Search PubMed⌕ Search

Biomedical subjects

M May

Publications and source records attributed to M May.

295 records · Page 17Linked to original sources
PubMedDate not supplied

Is it possible to provide a prognosis after radical prostatectomy for prostate cancer by means of a PSA regression model?

BACKGROUND: For over 15 years, studies have been done to evaluate the elimination kinetics of the prostate-specific antigen (PSA) after radical prostatectomy. Even though evaluation of PSA regression in the two-compartment model has become established, no clear data are currently available as to whether a statement can be made with regard to tumor prognosis from a computation of the PSA half-life (PSA-HL). This study focuses on the determination of the PSA-HL in the two-compartment model and on its correlation with the biochemical recurrence-free survival. In addition, a computer program is being developed to simplify the determination of PSA-HL. MATERIAL AND METHODS: Seventy-seven prospective patients were examined who subsequently had a radical prostatectomy at our facility without neoadjuvant or adjuvant hormone deprivation. In addition to preoperative measurement of the PSA value (dO), PSA determinations were carried out postoperatively on days 5, 10 and 60, and at four-monthly intervals thereafter (mean follow-up: 16 months). By means of the computer program developed for this purpose, CTK.TumW, the PSA half-lives for the first (d0-d5, PSA-HL1) and second (d5-d10, PSA-HL2) compartments were subsequently determined and their effect on biochemical recurrence-free survival was assessed. RESULTS: PSA-HL1 and PSA-HL2 were 1.89 (+/- 0.03) and 3.39 (+/- 0.14) days, respectively. Whilst PSA-HL1 did not permit any prognostic statement, the median PSA-HL in the second compartment between patients with and without disease progression differed significantly (4.44 versus 3.12 days; p < 0.001). Discrimination analysis produced a cutoff of 3.8 days for the second compartment; patients with a PSA-HL2 > or = 3.8 days had a significantly worse biochemical recurrence-free survival after 18 months than the other patients (27% versus 93%; p < 0.001). CONCLUSION: The PSA regression kinetics after radical prostatectomy follows a two-compartment model in which the prognostic value of the PSA-HL1 is limited. When a cutoff of 3.8 days is used, evaluation of the PSA-HL in compartment 2 (d5-10) appears to permit a prognostic statement. Due to the limited postsurgical follow-up, the disease process was only assessed as biochemical recurrence-free survival, and a longer follow-up will be necessary to generate data on progression-free survival.

Aged↗
PubMedDate not supplied

Asymptomatic enophthalmos: the silent sinus syndrome.

Although uncommon, enophthalmos may be a presenting symptom of chronic maxillary sinusitis with secondary attentuation of the orbital floor. As such, as awareness of this entity, known as the "silent sinus syndrome," is important to all practising otolaryngologists. Two such cases are presented herein, together with a discussion of the pathophysiology, management, and current literature.

Adult↗
PubMedDate not supplied

Treatment of facial spasm with Oculinum (C. botulinum toxin).

Forty-six consecutive adult patients with facial spasm were treated with one or more Botulinum toxin (Oculinum) injections to control muscle spasm. During the follow-up period of 6.6 months (one week-12 months), 27 patients required retreatment with a mean time interval of 3.4 months between treatments. Control of facial spasm was achieved in all patients. Complications included occasional bruising around the injection site and a transient blepharoptosis in one patient. No systemic effect was observed. This preliminary report suggests that treatment with Botulinum toxin (Oculinum) is an acceptable alternative to surgical management in select patients.

Adult↗
PubMedDate not supplied

Fatigue in 7- to 12-year-old patients with cancer from the staff perspective: an exploratory study.

PURPOSE/OBJECTIVES: To document and analyze the perspectives of staff members who provide direct care to 7- to 12-year-old patients with cancer regarding the nature and characteristics of fatigue, causes of fatigue, and effective interventions for this population of young patients. DESIGN: Exploratory. SETTINGS: A pediatric oncology unit at a children's hospital in the southwest and a pediatric research center for childhood catastrophic diseases in the mid-south. SAMPLE: A convenience sample of 38 staff members (8 advanced practice nurses, 23 staff nurses, 2 nurses managers, 3 nutritionists, 1 chaplain, and 1 physician) whose experience in pediatric oncology ranged from two months to 23 years. METHODS: Nine open-ended questions were posed to staff members during focus group sessions. Staff responses were analyzed using content analysis techniques and the Wilson concept analysis technique. MAIN RESEARCH VARIABLE: Staff perceptions of fatigue in 7- to 12-year-old patients with cancer. FINDINGS: Fatigue is a state of diminished to complete loss of energy or will that is influenced by environmental, biochemical, personal, cultural, and treatment-related factors. This state, which may be acute, episodic, or chronic, can be accompanied by a changing emotional or mental state. CONCLUSIONS: Staff perceive fatigue to be a debilitating symptom for these children. When attempting to determine the presence or absence of fatigue, staff primarily compare a child's current state with his or her previous state rather than that of other children. Staff see themselves as having a role in causing and alleviating fatigue in this patient group. IMPLICATIONS FOR NURSING PRACTICE: Staff can use these findings to help them identify the presence of fatigue in these children and to identify contributing and alleviating factors.

Adult↗