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Biomedical subjects

A S Moore

Publications and source records attributed to A S Moore.

At least 55 records · Page 3Linked to original sources
PubMed1982

Meeting the challenge of research in family medicine: report of The Study Group on Family Medicine Research.

The challenge of research in family medicine is addressed in this paper by describing the rationale for research, appropriate content areas, resources available, and needs for the future. Family medicine has the opportunity to study health and disease in humans within their natural habitat over long periods of time, and to examine the multiple aspects of personal and family health care delivery. Resources for research include large primary care study populations, practitioner and faculty researchers, and technical support systems. The basic needs for the future are to increase the quantity and quality of researchers and to attract more funds designed for research. It is recommended that family medicine practitioners and teachers support research and participate more actively; that family medicine academic units provide their learners more research curricular time and their faculties more research activity time, and that they develop Family Medicine Research Centers; that family medicine professional organizations raise funds to support research, promote research opportunities for their members, and communicate to others the research activities, resources, and needs of family medicine; and that the requirements for residency training be modified to include elective research opportunities.

Canada↗
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Ultrasonography of canine gastric epithelial neoplasia.

Signalment, clinical and ultrasonographic findings from 16 dogs with histologically confirmed gastric epithelial neoplasia were reviewed. The most common clinical findings were vomiting, anorexia and weight loss. Hematemesis and melena were uncommon findings. Ten (10/16) dogs were female and there were four Chows. The most common ultrasonographic findings were transmural thickening of the gastric wall associated with altered wall layering. A poorly echogenic lining often was noted on the innermost and/or the outermost portions of the gastric wall, separated by a more echogenic central zone. The distribution of these changes was variable. This ultrasonographic feature, called pseudolayering, was present in 14 dogs. It was believed to most likely correlate to the unevenly layered tumor distribution noted histopathologically. The maximum wall thickening ranged from 1 cm to 2.7 cm. Regional lymphadenopathy was identified ultrasonographically in 15 dogs. Ultrasound-guided fine-needle aspiration biopsy or automated microcore biopsy, endoscopic biopsy, surgical biopsy or necropsy resulted in the diagnosis of carcinoma in 15 dogs and of carcinoid tumor in one dog. The results of this study suggested that ultrasonography was a useful tool for the detection and diagnosis of canine gastric epithelial neoplasia. Furthermore, ultrasonography can assist in obtaining diagnostic samples and in clinical staging of the tumor.

Adenocarcinoma↗
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Cisplatin (cisdiamminedichloroplatinum) for treatment of transitional cell carcinoma of the urinary bladder or urethra. A retrospective study of 15 dogs.

The records of 15 sequential cases of transitional cell carcinoma of the urinary bladder or urethra in dogs were examined to determine the results of treatment with cisplatin (cisdiamminedichloroplatinum) and to record and assess toxicities. All dogs had measurable disease and were considered eligible for evaluation of toxicity following one cisplatin treatment. Three dogs were eliminated from evaluation of efficacy because of acute toxicities. Of the 12 remaining dogs that received two or more cisplatin treatments, evaluations at the end of the second month of treatment revealed no complete responses; however, three dogs showed partial responses and six dogs maintained stable disease. Three dogs had tumor progression. The median survival time for these 12 dogs was 180 days (mean, 220 days; range, 36 to 589 days). Three dogs were azotemic before treatment. Two of these dogs showed improvement in renal function following therapy. Six of the other twelve dogs developed increases in serum creatinine during therapy. The objective and subjective improvements of some dogs to cisplatin chemotherapy suggest that this agent is active in selected dogs with transitional cell carcinomas of the urinary tract.

Animals↗
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Intracavitary cisplatin chemotherapy experience with six dogs.

Six dogs with a median age of 7 years (range = 5-14 years) were presented for signs referable to thoracic or abdominal effusion associated with neoplasia of the body cavities. Intracavitary cisplatin was administered at 50 mg/m2 every 4 weeks for a median of 2.5 treatments (mean = 3, range = 1-6). Three dogs with pleural mesothelioma had complete resolution of effusion for 289, 129, and greater than 306 days without evidence of tumor growth. Resolution of effusion occurred after one treatment in two dogs and after two treatments in one dog. In three dogs with carcinomatosis of unknown origin, complete responses was seen in two dogs after one treatment for 255 and greater than 807 days, respectively. Intracavitary chemotherapy with cisplatin was associated with palliation and control of malignant pleural and/or abdominal effusion in five of six dogs. Toxicity was minimal, and this method of therapy should be further explored in dogs with similar malignancies.

Adenocarcinoma↗
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Cytosine arabinoside as a single agent for the induction of remission in canine lymphoma.

Cytosine arabinoside (AraC) was administered as a continuous IV infusion to 15 dogs with malignant lymphoma at a dose of 300 mg/m2/d for 2 consecutive days. Dogs were re-examined 7 d after treatment for response to therapy and for hematologic toxicity. Regardless of response, all dogs were started on combination chemotherapy at this time. Other toxicities were reported by owners. No dog responded objectively to Ara-C treatment, although 1 dog with circulating lymphoblasts had partial regression of lymphadenopathy but persistent blastemia. Thrombocytopenia (platelet count < 200,000/microL) 7 days posttreatment was the most commonly encountered hematologic toxicity, occurring in 10 of 14 dogs. Three of these 10 dogs were also mildly neutropenic (neutrophil counts of 2000 to 3000 cell/microL). Nonhematologic toxicity occurred in 8 of 15 dogs and was principally gastrointestinal in nature and mild in severity. Cytosine arabinoside at a dose of 300 mg/m2/day was not considered an active drug for the induction of remission in dogs with lymphoma.

Animals↗
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Actinomycin D for reinduction of remission in dogs with resistant lymphoma.

Twenty-five dogs with malignant lymphoma refractory to chemotherapy were treated with actinomycin D at a median dose of 0.7 mg/m2 (range, 0.5 to 0.9 mg/m2) every 3 weeks. The dogs treated had received between 2 and 8 chemotherapeutic agents (median 7), for a median of 266 days before being treated with actinomycin D. For 23 of the 25 dogs, previous chemotherapy included doxorubicin. No dog responded to actinomycin D chemotherapy.

Animals↗
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A comparison of doxorubicin and COP for maintenance of remission in cats with lymphoma.

Thirty-eight cats with lymphoma were treated with vincristine, cyclophosphamide, and prednisone (COP). They were randomized at entry to receive maintenance chemotherapy consisting of either single-agent doxorubicin or continued COP therapy, starting on week 4 of treatment and continuing for 6 months or until relapse. Eighteen cats achieved complete clinical remission after COP induction chemotherapy. The median remission duration for 11 cats continuing to receive COP was 83 days, which was significantly shorter than for 7 cats that received doxorubicin (281 days). Thus, doxorubicin should be considered a well-tolerated and efficacious agent for the maintenance of remission in cats with lymphoma.

Animals↗
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Evaluation of a multidrug chemotherapy protocol (ACOPA II) in dogs with lymphoma.

A chemotherapeutic protocol using cyclophosphamide, vincristine, prednisone, doxorubicin, and L-asparaginase (ACOPA II) was evaluated in dogs with lymphoma. The response rate for 68 dogs treated with ACOPA II (complete remission [CR] 65%, partial remission [PR] 10%) was lower than that for 41 dogs treated with a related protocol previously evaluated (ACOPA I; CR 76%, PR 12%). Initial treatment with doxorubicin and prednisone did not decrease the prevalence or severity of toxicity during induction. The mortality during induction was 22%. The median duration of CR for dogs treated with ACOPA II was 9 months, with 40% still in remission at 1 year and 21% at 2 years. The rate of CR was lower for dogs with signs of illness at presentation (substage b) and for dogs weighing less than 15 kg. Age was negatively correlated with survival time and duration of remission. Dogs with immunoblastic lymphoma had a more favorable prognosis than did those with lymphoblastic lymphoma. Survival times were also longer for dogs in substage a at presentation. Seven dogs in which treatment was discontinued while in remission had comparable remission duration to that achieved by dogs receiving long-term maintenance chemotherapy.

Animals↗
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Vincristine therapy for mast cell tumors in dogs.

Twenty-seven dogs with naturally occurring mast cell tumors were treated with weekly i.v. injections of vincristine (0.75 mg/m2) for 4 treatments. Two dogs (7%) had a partial response. Nine dogs (32%) had treatment stopped prematurely because of toxicity or a perceived deterioration in their quality of life. We conclude that vincristine is ineffective as a sole treatment for measurable mast cell tumors in dogs and produces an undesirable number of adverse reactions.

Animals↗
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Feline lymphoma (145 cases): proliferation indices, cluster of differentiation 3 immunoreactivity, and their association with prognosis in 90 cats.

Paraffin-embedded, formalin-fixed tissue samples from 145 cats with lymphoma were analyzed for cluster of differentiation 3 (CD3, a surface antigen) immunoreactivity, argyrophilic nucleolar organizer region (AgNOR) frequency, and proliferating cell nuclear antigen labeling index (PCNA-LI). This information along with signalment, anatomic site, and feline leukemia virus (FeLV) antigen status was used to determine the potential of these indicators to predict response to therapy, remission, and survival times, and to characterize cats with lymphoma in the era of general availability of FeLV testing and vaccination. Alimentary lymphoma, primarily occurring in older, FeLV-negative cats, was the most common site of involvement. Although the majority of tumors from FeLV-positive cats were CD3-immunoreactive, only one half of CD3-immunoreactive tumors occurred in FeLV-positive cats. Median remission duration and survival times were 126 days and 143 days, respectively, for all cats. Measures of tumor cell proliferation (AgNOR frequency and PCNA-LI) and CD3-immunoreactivity were not predictive of outcome. When all prognostic factors were accounted for by multivariate analysis, response to therapy, FeLV status, and clinical substage were predictive of outcome. FeLV-negative cats that achieved a complete response following induction therapy were likely to have durable (i.e., > 6-month) responses, particularly when doxorubicin was included in the chemotherapy protocol. However, FeLV-positive cats had significantly shorter remission and survival times with available chemotherapeutic protocols.

Animals↗
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A combination chemotherapy protocol (VELCAP-L) for dogs with lymphoma.

Ninety-eight dogs with lymphoma treated with a 5-drug combination chemotherapy regimen (vincristine, L-asparaginase, cyclophosphamide, doxorubicin, prednisone [VELCAP-L]) were evaluated for pretreatment characteristics predictive for response and remission duration. The complete remission rate was 69%, with a median remission duration of 55 weeks. Dogs with advanced stage of disease, constitutional signs, dogs that were older, and dogs that were dyspneic were less likely to achieve remission. Once in remission, small dogs and dogs without pretreatment thrombocytopenia were likely to have longer remission duration. Toxicoses were frequent, but rarely fatal, and no predictitive factors were found for a dog developing toxicoses. VELCAP-L is an effective treatment for dogs in stage I-III lymphoma, particularly in young, small animals.

Age Factors↗
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Lomustine (CCNU) for the treatment of resistant lymphoma in dogs.

Forty-three dogs with lymphoma that had relapsed or had failed to achieve complete remission to previous chemotherapy were treated with lomustine (1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea [CCNU]) at a dosage of 90-100 mg/m2 body surface area p.o. every 3 weeks. Durable complete or partial responses occurred in 11 dogs for a median of 86 days. The acutely dose-limiting toxicosis was neutropenia 7 days after administration, resulting in a recommended dosage of 90 mg/m2. Cumulative thrombocytopenia occurred in dogs receiving continued CCNU treatment, and a dose interval of 3 weeks may be too short for continued administration of this drug. Toxicoses evident as fever or central nervous system signs or renal damage were uncommon or rare. CCNU is effective in the treatment of relapsed lymphoma.

Animals↗
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Treatment of canine mast cell tumors with CCNU (lomustine).

The efficacy and toxicity of CCNU (1-[2-chloroethyl]3-cyclohexyl-1-nitrosourea) were evaluated in 23 dogs with measurable mast cell tumors (MCT). Twenty-two dogs had cutaneous MCT and 1 dog had an intranasal MCT Nineteen (83%) dogs had biopsy of their original mass performed and 4 (17%) had aspiration cytology of masses. Of the 19 tumors histologically graded, 1 (5%) neoplasm was classified as grade I, 10 (53%) were grade II, and the remaining 8 (42%) were grade III. Dogs were treated with CCNU at a dosage of 90 mg/m2 body surface area every 3 weeks. Response could be evaluated in 19 dogs. Eight of the 19 dogs (42%) had a measurable response to CCNU. One dog had a durable complete response for 440 days. Seven dogs (37%) had a partial response for a median and mean duration of 77 days and 109 days, respectively (range, 21-254 days). Treatment with CCNU resulted in stable disease in 6 dogs (32%) for a median and mean duration of 78 days and 122 days, respectively (range, 42-347 days). The acute dose-limiting toxicity was neutropenia 7 days after administration of CCNU. The median and mean neutrophil counts 7 days after CCNU were 1,452 cells/microL and 1,683 cells/microL, respectively (n = 17). Other toxicoses were uncommon. CCNU should be considered an active agent in the treatment of MCT in dogs.

Animals↗
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Evaluation of ifosfamide for treatment of various canine neoplasms.

lfosfamide (3-[2-chloroethyl]-2[(2 chloroethyl)amino]tetrahydro-2H-1,3,2-oxazaphosphorine 2-oxide) is an alkylating agent with a broad spectrum of antitumor activity. The efficacy and toxicity of ifosfamide were evaluated in 72 dogs with spontaneously occurring tumors. Forty dogs (56%) had lymphoma, 31 (43%) had sarcomas, and 1 had a metastatic carcinoma. Five dogs received ifosfamide at dosages <350 mg/m2 IV. Neither toxicity nor response were observed, and the remaining dogs received ifosfamide at 350 mg/m2 (n = 18) and 375 mg/m2 body surface area IV (n = 49). Saline diuresis and the thiol compound mesna were used to prevent urothelial toxicity. Fifty-two dogs had measurable tumors and could be evaluated for response. Complete responses were seen in 1 dog with metastatic leiomyosarcoma of the urinary bladder and in 1 dog with metastatic cutaneous hemangiosarcoma. One dog with lymphoma had a partial response for 112 days. Six dogs with splenic hemangiosarcoma received ifosfamide postsplenectomy and their median survival time was 147 days. The acute dose limiting toxicity was neutropenia 7 days after administration of ifosfamide. The median and mean neutrophil counts 7 days after ifosfamide at 350 mg/m2 were 2,035 cells/microL and 4,773 cells/microL, respectively (n = 12). The median and mean neutrophil counts 7 days after ifosfamide at 375 mg/m2 were 2,500 cells/microL and 3,594 cells/microL, respectively (n = 37). No dog developed clinical or microscopic evidence of hemorrhagic cystitis. Ifosfamide appears safe to use in tumor-bearing dogs, and the evaluation of combination chemotherapy protocols that include ifosfamide should be considered.

Animals↗
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Single agent chemotherapy with doxorubicin for feline lymphoma: a retrospective study of 19 cases (1994-1997).

Medical records of 21 cats with confirmed lymphoma treated with single-agent doxorubicin were reviewed. Nineteen cats met the inclusion criteria for this retrospective study. Doxorubicin was given at a dosage of 25 mg/m2 (n = 8) or 1 mg/kg (n = 11) IV, every 3 weeks for a total of 5 treatments. Four of 16 tested cats were positive for feline leukemia virus (FeLV) and all 16 cats tested negative for feline immunodeficiency virus. Eight of the 19 cats (42%) responded to doxorubicin for a median duration of 64 days (range, 35-575 days). Five cats (26%) achieved a complete response (CR) to doxorubicin for a median duration of 92 days (range, 54-575 days). Partial response was observed in 3 cats. Institution was the only significant prognostic indicator for response, with cats treated at Colorado State University being more likely to achieve CR than cats treated at Tufts University. Cats that achieved CR to doxorubicin and FeLV-negative cats had significantly longer survival times. Loss of appetite was the most common toxicity, observed in 9 cats (47%), and was severe in 5 cats (26%). Other toxicoses were less frequent and included vomiting, diarrhea, and myelosuppression. Doxorubicin was not very effective at inducing and maintaining remission in the cats in this study. Therefore, if doxorubicin is used for the treatment of feline lymphoma, it should be combined with other effective chemotherapeutic drugs in a combination protocol.

Animals↗
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Retrospective study of orthovoltage radiation therapy for nasal tumors in 42 dogs.

Megavoltage radiation therapy currently is the standard of care for dogs with nasal tumors. Some studies report that surgery and adjunctive orthovoltage radiation therapy result in longer control of these tumors than does megavoltage radiation therapy alone. This study reports less effective control of nasal tumors in dogs treated with surgery and orthovoltage radiation than previously observed, supporting the superiority of megavoltage radiation therapy for these tumors. In addition, this study suggests 2 new prognostic indicators for dogs with nasal tumors and describes toxicity associated with surgery and orthovoltage therapy. Forty-two dogs with nasal tumors were treated with surgical cytoreduction and 48 Gy orthovoltage radiation therapy administered in twelve 4-Gy fractions. Median survival was 7.4 months. One- and 2-year survival rates were 37% and 17%, respectively. Dogs with facial deformity had shorter survival than those without deformity (P = .005). Dogs with resolution of clinical signs after treatment had longer survival than those with chronic nasal signs (P = .0001). Acute radiation toxicity was moderate to severe for skin and eye and negligible for oral mucosa. Toxicity healed within 1 month after radiation therapy. Late toxicity was mild, but 70% of evaluable dogs experienced persistent ocular signs. Only 39% of dogs achieved a disease-free period.

Animals↗