Biomedical subjects

C D Barton

Publications and source records attributed to C D Barton.

3 recordsLinked to original sources

PubMed1998

Quality of life in patients undergoing salvage procedures for locally recurrent prostate cancer.

BACKGROUND AND OBJECTIVES: As patients are being treated for prostate cancer at a younger age, a significant number of them will ultimately fail the primary treatment and will be candidates for potentially curative salvage therapy. The purpose of this study was to evaluate the impact of salvage therapy for locally recurrent prostate cancer upon the patients' quality of life. METHODS: A cohort of 68 men with locally recurrent prostate cancer undergoing salvage treatment was included in this analysis. Data were collected for the study by mailing the subjects a self-administered questionnaire that included a General Functional Assessment of Cancer Therapy (FACT-G) and a Prostate Cancer Treatment Outcome Questionnaire (FACT-P). Group comparisons were conducted using one-way analysis of variance (ANOVA). RESULTS: Overall, 50% and 88.6% of patients were free of biochemical recurrence in the salvage surgery (SS) and salvage radiotherapy (SRt) group, respectively (P=0.4). The physical well-being (PWB) subscale of FACT-G was significantly higher for the SRt patients (P=0.008). Using the Trial Outcome Index Prostate subscale, the Trial Outcome Index Incontinence Urinary scores, and the Functional Assessment of Incontinence Therapy-Urinary score group comparisons, patients in the SRt group had a higher quality of life than patients in the SS group (P=0.038, P=0.001, and P=0.001, respectively). CONCLUSIONS: In the current study, patients with clinically localized prostate cancer who are at high risk for local disease recurrence may have a trend toward better disease-free survival and a better urinary continence rates if the primary treatment is radical prostatectomy rather than radiation therapy.

Aged↗

PubMed1996

Clinicians' judgement of capacity of nursing home patients to give informed consent.

OBJECTIVE: The study determined the rate of incapacity to give informed consent for medical treatment among patients admitted to a nursing home and assessed whether clinical staff members recognized this incapacity and whether they used alternative means to provide surrogate decision making for their patients' treatment. METHODS: After 44 patients admitted to a nursing home affiliated with a major teaching hospital gave oral consent, two standardized tests, the Hopkins Competency Assessment Test (HCAT) and the Mini Mental State Examination (MMSE) were administered to them. Later a researcher blind to the test results reviewed subjects' clinical records to determine whether staff recognized any incapacity in giving informed consent for medical treatment. RESULTS: Twenty of 44 subjects were identified by the HCAT as incompetent to give informed consent for medical treatment. Clinical staff had identified 13 of those subjects as clinically incompetent. None of the subjects whom clinical staff identified as clinically incompetent was provided with surrogate decision makers in accordance with procedures outlined in state law. CONCLUSIONS: The prevalence of incapacity to give informed consent in the nursing home population was high. Clinical screening by staff did not identify all clinically incompetent patients, and staff had unresolved conflicting opinions about individual patients' capacity to give informed consent. Even when staff recognized a patient's incapacity to give informed consent, proper legal procedures for appointing surrogate decision makers were not followed.

Adult↗

PubMed1993

Mood variability in normal subjects on lithium.

To investigate the effect of lithium carbonate on normal volunteers' moods, we randomly assigned 30 subjects to 5 weeks each of placebo and lithium treatment with crossover at midstudy. Lithium levels were maintained during the treatment period at a mean serum level of 0.54 mEq/L. All subjects completed visual analogue mood scales (VAMS) daily throughout the study period; segmented visual analogue scales (SVAS) measuring mood, anxiety, and energy and the Profile of Mood States (POMS) were completed weekly at testing sessions. Neither mean mood nor mood variability as assessed by the delta square (mean square successive difference) differed between placebo and lithium conditions. Segmented visual analogue scale mood ratings were highly correlated with the VAMS and similarly showed no difference between conditions. The self-rated mood variability, however, declined significantly in both experimental conditions as a function of time on study. None of the POMS factors differed between placebo and lithium conditions. These data suggest that lithium, in modest doses administered over 5 weeks, does not have a substantial mood-stabilizing effect in normal subjects.

Adult↗