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Biomedical subjects

A J Riley

Publications and source records attributed to A J Riley.

At least 19 recordsLinked to original sources
PubMed1999

Self-assessment of morbidity following radical hysterectomy for cervical cancer.

The aim of this study was to assess the magnitude of the morbidity following radical surgery for early stage cervical cancer. We performed a retrospective survey of all women who had undergone a radical hysterectomy and lymphadenectomy between the months of July 1995 and December 1996 inclusive at either the Royal Marsden or St George's Hospital (n =38), using a detailed questionnaire on bladder, ano-rectal and sexual function, both before and after treatment. Sixteen women (44.4%) received adjuvant radiotherapy. The mean interval between surgery and inquiry was 16.4% months (range 8-25 months). The mean age at the time of surgery was 40.5 years. Thirty-six out of 38 women contacted responded (94.7%). Overall 33 women (91.7%) reported new bladder, ano-rectal or sexual symptoms. Complaints of urinary incontinence, particularly of urge incontinence, and of voiding difficulties increased significantly after surgery (P <0.05). However, only 5.3% of women had sought treatment. Tenesmus increased significantly (P <0.05), while increases in diarrhoea and faecal incontinence were not statistically significant (P =0.051). Although 12.9% of women stated an improvement in their sex lives, 54.8% thought that their sex life was worse after treatment, and 12.9% of women had ceased sexual activity altogether. Of women of childbearing age 53.8% felt adversely affected by their loss of fertility. Bladder, ano-rectal and sexual symptoms are very common following radical hysterectomy for cervical cancer, with adverse effect on quality of life, and persist into the second year after treatment.

Journal Article↗
PubMed1998

A comprehensive evaluation of the mechanism of skin tumorigenesis by straight-run and cracked petroleum middle distillates.

The role of skin irritation and other factors on the tumorigenic activity of petroleum middle distillates (PMDs) in mice was examined in a comprehensive research program. The program culminated in a 2-year dermal carcinogenicity study which compared the effects of equal weekly doses of irritating and nonirritating PMDs. Modified Ames mutagenicity studies and three- to seven-ring polycyclic aromatic compound (PAC) analyses indicated that the mutagenic activity of PMDs was correlated to PAC content. In subchronic and subacute studies, PMDs produced marked skin irritation which was ameliorated if the test samples were diluted in mineral oil. The reduction in irritation level was not a result of reduced dermal absorption. Straight-run kerosine (SRK), straight-run gas oil (SRGO), and catalytically cracked light cycle oil (LCO) were evaluated in the dermal carcinogenicity study. Test materials were applied either undiluted (2x/week) or as 28.5% (7x/week) or 50% (4x/week) concentrations in mineral oil for a total weekly dose of 100 microliters PMD per animal. All three materials produced moderate to marked skin irritation and increased tumor frequency when applied undiluted. When diluted, the irritant effects of SRK and SRGO, which contain low levels of PACs, were ameliorated, and there were no significant increases in tumors relative to controls. LCO, containing 8.7% three- to seven-ring PACs, increased tumor frequency when diluted, even when skin irritation was limited. These data indicate that the tumorigenic activity of straight-run MDs is likely a consequence of a nongenotoxic process, associated with frequent cell damage and repair. PMDs which contain low levels of three- to seven-ring PACs are unlikely to cause tumors in the absence of prolonged skin irritation. In addition, genotoxic mechanisms may also contribute to tumor formation for other PMDs containing higher levels of PACs, e.g., products blended with cracked stocks.

Animals↗
PubMed1998

Management of vulval pain--whose responsibility?

Vulval pain can be acute or chronic. Usually patients present to their general practitioner when the pain is acute but, when specialist advice is required, vulval pain can present a real dilemma over to whom to refer patients. Genitourinary medicine, gynaecology, dermatology and sexual dysfunction clinics all play an important part in the holistic management of this symptom. Consultation in a sympathetic environment with appropriate investigations and collaboration between different disciplines may provide a diagnosis and management.

Female↗
PubMed1997

Impotence and its non-surgical management.

Impotence is a common symptom which can cause considerable distress to both the sufferer and his partner. The use of pharmacotherapy to improve erectile function will continue to increase as safe and effective drugs are developed. However, restoring erectile function should not be the only treatment objective. It is also essential to address personal and emotional factors in the sufferer, conflicts in his relationship with his partner, and sexual problems in his partner, all of which may be instrumental in causing or maintaining the presenting impotence. We advocate a combined approach with appropriate medical treatment and sex and couple therapy.

Adult↗
PubMed1996

Perceived carer attitudes to alcohol dependent patients.

Negative attitudes among carers towards people with alcohol-related problems have been reported in many studies. However, few studies have examined whether these attitudes are perceived by patients during face to face contact with healthcare professionals when receiving inpatient treatment. A sample of 26 discharged patients completed a 37-item questionnaire following treatment for alcohol problems. The Likert scale was used to measure whether patients felt that the attitude under investigation existed in the caring environment. The findings indicated that negative attitudes reported in other studies were not perceived by patients during inpatient treatment. Some barriers to treatment effectiveness such as prognostic pessimism were detected by the patients. Many upheld the view that the only goal of treatment adopted by staff was that of total abstinence. There is an increasing need to obtain feedback from patients who have received inpatient care. Greater flexibility and creativity in the care of the alcohol dependent person needs to be explored rather than the maintenance of a prescriptive approach.

Alcoholism↗
PubMed1988

Identification of immunotoxic effects of chemicals and assessment of their relevance to man.

Immunotoxicity is defined as the adverse effects of foreign substances (xenobiotics) on the immune system. Two types of effects are possible: immunosuppression (which may result in an increased susceptibility to infection or to the development of tumours) and immunopotentiation (which may manifest as an allergy or as autoimmunity). There is, as yet, little evidence that well controlled occupational exposure to industrial chemicals has led to clinically significant immunosuppression. In contrast, a number of industrial chemicals have been shown to cause immunopotentiation in exposed populations, producing occupational asthma and contact dermatitis and possibly autoimmunity. In experimental models, immunosuppression (usually assessed by in vivo or in vitro immune function tests) has been induced by a wide range of chemicals but there are a few reports of the immunosuppression leading directly to an increased susceptibility to infection or to the development of tumours. Predictive experimental models are available for type IV allergic reactions, but the identification of chemicals that have a potential to cause other types of allergy or autoimmune reactions requires further research and the development and validation of new animal models. It is considered that routine subacute and chronic toxicity studies should include a full gross and histopathological assessment of the lymphoid organs to more accurately detect the potential of a chemical to cause immunotoxicity. Should such studies indicate that a substance has affected the immune system directly, an assessment of overall immune competence and function tests may be necessary using dose levels below those which cause frank toxicity. However, precise interpretation of immune function tests in terms of their relevance to human health requires an improved understanding of the extent of the functional reserve of the immune system. A strategy for assessing immunotoxicity in exposed human populations demonstrates a need for reliable clinical assessment, accurate medical record-keeping, an environmental and biological monitoring for levels of contaminating chemicals and the judicious use of well-validated immune function tests.

Animals↗
PubMed1986

A comparative study of the effects of ranitidine and cimetidine on carbohydrate tolerance, growth hormone secretion and the hypothalamic-pituitary-gonadal axis in man.

The effect of chronic oral administration of cimetidine (1 g per day) and ranitidine (300 mg per day) on plasma levels of prolactin (PRL), testosterone, dihydrotestosterone (DHT), luteinizing hormone (LH), follicle stimulating hormone (FSH), sex hormone binding globulin (SHBG) and human growth hormone was compared in 2 groups of male patients who presented with dyspeptic symptoms. Eight were treated with ranitidine and 9 with cimetidine for 4 weeks. The glucose and insulin response to a 100 g oral glucose load was also assessed. Cimetidine treatment resulted in a significant increase in plasma testosterone levels which was not found in the ranitidine group. No significant change occurred in PRL, LH, FSH, SHBG, DHT and growth hormone. There was no evidence of a significant alteration in carbohydrate metabolism.

Adult↗
PubMed1984

Response of the upper respiratory tract of the rat to white spirit vapour.

The threshold limit value (TLV) adopted by industry for white spirit is that of Stoddard's solvent and is currently set at 100 ppm (525 mg/m3). Exposure of rats to atmospheres containing an average of 214 mg/m3, 4 h/day, for 4 consecutive days resulted in irritation of the membranes lining the upper respiratory tract but only minimal signs of lung injury. Histopathological changes were observed in the nasal cavity, trachea and larynx and included loss of cilia, mucous and basal cell hyperplasia and squamous metaplasia. These results suggest that in man exposure to white spirit at or around the TLV may result in irritation of the upper respiratory tract.

Animals↗
PubMed1982

Effect of beta-adrenoceptor antagonists on prevalence of peripheral vascular symptoms in hypertensive patients.

1 Eight hundred patients were approached by questionnaire to give details of side effects of their antihypertensive medications. The response rate was 72.8%. The percentage of those questioned who were taking beta-adrenoceptor antagonists at the time was 54.6%. 2 Raynaud's phenomenon (P less than 0.05) and complaints of cold extremities (P less than 0.001) were significantly more frequent in women than in men, 74.8% of women complained of cold extremities. 3 Exposure to beta-adrenoceptor antagonists did not increase the prevalence of Raynaud's phenomenon in either men or women in the study, but did increase the prevalence of cold extremities in men (P less than 0.001). Propranolol, labetalol, oxprenolol and possibly atenolol were likely to produce such side effects. Smoking and the addition of vasodilators did not alter the effect of beta-adrenoceptor blockers on peripheral vascular symptoms. Complaints of cold extremities were not associated with an excess of complaints of other side effects.

Adrenergic beta-Antagonists↗
PubMed1982

A method for monitoring drug effects on male sexual response: the effect of single dose labetalol.

1 A method for monitoring the effect of drugs on the genital response to stimulation provided by vibration is described. 2 Using this method, the effect on male sexual response of two oral doses (100 mg and 300 mg) labetalol were studied and compared with placebo in six subjects. 3 Labetalol did not affect the attainment or maintenance of erection. 4 Labetalol delayed ejaculation in a dose-related manner. 5 Labetalol treatment resulted in a significant dose-related delay in detumescence.

Dose-Response Relationship, Drug↗
PubMed1982

Partial ejaculatory incompetence: the therapeutic effect of midodrine, an orally active selective alpha-adrenoceptor agonist.

The syndrome of partial ejaculatory incompetence has been reviewed. 6 patients, diagnosed as suffering from partial ejaculatory incompetence, were studied. For each subject, large numbers of spermatozoa were present in the post-masturbation urine sample providing evidence of disturbed ejaculatory function. The effect of a potent alpha-adrenoceptor agonist (Midodrine) was evaluated in these patients by means of a double-blind crossover study. Active treatment resulted in a significant increase in intensity of orgasmic sensation, and in a statistically significant improvement in ejaculatory function.

Adult↗