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P J Anslow

Publications and source records attributed to P J Anslow.

4 recordsLinked to original sources

An audit of selected patients with non-functioning pituitary adenoma treated by transsphenoidal surgery without irradiation.

OBJECTIVE: To determine whether the rate of tumour regrowth in patients with non-functioning pituitary tumour treated by transsphenoidal surgery and selected for observation without post-operative irradiation is acceptably low, and to identify a group of patients who could appropriately avoid pituitary irradiation. SUBJECTS: One hundred and thirty-two patients treated by transsphenoidal surgery, of whom 98 did not undergo post-operative irradiation. These 98 were selected as having had apparently complete surgical removal, and as lacking features of tumour invasion or rapid growth; 73 of them are being followed by serial pituitary imaging to detect tumour regrowth. RESULTS: Forty-two patients who have been imaged on two or more occasions or more than two years after operation have shown no sign of tumour regrowth; 25 of them have been imaged at 3 or more years after operation, 13 at more than 5 years, and 4 at more than 10 years. Eight patients have shown regrowth as judged by imaging, although only one had pressure symptoms at the time; 5 out of 6 of these recurrences were found within 5 years of operation (two cannot be timed). The unirradiated group of 73 patients showed 90% recurrence-free survival at 5 years (95% confidence limits 80-100%). CONCLUSIONS: Provided that careful surgery and meticulous recall mechanisms for imaging can be ensured, patients so selected may be given the information contained in these results and offered the choice of follow-up by imaging alone, without pre-emptive irradiation. We recommend that they should be imaged 6-8 weeks post-operatively, then at either 6 or 12 months depending on the appearance, and then every 3-5 years for at least 15 years. By this means, many patient-years of good health and relative medical independence can be gained, together with some financial saving.

Adenoma↗

Comparison of sexual behaviour and risk of HIV transmission of Scottish inmates, with or without a history of intravenous drug use.

The sexual behaviour and intravenous drug use (IVDU) of a sample of 559 inmates (480 males and 79 females) was investigated. Sexual behaviour and IVDU prior to imprisonment, during imprisonment, and that expected after release, was assessed. Alterations in sexual behaviour as a means of HIV risk reduction was also assessed in relation to IVDU status. Prior to imprisonment most IVDUs and non-IVDUs engaged in unprotected intercourse. Sexual behaviour during imprisonment, as reported by inmates, was almost negligible for both groups. Expected sexual behaviour after imprisonment differed little from that before imprisonment for both IVDUs and non-IVDUs. Selecting partners more carefully and reducing their number was the most common method of HIV risk reduction for both IVDUs and non-IVDUs prior to imprisonment and was expected to be increasingly so after release. There was little difference in the sexual behaviour of IVDUs and non-IVDUs prior to imprisonment, during imprisonment, and as expected after release. However, IVDU inmates were more likely to have had an IVDU sexual partner than did non-IVDU inmates. Those IVDU inmates who had an HIV test, and those who had an IVDU sexual partner, were more likely to expect to continue IVDU after imprisonment. IVDU inmates, who had an IVDU sexual partner, were also more likely to have shared injected equipment but no more likely to have sterilized injecting equipment than did IVDU inmates whose sexual partner was not involved with IVDU. Results are discussed in relation to risk of HIV transmission for IVDUs and their sexual partners.

Adolescent↗

Intravenous drug use and HIV transmission amongst inmates in Scottish prisons.

The intravenous drug use behaviour and HIV risk reduction strategies used by a group of Scottish inmates prior to prison, during imprisonment and as expected after release was investigated. From a sample of 559 inmates (480 males and 79 females) 27.5% were involved in IVDU prior to imprisonment, 7.7% on at least one occasion during a period of imprisonment and 14.7% expected to do so after release. Prior to imprisonment 17.3% had shared needles, 5.7% at some time during imprisonment and 4.3% expected to do so after release. Some form of HIV risk reduction strategies were practised by the majority of IVDU inmates prior to imprisonment, during imprisonment and were expected to continue after release. The most at risk inmates were those who continued to share injecting equipment without reduction and without sterilizing. The reduction in IVDU and needle sharing during imprisonment in comparison to prior to imprisonment was paralleled by a self-perceived reduction of personal risk from HIV during imprisonment.

Adult↗