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Biomedical subjects

M P Wright

Publications and source records attributed to M P Wright.

15 recordsLinked to original sources
PubMed2001

Percutaneous retrograde varicocele embolisation using tungsten embolisation coils: a five year audit.

OBJECTIVE: To assess the efficacy of percutaneous retrograde varicocele embolisation using Spirale tungsten coils over a period of five years. PATIENTS AND METHODS: Fifty consecutive patients underwent local anaesthetic day case varicocele embolisation via a right femoral approach. Venous anatomy was identified and classified. Morbidity and recurrence were recorded at three month clinical follow up. RESULTS: The procedurewas technically successful in 94% of the patients. The varicocele recurred in 16%, the majority of whom had complex venous anatomy. 8% of the patients complained of discomfort at follow up. CONCLUSIONS: Although the coils used in this study have been withdrawn, a high technical success rate is described with failure being predominantly due to complex venous anatomy.

Adolescent↗
PubMed2000

Surveillance for bladder cancer: the management of 4.8 million people. South-west Urologists.

OBJECTIVE: To document the workload of bladder cancer surveillance on the British urologist. Methods Thirty-one consultant urologists serving a population of 4.8 million were sent postal questionnaires eliciting their views on the management of superficial bladder cancer. The number, type and outcome of cystoscopies performed over a 6-week period throughout the region was then assessed prospectively. Results One person in 1450 in the South-west region is undergoing follow-up for bladder cancer. Of the responding consultants, 36% would give a single dose of intravesical chemotherapy within 24 h of resection for a G1/2 pTa tumour and 84% would perform the first check cystoscopy at 3-4 months. Over the 6-week period of the study, 696 cystoscopies were performed; there was considerable variation among centres in the choice of cystoscopy type, with 3-80% being rigid cystoscopies. Overall, there was a positive finding in 31% of the assessments. CONCLUSION: This study documents the practice of a significant number of UK urologists in the management of superficial bladder cancer. There are considerable variations among individuals in the type and timing of check cystoscopy.

Cystoscopy↗
PubMed1999

Sodium hyaluronate carboxymethylcellulose-based bioresorbable membrane (Seprafilm)--does it affect tumor implantation at abdominal wound sites?

PURPOSE: This study examines the effects of a sodium hyaluronate-based bioresorbable membrane (Seprafilm) on tumor implantation at surgical wound and laparoscopic trocar sites. METHODS: GW-39, an established human colon cancer line carried in immunocompetent golden Syrian hamsters was used as the experimental model. Under general anesthesia, a 2-cm midline incision was made to allow placement of four 5-mm abdominal trocars. Hamsters were then randomly assigned to preSeprafilm, postSeprafilm, and control (no Seprafilm) groups. In the preSeprafilm group 0.5 ml of a 5 percent (vol/vol) suspension of the GW-39 tumor cells (approximately 1.675 x 10(6) cells) was injected into the abdomen of each hamster via midline incision. Trocars were removed, the wounds were closed, and 1 cm2 of Seprafilm was placed on the peritoneal surface of each trocar site. In the postSeprafilm group the membrane was placed at each site before injection of tumor cells. The control group did not receive Seprafilm. The animals were killed after seven weeks, and the abdominal wound sites were excised. Sites without gross tumor underwent histologic evaluation. RESULTS: One hundred thirty-two animals were randomly assigned to the three groups. The preSeprafilm group had an 87 percent tumor implantation rate. The postSeprafilm group had a 90 percent tumor implantation rate. The control group had an 88 percent tumor implantation rate. Chi squared analysis demonstrated that these total tumor implant rates and mean tumor mass were similar at all wound sites and between groups. No toxicity was observed in any of the experimental groups. CONCLUSIONS: Sodium hyaluronate-based bioresorbable membrane (Seprafilm) does not influence GW-39 human colon cancer implantation at abdominal wound sites in this hamster model.

Abdomen↗
PubMed1998

Prevalence and impact of incontinence and impotence following total prostatectomy assessed anonymously by the ICS-male questionnaire.

OBJECTIVES: The aim of this study was to assess the incidence of incontinence and impotence in patients following total prostatectomy and assess the impact their symptoms have on their quality of life. PATIENTS AND METHODS: Between 1987 and 1994, one surgeon performed retropubic total prostatectomies on 89 patients, of which 87 were available for follow-up. All patients were sent an ICS-male questionnaire. Patients' ages ranged from 49 to 73 years (median 65). The interval between surgery and completing the questionnaire ranged from 7 to 87 months (median 22). RESULTS: The response rate was 95%. No patients reported incontinence pre-operatively. Postoperatively, 69% (57/83) of patients suffered to some degree of leakage of urine and 24% (29/83) used pads. Of these, 60% used 1 pad per day, 15% 2 pads and 25% (5 patients) used 3 or more. Nocturnal incontinence was reported by 20% of patients. Urinary incontinence was considered a problem in only 34% (28/83) of patients. Sixty-five percent of patients using pads considered urinary leakage to be a problem, but only 1 considered it a serious problem. 89% claimed to have been potent prior to surgery. The overall postoperative potency rate was 41% (30/74) in those potent pre-operatively. However, 67% of patients reporting potency had severely reduced rigidity, and only 12% (9/74) achieved what they considered full erections. Ten percent of all patients considered postoperative impotence to be a serious problem, and 47% stated that it was not a problem at all. CONCLUSIONS: The incidence of incontinence and impotence following total prostatectomy is higher than earlier reports suggest, but the impact of these complications appears to be surprisingly low. These results allow patients to be given realistic expectations when counselled prior to this operation.

Aged↗
PubMed1995

Late reoperation in vascular surgery.

OBJECTIVES: Assessment of late reoperation (after 30 days) following vascular surgery. DESIGN: Analysis of a prospectively collected database of consecutive patients undergoing vascular surgery. SETTING: A single teaching unit's experience between 1986-1993. MATERIALS: Patients undergoing 2501 primary arterial reconstructions. CHIEF OUTCOME MEASURES: Reoperation after 30 days. MAIN RESULTS: One hundred and fifty eight patients (6%) underwent further operations, at more than 1 month after the primary procedure. Primary procedures at highest risk for reoperations were axillobifemoral bypasses and femorodistal bypasses with respective late reoperation rates of 20% and 16%. The majority of patients required late reoperation because of graft occlusion or stenosis. Overall, of the 158 late reoperations performed, 114 were related to the same arterial segment with the same presenting symptoms as the primary operation, and 44 for a different indication. A second or subsequent reoperation was required in 54 patients and the overall operative mortality was 11%. CONCLUSION: Patients undergoing certain vascular procedures, should be informed of the high risk of a subsequent procedure when consent is obtained.

Aged↗
PubMed1991

Risk assessment for HIV infection: validation study of a computer-assisted preliminary screen.

Development has been undertaken for microcomputer software intended to assess individual risk for HIV infection by analyzing personal case histories pertinent to drug abuse, receptive blood transfusion, and sexual behavior. The software performs interactive confidential interviews of individuals desiring expert assistance when deciding whether to commit to an antibody test. In the first phase of a validation study, 87 subjects responded to the computer interview. For each subject, human immunodeficiency virus (HIV) antibody status was on clinical record. This sample included 70 subjects, 29 of whom were HIV seropositive, recruited from the clientele of an AIDS antibody testing and counseling facility. In this phase, the software accurately assessed 28 of 29 seropositives (96.6%) to be at risk for HIV. The second phase was based upon participation of an additional 74 subjects who were undergraduates at the University of Oklahoma. In this presumed low-risk sample, 55 members reported never having previously tested for HIV antibodies. Seven members (12.7%) of the untested group were declared at risk in the course of receiving confidential computer screen advice. Of these 7, there were 3 members (42.9%) who were motivated by the computer to voluntarily seek HIV antibody testing. Of the 7 declared at risk, 2 members (3.9%) were among the 51 seronegative subjects classified as heterosexuals without specific and identified risks. All Phase II subjects seeking follow-up antibody tests were found seronegative.

Diagnosis, Computer-Assisted↗
PubMed1974

Cinefluorography.

Explore the source record for details and available documents.

Cineradiography↗
PubMedDate not supplied

The microbiology and cleaning of thermoplastic splints in burn care.

The ability of thermoplastic splints to be a vehicle for the transfer of microorganisms from the burn wound was explored. Twenty splints were evaluated and 10 (50%) were found to have recoverable microorganisms immediately after being removed from the burn patient. Air drying for 10 minutes was not shown to be an effective method of removing contaminating microorganisms. A cleaning protocol using a quaternary ammonia solution proved to be 100% effective in removing microorganisms from thermoplastic splint material.

Adolescent↗
PubMedDate not supplied

Gender differences in medical school attrition rates, 1973-1992.

Retention is a critical problem in medical school education. We report here on research that examined gender differences in attrition rates between 1973 and 1992. Using secondary data compiled from the annual reports on undergraduate education published in JAMA, both descriptive and inferential analyses of medical school attrition rates were conducted. Data show that medical school attrition rates have steadily increased across the country since 1973 and that women drop out of medical school at consistently greater rates than men. These results highlight the importance of future analyses that attempt to delineate the causes as well as the consequences of dropping out of medical school for women and the institutions that support them.

Education, Medical, Undergraduate↗
PubMedDate not supplied

Automated interviewing for hepatitis B risk assessment and vaccination referral.

INTRODUCTION: This study describes a convenient, anonymous, and private method to assess risk for hepatitis B and recommend vaccination for those determined to be at risk. METHODS: We used an automated telephone interview and computerized risk assessment to inform callers of their hepatitis B risk status and direct those at risk for testing, counseling, and vaccination. The project's efficacy was compared to previously reported projects, and the expense was compared to estimates assuming universal vaccination. RESULTS: This pilot project found that 63% of completed interviews indicated risk. Of those at risk, 47% reported for testing, and 89% of those tested required vaccination. Of those requiring vaccine, 75% (32% of at-risk callers) completed the three-dose series. Of those tested, 9% previously had natural infections and 2% were carriers. CONCLUSIONS: Until adolescents are universally vaccinated, computerized hepatitis B risk assessment can facilitate prevention and decrease vaccination program costs. Privacy and anonymity may increase participation of groups difficult to reach before the onset of risky behaviors that results in treatment for STDs and drug abuse.

Adult↗