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Biomedical subjects

S Vernon

Publications and source records attributed to S Vernon.

At least 37 records · Page 2Linked to original sources
PubMed1994

Written consent about sexual function in men undergoing transurethral prostatectomy.

OBJECTIVE: To review the written recording of consent about possible sexual dysfunction after transurethral resection of the prostate (TURP), and the incidence of sexual dysfunction in sexually active men after TURP, from a large scale audit of transurethral prostatectomy held in 12 hospital sites in the Northern Region. PATIENTS AND METHODS: Over an 8-month period data were collected from 12 separate hospital sites within the Northern Region by two independent nurse co-ordinators who travelled to each of the sites. Information was gathered from medical records, operation lists and theatre books using a standard proforma. The Nottingham Health Profile (NHP) was used as a quality of life instrument in a subgroup of patients who were asked about sexual function before and after operation. RESULTS: Advice about retrograde ejaculation was recorded infrequently, with only 30% of case notes including a statement about this (inter-site variations 0-78%). The mean age of patients in whom a written record was made was lower (70 [0.44 SEM] years) than those in whom there was no recording (72 [0.25] years; P < 0.001), but marital status did not appear to be a significant factor. No significant differences in NHP were found comparing men who did or who did not have written evidence about consent regarding retrograde ejaculation. In addition, in a subset of men who had been asked pre-operatively about sexual function, no significant differences were found in overall NHP measurements in those who did or who did not develop retrograde ejaculation. In men who were sexually active before operation, the incidence of major sexual problems, impotence and retrograde ejaculation were 12%, 11% and 24% respectively. CONCLUSION: The incidence of sexual dysfunction following TURP in this audit concurred with previously reported studies (4-40%), but despite this most urologists in our audit were not recording that they had advised their patients about this possible outcome.

Aged↗
PubMed1994

Deaths and complications following prostatectomy in 1400 men in the northern region of England. Northern Regional Prostate Audit Group.

OBJECTIVE: To determine the degree of variation in mortality and major morbidity following transurethral resection of the prostate (TURP), and to assess intersite variation for mortality and morbidity over 12 sites within the Northern Region. Further, to determine whether the previously observed effects on morbidity of unit size, patient through-put and emergency admission were borne out in contemporary urological practice in the Northern Region. PATIENTS AND METHODS: For an 8 month period, 1 April 1991-31 November 1991, an independent audit of TURP was performed on 12 different hospital sites throughout the Northern Region. A constant data set was designed which was collected on each patient before and 3 months after operation by two independent clinical co-ordinators who travelled to each of the sites. All case notes were reviewed at 3 months after operation by the co-ordinators using a standard proforma, rather than depending upon self reporting by medical staff. Data on factors potentially affecting mortality and morbidity were collected, including emergency admission, diagnosis of prostate cancer, American Society of Anesthesiologists' co-morbidity scores, and age and differences in throughput in the 12 sites. The effect of through-put or 'volume' on mortality and morbidity was assessed by comparing morbidity and the number of cases performed. RESULTS: The early mean death rate was 13 of 1396 patients (0.9%), with an inter-site variation ranging from 0% to 3.8%. A mean of 2.0% of men were returned to theatre after TURP, 2.4% of patients received a blood transfusion (> 2 units) after operation, and 8.0% of patients developed post-operative sepsis; these complications varied sixfold, sevenfold and 17-fold across the different sites respectively. Those units performing < or = 100 operations over the audit period (equivalent to < 150 operation per year) had a significantly increased rate of deaths and complications which was not related to population differences, though some low volume units had good results. Elderly men who were admitted as emergencies or with prostate cancer were particularly vulnerable to complications. CONCLUSIONS: The overall early mortality rate after TURP for benign prostatic hyperplasia across the Region compares well with other reported large series. The significant variation in morbidity rates found in this study suggests that careful attention needs to be paid by Urologists, Purchasers and Providers to morbidity rates after prostatectomy.

Age Factors↗
PubMed1992

Teaching social skills to students with autism to increase peer interactions in an integrated first-grade classroom.

We investigated the use of social skills groups to facilitate increased social interactions for students with autism and their nonhandicapped peers in an integrated first-grade classroom. Social skills groups consisted of training students and peers in initiating, responding, and keeping interactions going; greeting others and conversing on a variety of topics; giving and accepting compliments; taking turns and sharing; asking for help and helping others; and including others in activities. Training occurred during the first 10 min of 20-min play groups, four times per week. Using a multiple baseline across subjects design, results demonstrated increases in the frequency of, time engaged in, and duration of social interactions, as well as the responsivity of students and peers to each other. Results were maintained when students were monitored and given feedback on social performance in play groups and during follow-up.

Autistic Disorder↗
PubMed1990

Serological monitoring of vesicular stomatitis New Jersey virus in enzootic regions of Costa Rica.

The activity of vesicular stomatitis viruses was monitored on 3 dairy farms in Costa Rica. Antibody levels were measured and clinical disease monitored in 165 cattle during a 20 month period (1986-1988). Vesicular stomatitis New Jersey (VS NJ) virus was shown to be enzootic on these farms by a 94.2% prevalence of neutralizing antibody; this did not vary significantly between herds. The mean prevalence of antibody to vesicular stomatitis Indiana (VS IN) virus was 15.2%, but was significantly higher in 1 herd. A total of 25 cases (annual incidence rate of 9%) of clinical vesicular stomatitis (VS) was reported. VS NJ virus was identified as the causal agent by detection of VS NJ virus antigens by the complement fixation test. VS NJ virus was isolated in 11 cases. All episodes of disease occurred between November and January, the beginning of the dry season. Most animals maintained stable neutralizing antibody titers throughout the study, and all diseased animals were previously seropositive to VS NJ virus. A total of 31 animals with neutralizing antibodies to VS NJ virus had a VS NJ virus-specific IgM response, and 6 animals had IgM responses that persisted for as long as 6 months. There was no relation between IgM responses and clinical disease occurrence. VS NJ virus persisted predominantly as a subclinical infection in cattle throughout the year in enzootic areas of Costa Rica. The humoral response did not prevent reinfection with VS NJ virus.

Animals↗
PubMed1989

Assessment of colorectal cancer screening outcomes among workers involved in polypropylene manufacture.

To follow up on a previous finding of an elevated colorectal cancer incidence rate among Exxon employees on a unit devoted to the manufacture of polypropylene (the polyolefin unit [POU]), a company-sponsored screening program was offered to all former and present POU workers. Overall participation was 52.5%, with lower participation among older workers and workers who had retired or were no longer employed by the company. Evaluation of polyp prevalence rates for POU workers v rates for non-Exxon employees screened at the same clinic showed a general pattern of elevated rates for POU employees, especially for mechanical and process workers. This pattern was most marked for polyps at least 0.5 cm in diameter, but findings were less clear for adenomatous polyps. The effect of factors that might bias evaluation of colorectal polyp prevalence rates (eg, selection bias, observation bias, genetic susceptibility) is discussed, but none of these factors seemed a likely explanation for the findings observed in this study.

Adult↗
PubMed1985

An open study evaluating the reactogenicity and immunogenicity of a DTP vaccine containing an acellular pertussis component in four to six year old children.

Acellular pertussis vaccines have been used for mass immunization of children in Japan since the fall of 1981, but until recently they have not been evaluated in the United States. We report a trial with a DTP vaccine containing an acellular pertussis component in 36 four to six year old children who had previously received four doses of United States DTP licensed vaccine with a whole cell pertussis vaccine component. The study vaccine contained diphtheria and tetanus toxoids and 300 HA units of Takeda acellular pertussis component. The principle immunizing antigens in the pertussis component of the vaccine were lymphocytosis promoting factor (LPF) and filamentous hemagglutinin (FHA). Local and systemic reactions were monitored during the first 48 hours after vaccination, and pre-immunization and one month post-immunization serum specimens were obtained for antibody assay. The following reaction rates were noted: redness 50%, tenderness 50%, swelling 41%, fever (greater than or equal to 38 degrees C) 3%, drowsiness 17%, fretfulness 14%, anorexia 11%, and vomiting 6%. Pertussis antibody values (preimmunization/postimmunization) were as follows: agglutinin GMT, 1:21/1:100; FHA mean ELISA u, 28 +/- 6/greater than or equal to 229 +/- 47; LPF mean ELISA u, 176 +/- 59/1732 +/- 280. The pertussis component of the study vaccine would appear to be less reactogenic than United States whole cell pertussis vaccines but still immunogenic when given as a booster immunization to four to six year old children. Further studies are needed to assess reactions and immunogenicity in younger and previously unimmunized children.

Anorexia↗
PubMed1984

Susceptibility to varicella virus of certain adults in the southeastern United States.

The serologic status of 76 adults was determined to evaluate their immunity to the varicella virus. Previous reports indicate that 92% to 98% of the adult population develop this immunity. Our experience with nosocomial varicella infection in two hospital employees suggested that more adults in this subtropical region may be susceptible to varicella infection. Three (7.1%) adults with a definite history of varicella had a positive indirect fluorescent antibody (IFA) test. Twenty-eight (72%) of 39 employees without a history had a positive serology, a rate lower than previously reported (p less than 0.002). Twenty-nine (85%) of 34 other adults and 60 (79%) of the 76 adults tested had positive tests; these rates are also lower than reported (p = 0.003 and less than 0.001, respectively). These data indicate that some adult groups may be more susceptible to varicella infection and suggest that knowledge of immunity should be an important health concern in some hospitals.

Adult↗
PubMed1983

Resection of pulmonary metastases from nonseminomatous testicular tumors. Correlation of clinical and histological features with treatment outcome.

Clinical and histological correlates of survival in patients undergoing complete resection of pulmonary metastases from nonseminomatous testicular carcinoma were determined in 25 Stage C patients aged 17-38 years treated from 1969-1978. All patients had orchiectomy and retroperitoneal lymphadenectomy. Nineteen patients received combination chemotherapy before resection, and all received chemotherapy after resection. Three patients had four additional thoracotomies for pulmonary recurrence. Survival was measured from time of first thoracotomy to time of last followup or death. Actuarial survival for the entire group at one, two, and five years was 80, 63, and 59%, respectively. Median follow-up of the survivors was 3.5 years. Patients in low tumor burden groups such as those with no tumor in retroperitoneal nodes, with unilateral metastases, or with single metastases had better prognosis, as did patients whose primary tumors were moderately well differentiated. Characteristics of pulmonary metastases that favorably influenced the prognosis were the presence of mature teratoma, presence of few mitoses, lack of mononuclear infiltrate, and lack of desmoplastic response. These findings confirm the effectiveness of multimodality therapy which includes the resection of pulmonary metastases for Stage C nonseminomatous carcinoma of the testes. In addition, they suggest that consideration should be given to the stratification of prospective clinical trials on the basis of tumor burden and histologic characteristics of the primary and metastatic lesions.

Adolescent↗