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Biomedical subjects

S E Scott

Publications and source records attributed to S E Scott.

11 recordsLinked to original sources
PubMed2006

Patient delay in oral cancer: a qualitative study of patients' experiences.

Up to 30% of patients delay seeking the advice of a healthcare professional after self-discovery of symptom(s) of oral cancer. Reasons for this patient delay are poorly understood. The aim of the present study was to explore patients' initial experiences and reactions to developing symptoms of oral cancer, and to identify factors influencing their decision to consult a health care professional. In-depth semi-structured interviews were conducted with 17 consecutive patients who had received a diagnosis of oral squamous cell carcinoma, but had yet to start treatment. Participants were asked about their beliefs about their symptoms over the course of the disease and their decision to seek help. The tape-recorded interviews were transcribed verbatim and analysed using 'Framework analysis'. Oral symptoms were rarely attributed to cancer and were frequently interpreted as minor oral conditions. As a result of these beliefs, patients tended to postpone seeking help or fail to be concerned over their symptoms. Prior to seeking help, patients responded to symptoms by using self-medication, changing the way they ate and disclosing their discovery of symptoms to friends or family. Problems with access to healthcare professionals and patients' social responsibilities acted as barriers to prompt help-seeking. This study has documented that an individual's interpretation of oral cancer symptoms may be misguided and this can adversely affect subsequent help-seeking behaviour.

Adaptation, Psychological↗
PubMed2005

The idiosyncratic relationship between diagnostic delay and stage of oral squamous cell carcinoma.

Approximately half of patients with oral cancer present with advanced lesions when five-year survival rates are as low as 20%, however, diagnostic delay has repeatedly been found to be unrelated to the stage of oral cancer at diagnosis. The aim of this study was to investigate why diagnostic delay is frequently unrelated to the stage of oral cancer at diagnosis. The odds ratio (OR) of early versus advanced oral squamous cell carcinoma was calculated for 245 consecutive patients with untreated oral squamous cell carcinoma. Being female (OR=0.40; 0.19-0.80; p<0.05) and married (OR=0.27; 0.11-0.66; p<0.01) was predictive of early stage disease. Being non-white (OR=5.42; 1.66-17.67; p<0.01) was predictive of advanced stage disease. There is no evidence that these patient demographics are associated with faster growing tumours, yet it is possible that those who are male, unmarried and non-white may not notice an oral lesion until it is advanced in stage. It is concluded that differences in tumour biology are not a likely explanation for the absence of a delay-stage relationship but instead, a proportion of tumours may be silent until advanced in stage.

Adult↗
PubMed1999

Low probability of chloroplast movement from oilseed rape (Brassica napus) into wild Brassica rapa.

Pollen-mediated movement of transgenes from transplastomic oilseed rape (Brassica napus) into wild relatives will be avoided if chloroplasts are maternally transmitted. We assess the probability of chloroplast exchange between conventional oilseed rape and wild Brassica rapa to model the future behavior of transplastomic cultivars. Primers specific to cpDNA were used to demonstrate maternal inheritance of chloroplasts in 47 natural hybrids between cultivated B. napus and wild B. rapa. We conclude that there will be no or negligible pollen-mediated chloroplast dispersal from oilseed rape. Transgene introgression could still occur in mixed populations, however, if B. napus acted as the recurrent female parent. Rate of transfer would then depend on the abundance of mixed populations, their persistence as mixtures, and hybridization frequency within stands. A low incidence of sympatry (0.6-0.7%) between wild B. rapa and cultivated B. napus along the river Thames, UK, in 1997 and 1998, suggests mixed stands will form only rarely. Eighteen feral populations of B. napus also showed a strong tendency toward rapid decline in plant number, seed return, and ultimately, extinction within 3 years. Conversely, hybrid production is significant in mixed stands, and the absence of control practices means that oilseed rape will have slightly greater persistence. We infer that some introgression from transplastomic B. napus into B. rapa is inevitable in mixed populations even though such populations will occur infrequently and will tend to lose B. napus plants relatively quickly. Chloroplast exchange will be extremely rare and scattered.

Brassica↗
PubMed1990

Efficacy and safety of monophasic and biphasic waveform shocks using a braided endocardial defibrillation lead system.

Endocardial lead systems for implantable cardioverter-defibrillators utilize large (12F) rigid catheters with spring defibrillation electrodes, and lead system failure has been observed during long-term implant. We evaluated a novel flexible 8F braided electrode catheter for pacing and defibrillation in canine experiments. Active fixation and pacing were accomplished using a screw-in distal electrode, and defibrillation pulses were delivered through a braided electrode. Two braided electrode catheters were positioned in the right ventricular apex (6 cm2) and in the superior vena cava-right atrial junction (5 cm2), respectively. An elliptical 13 cm2 surface area patch electrode was positioned along the left lateral cardiac border. Ventricular fibrillation (VF) was induced and monophasic and asymmetric biphasic shocks (leading voltages 260 to 1000 V) were delivered via dual and triple electrode configurations in each animal using a prospective randomized crossover study design. Mean right ventricular pacing threshold was 0.5 +/- 0.2 mA, with a mean electrogram amplitude of 11.1 +/- 2.8 mV during sinus rhythm prior to fibrillation and defibrillation. Two hundred seven VF inductions (mean 30 +/- 4 per animal) were analyzed. The mean defibrillation threshold could be reduced to 8.0 +/- 3.2 joules with biphasic shocks from 12.9 +/- 5.1 joules obtained for monophasic shocks using a dual electrode system (p less than 0.004). Mean shock leading voltage was correspondingly reduced to 488 +/- 100 V from 691 +/- 154 V (p less than 0.0006).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Secondary tracheoesophageal puncture for voice rehabilitation after laryngectomy.

Since the introduction of the tracheoesophageal puncture technique for restoration of voice in 1980, 125 secondary punctures have been performed in 117 patients at the Cleveland Clinic Foundation. Preoperative evaluation, pharyngeal preparation, and their relation to final speech results were reviewed retrospectively. Critical factors in the rehabilitation of these patients are discussed based on our experience and a review of the literature.

Adult↗
PubMed1988

Assessment of quality of survival in children with medulloblastoma and cerebellar astrocytoma.

To determine the quality of survival for children with posterior fossa tumors, comprehensive neuropsychological, behavioral, and academic assessment and physician ratings of functional status were obtained on 15 brain tumor patients (ages 6-19 years) at a median of 20 months post-diagnosis. More than 50% of the children (whether irradiated or not) experienced major problems in academic, motor, sensory, cognitive, and emotional function. All but two children were reported by teachers to be "slow workers," and four of 15 patients were able to maintain their school work in regular classes. Although 80% of the patients were rated by physicians as having "excellent" or "good" functional status, no relationship was found between these global ratings and psychometric measures. Although the affected site was the posterior fossa, deficits also involved higher cortical function. These findings indicate the need for further evaluation of treatment effects and the provision of intervention for survivors.

Achievement↗
PubMed1988

Chemotherapy side effects in pediatric oncology patients: drugs, age, and sex as risk factors.

Nausea, vomiting, and the extent to which chemotherapy-bothered children were assessed by patient and parent ratings for 31 children (65 courses) receiving combination chemotherapy with either high-dose cyclophosphamide or doxorubicin/daunorubicin. Patients and parents both reported more severe vomiting with cyclophosphamide than with the anthracyclines. The use of antiemetics did not affect emesis for the former drug; for the anthracyclines, there was more severe emesis for courses with antiemetics than for those with none. Adolescents reported more severe nausea than children, and females reported both more nausea and bother than males. There were no significant age or sex findings for parent reports. The findings suggest that chemotherapy-related nausea and vomiting in children is a complex phenomenon not accounted for by drugs alone.

Adolescent↗
PubMed1974

Effects of posture on limb blood flow in late pregnancy.

Arm and leg blood flow was measured in 40 patients in late pregnancy in the supine and left lateral positions, and the changes were contrasted with changes found in 15 patients investigated in the early puerperium. A significant reduction in leg flow occurred in the pregnant subjects when the supine position was assumed. A further 30 patients in late pregnancy had leg flow measured in the following positions: left lateral, supine, right lateral, and the two mid-positions. Leg flow significantly increased on moving from the supine to all other positions except the right intermediate position, indicating that a leftward tilt is more effective in preventing caval compression.

Arm↗