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M J Webb

Publications and source records attributed to M J Webb.

96 records · Page 6Linked to original sources

Use of antihypertensive and antithrombotic medications after stroke in community-based care.

BACKGROUND: Secondary stroke prevention strategies include pharmacologic approaches to control hypertension and reduce thromboembolic risk. OBJECTIVE: To describe antithrombotic and antihypertensive medication use, and rates of blood pressure control in the Kansas City Stroke Study, a prospective stroke cohort receiving community-based care after primarily mild and moderate stroke. METHODS: Participants from 12 area hospitals provided information about medication use prior to stroke. Study personnel measured blood pressures at enrollment and at one, three, and six months, and collected medication data at six months during in-home assessment. RESULTS: Complete data at six months were available for 355 subjects with ischemic stroke, among whom 13% had atrial fibrillation and 67% had prior hypertension. Prior to stroke, only 45% of the patients were receiving any antithrombotic (anticoagulant and/or antiplatelet) therapy; this figure rose to 77% at six months. Antithrombotic treatment rates among those with atrial fibrillation were 59% before stroke and 83% at six months, including warfarin in 64%. Approximately 70% of subjects had controlled blood pressures one, three, and six months after stroke, defined as systolic blood pressure < or = 140 mm Hg and diastolic blood pressure < or = 90 mm Hg. Use of multiple antihypertensive agents was common; calcium-channel blockers and angiotensin-converting enzyme inhibitors were used most frequently. However, 19% of subjects with uncontrolled blood pressure were untreated at six months. CONCLUSIONS: Although room for improvement remains, these data suggest improved rates of antithrombotic and antihypertensive medication use after stroke in community-based care in a midwestern metropolitan community, compared with previous reports.

Aged↗

Detection of p53 antigen expression in cytologic preparations of ovarian carcinomas.

We explored the value of p53 immunostaining in detection of malignant cells in cytologic analyses in ovarian cancer patients. Ninety-six percent of 23 tumor touch preparations had nuclear staining with PAb240: 44% had nuclear only, 26% had both nuclear and cytoplasmic staining, and 26% had cytoplasmic staining alone. Eight of 20 cytospins of peritoneal washings from ovarian cancer patients were PAb240 positive, 6 had cytoplasmic, and two had nuclear staining. Cytospins of fluid from 3/15 patients with no malignancy revealed cytoplasmic staining of mesothelial cells. The lack of concordance between staining of primary tumors and cytospins of peritoneal washings and the apparent reactivity in some benign samples may limit the utility of immunohistochemical detection of malignant cells in the peritoneal fluid of ovarian cancer patients.

Adolescent↗