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Biomedical subjects

J Snape

Publications and source records attributed to J Snape.

At least 19 recordsLinked to original sources
PubMed2001

Investigations of the origins of estrogenic A-ring aromatic steroids in UK sewage treatment works effluents.

The present preliminary study describes an investigation of a putative aromatisation pathway in sewage from cholesterol through the corresponding A-ring aromatic steroid, norcholest-1,3,5(10)-trienol (NCT) to estrone. The synthesis and analytical characterisation of NCT and of the trimethyl silyl ether by gas chromatography-mass spectrometry, is described. The analytical properties of synthetic NCT were used to direct a search for the compound over several months in 1998 in the effluents of two sewage treatment works (STW; Deephams and Harpenden, north London). The study was prompted by the earlier findings that increased vitellogenin concentrations in the plasma of caged male rainbow trout held in the STW effluents (so-called fish 'feminisation') could be attributed to the presence of A-ring steroids such as estrone. Until now it has been assumed that these steroids originate from the STW influents and it is not clear to what extent, if at all, aromatisation of steroids might occur during STW operation. NCT was only detected in the solid particles associated with the effluents on one occasion in 8 months. This suggests that the hypothesised pathway is not a major one. Confirmation of previous reports of estrone and 17 beta-estradiol was also obtained using a published analytical method and by a simple modification of the method these reports were extended to include a regular occurrence of the weaker estrogen, 16 alpha-estriol in the case of Harpenden STW effluents in 1998.

Environmental Monitoring↗
PubMed2000

Effects of glaucoma medications on the cardiorespiratory and intraocular pressure status of newly diagnosed glaucoma patients.

AIMS: To evaluate the short term cardiovascular, respiratory, and intraocular pressure (IOP) effects of four glaucoma medications in newly diagnosed glaucoma patients. METHODS: 141 newly diagnosed glaucoma patients were recruited and underwent a full ocular, cardiovascular, and respiratory examination, including an electrocardiogram (ECG) and spirometry. They were prescribed one of four topical glaucoma medications and reviewed 3 months later. One eye of each patient was randomly chosen for analysis, performed using analysis of variance and the chi(2) test. RESULTS: Latanoprost had the greatest mean IOP lowering effect in both the primary open angle glaucoma (POAG) (p = 0.005) and the "presumed" normal tension glaucoma (NTG) groups (p = 0.33), reducing the IOP by 8.9 mm Hg and 4.1 mm Hg respectively. Timolol was associated with lowered pulse rates and reductions in the spirometry measurements. 41% of patients using brimonidine complained of systemic side effects and over 55% of patients using betaxolol complained of ocular irritation. 28% of patients required an alteration in their glaucoma management. CONCLUSIONS: Latanoprost appears to be a useful primary treatment for glaucoma patients, in view of superior IOP control and a low incidence of local and systemic side effects. Timolol causes a reduction in measurements of respiratory function, a concern in view of the potential subclinical reversible airways disease in the elderly glaucoma population. Brimonidine is associated with substantial, unpredictable systemic side effects and betaxolol causes ocular irritation and weak IOP control. Spirometry is advised in all patients receiving topical beta blocker therapy to control their glaucoma.

Adrenergic alpha-Agonists↗
PubMed2000

Medical urology.

Explore the source record for details and available documents.

Adult↗
PubMed1998

Pneumatosis coli: an uncommon but treatable cause of faecal incontinence.

Pneumatosis intestinalis is defined as the presence of gas within the bowel wall. Small bowel pneumatosis is less commonly reported and more severe than colonic disease in adults. Pneumatosis coli is characterised by multiple collections of encysted gas occurring within the sub-mucosa and subserosa of the colon and rectum. It is an uncommon condition which typically presents in late middle age and has been associated with a number of gastrointestinal (e.g. pyloric stenosis, sigmoid volvulus and ischaemic bowel) and non-gastrointestinal (e.g. chronic obstructive pulmonary disease, depression and multiple sclerosis) diseases. Some cases, however, are idiopathic or primary. Symptoms can include diarrhoea, constipation, mucus per rectum, bleeding, flatus, abdominal pain and, rarely, faecal incontinence. We report on two patients, one of whom presented with faecal incontinence, the other who had troublesome lower gastrointestinal symptoms including faecal incontinence. Both responded well to continuous oxygen therapy.

Aged↗
PubMed1997

Educational sources of stress in midwifery students.

This article presents the findings of a study that investigated educational sources of stress among student midwives working in England. The study set out to address the question, what are the clinical and educational experiences that can give rise to stress? Students were invited to complete a 45-item questionnaire which asked them to identify the extent to which a particular statement, in their experience, led to feelings of stress. There were four categories of response: 'not at all', 'a little', 'much' and 'very much'. Responses from 199 students (127 preregistration and 72 preregistration (shortened)) were obtained. Factor analysis was used to determine the structure of the data set, and two factors emerged. Factor 1, accounting for 29.6% of variance, was labelled 'organizational and learning experience' sources of stress, while factor 2, accounting for 6.6% of variance, was labelled 'home and family' sources of stress. Further analysis on those items that were reported as having proportionately large numbers of students responding 'very much' was performed. Results from three items, 'insufficient time to carry out assignments', "dealing with study vs. home/personal demands', and while on placements being exposed to "life and death situations', were found to be significantly different between preregistration and preregistration (shortened) students. These findings suggest that a wide variety of events cause students stress. While clinical sources of stress may be expected to exist, it must also be recognized that relationships with tutorial staff and aspects of the learning environment within colleges can also lead to stress.

Adolescent↗
PubMed1993

Occupational stress in neurosurgical nursing.

Occupational stress in nursing has been a popular topic for investigation. While many practice areas have been studied, the neurosurgical intensive care units (ICUs) and neuromedical/surgical units have largely been overlooked. Using interviews, this exploratory study examined aspects of neurosurgical nursing that were perceived as stressful by staff. Findings suggest that being exposed to life and death situations among young children, being short of essential resources, being on duty with too few staff and dealing with aggressive relatives constituted major stressful events. The frequency of occurrence of stressors was also investigated; working unsocial hours, being short of essential resources, being exposed to life and death situations in adults, and dealing with fluctuations in workload were cited as common happenings. Stressors perceived as having the most effect on work included being exposed to life and death situations among children and adults and being short of essential resources. Comments made by staff suggest that performance at work is adversely influenced by stress. While no neurosurgery-specific stressors were identified, the conclusion from this study is that intensely stressful events do occur in these ICUs and although such events may not happen often, they can adversely affect work performance, according to the staff involved.

Adult↗
PubMed1992

Occupational stress in neurosurgery: an exploratory study.

Occupational stress in nursing has been a popular topic for investigation. In particular, comparisons between practice areas such as the intensive care unit (ICU) and medical-surgical unit have attempted to identify what factors are stressful, and whether some nursing environments are more stressful than others. Such studies have led to inconclusive findings. While many practice areas have been studied, the neurosurgical ICU and neuromedical/neurosurgical units have largely been overlooked. Using interviews, this exploratory study examined aspects of nursing perceived as stressful by staff members working in ICU and medical-surgical units in a neuroscience center. Findings suggested that patient care, communication, workload, management and supervision, organizational and personal circumstances are major sources of stress. These findings are in keeping with studies of stress conducted in national and international non-neurosurgical nursing practice areas.

Burnout, Professional↗
PubMed1990

Carcinoma of the caecum in a scorbutic patient.

The clinical findings of scurvy have been known for well over 3,000 years. In 1753, Sir James Lynd demonstrated the efficiency of citrus fruit in the prevention of this condition. Scurvy still occurs from time to time in this country, notably in the elderly, particularly in bachelors who live alone and eat a poor diet. Scurvy has been associated with gastrointestinal malignancy, but, as far as we know, it has not been reported in association with carcinoma of the caecum. We report the case of an elderly female patient who presented with features of scurvy and was also found to have carcinoma of the caecum.

Adenocarcinoma, Mucinous↗
PubMed1989

Long-term follow-up of habit retraining for bladder instability in elderly patients.

Sixty patients with detrusor instability were contacted 2 to 3 years after their initial diagnosis and treatment. When first treated, 40 had improved, nine were catheterized and the remainder were unchanged. By the time of the first outpatient appointment 1 month later, a further 6% had been catheterized and 26% had lost control. Two to 3 years later, 17 of the 40 who had improved initially had maintained their improvement. The control in all the remainder had deteriorated and ten of the original 60 had died. Four of these deaths occurred in the group initially catheterized, only two of this group still had their catheter in situ, but were experiencing problems from it, and the remaining three had removed their catheter and were managing with pants and pads. Thus, two-thirds of elderly patients with bladder instability respond initially to treatment, but 2 to 3 years later only two-fifths of these are still deriving benefit.

Aged↗
PubMed1987

Urodynamic findings in sacrococcygeal chordoma.

The clinical and urodynamic findings in two cases of sacrococcygeal chordoma are described. The urodynamic findings suggest that the urinary problems in this condition are caused by an incomplete lower motor neurone lesion.

Aged↗
PubMed1986

Nurses' attitudes to care of the elderly.

There are problems recruiting nurses to the geriatric wards in Leicester. Using a Likert attitude scale, attitudes of training and trained nurses to the care of the elderly were assessed. Although the trained staff had a significantly more positive attitude than the nurse learners, the latter felt that the attitudes of the trained staff were poor. Possible explanations for this contraindication are discussed.

Aged↗