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Biomedical subjects

J Waxman

Publications and source records attributed to J Waxman.

At least 127 records · Page 7Linked to original sources
PubMed1988

Short-term therapy for acute myelogenous leukemia.

Since 1978, 187 patients (age range, 15 to 59, median 44 years) have received short-term chemotherapy as part of three sequential open studies (B-IX, X, Xb) or a randomized clinical trial (B-XI). An intended six cycles of Adriamycin (ADR) (doxorubicin; Adria Laboratories, Columbus, OH), cytarabine (ara-C), and thioguanine (TG) were administered with as short an intercycle time as possible. No further therapy was administered. Complete remission (CR) was achieved in 118 of 187 patients (63%). On univariate and multivariate analyses achievement of CR correlated adversely with a low serum albumin at presentation and an antecedent marrow disorder. Forty-five patients continue in first remission between 15 months and 8 1/2 years, no relapses being seen after 3 1/2 years (median follow-up, 3 1/2 years). The median duration of remission was 1 year. M3 morphology, a blast count less than 100 x 10(9)/L, and absence of hepatosplenomegaly correlated favorably with remission duration. There was no difference in duration of remission between patients receiving 3, 4, 5, or 6 cycles. The best results overall were achieved in patients under the age of 40, with 43% projected to remain free of disease at 5 years. Fifty patients remain alive between 17 months and 9 years, the predicted actuarial survival being 25% at 5 years.

Actuarial Analysis↗
PubMed1988

Administration of a gonadotropin releasing hormone analogue in oligozoospermic infertile males.

This study investigated the stimulatory potential of a superactive gonadotropin releasing hormone analogue in idiopathic oligozoospermia. In a double-blind trial, 19 men were randomized to receive buserelin (D-Ser(TBU)6-GnRH ethylamide) in one of two dosages or saline, twice weekly, for twelve weeks. Treatment did not lead to a significant increase in serum concentrations of the pituitary gonadotropins or in sperm concentrations. However, in the dosages and schedules investigated, there was no inhibitory effect of the analogue. Further assessment of this approach is suggested.

Buserelin↗
PubMed1988

A review of the Hammersmith Hospital, St. Bartholomew's Hospital, and Institute of Urology studies of buserelin in advanced prostatic cancer.

This article reviews studies by our group on the role of LHRH agonists in prostatic cancer. Early work showed these agents to be an effective treatment of prostatic cancer, establishing an intranasal dosage regimen that suppressed serum testosterone into the castrate range. Although treatment was without cardiovascular toxicity, other side effects of agonist therapy were noted. An initial exacerbation of disease resulted from the stimulatory effects of these compounds. As a result, combination therapies with antiandrogens in the early phase of treatment is recommended. A long-term follow-up of patients who had received intranasal buserelin demonstrated a failure of suppression of the pituitary-gonadal axis. This was thought to represent difficulty in complying with intranasal treatment or true escape of the axis from agonist control. Against this background, depot preparations of buserelin have been investigated. Two series of implants were studied. The PHB series, although difficult to administer, have provided pharmacological and endocrine data that have allowed for the introduction of the injectable P series implants. These preparations, which are designed to be administered once every 2 months, provide effective suppression of testosterone over this period. Such formulations provide an obvious advantage over conventional treatment regimens.

Administration, Intranasal↗
PubMed1987

The effects of a gonadotropin-releasing hormone agonist on testicular histology.

We have described the histologic changes in the testes of men treated with buserelin for prostatic cancer. If these changes are reversible, then the agonist analogues, together with testosterone replacement therapy, could be used safely for male contraception. If the changes are irreversible, then boys with central precocious puberty treated with such compounds would be of normal height, but sterile.

Aged↗
PubMed1987

Takayasu's arteritis diagnosed in a patient with long-standing arthralgias and arthritis.

A 50-year-old woman had seronegative polyarthritis for three years, followed by vascular obstruction with classic Takayasu's arteritis. She responded symptomatically to high-dose steroid therapy and remains in long-term remission (joints and vasculature) after taper of medication. Literature review documents this relationship of arthritis to vasculitis in this and other types of vascular inflammation.

Aortic Arch Syndromes↗
PubMed1986

Fibromyalgia and menopause. Examination of the relationship.

Women predominate at all ages among patients diagnosed as having primary fibromyalgia. Of 100 patients reviewed, the average age at onset of fibromyalgia was 46. Of 65 patients in whom menopause occurred before diagnosis of fibromyalgia, the average age at menopause was 42, and most of these women had menopause related to surgery and insufficient estrogen therapy. Estrogen deficit is, thus, a prominent promoting factor in the majority of fibromyalgia patients and is likely to have an effect on sleep, mood, and anxiety state. These emotional responses may subsequently be somatized as pain. Therefore, estrogen therapy should be added to the treatment armamentarium for fibromyalgia in selected patients.

Adult↗
PubMed1986

Methotrexate, cisplatin and carboplatin as single agents and in combination for metastatic bladder cancer.

A review of 78 previously untreated patients with bidimensionally measurable metastatic bladder cancer who were entered into a series of studies of cytotoxic chemotherapy has shown that complete response occurred in 1 of 23 patients receiving methotrexate, none of 15 receiving cisplatin, none of 20 receiving the platinum analogue carboplatin and 3 (2 with histological confirmation) of 20 receiving methotrexate in combination with cisplatin. WHO/UICC performance status 3 and 4, though a prediction of lower response, did not provide a means for excluding patients who might benefit from chemotherapy. Studies using serial cytology showed that 5 of 8 responders according to standard criteria had complete loss of malignant cells from the urine compared with none of 10 non-responders and there was a suggestion that duration of response was longer in those whose urine was negative for malignant cells than in those which remained positive.

Antineoplastic Agents↗
PubMed1986

Laryngeal manifestations of Wegener's granulomatosis: case reports and review of the literature.

We report two patients with laryngeal manifestations of Wegener's granulomatosis to demonstrate the marked variability of presentation in this disease. The reported literature is reviewed and shows a similar spectrum with early and late onset of laryngeal granulomata, subglottic in location. Of all the patients with Wegener's granulomatosis reviewed, 8.5% will eventually develop a subglottic lesion. Therapy depends upon response to steroids, cytotoxic drugs, and radiation therapy. Usually surgical therapy will be necessary.

Airway Obstruction↗
PubMed1985

Traumatic amputation of the left lower renal pole in children.

Four children between 5 and 10 years old suffered traumatic amputation of the left lower renal pole following flank trauma. All patients were evaluated with excretory urography and isotope renography. The renal scan clearly demonstrated failure of perfusion of the lower renal pole and urinary extravasation, and was believed to be more valuable than the standard excretory urogram as a diagnostic tool. All children were managed similarly: delayed (72 to 96 hours) exploration, simple removal of the amputated segment and insertion of a Penrose drain. They all have done well. The patients were normotensive at followup and had excellent function of the remaining portion of the kidney.

Amputation, Traumatic↗