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Biomedical subjects

V Watson

Publications and source records attributed to V Watson.

15 recordsLinked to original sources
PubMed2004

Eliciting preferences for drug treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia.

PURPOSE: There are 2 main medical preparations available for lower urinary tract symptoms resulting from benign prostatic hyperplasia (BPH). Choosing between an alpha-blocker and a 5alpha-reductase inhibitor requires trade-offs between their attributes or characteristics. We investigated the relative importance of and trade-offs between the attributes of the 5alpha-reductase inhibitor dutasteride and alpha-blockers in community dwelling men using a validated technique. MATERIALS AND METHODS: A discrete choice experiment was administered to 211 men older than 40 years who were randomly selected from the general United Kingdom population. Attributes investigated in the discrete choice experiment were time to symptom improvement, sexual and nonsexual side effects, the risks of acute urinary retention (AUR) and surgery, cost and prostate size decrease. Using regression analysis the relative importance of these attributes, the trade-offs that men are willing to make between these attributes and the willingness to pay for each attribute were estimated. RESULTS: All attributes were important to respondents. The most important attribute was side effects. The least preferred side effects was impotence, followed by decreased libido and dizziness. Respondents were willing to wait 13, 2 and 8 months longer for symptom improvement in exchange for decreased prostate size, and the risks of AUR and surgery, respectively. Men reporting moderate symptoms were less concerned about sexual side effects, time to symptom improvement and the risk of AUR compared with men reporting mild symptoms. CONCLUSIONS: Given the attribute levels of BPH medical treatment, overall community dwelling men preferred the 5alpha-reductase inhibitor over alpha-blockers. In the interests of shared decision making it is important to consider the importance of eliciting the preferences of patients with BPH.

Adrenergic alpha-Antagonists↗
PubMed2001

Hepatitis B vaccines: assessment of the seroprotective efficacy of two recombinant DNA vaccines.

BACKGROUND: In universal vaccination programs, when there is no postvaccination sero-1 logic assessment of response, there must be confidence that the vaccines used provide a high degree of seroprotection. OBJECTIVE: This parallel analysis of 2 recombinant hepatitis B vaccines (Engerix B and Recombivax/HB-Vax II) was conducted to review the seroprotective efficacy of each vaccine in defined populations. METHODS: Clinical studies of the 2 vaccines published as manuscripts or conference abstracts in the public domain between January 1986 and April 1999 were identified retrospectively by unrestricted screening of journals through BIOSIS, MEDLINE, and EMBASE and the Internet. Unpublished or internal company data were excluded to maintain impartiality. The studies were reviewed and analyzed. The studies were not assessed for quality other than a judgment of their eligibility for inclusion in the analysis. The primary outcome measure was the proportion of subjects in defined populations who showed an early seroprotective response to currently licensed vaccination schedules. Summary statistical analyses of seroprotective response rates and 95% CIs were calculated for each vaccine for each population. Seroprotective response was defined by an anti-hepatitis B surface antigen titer > or =10 IU/L measured between 1 and 3 months after the final vaccination. Because the study was designed specifically to review published immunogenicity data, safety data were not assessed. The study was not designed to demonstrate superiority of one vaccine over the other. RESULTS: A total of 181 clinical studies representing 32,904 vaccinated subjects were reviewed and analyzed, of whom 24,277 had been vaccinated with Engerix B and 8627 vaccinated with Recombivax/ HB-Vax II. Seroprotection was achieved in 20,060 subjects (95.8%) with Engerix B and in 7774 subjects (94.3%) with Recombivax/HB-Vax II in the normal population vaccinated according to currently licensed 3-dose schedules. In a subgroup analysis, response rates in health care workers were 6492 subjects (94.5%) for Engerix B and 3245 subjects (92.2%) for Recombivax/HB-Vax II. Children and adolescents (1-19 years) showed the highest response rates to vaccination (4612 [98.6%], Engerix B; 2292 [98.9%], Recombivax/HB-Vax II). A total of 2875 infants (<1 year) (95.8%) achieved seroprotection with Engerix B; 701 (88.5%) achieved seroprotection with Recombivax/ HB-Vax II. CONCLUSIONS: Hepatitis B vaccination programs using either Engerix B or Recombivax/HB-Vax II can achieve high seroprotective response rates, particularly in childhood and adolescence. Ideally, younger populations should be a primary target in current universal vaccination programs.

Adolescent↗
PubMed1998

Pain in participants of adult day care centers: assessment by different raters.

The aim of this study is to compare the assessment of pain in 200 elderly persons participating in five senior day care programs, as rated by family caregivers, day care staff members, and the participants themselves. Staff members and participants provided information in a face-to-face interview. Family members provided information about the participants and their demographic characteristics via a mailed questionnaire. Agreement rates among informants ranged between 63% and 69%, showing moderate agreement rates. Health status (as reflected in number of medications taken and the presence of a diagnosis of musculoskeletal disease) and depression were associated with ratings of pain by all the informants. The assessment of pain in the elderly population is very difficult and there is a need for reliable and valid pain assessments to be used by different raters. The relationship between pain, depression and other variables should be further explored.

Aged↗
PubMed1995

Agitation among elderly persons at adult day-care centers: the experiences of relatives and staff members.

Two hundred participants (mean age = 80 years) from five senior day-care centers were included in a study of agitation. Staff members at the centers and participants' relatives rated the frequency with which participants displayed agitated behaviors, via an expanded version of the Cohen-Mansfield Agitation Inventory. The most frequent behaviors noted were general restlessness, repetitious sentences, verbal interruptions, and pacing. A three-factor solution for staff members' ratings included (a) physically nonaggressive behaviors, including general restlessness and pacing; (b) verbally agitated behaviors, including complaining and constant requests for attention; and (c) aggressive verbal behaviors, including cursing and temper outbursts. A three-factor solution for relatives' ratings included (a) physically nonaggressive behaviors, including general restlessness and pacing; (b) verbally agitated behaviors, including constant requests for attention and related interruptions; and (c) aggressive behaviors, including cursing, grabbing, kicking, and pushing. The syndromes of both models showed similarity to the factors found in a nursing home population, although differences were also apparent.

Aged↗
PubMed1994

The duration of the second stage of labour.

Fetal outcomes following extended second-stage labour include respiratory acidosis, lower umbilical vein and artery pH, lactacidaemia and early neonatal seizures. Maternal outcomes following extended second-stage labour include postpartum haemorrhage, puerperal fever, backache, musculoskeletal problems, stress incontinence and denervation of the pelvic floor. It is suggested that intervention should be based on the use of judgement and skill rather than strict adherence to timetables.

Female↗
PubMed1984

SLIPS. A data base system for computer storage and analysis of phonological errors.

The analysis of phonological errors made by normal individuals (slips of the tongue) and brain-damaged patients (paraphasias) is a challenging problem. SLIPS is an experimental data base system for computer storage and analysis of such errors. This paper introduces SLIPS and describes its main features. Some of the problems that arise in analyzing phonological error data are explained, and examples of their solution are presented.

Computers↗
PubMed1982

Viral hepatitis: a four-year hospital and general-practice study in Sydney. 2. Transmission of viral hepatitis among residential contacts in Sydney.

Clinical and serological study of household contacts of index patients suffering from acute viral hepatitis showed the high infectivity of hepatitis A viral (HAV) for susceptible contacts. The anti-HAV specific IgM developed in sera of 67% of susceptible children and 31% of susceptible adult contacts. Of 81 susceptible contacts whose sera became anti-HAV positive, 28.4% developed clinically overt hepatitis. Administration of human immunoglobulin reduced the rate of clinical expression of hepatitis A among susceptible contacts; it also appeared to reduce the actual infection rate. The infection rate among susceptible adult contacts of adult index cases suffering from hepatitis B was 24%. Of 25 susceptible contacts whose sera became HBV-marker positive, 24% developed clinical illness. Transmission occurred probably both by parenteral and non-parenteral means. It is currently not possible to determine susceptibility or seroconversion to hepatitis non-A non-B agents.

Adolescent↗
PubMed1982

Viral hepatitis: a four-year hospital and general-practice study in Sydney 1. Epidemiological features, natural history, and laboratory findings.

We studied 761 patients admitted to hospital with viral hepatitis between 1971 and 1974, and 53 patients with viral hepatitis seen in general practice in Sydney, following up some of them for one to two years. We evaluated factors contributing to each type of hepatitis. We noted differences in the patterns in hepatitis A, B and non-A non-B between Anglo-Saxon and non-Anglo-Saxon sectors of the community. All patients with hepatitis A regained normal liver function within 20 months of the acute illness. Of 115 hepatitis B patients seen at 12 months, 6% had chronic hepatitis Bs antigenaemia, 60% had developed anti-HBs antibodies, and 7.3% still had abnormal liver function. Of 20 non-A non-B patients followed for 12 months, liver function was still abnormal in three, but one of these had developed hepatitis B. The case fatality rate for the whole series was 0.66%.

Adolescent↗
PubMedDate not supplied

New neurointerventional therapies for stroke patients.

New neurointerventional procedures affect patient outcomes following stroke. Intraarterial thrombolysis, cerebral angioplasty, coils placed inside aneurysms, and vessel occlusion with embolic agents serve as options for stroke patients with conditions not as amenable to traditional surgical or medical management. By understanding these new neurointerventional therapies, critical care nurses can utilize a focused neurological assessment to intervene and maintain perfusion to the brain following the procedures.

Cerebrovascular Disorders↗