Three hundred and forty-four patients with operable colorectal adenocarcinoma, Dukes' stage B or C, were entered into a randomized controlled trial of intraoperative and postoperative intravenous urokinase and/or long-term sodium warfarin therapy. The factorial design of the trial allowed evaluation of each therapy separately. Age, sex, Dukes' stage and cancer site were similar in the treatment groups. Using life-table methods, survival and recurrence/metastases free survival were estimated up to 6 years postoperatively. No significant effects of either therapy on these endpoints were found.

Aged↗

PubMedDate not supplied

Mortality in the first year after coronary artery bypass surgery. Irish Cardiac Surgery Register.

In the three years 1983-1985 the Irish Cardiac Surgery Register (ICSR) recorded details on 1,534 patients who underwent primary isolated coronary artery bypass grafting (CABG). This unselected series of patients accounted for all such operations in the Republic of Ireland during this period and provides information on a wide spectrum of clinical subgroups of patients with ischaemic heart disease. There were 52 operative deaths (3.4%). At one year the number of deaths had risen to 75 (4.9%). Factors related to operative mortality were female sex, age greater than 60, left ventricular failure, history of myocardial infarction in the six weeks prior to surgery, poor left ventricular function and extensive disease of vessels to be grafted. All of the above factors except female sex were related to one year mortality. Analysis of late deaths (1.5%) separately showed evidence of pre-operative impaired left ventricular function to be an important prognostic indicator.

Adult↗

PubMedDate not supplied

Predictors of first hip fracture and mortality post fracture in older women.

BACKGROUND: Hip fracture causes significant morbidity and mortality in older women. AIM: To document factors contributing to the risk of hip fracture in older women and to assess the effect of hip fracture on subsequent mortality. METHODS: Case-control study of 89 women with hip fracture and 89 controls, with two-year follow-up. Singh index and bone mineral density were calculated. RESULTS: Osteoporotic indices did not differ significantly between cases and controls. Significant predictors of risk were sleeping tablets, perception of health as fair/poor and a lower mental status score. Patients were 3.57 times more likely to die in the first year after fracture, with no difference between the groups in year two. After adjustment, hip fracture did not remain significantly associated with mortality. Inability to walk 100 yards alone prior to fracture and lower social class were significantly associated with mortality at 12 months. Age alone was significantly associated at 12-24 months. CONCLUSIONS: Factors related to falls and fracture may be more discriminatory predictors of hip fracture risk than osteoporosis in older females. Medications for sleep should be prescribed with caution. Hip fracture may have an independent effect on one year mortality, this effect is not seen in the second year.

Accidental Falls↗

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Predictors of exercise capacity and adaptability to training in patients with coronary artery disease.

PURPOSE: Systolic left ventricular dysfunction is a weak predictor of exercise tolerance in patients with chronic congestive heart failure. This study aimed to determine physiologic and other predictors of effort tolerance and adaptability to training in a wide variety of patients with coronary artery disease. METHODS: One hundred seventy-one patients (group 0) with documented coronary artery disease and various degrees of left ventricular dysfunction were enrolled into a medically supervised exercise training program for 6 months. One hundred six patients had an ejection fraction greater than 50% (group 1), 38 patients between 35% and 50% (group 2), and 27 patients less than 35% (group 3). RESULTS: Resting parameters of systolic and diastolic left ventricular function did not predict the effort tolerance of patients with coronary artery disease at any level of left ventricular impairment. Noncardiac factors including age, gender, Broca index, and forced vital capacity explained 50% of the variation in peak oxygen uptake in group 0. Peak oxygen uptake, ventilatory threshold, and treadmill time to exhaustion increased significantly after training in all groups. The magnitude of the improvement in these variables was the same for all groups. CONCLUSIONS: Noncardiac factors were better predictors of the effort tolerance of patients with coronary artery disease than parameters of left ventricular function at entry to an exercise program or after 6 months of training. A similar degree of adaptation to training was seen in all patients regardless of their degree of left ventricular systolic or diastolic dysfunction.

Adaptation, Physiological↗

PubMedDate not supplied

OVX1 and CEA in patients with colon carcinoma, colon polyps and benign colon disorders.

The OVX1 tumor marker promises to complement CA125 for detection of early stage ovarian carcinoma. OVX1 has also been shown to be elevated in colon cancer patients. This study is designed to assess serum OVX1 levels in patients with specific stages of colon cancer, colon polyps or other GI disorders. Serum OVX1 and CEA were measured by radioimmunoassay or enzyme immunoassay for 206 patients at the time of colonoscopy or staging for colon carcinoma. In patients with stage I, II, III, or IV colon carcinoma, serum OVX1 was positive in 37%, 48%, 74% and 63%, respectively. Fifty-three percent of patients with colon polyps had elevated OVX1 levels, while OVX1 levels were positive in only 7% of healthy controls. If both OVX1 and CEA were considered, at least one of these markers was elevated in 36%, 60%, 79% or 89% of patients with stage I, II, III or IV colon carcinoma, respectively. The majority of patients with inflammatory bowel disease or diverticulosis also had elevated OVX1 levels. Both markers were positive in 27% of patients with colon carcinoma, and not in any patients with a normal colonoscopy or with a diagnosis of diverticulosis or hemorrhoids. In conclusion, serum OVX1 improves the sensitivity of CEA for detecting colon polyps and colon cancer; however, the use of OVX1 in this setting is hindered by its elevation in non-malignant colonic processes.

Antigens, Tumor-Associated, Carbohydrate↗

PubMedDate not supplied

Haemopoietic cell transplantation. An overview.

Major technological advances in the last ten years have facilitated the efficient harvesting and manipulation of specialised haemopoietic progenitor cells that have the capacity to reconstitute the body's entire haemopoietic and immune system following myeloablative cancer therapy.

Hematopoietic Stem Cell Transplantation↗

PubMedDate not supplied

Trends in smoking prevalence: the Kilkenny Health Project Population Surveys 1985 to 1991.

The statistics on cigarette smoking prevalence in Irish adults show that considerable progress was made during the 1970s and 1980s, with declines in men and women, and in different age and social class groupings. These trends were confirmed in population surveys carried out by the Kilkenny Health Project.

Adolescent↗

PubMedDate not supplied

Safe handling of cytotoxic drugs.

Guidelines for the handling of cytotoxic drugs and related waste in health care establishments have recently been developed by the WorkCover Authority of NSW in collaboration with the New South Wales College of Nursing. Competencies for accreditation of staff involved in the reconstitution, storage, transport, administration and management of waste related to cytotoxic drug use have also been developed.

Accreditation↗