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Biomedical subjects

E Robinson

Publications and source records attributed to E Robinson.

At least 253 records · Page 14Linked to original sources
PubMed1984

Further studies on the treatment of advanced gastric cancer by 5-fluorouracil, Adriamycin (doxorubicin), and mitomycin C (modified FAM).

Twenty-two previously untreated patients with advanced gastric adenocarcinoma were treated with a modification of the original 5-fluorouracil, Adriamycin (doxorubicin), and mitomycin C (FAM) combination chemotherapy. The cycles were repeated every 6 weeks. There were four partial remissions and no complete response (overall response rate of 18%, with confidence interval of 0.02-0.34 for a confidence level of 95%). Duration of response ranged between 2.5 and 12 months. The overall median survival was 6.8 months. The median survival of responding patients (13.6 months) and the nonresponders (5.8 months) did not significantly differ. Sex and initial performance status did not influence the response to FAM. Toxicity was mild to moderate, and in only a few patients was it necessary to significantly reduce the drug doses or to prolong the intervals between treatments. Combining the current results with those obtained in a study recently reported the authors in which the original FAM was given to 33 evaluable patients, 11 responders have been seen among 55 consecutive patients with evaluable disease. These results are obviously inferior to those reported by other groups of investigators and led the authors to try another combination chemotherapy.

Adenocarcinoma↗
PubMed1984

Delay in diagnosis of cancer. Possible effects on the stage of disease and survival.

A total of 2299 new cancer patients were referred to the Northern Israel Oncology Center in 1974 and in 1980. The stage of disease, delay in diagnosis, the responsibility for the delay, and the survival of those referred in 1974 were investigated. At the time of diagnosis, 39% of the patients had localized disease, 34% had locally advanced disease, and 23% had metastatic disease. In 52% of the patients there was no delay in diagnosis. No correlation was found in the group as a whole between the stage of disease and delay in diagnosis. Only in the breast cancer group without delay in diagnosis, however, were there significantly more patients at an early stage than at an advanced stage of disease. At each stage of disease, responsibility for the delay was shared about equally between the patients and the physicians, except in advanced breast cancer, where the patients were more often responsible for the delay. The survival rate was higher in patients in whom the disease was diagnosed earlier. It was also higher at each clinical stage (Stages I and II) in patients who had no delay than in those with delay in diagnosis. The survival rate was higher in patients who were themselves responsible for the delay in diagnosis than in patients whose physicians were responsible for the delay. In 1980, less diagnosis were delayed in fewer patients than in 1974 (42% versus 65%). Responsibility for the delay in 1980 lay equally with the patients and with the physicians, but when compared to 1974, the physicians' responsibility and administrative delay were less. Campaigns for early diagnosis are advocated.

Humans↗
PubMed1984

Methotrexate-related deaths in patients previously treated with cis-diamminedichloride platinum.

Among 106 patients treated with conventional-dose methotrexate (MTX) following prior therapy with cis-diamminedichloride platinum (CDDP), six died with clinical manifestations of MTX toxicity. Death occurred 6-13 days after the administration of 20-50 mg/m2 MTX. Toxicity included severe stomatitis and myelosuppression, which appeared in all six patients, skin rash in five, and diarrhea in four. Renal failure appeared in five cases and hepatic toxicity in four. All these patients had received MTX earlier without developing any serious toxicity. At the time of the last MTX administration, all had normal blood counts and also normal kidney and liver function tests. Prior therapy with CDDP may be responsible for this relatively high incidence of MTX-related deaths.

Aged↗
PubMed1984

Quality of care: compared perceptions of patient and prosthodontist.

The results suggest that, with the exception of retention, differences between patients' and prosthodontists' perceptions of treatment with complete dentures display greater variability with regard to function than to either esthetics or comfort. Although the literature has suggested that satisfying the esthetic concerns of the patient is likely to be a major hurdle in denture treatment success, this study suggests that occlusion, retention, and vertical dimension may be of more importance to effective communication. Misconceptions and unreal expectations should be dealt with early in the treatment program to avoid patient dissatisfaction. During the 1972 International Prosthodontic Workshop held in Ann Arbor, Michigan, the statement was made that patients were generally an unreliable guide as to the adequacy of their dentures, especially after wearing them for a period of time, and that further research to document the patient's reliability seemed unnecessary. This study has demonstrated that patients are quite reliable judges of many criteria related to dentures, provided channels for two-way communication are opened. With the ever greater economic stresses that force dentists to consider patients' concerns, perhaps it is increasingly the dentist's responsibility to better educate patients to evaluate all aspects of the quality of care they receive and encourage extensive two-way communication early in the treatment process. The adjusted quality assessment criteria used in the present study may be a useful instrument to use with patients prior to the initial interview in an effort to establish a better dentist-patient relationship.

Consumer Behavior↗
PubMed1984

Prostaglandin-related and adherent cell suppressor system in apparently cured Hodgkin's disease patients.

Lymphocyte proliferation (LP) by phytohemagglutinin (PHA) and two suppressor systems of mononuclear cells was investigated in 22 patients with Hodgkin's disease (HD) who were apparently cured at the time of study. The results were compared with those obtained in healthy controls and in a group of patients with inoperable carcinoma of the bronchus. The prostaglandin-related suppressor cell system ( PGSS ) was tested by adding 1 microgram/ml indomethacin to the mononuclear leukocyte cultures. The adherent cell suppressor system ( ACSS ) was tested by removal of the adherent cells on plastic petri dishes. The PGSS index of suppression was defined as the ratio of LP by PHA with indomethacin to LP without indomethacin. The ACSS index was defined as the ratio of the nonadherent cell LP to the total LP. The mean PGSS index in HD patients (1.1 +/- 0.25) was significantly higher (p less than 0.01) than in healthy controls (0.94 +/- 0.2). The ACSS index in HD patients (1.08 +/- 0.47) was also higher (p less than 0.02) than in controls. The LP by PHA value in HD patients (23,908 +/- 14,770 cpm) was significantly lower (p less than 0.001) than in controls (47,151 +/- 17,706 cpm). ACSS values in bronchogenic cancer patients were lower than in HD patients. The LP by PHA value was significantly lower in HD patients compared with bronchogenic carcinoma patients (p less than 0.02). HD patients who had a PGSS index of 1.3 or higher had a significantly lower LP value than those with a PGSS index lower than 1.3.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

The fight against the delay in the diagnosis of cancer.

The cure rate of cancer patients is greater if the disease is diagnosed at an early stage. Delay in diagnosis was found in 50% of the patients referred to our center; most of those who delayed had advanced disease. The reasons for the delay are discussed. It is suggested to perform an international study in order to investigate the magnitude of the delay, its causes and its effect on the cure rate.

Humans↗
PubMed1983

Oral administration of the methanol extraction residue of BCG (MER/BCG): a phase I study in non-oat cell lung cancer patients.

Intradermal, interlesional and intravenous MER/BCG have been reported to possess immunostimulatory properties and combined with chemo-radiotherapy an anti-neoplastic effect. Due to local and systemic side effects of the methanol extraction residue of BCG therapy a new approach to oral administration was investigated. Seventeen patients with inoperable non-oat cell lung cancer were given oral MER for 30 days. Skin tests to 5 recall antigens and various concentrations of MER, lymphocyte stimulation by PHA were done before and repeated during therapy. The initial group of patients received a dose of 1.25 mg per day and when no side effects were detected the dose was gradually escalated in subsequent groups of patients up to 5 mg. Oral MER was well tolerated even at the higher dose with no clinical or laboratory side effects. No regression in tumor size was seen. In 6 of 17 patients the disease remained stationary for a mean of 6 months (Range 6-14 months). In the remainder, disease progressed after a mean of 15 weeks. Two patients had cutaneous PPD reactivity converted from negative to positive, in one it became negative, while the remaining patients maintained their original responsiveness. No major changes could be observed in the in vivo immune tests performed following the course of treatment. In view of the reported relative efficacy of oral BCG administration, and considering the very low toxicity with oral MER, further studies employing considerably higher doses of this nonviable vaccine are now justified.

Adenocarcinoma↗
PubMed1983

Multidrug chemotherapy using bleomycin, methotrexate, and cisplatin alone or combined with radiotherapy in advanced head and neck cancer.

Twenty-two patients with advanced cancer of the head and neck where treated with a combination of bleomycin, methotrexate, and cisplatin. In ten previously untreated patients, a complete response (CR) rate of 20%, a partial response rate of 50%, and a no change rate of 30% were observed. With the addition of radiotherapy, the local CR rate in this group of patients increased to 60%. In 12 patients with recurrent disease after surgery and/or radiotherapy, the CR rate was 25%, the partial response rate was 16.7%, and the no change rate was 58.3%. Toxic effects were acceptable, with no fatalities. These short-term results encourage accrual of more patients in the study and further follow-up to determine whether the cure rate can be increased by using cisplatin and radiotherapy in patients with advanced previously untreated head and neck cancer. More energetic treatment should be investigated in patients having disease recurrence after radiotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

The role of CT scan of the brain in the pre-operative work-up of solitary lung metastases associated with colorectal cancer.

This report presents three cases of 'cured' rectal cancer which developed solitary lung metastases during the follow-up period. Further metastatic work-up did not disclose any evidence of disease. Neurological examination was normal. Surgical resection of the pulmonary metastases was done. Brain metastases were discovered a short time after. The importance of the CT scan of the brain in the pre-operative work-up is discussed.

Adenocarcinoma↗
PubMed1983

Carcinoembryonic antigen in patients with colorectal cancer: correlation between stage of disease and antigen level.

Carcinoembryonic antigen (CEA) levels were measured by radio-immunoassay in the sera of 339 patients with various stages of colorectal cancer. Of 298 patients considered to be free of disease, 61 (20.5%) were found to have elevated CEA values of greater than 10 ng/ml. Of these patients, 36 had subsequent disease progression, 23 had only a transient rise in CEA and 2 showed a persistent increase with no clinical deterioration during the study period. Of 41 patients with known active disease, only 27 (65.9%) had elevated CEA values, most greater than 30 ng/ml, whereas the remaining 14 patients had CEA levels less than 10 ng/ml. Of a total of 77 patients with known active colorectal cancer throughout the whole study period, these 14 (18%) represent the number of false-negative CEA determinations. This relatively high rate of false-negative measurements should not obscure the fact that full accordance between CEA levels and clinical status as determined throughout 38 months of follow-up, occurred in 323 of the 339 patients.

Carcinoembryonic Antigen↗
PubMed1982

Malignant lymphoma in first-degree blood relatives.

The statistical significance of familial lymphoma in first-degree blood relatives was evaluated for the series of all lymphoma cases referred to our department since 1968. Four pairs of immediate relatives with Hodgkin's disease (HD) were found among 183 patients diagnosed between 1960 and 1980. The expected number during that period was 0.45. Thus, close relatives of HD patients had about ninefold increased risk of the disease (P less than 0.005). Mixed-cellularity was the most common subtype in these familial cases (6/8 patients). There were three pairs of close relatives with non-Hodgkin's lymphoma (NHL) among 532 patients diagnosed during the same period, 1960-1980. The expected number was 3.86. These findings further indicate that HD may differ from NHL with regard to familial clustering.

Adolescent↗