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Biomedical subjects

H Anderson

Publications and source records attributed to H Anderson.

At least 289 records · Page 16Linked to original sources
PubMedDate not supplied

VAD chemotherapy--toxicity and efficacy--in patients with multiple myeloma and other lymphoid malignancies.

Thirty-three patients with multiple myeloma (11 untreated, 15 refractory and seven relapsed patients) have received vincristine and adriamycin infusion therapy with oral dexamethasone (VAD). The median number of course received was five. In addition 16 patients with lymphoid malignancy have received a median of four courses of VAD. Three patients who relapsed after VAD have received further VAD therapy making 52 patient treatments assessable for toxicity. Ten per cent had nausea, 4 per cent vomiting, 4 per cent total alopecia, 25 per cent constipation, 33 per cent paraesthesiae, 8 per cent proximal myopathy, 33 per cent dyspepsia, 23 per cent proven bacteraemia, and 19 per cent chest infections. Infections were not usually associated with neutropenia. Shingles was seen in four patients with myeloma, but none of the patients with lymphoid malignancy. The response rate in myeloma was 9/11, for previously untreated patients, 3/7 for relapsed, and 8/15 for refractory patients. Responses have been seen in other lymphoid malignancies-1/2 patients with relapsed acute lymphoblastic leukaemia had a complete remission. Two out of seven patients with chronic lymphocytic leukaemia achieved a partial remission, and a further three had a clinical improvement. Three out of six patients with non-Hodgkin lymphoma and one patient with macroglobulinaemia achieved a partial remission.

Adult↗
PubMedDate not supplied

Total pancreatectomy for cancer of the pancreas: is it appropriate?

During the late 1960s total pancreatectomy was advocated on theoretic grounds as an operation superior to subtotal (Whipple) resection in patients with pancreatic cancer. There are, however, no prospective randomized studies and only few institutional comparisons between the two operations. The aim of the present paper was to report the clinical outcome of total and subtotal pancreatectomy, respectively, in a consecutive series of patients with exocrine pancreatic cancer. The short- and long-term results of 89 consecutive patients who underwent total pancreatectomy (1959-1984) for pancreatic cancer were retrospectively compared with a similar group of 36 patients who had a subtotal pancreatectomy (1985-1992) for the same diagnosis. The clinical characteristics were on the whole similar in the two groups. Postoperative mortality and morbidity, the amount of intraoperative bleeding, operation time, reoperation rate, postoperative days in the intensive care unit, and duration of hospital stay were statistically significantly increased after total pancreatectomy. The 5-year survival rate was lower after total pancreatectomy when hospital deaths were included in the analysis. At multivariate analysis total pancreatectomy adversely influenced long-term survival compared to subtotal resection, as did positive lymph nodes and poor histologic differentiation. Better early and long-term results were found after subtotal than after total pancreatectomy in patients with exocrine pancreatic cancer. Although the two operations were done during different time periods, we believe the results suggest that total pancreatectomy cannot be recommended as a routine treatment for this patient group.

Adult↗
PubMedDate not supplied

Effect of treatment for nicotine dependence on alcohol and drug treatment outcomes.

This study was designed to examine the effect of a policy banning smoking and a smoking-cessation intervention on alcohol and drug treatment outcomes. We compared long-term alcohol and drug treatment outcomes in two cohorts hospitalized for substance use treatment, subjected to different smoking policies and cessation interventions in two periods. The study included 314 male patients, aged 18-65. The intervention cohort was subjected to a total hospital smoking ban and concurrent drug and nicotine dependency treatment, with a requirement for nicotine abstinence during hospitalization. The control cohort was hospitalized under a policy permitting smoking in designated areas, with no specific smoking-cessation intervention. Current alcohol, drug, and tobacco use were ascertained by follow-up interview with patients 8-21 months after completion of treatment. There was a 60% response rate in the intervention group (n = 92) and a 66% response rate in the control group (n = 105). Among respondents, there were no significant differences between intervention and control groups in rates of "improvement" for alcohol, cocaine, or marijuana use, or for these drugs combined, although there was a nonsignificant trend toward less "improvement" in the intervention group. When nonrespondents were analyzed as treatment failures, the rate of "improvement" was significantly worse for cocaine users in the intervention group, but not for other drug users or for all patients combined. Ten percent of patients reported quitting smoking in the intervention group compared to 4% in the control group (difference not significant). Although patients resisted the mandatory nature of the smoking intervention, many continuing smokers requested information and referral for smoking cessation at the time of follow-up. These data suggest that concurrent intervention for nicotine dependence did not significantly harm treatment outcomes of patients using alcohol or marijuana as their drug of first choice. Due to a trend in this direction, this possibility should be investigated in randomized, controlled trials. The intervention was associated with a small increase in self-reported smoking cessation. There is considerable interest in this patient population in smoking cessation after completion of treatment.

Adolescent↗
PubMedDate not supplied

Role of exposure databases in risk management.

Despite the development of numerous national exposure-related databases, exposure assessment remains a weak link in the chain of risk assessment and risk-management activities. Most databases include measures of environmental releases or concentrations of pollutants in specific media, but do not include actual measures of exposure. If accurate estimates of exposure experienced by populations or individuals are absent, it is impossible to judge the effectiveness of risk-management strategies. The Risk Management Work Group evaluation identified the following needs: refinement of measurements of total exposure experienced by individuals, improved characterization of the distribution of exposures in the population, longitudinal monitoring of exposure trends, and improved information about the public health implications of exposure. Recommendations are presented with the hope that the utility of existing databases will be improved and that future initiatives will be developed that meet the needs of risk management.

Databases, Factual↗
PubMedDate not supplied

Incidence and prognostic significance of blood lymphocyte clonal excess in localized non-Hodgkin's lymphoma.

Despite elaborate staging procedures, a substantial number of patients with localized NHL experience dissemination after local therapy, indicating that current routine methods are insufficient to detect tumour spread. We have used flow cytometric clonal excess (CE) analysis of peripheral blood in conjunction with routine staging procedures to study the occurrence of occult leukaemic spread in patients with localized NHL stages I, IE and IIE. CE in peripheral blood was a rare finding, identified in only 11% (14/130), and slightly more frequent in low-grade NHL, 20% compared to high-grade NHL, 7%. There was no correlation to any of the other major prognostic factors studied. Occult tumour spread would suggest an increased risk of relapse and possibly a decreased survival after local therapy. Among 93 patients given only local treatment there was an increased risk of relapse in those with low-grade malignant lymphomas and CE, which was not found in patients with high-grade malignant lymphomas and CE. CE in peripheral blood had no influence on survival in either of the histologic groups. A tentative explanation is that circulating lymphoma cells represent indolent populations irrespective of the histology of the primary tumour. The malignant nature of such a lymphoma spread might not be obvious during this rather limited follow-up of a median 34 months. The clinical interpretation is that the existence of CE in peripheral blood in patients with localized high-grade NHL should have no influence on the choice of therapy. In localized low-grade lymphoma the same therapeutic attitude which applies to widespread disease might be considered.

Adult↗
PubMedDate not supplied

Venereal transmission of shigellosis in Seattle-King county.

In the past, shigellosis in Seattle-King County has been primarily a disease of children, their parients, and foreign travelers. During the 18 months beginning in July 1975, an outbreak of shigellosis in Seattle's community of gay men involved both Shigella flexneri and Shigella sonnei. They accounted for nearly 30% of all cases of shigellosis reported to the health department. Fellatio and/or oral-anal contact was reported by 90% of the infected homosexual men; this was probably the mechanism of transmission of most infections. Intercity spread was determined by case histories and by the finding of S. flexneri 3, a previously unusual organism in Seattle.

Dysentery, Bacillary↗
PubMedDate not supplied

Increased renal prostanoid synthesis after unclipping the one-kidney, one-clip hypertensive rat: effect of renal denervation.

Renal denervation of hypertensive one-kidney, one-clip (1K, 1C) rats resulted in a minor fall in blood pressure (216, s.e.m. = 4, to 182, s.e.m. = 4, mmHg) 24 h later, which returned to predenervation levels with 1 week. Subsequent unclipping led to a similar fall in blood pressure in denervated (202, s.e.m. = 4 to 142, s.e.m. = 3) and sham-denervated (211, s.e.m. = 5 to 147, s.e.m. = 4) rats. Unclipping also resulted in a marked rise in urinary PGE2 and 6-keto PFG1 alpha in both denervated and sham-denervated animals. It appears that 1K, 1C hypertension, 8 weeks after clipping, is only slightly dependent on renal nerves. Unclipping results in increased renal synthesis of PGE2 and PGI2 which is not dependent on intact renal innervation.

Animals↗
PubMedDate not supplied

Daytime sleep tendency before and after discontinuation of antiepileptic drugs in preadolescent children with epilepsy.

In 9 preadolescent children treated for epilepsy who had been free from seizures long enough for treatment to be discontinued, daytime vigilance was studied before and after discontinuation of antiepileptic drugs (AEDs). Comparisons were made with healthy controls. Multiple sleep latency test (MSLT), EEG, and a questionnaire were used. As part of the analysis of the MSLT, a new measure, the daily average sleep tendency (DAST), was constructed to overcome the problems with data censoring of the classic MSLT analysis. The patients had significantly (p less than 0.001) higher daytime sleep tendency, even after drug discontinuation, than controls, a result that could neither be attributed to AED treatment nor to recent epileptic seizures or complicated epilepsy.

Anticonvulsants↗
PubMedDate not supplied

Identification of normal hearing carriers of genes for deafness.

The dominant and sex-linked forms of hereditary hearing loss, which have long been recognized, are readily identified on the basis of the family history and routine hearing tests. The mode of inheritance of the recessive forms of hereditary deafness, on the other hand, has been extremely difficult to determine. The research of the last few years, however, has disclosed that carriers of genes for recessive deafness can be identified by audiometric recording of certain peculiarities in the hearing function. This is an important advance, not only as regards diagnositc work, but also in the research into the genetics of deafness.

Auditory Threshold↗