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Biomedical subjects

J W Yates

Publications and source records attributed to J W Yates.

At least 55 records · Page 3Linked to original sources
PubMed1981

Religion in patients with advanced cancer.

Data on religious belief, activity, and connections, and ratings of happiness, life satisfaction, and pain level were obtained periodically from 71 patients with advanced cancer. Religious belief showed substantial positive correlation with life satisfaction, and religious activity and connections were significantly correlated with both happiness and life satisfaction. Religious patients also reported significantly lower levels of pain, even though they were no less likely to report the presence of pain. Data from the 36 patients who have since died show no correlation between the religion variables and duration of survival. In general, the patients showed little change in religious belief over time. Religion seems to be an important source of support for many patients.

Adult↗
PubMed1981

Physical function assessment in patients with advanced cancer.

Accepted physical therapy assessment techniques were compared with the Karnofsky Performance Status scores in a group of patients with advanced cancer. Assessment of patients' physical functioning by physical therapy evaluation techniques was highly correlated with the Karnofsky Performance Status score. The KPS has been demonstrated to be a reliable assessment tool and is a good indicator of those patients most likely to maintain independent physical function. Extensive physical therapy measures in this patient population appear to offer no advantage over the KPS as an evaluation tool for studies.

Activities of Daily Living↗
PubMed1981

Lung abscesses following corticosteroid therapy for central nervous system metastases.

Although the occurrence of lung abscesses has decreased among the general population since the advent of antibiotics, a specific subgroup of cancer patients has demonstrated a propensity for this complication. Four patients with lung cancer, receiving corticosteroid therapy for brain metastases, developed large lung abscesses. These patients represent 12% of the 33 patients with central nervous system metastases seen in this institution over the period of one year. Physicians should be alert to this possible complication of corticosteroid therapy in patients with lung cancer.

Adrenal Cortex Hormones↗
PubMed1981

Prediction and management of pain in patients with advanced cancer.

In a prospective controlled study, patients with incurable cancer and an estimated prognosis of three months to one year were allocated to two patient groups for evaluation of supportive interventions. One group, called "intensive," received home visits by a nurse practitioner acting as an extension of a multidisciplinary team; the other, termed "nonintensive," did not receive such visits. Both patient groups were periodically evaluated in their homes by an observer and by self-ratings, to measure changes in quality of life as their disease progressed. Several methodologic problems were identified, which have implications for future research. Pain problems later in the course of cancer seem to be predictable in those patients with higher scores on the Cornell Medical Index M-R scales (greater emotional disturbance) and on the Rotter Locus of Control (I-E) scale (expectation of more external control of self). The study also found that the home visiting nurse practitioners, specially trained in pain treatment, improved pain control in the "intensive" group of patients over the last 90 days of life, when pain was an increasingly major problem. Such nurses can significantly improve the quality of life for patients dying outside of institutions.

Home Care Services↗
PubMed1980

The aggressive surgical management of hypercalcemia due to ectopic parathormone production.

A patient with slowly progressive metastatic renal cell carcinoma had life-threatening hypercalcemia secondary to ectopic parathormone production. Aggressive surgical debulking resulted in prolonged control of the hypercalcemia. This case illustrates the value of this surgery in the control of paraneoplastic endocrine syndromes refractory to medical management in patients with slow-growing metastatic disease.

Adenocarcinoma↗
PubMed1980

Evaluation of patients with advanced cancer using the Karnofsky performance status.

The Karnofsky Performance Status Scale (KPS) was designed to measure the level of patient activity and medical care requirements. It is a general measure of patient independence and has been widely used as a general assessment of patient with cancer. Although there is a long history of use of the KPS for judging cancer patients, its reliability and validity have been assumed without formal investigation. The interrater reliability of the KPS was investigated in two ways, both of which gave evidence of moderately high reliability. The patients evaluated in their home were usually assigned a lower KPS score compared with a similar evaluation at the same time done in the outpatient clinic. Costruct validity of the KPS was demonstrated by strong correlation with several variables relating to physical function. On-study KPS score accurately predicted early death, but high initial KPS scores did not necessarily predict long survival. Patient deterioration with subsequent death within a few months could be predicted to a limited extent by a rapidly dropping KPS. These results suggest that the KPS has considerable validity as a global indicator of the functional status of patients with cancer and might be helpful for following other patients with chronic disease.

Adult↗
PubMed1980

Effect of osmotic diuresis on gentamicin-induced nephrotoxicity in rats.

The effect of isosorbide diuresis on gentamicin excretion and tissue accumulation as well as gentamicin-induced histopathologic changes in renal tissue were examine in rats. Gentamicin (30, 60, 120, 160 mg/kg) was administered s.c. for 10 consecutive days with or without isosorbide pretreatment. Osmotic diuresis with isosorbide did not significantly reduce the dose-dependent extent of gentamicin accumulation in renal tissues in comparison to nondiuresed rats. Although the urinary concentration of gentamicin was reduced in the diuresed animals, total gentamicin excretion remained unaffected. In addition, diuresis altered neither the renal excretion of the proximal tubular cell marker enzyme, N-acetyl-B-glucosaminidase, nor the severity of pathologic damage as determined by light microscopic examination of renal tissues. It appears that osmotically-induced diuresis alone is insufficient to prevent or significantly reduce gentamicin nephrotoxicity in rats. This is in contrast to other forms of diuretic therapy, such as furosemide, which have been shown to effectively reduce renal accumulation and resultant renal toxicity of aminoglycoside administration.

Acetylglucosaminidase↗
PubMed1979

Combination radiotherapy and chemotherapy for small cell carcinoma of the lung.

Twenty previously untreated patients with small cell carcinoma of the lung were treated with cyclophosphamide, 400 mg/m2 and Adriamycin, 40 mg/m2 IV on day 1, followed by cytosine arabinoside, 20 mg/m2, every 12 hours subcutaneously on days 5--9; this regimen was repeated every 28 days. On days 14--28 of the first cycle, each patient received 3,000 rads to the primary tumor and whole brain. Following eleven courses, Adriamycin was discontinued and patients received cyclophosphamide, 800 mg/m2 IV on day 1 and methotrexate, 15 mg/m2 IV on days 5--7. This regimen was repeated every 28 days. Toxicity included nausea, vomiting, alopecia, leukopenia, thrombocytopenia, and esophagitis. Overall response rate was 65%. Media survival in limited disease was 14.5 months, and in extended disease it was 4.5 months. This combination is active in localized small cell carcinoma but provides no superiority over other regimens.

Alopecia↗
PubMed1979

Combination chemotherapy of colorectal cancer with 5-fluorouracil, methyl-1,3-cis(2-chloroethyl)-1-nitrosourea, and vincristine.

The combination of 5-fluorouracil (5-FU), methyl-1,3-cis(2-chlorethyl)-1-nitrosourea (methylCCNU), and vincristine (VCR) has been reported to produce a 43.5% response rate in metastatic colorectal cancer, although subsequent studies did not produce such good response rates. The clinical trial reported here was undertaken to assess the reported results. In 52 evaluable patients the overall response rate was 11%. No complete remissions were observed. Six patients with colon carcinoma had a partial remission lasting for a median of ten months, with a median survival of 15 months. No responses were observed in rectosigmoid cancer. The median survival for nonresponders was 7.5 months. Thirty-three percent of the patients had significant hematological toxicity (while count) less than or equal to 1,000/mm3, platelets less than or equal to 50,000/mm3); 58% of the patients experienced nausea and vomiting; and 32% experienced some degree of neurotoxicity. In our hands the combination of 5-FU, methylCCNU, and VCR produced a response rate of 11% in metastatic colorectal cancer with a considerable amount of toxicity.

Antineoplastic Agents↗
PubMed1978

Breast self-examination practices and breast-cancer stage.

To determine the relation between breast self-examination performance and the clinical and pathological stage of breast cancer at first diagnosis, we studied 335 patients with breast cancer. Approximately one fourth of the patients reported that they had been practicing monthly breast self-examination, and half that they had never practiced breast self-examination. More frequent performance of breast self-examination was associated with more favorable clinical stage and fewer axillary-lymph-node metastases on histologic examination. On pathological examination, the age-adjusted maximum tumor diameter of patients practicing monthly breast self-examination was 1.97 +/- 0.22 cm (mean +/- S.E.M.) as compared to 2.47 +/- 0.20 for those performing self-examination less often than monthly and 3.59 +/- 0.15 for patients never performing breast self-examination. These data associating more favorable clinical and pathological stages of breast cancer with more frequent breast self-examination need to be extended by determination of the survival rates of the various self-examination groups.

Adult↗
PubMed1976

Staphylococcal bacteremia in a "Germ-free" unit.

The rate of carriage and infections due to strains of Staphylococcus aureus were evaluated in adults with acute leukemia in isolators characterized by laminar air flow and barrier isolation. Patients were randomly given antimicrobial prophylaxis with oral nonabsorbed antibiotics and a nasal antibiotic ointment. In four years S aureus was isolated from the nostrils or other sites in 36 patients. Persistent isolation was noted in 24 patients. Suppression of gut flora was associated with a higher carriage rate of S aureus. Five episodes of bacteremia due to S aureus occurred at the nadir of leukopenia induced by chemotherapy. Death occurred within five days in the three patients whose peripheral white blood cell count did not rise. Patient isolation and suppression of gut flora helped reduce infections due to Pseudomonas sp and fungi, but S aureus emerged as a life-threatening pathogen.

Anti-Bacterial Agents↗
PubMed1975

Filtration leukapheresis for granulocyte transfusion therapy. Clinical and laboratory studies.

To study the clinical efficacy of granulocytes obtained by filtration leukapheresis, patients with clinically evident infection and granulocyte counts of smaller than 500 per cubic millimeter were randomly assigned to receive conventional therapy alone or with a granulocyte transfusion obtained from a single donor each day for four days. Five of 19 control patients survived to day 20, and 15 of 17 in the transfused group survived. Comparison of the two populations for variables such as age, disease, and severity and type of infection revealed no other factor that could account for the difference in survival. Outcome was not demonstrated to be related to HL-A match, post-transfusion counts, or presence of leukocyte antibodies. Functional studies of granulocytes obtained by filtration leukapheresis showed only minor differences although appearance was altered. Granulocytes so obtained can be used safely and efficaciously as adjunctive therapy for infection associated with granulocytopenia.

Acute Disease↗