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Biomedical subjects

M Wells

Publications and source records attributed to M Wells.

At least 235 records · Page 13Linked to original sources

Reducing distress in cancer patients with an orientation program.

The purpose of this study was to test a brief orientation program for reducing anxiety, depressive symptoms, and overall distress in cancer patients at their initial clinic visit. One hundred and fifty consecutively referred patients seen in an oncology outpatient clinic were randomly assigned to an intervention or usual care control group. The intervention group received a clinic tour, general information about clinic operations, and a question and answer session with an oncology counselor. Outcome measures included the State-Trait Anxiety Inventory (STAI), the Brief Profile of Mood States (POMS), the Center for Epidemiologic Studies-Depression (CES-D) Scale, and an oncology clinic questionnaire which were administered at the initial clinic visit and follow-up. There were no statistically significant clinical or demographic differences between groups at initial assessment. At follow-up, the intervention group had lower state anxiety, lower overall distress, and fewer patients reporting depressive symptoms. Patients in the intervention group demonstrated significantly more knowledge about clinic operations and greater satisfaction with care. These data provide evidence that anxiety, distress and depressive symptoms can be reduced with an orientation program. This finding has particular relevance in the early stages of diagnosis where patients may suffer symptoms of anxiety and depression.

Adaptation, Psychological↗

Peroxidase-labelled lectin binding of human extravillous trophoblast.

The binding of four peroxidase-conjugated lectins, concanavalin A (Con-A), wheat germ agglutinin (WGA), peanut agglutinin (PNA) and soybean agglutinin (SBA), in both fixed and frozen tissue sections of human extravillous trophoblast (EVT) was determined. On the basis of its lectin binding properties the EVT cell population was found to be heterogeneous. PNA and SBA did not bind to any of the EVT cells. Con-A and WGA bound to most EVT cells, with the exception of the trophoblast of the chorion laeve. The trophoblast giant cells bound only Con-A and not WGA. The villous cytotrophoblast, from which the EVT cells are said to derive, does not express the sugar groups detected by the above lectin probes. The expression of mannosylated and di-N-acetylchitobiosyl residues by a fetally derived cell invites speculation that such expression enables it both to invade host maternal tissues and to avoid any adverse host immunological response.

Arachis↗

Maternal and fetal cellular relationships in the human placental basal plate.

Maternal and fetal cellular relationships in the normal human term placental basal plate were investigated by single and double immunohistochemical labelling techniques. Extravillous fetal trophoblast in the basal plate was uniformly reactive with markers of low-molecular-weight cytokeratins. The predominant maternal leucocyte population in the basal plate consisted of leucocyte-common-antigen-positive, class II MHC-positive macrophages, which exhibited acid phosphatase activity. Double-labelling methods highlighted the close association of these macrophages with extravillous trophoblast: they often extended processes around the fetal cells and were also observed within islands of cytotrophoblast. Other leucocytes were uncommon, although aggregates of T cells were apparent in some tissues.

Antibodies, Monoclonal↗

Upregulation of CD44 expression by interleukins 1, 4, and 13, transforming growth factor-beta1, estrogen, and progestogen in human cervical adenocarcinoma cell lines.

Although cervical adenocarcinoma constitutes approximately 10-20% of primary malignant tumors of the uterine cervix, its pathogenesis is less well understood than that of the corresponding squamous cancer. CD44 is a cell surface glycoprotein postulated to play a role in many biologic processes including tumor growth and metastasis. We have previously reported from immunohistochemical studies that a particular CD44 variant (CD44v5) is consistently overexpressed in endocervical neoplasia. It thus has potential as a diagnostic marker and even as a target for therapeutic approaches directed against specific epitopes. The aim of this study was to investigate which cytokines and hormones are capable of modulating CD44v5 expression, using a cell culture model. The effects of interleukin (IL)-1alpha, IL-1beta, IL-4, IL-13, transforming growth factor (TGF)-beta1, estrogen, and progestogen on CD44v5 expression were examined in cultures of three human cervical adenocarcinoma cell lines (HeLa, HeLa229, and HS588T). Expression was assessed using dual fluorescence-labeled flow cytometry and western blotting techniques. It was found that incubation of cultures for 72 h with IL-1alpha, IL-1beta, IL-4, IL-13, TGF-beta1 (all at 0.1-10 ng/mL), estrogen (5-10 ng/mL), or progestogen (5-20 ng/mL) induced significant upregulation of CD44v5. These factors are likely to exert a similar stimulatory influence in vivo and may contribute to the process of carcinogenesis.

Adenocarcinoma↗

Expression of epidermal growth factor receptor and transferrin receptor by human trophoblast populations.

Epidermal growth factor (EGF) has several roles, including stimulation of cell division and differentiation. EGF receptor (EGFR) has been localized to villous syncytiotrophoblast, but expression by other human trophoblast populations has not been reported. EGFR expression was examined in normal and pathological placental tissues using a streptavidin-biotin-peroxidase technique; results were compared with expression of transferrin receptor (Tf-R) in similar tissues. EGFR was detected on villous syncytiotrophoblast in early and term pregnancy with labelling of the apical membrane, focal cytoplasmic reactivity, and patchy labelling of the trophoblast basement membrane. In contrast with other reports, EGFR was also consistently localized to villous cytotrophoblast, chorion laeve, and extravillous trophoblast populations in maternal uterine tissues. Maternal decidua showed diffuse labelling of stromal cells, particularly in the superficial zones. The reaction pattern in ectopic tubal pregnancy was similar to that in early intrauterine pregnancy. In molar pregnancy, EGFR was detected on villous syncytiotrophoblast and cytotrophoblast. In contrast, in normal, ectopic, and molar pregnancies labelling for Tf-R was confined to syncytiotrophoblast and to the proximal portions of the cytotrophoblast columns. Expression of EGFR by all trophoblast cells may represent a mechanism of placental growth and proliferation control. EGFR may also be involved with establishment of differentiated trophoblast functions including hormone secretion.

Antibodies, Monoclonal↗

Continence following childbirth.

Urinary and faecal incontinence are problems that can severely limit the social, emotional and sexual being of the woman. Childbirth is one of the major causes of incontinence in women, especially following long second stages of labour, traumatic deliveries, large babies and in multigravidae. This article highlights the issues surrounding childbirth and incontinence and the implications that they have for nursing care. Nurses, especially community nurses, midwives and practice nurses, need to take a proactive stance to the identification of incontinence in women. Once a problem has been identified, it is important that the woman has a thorough assessment and examination before deciding on a plan of care. The use of pelvic floor exercises is the main non-surgical treatment for women with mild to moderate stress incontinence and these can be taught by nursing staff.

Exercise Therapy↗

A multicentre comparative evaluation of catheter valves.

Catheter valves are an alternative to leg bags for urine drainage, but no studies have yet been published which have compared the performance of different valves. This study was undertaken to evaluate the performance of the seven catheter valves available on the UK market in April 1996. The study was carried out by the Continence Products Evaluation (CPE) Network funded by the Medical Devices Agency (Department of Health). Each valve type was tested for 1 week by 19-36 cognitively unimpaired and manually dextrous subjects recruited from 11 test centres. At the end of each week, subjects completed an evaluation form (based on a three-point rating scale) to record product performance. The same catheter valves were also tested for ease of opening/closing by 33 subjects (mostly catheter users) who had some manual impairment. Performance scores varied widely between products. It was found that, to be successful, a valve needs to be easy to manipulate, leak-free, comfortable and inconspicuous. Prescribers need to be aware of the strengths and limitations of different valves for appropriate product selection.

Attitude to Health↗