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Biomedical subjects

J Bibby

Publications and source records attributed to J Bibby.

10 recordsLinked to original sources
PubMed2000

Tension-free vaginal tape for primary genuine stress incontinence: a two-centre follow-up study.

OBJECTIVE: To assess the safety and efficacy of the tension-free vaginal tape procedure in the treatment of primary genuine stress incontinence. PATIENTS AND METHODS: A two-centre follow-up study was conducted on 40 women with urodynamically confirmed primary genuine stress incontinence who had a tension-free vaginal tape inserted under local anaesthesia with sedation. Operative details were recorded and all patients followed up both subjectively, and objectively with repeat urodynamic studies and pad testing. RESULTS: The mean (range) age of the women was 51.1 (33-86) years, the median parity 2 (0-4) and mean body mass index 25.1 (19-35). The mean anaesthesia and operative duration was 42 (25-65) min; 93% of the women resumed immediate spontaneous voiding with no need for catheterization. The mean inpatient stay was 2.2 (2-4) days (where 2 days is equivalent to one night in hospital). The follow-up was conducted at a mean interval of 12.3 (6-24) months. Subjectively, 80% of women were cured and 17.5% significantly improved; objectively, genuine stress incontinence was cured in 95%. Symptomatic postoperative detrusor instability was found in 15% of women and symptoms of voiding dysfunction identified in 5% of women. There were no defects in healing or tape rejection. CONCLUSION: The tension-free vaginal tape procedure is a promising new technique that, in this short-term analysis, appears to be safe and effective. Intra-operative complications are uncommon and both hospital stay and recovery are short. Voiding complications are rare but symptomatic postoperative detrusor instability had an incidence of 15%.

Adult↗
PubMed1999

Evidence-based practice. Guiding lights.

Traditional methods of implementing clinical guidelines and changing professional practice endure despite evidence that they are ineffective. The increasing demand for guideline implementation will have to be met within existing resources. Work in one health authority, which marries the methods of changing practice shown to be effective with the limited resources available, is already showing dividends.

Education, Medical, Continuing↗
PubMed1991

Prevalence of HPV cervical infection in a family planning clinic determined by polymerase chain reaction and dot blot hybridisation.

The overall prevalence of human papillomavirus (HPV) cervical infection in 131 women attending a family planning clinic was 7% (HPV 6/11, 16, 18, 31) by dot blot hybridisation, 53% (HPV 11, 16, 31) by polymerase chain reaction (PCR), and 56% by the two methods combined. HPV 16 and 18 were the commonest types (4% each) by dot blot, HPV 16 (39%) by PCR. Fifteen percent of subjects had mildly abnormal cervical cytology (grades 1A, 2A, or 3). There was no significant correlation between cytological abnormality and HPV positivity, or between cytological or HPV status and other postulated risk factors for cervical neoplasia. It is concluded that PCR is considerably more sensitive than dot blot DNA hybridisation in detecting HPV cervical infection in such a "low risk" setting, where HPV copy number may be low. Firm conclusions cannot be drawn from our results regarding a causal role for HPV or other factors in the development of cervical neoplasia.

Adolescent↗
PubMed1978

Specific production of prostaglandin E by human amnion in vitro.

Prostaglandin production by intra-uterine human tissues has been investigated using a method of tissue superfusion. Tissues were obtained at elective Caesarean section and after spontaneous vaginal delivery. It was found that all the tissues studied (amnion, chorion, decidua and placenta) produced more prostaglandin E (PGE) and 13,14-dihydro-15-keto-prostaglandin F (PGFM - the major circulating metabolite of prostaglandin F) than prostaglandin F (PGF). Amnion produced significantly more PGE (but not PGF or PGFM) than any other tissue. Prostaglandin production by each tissue was similar whether it was taken at elective Caesarean section or after spontaneous vaginal delivery.

Amnion↗
PubMed1978

Prostaglandins in the human umbilical circulation at birth.

Prostaglandin E (PGE), prostaglandin F (PGF) and 13, 14-dihydro-15-keto-prostaglandin F (PGFM) have been measured in umbilical cord plasma obtained immediately after delivery of the baby before clampiing of the cord. In general the prostaglandin levels followed the pattern PGFM greater than PGE greater than PGF. A significant arterio-venous difference was demonstrated only for PGE with raised venous levels (P less than 0.01). In cord blood samples obtained from infants whose mothers had received epidural anaesthesia, no arterio-venous difference for PGE could be demonstrated although the mean levels were not significantly different from controls. The concentrations of prostaglandins in umbilical cord plasma proximal to the placenta were found to rise continuously from the time of delivery of the baby with no significant changes after cord clamping or placental delivery. The possible physiological significance of these findings is discussed.

Anesthesia, Epidural↗
PubMed1978

Plasma concentrations of prostaglandins during late human pregnancy: influence of normal and preterm labor.

Highly sensitive and specific RIA procedures have been used to measure prostaglandin concentrations in the peripheral circulation of late pregnant and parturient women. The concentrations of prostaglandin E (PGE) and prostaglandin F (PGF) in plasma samples assayed within 4 weeks of collection were not significantly different among the groups studied, the levels (mean +/- SEM, picograms per ml) were: late pregnancy (n = 13): PGE, 4.8 +/- 1.0; PGF, 6.2 +/- 0.5; early term labor (n = 5): PGE, 6.8 +/- 1.5; PGF, 7.9 +/- 0.7; late term labor (n = 5): PGE, 5.4 +/- 2.2; PGF, 12.4 +/- 3.5; and preterm labor (n = 7): PGE, 4.4 +/- 0.4; PGF, 6.9 +/- 1.4. The concentration of 13,14-dihydro-15-keto-prostaglandin F (PGFM) in late pregnancy was 59.0 +/- 7.8 pg/ml. During spontaneous term labor, the concentration of PGFM was significantly elevated (P less than 0.01) to 142.8 +/- 32.3 pg/ml in early labor and 282.7 +/- 55.3 pg/ml in late labor. The concentration of PGFM in plasma from patients in preterm labor (62.7 +/- 17.4 pg/ml) was not significantly different from that found during late pregnancy, but was significantly lower than levels found at term during early labor (P less than 0.05). The concentration of PGE increased significantly in frozen plasma samples stored for more than 4 weeks in all groups studied; the concentration of PGF was significantly elevated after storage only in the late pregnancy group (P less than 0.01). The plasma concentration of PGFM in all groups studied was unaffected by storage. It is concluded that measurement of PGFM concentrations is the most reliable method available of monitoring prostaglandins in the peripheral circulation and that great care must be exercised in the assay and interpretation of prostaglandin levels in human plasma.

Female↗
PubMed1977

Rapid increases in plasma prostaglandin concentrations after vaginal examination and amniotomy.

Peripheral plasma concentrations of 13,14-dihydro-15-keto prostaglandin F (PGFM) were measured in three groups of women after the 37th week of pregnancy. Samples were taken before and five minutes after (a) amniotomy, (b) vaginal examination with sweeping of the fetal membranes, or (c) vaginal examination without sweeping of the membranes. Each procedure significantly raised the circulating PGFM levels, although amniotomy and vaginal examination with membrane sweep were more potent stimuli than vaginal examination alone. These findings suggest that there is a considerable potential for rapid increases in prostaglandin production during late pregnancy and provide a possible explanation for the fact that amniotomy and vaginal examination with membrane sweep often initiate labour.

Amnion↗