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Biomedical subjects

A Cnaan

Publications and source records attributed to A Cnaan.

77 records · Page 5Linked to original sources

A randomized phase II study of acivicin and 4'deoxydoxorubicin in patients with hepatocellular carcinoma in an Eastern Cooperative Oncology Group study.

We analyzed 56 of 75 previously untreated patients with hepatocellular carcinoma who entered on a prospectively randomized trial of acivicin versus 4'deoxydoxorubicin (esorubicin). At least one episode of severe toxicity was documented in 23% of the patients on acivicin and 45% of those on 4'deoxydoxorubicin. Two patients responded to 4'deoxydoxorubicin. One response was partial, lasting 58 weeks, and one was complete, lasting more than 4 years. The 90% confidence interval for response is 1-20%. In view of a 45% rate of severe or worse toxicity with 4'deoxydoxorubicin, this drug cannot be recommended as treatment. There were no responses on acivicin.

Antibiotics, Antineoplastic↗

Survival analysis in natural history studies of disease.

Clinicians often wish to use data from clinical trials or hospital databases to study disease natural history. Of particular interest are estimated survival and prognostic factors. In this context, it may be appropriate to measure survival from diagnosis or some other time origin, possibly prior to study entry. We describe the application of methods for truncated survival data, and compare these with the standard product limit estimator and proportional hazards models in the measurement of survival from entry. Theoretical considerations suggest that analysis of survival from entry may under- or overestimate the survival distribution of interest, depending on the shape of the true underlying hazard. Analogous results hold for the coefficients from a proportional hazards model. We illustrate our findings with data from a multicenter clinical trial and a hospital database.

Actuarial Analysis↗

Prognostic factors for survival in hepatocellular carcinoma.

Associations between patient characteristics and survival were investigated in 432 patients with hepatocellular carcinoma. Those patients were prospectively studied by the Eastern Cooperative Oncology Group, and each had his or her diagnosis reconfirmed by a pathology review panel. There were 301 North American and 131 South African patients. Sixty-nine % of the North American patients and 82% of the South African patients were male. There were 187 Black patients, 62 of whom were from North America. The study population is unique among hepatocellular carcinoma patients in that eligibility, evaluability, and endpoint definitions were standardized, and patients from both North America and South Africa received similar treatments at a similar time. Factors with the most significant adverse effect on survival are impaired performance status, male sex, older age, and disease symptoms (jaundice and reduced appetite). There is no apparent difference in survival between White and Black patients within North America, but North American patients survived longer than South African patients. Among the different therapies, p.o. 5-fluorouracil was associated with the poorest median survival time (6 wk), and i.v. 5-fluorouracil plus semustine with the best median survival time (24 wk).

Adult↗

Frequency of carriers of chronic (type I) Gaucher disease in Ashkenazi Jews.

In this study we estimate the frequency of carriers of chronic (type I) Gaucher disease among Ashkenazi Jews by examining the glucocerebrosidase activity in leukocytes in a population of 635 blood donors (441 Ashkenazi) and 57 obligatory heterozygotes. Estimation using the defect in the enzyme glucocerebrosidase (beta-glucosidase) in leukocytes is complicated by the existence of considerable overlap between enzyme activity in normals and in heterozygotes. The assay was carried out with a natural substrate labeled with 14C. Discriminant analysis was used to establish an optimal cutoff point between the obligatory heterozygotes and normal (non-Ashkenazi) subjects for the purpose of estimating frequency of carriers. Applied to the Ashkenazi group, the cutoff point identified 3.17% as heterozygotes. Corrected for errors in classification, the carrier rate was estimated as 4.67%. This figure is in good agreement with a carrier rate of 4% estimated from the number of known cases of clinical Gaucher disease ascertained in Israel.

Ethnicity↗

Mentally retarded workers' reactions to their jobs.

Reactions of 34 mentally retarded employees to their jobs were examined in a field study conducted at a sheltered workshop. Three experienced social workers observed a group of retarded employees whose job was assembling toys. The workers were then interviewed on their perceptions of and reactions to their job characteristics and supervision, and these were related to performance data that included performance time, productivity, and effort ratings. Results showed that performance measures were related to perceived job characteristics and that growth-need strength (people's needs for personal development and achievement) affected these relationships. On the basis of these results, we discussed the feasibility of using motivation models for retarded workers that were designed for nonretarded workers.

Adult↗