Biomedical subjects
Publications and source records attributed to J Page.
A case of extraskeletal chondrosarcoma of the left brachial plexus is described with emphasis on the diagnostic and therapeutic difficulties of this site. With combination therapy the patient survived 6 years. Recurrent disease in the plexus region and adjacent spinal cord resulted in a painful, flail limb.
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Recognising the present paucity of doctors trained at the University of the West Indies who are working in rural government health facilities in Jamaica, and its impact on the health services, this study was done to determine the factors influencing the decision of UWI-trained interns to work in these facilities post-internship. A questionnaire was administered to 57 UWI-trained medical graduates presently doing their internship in Jamaica. The results showed that there was no significant difference in the choice of placement with respect to sex, or residential background of the intern, though the latter seemed to indicate a trend. Of those who thought they would work in a rural government health facility, two-thirds would do so immediately post-internship but 50% did not plan to work there for more than five years. Opportunities for postgraduate training and lack of equipment were the most important deterrents to working in a rural government health facility.
Plan to take advantage of the NANN research funding available to you! The NANN Research Committee encourages you to submit your completed research grant proposal to Karen Thomas, PhD, RN, Chairperson, Research Committee, NANN national office, by August 1, 1991.
The treatment of the preschool child in general dental practice is interrelated with financial considerations in a similar way to treatment of all other patients. However for young children requiring conservation treatment in particular the time and consequently the costs involved are considerable. This paper provides examples of these problems experienced in the author's own practice.
The value of chemotherapy in advanced non-small cell lung cancer (NSCLC) remains contentious. Because of this two separate but very similar trials were set up in Australia and Southampton (UK). Two hundred and one patients with stage IIIb or IV NSCLC were randomly assigned to cisplatin 120 mg m-2 on days 1 and 29 and vindesine 3 mg m-2 weekly x 6 or to no chemotherapy. Both groups were eligible to receive radiotherapy or other palliative treatment as required. Of 188 evaluable patients, 97 received chemotherapy and 91 were in the control arm. Response was assessed between days 42 and 49. Responders continued chemotherapy at the same doses though cisplatin being given 6 weekly x 4 and the vindesine 2 weekly x 12. The overall response rate to chemotherapy was 28%; there were no significant differences according to major prognostic criteria. Although the overall survival of the chemotherapy group (median 27 weeks) was longer than that of the no chemotherapy group (median 17 weeks) this was not statistically significant (log rank P = 0.33). For patients without dissemination (IIIb), median survival was 45 weeks in the chemotherapy arm and 26 weeks in the non-chemotherapy (log rank P = 0.075). Toxicity was universal and frequently severe: of 17 patients discontinuing chemotherapy after one cycle, 13 did so because of unacceptable toxicity. This chemotherapy cannot be recommended as routine treatment. Further phase III studies of chemotherapy in advanced NSCLC should continue to use a no chemotherapy control and should also attempt to measure quality of life, an issue not addressed effectively in this or other recent trials.
A fracture of the scapula is frequently associated with other significant injuries. In the case described, a motorcycle accident victim sustained multiple injuries, including a scapular fracture associated with a tear of the subclavian artery, demonstrated by angiography and confirmed at operation. A literature review revealed no similar case.
A quantitative structure-activity relationship has been formulated for 646 antimalarials acting against P. berghei in mice. The equation developed has 14 terms, 9 of which are indicator variables. The correlation coefficient for the QSAR is 0.898 and the standard deviation is 0.309. The antimalarials are all arylcarbinols of the type X-ArCHOHCH2NR1R2. Sixty different aryl structures, including a variety of heterocyles, are contained in the study. The most important determinate of activity is found to be the electron-withdrawing ability of the substituents X; the hydrophobic character of X and R plays less important roles. Suggestions for more potent analogues are made and the lack of activity of about 100 additional analogues is also considered.
Intubating conditions were studied in two groups of patients who received either fazadinium 1 mg/kg or pancuronium 0.1 mg/kg (group 1), or either fazadinium 0.5 mg/kg or pancuronium 0.08 mg/kg (group 2). In group 1 intubating conditions were studied at 30, 45, 60 and 75 s after injection of the relaxant drug, and in group 2 at 60 s after injection. Fazadinium provided better intubating conditions than pancuronium during the first 60 s after administration in group 1 (P less than 0.01). In group 2 there was no significant difference between the conditions provided by the two drugs.
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