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Biomedical subjects

R Robertson

Publications and source records attributed to R Robertson.

120 records · Page 7Linked to original sources
PubMedDate not supplied

Post-treatment sexual adjustment following cervical and endometrial cancer: a qualitative insight.

There is an increasing number of long-term survivors of cervical and endometrial cancer for whom quality of life is of major importance. We interviewed 20 women (aged 19-64) to explore the dynamics and components of post-treatment sexual adjustment and its impact on quality of life. Stratification by treatment received (surgery alone, surgery plus external-beam radiation, surgery plus brachytherapy, and surgery plus external-beam radiation and brachytherapy) and time since treatment (immediately post treatment, during the next 2 years and thereafter) was undertaken, to ensure representation of all relevant experiences and views, and to allow time for any long-term side effects to appear. The NUD*IST software (Non-numerical Unstructured Data by Indexing, Searching and Theorising) was used to assist with the coding of audio-taped, transcribed interviews and to search for themes and segments. While the data supported findings reported in the literature, important new themes emerged in the course of the qualitative analysis. These included: (a). issues related to being 'feminine', (b). the role of intimacy in post-treatment adjustment and (c). the importance of communication between health professionals, patients and partners. A model is presented that integrates these issues and highlights the need for effective interventions to improve post-treatment outcomes. The provision of information, support and modification of rehabilitation devices is suggested.

Adaptation, Psychological↗
PubMedDate not supplied

Sexual functioning in patients following radical hysterectomy for stage IB cancer of the cervix.

Despite extensive research on sexual dysfunction after gynecological cancer, uncertainty remains regarding the nature and extent of sexual problems following surgery for early cervical cancer. This study investigated whether radical hysterectomy for stage IB cancer of the cervix without adjuvant treatment entails short- or long-term sexual difficulties. Twenty patients with stage IB cervical cancer undergoing radical hysterectomy (CG), 18 women treated with hysterectomy for a benign gynecological condition (BG), and 20 gynecologically healthy women (HG) were studied. At 0, 4, and 8 months postoperatively, data were prospectively gathered using standardized questionnaires and specifically developed scales. Sexual functioning was covered in 15 specifically designed items and analyzed using Fisher's exact tests. For all other variables, group comparisons were computed using analysis of variance (ANOVA) or nonparametric statistical equivalents. Nonsignificant trends, consistent across time and groups, resulted for most of the sexual variables. Preoperatively, cancer patients exhibited slightly better sexual functioning than the other two groups, but over time this decreased slightly. Conversely, sexual functioning among the patients with benign disease showed steady improvement. These results indicate that radical hysterectomy for stage IB cervical cancer does not entail major sexual sequelae. Because of the limited sample size of our study, conclusions must be drawn cautiously.

Adult↗
PubMedDate not supplied

Group A streptococcal sepsis and ovarian vein thrombosis after an uncomplicated vaginal delivery.

BACKGROUND: Group A streptococcal puerperal sepsis is an uncommon peripartum infection that can quickly progress to a fulminant, multisystemic infection and life-threatening toxin-mediated shock. This infection can be asymptomatic during a short hospital stay after a routine delivery. Early treatment with antibiotics might not alter the course of tissue destruction caused by the exotoxin A. METHODS: Literature searches were performed using the key words "puerperal infections," "streptococcal infections," "septic sacroiliitis," "postpartum septic arthritis," and "postpartum ovarian vein thrombosis." After patient consent was obtained, a report was prepared documenting the disease course, diagnosis, and treatment of a case of puerperal sepsis with multiple serious complications. RESULTS AND CONCLUSION: Puerperal sepsis occurs when streptococci colonizing the genital tract or acquired nosocomially invade the endometrium, adjacent structures, lymphatics, and bloodstream. A lack of symptoms early in the course of infection is common; later, minor somatic complaints can quickly progress to septic shock as effects of the exotoxin A are manifest. Women who complain of fever, pelvic pain, or unexplained systemic symptoms in the early postpartum period should have a detailed history and physical examination. All sites of suspected infection should be cultured. If sepsis is suspected, diagnostic imaging includes chest radiographs, contrast-enhanced computed tomographic scans, or magnetic resonance imaging to rule out ovarian vein thrombosis, pelvic abscess, or sacroiliac septic arthritis. Broad-spectrum antibiotic coverage must be initiated immediately after collection of cultures. Clindamycin plus a beta-lactam antibiotic is preferred for streptococcal toxic shock syndrome.

Adult↗
PubMedDate not supplied

Characterization of diaminouracil metabolites of caffeine in human urine.

A major caffeine metabolite (A1) has been isolated from human urine by a combination of solvent extraction, reverse phase high-pressure liquid chromatography, and silica gel open column chromatography. The chromatographic and spectral properties of A1 are identical with an authentic sample of 5-acetylamino-6-amino-3-methyluracil. A stable isotope-labeling study, in which [2-14C]caffeine in a 1:1 mixture of unlabeled caffeine and [1,3-15N-8-13C] caffeine was administered to subjects, demonstrated that the C-8 carbon of caffeine was lost during the biotransformation to A1. Thus, the acetyl group in A1 does not originate from caffeine. The 1:1 ratio of the mass spectral ions for A1 isolated from the stable isotope study and the specific activity of A1 support caffeine as the principal source of A1. A related metabolite (A2) was too labile for complete purification and structural identification. The chromatographic and mass spectral properties of the degradation product of A2 were identical with those of A1.

Biotransformation↗