Search PubMed⌕ Search

Biomedical subjects

Cameron Platell

Publications and source records attributed to Cameron Platell.

8 recordsLinked to original sources
PubMed2003

Dose surgical sub-specialization influence survival in patients with colorectal cancer?

AIM: To perform a review of patients with colorectal cancer to a community hospital and to compare the risk-adjusted survival between patients managed in general surgical units versus a colorectal unit. METHODS: The study evaluated all patients with colorectal cancer referred to either general surgical units or a colorectal unit from 1/1996 to 6/2001. These results were compared to a historical control group treated within general surgical units at the same hospital from 1/1989 to 12/1994. A Kaplan-Meier survival analysis compared the overall survivals (all-cause mortality) between the groups. A Cox proportional hazards model was used to determine the influence of a number of independent variables on survival. These variables included age, ASA score, disease stage, emergency surgery, adjuvant chemotherapy and/or radiotherapy, disease location, and surgical unit. RESULTS: There were 974 patients involved in this study. There were no significant differences in the demographic details for the three groups. Patients in the colorectal group were more likely to have rectal cancer and Stage I cancers, and less likely to have Stage II cancers. Patients treated in the colorectal group had a significantly higher overall 5-year survival when compared with the general surgical group and the historical control group (56 % versus 45 % and 40 % respectively, P<0.01). Survival regression analysis identified age, ASA score, disease stage, adjuvant chemotherapy, and treatment in a colorectal unit (Hazards ratio: 0.67; 95 % CI: 0.53 to 0.84, P =0.0005), as significant independent predictors of survival. CONCLUSION: The results suggest that there may be a survival advantage for patients with colon and rectal cancers being treated within a specialist colorectal surgical unit.

Adult↗
PubMed2002

A low-morbidity murine model of peritonitis.

PURPOSE: Peritonitis continues to be a major source of mortality and morbidity in patients undergoing abdominal surgery. The aim of this study was to develop a nonfatal model of bacterial peritonitis in mice so that we could study aspects of the pathobiology and treatment of peritonitis in an in vivo model. METHODS: Mice were inoculated via a midline laparotomy with 0.5 mg of zymosan in 0.1 ml of saline into the subomental space. At 24, 48, and 96 hours after treatment, animals were killed, and analysis was performed to determine the degree of peritoneal inflammation. End points included intraperitoneal cellular influx, tumor necrosis factor-alpha concentrations, and myeloperoxidase activity. In addition, peritoneal lavage fluid was plated onto blood agar for analysis of bacterial colony-forming units. There were 40 mice in each group. RESULTS: There were no deaths in either group. Facultative Gram-negative bacteria were cultured from the peritoneal cavities of zymosan-treated animals at 24 and 48 hours after insult (colony-forming unit counts of 92+/-11 vs. 0 in control animals). In the zymosan-treated animals, there were significantly increased numbers of inflammatory cells (especially neutrophils) in the peritoneal cavity at 24 and 48 hours after treatment; these numbers returned to control levels by 96 hours. Myeloperoxidase activity was also elevated both in the peritoneal fluid (2.4 X 10(-4) units/ml compared with 1.6 x 10(-4) units/ml, P < 0.05) and in remote organs (i.e., lung, P < 0.05; liver, P < 0.001; and kidney, P < 0.05) at 24 hours after treatment. There was no significant difference in tumor necrosis factor-alpha levels between zymosan-treated and control mice in either serum or peritoneal fluid at any time point investigated. There was no mortality in either the zymosan-treated or control animals. CONCLUSION: In this model of bacterial peritonitis in mice, we have demonstrated how the peritoneal cavity can resolve a relatively localized inflammatory insult within 96 hours of induction. This response is characterized by a cellular influx of predominantly neutrophils and macrophages and by pronounced oxidative activity. We will use this in vivo model to characterize aspects of the pathobiology and treatment of peritonitis.

Animals↗
PubMed2002

Dendritic cells.

Dendritic cells (DC) are the most effective or 'professional' of the antigen-presenting cells (APC) that initiate primary immune responses. They are located at surveillance sites where they capture and process antigens. They then initiate and regulate T- and B-cell responses by expressing lymphocyte costimulatory molecules, migrating to lymphoid organs and secreting biologically active molecules. Dendritic cells not only activate lymphocytes to induce the immune response, but they also minimize autoimmune reactions by tolerizing T cells to self-antigens. Recent Phase I and II clinical studies have shown promise in the use of antigen-pulsed autologous DC for vaccination of cancer patients. Dendritic cells also have applications in preventing rejection after transplantation, immunization against viral infections and immunosuppression in autoimmune diseases.

Antigen-Presenting Cells↗
PubMed2002

Use of adjuvant, preoperative chemo-radiotherapy in patients with locally advanced rectal cancer.

BACKGROUND: The objective of this study was to perform a non-randomised prospective examination of the efficacy of adjuvant, preoperative chemo-radiotherapy in patients with locally advanced rectal cancer. METHODS: Between 1996 and 2001, patients presenting with biopsy-proven, locally advanced, rectal cancers within 12 cm of the anal verge were referred for a long course of adjuvant chemo-radiotherapy prior to their surgery. Locally advanced lesions were defined by either: (i) endoanal ultrasound showing at least full thickness penetration of the rectal wall (i.e. T3, T4); (ii) abdominal computed tomography scan showing infiltration of adjacent structures, or; (iii) clinical examination demonstrating a fixed lesion. All patients were followed through the hospital colorectal unit. A Kaplan-Meier survival analysis was used to determine survival and local recurrence rates. RESULTS: There were 60 patients with a mean age of 61.5 years (range 33-77 years) with a sex distribution of males to females of 1.7-1.0. Curative resections were performed in 81% of these patients. The remainder (n = 12) were found to have either metastatic disease at operation (n = 5), inoperable disease (n = 2), or had positive resection margins on histology (n = 7). The mean follow up was 2.1 years (maximum 5.1 years). The overall 2-year survival rate was 86.1% (95% CI +/-5.4%). In patients undergoing curative resections, the overall 2-year survival rate was 91.4% (95% CI +/-4.8%), and the 2-year disease free survival rate was 85.1% (95% CI +/-6.2%). The 2-year local recurrence rate was 7.5%. CONCLUSIONS: The use of adjuvant, preoperative, chemo-radiotherapy in patients with locally advanced rectal cancer is associated with high short-term survival and a low recurrence rate.

Adult↗
PubMed2000

The omentum.

Explore the source record for details and available documents.

Journal Article↗