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Biomedical subjects

J Northover

Publications and source records attributed to J Northover.

31 records · Page 2Linked to original sources
PubMed1991

Post-myelogram headache--physiological or psychological?

Psychological aspects of post-lumbar puncture headache have hitherto received little attention. A hundred consecutive patients admitted for elective myelography were studied. Post-myelogram headache was assessed by an independent observer and found to be strongly associated with normality of the test (P less than 0.001). Psychological testing showed a trend between Hospital Anxiety Depression score and normality of myelogram as well as development of headache, although this did not achieve statistical significance. This study suggested that there is a large psychological as well as organic component to post-myelogram headache.

Adolescent↗
PubMed1991

The effect of self-administered faecal occult blood tests on compliance with screening for colorectal cancer: results of a survey of those invited.

To determine the relative importance of health beliefs and the characteristics of different methods of faecal occult blood screening in predicting acceptance of the test a self completed questionnaire was offered to 590 patients registered with a practice in an Oxfordshire market town. The patients were an age-sex stratified random sample of those who had been offered screening as part of a trial in which one of three different faecal occult blood screening tests, two of which were self-reported, had been offered. The overall adjusted response rate was 70.1%. Those who complied with the test had more positive attitudes to the implications of a positive test, to treatment and to the value of screening in general. The experience of a close relative or friend with bowel cancer was associated with an increased likelihood of compliance [odds ratio = 15.2 (9.4-24.3)]. Three were marked differences between the tests in the proportions of patients finding them 'messy' or 'disgusting' (Haemoccult 72.0%, Coloscreen 48.0%, Early Detector 55.4% chi 2 Haemoccult vs. self-reported = 5.05 P less than 0.05), and the odds of finding the procedure disgusting were significantly higher among patients who did not complete the test [odds ratio 6.9 (3.1-15.5)].

Attitude to Health↗
PubMed1990

Experiences of patients with false positive results from colorectal cancer screening.

A survey was conducted to study the experiences of patients with false positive results for colorectal cancer. The study patients were participants in a randomized trial of compliance with different methods of colorectal cancer screening by faecal occult blood testing. Fifty four out of fifty six patients (96.4%) with false positive results agreed to be interviewed. An age and sex matched control group of 112 patients with negative test results was identified --92 (82.1%) returned questionnaires. Thirteen of the patients with false positive results (24.1%) and 19 controls (20.7%) were to some extent distressed by the initial letter inviting them to participate in the screening programme. Thirty seven of the patients with false positive results (68.5%) felt some degree of distress at the initial positive test result and 19 (35.2%) some distress because of delays experienced in the process of being screened. Ten false positive patients had colonoscopy and the median waiting time for this procedure was 10 days--half of the patients found this wait distressing. Nevertheless, 53 of the patients with false positive results (98.1%) felt that it had been worthwhile to have had the test. Generally, colorectal screening was as acceptable to the patients who experienced false positive results as to those with negative results.

Adult↗
PubMed1983

Effect of catheter tunnelling and a nutrition nurse on catheter sepsis during parenteral nutrition. A controlled trial.

In a three-year controlled trial of subcutaneous catheter tunnelling as a method of reducing total parenteral nutrition (TPN) catheter sepsis 99 silicone catheters (52 tunnelled, 47 untunnelled) were inserted into the subclavian (94%) or jugular (6%) veins under aseptic conditions. The influence of a nutrition nurse, who joined the nutrition team after 18 months, on catheter sepsis rate was also documented. Catheter sepsis was confirmed in 13 of 47 (28%) untunnelled catheters and only 6 of 52 (11.5%) tunnelled catheters (p less than 0.05). A nutrition nurse reduced sepsis rate from 33% (tunnelled 6, untunnelled 11) to 4% (0 tunnelled; 2 untunnelled) (p less than 0.001). There was no significant difference between tunnelled and untunnelled catheters in sepsis rates after the arrival of the nutrition nurse. Although 85% patients had concurrent internal sepsis, the pathogens implicated in catheter sepsis came from superficial sites in 16 of 19 cases (p less than 0.01). Rigorous aseptic nursing care is thus the most significant factor in the reduction of TPN catheter sepsis, but tunnelling can reduce sepsis rate when nursing care is suboptimum.

Antisepsis↗
PubMedDate not supplied

The use of prognostic markers in surgery for colorectal cancer.

The basis for prognostic prediction after surgery for colorectal cancer remains the various pathological staging systems based on that of Dukes. Serum prognostic markers have not shown significant independent prognostic power compared with these predictive tools. Much energy has been expended in examining the ability of serum markers to predict recurrent tumour prior to the onset of symptoms. Carcinoembryonic antigen (CEA) has been a particular subject of attention, and has been widely, though variably, advocated as a useful predictor in these circumstances. It has been estimated that around half a million Americans are presently undergoing regular postoperative CEA monitoring to this end. Controversy continues regarding the therapeutic utility of such monitoring. This may be resolved when the results of the only randomised trial in the field are published in the near future. No other serum marker, nor any combination of markers, has been shown clearly to be superior to CEA as a predictor of recurrent tumour.

Biomarkers, Tumor↗
PubMedDate not supplied

Response to 5-fluorouracil of orthotopically xenografted human colon cancers with a microsatellite instability: influence of P53 status.

Response to 5-FU of 5 different human colon cancers (hCC) with a DNA microsatellite instability (MSI), xenografted into nude mice, was analysed according to their p53 status. Two hCC (TC82 and TC71) had a mutated p53 (mutp53), while two others (TC33 and LoVo) had a wild type p53 (wtp53); the fifth tumour (X17LoVo) originated from the stable transfection of LoVo cells with a dominant mutp53 (273his) vector. All tumours were implanted onto the caecum of nude mice to induce orthotopic growth of hCC. 5-FU was administered at 40 mg/kg per day for 5 consecutive days. A significant growth inhibition of TC82 and TC71 tumours (of 68 and 60%, p < 0.05 and < 0.01 respectively) was observed, whereas 5-FU had no effect on TC33 and LoVo. Moreover, the mutp53 transfected tumour, X17LoVo, displayed significant sensitivity to 5-FU (p < 0.05). This suggests that distinct genetic alterations influence differently the response of hCC to this antimetabolite.

Adenocarcinoma↗
PubMedDate not supplied

Which type of follow-up?

Most patients and many surgeons assume that proactive follow-up after rectal cancer surgery is useful in most cases and therefore an essential part of surgical care. The evidence base for this contention is sparse. What evidence there is suggests that there is little effect on the supervivability of recurrent cancer however intense, costly--or the opposite--the follow-up program may be. This review examines some of the issues in this difficult area, and suggests some reasonable conclusions on what degree of follow-up might be applied in the absence of a wide and easily applicable evidence base.

Aftercare↗