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Biomedical subjects

E Cox

Publications and source records attributed to E Cox.

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

Cutaneous melanoma of the head and neck. A review of 399 cases.

A retrospective search of the Duke University Melanoma Clinic patients identified 399 cases with primary malignant melanoma located in the head and neck region. Ninety-five percent of the deaths in this series were from metastatic melanoma. Various clinical and pathological data were examined and their effects on survivability and disease-free intervals were evaluated. The characteristics noted included sex, age, depth of the invasion, thickness, site of the lesion, histologic type, and nodal status. A multivariate regression analysis identified the following factors as having a negative effect on survival: nodular histologic type, scalp primary, increasing Clark level, and male sex. In comparing head and neck, extremity, and truncal primary sites, the median survival for patients with head and neck malignant melanomas was notably less. These differences correlated with a higher incidence for male patients, for patients with thicker lesions, and for patients with an increased frequency of nodular histologic type.

Adolescent↗
PubMed1983

Phase I study of pharmacological and immunological effects of human lymphoblastoid interferon given to patients with cancer.

An extensive Phase I evaluation of human lymphoblastoid interferon has been completed which, in addition to describing its clinical and pharmacological effects, emphasized a broad-scale evaluation of the immune response as a function of interferon dosage. Dose-limiting toxicity was generally due to constitutional symptoms which are remarkably similar to those produced by influenza, although transient peripheral and central neurotoxicity (including deterioration in cognitive and behavioral functions) is observed at higher doses. It is difficult to establish "clean" dose-response effects except for fever and bone marrow suppression, neither of which is a major dose limitation. Enhancement of the immune system was limited to natural killer cells which had a complex dose-response relationship, whereby low interferon concentrations were less stimulatory (than were high doses) following a single dose but gave more sustained stimulation over a 5-week course of 3 times per week i.m. administration. The effects on various measures of monocyte function and of nonspecific immunity (hypersensitivity, immunoglobulins, complement) were negative. We suspect that in practice it may be difficult to exploit the narrow dosage window of immunostimulation, but it is important to note that the nontoxic lower doses were more stimulatory than were the very high doses which are being used in numerous clinical trials.

Adult↗
PubMed1983

Metastatic malignant melanoma with an unknown primary.

Patients who are diagnosed initially as having metastatic melanoma with no known cutaneous, mucosal or ocular primary are a perplexing clinical problem. In the Duke University Melanoma Clinic, 124 patients have been identified as meeting the criteria of an unknown primary melanoma. This represents 4.8 per cent of the total melanoma population seen at this institution. There were 2.5 times as many males as females with an average age at diagnosis of 47.9 years. Regional lymph node disease was the most common presentation with 64 per cent of the patients falling into this category. Those patients who showed initial evidence of hematogenous spread of their melanoma had a worse prognosis than their counterparts who manifested primarily lymphatic spread. When compared with control population groups with known primary melanoma, the unknown primary group had equal survival emphasizing that surgical treatment should be similar for both groups.

Adolescent↗
PubMed1982

Malignant melanoma in black American and white American populations. A comparative review.

Malignant melanoma, a type of cancer that accounts for 1% to 3% of all malignant neoplasms in 20 times more frequent in the American white than black population. During a computer-aided retrospective chart review of more than 2,500 patients with melanoma being followed up at the Duke University Comprehensive Cancer Center, 31 blacks have been identified. Primary lesions of the foot were predominant in blacks with melanoma, and a high percentage of these were classified pathologically as acral lentiginous primary lesions. Black patients had a more advanced stage of disease at first presentation and a more deeply invasive primary lesion than their white counterparts. Five-year survival for the total black population was 23%. Blacks had a significantly worse prognosis than the white population when a comparison with the total group was made that was controlled for sex, age, site of primary lesion, stage of disease at presentation, and Clark level of primary melanoma lesion. This emphasizes the aggressive nature of this disease in the American black.

Adolescent↗
PubMed1980

Integrating the teaching of sickle cell anemia into the curriculum of the Cincinnati public school system.

In an effort to determine the impact of one aspect of the Cincinnati Comprehensive Sickle Cell Center's educational program, a study of the level of knowledge of sickle cell facts by elementary and secondary school students in the Cincinnati public school system was conducted. An underlying assumption of this study was that a specially adapted sickle cell teaching curriculum in conjunction with in-service training for science teachers by sickle cell education staff was effective and practical. The study provided support for this assumption and has important implications for educating the general public about sickle cell disease and sickle cell trait. This study was undertaken during the 1975-1976 school year, and has subsequently led to the adoption of this sickle cell teaching curriculum by the Cincinnati Board of Education.

Anemia, Sickle Cell↗
PubMed1979

Prognostic factors in metastatic and hormonally unresponsive carcinoma of the prostate.

Eighty-eight patients with hormone-resistant Stage IV prostate cancer were treated with a five-drug chemotherapy program. Patient demographic data, prior therapy, symptoms, extent of disease, and laboratory studies were analyzed statistically to evaluate the association of these parameters with survival from the onset of chemotherapy. Factors associated with short survival included age greater than 65, severe bone pain, poor performance status, presence of soft tissue metastases, anemia, elevation of serum LDH, SGOT, alkaline and acid phosphatases, and prolactin, and hypoalbuminemia. Race, stage at initial diagnosis, prior radiation therapy, prior orchiectomy, and elevation of CEA had no prognostic association. We suggest that clinical trials of new therapies of hormone-resistant prostate cancer take into account the presence of these prognostic factors in the analysis of the results of therapeutic programs.

Aged↗
PubMed1978

Treatment of chronic granulocytic leukemia with melphalan.

Thirty-three patients with newly diagnosed chronic granulocytic leukemia (CGL) were treated with melphalan between 1968 and 1976. Within 3 mo of beginning therapy subjective and objective disease parameters improved. Disease control was easily maintained with this agent until hematologic exacerbation occurred. The median duration of disease control was 25.3 mo, and the median duration of survival was 28.6 mo. Serious side effects were not produced. Thus melphalan appears to be another agent that may be used to control the manifestations of CGL prior to hematologic exacerbation.

Adolescent↗