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Biomedical subjects

J Cassell

Publications and source records attributed to J Cassell.

17 recordsLinked to original sources
PubMed2003

Sex differences in the experience of testing positive for genital chlamydia infection: a qualitative study with implications for public health and for a national screening programme.

OBJECTIVES: To explore men's and women's accounts of chlamydia testing, with a view to understanding sex differences in attitudes and in behaviours of public health importance. METHODS: Semistructured interviews with 24 heterosexual patients (12 men; 12 women) diagnosed with genital chlamydia infection, at a large sexual health clinic in central London were transcribed and analysed using qualitative thematic analysis. RESULTS: Participants' expressions revealed important sex differences. Women felt anxious about their future reproductive health, feared stigmatisation, and blamed themselves for contracting chlamydia; whereas men generally reported less concern, were unwilling to disclose their condition to sexual partners, and some men projected attributions of blame onto their partners. Delays in seeking care appeared to be related to perceptions of chlamydia as a relatively minor infection, particularly in men. CONCLUSIONS: Health promotion needs to reflect sex and age differences, emphasising the negative consequences of delayed clinic attendance and exposure to repeat infections. For health professionals to respond appropriately and effectively to increasing numbers of chlamydia infections, there is a need to understand men's avoidant attitudes and behaviours in relation to sexual and reproductive health.

Adolescent↗
PubMed2002

Why we should not seek individual informed consent for participation in health services research.

Ethics committees now require that individuals give informed consent to much health services research, in the same way as for clinical research. This is misguided. Existing ethical guidelines do not help us decide how to seek consent in these cases, and have allowed managerial experimentation to remain largely unchecked. Inappropriate requirements for individual consent can institutionalise health inequalities and reduce access to services for vulnerable groups. This undermines the fundamental purpose of the National Health Service (NHS), and ignores our rights and duties as its members, explored here. Alternative forms of community consent should be actively pursued.

Decision Making, Organizational↗
PubMed1998

Repeated exposure to trimethylolpropane phosphate induces central nervous system sensitization and facilitates electrical kindling.

Trimethylolpropane phosphate (TMPP), pentylenetetrazol (PTZ) and N-methyl-beta-carboline-3-carboxamide (FG-7142) were evaluated and compared for facilitation of electrical kindling in freely moving rats. Stimulating/recording electrodes were implanted in the left amygdala (LAD), right amygdala (RAD) and left bed nucleus (LBN) of the stria terminalis. TMPP (0.275 mg/kg), PTZ (20 mg/kg), FG-7142 (7.5 mg/kg) or vehicle was administered intraperitoneally (i.p.) to separate groups of rats 3 times/week for 10 weeks. Stimulation of the LAD (0.1 Hz, 0.1-ms duration, 280-1500 microA, 20 pulses) 24 h following the drug administration evoked epileptiform after-discharges (ADs) in the LBN and RAD of 12.5% and 17% of rats after the seventh dose of TMPP and PTZ, respectively, and in 20% of rats from the LBN and RAD after the ninth and nineteenth dose of FG-7142, respectively. The same stimulation also induced myoclonic jerks after nine doses of TMPP or PTZ, or after thirteen doses of FG-7142 in 25%, 30% and 20% of animals tested, respectively. Chemically kindled clonic seizures were observed in 100% of TMPP or FG-7142 and 50% of PTZ treated rats by the thirtieth dosing. Control animals exhibited neither behavioral nor electrographic seizures to vehicle injection or to the LAD stimulation. Kindling stimulation applied to the LAD (60 Hz, 2-s train duration, 20-1500 microA, 0.1-ms pulse duration) 4 weeks following the completion of drug treatments evoked epileptic after-discharges from the LAD, LBN and RAD in all treated groups, with generally decreased threshold and latency to onset of after-discharges, compared to vehicle controls. The present study suggests that repeated exposure of rats to sub-convulsive doses of TMPP, PTZ and FG-7142 induces long-term central nervous system sensitization that may be related to both chemical kindling and the facilitation of electrical kindling.

Animals↗
PubMed1998

RP59500 (Quinupristin/dalfopristin): three case reports of its use in infection due to Enterococcus faecium.

We describe three cases of Enterococcus faecium sepsis arising in immunocompromised patients, severely ill with other conditions, who were treated with the new injectable streptogramin RP59500. There are still few reports of clinical experience with this drug. All had bacteriological resolution, with one patient recovering fully. Although two of the three patients died, this was due to underlying disease in one case and a gram-negative superinfection in another. Quinupristin/dalfopristin therapy was not associated with significant adverse effects in any of the patients.

Adolescent↗
PubMed1998

Against medical ethics: opening the can of worms.

In a controversial paper, David Seedhouse argues that medical ethics is not and cannot be a distinct discipline with it own field of study. He derives this claim from a characterization of ethics, which he states but does not defend. He claims further that the project of medical ethics as it exists and of moral philosophy do not overlap. I show that Seedhouse's views on ethics have wide implications which he does not declare, and in the light of this argue that Seedhouse owes us a defence of his characterization of ethics. Further, I show that his characterization of ethics, which he uses to attack medical ethics, is a committed position within moral philosophy. As a consequence of this, it does not allow the relation between moral philosophy and medical ethics to be discussed without prejudice to its outcome. Finally, I explore the relation between Seedhouse's position and naturalism, and its implications for medical epistemology. I argue that this shows us that Seedhouse's position, if it can be defended, is likely to lead to a fruitful and important line of inquiry which reconnects philosophy and medical ethics.

Ethical Theory↗
PubMed1991

Surgeon-warriors?

Explore the source record for details and available documents.

General Surgery↗
PubMed1990

Failed partial nephrectomy: local recurrence vs. multicentric disease.

Candidates for partial nephrectomy for renal cell carcinoma include those with (1) bilateral synchronous lesions, (2) tumour in a solitary kidney and (3) renal mass and borderline renal function. Present imaging techniques aid in the identification of appropriate candidates for partial nephrectomy and in the preoperative assessment for technical feasibility of the operation. Studies have shown that the postoperative local recurrence rate ranges from 9 to 13%. We submit a case report in which a 65-year-old male with a history of colon carcinoma four years earlier was found to have a 3 cm left lower pole lesion on his follow-up abdominal CT scan. Upon intended partial nephrectomy, a small synchronous upper pole mass was noticed as well as numerous cortical lesions despite extensive preoperative imaging to the contrary. It is our feeling that finer imaging techniques including thinner CT cuts, additional imaging planes and continued use of renal ultrasound will aid in the identification of ipsilateral, synchronous lesions and draw further distinction between local recurrence and multicentric disease.

Aged↗
PubMed1987

Reflex responses to baroreceptor, chemoreceptor and nociceptor inputs in single renal sympathetic neurones in the rabbit and the effects of anaesthesia on them.

Reflex responses of renal postganglionic neurones to stimulation of arterial baroreceptors, arterial and central chemoreceptors and cutaneous nociceptors, and the rhythmicity of their resting activity were studied in paralyzed, artificially ventilated rabbits, anaesthetized with either alfathesin or chloralose-urethane. A 'vasoconstrictor' response pattern was seen in all units. Perivascular balloon-induced falls in blood pressure increased firing while pressure rises silenced 90% of units and reduced firing in the rest. Resting activity was linked to pressure changes within the cardiac cycle and to the artificial respiratory cycle. The largest excitation occurred during hypoxia and injections of CO2 saturated solutions into the carotid artery while hypercapnia and stimulation of cutaneous nociceptors only slightly increased firing. Parameters characterizing rhythmicities and reflex responses were unimodally distributed with no apparent subgrouping of units on quantitative grounds. Unit response patterns were similar to those recorded in the whole renal nerve. With one exception, no silent units were found which responded to the afferent inputs studied. Nor was there a small-spike fibre group which was excited by angiotensin. However, reflex responses were significantly influenced by the anaesthetic regime selected for use. Under alfathesin, baroreceptor and chemoreceptor reflexes were double those found with chloralose-urethane. Under chloralose-urethane, hypoxia increased both rhythmicities, while under alfathesin, cardiac rhythmicity was decreased and respiratory rhythmicity was variably affected. We concluded that renal sympathetic neurones are a functionally uniform population which behave like vasoconstrictors.

Action Potentials↗
PubMed1983

Factors determining the frequency content of the electromyogram.

The contribution of central and peripheral factors to the frequency content of the electromyogram was examined in 10 subjects performing maximal 45-s contractions of thenar muscles. The median frequencies (Fm) of surface-recorded electromyograms and compound action potentials were similar early (P greater than 0.6) and late (P greater than 0.5) in the contractions. There was a mean decrease in the Fm during contraction of 39% for electromyograms and 35% for compound potentials (P greater than 0.1). The Fm of electromyograms increased 11% (P less than 0.02) in only the 1st s of contraction as force was raised from 25 to 100% of maximum. Only one of five subjects showed evidence of increasing synchronization of motor unit discharge during contraction. There was no evidence that delay or dispersion of action potential propagation in terminal nerve fibers or at the neuromuscular junction had a significant effect on frequency content. The findings indicated that the spectral content of muscle electrical activity, and its shift during contraction, primarily reflects intrinsic muscle properties.

Adult↗