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Biomedical subjects

L Edwards

Publications and source records attributed to L Edwards.

At least 91 records · Page 5Linked to original sources
PubMed1990

The effect of intralesional interferon gamma on basal cell carcinomas.

This open label study evaluated the effect of nine intralesional injections of two different doses of interferon gamma on basal cell carcinomas in 29 patients. One group of 15 patients received interferon gamma, 0.01 mg (20,000 IU), intralesionally three times a week for 3 weeks. Fourteen patients received interferon gamma, 0.05 mg (100,000 IU), intralesionally in the same dosage schedule. Excisional biopsy specimens 12 weeks after therapy showed no evidence of tumor remaining in 7 of 14 patients (50%) treated with the higher dose of interferon gamma, whereas only 1 of 15 patients (7%) treated with low-dose interferon gamma was cured according to histologic criteria (p = 0.025). Seventy-six percent of patients reported at least one adverse reaction, but most were considered mild by the patient and the investigator.

Adult↗
PubMed1990

Intralesional interferon therapy for basal cell carcinoma.

In a clinical trial of 172 patients at four medical centers, interferon alfa-2b (1.5 x 10(6) IU) or a placebo was injected directly into biopsy-proved noduloulcerative or superficial basal cell carcinomas three times weekly for 3 weeks, for a cumulative dose of 13.5 million IU. Efficacy of treatment was determined at 16 to 20 weeks by examination of biopsy specimens that demonstrated cure of lesions in 86% of interferon-treated patients and in only 29% of placebo-treated patients. During the treatment course and follow-up, an initial inflammatory response was observed at the treatment sites, followed by diminished erythema, improvement in overall appearance, and a decrease in size of lesions. Side effects of treatment, mainly flu-like symptoms, were usually mild and transient and occurred more commonly in the interferon-treated group. Only three patients, all in the interferon-treated group, discontinued therapy because of side effects. One year after initiation of therapy, 81% of interferon recipients and 20% of those given the placebo remained tumor free. Noduloulcerative and superficial lesions were equally responsive to treatment with interferon. For some patients with noduloulcerative or superficial basal cell carcinomas, intralesional interferon alfa-2b may be an alternative, effective treatment.

Basal Cell Carcinoma↗
PubMed1990

Midnight removal: an improved approach to removal of catheters.

There is no recognised policy regarding the timing of urethral catheter removal, although early morning removal is commonly practised. Removing the catheter at midnight allows patients to return to a normal voiding pattern more rapidly and to leave hospital earlier.

Female↗
PubMed1990

What on earth are we drinking?

During the past few years there has been a considerable increase in the number and variety of still and carbonated bottled drinking waters, which have an enormous variation in calcium content ranging from 0 to over 500 mg/l. Patients with upper urinary tract stones are often advised to maintain a high fluid intake in order to achieve an increased urinary output. If they find tap water unpalatable and drink bottled water instead, they could significantly increase their daily calcium intake by as much as 1.5 g. The majority of bottled waters presently available in this country, together with tap water samples from throughout the British Isles, have been analysed and the results suggest that there are some waters which stone formers should avoid.

Calcium↗
PubMed1990

The effect of topical interferon alpha 2b on actinic keratoses.

As a result of the known effects of intralesional interferon alfa 2b (Intron A) on actinic keratoses, we have now examined the effects of topical interferon alfa 2b gel on actinic keratoses. Twenty-four subjects each treated three actinic keratoses with either interferon gel 30 million IU/gm or a placebo preparation applied topically 4 times a day for 4 weeks. Although more lesions treated with the active interferon showed clinical improvement, this difference was not statistically significant.

Administration, Topical↗
PubMed1990

First family planning visit in school-based clinics.

The timing of the first family planning visit for 144 female adolescents using school-based clinics in four St. Paul, Minn., high schools was studied. Mean delay time for the sample was 11.4 months and the median was 7.8 months. Almost 50% of the sample arrived within two months of either a planned onset of sexual intercourse (virgin group) or a recent start of sexual activity (short delay group). Early onset of sexual activity (v age 15) was more prevalent among long delayers (47.9%) than among short delayers (21.1%). Longer delayers were more likely to come from the lowest socioeconomic groups. Short delayers and longer delayers were equally likely to have been motivated to attend the clinic because they feared they were pregnant. Reasons for choosing this clinic over others reflected the importance of confidentiality, comprehensiveness of services, and the specific adolescent orientation of care.

Adolescent↗
PubMed1990

The effect of topical tretinoin on dysplastic nevi. A preliminary trial.

Twenty-one patients were enrolled in a randomized, double-blind study that examined the effects of topical 0.05% tretinoin (all-trans-retinoic acid; vitamin A acid; Retin-A) solution on dysplastic nevi. Following histologic confirmation of the diagnosis of dysplastic nevus in three representative lesions, patients applied either tretinoin or a placebo containing 50% alcohol to selected dysplastic nevi once a day under tape occlusion, or twice a day unoccluded, for 4 months. Immediate posttreatment comparative photographs showed marked fading or elimination of some dysplastic nevi clinically, and histologic examination of excisional biopsy specimens showed disappearance or reversion to benign nevi in many of the treated lesions. There were no clinical or histologic changes in those dysplastic nevi treated with placebo. This study shows a definite biological effect of topical tretinoin on some dysplastic nevi.

Administration, Cutaneous↗
PubMed1990

The effect of an intralesional sustained-release formulation of interferon alfa-2b on basal cell carcinomas.

Intralesional interferon alfa-2b has been proven effective in the treatment of basal cell carcinomas. Because nine injections over a 3-week period have been necessary to produce clinically significant cure rates, a sustained-release protamine zinc chelate interferon formulation has been developed. In this study, 65 basal cell carcinomas were treated in one of two dosing schedules with intralesional sustained release interferon alfa-2b (10 million IU per injection). Thirty-three patients received a single injection and 32 patients received one injection per week for 3 weeks. At study week 16, 80% of evaluable tumors treated with three injections and 52% treated with one injection were cured histologically. Two patients discontinued injections because of side effects. A sustained-release protamine zinc preparation of interferon alfa-2b shows promise as a practical, effective, and cosmetically elegant treatment for basal cell carcinoma.

Adult↗
PubMed1989

Effect of oral isotretinoin on dysplastic nevi.

We previously reported a favorable histologic response of dysplastic nevi to topical tretinoin in three patients. To investigate the anticancer and cancer preventive effects of retinoids we have examined the effect of systemic isotretinoin on dysplastic nevi. After confirmatory baseline biopsies, eleven patients with the dysplastic nevus syndrome were treated with oral isotretinoin, 40 mg twice a day for 4 months. At completion of therapy, at least three previously identified and photographed clinically typical dysplastic nevi were rephotographed and removed for histologic evaluation. Eight patients completed the full course of medication. There were no clinical changes in the dysplastic nevi in these patients. Posttherapy biopsy specimens in six volunteers revealed most of the remaining lesions to be dysplastic nevi. The majority of lesions biopsied in two subjects showed normal, benign nevi only. This proportion of clinically typical dysplastic nevi that prove to be normal nevi histologically (28%) is not significantly different from that reported by others. Oral isotretinoin does not appear to have a significant biologic effect on the clinical or histologic appearance of dysplastic nevi in the treatment schedule employed.

Administration, Oral↗
PubMed1989

Vulvar lichen planus.

The clinical presentation of lichen planus of the vulva spans a spectrum from subtle, fine, reticulate papules to severe erosive disease accompanied by scarring and loss of the normal vulvar architecture. The end result may mimic other diseases. Because cutaneous lichen planus is usually absent and oral disease may be asymptomatic, the diagnosis can be easily missed unless the clinician has a high index of suspicion. Although treatment for vulvar lichen planus is suboptimal, a correct diagnosis may end the patient's search for an answer and help to prevent unnecessary procedures and therapies.

Adult↗
PubMed1988

How would you like to have an orchidectomy for advanced prostatic cancer?

One hundred thirteen patients were randomized for the study. There was no significant difference between the groups for response or survival. The incidence of side effects related to the reduction of testosterone was similar in both groups. Disease "flare" was seen in three patients treated with long-acting D-Trp-6 LH-RH. All symptoms resolved by the end of 8 weeks. There was less psychological morbidity in the D-Trp-6 LH-RH group but the difference did not reach statistical significance. Our results indicate that long-acting D-Trp-6 LH-RH offers a safe and effective alternative to surgical orchidectomy.

Antineoplastic Agents↗
PubMed1988

168 double J (pigtail) ureteric catheter insertions: a retrospective review.

The medical records of 116 patients who had 168 ureteric double J (pigtail) catheters inserted over a 6-year period between 1981 and 1987 were reviewed. Eighty-five patients had pigtails inserted for benign conditions and 31 for malignant disease. The pigtail catheters were inserted cystoscopically in 88 patients, percutaneously in 7 patients and by open surgery in 21 patients. Of 168 pigtail catheters used, 147 were soft (silicone, multilength) and 21 hard (polyurethane). No mortality was attributable to the use of these catheters but certain complications were commonly encountered. Loin discomfort occurred after 32 (19%) insertions; 27 of 147 (18%) soft catheters and 5 of 21 (24%) hard catheters. Trigonal irritation, confirmed cystoscopically was reported in 26 of 147 (18%) insertions of soft catheters and in 6 of the 21 (29%) with hard catheters (chi 2, P = 0.37). Urinary tract infection (confirmed by urine microscopy and culture) occurred after 46 (31%) soft catheter insertions and after 13 of 21 (61%) hard catheter insertions (chi 2 test, P = 0.01). Stent migration occurred in five patients and obstruction in two. Pigtail catheters are safe ureteric stents which are easy to insert and their use is supported by this study. The complications of associated infection, trigonal irritation and loin discomfort are relatively common and still occur even with soft catheters. Careful monitoring of all patients with pigtail catheters in position is recommended.

Adult↗
PubMed1988

Pharmacokinetics and metabolism of retinol administered at a chemopreventive level to normal subjects.

Thirteen subjects between the ages of 50 years and 70 years were administered a daily 25,000 IU dose of retinol for 9 months. Two subjects experienced mild skin dryness, headaches, and/or alopecia. There were no significant changes in serum chemistries. High performance liquid chromatography assays for plasma retinol revealed no evidence of drug accumulation; however, there was a significant increase in the plasma concentration-versus-time curve for retinyl palmitate concentrations between the first and subsequent sampling days (P = 0.009). The mean skin retinol and retinyl palmitate concentrations in 7 retinol-treated subjects (131.7 and 15.9 ng/g, respectively) were not significantly different from those observed in 13 age-matched controls (118.9 and 25.5 ng/gm, respectively).

Adipose Tissue↗
PubMed1988

Desquamative vaginitis: lichen planus in disguise.

A principal cause of desquamative vaginitis is erosive lichen planus. We report five cases to illustrate the classic oral and vaginal findings, describe the histology, and relate the therapeutic response of the disease. Early recognition of the disorder and prompt use of corticosteroids and vaginal dilators may prevent the common sequelae of adhesion formation and vaginal stenosis.

Administration, Topical↗
PubMed1987

Competition of milrinone, a non-iodinated cardiac inotropic agent, with thyroid hormone for binding sites on human serum prealbumin (TBPA).

Milrinone [2-methyl-5-cyano-(3,4'-bipyridin)-6(1H)-one] is a positive cardiac inotropic agent recently shown to have thyromimetic activity in vitro in a rabbit myocardial membrane Ca2+-ATPase system [K. M. Mylotte et al., Proc. natn. Acad. Sci. U.S.A. 82, 7974 (1985)]. In the present studies, milrinone was examined for activity as an inhibitor of iodothyronine binding by human serum thyroid hormone transport proteins, thyroxine-binding globulin (TBG), prealbumin (TBPA) and albumin. Polyacrylamide gel electrophoresis at pH 9.0 of sera equilibrated with [125I]thyroxine showed that milrinone competed with L-thyroxine (T4) for binding sites on TBPA (10 and 100 microM milrinone caused 61 and 73% reductions, respectively, in T4 binding to TBPA, P less than 0.01); T4 displaced from TBPA was bound by TBG and albumin. Comparable reductions in T4 binding to TBPA were observed in electrophoretic studies conducted at pH 7.4. Binding of triiodo-L-thyronine (T3) to TBPA was electrophoretically confirmed and shown to be decreased in the presence of milrinone. Electrophoresis of purified TBPA also demonstrated that [14C]milrinone co-migrated with this transport protein and that milrinone displaced tracer T4 from TBPA. Amrinone, the 2-H-5-NH2 analog of milrinone, had less than 5% of the activity of milrinone as an inhibitor of T4 binding in electrophoretic studies. Scatchard analysis of T4 and milrinone binding to purified TBPA, measured by equilibrium dialysis, showed two classes of binding sites, with association constants, respectively, of 6.1 X 10(7) M-1 and 1.6 X 10(6) M-1 for T4, and 1.7 X 10(6) M-1 and 8.9 X 10(2) M-1 for milrinone. Computer graphic modeling of the binding of milrinone to the T4 site in the crystal structure of TBPA showed that milrinone best occupied this site when the substituted bipyridine ring overlapped the phenolic ring of T4. In this orientation the 5-cyano group, which has an electronegativity similar to that of iodine, occupied the same volume as the 5'-iodine of T4. The 5-amino group of amrinone lacks these characteristics. In this orientation, the keto function of milrinone overlapped the T4 4'-hydroxyl and could participate in similar intermolecular interactions. Thus, milrinone, a non-iodinated bipyridine, and thyroid hormone share structural and biochemical homologies and compete for the same binding site on TBPA.

Amrinone↗