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Biomedical subjects

C Cummings

Publications and source records attributed to C Cummings.

At least 55 records · Page 3Linked to original sources
PubMed1989

Chemoradiotherapy toxicity during bone marrow transplantation: time course and variation in pain and nausea.

Chemoradiotherapy-induced toxicity following unmodified allogeneic marrow grafting was studied. Patients with hematologic malignancy (n = 157) received cyclophosphamide (120 mg/kg) followed by single or fractionated total body irradiation (TBI); aplastic anemia patients (n = 41) received only cyclophosphamide (200 mg/kg). Physicians rated mucositis, pain and nausea daily as (0) none, (1) mild, (2) moderate, (3) severe, (4) life threatening. Oral mucositis pain began several days prior to transplant, peaked during the second week after transplant, and declined thereafter. Patients with hematologic malignancies (maximum mean rating of 1.6, day 11) experienced more pain than aplastic anemia patients (maximum mean rating of 0.7, day 6). Nausea peaked before transplant and gradually declined. Nausea was higher (p less than 0.001) in patients with aplastic anemia (maximum mean rating of 1.3, day -2) than with hematologic malignancies (maximum mean rating of 0.9, day -6). There was no significant difference between single dose 1000 cGy and 6-day 1200 cGy irradiation. Recipients of 1575 cGy rather than 1200 cGy TBI had significantly (p less than 0.01) higher levels of pain (mean rating 1.25 and 0.82, respectively) and nausea (mean rating 1.27 and 0.72, respectively). Additional research is needed to determine the predictors, consequences and best methods of controlling these toxicities.

Adolescent↗
PubMed1988

Feasibility and efficacy of weekly intraarterial cisplatin in locally advanced (stage III and IV) head and neck cancers.

Thirty-five consecutive patients with primary unresectable head and neck cancers were considered eligible for protocol treatment with neoadjuvant intraarterial cisplatin. External carotid artery catheterizations were technically feasible in 29 patients (83%). Twenty-five patients with 28 primary tumors received intraarterial cisplatin, 100 mg/m2, every seven to 14 days for three cycles. The most common toxicity was nausea and vomiting. Ipsilateral hemialopecia, transient VII nerve palsy, and blurring of vision seem to be unique to this route of administration at this dose. A complete response was seen at the primary tumor site in nine of 28 (32%), with 14 of 28 partial responses (50%). In evaluating both primary tumor and nodal disease, five of 25 patients achieved a complete response and 15 of 25 a partial response. In previous reports, one complete response was observed in 74 patients with head and neck cancer treated with neoadjuvant intravenous (IV) cisplatin every 3 weeks. The overall response of 82% reported here is comparable to that reported with combination chemotherapy and suggests an advantage to the arterial administration of cisplatin when possible in the neoadjuvant setting.

Carotid Artery, External↗
PubMed1987

Comparison of enzyme immunoassay and culture for diagnosis of chlamydial conjunctivitis and respiratory infections in infants.

The efficacy of Chlamydiazyme (Abbott Laboratories, North Chicago, Ill.) in detecting neonatal conjunctival and respiratory infections caused by Chlamydia trachomatis was determined by comparison of this enzyme immunoassay (EIA) with the method of isolation of chlamydiae in tissue culture. The sensitivity and specificity of Chlamydiazyme for detecting C. trachomatis in conjunctival specimens from infants with conjunctivitis were 98 and 94%, respectively. For nasopharyngeal infection in infants with conjunctivitis, the sensitivity and specificity were 87 and 92%, respectively. There were nine nasopharyngeal specimens that were Chlamydiazyme positive and culture negative. All of these specimens demonstrated the presence of typical fluorescing chlamydial elementary bodies when pellets of the original specimens were examined with a fluorescein-conjugated monoclonal antibody. When the EIA was performed on nasopharyngeal specimens from infants with suspected chlamydial pneumonia, 6 culture-positive and 10 culture-negative specimens were correctly identified.

Chlamydia Infections↗
PubMed1987

Pneumocystis carinii pneumonia following 5-fluorouracil administration.

A 54-year-old man who had been treated with monthly courses of 5-fluorouracil for one year developed Pneumocystis carinii pneumonia. No evidence of significant, permanent, immunologic impairment was evident one year after the patient became infected. An infection associated with 5-fluorouracil treatment is implicated.

Fluorouracil↗
PubMed1986

Cryptococcal pneumonia in a patient with sickle cell disease.

We present the findings in a patient having sickle cell disease who developed multilobar pneumonia. Cultures of bronchial aspirates and histologic specimens grew Cryptococcus neoformans. There was neither spontaneous clearing of the infection nor a response to bactericidal antibiotics. The patient had no underlying malignant neoplasm or immunodeficiency as indicated by history, physical examination, and specialized tests of humoral and cell-mediated immunity.

Adult↗
PubMed1985

Crystalline regions in collagen fibrils.

A new image processing technique, content-dependent anisotropic spatial frequency filtering, has been developed to visualize the location and orientation of crystalline regions in collagen fibril cross-sections. The results show that most crystalline regions are oriented with their approximately 4 nm periodicity directed radially from the fibril centre. This periodicity corresponds to the separation between rows of molecular ends in the quasi-hexagonal molecular packing scheme. The extent of crystallinity increases with radius and frequently the lattice is either continuously distorted or interrupted by sharp discontinuities.

Animals↗
PubMed1984

A clinical and ultrastructural study of osteogenesis imperfecta after flavonoid (Catergen) therapy.

A trial of the flavonoid Catergen (Zyma) has been undertaken in 11 adults with osteogenesis imperfecta (Ol). The only significant clinical or metabolic side-effects were severe headaches, which necessitated the withdrawal of 3 patients from the trial. Patient compliance in terms of palatability of Catergen was good, and 3 of the 8 patients who completed the trial experienced subjective improvement. After 6 months' treatment with Catergen, the abnormally narrow collagen fibrils found in the osteoid region in a pretreatment bone biopsy specimen from a middle-aged man with the common type 1 (autosomal dominant) form of Ol showed a significant reversion to normal diameters. Post-treatment specimens from his 2 affected sons, who exhibited the same defect, showed a similar but less marked response.

Adult↗
PubMed1984

Collagen defect of bone in osteogenesis imperfecta (Type I). An electron microscopic study.

Osteogenesis imperfecta (OI) is an inherited disorder of connective tissue metabolism characterized by fragility of the bones, resulting in multiple fractures. In this study electron microscopic examination of the osteoid region of iliac crest bone biopsy specimens from a 55-year-old man and his three sons (18, 21, and 25 years of age) affected with the common Type I (autosomal dominant) form of OI revealed collagen fibrils consistently smaller in diameter than those from normal age-matched control subjects, with the majority of OI fibrils measuring 0.04-0.06 micron, as opposed to 0.06-0.08 micron in the control subjects. This defect may be due to the biosynthesis of Type III collagen, not normally found in adult lamellar bone or, more likely, to a failure of maturation of Type I fibrils to their normal diameters, possibly owing to the increased levels of hydroxylysine previously reported in OI collagen, a factor known to be inversely related to fibril diameter.

Adolescent↗
PubMed1983

A prospective randomized trial of methotrexate versus cisplatin in the treatment of recurrent squamous cell carcinoma of the head and neck.

A prospective randomized study was conducted to determine the relative effectiveness, toxicity and tolerance of methotrexate (MTX) versus cisplatin (DDP) in patients with recurrent head and neck squamous cell carcinoma. Forty-four patients were randomized to receive either MTX, 40 mg escalated to 60 mg/m2 IV push weekly, or DDP, 50 mg/m2 6 hour infusion days 1 and 8 every 4 weeks. All patients had objectively measurable disease and a performance status greater than 60% (Karnofsky scale). All had been treated with surgery and/or radiotherapy. No patients had prior chemotherapy. Prior treatment, performance status, and site of primary disease were comparable in both groups. Complete and partial objective responses were achieved in 23.5% of the MTX group and 28.6% of the DDP group (P = 0.51). Median duration of response was 84 days in the MTX group and 92 days in the DDP group. Median survival of patients was 6.1 months with MTX and 6.3 months with DDP. Mucositis was noted in 38% of patients in the MTX group (P = 0.001) compared to none in the DDP group. Vomiting occurred in 87% of patients in the DDP group (P less than .0001) compared to 10% of patients in the MTX group. This study demonstrates that in the treatment of recurrent head and neck squamous cell carcinoma, MTX and DDP are equally effective, although MTX appears to be better tolerated.

Carcinoma, Squamous Cell↗
PubMed1983

Effect of hypoxia on laryngeal reflex apnea--implications for sudden infant death.

Apnea was elicited by the application of chemical stimuli to the laryngeal region of 25 piglets from 1 to 70 days of age. Animals were tested under normoxic and hypoxic (Flo2 10%) conditions with water and solutions of graded acid and salt concentration. The chemoreflex was found to diminish with postnatal age. Fatal apneic episodes were confined to animals less than 3 weeks of age. Hypoxia consistently augmented the reflex, and in some cases elicited fatal apnea in animals that had survived similar stimulation under normoxic conditions. A direct relationship was also found between the strength of stimulus and respiratory response. Apnea increased with diminishing NaCl concentration or pH. The reflex was abolished by bilateral section of the superior laryngeal nerves. Fatal apnea elicited by laryngeal chemo-stimulation under the circumstance of hypoxia may provide further insight into the enigma of sudden infant death.

Age Factors↗
PubMed1982

Increased morphological variants in children with learning disabilities.

Previous studies have shown that children with learning disabilities have more morphological variants or anomalies than normal children, suggesting that the morphological and central nervous system effects may be the result of the same prenatal factors. The morphological variants were assumed to have arisen in the first 3 months of prenatal development, which may not be so. We have partitioned variants into those that probably arise early in fetal development ("early" variants) and those that could arise later and could be due to altered growth ("late" variants). There was an increase in both "early" and "late" variants but only that the "late" variants was statistically significant. Although the method of measuring one "early" variant (dermal patterns) was sensitive enough to detect mild disturbances in children with isolated congenital heart disease, such a disturbance was not found in our group of learning-disabled patients. Our findings suggest that the developmental disturbances resulting in morphological variants may act later in prenatal development than was previously believed. This information may be helpful in searching for clues to the etiology of this heterogeneous group of disabilities.

Adolescent↗
PubMed1982

Relapse in opiate addicts: a behavioral analysis.

Behavioral interviewing was used to study the relapse antecedents and concomitants of 38 opiate addicts on methadone maintenance. Relapse situations were categorized with regard to intra- or interpersonal determinants and implications for behavioral treatment interventions were discussed. Situations were also analyzed within an opponent process theory of motivation framework. Practical and theoretical difficulties with the study of relapse situations in substance abusing populations were highlighted.

Adult↗
PubMed1980

The first febrile seizure--antipyretic instruction plus either phenobarbital or placebo to prevent recurrence.

A randomized double-blind study was carried out comparing single daily dose phenobarbital plus antipyretic instruction to a placebo plus antipyretic instruction to prevent a recurrent seizure following an initial simple febrile seizure. Parents of 138 consecutive children presenting to an emergency room with a first simple febrile convulsion received verbal and written instructions about fever control. Seventy-nine then agreed to participate in this study. Children were randomized to receive either placebo with riboflavin tracer (n = 40) or phenobarbital 5 mg/kg in a single daily dose with a riboflavin tracer (n = 39) for 12 months or until another seizure occurred. Urine fluorescence for riboflavin was used to monitor compliance in all patients. Serum phenobarbital levels were obtained at each follow-up visit and averaged 1.4 mg/dl throughout the study. The significant difference (P less than 0.02) in the incidence of recurrent seizures between patients receiving phenobarbital (2/39) and those receiving placebo (10/40) suggests that a single daily dose of phenobarbital is more effective than counseling parents about antipyretic therapy in preventing recurrent seizures following an initial febrile seizure.

Child, Preschool↗
PubMed1980

Aggressive conduct disorder of children. The clinical picture.

Aggressive conduct disorder, defined broadly on the basis of fighting, disobedience, destructiveness, and meanness, was diagnosed in 65 out of 136 boys and 17 of 43 girls consecutively admitted to a psychiatric clinic. Psychotic, brain damaged, and seriously retarded children were excluded from the series. Boys and girls with conduct disorder differed significantly from those with other diagnoses on a number of noncriterion symptoms, particularly those grouped as reactive and egocentric. Boys with conduct disorder were more often involved in antisocial behavior, girls in precocious sexual behavior. The study presents a more detailed clinical picture of the disorder, and suggests that the presence of specific antisocial behavior may be a useful criterion for dividing affected boys into two roughly equal subgroups.

Aggression↗