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Biomedical subjects

M Gray

Publications and source records attributed to M Gray.

At least 73 records · Page 4Linked to original sources
PubMed1999

Electrovaporization of the prostate: initial experiences and nursing management.

UNLABELLED: STUDY DESCRIPTION: Electrocautery power is increasingly used to destroy prostatic tissue as well as to control bleeding during transurethral surgery for benign prostatic hyperplasia. This study summarizes our initial experiences with the electrovaporization procedure and combines these with the published findings of others in order to provide recommendations for the nursing management of this increasingly common urologic surgical procedure. METHODS: A retrospective review of 36 consecutive patients managed by electrovaporization of the prostate was completed. A standardized data collection form was used to evaluate the preoperative preparation, intraoperative experiences, and short-term postoperative responses to the electrovaporization procedure. These data were combined with the published experiences of others in order to provide initial insights into the nursing management of patients undergoing this procedure. RESULTS: Patient preparation was similar to that used for transurethral resection of the prostate. No patients experienced significant intraoperative bleeding. Two subjects (7%) experienced significant but transient hematuria in the postoperative period. Five men (17%) experienced urinary retention requiring catheterization, of these three were caused by blood clots and two were attributable to pre-existing detrusor muscle weakness. Urinary tract infection occurred in eight patients (27%), three of which were accompanied by a fever. All patients reported urethral and suprapubic pain following the procedure. One subject experienced flank pain caused by an acute obstruction of a solitary ureter, and one reported bladder spasms. Significant pain requiring analgesia resolved within 5 days of the procedure in all cases. CONCLUSIONS: The preoperative nursing management of the patient undergoing electrovaporization of prostate tissue is similar to that for transurethral resection of the prostate with the exception of patient teaching. Patient education should emphasize self-assessment for urinary retention, hematuria, and urinary tract infection. The postprocedural care initially focuses on monitoring the patient for catheter patency, hematuria, and infection. Patients and significant others should be warned that delayed hematuria and urinary retention may occur days or weeks after electrovaporization of the prostate. During the past decade, the number of alternative procedures for prostate tissue destruction has grown significantly. Each of these procedures offers potential advantages when compared to the classic transurethral resection of the prostate (TURP). While their usefulness in treating obstruction due to benign prostate enlargement has been reasonably well described (McCullough, 1998), the nursing management of patients undergoing many of these procedures has not been adequately studied or described. The purpose of this study was to summarize our initial experiences with the VaporTrode procedure and to better define the nursing management of patients undergoing this increasingly common urologic surgery.

Aged↗
PubMed1998

Distinct mechanisms for K+ efflux, intoxication, and hemolysis by Bordetella pertussis AC toxin.

Adenylate cyclase (AC) toxin from Bordetella pertussis delivers its catalytic domain to the interior of target cells where it converts host ATP to cAMP in a process referred to as intoxication. This toxin also hemolyzes sheep erythrocytes by a mechanism presumed to include pore formation and osmotic lysis. Intoxication and hemolysis appear at strikingly different toxin concentrations and evolve over different time scales, suggesting that different molecular processes may be involved. The present study was designed to test the hypothesis that intoxication and hemolysis occur by distinct mechanisms. Although the hemolytic activity of AC toxin has a lag of >1 h, intoxication starts immediately. Because of this difference, we sought a surrogate or precursor lesion that leads to hemolysis, and potassium efflux has been observed from erythrocytes treated with other pore-forming toxins. AC toxin elicits an increase in K+ efflux from sheep erythrocytes and Jurkat cells, a human T-cell leukemia line, that begins within minutes of toxin addition. The toxin concentration dependence along with the analysis of the time course suggest that toxin monomers are sufficient to elicit release of K+ and to deliver the catalytic domain to the cell interior. Hemolysis, on the other hand, is a highly cooperative event that likely requires a subsequent oligomerization of these individual units. Although induction of K+ efflux shares some structural and environmental requirements with both intoxication and hemolysis, it can occur under conditions in which intoxication is reduced or prevented. The data presented here suggest that the transmembrane pathway by which K+ is released is separate and distinct from the structure required for intoxication but may be related to, or a precursor of, that which is ultimately responsible for hemolysis.

Adenylate Cyclase Toxin↗
PubMed1998

Protease inhibitor combination therapies and perceptions of gay men regarding AIDS severity and the need to maintain safer sex.

BACKGROUND: Advances in the treatment of HIV disease with protease inhibitor combination therapies have been widely documented in the media. OBJECTIVES: To investigate perceptions concerning the severity of HIV/AIDS and the need to maintain safer sex practices in the light of recent HIV treatment advances. METHODS: A survey eliciting demographic characteristics, HIV serostatus and treatment information, and HIV/AIDS severity and safer sex perceptions was administered to a community sample of 379 homo-/bisexual men who reported awareness of combination therapy regimens. RESULTS: Ten per cent of all respondents agreed or strongly agreed with the statement that 'AIDS is now very nearly cured' and 13% felt that the threat of AIDS is less serious than in the past. HIV-positive men were more likely to perceive AIDS as a less serious threat or as very nearly cured. Overall, 8% of men in the sample indicated that they practice safer sex less often since new AIDS treatments came along; 18% of HIV-positive men on combination therapy regimens said they practice safer sex less frequently since treatments have advanced. Regardless of serostatus, nearly 20% of men indicated they would stop practicing safer sex if an AIDS cure was announced. CONCLUSION: It is essential to integrate behavior change counseling into HIV treatment programs and to temper optimism concerning treatment advances with recognition that the threat of HIV/AIDS remains great.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Further support for an association between a polymorphic CAG repeat in the hKCa3 gene and schizophrenia.

A recent study has suggested that a polymorphism in the hKCa3 potassium channel may be associated with raised susceptibility to schizophrenia. Despite its modest statistical significance, the study is intriguing for two reasons. First, hKCa3 contains a polymorphic CAG repeat in its coding sequence, with large repeats more common in schizophrenics compared with controls. This is interesting in view of several repeat expansion detection (RED) studies that have reported an excess of large CAG repeats in psychotic probands. Second, the hKCa3 gene is a functional candidate gene because studies of antipsychotic and psychotogenic compounds suggest that glutamatergic systems modulated by SKCa channels may be important in schizophrenia pathogenesis. In the light of the above, we have tested the hypothesis of an association between schizophrenia and the hKCa3 CAG repeat polymorphism using a case control study design. Under the same model of analysis as the earlier study, schizophrenic probands had a higher frequency of alleles with greater than 19 repeats than controls (chi 2 = 2.820, P = 0.047, 1-tail). Our data therefore provide modest support for the hypothesis that polymorphism in the hKCa3 gene may contribute to susceptibility to schizophrenia.

Alleles↗
PubMed1998

Results of behavioral treatment for urinary incontinence in women.

Recent research on pelvic muscle exercises, which are known to be effective in stress and mixed urinary incontinence, has demonstrated that this therapy has a durable effect. However, the mechanism that creates its efficacy remains unclear. Transvaginal electrical stimulation has been used to manage stress, urge and mixed urinary incontinence. Conflicting evidence exists concerning its efficacy in stress urinary incontinence, but its benefit to women with mixed and urge incontinence is well established.

Journal Article↗
PubMed1998

A study of young people's perceptions of their orthodontic need and their experience of orthodontic services.

A study investigating young people's perceptions of their orthodontic needs, demands and their experience of orthodontic services was conducted in Walsall and Dudley health districts, using a self-completed questionnaire. The subjects were 4812 individuals in year 10 of education (average age 15.0 years). Overall, the level of malocclusion perceived by the young people was similar to that identified by dentists in the 1993 national survey of children's dental health. The level of reported malocclusion by boys and girls, white and non-white students and students from the two districts was the same; however fewer students from the less prosperous neighborhoods reported having straight teeth, and more non-white students with irregularities wanted to have straight teeth. Although many young people reported having a malocclusion, the majority were not concerned about it. The study revealed significant differences in experience of treatment. Boys, non-white students and students from less prosperous areas were less likely to report having active orthodontic treatment. Access to specialist services was lower for the non-white students and students from less prosperous areas. A higher proportion of students treated with fixed appliances reported straight teeth after treatment than those treated by extractions alone or by removable appliance therapy.

Adolescent↗
PubMed1998

Psychometric evaluation of the international prostate symptom score.

The International Prostate Symptom Score represents an important development in the understanding of benign prostatic hyperplasia (BPH) and its clinical management. This instrument provides reasonable reliability, content validity, and predictive validity. However, it is limited by a lack of concurrent validity so it can not be used to discriminate the voiding dysfunction associated with BPH from that associated with unrelated conditions. Psychometric properties of this symptom score are evaluated and suggestions provided for increased involvement for urologic nurses in its clinical application and future development.

Aged↗
PubMed1997

Caring for older people in the community.

This is a brief report of the aims and structure of a two-year project, which commenced in August 1996, researching the educational needs of nurses who care for older people in the community. The study involves the development and evaluation of an educational programme designed to help improve the efficiency of nurses working in this area.

Clinical Competence↗