IMRT in abdominal neuroblastoma.
Explore the source record for details and available documents.
Abdominal Neoplasms↗
Biomedical subjects
K Cooke
Publications and source records attributed to K Cooke.
The reliability and validity of a field hockey skill test.
High test retest reliability is essential in tests used for both scientific research and to monitor athletic performance. Thirty-nine (20 male and 19 female) well-trained university field hockey players volunteered to participate in the study. The reliability of the in house designed test was determined by repeating the test (3 - 14 days later) following full familiarisation. The validity was assessed by comparing coaches ranks of players with ranked performance on the skill test. The mean difference and confidence limits in overall skill test performance was 0.0 +/- 1.0 % and the standard error (confidence limits) was 2.1 % (1.7 to 2.8 %). The mean difference and confidence limits for the "decision making" time was 0.0 +/- 1.0 % and the standard error (confidence limits) was 4.5 % (3.6 to 6.2 %). The validity correlation (Pearson) was r = 0.83 and r = 0.73 for female players and r = 0.61 and r = 0.70 for male players for overall time and "decision making" time respectively. We conclude that the field hockey skill test is a reliable measure of skill performance and that it is valid as a predictor of coach-assessed hockey performance, but the validity is greater for female players.
Decision Making↗
Changing patterns in the acute pain service: epidural versus patient-controlled analgesia.
This study involved an audit and a survey of the Acute Pain Service at Princess Alexandra Hospital. It was found in the audit that the relative choice of epidural analgesia had declined by 50% over the five-year time period of 1998-2003. The survey of consultants showed that 82% of them had changed their practice and that they were performing fewer epidural anaesthetics. Two of the most common reasons given for this change in practice related to fear of litigation (34%) and lack of evidence (21%). These results show that within this department approaches to postoperative pain control had changed and that this appears to have resulted from factors such as the medicolegal environment and the possible influence of evidence based medicine.
Analgesia↗
Novel erythropoiesis stimulating protein (darbepoetin alfa) alleviates anemia associated with chronic inflammatory disease in a rodent model.
OBJECTIVE: We developed a rodent model of noninfectious systemic inflammation to examine the pathogenesis of the associated anemia of chronic disorders (ACD), to evaluate the similarity of this ACD model to human ACD, and to evaluate the potential efficacy of novel erythropoiesis stimulating protein (darbepoetin alfa) as an ACD therapy. METHODS: Lewis rats were immunized with peptidoglycan-polysaccharide polymers (PG-APS), the chronic inflammation and associated ACD were characterized, and the effects of darbepoetin alfa treatment on complete blood counts (CBC), red blood cell (RBC) indices, and iron metabolism were analyzed weekly. RESULTS: Acutely inflamed rats had reduced peripheral blood (PB) RBC counts and hemoglobin (Hb) concentrations and increased reticulocyte counts. PB RBC numbers normalized during chronic inflammation, but RBC remained hypochromic and microcytic. Consequently, the rats remained chronically anemic. Anemic rats had fluctuating serum erythropoietin (EPO) concentrations, but mean EPO concentrations never varied significantly from baseline control levels. Histology of anemic rat spleen sections revealed reticuloendothelial siderosis. Total serum iron concentrations were chronically low. Peritoneal exudate cells (PEC) isolated from anemic rats and stimulated with PG-APS in vitro produced more interleukin (IL)-1alpha and interferon (IFN)-gamma, and significantly more tumor necrosis factor (TNF)-alpha and IL-10 than control cultures. Darbepoetin alfa restored Hb concentrations to baseline levels within 2 to 7 weeks, depending on dosage. A refined treatment strategy restored Hb to baseline and maintained those levels with reduced dosing. CONCLUSION: ACD in this rodent model closely replicates human ACD. Darbepoetin alfa treatment reversed ACD in this model by increasing RBC production and RBC hemoglobinization while reducing siderosis and hypoferremia.
Anemia↗
Behaviour change and treatment of core groups: its effect on the spread of HIV/AIDS.
A general model is considered for treatment and behaviour change of the Human Immunodeficiency Virus (HIV) infected in a highly sexually active core group of female commercial sex workers (CSWs) and a 'bridge population' of young unpartnered males. In this model, the spread of HIV/AIDS in the community is carried out mainly through the sexual interaction between the core group and the bridge population which acts as a bridge for the spread of disease to the general population. We will consider the effect of treatment of the infected and/or the subsequent behaviour change when targeted toward the core group and the bridge population. Analytical results will be given for a strategy which targets treatment and behaviour change at either the core group or the bridge population. Numerical examples are also provided to illustrate the biological significance of the treatment/behaviour change and its effect on the threshold parameter values. The results show that if the contact rates and transmission probabilities of the treated individuals are sufficiently reduced, the treatment/behaviour change can eradicate the disease provided that the level of treatment in the infected population is sufficiently high. However, an ill-planned treatment program which fails to meet the required reductions in contact rate or transmission probability could have a detrimental effect on the spread of the epidemic.
Asia↗
Interaction of maturation delay and nonlinear birth in population and epidemic models.
A population with birth rate function B(N) N and linear death rate for the adult stage is assumed to have a maturation delay T>0. Thus the growth equation N'(t)=B(N(t-T)) N(t-T) e(-)d(1)T- dN(t) governs the adult population, with the death rate in previous life stages d(1)>==0. Standard assumptions are made on B(N) so that a unique equilibrium N(e) exists. When B(N) N is not monotone, the delay T can qualitatively change the dynamics. For some fixed values of the parameters with d(1)>0, as T increases the equilibrium N(e) can switch from being stable to unstable (with numerically observed periodic solutions) and then back to stable. When disease that does not cause death is introduced into the population, a threshold parameter R(0) is identified. When R(0)<1, the disease dies out; when R(0)>1, the disease remains endemic, either tending to an equilibrium value or oscillating about this value. Numerical simulations indicate that oscillations can also be induced by disease related death in a model with maturation delay.
Adult↗
Natural killer and lymphokine-activated cytotoxicity following anaesthesia in patients with uveal malignant melanoma.
The role of enucleation in the treatment of ocular melanoma has been questioned by those who believe that it may increase circulating melanoma cells, increasing the incidence of metastases. Some aspects of the immune system are depressed by general anaesthesia, therefore this study was initiated to assess the effect of general anaesthesia on natural killer (NK) cell and interleukin-2 (IL-2)-activated cytotoxicity in 19 patients using 51Cr-labelled target cells (K 562 and SW 742). NK cytotoxicity was increased at induction and during the operation which was due to significant increases in female, but not male patients. At 1 week post-surgery, female patients had decreased NK cytotoxicity compared with males at this interval. NK cytotoxicity compared with males at this interval. NK cytotoxicity was increased intra-operatively when alfentanyl was used, and if the mean tumour diameter was > 15.0 mm the NK cytotoxicity was increased intra-operatively compared with that in patients with smaller tumours. IL-2-stimulated cytotoxicity was reduced at 1 day post-surgery in females only. There was an increased IL-2-stimulated cytotoxicity at induction when propofol was used and IL-2-stimulated cytotoxicity was reduced at 1 week post-operatively if the patient's mean tumour diameter was > 15.0 mm. If NK cell and lymphokine-stimulated cell cytotoxicity are involved in limiting metastatic disease, the patient' sex and tumour size and the anaesthetic agent used may influence the survival rates following surgery.
Adult↗
MR urography: technique and application.
PURPOSE: To evaluate a magnetic resonance (MR) technique for depicting the kidneys and urinary tract. MATERIALS AND METHODS: Fourteen patients with urinary tract obstruction and 20 without obstructions were examined with a modified, heavily T2-weighted fast spin-echo pulse sequence (MR urography). In addition, six healthy volunteers underwent modified MR urography with intravenous administration of furosemide and ureteral compression prior to imaging. RESULTS: MR urography provided high-resolution images of the kidneys and urinary tract in all patients with obstruction with intact collecting systems. Anatomic anomalies were depicted in two patients. Intraluminal neoplasia was well demonstrated in both obstructed and nonobstructed systems (n = 4). Furosemide-enhanced MR urography provided fine anatomic and functional detail of both the kidneys and urinary tract (n = 6). CONCLUSION: MR urography may provide an alternative to more conventional urinary tract imaging techniques. It does not require ionizing radiation or iodinated contrast material. When combined with furosemide and ureteral compression, MR urography provides fine detail and reflects function.
Adult↗
General practice consultations involving pigmented naevi presented for assessment of malignancy.
AIM: To outline the initial general practice care of pigmented naevi presented for assessment of malignancy. METHOD: Fifty six general practitioners completed a brief record for each patient presenting a pigmented skin lesion for assessment of malignancy; records were maintained prospectively for periods over October 1988 to April 1989. 2614 records were received. RESULTS: Numbers of consultations increased sharply with age to peaks at 15-19 for men and 30-44 for women; at ages 20 44 the sex ratio was 1.9 (F/M). Lesions were usually typical (51%) or atypical (24%) moles. 22% of patients were biopsied by the practitioner and 8% were referred, to dermatologists (4%) or surgeons (4%). CONCLUSIONS: The age pattern of presentations is younger than is optimal. General practitioners' decisions and actions are of crucial importance in the effective functioning of melanoma early detection programmes.
Adolescent↗
Radioprotection of mice by recombinant rat stem cell factor.
Treatment with recombinant rat stem cell factor (rSCF) protects mice from the lethal effects of irradiation. Mice treated with a single dose of rSCF prior to irradiation of up to 1150 rads [given as a split dose (1 rad = 0.01 Gy)] resulted in > 80% long-term survival, whereas a single injection given after the last dose of irradiation was not radioprotective. The combination of pre- and posttreatment (-20 h, -2 h, and +4 h) with rSCF resulted in 100% survival of otherwise lethally irradiated mice. Using this optimum schedule of rSCF administration, a radioprotective factor of 1.3-1.35 was achieved. The major cause of death in the control animals was massive bacteremia consisting of enteric organisms. The rSCF-treated animals had a much lower frequency of septicemia, due primarily to a rapid hematopoietic recovery of bone marrow function not evident in control animals.
Animals↗
Primary malignant melanoma of skin in four regions of New Zealand.
AIMS: to describe the incidence and thickness of a representative collection of melanomas occurring in recent years in New Zealand. METHODS: all pathology reports of primary malignant melanoma of the skin, in defined periods in 1987-9, were collated for four regions of New Zealand. RESULTS: nonMaori incidence rates were 52 and 58 melanomas per 100,000 person years for men and women, respectively. These rates are much higher than the 24 per 100,000 person years for melanoma registrations in 1983-4. The age standardised invasive melanoma rate of 35 per 100,000 person years was higher than those of most Australian states and close to the rate for Queensland in 1986. Preinvasive melanomas comprised 26% of all melanomas. Of invasive melanomas, 58% in men and 55% in women were less than 0.76 mm in thickness; 7% of invasive melanomas in men and 5% in women were at least 3.5 mm thick. CONCLUSIONS: increasingly early detection of malignant melanomas in successive years is likely to have contributed to the recent increase in incidence, perhaps to a major degree, but an environmental cause cannot be excluded.
Adolescent↗
Growth in children after bone marrow transplantation for advanced neuroblastoma compared with growth after transplantation for leukemia or aplastic anemia.
The linear growth of 26 children with progressive and advanced neuroblastoma treated with high-dose chemotherapy, total body irradiation, and bone marrow transplantation between 1978 and 1988 at the Children's Hospital of Philadelphia was compared with the growth of 33 children who had transplants for leukemia and of 12 who had transplants for aplastic anemia. The mean growth velocity, expressed as a standard deviation score, for the children who underwent bone marrow transplantation for neuroblastoma was -2.83. This was significantly (p less than 0.005) less than the standard deviation scores for children with transplants for acute lymphoblastic leukemia, acute nonlymphocytic leukemia, and aplastic anemia, which were -0.98, -0.07, and -1.05, respectively. A 6-year follow-up study of 32 long-term survivors of cancer revealed that the 11 patients with neuroblastoma continued to grow poorly, whereas a comparison group of 21 survivors of bone marrow transplantation for leukemia had essentially normal growth 2 years after the procedure. Major therapeutic differences between the two groups included the doses of local radiotherapy and the type and number of cytotoxic agents used. In comparison with the relatively mild growth-inhibiting effects of preparative regimens for leukemia and aplastic anemia, the very intensive preparative regimens used in patients with neuroblastoma have significant negative effects on growth.
Anemia, Aplastic↗
Trends in nonmelanoma skin cancer mortality.
Nonmelanoma skin cancer mortality rates for recent decades show a biphasic pattern: from 1950-65 rates decreased; from 1966-86 rates increased. Age standardised mortality rates for 35-74 year old males increased from 1.6 (95% CI, 1.3-1.9) deaths per 100,000 person years in 1966-72 to 2.3 (95% CI, 2.0-2.5) deaths per 100,000 person years in 1980-86. Rates in women were lower but showed a similar percentage increase (46%), between these periods, to that observed for men (44%). The increased mortality from 1966 was presumably a result of increased ultraviolet exposure.
Adult↗
Giardiasis and municipal water supply.
Explore the source record for details and available documents.
Adolescent↗
The health effects of aluminium--a review.
This review covers the occurrence of aluminium in soil, air, water and food. In addition, aluminium levels in body tissues and its movement within the body have been considered. The adverse effects of aluminium that have been reported in recent years include Alzheimer's disease, dementia and hyperactivity and learning disorders in children.
Aluminum↗
Perceptions of pain relief after surgery.
OBJECTIVE: To assess patients' satisfaction with postoperative pain relief. DESIGN: A descriptive and questionnaire study of patients' experience. SETTING: Two surgical and two gynaecological wards. PATIENTS: 50 Patients admitted to hospital for cholecystectomy and 51 admitted for hysterectomy. MAIN OUTCOME MEASURES: Visual analogue scales with no divisions were completed by the patients immediately after each dose of postoperative analgesia was administered throughout their stay in hospital. A questionnaire completed on the fifth postoperative day recorded patients' recollections of their experience. Opinions were also sought from medical and nursing staff. RESULTS: During the first 24 hours after surgery recorded pain levels were 60% of the maximum and were not influenced by age, sex, or the type of operation performed. The median interval between the return of pain and a further injection of analgesic was 2 hours (interquartile range 1 to 3.5 hours). Expectations of pain relief were low, and for 70% of the patients the pain was at least as bad as they had expected. Only half of the medical and nursing staff questioned thought that postoperative analgesia should relieve pain completely; drugs were prescribed and administered with too little attention to the patient's response and too much concern about adverse effects and opioid dependence. CONCLUSIONS: The results suggest that the standard of postoperative pain relief is poor because of inadequate education of patients in what to expect (and demand), and of medical and nursing staff in how to prescribe and administer analgesia with reference to individual drug response.
Analgesics↗
Alcohol and local authorities.
Explore the source record for details and available documents.
Alcohol Drinking↗