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Biomedical subjects

C M Shapiro

Publications and source records attributed to C M Shapiro.

At least 127 records · Page 7Linked to original sources
PubMed1983

Multimodality therapy of stage III adenocarcinoma of the breast.

The results of a pilot multimodality program (surgery + radiotherapy + chemotherapy) are reported in 34 women with advanced stage III and IV adenocarcinoma of the breast. The median relapse-free survival for all patients was 24 months, with 74% of the premenopausal patients and 37% of the postmenopausal alive at five years (P = 0.18). The relapse rate was significantly lower in premenopausal patients when compared to the postmenopausal subgroup. Estrogen receptor status was not predictive for relapse or survival.

Adenocarcinoma↗
PubMed1983

Ketotifen and nocturnal asthma.

Patients with asthma often wheeze at night and they also become hypoxic during sleep. To determine whether ketotifen, a drug with sedative properties, is safe for use at night in patients with asthma, we performed a double blind crossover study comparing the effects of a single 1 mg dose of ketotifen and of placebo on arterial oxygen saturation (SaO2), breathing patterns, electroencephalographic (EEG) sleep stage, and overnight change in FEV1 in 10 patients with stable asthma. After taking ketotifen, the patients slept longer and their sleep was less disturbed than after taking placebo, true sleep occupying 387 (SEM 8) minutes after ketotifen and 336 (19) minutes after placebo (p less than 0.02). On ketotifen nights the patients had less wakefulness and drowsiness (EEG sleep stages 0 and 1) and more non-rapid eye movement (non-REM) sleep than on placebo nights, but the duration of REM sleep was similar on the two occasions. Nocturnal changes in SaO2, the duration of irregular breathing, and overnight change in FEV1 were unaffected by ketotifen.

Adolescent↗
PubMed1983

Arterial oxygenation during sleep in patients with right-to-left cardiac or intrapulmonary shunts.

We have studied arterial oxygen saturation (SaO2), breathing patterns, and electroencephalographic (EEG) sleep stage during nocturnal sleep in six patients with right-to-left cardiac or intrapulmonary shunts and six patients with chronic bronchitis and emphysema, chosen because they were equally hypoxaemic when awake (SaO2 during wakefulness: bronchitis 74-90%, mean 83%; shunt 77-89%, mean 83%). The patients with bronchitis had far greater falls in SaO2 when asleep than those with shunts (maximum fall in SaO2 during sleep: bronchitis 14-47%, mean 29%; shunt 5-10%, mean 8%; p less than 0.01). Significant episodes of hypoxaemia (defined as SaO2 falls greater than 10%) occurred in all six bronchitic patients, from once to seven times per night, but in none of the patients with shunts (p less than 0.05). Twenty-four of the 27 episodes of hypoxaemia occurred in rapid-eye-movement (REM) sleep and 24 were associated with hypopnoea. The two groups of patients had similar EEG sleep patterns and the same amount of hypopnoea during sleep. Thus the level of arterial oxygenation when the patient is awake is not the sole determinant of the degree of nocturnal hypoxaemia; the pathological process is also important.

Adult↗
PubMed1983

Transient hypoxemia during sleep in chronic obstructive pulmonary disease is not a sleep apnea syndrome.

We measured ear oxygen saturation (SaO2), chest wall movement, and oronasal air flow, and took electroencephalographic tracings during nocturnal sleep in 20 healthy subjects and 20 similarly aged patients with chronic obstructive pulmonary disease (COPD), none of whom was obese. Thirteen of the patients with COPD were persistently hypoxemic and hypercapnic when awake ("blue and bloated", Type B); the remaining 7 maintained relatively normal arterial gas tensions when awake despite equally severe airways obstruction ("pink and puffing", Type A). Hypoxemic episodes (HE) (SaO2 falls of greater than 10%) occurred during sleep in all the blue bloaters but in only 3 of 7 pink puffers and 3 of 20 normal subjects. However, the maximal change in arterial oxygen tension (PaO2) (calculated from SaO2 values assuming normal pH) was similar in all 3 groups, averaging 24 mmHg. Furthermore, the cumulative duration of apnea and hypopnea was the same in each group. Only one patient COPD had more than 2 apneas per night, and obstructive apnea was seen only in the healthy subjects. Sleep apnea syndromes thus appear to be rare in nonobese patients with COPD. Of the 40 HE in patients with COPD, 29 occurred during periods of hypoventilation. In 10 blue bloaters whose arterial blood was sampled during sleep, the measured fall in PaO2 during the HE (mean, 11.2 mmHg) was greater than the rise in PaCO2 (mean, 4.2 mmHg). Although these changes in arterial gas tensions could be produced by an increase in ventilation-perfusion imbalance during the HE, it is suggested that unsteady-state gas exchange during transient hypoventilation could provide an alternative explanation.

Adult↗
PubMed1982

Acute nephrotoxicity following cis-dichlorodiammine-platinum.

The effects of a single dose of cis-diamminedichloroplatinum (DDP) on the kidney function were investigated in 14 patients with disseminated malignancy and normal renal function. A single dose of DDP (30-50 mg/m2) caused severe proximal tubular dysfunction with increased urinary losses of calcium, magnesium, and amino acids. Phosphate excretion was not affected. DDP can cause proximal tubular dysfunction and close attention must be paid to serum calcium and magnesium levels.

Acute Kidney Injury↗
PubMed1982

Irregular breathing and hypoxaemia during sleep in chronic stable asthma.

Breathing patterns, ear oxygen saturation (SaO2), and EEG sleep-stage throughout an undisturbed night's sleep were compared in ten adult stable asthmatics and ten age-matched healthy subjects. The two groups slept equally long (5.0-7.2, mean 6.2 h), but the asthmatics slept less well; they had more periods of wakefulness and drowsiness and irregular breathing than did the healthy subjects. They also had greater and more frequent falls in SaO2. Most hypoxaemic episodes occurred in the rapid-eye movement phase of sleep and were associated with hypopnoea or apnoea, but no patient had a classical sleep-apnoea syndrome. The severity of nocturnal hypoxaemia was related to the level of SaO2 when the subjects were awake, but did not correlate with the fall in forced expiratory volume recorded in eight out of ten asthmatics after sleep.

Adult↗
PubMed1982

Prognostic value of the estrogen receptor level in pathologic stage I and II adenocarcinoma of the breast.

The relationship between estrogen receptor levels and recurrence of breast cancer was examined in 302 patients with adenocarcinoma of the breast, pathologic stage (PS) I and II. All 117 patients with PS II adenocarcinoma of the breast received adjunctive chemotherapy. In this series, there was no association between the estrogen receptor level and recurrence in either the 185 patients with PS I adenocarcinoma of the breast or the 117 patients with PS II adenocarcinoma of the breast. The most important prognostic variable was the presence or absence of axillary metastases.

Adenocarcinoma↗
PubMed1982

Metastatic fungal chorioretinitis developing during Trichosporon sepsis.

A 70-year-old woman treated for acute myelogenous leukemia developed systemic trichosporosis and presumptive trichosporon chorioretinitis. The elevated choroidal lesion appeared during an episode of trichosporon sepsis and increased in size during immunosuppression. Possible retinal vein occlusion and neovascularization were further complications that may be due to the angioinvasive properties of the organism.

Aged↗
PubMed1981

Slow-wave sleep: a recovery period after exercise.

Sleep recordings were carried out on athletes on four successive nights after completing a 92-kilometer road race. Significant increases in total sleep time and slow-wave sleep were found after this metabolic stress. The results show a definite exercise effect on sleep and support sleep-restoration hypotheses.

Adolescent↗
PubMed1981

Sleep and the athlete.

Sleep is generally considered to be restorative and the notion of exercise being associated with the changes in subsequent sleep is popular but has only recently been demonstrated. There are several facets of exercise performed that have an influence on sleep. These include the intensity and duration of the exercise, and the interval between the cessation of exercise and sleep onset. Other factors that may alter sleep after exercise are the age and fitness of the subject, and his lean body mass. Most studies on the effect of exercise on sleep can be interpreted as being partially or totally supportive of the restorative theory of sleep function.

Aging↗
PubMed1981

Histiocytic lymphoma (reticulum-cell sarcoma) of bone. Current strategy for orthopaedic surgeons.

We retrospectively reviewed the cases of eight patients with histiocytic lymphoma (reticulum-cell sarcoma) appearing as a primary bone lesion. Histological findings were classified according to the criteria of Rappaport. Lesions were staged as suggested by the Ann Arbor Conference. After thorough staging, four of the eight patients were shown to have more extensive disease than was initially thought, which altered the therapeutic approach used. Thorough staging is necessary for improved survival of patients with histiocytic lymphoma of bone. We suggest a diagnostic strategy for patients with histiocytic lymphoma presenting in bone that leads to appropriate therapy.

Adult↗
PubMed1980

Bronchial carcinoid metastatic to skin. Light and electron microscopic findings.

This case report illustrates the value of ultrastructural examination of an undifferentiated carcinoma mestastatic to skin. In this patient, ultrastructural study of a cutaneous nodule demonstrated cytoplasmic neurosecretory granules characteristic of an amino precursor-uptake and decarboxylation cells (APUD) tumor and supported the diagnosis of metastatic bronchial carcinoid. Additional nine cases of bronchial carcinoids metastatic to skin are also briefly reviewed.

Bronchial Neoplasms↗
PubMed1979

Scaling sex attitudes and behavior in South Africa.

Sex attitudes and behavior were scaled according to Guttman scale criteria among 300 members of the public, students, and nurses in Johannesburg, South Africa, replicating the central features of earlier studies conducted in the United States. The study presents an initial attempt to establish norms of sex attitudes and behavior in South Africa. The scales are shown to provide reliable tools for sex research and clinical practice.

Attitude↗
PubMed1979

Eosinophilic granuloma of the second cervical vertebra.

The occurrence of eosinophilic granuloma in the body of the second cervical vertebra of a young adult male is presented. The necessity of making a histologic diagnosis and prevention of vertebral instability led to operative intervention. Treatment consisted of posterior fixation of the spinous processes of the second and third cervical vertebrae with size 0 wire. Through a transoral approach the lesion was curetted, and bone chips were placed in the vertebral defect. The patient remains well, and disease-free, after 36 months.

Adult↗
PubMed1978

Combined modality therapy for stage IIIMO non-oat cell bronchogenic carcinoma.

Thirty-nine patients with stage IIIMO non-cell bronchogenic carcinoma (NOBC) were treated with combined modality therapy: radiation therapy and chemotherapy with cyclophosphamide, adriamycin, methotrexate, and procarbazine. The median survival for all patients treated was 9.6 months compared to 6.4 months for historical controls (P = 0.015). Patients who responded to the treatment program had a significantly longer survival (median, 15.2 months) compared to nonresponders and historical controls (P less than 0.005). It is concluded that combined modality therapy is moderately effective therapy in stage IIIMO NOBC.

Carcinoma, Bronchogenic↗