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Biomedical subjects

C C Bailey

Publications and source records attributed to C C Bailey.

At least 73 records · Page 4Linked to original sources
PubMed1989

Excess benign melanocytic naevi after chemotherapy for malignancy in childhood.

OBJECTIVE: To see whether children who have had chemotherapy develop increased numbers of moles. DESIGN: Blind assessment of patients having chemotherapy and subsequent comparison with the first suitable patients matched for age and sex who were attending the clinic during the same period after having completed treatment. Controls were obtained the following year by taking the first suitable patients attending a routine dermatology outpatient clinic who matched the study groups for age and sex. SETTING: Referrals to a paediatric oncology clinic and a dermatology clinic at two city hospitals. PATIENTS: The group receiving chemotherapy comprised all 32 patients with acute lymphatic leukaemia, lymphoma, and rhabdomyosarcoma who were attending the paediatric oncology clinic on two mornings a week during October 1987 to March 1988. The group who had completed treatment comprised 32 patients who were attending for follow up during the same period and who matched the first group for age and sex. Thirty two other patients attending the dermatology outpatient clinic with unrelated skin conditions served as controls. END POINT: Definite increase in numbers of moles on children after a course of chemotherapy. MEASUREMENTS AND MAIN RESULTS: Moles were counted by one observer on defined areas of the body and divided into those less than 3 mm and greater than or equal to 3 mm diameter. Patients receiving chemotherapy had a similar number of moles to the control group. By contrast patients who had completed chemotherapy had significant increases both in moles less than 3 mm and greater than or equal to 3 mm and in the total number of moles. These patients were more likely to have moles on acral sites. CONCLUSIONS: Children with substantially increased numbers of moles (benign melanocytic naevi) after successful chemotherapy for malignancy may have an increased risk of melanoma. They should be offered prolonged surveillance and cautioned about exposure to ultraviolet light.

Adolescent↗
PubMed1988

Accidental actinomycin D overdosage in man, a case report.

Although actinomycin D is a relatively old cytotoxic agent, relatively little is known about its toxicity in man in comparison with some of the newer cytotoxic agents that have been extensively investigated. We wish to describe a case where an overdose of actinomycin D was inadvertently administered.

Adolescent↗
PubMed1988

Relapse of Hodgkin's disease with anaemia and weight loss.

Two children previously treated for Hodgkin's disease had relapse associated with anaemia and weight loss but no other abnormal clinical findings. It was not possible to confirm the diagnosis by bone marrow aspirate or trephine and in each case laparotomy was required in order to establish a histological diagnosis.

Anemia↗
PubMed1988

Surgical management of thoracic malignancy in childhood: eight years' experience in Leeds.

During the period 1978 to 1986, 13 children aged 2-15 years underwent surgical resection of malignant thoracic tumours. Five children with neuroblastomas presented with chest pain and infections, pleural effusions, dysphagia, lymphadenopathy and paraplegia. Chemo- and radiotherapy were given preoperatively to previously diagnosed cases and postoperatively to all survivors. At operation, complete tumour clearance was possible in only two cases. Two children remain alive with no sign of recurrence at 6 and 7 1/2 years. Eight children with pulmonary metastases had undergone resection of the primary tumour and systemic chemotherapy. All were asymptomatic and were detected by chest radiographs. Wedge resection or lobectomy was performed. Two required contralateral resections at 4 months. Two children remain alive with no evidence of recurrence at 2 and 6 1/2 years. We conclude that aggressive surgical resection of childhood thoracic malignancy is worthwhile, but cooperation with a paediatric oncology team is essential.

Adolescent↗
PubMed1987

Prospective randomized cooperative medulloblastoma trial (MED 84) of the International Society of Paediatric Oncology (SIOP) and of the (German) Society of Paediatric Oncology (GPO).

This international, prospective, randomised therapeutic study is based on previous, separate studies of the two societies. The study asks two principal questions: Is it possible to improve the results of therapy by inserting, between surgery and post-operative irradiation, an intensive course of chemotherapy consisting of vincristine, procarbazine and methotrexate, followed by citrovorum factor rescue? In "low risk" patients (i.e. those with macroscopically "complete" resection and absence of metastases at diagnosis), can the radiotherapy to CNS areas outside the primary tumour site be reduced by 10 Gy with the aim of reducing late sequelae of irradiation but without compromising survival results? The study also aims at standardising diagnostic methods, neurosurgical procedure and radiotherapeutic technique employed in this tumour. For statistical reasons, results can only be disclosed after the end of the recruitment phase. It is intended to include approximately 350 patients in the study, which is planned to continue until the end of 1988.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Serum neuron-specific enolase in children's cancer.

To test its diagnostic potential and sensitivity in paediatric malignancy, serum NSE was measured at diagnosis in 191 children with solid tumours and 25 with acute leukaemia. In stages I + II, III + IV and IVs neuroblastoma median levels were 18.0, 91.0 and 24.0 ng ml-1 respectively. For Wilms' patients, median values for stages I, II, III and IV disease were 16.6, 18.0, 29.0 and 47.0 ng ml-1 respectively. High levels of NSE were also found in patients with other types of tumour. Children in clinical remission after treatment for neuroblastoma invariably had normal NSE levels (mean +/- s.d. = 9.2 +/- 3.0 ng ml-1) even though the majority had radiologically identifiable residual disease. The values rose when relapse was radiologically or clinically obvious. We conclude (a) that, though levels of greater than 100 ng ml-1 are highly suggestive of advanced neuroblastoma, caution should be exercised in using serum NSE as a diagnostic test in children with cancer and (b) that serum NSE levels are not a sensitive index of residual neuroblastoma in patients, with initially elevated levels, that are receiving treatment.

Child↗
PubMed1987

Developmental responses to opioids reveals a lack of effect on stress-induced corticosterone levels in neonatal rats.

The neonate has an unusual capacity for survival and the possibility exists that mechanisms for controlling stress responses may differ in the developing animal. In adults both endogenous and exogenous opioids can modulate the corticosterone responses to stress. We have studied this effect in neonatal rats and found that opioid modulation is absent in early postnatal development. Neonatal rats of either sex were injected with morphine (5-50 mg kg-1), fentanyl (10-100 micrograms kg-1), buprenorphine (0.1-30 mg kg-1) or naloxone (0.1-10 mg kg-1) and plasma corticosterone measured fluorimetrically 15 or 20 min later. In addition naloxone reversibility studies (1 mg kg-1, co-administered) were carried out for the opioid agonists. In adult rats, elevations in plasma corticosterone caused by injection stress were potentiated by morphine, fentanyl and buprenorphine. In neonates, though injection stress-induced rises in plasma corticosterone were absent at 10 days, elevations were observed at 21 days and later. However, significant potentiation of this corticosterone response by fentanyl was absent at 21 days and at later ages (30 and 40 days) for morphine and buprenorphine. The potentiating effect of all three agonists did not become fully effective until day 45. In addition, in animals acclimatized to injection stress by 7 day injection pretreatment, fentanyl did not significantly alter corticosterone levels in 30 day old neonates. High doses of naloxone (10 mg kg-1) significantly increased the corticosterone response to injection stress in adult rats but this effect was absent in 30 day old animals. A dose of naloxone (I mg kg-') which had no significant effect on the corticosterone response inhibited the effects of morphine, fentanyl and buprenorphine in 45 day old and adult rats. 5 This late development of opioid action is unusual in comparison with the maturation of endogenous peptides, receptors and antinociceptive responses and suggests that alternative mechanisms may be involved in stress-control in the neonate.

Aging↗
PubMed1986

Ontogeny of catecholamine and GABA levels in rat brain: lack of effect of perinatal lead exposure.

In this study we report the ontogeny of noradrenaline, adrenaline, dopamine, and gamma-aminobutyric acid (GABA) in the rat striatum and the effect of perinatal exposure to low levels of lead. Lead administered in the maternal drinking water (100, 300 and 1000 ppm) from conception to weaning had no effect on the ontogeny of catecholamines. There was a 50% decrease in the levels of GABA at 10 days in rats exposed to the highest dose of lead, but no other changes were observed in lead-exposed rats at 21 and 30 days of age. These results contrast with our previously reported decrease in the levels of striatal proenkephalin products in lead-exposed rats, and suggest that this inhibitory effect of lead does not represent a generalised neurochemical toxicity.

Administration, Oral↗
PubMed1985

Speed of relapse in children with acute lymphoblastic leukaemia.

16 children with acute lymphoblastic leukaemia (ALL) who relapsed on maintenance treatment between September 1978 and December 1981 were studied. Their previous bone marrow aspirates were reviewed to determine the first evidence for marrow relapse and the subsequent rate of evolution of the disease. 60% of children had bone marrow evidence of unsuspected relapse at 8 wk, and 40% had evidence at 12 wk before clinical or peripheral blood relapse occurred. Early detection of relapse will prevent continued use of ineffective maintenance chemotherapy and may also reduce morbidity during subsequent induction therapy. Regular 8-weekly marrow aspirates are therefore recommended during first remission of ALL in children with a histocompatible sibling who would be eligible for bone marrow transplantation in second remission.

Bone Marrow Examination↗
PubMed1985

Methotrexate blood level monitoring.

Methotrexate toxicity can be avoided following high-dose therapy if certain management procedures are adhered to. These include careful fluid balance management and therapeutic drug level monitoring. A case is reported of an episode of methotrexate toxicity resulting from a fluid balance problem.

Child↗
PubMed1984

Low molecular weight plasma proteins in the cerebrospinal fluid of children with hematological malignancies.

The concentration of beta-2-microglobulin (beta 2-m) and of post gamma globulin (P gamma G) was examined in serum and cerebrospinal fluid from children with acute lymphatic leukemia (ALL) and non-Hodgkin's lymphoma (NHL). Data were analysed in order to determine whether concentration of beta 2-m or P gamma G during remission would be of value in predicting relapse or eventual outcome. Mean serum concentration of beta 2-m was similar in good and poor prognosis patients with ALL in remission and was not significantly altered in CNS or marrow relapse. Mean CSF concentration in NHL was also similar in both prognostic groups, and in poor prognosis patients was not significantly altered in relapse. The same pattern was seen when P gamma G was measured in CSF (serum concentration of this protein being too low for accurate determination). High within patient variability of levels of beta 2-m and P gamma G appeared to relate to chemotherapy rather than the disease process. Concentration of P gamma G was persistently raised in three children with brain damage of differing etiologies. Levels of two other low molecular weight proteins, retinol binding protein and alpha 1-microglobulin, were also determined in order to establish that beta 2-m and P gamma G concentration was not influenced by alteration in permeability of the blood-brain barrier. The beta 2-m and P gamma G concentration, although higher than reported in healthy children [5] does not appear to be of value as a prognostic indicator in ALL and NHL in children.

Adolescent↗