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Biomedical subjects

C Pratt

Publications and source records attributed to C Pratt.

99 records · Page 6Linked to original sources

Phase I therapy trials in children with cancer.

PURPOSE: This study examined the response and toxicity rates of antineoplastic drugs evaluated in phase I clinical trials in children to identify trends in response and toxicity over time. PATIENTS AND METHODS: Full length, peer-reviewed articles describing the results of single agent phase I therapy trials in children younger than 21 years with cancer were reviewed. Tumor-specific response data and doses of drugs that resulted in objective responses were noted. Deaths that occurred on study caused by drug toxicity, progressive disease (PD), or complications of marrow aplasia were identified, along with drug doses that resulted in toxic death. Temporal trends in response rates, toxicity, and number of patients entered in trials were examined. RESULTS: A total of 1,606 patients with cancer were enrolled in 56 single-agent pediatric phase I therapy trials published between 1978 and 1996. Of these, 1,257 were evaluated for response by tumor type. The overall objective response rate was 7.9%. Response rates were highest for patients with neuroblastoma (17.7%) and acute myelogenous leukemia (11.6%). Patients with osteosarcoma and rhabdomyosarcoma had response rates of < 3%. Sixty percent of responses in patients with solid tumors occurred at 81 to 100% of the maximum tolerated dose (MTD), although 42% of responses in patients with leukemia occurred at > 100% of the MTD. Death on study was noted in 7.0% of all patients entered in trials. Only 0.7% of patients experienced a death related to drug toxicity. PD accounted for the death of 5.6% of study participants. A trend of increasing response rate despite smaller trial size was noted over the last 7 years of this period. CONCLUSION: Phase I trials in children with cancer represent a safe mechanism to determine the MTD, toxicity profile, and pharmacokinetics of new agents for use in children with cancer.

Adolescent↗

Classroom and playground interaction of students with and without disabilities.

The classroom and playground behaviors of students with disabilities, in an integrated classroom, are frequently cited as reasons for rejection of these students by their regular-class peers. We compared the classroom and playground behavior of 95 students with mild disabilities with that of 95 students without disabilities, age and sex matched, and enrolled in the same classes. The children, age 8-13 years, attended state government elementary schools. Behaviors were observed using a time-sampling method with nine categories of behavior in each setting. The behavior of both groups of students was in many ways similar, regardless of the presence of disabilities.

Adolescent↗

My defining moment.

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Attitude of Health Personnel↗

Don't get specific.

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Attitude of Health Personnel↗

4'-demethylepipodophyllotoxin 9-(4,6-o-2-thenylidene-beta-D-glucopyranoside) (NSC-122819; VM-26) and 4'-demethylepipodophyllotoxin 9-(4.6-0-ethylidene-beta-D-glucopyranoside) (NSC-141540; VP-16-213) in childhood cancer: preliminary observations.

We evaluated the responses of 39 children with cancer who, after failure to respond to conventional chemotherapeutic agents, received either or both of two epipodophyllotoxins: 4'-demethylepipodophyllotoxin 9-(4,6-o-2-thenylidene-beta-D-glucopyranoside) (NSC-122819) and 4'-demethylepipodophyllotoxin 9-(4,6-o-ethylidene-beta-D-glucopyranoside) (NSC-141540). Seventeen patients has acute lymphocytic leukemia (ALL). 12 had acute nonlymphocytic leukemia (ANLL), and ten had solid tumors. Initially, the patients in each disease category were randomized to receive 50 mg/m2/dose of NSC-122819 intravenously (iv) twice weekly or 75 mg/m2/dose iv of NSC-141540 twice weekly for 4 weeks. Drug dosages and schedules of administration were adjusted during the course of the study. Although objective responses were not detected in the heterogeneous group of solid tumor patients, definite clinical responses were obtained in nine of the 29 patients with acute leukemia. The responses to the two epipodophyllotoxins were noted in patients with ALL as well as in patients with ANLL. Toxic side-effects included nausea, vomiting, diarrhea, fever, alopecia, leukopenia, and thrombocytopenia. These results, the first reported with both NSC-122819 and NSC-141540 in childhood cancer, indicate that the epipodophyllotoxins are well tolerated and may be effective against acute leukemia.

Acute Disease↗

Gender differences in homicide in Contra Costa County, California: 1982-1993.

INTRODUCTION: Homicide is the third leading cause of injury death for women in the United States. However, few studies have examined the circumstances specific to female homicide. This study examines gender differences in circumstances surrounding homicides in Contra Costa County for a 12-year period. METHODS: Uniform Crime Reporting (UCR) data for Contra Costa County from 1982 through 1993 were analyzed. Variables examined were gender of the victim, victim-offender relationship, age of victim, weapon used, location of homicide, precipitating circumstances, and gender of the offender. RESULTS: Forty-six percent of the women were killed by their spouse, other family member, or intimate partner, compared to only 11.4% of men. In contrast, men were more likely to be killed by a stranger than women (17.9% versus 10.9%, P = .02). A higher percentage of women than men were killed with a blunt object, a personal weapon (i.e., fists, feet, and teeth), or other weapon (24.9% versus 10.6%, p < .01), and in a residence (60.1% versus 34.8%, P < .001). Men were more likely than women to be killed by a firearm, in a public place (i.e., a parking lot or street), and while a felony was being committed. CONCLUSIONS: These findings are consistent with the hypothesis that many female homicides may be the result of domestic violence, belying the myth that the principal perpetrators of homicides against women are strangers. The differences between female and male homicides indicate that gender-specific prevention strategies need to be pursued.

Adult↗