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Biomedical subjects

E Cameron

Publications and source records attributed to E Cameron.

At least 19 recordsLinked to original sources
PubMed1992

Low dose preoperative radiotherapy for carcinoma of the oesophagus: results of a randomized clinical trial.

One-hundred-and-seventy-six patients with potentially operable squamous cell carcinoma or adenocarcinoma of the middle or lower thirds of the oesophagus were randomly assigned to preoperative radiotherapy or surgery alone. Patients assigned to the radiotherapy arm received 20 Gy in 10 treatments over 2 weeks, using parallel opposed 4 MV beams. The preoperative radiotherapy was not associated with any significant acute morbidity or any increase in operative complications. The median survival of the overall group of 176 patients was 8 months, and the 5-year survival was 13%. There was no significant difference in the survival of the 90 patients who received preoperative radiotherapy and the 86 who were managed by surgery alone. Proportional hazards analysis identified lymph node involvement, high tumour grade and male sex as significant adverse prognostic features, but the treatment option assigned had no prognostic significance. It was concluded that low dose preoperative radiotherapy offered no advantage over surgery alone.

Adenocarcinoma↗
PubMed1992

The minimum effective dose of lignocaine to prevent injection pain due to propofol in children.

In a single-blind study of 100 children aged 1 to 10 years, the minimum effective dose of lignocaine required to prevent injection pain due to propofol was 0.2 mg.kg-1 when veins on the dorsum of the hand were used. This is more than twice the adult value. We concluded that injection pain should not limit the use of propofol in children if an adequate amount of lignocaine is mixed immediately prior to injection.

Anesthesia, Intravenous↗
PubMed1992

Renal transplantation at the University of Pennsylvania Medical Center: an update of results in the cyclosporine era.

This chapter presents a summary of living-related, living-unrelated, and cadaver renal transplantation performed at the University of Pennsylvania Medical Center between January 1984 and October 1992. Over the past 9 years, 895 patients (557 males, 338 females, mean age 42 yrs) received 942 renal transplants; 599 patients received kidneys from cadaver donors (n = 627) and 296 patients received kidneys (n = 315) from living donors of all types. During this period, 151 patients were retransplanted, sometimes more than once (159 total retransplants, 124 secondary grafts, and 35 third or more transplants). An analysis of patient ant graft survival rates (calculated by actuarial methods) for different categories of transplant recipients was performed. Black recipients, as a racial subcategory, had the poorest graft outcome, especially when followed over the long term. Graft survival rates for Black recipients who were retransplanted with cadaver grafts were even worse and were noted to be similar to the diabetic population that received cadaver retransplants (66% vs 62% at 1 yr and 32% vs 25% at 5 yrs). Diabetic recipients of living-donor transplants had excellent graft survival results, similar to nondiabetic, living-donor recipients (patient survival rates 98% and 92% vs 97% and 92% at 1 and 5 yrs; graft survival rates 92% and 82% vs 92% and 82% at 1 and 5 yrs). HLA-identical recipients of first cadaver grafts demonstrated the best outcome in the entire cadaver series (graft survival rates 91% and 83% at 1 and 5 yrs, respectively). HLA-identical recipients of second or more cadaver grafts had poorer results than expected (50% graft survival at 1 yr) despite a 100% patient survival rate. HLA-identical recipients of living-related grafts had the best graft survival rates (96% at 1 yr and 94% at 5 yrs) and superior graft survival rates for retransplanted grafts as well (100% at 1 and 5 yrs). We conclude that in the last decade, patient and graft survival rates for cadaveric and living-donor renal transplants have improved dramatically relative to the results obtained in the pre-CsA era. Long-term graft survival in Black recipients remains lower than in other races, suggesting the need to analyze other factors to explain poorer graft survival in this recipient population. Results in diabetic recipients continue to be excellent at our center, encouraging the continuation of our aggressive approach to try to transplant diabetics as early as possible, particularly when a living donor is available.

Academic Medical Centers↗
PubMed1991

Preliminary results of left heart bypass in pigs using a heparin-coated centrifugal pump.

To assess the feasibility of left ventricular assist without systemic heparinization, we used a commercially available (Sarns 3M) centrifugal pump with tubing set and cannulas, all internally precoated for the purpose of this study with heparin, to bypass the left ventricle in 12 pigs for periods of either 1 or 3 hours. There was no significant activation of clotting and there was no sign of generalized embolization. However, on postmortem studies, 5 kidneys out of 22 examined showed signs of minimal thromboembolism. This experiment shows that artificial left ventricular assist, free of systemic heparinization but using heparin precoating, is feasible and safe, at least for a short period of time.

Animals↗
PubMed1991

Innovation vs. quality control: an 'unpublishable' clinical trial of supplemental ascorbate in incurable cancer.

A computerized data bank was created recording the details of all cancer patients attending three district general hospitals in West Central Scotland over a 4.5 year period 1978-1982. At the conclusion of the trial, the records of 2804 individual patients were available for study, of whom 1826 had reached an incurable stage. 294 of these incurable cancer patients had received supplemental ascorbate at some stage in their illness, whereas 1532 had not, and served as controls. Analysis showed that the ascorbate-supplemented patients had a median overall survival time (343 days) almost double that of the controls (180 days). Our difficulties in having this simple, but important, observation published are briefly recounted in the introduction.

Ascorbic Acid↗
PubMed1991

Protocol for the use of vitamin C in the treatment of cancer.

A protocol for the use of vitamin C in the treatment of cancer, developed over a number of years in Vale of Leven Hospital, Scotland, is presented. Clinical experience has shown this protocol to be both safe and efficient. It need not be followed 'to the letter', but provides general guidance to physicians unfamiliar with this therapeutic approach. It recommends that all cancer patients treated in this fashion be given an initial course of intravenous ascorbate followed by a maintenance oral dose to be continued indefinitely thereafter. The importance of continuous as opposed to intermittent administration is emphasized.

Administration, Oral↗
PubMed1991

Reticulum cell sarcoma: two complete 'spontaneous' regressions, in response to high-dose ascorbic acid therapy. A report on subsequent progress.

In 1975, we reported the remarkable case of a 42-year-old man with histologically proven widely disseminated reticulum cell sarcoma who, in a remarkably short time, appeared to enjoy not one, but two, complete spontaneous regressions of his fatal illness. Both these regressions coincided exactly in time with intravenous high-dose ascorbate administration, and it seemed reasonable to conclude that this unconventional therapy must have been responsible for his excellent responses. For those interested in spontaneous regressions of cancer and the possible mechanisms, we now report his subsequent progress some 17 years later.

Adenocarcinoma↗
PubMed1990

Mitral prosthetic replacement in small left atria.

A modified transseptal approach for exposure of the difficult mitral valve is described. This allows the surgeon to visualize the valve, especially during prosthetic replacement, in the presence of a small, friable, or noncompliant left atrium.

Aged↗
PubMed1990

Paediatric acquired immunodeficiency syndrome (PAIDS) in Trinidad and Tobago.

The first twenty-one cases of Paediatric Acquired Immunodeficiency Syndrome (PAIDS) in Trinidad and Tobago were studied. An overwhelming majority of patients were of African descent. Most of the children presented within the first year of life, the average time between presentation and death was 4 1/2 months, and the majority presented with either diarrhoea or pneumonia or failure to thrive, common conditions in the West Indies. Fever lasting longer than two weeks as well as hepatomegaly were clues which led to a definitive diagnosis.

AIDS Serodiagnosis↗
PubMed1990

Therapeutic monitoring of cyclosporine: impact of a change in standards on 125I-monoclonal RIA performance in comparison with liquid chromatography.

This study examines the measurement of cyclosporine (CsA) by 125I-monoclonal RIA, and describes the impact of the recent change in the standard curve provided. CsA concentrations in serum and whole-blood control samples measured by 125I-RIA were initially 8-18% higher than those by HPLC. During the first two months of 1989, a significant and sustained deviation in the 125I-RIA produced results that exceeded the HPLC results by 21-28% (P less than 0.001). Introduction of the new standard curve in March 1989 returned the concentration of the whole-blood controls to the previous range (11-12% above HPLC, P less than 0.001). Measurement of clinical samples from heart, liver, and bone-marrow graft recipients by 125I-RIA by both old and new kit standards produced a close linear correlation (y = 0.89 x - 19.02; r = 0.99; n = 75, range = 40-850 micrograms/L), with use of the new standards yielding results 82 (SD 8)% of those with the preceding assay. However, even with the new standard curve, CsA concentrations by 125I-RIA in the clinical samples exceeded those by HPLC by a factor of 1.37 (SD 0.18) to 1.52 (SD 0.19). Segregation for transplant type did not affect the RIA/HPLC ratio. The results suggest cross-reactivity of the 125I-RIA with material present in vivo.

Antibodies, Monoclonal↗
PubMed1989

Who gets a bath?

Explore the source record for details and available documents.

Aged↗
PubMed1989

District nursing, the disabled and the elderly: who are the black patients?

Community care research in central Birmingham has shown that disabled and old black people are under-represented on the caseloads of district nurses compared to their white counterparts. Whilst factors suggested as contributing to this (service ethnocentrism and general practitioners as 'gate-keepers') are discussed elsewhere, this paper focuses on those few old and disabled black people who are district nurse patients. Following comparisons between these black and white patient groups, the differing perspectives of black patient and district nurse are explored. Stereotypes and myths, knowledge about each other and language/communication are discussed as important areas which may disadvantage black patients in their interaction with district nurses. Attention is drawn to the urgent need for district nursing to address the issue of black disabled and old people in the community and the accompanying central role of research.

Black or African American↗
PubMed1989

The nursing auxiliary service and the care of elderly patients.

Although nurse auxiliaries comprise a large and rapidly expanding part of the district nursing service, nursing research has largely neglected this group of nurses and the people they see. Using a patient-centred approach, which is a key element of the research, we studied the characteristics of patients who were either physically handicapped, frail elderly or elderly mentally infirm, who make up a large majority of the patients. We found that auxiliaries' patients fell into a typical 'at risk' group; they were older and more likely to be living alone than qualified nurses' patients, and yet they received less frequent visits. Motives for providing and continuing the service to patients were not always related to nursing need, and while recipients were grateful for the service, both they and auxiliaries themselves identified areas of potential improvement. The need to continue to monitor and improve the overall quality, effectiveness and efficiency of the service to patients and potential patients, demands that practitioners, managers and researchers systematically review referral to the service and the work of the nurse auxiliary using a patient-focused approach.

Activities of Daily Living↗
PubMed1989

District nurses' patients--issues of caseload management.

Current pressures on all community services mean that practitioners must give more detailed attention to evaluation of patient outcomes and caseload review. District nursing caseloads in one health authority have been examined using a patient-focused approach. Random samples of patients who were either physically disabled, frail elderly, or elderly mentally infirm (n = 202) were examined for the distinctive and differing characteristics, if any, of recently referred and long-stay patients. Recently referred patients in our sample were either terminally ill, or had more chronic physical disorders. Patients who stayed on the books received either injections, general care from qualified staff or baths from nurse auxiliaries. Although covering similar areas of the health authority, nursing teams varied in the proportions of recently referred and long-stay patients, suggesting that individual nurses' caseload management is a crucial determinant of length of time on the books. In particular, nursing and medical review of all patients receiving vitamin B12 injections is urgently called for. In order for caseload monitoring to be facilitated, practitioners need relevant local and patient based data in order to make inter-team comparisons. The findings also have training and management support implications.

Aged↗
PubMed1979

Ascorbic acid and cancer: a review.

Host resistance to neoplastic growth and invasiveness is recognized to be an important factor in determining the occurrence, the progress, and the eventual outcome of every cancer illness. The factors involved in host resistance are briefly reviewed, and the relationship between these factors and ascorbic acid metabolism is presented in detail. It is shown that many factors involved in host resistance to neoplasia are significantly dependent upon the availability of ascorbate.

Animals↗
PubMed1978

Supplemental ascorbate in the supportive treatment of cancer: reevaluation of prolongation of survival times in terminal human cancer.

A study has been made of the survival times of 100 terminal cancer patients who were given supplemental ascorbate, usually 10 g/day, as part of their routine management and 1000 matched controls, similar patients who had received the same treatment except for the ascorbate. The two sets of patients were in part the same as those used in our earlier study [Cameron, E. & Pauling, L. (1976) Proc. Natl. Acad. Sci. USA 73, 3685-3689]. Tests confirm that the ascorbate-treated patients and the matched controls are representative subpopulations of the same population of "untreatable" patients. Survival times were measured not only from the date of "untreatability" but also from the precisely known date of first hospital attendance for the cancer that eventually reached the terminal stage. The ascorbate-treated patients were found to have a mean survival time about 300 days greater than that of the controls. Survival times greater than 1 yr after the date of untreatability were observed for 22% of the ascorbate-treated patients and for 0.4% of the controls. The mean survival time of these 22 ascorbate-treated patients is 2.4 yr after reaching the apparently terminal stage; 8 of the ascorbate-treated patients are still alive, with a mean survival time after untreatability of 3.5 yr.

Adult↗