Biomedical subjects

Jane Miller

Publications and source records attributed to Jane Miller.

12 recordsLinked to original sources

PubMed2006

The causes and consequences of overactive bladder.

Overactive bladder (OAB) is a syndrome characterized by symptoms of urinary urgency with or without urgency urinary incontinence (UUI), usually with frequency and nocturia. OAB affects approximately 17% of women in the United States and Europe. The causes of OAB, as with many bladder disorders, are multifactorial and are not completely understood. The primary functions of the lower urinary tract (bladder and bladder outlet mechanism) are storage and evacuation of urine. The bladder and the micturition cycle are under complex neural control involving both the sympathetic and parasympathetic nervous systems. Micturition may occur in response to the activation of receptors in the bladder muscle and detection of chemical stimuli by receptors within the bladder lining. Neurogenic or myogenic bladder dysfunction can lead to the symptoms of urgency, frequency, and UUI that characterize OAB. The consequences of this condition are far-reaching and include direct medical consequences and coping strategies that adversely affect quality of life. Although the prevalence of OAB increases with age, it is not a normal consequence of aging. Antimuscarinic agents (e.g., oxybutynin, tolterodine, trospium, solifenacin, and darifenacin) have demonstrated efficacy for the treatment of OAB symptoms in multiple clinical trials. This review explores the physiological basis for OAB, the effects of OAB on health-related quality of life, and the pharmacotherapies that may provide relief to patients with this distressing condition.

Adaptation, Psychological↗

PubMed2006

Skills, bravery, courage, and foolhardiness: Seventy-five years of social work in health care in Melbourne, Australia.

The lessons from the history of health social work in Melbourne, Victoria can be extrapolated to social work in other parts of Australia and internationally. Based on consultation with social workers, archival material and personal reflections this article traces 75 years of health social work in Melbourne and Victoria within the context of the prevailing social influences. The profession, which was started by local opinion leaders and public demand, is now well established. Initially Australians looked to Britain to guide the new profession, but by the latter part of the twentieth century they increasingly looked to the USA. Many challenges still face health social work. Sharing of knowledge and experience will strengthen social work locally and internationally.

Australia↗

PubMed2006

The international exchange program: In the first person.

This commentary presents personal reflections on the Social Work Leadership Enhancement Program in the Department of Social Work Services at the Mount Sinai Medical Center in New York. The value of the program, not only for the participants from other countries, but also the value of the exposure of social workers from other countries to the department staff is recognized. The international influence is unequalled. How if affects and nurtures global social work thinking, its impact on those taking part in the program, as well as the ever-expanding influence of the program on a growing network of social workers is noted.

Australia↗

PubMed2005

Two for good measure: six versus eight cycles of carboplatin and paclitaxel as adjuvant treatment for epithelial ovarian cancer.

INTRODUCTION: Although the standard of care for advanced epithelial ovarian cancer (EOC) is six cycles (6C) of platinum-taxane (PT), there have been no studies on the optimal duration of treatment in the era of adjuvant taxanes. At our center, some women receive eight cycles (8C) of PT, based on physician judgment. We were interested in evaluating the outcomes of women treated with 8C of PT for EOC as compared to a cohort who received 6C. METHODS: We retrospectively identified women with Stage III or IV EOC between 1998 and 2003 who received 6C or 8C of PT. The endpoints were disease-free (DFS) and overall survival (OS). CA-125 response was defined as a decrease in CA-125 of 50% in four serial samples or of 75% over three samples. RESULTS: One hundred and twenty-two women met criteria for inclusion; 84 received 6C, and 38 received 8C. Comparing the cohorts receiving 6C versus 8C, 71% versus 26% were optimally debulked (P < 0.01). 79 patients were evaluable by CA-125 (52 6C/27 8C), and all responded. 88% receiving 6C and 81% receiving 8C normalized their CA-125 at end of treatment (P = 0.20). The proportion with a normal CA-125 at Cycle 2 was 29% versus 12%, respectively (P = 0.15) and, at Cycle 4, was 88% versus 36%, respectively (P < 0.01). DFS was 13 months with 6C and 8 months with 8C (P = 0.01). OS was 31 versus 23.5 months (P = 0.02), respectively. When the survival analysis is restricted to suboptimal debulked patients only, the DFS is 12.5 versus 8 months (P = 0.02), and OS is 32 versus 26.5 months (P = 0.15), respectively. CONCLUSIONS: Two further cycles of PT did not improve DFS or OS for patients with advanced EOC. Patients who do not achieve remission after 6C are unlikely to benefit from additional chemotherapy using the same agents and should be considered for clinical trials involving novel agents with different mechanisms of action.

Adenocarcinoma↗

PubMed2005

Cross-sensitivity between paclitaxel and docetaxel in a women's cancers program.

PURPOSE: With the use of steroid premedication, the incidence of severe hypersensitivity reactions (S-HSR) to paclitaxel is estimated to be 2%. For those who develop a S-HSR to paclitaxel, docetaxel has been employed as an alternative agent though the presence of cross-sensitivity has not been established. We sought to define the incidence of S-HSR to docetaxel following a paclitaxel S-HSR in an academic women's cancer program. METHODS: Patients treated with either paclitaxel (P) or docetaxel (D) between 11/1999 and 8/2004 were identified through our pharmacy database. Records were reviewed and data collected on those patients who had a S-HSR, defined as symptoms for which drug was discontinued, to P, D, or both. RESULTS: 718 patients received P and 93 received D. 59 received D following treatment with P. The presence of S-HSR for P was 2.2% (16/718 patients) and for D was 9.7% (9/93 patients). 10 patients with S-HSR to P crossed over to D and all nine patients reacting to D had a prior reaction to T for a cross-sensitivity rate of 90% (9/10 patients). CONCLUSIONS: Cross-sensitivity of D after P was 90% at our institution. Given the different vehicles used in P and D, it is likely attributed to the taxane moiety. Caution is required with re-challenge of patients with docetaxel if they have previously reacted to paclitaxel.

Antineoplastic Agents, Phytogenic↗

PubMed2005

Gender, Internet identification, and Internet anxiety: correlates of Internet use.

This paper reports a study that investigated the effects of gender, Internet anxiety, and Internet identification on use of the Internet. The study involved 608 undergraduate students (490 females and 118 males). We surveyed the students' experience with the Internet, as well as their levels of Internet anxiety and Internet identification. We found a number of gender differences in participants' use of the Internet. Males were proportionally more likely to have their own web page than were females. They used the Internet more than females; in particular, they were more likely to use game websites, to use other specialist websites, and to download material from the Internet. However, females did not use the Internet for communication more than males. There was a significant positive relationship between Internet identification and total use of the Internet, and a significant negative relationship between Internet anxiety and total use of the Internet. Controlling for Internet identification and Internet anxiety, we found a significant and negative correlation between gender and use of the Internet. In total, all three of our predictors accounted for 40% of the variance in general Internet use: with Internet identification accounting for 26%, Internet anxiety accounting for 11%, and gender accounting for 3%.

Anxiety↗

PubMed2003

The 2b protein of cucumoviruses has a role in promoting the cell-to-cell movement of pseudorecombinant viruses.

Pseudorecombinant viruses (i.e., those containing a reassorted genome of closely related multipartite viruses) are often not as competitive as the parental viruses. The role of the 2b gene in hypervirulence and maintenance of a progressive infection was assessed in a pseudorecombinant virus formed between RNAs 1 plus 2 of Cucumber mosaic virus (CMV) and RNA 3 of Tomato aspermy virus (TAV). The presence of RNA 3 of TAV was found to affect the level of RNA accumulation but not the level of virulence. By contrast, the 2b genes of both TAV and a hypervirulent strain of CMV (WAII-CMV) were found to affect the virulence of the pseudorecombinant viruses but not the levels of viral RNA accumulation. The 2b gene rather than the overlapping open reading frame encoding the C-terminal 41 amino acids of 2a protein of the corresponding virus was found to be essential for promoting infection of the pseudorecombinant viruses in planta. However, the 2b gene was not essential for replication of pseudorecombinant viruses containing CMV RNAs 1 plus 2 and TAV RNA 3. These results indicate that the 2b protein is involved in promoting the cell-to-cell movement of the pseudorecombinant viruses. These data also suggest the existence of specific interaction between the TAV 2b protein and either RNA 3 or its encoded proteins, which may be critical for promoting or maintaining infection or both.

Cucumovirus↗

PubMed2003

Cystoenteric conversion and reduction cystoplasty for treatment of bladder dysfunction after pancreas transplantation.

PURPOSE: Bladder drainage of pancreatic exocrine secretions during pancreas transplantation can lead to significant urological complications. Our experience with cystoenteric conversion (CEC) is reviewed with respect to safety and efficacy. Select patients underwent concurrent reduction cystoplasty. MATERIALS AND METHODS: A total of 255 pancreas transplantations were performed at the University of Washington between 1990 and 2001, of which 236 were bladder drained and 33 required enteric conversion of bladder drainage. An additional patient from an outside institution required conversion. These cases were reviewed retrospectively. Of the patients 21 with large capacity (greater than 500 ml) bladders underwent concurrent reduction cystoplasty. RESULTS: Mean age of the 20 male and 14 female patients was 44 years (range 33 to 60) and mean interval between transplantation and CEC was 4.3 years (0.6 to 9). The most frequent indication for CEC was recurrent urinary tract infections (15 of 34 cases, 44%). Mean followup after CEC was 2.5 years (range 0.3 to 6.5). Six complications requiring reoperation were seen in 5 of the 34 patients (15%), one of which led to death (3%). Normal pancreatic graft function persisted in 30 of the 34 cases (88%). After reduction cystoplasty mean bladder capacity in all 34 cases decreased from 900 to 465 ml intraoperatively (p <0.0001) and from 650 to 362 ml in 9 according to urodynamics (p <0.015). Of the patients 30 (88%) experienced resolution of symptoms, while 3 (9%) experienced improvement and 1 (3%) continued to have recurrent infections. CONCLUSIONS: Although we advocate maximal conservative treatment of the urological complications of pancreas transplantation, CEC offers safe and effective management of these complications, and can easily be combined with reduction cystoplasty in select cases to optimize postoperative voiding function.

Adult↗

PubMed2003

Towards the development of a paediatric discharge planning screening tool.

This study reports the second phase in the development of a paediatric discharge risk screening tool. It describes evaluation of the reliability and validity of this tool, which is designed to identify children in need of post-discharge care beyond that of routine nursing and physician teaching and follow-up. The first group identified was children who possessed a non-routine or unpredictable pathway of post-hospital treatment. The second group encompassed those with multifaceted, complex post-hospital care needs, requiring extensive internal hospital department coordination and involvement of community-based care providers in the discharge planning process. It was found that discharge risk factors reflecting objective and easily observable illness and treatment criteria were the most reliable predictors of need for social work discharge planning. It is recommended that a discharge risk tool be completed in partnership with unit nursing staff, and that it be subjected to further review in other organizational settings.

Aftercare↗

PubMed2002

Rescue of the lethal scl(-/-) phenotype by the human SCL locus.

The stem cell leukemia (SCL) gene encodes a basic helix-loop-helix transcription factor with a critical role in the development of both blood and endothelium. Loss-of-function studies have shown that SCL is essential for the formation of hematopoietic stem cells, for subsequent erythroid development and for yolk sac angiogenesis. SCL exhibits a highly conserved pattern of expression from mammals to teleost fish. Several murine SCL enhancers have been identified, each of which directs reporter gene expression in vivo to a subdomain of the normal SCL expression pattern. However, regulatory elements necessary for SCL expression in erythroid cells remain to be identified and the size of the chromosomal domain needed to support appropriate SCL transcription is unknown. Here we demonstrate that a 130-kilobase (kb) yeast artificial chromosome (YAC) containing the human SCL locus completely rescued the embryonic lethal phenotype of scl(-/-) mice. Rescued YAC(+) scl(-/-) mice were born in appropriate Mendelian ratios, were healthy and fertile, and exhibited no detectable abnormality of yolk sac, fetal liver, or adult hematopoiesis. The human SCL protein can therefore substitute for its murine homologue. In addition, our results demonstrate that the human SCL YAC contains the chromosomal domain necessary to direct expression to the erythroid lineage and to all other tissues in which SCL performs a nonredundant essential function.

Animals↗

PubMed2002

Prevalence of comorbid psychiatric illness and its impact on symptom perception, quality of life, and functional status in women with urinary incontinence.

OBJECTIVE: The purpose of this study was to determine the prevalence and impact of major depression and panic disorder in women with urinary incontinence. STUDY DESIGN: Participants were 218 consecutive women with urinary incontinence over a 14-month period. Major depression and panic disorder diagnoses, symptom perception, incontinence-specific quality of life, functional status, and urinary incontinence type were assessed. RESULTS: The overall prevalence of major depression and panic disorder was 16% and 7%, respectively. In a comparison to patients with stress urinary incontinence, the odds of having major depression were 9.2 for patients with urge and 13.5 for patients with mixed urinary incontinence. Although clinically similar to patients who did not have depression, patients with depression rated their urinary incontinence as significantly more severe and had greater quality of life and functional status impairment. CONCLUSION: Current major depression and panic disorder are highly prevalent in women with urinary incontinence. Patients with urge and mixed urinary incontinence are significantly more likely to have coexistent psychiatric illness. Comorbid major depression significantly impacts a patient's urinary incontinence symptom reporting, incontinence-specific quality of life, and functional status.