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Biomedical subjects

J Weiner

Publications and source records attributed to J Weiner.

At least 145 records · Page 8Linked to original sources
PubMed1976

Immunotherapy and chemotherapy in children with neuroblastoma.

Recent advances with immunotherapy in animal tumors suggested that trials with a combination of chemotherapy and immunotherapy in human malignant tumors might be worthwhile. A pilot program with Vibrio cholera neuraminidase-treated tumor cells plus BCG was tested in 3 patients who had had chemotherapy for disseminated neuroblastoma. Two of these children were in "complete remission" after radiation therapy and chemotherapy before the administration of immunotherapy. Relapse occurred in 5-6 months in all 3 patients. These disappointing results are discussed in relation to problems of current chemotherapy in disseminated neuroblastoma including results obtained at second-look operations in patients obtaining "complete remission."

Adult↗
PubMed1976

Hidradenitis suppurativa occurring on the leg.

The case of a patient with a recurrent, painful ulceration on the lower leg, clinically and histologically resembling hidradenitis suppurativa, is presented. The fact that this site is devoid of apocrine glands supports the concept that apocrine involvement in hidradenitis suppurativa is coincidental and that these glands are involved secondarily. It is suggested that in this patient the pathogenesis of the disease is follicular occlusion rather than selective apocrine poral closure.

Diagnosis, Differential↗
PubMed1976

Chronic granulocytic leukemia. Review of 536 cases.

The Western Cancer Study Group (WCSG) retrospectively reviewed chronic granulocytic leukemia (CGL) diagnosed during 1960 to 1974 from 22 institutions. In 100 cases, patients had positive findings for the Philadelphia chromosome (Ph'+). In 426 cases karyotyping was not done (Ph'?). Ten patients had no Ph' chromosome (Ph'-). The ten Ph'- patients ranged in age from 8 to 85 years and in survival from 1 to more than 125 months. Their small number and heterogeneity precluded statistical analysis, but this notable heterogeneity of the Ph'- group may well be typical. Busulfan prolonged survival in the Ph'+ and Ph'? patients. Females and younger patients tolerated their disease better than males and older patients. Survival studies without reference to the Ph' status, treatment, age at diagnosis, and sex are probably not valid.

Adolescent↗
PubMed1976

Psychotropic drug therapy knowledge of health care practitioners.

The psychotropic drug therapy knowledge of eight types of health care practitioners was studied. An examination, dealing with case studies of schizophrenia, depression and mania, was developed. The categories of practitioners were: (1) clinical pharmacists in psychiatric practice, (2) psychiatrists, (3) physicians (nonpsychiatrists), (4) hospital pharmacists in mental health institutions, (5) hospital pharmacists in nonmental health institutions, (6) community pharmacists, (7) nurses in mental health institutions, and (8) nurses in nonmental health institutions. The specific areas of drug knowledge tested were: diagnosis; drug selection; side effects; adverse reactions; monitoring parameters; influence of other disease states; drug-drug interactions; drug-laboratory test interactions; and clinical drug judgment. Clinical pharmacists in psychiatric practice and psychiatrists had the highest scores, and the scores of these two groups were significantly higher than those of the other groups. Nurses practicing in nonmental health institutions had the lowest scores. The results suggested that clinical pharmacists trained in psychotropic drug therapy may be competent to manage this therapy of patients in mental health institutions. Patients receiving this therapy in nonpsychiatric facilities and in ambulatory environments are being served by physicians, nurses and pharmacists whose knowledge of psychotropic drug therapy may be inadequate.

Community Pharmacy Services↗
PubMed1975

BCG in the treatment of acute lymphocytic leukemia.

Children with acute lymphocytic leukemia, who were in remission after induction with prednisone and vincristine and consolidation with intravenous methotrexate, were randomized into three groups receiving (1) no further therapy, (2) BCG, and (3) chemotherapy with biweekly methotrexate and monthly prednisone and vincristine. Children continuing in remission after 8 mo on chemotherapy in group 3 were rerandomized into three similar groups, i.e., no therapy, BCG, and chemotherapy. In the primary randomization, the median duration of remission was identical in the groups receiving no therapy or BCG, (4 and 4.3 mo respectively), and both were significantly less than the median duration of remission on chemotherapy which had not been reached prior to secondary randomization at 8 mo. Results of secondary randomization were similar to those of primary randomization. As used in this study, BCG was ineffective in prolonging drug-induced remissions either early in remission or when the leukemic cell population might have been further reduced after 8 mo of maintenance chemotherapy.

Adolescent↗
PubMedDate not supplied

Spontaneous bacterial peritonitis.

Forty-three patients with spontaneous bacterial peritonitis (SBP) between 1973 and 1978 were identified. Criteria for SBP included a positive ascites culture and polymorphonuclear cell concentration greater than 250 cells per mm3. Chronic liver disease was documented by varices in 91%, severe histologic fibrosis or cirrhosis in 94%, splenomegaly in 91%, and past hospitalization for liver disease in 57% of the patients. SBP was detected within 7 days of admission in 17 patients (40%) and within 35 days in 38 patients. Single organisms were isolated from 38 patients and multiple organisms from 5 patients. Twenty-six of 43 patients survived the episode of SBP, but only 13 survived the hospitalization. Analysis of the survival curve from the onset of SBP revealed a rapid death rate and a slow death rate set of patients. Rapid death (less than or equal to 7 days from SBP onset) correlated with a lack of prior hospitalization for liver disease (p less than 0.001), hepatomegaly (p less than 0.001), increased serum bilirubin (p less than 0.005), serum creatinine (p less than 0.05), and peripheral white blood cell concentrations (p less than 0.05). Survival during hospitalization was associated with prior hospitalization with liver disease (p less than 0.001) and chills during the episode of SBP (p less than 0.001). The 43 patients were divided into Group 1 patients on the basis of a serum bilirubin greater than 8 mg% and/or serum creatinine greater than 2.1 mg%; Group 2 patients had lower values. Survival was greater in Group 2 patients with advanced, relatively quiescent liver disease compared to Group 1 patients for both the episode of SBP (91 vs. 29%; p less than 0.001) and for hospitalization (50 vs. 9%; p less than 0.05). Death in Group 2 patients was related to inadequate antibiotic therapy (p less than 0.05), nonhepatic factors, and new onset of renal failure. Although SBP in the setting of severe acute liver injury has a dismal prognosis, SBP with minimal acute liver injury has a relatively good prognosis for hospital survival even with advanced chronic liver disease. Long-term survival is also possible since 4 of 9 patients with prolonged follow-up have survived 3 years.

Anti-Bacterial Agents↗
PubMedDate not supplied

Detection and side-chain specificity of IgE antibodies to flucloxacillin in allergic subjects.

Unlike studies on the antigenicity of penicillins in laboratory animals, limited information is available on the allergenicity of penicillins in man, especially with regard to fine structural allergenic differences between the many different penicillins. Inconsistent with the earlier conclusions of others, our studies suggest that side-chain structures on the penicillin molecule are the major allergenic determinants in many reactions. Immediate allergic reactions to flucloxacillin were observed in a number of patients where diagnosis was confirmed by skin testing and detection of flucloxacillin-reactive IgE antibodies. Quantitative hapten inhibition studies revealed potent inhibition by flucloxacillin and three structurally related penicillins: oxacillin, cloxacillin and dicloxacillin. Analysis of the inhibition results showed that the side-chain group of flucloxacillin, 3-(2-chloro-6-fluorophenyl)-5-methyl-4-isoxazolyl, is recognized by some antibodies and that the 5-methyl-3-phenyl-4-isoxazolyl group, with or without halogen substituents, accounts for the reactivity of other antibodies and for the cross-reactions seen with some other penicillins. Since it is the side-chain group that distinguishes the many different penicillins, and since the side-chain groups are recognized by IgE antibodies in many of the allergic reactions, it is becoming clear that specific assays are required for the detection of IgE antibodies to each of the different penicillins.

Adult↗
PubMedDate not supplied

Occupational coronary heart disease among bridge and tunnel officers.

Traffic-control officers employed in New York City tunnels prior to 1981 have been at increased risk of mortality from coronary heart disease. In this study, the authors assessed current coronary heart disease prevalence and evaluated associations between coronary heart disease and occupational factors among New York City bridge and tunnel officers. A clinical cardiovascular disease surveillance and cross-sectional occupational epidemiologic study was conducted. The authors used comprehensive evaluations to identify current and prior incidences of coronary heart disease. Occupational risk factors evaluated included job strain, current and historic exposure to carbon monoxide, and occupational physical inactivity. Current carbon monoxide exposure was assessed via workshift changes in carboxyhemoglobin. Coronary heart disease occurred in 29 (5.5%) of the 526 bridge and tunnel officers examined. Risk of coronary heart disease was associated positively with total years each bridge and tunnel officer work had worked in that capacity (odds ratio = 1.64 for each decade of employment, adjusted for nonoccupational coronary heart disease risk factors). Carboxyhemoglobin levels were low in the subjects, and job strain and physical inactivity were very prevalent. Occupational factors contributed to the risk of coronary heart disease in New York City bridge and tunnel officers. The authors were unable to identify the specific factors that led to the increase in risk described.

Adult↗
PubMedDate not supplied

Multiple myeloma and occupation in Sweden.

The occurrence of multiple myeloma by occupational and industrial category was systematically assessed using the Swedish Cancer-Environment Registry, which links cancer incidence (1961-1979) with occupational data from the 1960 census. Incidence of multiple myeloma was significantly increased for a number of occupational groups such as farmers, smelter and metallurgy workers, and miners-quarrymen-rock blasters. Although caution must be applied in drawing causal inferences, this national linked-registry analysis may provide clues to the environmental determinants of multiple myeloma.

Humans↗
PubMedDate not supplied

Risk for cancer of the pharynx and oral cavity among male painters in the Nordic countries.

In an effort to evaluate a hypothesis raised by findings in Denmark that painters might experience an increased risk for pharyngeal and oral cancer, data were collected about these cancers among painters in Norway, Sweden, and Finland. The possible confounding effects of alcohol and tobacco were gauged by collecting data about cancer of the lung, larynx, esophagus, liver, and bladder, and about mortality from liver cirrhosis. Consistently increased risks for lung cancer among painters were found. The risks for cancer of the oral cavity and/or pharynx were increased in Norway, Sweden, and Finland, but not to the same extent as was observed in Denmark. The risks for cancer of the esophagus were slightly increased as were the risks for cancer of the liver and for cirrhosis of the liver in Denmark and Finland. The data from Norway, Sweden, and Finland could thus neither substantiate nor disprove the hypothesis that painters may experience an increased risk for cancer of the pharynx and oral cavity as a result of occupational exposures.

Humans↗