Biomedical subjects
A Brantley
Publications and source records attributed to A Brantley.
Rising violence in ERs cause hospitals to redesign security.
A growing number of problems caused by drugs, alcohol, gang violence and domestic quarrels are spilling over into emergency departments, creating security challenges for the nation's hospitals. In response, facilities are stepping up security measures, including redesigning emergency departments, installing airport-type metal detectors and broadening staff training.
5-Fluorouracil, cyclophosphamide, and vincristine for adenoid cystic carcinoma of the head and neck.
Twenty-one patients with adenoid cystic carcinoma of the head and neck were treated with intravenous boluses of cyclophosphamide and vincristine and 5-day continuous intravenous infusions of 5-fluorouracil (CVF) every 4 weeks. Eight patients received CVF as palliation for recurrent or metastatic disease. A sustained complete response (107+ months) was observed in one patient; one partial response and one mixed response each also were observed. In four patients disease stabilized, and in one disease progressed. Thirteen patients received six courses of CVF in the adjuvant setting after surgery and radiation for either primary or locoregional recurrent disease. Recurrences developed in two of seven patients with primary disease and three of six patients with recurrent disease with a median follow-up 45 months (range, 20-108+). Recurrence rate and time interval to recurrence were comparable to those of well-matched historical controls. Distant metastases have not developed in patients treated with CVF in the adjuvant setting, whereas distant metastases had developed in historical controls within comparable periods of follow-up. Serious toxicities were not encountered in any patient. The authors conclude that CVF is a well-tolerated combination chemotherapy program with activity in adenoid cystic carcinoma of the head and neck. This regimen, however, has not had a major impact in the adjuvant setting in preventing recurrent disease.
Pain in the head and neck cancer patient: changes over treatment.
The incidence, severity, and location of pain was evaluated in 30 head and neck cancer patients prior to treatment after the first phase of their treatment and upon the completion of treatment. The incidence of pain was relatively high (40%-70%) and tended to increase slightly over treatment. Patients having advanced disease (stage III or IV) had a higher incidence of pain. Pain severity ratings were stable over treatment. Pain was located close to tumor or incision sites, and a trend for patients to report a greater number of pain sites over treatment was noted. While medical status variables (disease stage and site) were found to predict pain status after the initial phase of cancer treatment, initial pain measurements were more likely to predict pain status at the completion of treatment.