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Biomedical subjects

B Fisher

Publications and source records attributed to B Fisher.

At least 469 records · Page 26Linked to original sources
PubMedDate not supplied

Conservative surgery for the management of invasive and noninvasive carcinoma of the breast: NSABP trials. National Surgical Adjuvant Breast and Bowel Project.

In 1976 the National Surgical Adjuvant Breast and Bowel Project (NSABP) initiated a randomized trial (B-06) to evaluate the worth of lumpectomy in the treatment of patients with stages I and II breast cancer. This report presents, for the first time, findings from that trial through 10 years of follow-up relative to ipsilateral breast tumor recurrence (IBTR), distant disease-free survival, and survival of patients who were treated by modified radical mastectomy, lumpectomy, or lumpectomy followed by breast irradiation. The report indicates that the incidence of IBTR observed in the B-06 trial is decreased by effective systemic therapy as well. Also commented on are a number of issues regarding the use of lumpectomy that are of concern to clinicians. They relate to the need for tumor specimen margins, the size of tumors amenable to lumpectomy, treatment of breast tumor recurrence, lumpectomy in older women, and other concerns. No patient or tumor characteristics have been identified that preclude the use of lumpectomy and radiation therapy. All evidence continues to justify the use of lumpectomy and breast irradiation for the treatment of invasive breast cancer. In addition, we have noted findings that indicate the propriety of lumpectomy and breast irradiation for treatment of localized ductal carcinoma in situ.

Breast Neoplasms↗
PubMedDate not supplied

The effects of excision of left ventricular scars on the electrocardiogram.

The effects of resection of post-ischemic ventricular scars on the electrocardiogram have been studied in 29 patients. No change occurred in atrial rhythm, P wave morphology, and A-V conduction. Fascicular blocks developed postoperatively in five patients. These were attributed to surgical trauma. Changes in mean frontal plane QRS axis were noted in 25 of 29 patients. There was no correlation between postoperative shifts in QRS axis and preoperative QRS axis, calculated scar size, or ventricular end-diastolic volume. No significant postoperative change was observed in Q waves or S-T segment deviation. It is concluded that electrocardiographic changes following scar resection occur randomly in a minority of patients. The presence of several unquantified factors makes it difficult to evaluate the post-resection electrocardiogram.

Cardiac Volume↗
PubMedDate not supplied

Outbreak of Mycoplasma pneumoniae infection among hospital personnel.

An outbreak of illness due to Mycoplasma pneumoniae occurred among employees of a large hospital. The spectrum of disease ranged from severe upper respiratory infection to multilobed pneumonia. No unusual increase in the incidence of respiratory illness due to this organism was observed in the surrounding community during the period under investigation. It was not possible to identify any single area of the hospital frequented by enough of the involved personnel to explain the spread of the infection among the hospital's employees. This is the first outbreak of M pneumoniae disease to be reported among hospital personnel.

Cross Infection↗
PubMedDate not supplied

Highlights from recent National Surgical Adjuvant Breast and Bowel Project studies in the treatment and prevention of breast cancer.

Findings from major National Surgical Adjuvant Breast and Bowel Project studies in women with breast cancer and negative axillary nodes are reported and discussed. Results of the B-13 and B-19 studies demonstrated that systemic chemotherapy (either with methotrexate and sequentially administered fluorouracil followed by leucovorin, or with cyclophosphamide plus methotrexate and fluorouracil) increased overall disease-free survival in women 49 years of age or younger, as well as in those 50 years old or older. Women older than 50 also experienced a survival advantage with chemotherapy. Moreover, women who received systemic chemotherapy after lumpectomy plus radiation therapy were significantly less likely to develop an ipsilateral recurrence of tumor. The B-14 study established the benefit of tamoxifen. When chemotherapy was added to tamoxifen in the B-20 trial, there was an increased benefit. The B-18 trial demonstrated that the outcome of patients who received preoperative chemotherapy was comparable to that of patients who received the same therapy postoperatively. Moreover, results suggested that breast tumor response to preoperative chemotherapy correlated with outcome. Also, larger tumors were sufficiently downstaged by preoperative chemotherapy to permit lumpectomy rather than mastectomy. The B-17 study in women with ductal carcinoma in situ concluded that radiation therapy should follow lumpectomy in women with localized, mammographically detected lesions. The P-1 Breast Cancer Prevention trial showed that tamoxifen was effective in significantly reducing the incidence of both invasive and noninvasive breast tumors in women at high risk for the disease. Although many questions remain, and a new study, P-2, has been designed to compare tamoxifen and raloxifene, it is appropriate to offer tamoxifen to women who are similar to those in the P-1 study and who may benefit from it.

Adult↗
PubMedDate not supplied

Measuring worksite resources for employee heart health.

PURPOSE: Intervention at the organizational rather than the individual level is gaining greater attention in worksite health promotion efforts. However, little research has been done on instruments to measure this domain. Therefore, the purpose of this study was to further test the utility of an existing organizational heart health support instrument by examining relationships among worksite structural characteristics and comparing these results to other survey findings. DESIGN: One-time cross-sectional. SETTING: New York State. SUBJECTS: One hundred fifteen volunteer worksites in the New York State Healthy Heart Program, representing manufacturing, government, education, health care, and other industries. MEASURES: A survey was conducted using HeartCheck, an organizational assessment of employee support for heart health. HeartCheck contains 175 items measuring organizational support for tobacco control, nutrition, physical activity, stress, screening, and administrative support structure. RESULTS: On average, only 22% of all worksite resources assessed were present in the sample. Having a workforce greater than 250 provided a 12% increase in predicted overall worksite resources. A predominantly female workforce (> 75%) provided 10% higher levels of worksite stress resources. Worksites with unions had higher levels of resources for physical activity (10%), screening (13%), and general supportive structures (10%). The presence of manual labor diminished support for tobacco control resources (-13%). Finally, manufacturing worksites demonstrated a clear advantage for all types of worksite resources, except for stress. CONCLUSION: A number of trends found in this study are consistent with earlier work. Industry type and size both predict worksite supports similar to previous studies. Other findings that appear to contradict previous work, including the relatively low level of support observed in this sample, can be explained by the comprehensive nature of the instrument. Overall, these findings demonstrate the utility of HeartCheck.

Cardiovascular Diseases↗
PubMedDate not supplied

Economic considerations in MRI.

The newest product of the medical technologic revolution, magnetic resonance imaging ( MRI ), has come at a time when many medical facilities are under unusual financial strain. Ultimately, MRI must be justified economically as a means of shortening hospital stays, reducing the need for other services, or both. Further, MRI introduces special problems referable to purchase decisions.

Capital Expenditures↗