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Biomedical subjects

K James

Publications and source records attributed to K James.

322 records · Page 18Linked to original sources
PubMedDate not supplied

A comparison of the incidence, duration, and degree of the neurologic toxicities of cisplatin-paclitaxel (PT) and cisplatin-cyclophosphamide (PC).

Logically, the choice of any ultimate optimum therapy requires, as well as comparison of the survival outcomes, a comparison of both subjective and objective toxicities in terms of incidence, degree of severity, and duration. Frequently such detail is not collected in large studies. Both cisplatin and paclitaxel are effective but neurotoxic drugs for ovarian cancer. The optimum choice is further complicated in that carboplatin is a possible alternative for cisplatin, being less neurotoxic but having greater hematologic toxicity. Similarly, 3-h and 24-h infusion schedules of paclitaxel have different incidences in opposite directions of hematologic and neurologic toxicities. One hundred fifty two eligible Canadian patients entered in a European-Canadian study that compared paclitaxel-cisplatin (PT, 79) patients with cyclophosphamide-cisplatin (PC, 73 patients) had both subjective and objective neurotoxicity data collected from treatment initiation to disease progression. Incidence, degree, and duration (compared in an analogous way to remission durations) of neurotoxicity were compared in the two arms to quantify the additional paclitaxel toxicity. No significant differences were found for motor toxicity, motor impairment, hearing impairment, or insomnia. For sensory changes during treatment, toxicity (all grades, 91% vs. 49%; grade 3 or higher, 29% vs. 3%) incidence, subjective impairment (a little or more, 89% vs. 40%; lots, 54% vs. 11%) incidence, and toxicity duration (all grades only), and impairment durations (both degrees) were all worse for PT. During follow-up, only the incidence of all-grade sensory toxicity was worse and this was not reflected by any other parameters. We conclude that paclitaxel adds considerably, but only temporarily, to the sensoy neurotoxicity of cisplatin.

Adult↗
PubMedDate not supplied

The effect of seminal plasma on macrophage function--a possible contributory factor in sexually transmitted disease.

The present studies confirm that small doses of human seminal plasma inhibit mitogen induced lymphocyte transformation and experiments in a murine model suggest this effect may be mediated through accessory macrophages. They also reveal that seminal plasma interferes with the attachment, spreading and phagocytic activity of C. parvum elicited murine peritoneal macrophages and the release of reactive oxygen species from zymosan triggered human peripheral blood monocytes and neutrophils. As macrophages are known to programme various aspects of the immune response our results may be relevant to the acquired immune deficiency syndrome (AIDS), the genesis of antisperm antibodies and the response to prostatic and cervical cancer.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Long-term follow-up confirms a survival advantage of the paclitaxel-cisplatin regimen over the cyclophosphamide-cisplatin combination in advanced ovarian cancer.

Two independent and consecutive randomized clinical trials, conducted by the American Gynecological Oncology Group and by an European-Canadian Intergroup, have shown superiority, in clinical response rate, progression-free survival, and overall survival, of a cisplatin-paclitaxel regimen over cisplatin-cyclophosphamide given as first-line chemotherapy for women with advanced epithelial ovarian cancer. The results of these studies, published with a median follow-up of about 3 years, have been updated with a 6.5-year follow-up: In each case, an 11% absolute gain in survival favoring the paclitaxel arm is shown; this advantage remains both statistically and clinically significant and supports a role for paclitaxel in frontline chemotherapy for advanced ovarian cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Cerebrospinal fluid lactate levels and prognosis in status epilepticus.

Despite recent advances in the treatment of status epilepticus (SE), the mortality and morbidity associated with this condition remains high. Although the reasons for this excessive mortality are not known, several factors are suspected, including cerebral ischemia, cardiovascular collapse, toxic stimulation by neurotransmitters and hormones, or toxic products of intermediary metabolism. Cerebral lactic acidosis can cause cortical injury and has been shown to occur with seizures in experimental animals and in a limited number of human studies. We determined cerebrospinal fluid (CSF) and plasma lactate in 29 patients with generalized SE of diverse etiology. CSF was obtained within 12 h of termination of clinical seizure activity. The mean CSF lactate for all SE patients was elevated (3.74 +/- 0.31 mM) as compared with that of normal controls (1.60 +/- 0.10 mM) from non-neurologic patients undergoing spinal anesthesia. In patients who died or had a poor neurologic recovery, CSF lactate level was 5.36 +/- 0.58 mM (9 patients), whereas in 20 patients who showed good recovery CSF lactate level was 3.01 +/- 0.22 mM (p less than 0.005). The results demonstrate that SE causes a significant increase in CSF lactate and suggest that the magnitude of lactate elevation may serve as a predictive indicator of morbidity and mortality.

Adult↗
PubMedDate not supplied

Functional electrical stimulation using microstimulators to correct foot drop: a case study.

This paper presents a case study that tested the feasibility and efficacy of using injectable microstimulators (BIONs) in a functional electrical stimulation (FES) device to correct foot drop. Compared with surface stimulation of the common peroneal nerve, stimulation with BIONs provides more selective activation of specific muscles. For example, stimulation of the tibialis anterior (TA) and extensor digitorum longus (EDL) muscles with BIONs produces ankle flexion without excessive inversion or eversion of the foot (i.e., balanced flexion). Efficacy was assessed using a 3-dimensional motion analysis of the ankle and foot trajectories during walking with and without stimulation. Without stimulation, the toe on the affected leg drags across the ground. BION stimulation of the TA muscle and deep peroneal nerve (which innervates TA and EDL) elevates the foot such that the toe clears the ground by 3 cm, which is equivalent to the toe clearance in the less affected leg. The physiological cost index (PCI) measured effort during walking. The PCI equals the change in heart rate (from rest to activity) divided by the walking speed; units are beats per metre. The PCI is high without stimulation (2.29 +/- 0.37, mean +/- SD) and greatly reduced with surface (1.29 +/- 0.10) and BIONic stimulation (1.46 +/- 0.24). Also, walking speed increased from 9.4 +/- 0.4 m/min without stimulation to 19.6 +/- 2.0 m/min with surface and 17.8 +/- 0.7 m/min with BIONic stimulation. These results suggest that FES delivered by a BION is an alternative to surface stimulation and provides selective control of muscle activation.

Adult↗
PubMedDate not supplied

Evaluation of environmental, nutritional, and host factors in cats with hyperthyroidism.

The pathologic changes associated with hyperthyroidism (adenomatous hyperplasia, adenoma of the thyroid gland) have been well characterized in cats, but the pathogenesis of these changes remains unclear. In this research, we undertook a case-control study to search for potential risk factors for this disease. Owners of 379 hyperthyroid and 351 control cats were questioned about their cats' exposure to potential risk factors including breed, demographic factors, medical history, indoor environment, chemicals applied to the cat and environment, and diet. The association between these hypothesized risk factors and outcome of disease was evaluated by conditional logistic regression. Two genetically related cat breeds (ie, Siamese and Himalayan) were found to have diminished risk of developing hyperthyroidism. Cats that used litter had higher risk of developing hyperthyroidism than those that did not. Use of topical ectoparasite preparations was associated with increased risk of developing hyperthyroidism. Compared with cats that did not eat canned food, those that ate commercially prepared canned food had an approximate 2-fold increase in risk of disease. When these 4 variables (breed, use of cat litter, consumption of canned cat food, and use of topical ectoparasite preparations) from the univariate analysis were selected for further study as candidate risk factors and analyzed by multivariate conditional logistic regression, a persistent protective effect of breed (ie, Siamese or Himalayan) was found. In addition, results suggested a 2- to 3-fold increase in risk of developing hyperthyroidism among cats eating a diet composed mostly of canned cat food and a 3-fold increase in risk among those using cat litter. In contrast, the use of commercial flea products did not retain a strong association. The results of this study indicate that further research into dietary and other potentially important environmental factors (eg, cat litter) is warranted.

Animal Nutritional Physiological Phenomena↗
PubMedDate not supplied

Community empowerment in the control of lymphatic filariasis in Misima, Milne Bay Province using diethylcarbamazine in combination with albendazole.

We report the successful implementation of a community-based lymphatic filariasis control program using annual single-dose treatment with diethylcarbamazine (DEC) in combination with albendazole. The target population included over 28,000 people in the Samarai Murua District, Milne Bay Province, Papua New Guinea. A community-based delivery model was as effective as the standard health services delivery model. The number of people tested in 1998 before mass drug administration (MDA) and in 1999, one year after treatment, were 1644 and 942 respectively; the number who received mass treatment was 29,883 in 1998 and 28,965 in 1999. The prevalence of antigenaemia decreased significantly from 19% to 12%. The cost of running the program also decreased by 50%. The total number of trained health staff required to conduct the MDA program declined from 62 in 1998 to 12 in 1999, a reduction of 81%, with a cost saving in salary and allowances. A salient organizational initiative that surfaced was the use of local expertise in the private sector as a catalyst for obtaining funds from external sources to manage and facilitate the program which was conducted with locally available resources.

Albendazole↗
PubMedDate not supplied

Diagnosis of combined intra and extra uterine gestations.

The ultrasound diagnosis of an ectopic pregnancy can be extremely difficult to achieve even for an experienced operator. The two case studies show that however rare any phenomenon might be, this should not be a reason for excluding it as a possible diagnosis. I hope that this article will help sonographers in the future to be aware of the possible existence of a combined intra and extra uterine pregnancy.

Adult↗
PubMedDate not supplied

Antibody responses, antitumour antibodies and Ig class and subclass levels in C. parvum treated mice.

This paper summarises the results of extensive studies performed in our laboratory during the past three years aimed at establishing the effect of C. parvum administration on humoral immunity in normal mice and mice previously challenged with viable MC fibrosarcoma cells. This treatment was found to (a) increase the response to thymus dependent and independent antigens, (b) result in the production of circulating immunoglobulins which bound to tumour cells and syngeneic tissues in vitro, and (c) marked increases in the levels of certain immunoglobulins, especially IgG2a and IgG2b. The latter effects were dependent upon the dose and route of injection and were inhibited by the administration of gold salts. Similar though less marked effects were also observed in T cell deprived and nude mice and in normal mice injected with other bacterial adjuvants. The mechanisms by which C. parvum exerts the above serological effects and their relevance to antitumour immunity, will be discussed.

Animals↗
PubMedDate not supplied

Further studies on the serological effects of C. parvum immunotherapy in cancer patients.

Previous serological studies undertaken in our laboratory have shown that the repeated administration of small doses of C. parvum to a small group of cancer patients resulted in a consistant increase in the levels of IgG (especially the IgG2b subclass), the development of antibodies to C. parvum and the transient appearance of 'rheumatoid factor like' substances in the serum (Br. J. Cancer, 32, 310, 1975). In the present paper we report the results of similar studies in small numbers of (a) inoperable bronchogenic carcinoma patients receiving combined C. parvum and cyclophosphamide therapy, and (b) brain glioma patients receiving intracerebral injection of C. parvum. As might be expected some of the serological changes observed in these patients were not as marked as previously noted. Nevertheless a number of the patients developed autoantibodies which were detectable by the latex and Ripley procedures but not by the Rose-Waaler test. There was no evidence of antinuclear factors by the fluorescence procedure.

Aged↗