Hyperammonemia in hydronephrosis].

A man aged 81 with bilateral hydronephrosis presented with lethargy deepening into coma caused by hyperammonaemia. The hyperammonaemia was most likely caused by excessive absorption of ammonia produced by Proteus mirabilis in the obstructed and dilated urinary tract. The patient died within a few hours.

Aged↗
PubMed1993

A comparison of five stroke scales with measures of disability, handicap, and quality of life.

BACKGROUND AND PURPOSE: Recently much debate has arisen on the appropriateness of assessing stroke outcomes with stroke impairment scales. Our purpose was to study the relationship between long-term impairments and functional outcomes in terms of disability, handicap, and quality of life. METHODS: We studied 87 patients who had a stroke 6 months earlier. Impairments were scored on five stroke scales: the Orgogozo Scale, the National Institutes of Health scale, the Canadian Neurological Scale, the Mathew scale, and the Scandinavian Stroke Scale. Disability was assessed with the Barthel Index, handicap with the Rankin scale, and quality of life with the Sickness Impact Profile. The linear relationship between stroke scales and functional scales was assessed with correlation coefficients. We used regression analyses to explain functional health. RESULTS: The stroke scales were highly related to one another (range, r = -.85 to .92). The correlation between stroke scales and functional scales was < .70 and decreased from Barthel (mean r2 = 47.5%) to Rankin (mean r2 = 36.5%) to Sickness Impact Profile (mean r2 = 33%). Stroke scales were rather poorly correlated with patients' psychosocial conditions (mean r2 = 11.5%). Functional health status was mainly related to leg power and orientation. The standardized stroke scale weights of the explanatory items were lower than their standardized regression weights. CONCLUSIONS: Stroke scales only partly explain functional health. The impact of impairments on functional outcomes seems to be underestimated by the stroke scale weights. The correlation patterns give empirical support to the hierarchical structure of the International Classification of Impairments, Disabilities and Handicaps.

Aged↗
PubMed1977

Tendon healing.

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Humans↗