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Biomedical subjects

J M Morrison

Publications and source records attributed to J M Morrison.

At least 37 records · Page 2Linked to original sources
PubMed1992

Comparison between a standard pancreatic supplement and a high enzyme preparation in cystic fibrosis.

This study compared the relative effectiveness of a standard pancreatic enzyme supplement ('Creon', Duphar) and a new preparation ('Pancrease HL', Cilag) containing about 3 times the lipase and more than 5 times the protease activity. Capsule dosage was adjusted to a ratio of approximately 3:1. Fat balances showed that absorption of fat did not change significantly on conversion to the new high-lipase product, and the coefficient of absorption of total energy was similarly maintained. The coefficient of protein absorption was significantly enhanced with the high enzyme preparation (P less than 0.01), which may explain the reported subjective improvement in stool odour. No adverse effects were recorded. Patient acceptability of the new compound was high; the great reduction in the number of capsules required at each meal was cited by all patients as the reason for their preference.

Adolescent↗
PubMed1992

West Midlands Oncology Association trial of adjuvant chemotherapy in node-negative breast cancer.

Between 1976 and 1984, 574 patients with operable breast cancer and histologically negative axillary lymph nodes were randomly assigned after mastectomy to receive either no further treatment or chemotherapy with oral LMF (fluorouracil, 500 mg, methotrexate, 25 mg, and chlorambucil, 10 mg, on day 1; fluorouracil, 500 mg, and chlorambucil, 10 mg, on day 2). There is no overall survival or relapse-free survival benefit at a median follow-up of 10 years and 8 years, respectively. There are significantly more local relapses in the control group (P less than .01), but an excess of distant relapses in the treated group is not statistically significant (P = .24). A positive treatment effect in small tumors (relapse-free survival, odds ratio = 0.55, P = .01) and a negative effect in progesterone receptor-positive tumors (survival, odds ratios = 2.04, P = .04) is probably ascribable to chance. Analysis of various prognostic factors shows that tumor size and histological grade have a clear effect on both relapse-free interval and survival.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Parathyroid hormone related protein and hypercalcaemia in breast cancer.

OBJECTIVE: To see whether parathyroid hormone related protein has a humoral role in breast cancer. DESIGN: Plasma concentrations and tumour expression of parathyroid hormone related protein were determined (by two site immunoradiometric assay and immunohistochemistry respectively) in women with breast cancer and related to the presence of bone metastases and serum calcium concentrations. SUBJECTS: Plasma concentrations of parathyroid hormone related protein were measured in 57 women with early breast cancer without apparent bone metastases, 28 women with bone metastases, and 13 women with bone metastases and hypercalcaemia. Tissue positivity for parathyroid hormone related protein was determined retrospectively in 106 primary breast tumours from women without apparent bone metastases and 72 tumours from women with bone metastases, 25 of whom subsequently developed hypercalcaemia. RESULTS: Plasma parathyroid hormone related protein concentrations were detectable (greater than 0.23 pmol/l) in 12 (92%) of the 13 hypercalcaemic patients with bone metastases compared with 10 (36%) of the 28 normocalcaemic patients with bone metastases and five (9%) of the 57 normocalcaemic patients without bone metastases. Parathyroid hormone related protein concentrations were significantly higher in hypercalcaemic than normocalcaemic patients with bone metastases. Tumour staining was positive for parathyroid hormone related protein in 22 (88%) of the 25 primary breast cancers from patients with bone metastases. Tumour staining was positive for parathyroid hormone related protein in 22 (88%) of the 25 primary breast cancers from patients with bone metastases who later developed hypercalcaemia compared with 25 (53%) of the 47 from women in this group who remained normocalcaemic and 55 (52%) of the 106 early breast cancers from women without known metastases. CONCLUSION: Tumour derived parathyroid hormone related protein may have an important humoral role in hypercalcaemia associated with metastatic breast cancer.

Bone Neoplasms↗
PubMed1991

Children seen frequently out of hours in one general practice.

OBJECTIVE: To identify reasons why some children receive more out of hours visits than most. DESIGN: A one year prospective study to identify the study group. This was followed by a case-control study involving a record search and personal interviews. SETTING: One three doctor urban general practice in West Lothian with 4812 patients. SUBJECTS: 40 children aged under 10 years identified as high users of the out of hours service (more than two visits a year) and 40 age and sex matched controls. MAIN OUTCOME MEASURES: Numbers of visits; social factors such as lone motherhood, low educational attainment; score for management response to clinical vignette. RESULTS: 147/756 (19%) out of hours visits in the study year were to children aged under 10 years; 109 (74%) to 41 children (6%). Problems seen were mainly minor, and little active management was required. Family and social factors which were significantly more common for the cases than for the controls included a lone mother (15 v 4), low educational attainment by the mother (25 v 14), receipt of income support (22 v 7), and non-ownership of the home (45 v 22) or a car (19 v 9). Mothers of the cases were more likely to choose to contact a doctor when presented with vignettes describing common childhood illnesses (median score for 16 vignettes 16.5 for cases v 14.5 for controls, Wilcoxon signed rank test, p = 0.01). CONCLUSIONS: Children seen more frequently than expected out of hours came from more socially disadvantaged families and their mothers were more likely to seek medical advice about minor childhood illness. Maternal education, to promote confidence in managing minor illness, may reduce their use of the out of hours service.

Age Factors↗
PubMed1990

Audit and follow-up of chronic benzodiazepine tranquillizer use in one general practice.

A search of the records of one general practice, serving 5282 patients, generated a list of 72 patients (1.36%) who had been using a benzodiazepine tranquillizer continuously for more than 6 months. These patients were interviewed and asked to discontinue the use of these drugs with the help of their general practitioner. An individual approach for each patient was agreed between the general practitioner and the patient. Patients who initially did not agree to try to stop the drug were included in the study. After 1 year, 27 (37.5%) of the patients had stopped using the benzodiazepine completely and 24 (33.3%) had reduced their previous consumption by more than 50%. This outcome was independent of sex, age, drug used, duration of use, whether they were exceeding the original dose of the drug and attendance at a consultant psychiatric clinic. It was significantly more likely that the patient would stop taking the drug if they originally wished to do so, but several of those who initially did not want to try to stop were able to do this. The excess number of consultations for the patients in the study for the year of the study compared with the year before the study only constituted 0.35% of the total number of consultations in the practice. The results were better than expected and the exercise was felt to be worthwhile, particularly as the increase in workload was very small.

Adult↗
PubMed1989

Wide local excision as the sole primary treatment in elderly patients with carcinoma of the breast.

Clinically localized carcinoma of the breast in 96 women was treated by wide local excision alone. The locoregional recurrence rate was 35 per cent at a mean follow-up of 47 months. There was no significant effect of recurrence on survival because of the relatively high mortality rate from unrelated conditions in these mainly elderly patients. Recurrence was successfully managed with tamoxifen in the majority of cases, with few patients requiring radiotherapy or further surgery. Recurrence in the breast was associated with significantly less systemic disease and mortality than recurrence in the axilla.

Aged↗
PubMed1989

West Midlands Oncology Association trials of adjuvant chemotherapy in operable breast cancer: results after a median follow-up of 7 years. I. Patients with involved axillary lymph nodes.

The aim of this study was to test the effectiveness of a regimen of combination chemotherapy known to be active in advanced breast cancer when given as an adjuvant treatment after mastectomy. A total of 569 patients with cancer of the breast and involvement of axillary lymph nodes were randomised, after simple mastectomy with axillary sampling, to receive either no adjuvant treatment or intravenous adriamycin 50 mg, vincristine 1 mg, cyclophosphamide 250 mg, methotrexate 150 mg and fluorouracil 250 mg (AVCMF) every 21 days for eight cycles. Randomisation was stratified according to menopausal status and tumour size. Treatment was started within 14 days of surgery in 94% of patients. Eighty-eight per cent of patients received at least seven cycles of chemotherapy with no dose reduction. The median relapse-free survival was prolonged by 14 months in patients treated with AVCMF (chi2 1 = 11.7; P = 0.0006). In the premenopausal group this period was 17 months (chi2 1 = 8.8; P = 0.003) compared with 8 months in the post-menopausal group (chi2 1 = 3.3; P = 0.07). Neither overall survival nor survival in these subgroups was significantly influenced by treatment.

Adult↗
PubMed1989

West Midlands Oncology Association trials of adjuvant chemotherapy in operable breast cancer: results after a median follow-up of 7 years. II. Patients without involved axillary lymph nodes.

The aim of this study was to test the effectiveness of a regimen of combination chemotherapy when given as an adjuvant treatment after mastectomy to patients with histologically negative axillary lymph nodes. A total of 574 patients with cancer of the breast and no involvement of axillary lymph nodes were randomised, after simple mastectomy with axillary sampling, to receive either no adjuvant treatment or oral fluorouracil 500 mg, methotrexate 25 mg and chlorambucil 10 mg p.o. on day 1 and fluorouracil 500 mg and chlorambucil 10 mg p.o. on day 2 (LMF) every 21 days for eight cycles. Randomisation was stratified according to menopausal status and tumour size. Treatment was started within 14 days of surgery in 97% of patients. Ninety per cent of patients received eight cycles of chemotherapy with no dose reduction. At a median follow-up of 7 years, there was no evidence that relapse-free or overall survival time were influenced by treatment.

Adult↗
PubMed1986

Human T-cell lymphotropic virus type III infection in a cohort of homosexual men in New York City.

Using blood samples collected since 1978, we investigated the epidemiology of human T-cell lymphotropic virus type III (HTLV-III), the etiologic agent of the acquired immunodeficiency syndrome, in a group of 378 homosexually active men who have resided in New York City since the acquired immunodeficiency syndrome epidemic began. The anti-HTLV-III prevalence was 6.6% in sera from 1978 or 1979, and the subsequent annual incidence of seroconversion among susceptible men ranged between 5.5% and 10.6%. The highest incidences were in recent years, even though these men reported a decrease in their sexual activity during this time. These data demonstrate the continuing risk of HTLV-III infections in the homosexual population studied and emphasize the need for more effective prevention of transmission. The year during which antibody was first present was the only factor identified that was associated with altered cell-mediated immunity in antibody-positive men. Men who became antibody positive in 1981 or earlier currently had significantly lower OKT4/OKT8 ratios than did those who seroconverted more recently. Further follow-up will be necessary to establish the reasons for this association.

Acquired Immunodeficiency Syndrome↗
PubMed1984

The value of serial bone scanning in operable breast cancer.

The value of initial and serial isotope bone scans was assessed in 685 patients with operable primary breast cancer. Nineteen (2.8 per cent) patients had a positive initial scan and negative skeletal radiographs; only nine of these developed other evidence of metastatic disease after a mean follow up of 21 months. Five hundred and ten patients had serial scans up to five years after simple mastectomy; 51 (10 per cent) had scan conversion, of whom 37 developed clinical or radiological confirmation of recurrent disease at a mean follow-up of 13 months. Compared with clinical or radiological methods for the detection of first metastases serial bone scans gave a mean lead time of five months in 15 patients and no lead time in the remaining 22 patients. Twelve of forty-five patients with radiologically proven bone metastases had negative scans. Neither initial or serial bone scanning is clinically useful or economically viable as a routine screening or follow-up procedure for patients with operable breast cancer.

Adult↗
PubMed1984

Dibromodulcitol, mitomycin C and vinblastine (DMV) chemotherapy in advanced breast cancer.

A combination of dibromodulcitol 500 mg orally, mitomycin C 10 mg i.v. and vinblastine 10 mg i.v. all given on day 1 and repeated every 4 weeks was given to 40 patients with advanced breast cancer. All but one had received previous endocrine therapy. The response rate (CR + PR) in 24 previously untreated patients was 66% and was 37% in 16 previously treated patients. The survival of responders was significantly longer than non-responders. Thirty-two per cent of patients experienced nausea and vomiting. There was little myelosuppression or thrombocytopenia on the day of starting a new course of therapy but the haemoglobin dropped by 2 g/dl in 32% of patients during therapy. Thus DMV is a relatively non-toxic active regimen for patients with advanced breast cancer.

Adult↗
PubMed1983

Twenty-four hour combination chemotherapy: a feasibility study with implications for improved adjuvant treatment of breast cancer.

Forty-three patients with metastatic breast cancer were treated with a total of 385 cycles of combination chemotherapy consisting of adriamycin, cyclophosphamide, 5-fluorouracil, methotrexate and vincristine sulphate given over 24 hr and followed by a leucovorin 'rescue'. Thirty patients (70%) responded with three complete remissions. Thirteen patients did not respond, including six in whom the progression of disease was apparently arrested. Duration of response ranged from 2 to 24 months. At 20 months, 10 of 30 responding patients were alive compared with 1 of 13 non-responders. Toxicity was minimal apart from nausea and vomiting. This study confirms previous reports that intensive chemotherapy can be given safely over 24 hr without loss of therapeutic effect. This regimen is now being tested as an adjuvant to mastectomy in node-positive operable breast surgery.

Adult↗
PubMed1982

The clinical value of immunohistochemically demonstrable CEA in breast cancer: a possible method of selecting patients for adjuvant chemotherapy.

The production of carcinoembryonic antigen (CEA) by human breast cancer tissue has been studied in relation to the prognosis of patients with breast cancer. All of the patients were in a controlled trial of adjuvant chemotherapy for the treatment of operable breast cancer. CEA was studied in primary tumours and axillary node metastases from these patients using an immunoperoxidase (PAP) method. Sections of 290 primary carcinomas and 217 axillary metastases were examined for CEA. The CEA status of the primary tumours was of no value as a prognostic indicator nor in the selection of patients for chemotherapy. In contrast, patients could be divided into 3 groups on the basis of the CEA results in the axillary nodes. In one group, in which cases were strongly positive for CEA (24% of the total) the prognosis, as reflected by recurrence free survival, was relatively good and chemotherapy produced no further advantage. In another group in which cases were weakly positive for CEA (18% of the total) the prognosis was poor but chemotherapy produced significant improvement. In a third group, in which cases were negative for CEA (58% of the total) the prognosis was poor and was not improved by chemotherapy, at least in the short term. Thus, the CEA status of axillary metastases may be clinically useful.

Breast Neoplasms↗