Biomedical subjects

G Whitfield

Publications and source records attributed to G Whitfield.

6 recordsLinked to original sources

PubMed2001

Written and computer-based self-help treatments for depression.

Patients and health purchasers are demanding the provision of effective and accessible mental health treatments. Psychotherapeutic approaches are popular with patients, but access to specialist psychotherapy services is often limited. Other ways of offering treatment within the time and resources available to most practitioners need to be considered. One possible solution is the use of structured self-help materials that address common mental disorders such as depression. Self-help treatments are available in a variety of formats such as books, CD-ROMS, audio and videotapes. Evidence exists for their effectiveness; however, a relatively neglected area has been a discussion of the educational aspects of such materials. Self-help materials aim to improve patient knowledge and skills in self-management. They require very clear educational goals and a content and structure that is appropriate for those who use them. Such work will enhance the credibility, take-up, and effectiveness of self-help materials within clinical settings.

Books↗

PubMed1995

Operative procedures in patients subsequently found to be human immunodeficiency virus positive.

This study investigated the number and range of surgical procedures performed in patients subsequently found to be human immunodeficiency virus (HIV) positive. Procedures were included if they occurred during a period when the patients were likely to have been infected with HIV but unaware of their HIV status. A total of 28 operative procedures were documented in 19 (22 per cent) of 86 patients. Several operations were major and invasive. All patients had recognized risk factors for HIV infection but these had not been elicited in the surgical records. Women and patients who acquired their disease through heterosexual intercourse were more likely to have undergone surgery before a diagnosis of HIV than homosexual men. The incidence of surgical procedures in patients with HIV infection was significantly greater than in the general population of Leicestershire; however, many of these were minor and related to the management of complications associated with HIV. Surgeons are performing operations on patients who are unknowingly infected with HIV. The risk of transmission of HIV to surgeons is remote, but surgeons must be aware of risk factors for HIV infection.

Adult↗

PubMed1990

Hysterectomy with extended surgical staging and radiotherapy versus hysterectomy alone and radiotherapy in stage I endometrial cancer: a comparison of complication rates.

Extended surgical staging (ESS) has been added to total hysterectomy and bilateral salpingo-oophorectomy (TAHBSO) in patients with clinical Stage I endometrial cancer in order to better define patterns of metastatic spread and the response to treatment. Adjuvant radiotherapy has a demonstrated efficacy in decreasing central recurrence in Stage I disease. The combined use of radical surgery and pelvic radiotherapy for cervical cancer patients results in an increased incidence of complications. This study compares major complication rates in Stage I endometrial cancer patients who underwent either TAHBSO with ESS or TAHBSO alone followed by adjuvant external beam radiotherapy (RT). Records of 52 patients with clinical stage I endometrial cancer were reviewed. Thirty-two patients underwent TAHBSO plus ESS and 20 patients had TAHBSO alone. All patients received postoperative, whole pelvis external radiotherapy. Four patients suffered complications potentially related to treatment which required rehospitalization, and all 4 were in the group which had undergone ESS. A comparison of complication rates between the ESS + RT group (4/37 or 10.8%) and TAHBSO + RT group (0/20) suggested a trend toward significance (P less than 0.10). Treatment protocols using extended surgical staging prior to adjuvant radiotherapy in Stage I endometrial cancer should examine complications potentially related to this combination, to further define treatment risks and benefits.

Adult↗

PubMed1990

A randomized study of the efficacy of adjuvant local graft irradiation following renal transplantation.

A prospective randomized study investigating the effectiveness of adjuvant local graft irradiation (LGI) following renal transplantation was performed at Georgetown University Hospital from 1983 until 1988. One hundred and thirty-eight patients were enrolled in the study with 117 patients receiving cadaver kidney transplantations and 21 patients receiving living related kidney transplantations. Seventy-one patients were randomized to receive adjuvant local graft irradiation consisting of 600 cGy in four fractions with chemical immunosuppression whereas the remaining 67 patients received chemical immunosuppression only (control group). The two groups were comparable at entry with respect to potentially important prognostic variables. Median follow-up for all patients was 30 months. The 3-year actuarial allograft success rate was 75% and 68% for the local graft irradiation and control groups, respectively. A nonsignificant trend favoring the irradiated group was noted. Subgroup analysis of the 21 recipients of kidneys from living related donors suggested an improvement in allograft survival for the local graft irradiation arm. Cadaver allograft survival was not significantly different between the two treatment arms. There was no apparent benefit in kidney function or time to the first rejection episode in the group receiving local graft irradiation.

Adult↗

PubMed1989

Postoperative adjuvant external-beam radiotherapy in surgical stage I endometrial carcinoma.

A combined surgical and radiotherapeutic approach is widely in Stage I endometrial adenocarcinoma. The technique and timing of the radiotherapy varies from center to center. Postoperative external-beam (EB) radiotherapy has the advantage of patient selection based upon surgical findings, comprehensive treatment of the pelvic nodal and vaginal cuff areas, and elimination of the need for an intracavitary procedure. Although frequently utilized, this technique is surprisingly poorly described in the medical literature. From 1979 to 1986, 46 surgical Stage I patients received adjuvant postoperative EB therapy at Georgetown University Hospital (GUH) (Washington, DC). Indications for treatment were Grade greater than or equal to 2 and/or depth of myometrial invasion of greater than 33%. The 5-year actuarial survival was 90% with a disease-free survival of 82%. The failure rate within the irradiated field was 6.5% with a distant failure rate of 8.7%. The rate of significant long-term complications was acceptable at 6.5%. The authors conclude that postoperative EB radiotherapy is an effective adjuvant therapy with results comparable to other available radiotherapeutic techniques.

Adenocarcinoma↗

PubMed1975

A technique for obtaining linear heat-survivor curves with Staphylococcus aureus and its application to the assay of sublethal heat injury.

Staphylococcus aureus was grown in a complex (HK) medium either by a batch technique or by a modified batch technique after growth in a chemostat. These cultures were heat-treated at 52 degrees C, and counted on trypticase soy agar (TSA) or trypticase soy agar containing 7.5% NaCl (TSAS). When linear heat-survivor curves were obtained decimal reduction times (D52 degrees C) could be calculated from the TSA counts and pseudodecimal reduction times (D' 52 degrees C) from the TSAS counts. The D or D' values of batch-grown cells varied from 22 to 133 min and from 3 to 12 min, respectively. With cells grown by the modified technique the values were less variable (D was 22-51 min and D' was 3-7 min). D and D' values could be calculated from the same heat treatment in two of the six estimations with cells grown by the modified technique.

Bacteriological Techniques↗