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Biomedical subjects

S McRae

Publications and source records attributed to S McRae.

12 recordsLinked to original sources
PubMed2005

Imiquimod 5% cream for the treatment of superficial basal cell carcinoma: results from a randomized vehicle-controlled phase III study in Europe.

BACKGROUND: Imiquimod is an immune response modifier that acts through toll-like receptor 7 to induce cytokine production and a subsequent innate and adaptive cell-mediated immune response. Clinical studies have demonstrated clinical and histological clearance of superficial basal cell carcinoma (sBCC) after treatment with imiquimod 5% cream. OBJECTIVES: To evaluate the safety and clinical efficacy of imiquimod (Aldaratrade mark; 3M Pharmaceuticals, St Paul, MN, U.S.A.) 5% cream for the treatment of sBCC in a multicentre, randomized, parallel, vehicle-controlled, double-blind, phase III clinical study conducted at 26 centres in Europe. METHODS: Subjects who had at least one histologically confirmed sBCC tumour were randomized to apply imiquimod or vehicle cream to the target tumour once daily, seven times per week (7 x/week) for 6 weeks. The target tumour location was identified with an indelible ink mark before treatment initiation. The treated tumour site was clinically assessed for treatment response at 12 weeks post-treatment and was then excised for histological evaluation. Efficacy assessments included the composite response rates (proportion of subjects with clinical and histological clearance) and response rates solely based on histology (proportion of subjects with histological clearance). Safety assessments, which included adverse events and scoring of local skin reactions (LSRs), were carried out throughout the study. RESULTS: In total, 166 subjects were enrolled in this study. For the intent-to-treat dataset, there was a statistically significant difference between imiquimod and vehicle groups for both composite clearance rates (clinical and histological assessments) and histological clearance rates. Composite clearance was demonstrated in 77% and 6% of subjects treated with imiquimod and vehicle cream, respectively. Histological clearance was demonstrated in 80% and 6% of subjects treated with imiquimod and vehicle cream, respectively. The most frequently reported safety findings were investigator-assessed LSRs and spontaneous reports by subjects of application site reactions, which occurred more frequently in the imiquimod group than in the vehicle group. CONCLUSIONS: Imiquimod 5% cream administered 7 x/week for 6 weeks is a safe and effective treatment for sBCC when compared with vehicle cream.

Adult↗
PubMed2000

Palliative care on Manitoulin Island. Views of family caregivers in remote communities.

OBJECTIVE: To describe family caregivers' experiences with palliative care services in rural communities. DESIGN: Qualitative study. SETTING: Manitoulin Island, Ont. PARTICIPANTS: Thirteen family caregivers of 12 deceased patients who had received palliative care services. METHOD: Twenty-five family caregivers were recruited by mail and local newspaper. Eight were excluded because they lived off the Island or were too recently bereaved; one declined an interview; and three were excluded by researchers. Initial contact was by telephone; those retained (13 people) were interviewed at home. Interviews were conducted by the same researcher using a semistructured interview guide. All interviews were audiotaped and transcribed, and content was analyzed. MAIN FINDINGS: Three interwoven themes were identified: access to services, quality of services, and support and caring. Hospital and community-based services were accessed with ease at the local level; difficulties were noted when accessing services in tertiary care centres. Participants were generally grateful for and pleased with services received. Two areas of concern raised by participants were communication and pain and symptom control. Participants suggested to the Ministry of Health ways to improve rural palliative care services. More public funding for in-home palliative care services was identified as a priority. CONCLUSION: Participants thought good services and supportive care at the local level made up for difficulties in accessing and using palliative services in tertiary care centres. Community spirit and culture were seen as making situations more bearable.

Aged↗
PubMed1997

Household and labour market change: implications for the growth of inequality in Britain.

The paper examines the relationships between population and household change, on the one hand, and labour market/employment change, on the other, and considers how these relationships have contributed to the growth of inequality. The perspective of the paper is sociological, although much of the work done in these areas has been carried out by demographers and economists. Areas where sociological research remains to be done are highlighted. Developments in patterns of fertility and in households are linked to the growth of individualism and to changes in the labour market, and shown to be implicated jointly in the marked growth of inequality in Britain. The paper argues that future research must link households and labour markets, and work towards understanding emerging new relationships between working and private lives, between living arrangements and labour supply, and between individual freedom and social integration.

Adolescent↗
PubMed1996

Elevated serum digoxin levels in a patient taking digoxin and Siberian ginseng.

A 74-year-old man taking a constant dose of digoxin for many years was found to have an elevated serum digoxin level with no signs of toxic effects. Common causes of elevated serum digoxin were ruled out, and the patient's digoxin level remained high after digoxin therapy was stopped. The patient then revealed that he was taking Siberian ginseng, a popular herbal remedy. The patient stopped taking ginseng, and the serum digoxin level soon returned to an acceptable level. The digoxin therapy was resumed. The patient resumed taking ginseng several months later, and the serum digoxin level again rose. Digoxin therapy was maintained at a constant daily dose, the ginseng was stopped once more, and the serum digoxin levels again returned to within the therapeutic range. It is unclear whether some component of the ginseng was converted to digoxin in vivo, interfered with digoxin elimination or caused a false serum assay result. The author cautions physicians to be alert to the potential for herbal remedies to interact with prescribed medications and to affect biochemical analyses.

Aged↗
PubMed1996

Hospital admission following ambulatory surgery.

BACKGROUND: Ambulatory surgery continues to grow in quantity and complexity of procedures. Effective measures of "quality" are not readily apparent. "Unplanned admission rate" may well reflect the quality of care in this area. Identifying factors related to this event could be helpful in quality assessment and improvement. METHODS: A review of all unplanned admissions for a 3-year period in a University-affiliated teaching hospital. RESULTS: An overall rate of 0.85% (129/15,132) was observed. Rate varies by specialty and no one procedure was at higher risk. Pain control, cardiopulmonary, and bleeding problems as well as larger than anticipated procedures accounted for 73% of the admissions. CONCLUSIONS: Unplanned admission following ambulatory surgery is relatively rare but could reflect overall quality in terms of the system, physician, and patient. Comparisons between institutions and within institution requires defining key demographic elements whose identification for now remains a challenge.

Aged↗
PubMed1996

Transitional cell carcinoma of the bladder in the pediatric patient.

PURPOSE: We report on 5 boys with transitional cell carcinoma of the bladder, describe the identifying characteristics, review the literature, and define the issues of diagnosis, treatment and followup in this rare disease in pediatric patients. MATERIALS AND METHODS: Five boys 11 to 18 years old were identified with transitional cell carcinoma of the bladder. Preoperative imaging and urinary cytology were correlated with cystoscopic and biopsy findings. RESULTS: In all patients evaluation was prompted by gross hematuria. Low grade lesions, definitive cystoscopic management and a low recurrence rate were uniform findings. Preoperative imaging identified the tumor in all cases and bladder ultrasound was the most sensitive scan with 4 of 4 cases identified. CONCLUSIONS: While rare, transitional cell carcinoma of the bladder in children presents a challenge in diagnosis and followup since cystoscopy typically requires general anesthesia in this age group. Bladder ultrasound was found to be extremely sensitive in identifying lesions, and it may be a valuable and minimally invasive surveillance tool.

Adolescent↗
PubMed1982

Casualty attendances: one year's experience at Waikato Hospital.

All casualty attendances (25 707) at a general hospital in the year 1979 were reviewed considering sex, age, employment, location of accident, mechanism of accident, diagnosis, time of arrival at casualty, day of week, week, and month. Males, young people (less than 32 years old), and working people were common attenders. Home accidents and weekend visits were frequent. these and other findings are discussed in the context of other recent similar studies.

Accidents↗
PubMed1982

Sustained mental stress alters human jejunal motor activity.

The effect of prolonged mental stress on upper small bowel motility was studied in 11 healthy, medical students using a pressure-sensitive radio-pill. During eight hours of continuous observation, subjects were stressed for four hours with a modified dichotomous listening test. During the first two hours of stress, inhibition of fasting motor complexes occurred and this effect was marked in the seven subjects who showed an appreciable cardiovascular response to stress.

Adult↗
PubMedDate not supplied

Cytologic diagnosis of a primary pure oat cell carcinoma of the bladder in voided urine. A case report.

BACKGROUND: The urinary bladder is an uncommon site for primary oat cell carcinoma, with as few as 30 histologically diagnosed cases described in the literature. The first reported cytologic diagnosis was made in 1991. CASE: A 76-year-old female presented with gross hematuria. Voided urine cytology showed small, dark cells with little visible cytoplasm and coarse chromatin. Subsequent histopathologic, immunopathologic and electron microscopic studies confirmed the diagnosis of primary oat cell carcinoma. CONCLUSION: The diagnosis of oat cell carcinoma is well recognized in respiratory cytology. The same cells found in a urinary specimen may suggest a primary oat cell tumor in conjunction with negative clinical and radiologic investigations for a primary tumor elsewhere.

Aged↗