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Biomedical subjects

Douglas E Paull

Publications and source records attributed to Douglas E Paull.

7 recordsLinked to original sources
PubMed2006

Determinants of quality of life in patients following pulmonary resection for lung cancer.

BACKGROUND: The purpose of the present study was to prospectively measure quality of life (QOL) before and after pulmonary resection for non-small cell lung cancer (NSCLC) and to determine which clinical perioperative variables predicted QOL. METHODS: Thirty-seven patients undergoing a curative resection for early-stage NSCLC were administered the Functional Assessment of Cancer Therapy-Lung (FACT-L) questionnaire serially. This was used to calculate a Trial Outcome Index (TOI), a measure of QOL. RESULTS: Perioperative variables associated with worse postoperative TOI included the presence of preoperative dyspnea (coefficient -7.89, 95% confidence interval -12.4 to -3.31, P = .01) and exposure to adjuvant chemotherapy (-14.7, -20.0 to -9.46, P = .001). CONCLUSIONS: Preoperative dyspnea and postoperative chemotherapy are associated with worse postoperative QOL among patients with resected, early-stage NSCLC. As adjuvant and neoadjuvant therapy protocols become more prevalent for these patients, QOL issues may assume greater importance.

Bronchoscopy↗
PubMed2006

Positron emission tomography in well differentiated fetal adenocarcinoma of the lung.

A 47-year-old woman with a 20 pack-year history of cigarette smoking presented with a chest x-ray demonstrating a left upper lobe lung density. Computed tomography of the chest showed a 3-cm lobulated mass in the apical left upper lobe. The lesion demonstrated intense focal uptake on FDG-PET scanning. The patient underwent left upper lobectomy. Pathology demonstrated the histologic and immunohistochemical findings of a well differentiated fetal adenocarcinoma (WDFA). The intense FDG-PET uptake and abundant glycogen stores associated with WDFA may be the result of its embryonic derivation and differential expression of glucose transporter proteins.

Adenocarcinoma↗
PubMed2005

Alcohol abuse predicts progression of disease and death in patients with lung cancer.

BACKGROUND: Few studies have examined long-term outcomes in alcohol-abusing patients with lung cancer. The purpose of this study was to examine the effect of alcohol abuse on the prognosis of patients with lung cancer. METHODS: The study was composed of 114 consecutive patients with nonsmall-cell lung cancer treated at a Department of Veterans Affairs Medical Center. An alcohol-abusing group consisted of 36 patients with one of the following at the time of lung cancer diagnosis: positive screening questionnaire, alcohol consumption more than 5 drinks or cans of beer a day, or criteria for a diagnosis of alcohol dependence/abuse according to the Diagnostic and Statistical Manual for Mental Disorders IV. The comparison group consisted of 78 nonabusing patients. RESULTS: Alcohol abusers, compared with nonabusers, had worse Kaplan-Meier overall survival (median 8.5 versus 17.5 months, p = 0.05) and progression-free survival (median 6.0 versus 15.5 months, p = 0.04). In multivariate analyses including alcohol abuse, Charlson comorbidity, pack-years smoking, performance status, and stage, only stage of disease, performance status, and alcohol abuse (odds ratio = 3.44, 95% confidence interval = 1.17 to 10.1, p = 0.02) predicted progression of disease or death within 12 months of diagnosis. Alcohol abuse was also an independent predictor of disease-specific survival (hazard ratio = 1.65, 95% confidence interval = 1.01 to 2.80, p = 0.05) and progression-free survival (hazard ratio = 1.79, 95% confidence interval = 1.12 to 2.86, p = 0.01) among patients with lung cancer. CONCLUSIONS: Alcohol-abusing patients with nonsmall-cell lung cancer have worse outcomes than nonabusing patients. The adverse prognosis associated with alcohol abuse is independent of comorbidity, performance status, or smoking history.

Aged↗
PubMed2004

Complications and long-term survival for alcoholic patients with resectable lung cancer.

BACKGROUND: The aim of this study was to determine the surgical risks and long-term survival in alcoholic patients undergoing resection for non-small-cell lung cancer. METHODS: Nineteen resected patients comprising the alcoholic group were identified by either a Diagnostic and Statistical Manual of Mental Disorders-IV diagnosis of alcohol dependence/abuse, or an alcohol consumption of 60 oz/d or more. Alcoholic patients were compared with 37 nonalcoholic patients undergoing resection. RESULTS: Alcoholic patients had an increase in major infectious complications (37% [7 of 19] versus 5% [2 of 37], P = 0.005), respiratory failure (42% [8 of 19] versus 5% [2 of 37], P </=0.001), and costs ($49,526 +/- $17,525 versus $18,385 +/- $3,260, P = 0.01). Alcohol abuse was the best predictor of perioperative respiratory and infectious complications (P = 0.002, B = 2.86, odds ratio = 17.5). Stage of disease (P = 0.03, B = 1.19, hazard ratio = 3.29) was a better predictor of long-term survival. CONCLUSIONS: Alcohol abuse significantly increases the risk and cost of lung cancer resection. For alcoholic patients surviving the perioperative period, long-term survival appears similar to non-alcohol-abusing patients.

Aged↗
PubMed2003

Thoracoscopic talc pleurodesis for recurrent, symptomatic pleural effusion following cardiac operations.

Seventeen patients who underwent a cardiac operation developed a recurrent, symptomatic pleural effusion ultimately requiring video-assisted thoracic surgery (VATS) and talc pleurodesis. These patients represented 0.4% of all patients undergoing a cardiac operation over the same time period. Compared with an age- and sex-matched control group of cardiac surgery patients, patients requiring VATS for recurrent pleural effusion were more obese with higher body mass index (31.9 +/- 1.2 versus 28.3 +/- 1.4 kg/M2, P = 0.03), were more likely to have undergone a complex cardiac operation (8/17 versus 1/17, P =.01) and were more frequently on anticoagulation and antiplatelet agents besides aspirin (8/17 versus 2/17, P =.02). Patients underwent 1.86 +/- 0.34 thoracenteses with drainage of 846 +/- 166 mL/thoracentesis prior to referral for VATS. On average, patients underwent VATS 4.83 +/- 1.49 months after their cardiac operation. There were 3 VATS-related complications (17.6%) and no deaths. VATS talc pleurodesis led to symptomatic and radiologic improvement in all patients with a mean follow-up of 8.2 +/- 1.5 months. VATS talc pleurodesis effectively and safely treats the unusual postcardiac surgery patient with refractory pleural effusion.

Aged↗