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Biomedical subjects

L Freedman

Publications and source records attributed to L Freedman.

At least 55 records · Page 3Linked to original sources
PubMed1988

Beneficial effect of heparin in the management of patients with APL.

115 patients with acute promyelocytic leukaemia (APL) were studied retrospectively to evaluate prognostic factors and assess therapeutic approaches, particularly the use of heparin in the management of disseminated intravascular coagulation (DIC). The remission rate was 86% (30/35 patients) in those who received heparin and 49% (39/80 patients) in those who received no heparin (P = 0.0002). This difference in remission rates was accounted for by a marked decrease in the number of haemorrhagic deaths, especially those due to intracranial haemorrhage (ICH), in the heparin treated group. Other factors associated with a poor remission rate were prothrombin ratio (PTR) greater than 1.3 (P = 0.008), fibrinogen less than 1.5 g/l (P = 0.02) and WCC greater than 2.0 x 10(9)/l (P = 0.03).

Acute Disease↗
PubMed1988

Allograft versus autograft bone in scoliosis surgery.

The results of a study of the use of autograft versus allograft bone in the surgery of idiopathic adolescent scoliosis are presented. Two groups of patients, matched for age, sex, level and angle of curve, received bone grafts, 20 patients having autogenous bone from the iliac crest and the other 20 having donor bone from a bone bank. Both groups had otherwise identical posterior fusions and Harrington instrumentation. There was no difference between the two groups in a blind, radiographic assessment of bone graft mass at six months, nor in maintenance of the curve correction over the same period. No major operative complications nor failures of instrumentation were encountered. There was, however, a marked reduction in operative time and blood loss in the patients receiving donor bone and also a much lower incidence of late symptoms relating to the operative sites. We conclude that, even in the presence of adequate iliac crest, the use of bank bone is superior for grafting in idiopathic scoliosis surgery.

Adolescent↗
PubMed1988

The management of congenital dislocation of the hip in the newborn.

We describe the results of a policy of highly selective splintage for CDH, using knee plasters. No child suffered because splintage was withheld. In those who were treated the results were satisfactory and the proportion who required a subsequent operation was extremely low. Avascular necrosis was not a significant problem. The method, although a little more time consuming, appears to offer significant advantages over current alternatives.

Hip Dislocation, Congenital↗
PubMed1988

Diagnosis and management of intestinal endometriosis. A report of five cases.

Five cases of intestinal endometriosis presented with infertility and pelvic pain. Rectal bleeding occurred in two patients and diarrhea in one. A diagnosis was achieved with a barium enema study and colonoscopy. All the patients had pelvic endometriosis as documented by laparoscopy. Endometriosis was present in the sigmoid colon in three patients and in the cecum in one; it was pericecal in the fifth. Bowel resection and pathologic study are necessary to relieve the symptoms and avoid neglecting a malignant tumor or other lesions.

Adult↗
PubMed1987

State of the art in comparative cancer clinical trials.

In order to investigate the current state of the art in clinical cancer research, a survey of comparative cancer clinical trials was conducted using a MEDLINE literature search of the 6-month interval from July to December of 1985. Data were obtained primarily from the published abstracts. The major observations from the study are as follows. First, trials in cancer research are published in an extraordinarily wide range of journals covering most of the major medical specialties in addition to the many cancer specialty journals. Second, randomization is now used quite extensively. It is the predominant method of control in chemotherapy trials and in trials reported in cancer journals. However, its use is much less common in other specialties, especially surgery, so efforts to popularize randomization in these specialties would be beneficial. Third, sample sizes are highly variable, and the median sample size (96 patients) is too small to reliably detect and evaluate moderate treatment advances. Finally, our survey reveals that published trials show an inordinately large proportion of breakthroughs in treatment compared with the generally accepted view that only slow progress is being made in developing effective cancer treatments. Our view is that this result reflects the strong tendency to publish only studies with positive results. This hypothesis is supported by the fact that in nonrandom trials there tend to be more positive conclusions and an absence of a strong association between conclusions and sample size.

Clinical Trials as Topic↗
PubMed1986

The application of flow cytophotometry in measurements of cell adhesion.

A common approach to the study of cell substrate interactions is the measurement of the attachment of cells to different substrates or to cultured cell layers. The evaluation of attachment is made either by scintillation counting of previously labelled adhering cells, or by light microscopy using the criterion of cell shape, sometimes refined by automatic image analysis. These methods have many drawbacks. This paper suggests the use of fluorescence-activated flow cytophotometry, (FC) which yields direct counts of the non-adhering cells. These "free" cells are removed after completion of the adhesion experiment from the microtitre plate wells. An internal standard, in the form of fluorescent polystyrene beads is added, allowing evaluation of the percentage of cells adhering to the well walls. Flow cytophotometry then produces data based on the analysis of large populations of cells. Unequivocal discrimination is obtained between the counted cells and counted fluorescent beads eliminating counting errors. The results can be processed on line by computer. A suspension of mouse splenocytes was used for the evaluation of the overall error of the method arising from inaccuracies in pipetting, interference of glutaraldehyde with ethidium bromide (EB) staining and instrumental error. Each adhesion experiment was terminated by staining and post-fixation and it was established that this introduces no change in cell counting, in comparison with the original unfixed cells. Prefixation, however, quenches the EB staining and would interfere with the counting procedure. The overall standard error of the technique was found to be 5%-10%.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Lateralized brain damage, sex differences, and the Wechsler Intelligence Scales: a reexamination of the literature.

Recent reviews have suggested that males and females show different patterns of intellectual impairment following lateralized brain injury. As the percentage of males in such studies increases, the magnitude of the difference between Verbal and Performance IQs increases. The present review reexamines this literature. Although the association between patient sex, pattern of intellectual deficit, and lateralized brain injury is reconfirmed for studies which used the Wechsler-Bellevue Intelligence Scale, there was no such relationship in those which used the more recent Wechsler Adult Intelligence Scale. In addition, it is shown that, in studies which used the former measure, the percentage of males may be highly correlated with other variables, a relationship which could have an effect on the pattern of intellectual loss following brain injury.

Adult↗
PubMed1983

Adjuvant chemotherapy with doxorubicin (Adriamycin) and 5-fluorouracil in T3, NX, MO bladder cancer treated with radiotherapy.

Radical radiotherapy alone has been compared with radical radiotherapy followed by chemotherapy using doxorubicin (Adriamycin) and 5-fluorouracil in a randomised prospective study on 129 patients presenting with T3, NX, MO transitional cell carcinoma of the bladder. One hundred and ten patients were evaluable with a minimum follow-up of 2 years. The addition of this form of chemotherapy did not appear to influence the survival rate or the proportion of patients free from tumour. It cannot be recommended for routine use in the primary treatment of infiltrating bladder cancer.

Carcinoma, Transitional Cell↗
PubMed1983

The gill withdrawal reflex is suppressed in sexually active Aplysia.

In Aplysia, the central nervous system and peripheral nervous system interact and form an integrated system that mediates adaptive gill withdrawal reflex behaviours evoked by tactile stimulation of the siphon. The central nervous system (CNS) exerts suppressive and facilitatory control over the peripheral nervous system (PNS) in the mediation of these behaviours. We found that the CNS's suppressive control over the PNS was increased significantly in animals engaged in sexual activity as either a male or female. In control animals, the evoked gill withdrawal reflex met a minimal response amplitude criterion, while in sexually active animals the reflex did not meet this criterion. At the neuronal level, the increased CNS suppressive control was manifested as a decrease in excitatory input to the central gill motor neurons.

Action Potentials↗
PubMed1977

Malignant round-cell tumours of bone: an analytical histological study from the Cancer Research Campaign's bone tumour panel.

A study of 40 cases of malignant round-cell tumour of one was made from the files of the Cancer Research Campaign's Bone Tumour Panel. Five pathologists made a careful study of observer error, involving repeated examination of routine paraffin sections, to determine whether the cases were a homogeneous group or a collection of differing sub-groups. Cell outline, nuclear staining, nuclear pleomorphism, conspicuous nucleoli, reticulin pattern and intracellular glycogen were the histological features selected for study. For each feature, the results were analysed to assess the importance of differences between tumours, between samples of tissue from the same tumour, and between observers. It is concluded that round-cell tumours of bone are a heterogeneous group, although completely distinct sub-groups could not be identified. Certain histological features tend to be associated, and it is reasonable to distinguish on histological grounds between Ewing's sarcoma and reticulum-cell sarcoma, although some tumours are not typical of either group.

Age Factors↗
PubMed1976

A modification of the Johnson-Neyman technique comparing two regressions, applied to treatment effects dependent on baseline levels.

Treatment effects can often depend on baseline (pre-treatment) variables. This is ignored in many studies, or else the relationship is removed statistically by analysis of covariance. The latter method, however, assumes that slopes are equal and also loses information on the base-line contribution. Instead, the Johnson-Neyman technique does not assume that slopes are equal and furthermore permits examination of the baseline contribution. The method was devised for education research and is here extended to biological studies. However, the method assumes that variances are equal for the regressions, which might not be always so. The mmodification proposed accommodates inequalities of variance, whether intrinsic to the regressions or resulting from differences in group size. The Johnson--Neyman technique is discussed in relation to alternative analyses and, in appropriate situations, is considered to yield more information. Furthermore, with the refinement described, it involves even fewer assumptions and becomes more powerful.

Biology↗
PubMed1976

23. The long-term care component of the Massachusetts Cooperative Health Statistics Program.

The Office of Health Planning and Statistics of the Massachusetts Department of Public Health, with the support of the National Center for Health Statistics, has over the past two years established two data programs in long-term care. The first of these involves experimentation with large-scale collection of patient-specific data from long-term care facilities, with the goal of developing statistically valid algorithms to predict the most appropirate level of care for individual patients. The second program has been the development of a data base for home health care agencies, the elements of which are an agency-specific annual statistical report and a patient-specific discharge abstract program. These two programs mark an effort to document home health care activities so as to provide a base of information for program development and evaluation.

Home Care Services↗