Biomedical subjects
E Wilkes
Publications and source records attributed to E Wilkes.
Endothelial cell counts following pars plana vitrectomy in pseudophakic and aphakic eyes.
In 13 pseudophakic eyes, endothelial cell counts remained stable following pars plana vitrectomy. The posterior chamber pseudophakos apparently had a protective effect on the corneal endothelium, even though the posterior lens capsule was removed during surgery. By contrast, in nine aphakic eyes, a statistically significant (p greater than .05) cell loss of 7.6% occurred after pars plana vitrectomy. We conclude that vitrectomy therefore poses an increased risk to the cornea in aphakic, but not in pseudophakic eyes.
The planning, execution, and evaluation of a breast cancer detection awareness program.
A Breast Cancer Detection Awareness Program (BCDAP) was conducted in Western New York during the spring of 1987 in conjunction with a national effort by the American Cancer Society. The importance of screening mammography was promoted by public education through the media combined with promotion of breast cancer screening services available from 26 health care providers. Women were instructed to call a hot line to receive a coupon for a low-cost mammogram, if eligible to participate. A provider directory was included to facilitate scheduling appointments. The program resulted in 6,355 women requesting a coupon. From this population 3,178 women utilized the coupon to receive a mammogram. Although the screening rate of 50% was encouraging, approximately half of the callers to the hot line did not receive a mammogram. To increase the screening rate in future programs, it would be useful to determine why some women did not take advantage of the discount coupon.
Biomedical ethics: an Anglo-American dialogue. A personal view of future trends.
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The control of cancer pain in the community: science or pragmatism?
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Women's knowledge and beliefs about breast cancer risk factors, symptoms, detection methods, and treatments.
This paper presents results from a survey of adult women that assessed knowledge, beliefs, and practices regarding the causes, symptoms, detection methods, and treatment of breast cancer. The study population was determined through random selection of household telephone numbers from the Buffalo, New York area telephone directory. Completed interviews were collected from 563 women over the age of 18. Telephone interviews were conducted by trained interviewers, between April and July of 1985. Survey results are compared to those found in the 1979 National Cancer Institute nationwide survey on breast cancer to evaluate if ther have been changes in public awareness about the disease. Differences in knowledge, beliefs, and practices regarding breast cancer were also studied in relation to age, race, and educational background. Overall, women's knowledge about breast cancer has significantly increased since the 1979 survey. However, while more women can name mammography as a diagnostic tool only 15% of women who have heard of mammography reported having had a mammogram. Generally, younger women, white women and those with some college education were more knowledgeable about breast cancer risk factors, symptoms, detection methods, and treatments. Results from this study suggest that although knowledge about breast cancer has improved, women have not adopted recommended early detection practices. Special efforts need to be directed toward health professionals, making mammography more accessible to women who are nonwhite, older and with no college education.
Terminal care: how can we do better?
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Defibrillators in general practice.
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Rheumatoid arthritis: review of searches for an infectious cause. Part II.
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Rheumatoid arthritis: review of searches for an infectious cause. Part I.
No distinctive pattern has yet emerged from the accumulated mass of results that would provide a generally acceptable hypothesis of the etiology of rheumatoid arthritis. A number of immunologic aberrations have been described, but there has been no identification of a key immunologic defect that might link together the various components of the immune response into an agreed pattern. The possibility of a persistent antigenic stimulus arising from an infection cannot be confirmed or refuted. If a virus is involved, it would seem more likely to be a "slow" virus rather than a commonly recognized form, but there is no strong candidate of this type in view. Despite the fact that mycoplasmas are undoubtedly arthritogenic in other species, their role as an etiologic agent in rheumatoid arthritis has not been proven. The idea that bacterial cell wall peptidoglycan may provide a persistent stimulus has much to offer, but it is not possible at this stage to accept peptidoglycan as a recognized etiologic factor. This suggestion will, however, indoubtedly stimulate much further investigation.
A different kind of day hospital--for patients with preterminal cancer and chronic disease.
A new day hospital has been set up in Sheffield for patients with preterminal cancer and chronic disease. During the first 26 months 197 patients with cancer and 66 chronically sick patients attended. Of the 2701 attendances by patients with cancer, breast cancer accounted for 38%. One hundred and forty of the patients with cancer died, 83% in the terminal-care unit and 12% at home. Ninety per cent of respondents to a questionnaire thought that the support provided was of great importance to both patient and family; and over two-thirds of the patients were said to have benefited from improved control of symptoms. A similar facility could be developed within existing day hospitals without major revenue consequences, and should produce a genuine improvement in care. This study suggests, however, that it would not shorten the terminal stay in hospital.
Mental state and other prognostic factors in femoral fractures of the elderly.
Fifty elderly patients with fractured femurs were followed up for six months. A hospital stay of less than 28 days and a good prefracture mental state were such important favourable prognostic factors that their absence made the outlook poor and carried clear implications concerning management.
Quality of life: effects of the knowledge of diagnosis in terminal illness.
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Mild hypertension: a clinical trial conducted in hospital general practice.
To compare findings in a hospital trial of hypotensive drugs with those in a general practice trial several patients with mild hypertension were studied at the same time in hospital and in general practice. They received bendrofluazide and potassium chloride or bendrofluazide, potassium chloride, and reserpine according to a double-blind crossover protocol, and blood biochemical values were studied over eight weeks and six months. When reserpine was withdrawn from nine women they followed a modified protocol comparing bendrofluazide and potassium chloride with potassium chloride alone. The blood pressure values measured by the general practitioners were similar to those measured in hospital. Both the diuretic alone and the diuretic with reserpine produced significant falls in blood pressures. Although plasma renin activity increased on diuretic treatment, continued treatment did not produce a further increase, and levels gradually declined towards normal.
BCG for handicapped children.
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Modern obstetrics and the general practitioner.
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Terminal care and the special nursing unit.
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