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Biomedical subjects

M Delgado

Publications and source records attributed to M Delgado.

At least 199 records · Page 11Linked to original sources
PubMed1983

Efficacy of and errors in randomized multicenter trials. A review of 230 clinical trials.

An attempt was made to study the efficacy in and one of the errors of randomized multicenter clinical trials. Efficacy was defined for the present purpose as a statistically significant clinical difference between at least 2 of the treatment arms studied. The error studied was defined here as non-excluded protocol deviations found during a systematic record review. The nature (multicenter randomized trial or un-controlled pilot study) of 8 so-called "breakthrough" studies which seemed particularly important for future cancer treatment was also established. The number of yearly randomized trials seems to have increased by a factor of 10 between 1969 and 1981, as judged by the abstracts published by the American Society of Clinical Oncology. 23% yielded statistically significant results, which is 18% over the 5% expected chance significances. Of 174 papers and abstracts published by one group, only 18 were reviewable original studies. The corresponding figures for another group was 6 of 22. This explains why only 8 scientifically new statistical significances were found in one series of 76 original articles. The mean dose of cytostatics actually given to 192 breast cancer patients varied, as judged by a record review, between 71 and 93% of the protocol doses. These figures agree with the 15-30% of nonexcluded protocol deviations found previously. Of the 8 "breakthrough" studies, 7 were single center pilot studies without randomized controls, and only 1 was a randomized multicenter study. It is suggested that more relevant questions can be asked in multicenter randomized clinical trials if they are based on promising single center pilot results, and that record reviews should be performed so that protocol deviations can regularly be reported.

Antineoplastic Agents↗
PubMed1982

[Aclacinomycin-A in acute leukaemias and leukaemic non-Hodgkin lymphomas (author's transl)].

Aclacinomycine-A (ACM), a new anthracycline derivative, was administered intravenously to 50 patients in doses of 10-30 mg/m2/day for periods of 6 to 30 days. Among the 45 patients who could be assessed, 17 were suffering from acute myeloid leukaemia, 19 from acute lymphoid leukaemia and 9 from non-hodgkin lymphoma. The results confirmed those first published by the authors in 1978 and led them to propose new measures aimed at reducing the toxicity of ACM. Depending on the dosage, complete or partial (more than 50%) remissions were obtained in patients with acute myeloid leukaemia. In the 19 patients with acute lymphoid leukaemia, complete remission was observed in 2 and partial remission in 2. Among the 9 patients with non-hodgkin lymphoma, there was 3 complete and 1 partial remissions. ACM did not produce alopecia and, as predicted by the authors' experimental study on hamsters, did not have major cardiac toxicity. The gastrointestinal toxicity, which had forced a reduction of the total dose in the first trial, proved moderate, even with normal dosage.

Aclarubicin↗
PubMed1982

[Results of 2 protocols in the treatment of acute lymphoid leukemia in children, according to prognostic factors].

Children with acute lymphoid leukemia (ALL) were treated according to two protocols. A group of 65 patients in which prognostic factors were no taken into account were treated with a combination of vincristine, asparaginase and prednisone to induce remission, followed by neuromeningeal prophylaxis with intraraquideal methotrexate and cranial irradiation with 2400 rads, two years maintenance therapy with 6-mercaptopurine and methotrexate, and then reinforcing chemotherapy, BCG scarification and injection of irradiated leukemic cell. No relapses were observed in the first 4.5 years. After 7.5 year, general survival was of 60 per 100, with 44 per 100 disease-free. A group of ALL children having a good prognosis were treated as indicated but adding adriamycin during the induction of remission and vindesine during the maintenance period. During the first three years no relapses were seen, and the general survival was 82 per 100, including a high proportion of disease-free children.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1980

Consultation to a Puerto Rican drug abuse program.

The increasing number of Hispanics residing within the United States requires the development of human service programs which are culturally and linguistically relevant to this population. The area of drug abuse is no exception to this need. However, the limited amount of resources targeted to serve drug-addicted Hispanics has required the development of innovative strategies to maximize existing resources. The development of collaborative programs for reaching Hispanic addicts and their families is one means of impacting on the needs of this group. This article delineates a collaborative effort between a Puerto Rican drug abuse program and a Hispanic component of a youth guidance center in Worcester, Massachusetts. This effort involved a series of joint undertakings focused on needs assessment, consultation, program development, and in-service training. In addition, a series of recommendations is made to assist other programs in developing comparable interagency projects.

Adult↗
PubMed1979

Strategic intervention: a mental health program for the Hispanic community.

Over the past three years the Worcester Youth Guidance Center has developed a series of mental health programs directed to the Hispanic community of Worcester, Massachusetts. The model for these programs has been that of strategic intervention. This approach was based upon knowledge gained from the literature and extensive exploratory contacts with key Hispanic leaders. The Center's Hispanic Program consists of five components: (1) community education and training. (2) clinical consultation, (3) program consultation, (4) research, and (5) clinical intervention and case management. This article describes these components in detail and presents a rationale for strategic intervention.

Allied Health Personnel↗
PubMed1979

Formal education and intellectual functioning in the immigrant Cuban elderly.

Formal educational experience during childhood and adolescence is an important modifier of intellectual functioning in North American elderly populations. The culture-independence of this relationship was examined with 31 immigrant Cuban elderly men and women who received their education in Cuba. The amount of formal education was significantly related to performance on measures of classification, combinatorial analysis (males only), hypothesis testing, and matrices. An index of fluid intelligence (matrices) also was significantly related to performance on the classification and hypothesis testing tasks. All participants conserved both liquid and mass, thus showing no regression on these two concerete operational tasks.

Aged↗
PubMed1979

Herbal medicine in the Puerto Rican community.

This article focuses on one aspect of health in the Puerto Rican community in the United States--the continuing utilization of herbal medicine and folk healers in the prevention and cure of illness. In addition to providing a fundamental explanation of this system of healing, the author makes recommendations for increasing the satisfaction of Puerto Rican patients with health care services.

Attitude to Health↗