Search PubMed⌕ Search

Biomedical subjects

M Hansen

Publications and source records attributed to M Hansen.

At least 289 records · Page 16Linked to original sources
PubMed1987

Urinary tract infections in connection with transurethral resection of the prostate.

The study evaluates the incidence and consequences of infectious complications after 700 transurethral resections of the prostate. The patients were treated individually for bacteriuria according to urine cultures. No general antibacterial prophylaxis was used. 376 patients (54%) had negative urine cultures throughout the course and received no antibacterials. Of the 256 patients with an indwelling catheter before surgery only 64 (25%) had negative cultures throughout, as opposed to 312 (70%) out of 444 patients without an indwelling catheter preoperatively. Antibacterial treatment was given to 127 patients (18%) before surgery because of bacteriuria. Positive urine cultures postoperatively indicated antibacterial therapy to 197 patients (28%). Four non-fatal cases of septicemia were recorded. The influence of bacteriuria and indwelling catheters on the postoperative course and on the length of hospital stay is documented. It is concluded that antibiotic prophylaxis may be indicated in patients with a preoperative urethral catheter; other patients should be treated if and when bacteriuria occurs.

Aged↗
PubMed1987

Use of blood in transurethral prostatectomy--routine or selective cross-matching?

In our series of 700 transurethral resections of the prostate 464 patients (66%) received no blood transfusions, while 121 patients (17%) received two or more units of blood. A significant relationship was demonstrated between the size of the prostate and the estimated blood loss, as well as between the presence of a preoperative urethral catheter and the blood loss.

Aged↗
PubMed1986

Detection of bone marrow relapse in patients with small cell carcinoma of the lung.

From a total of 874 patients with small cell lung cancer (SCC), a series of 104 patients were reviewed to determine if bone marrow relapses are detectable by routine clinical investigations. Autopsy, including microscopical bone marrow examination, was performed in all the 104 patients and bone metastases were disclosed in 36 patients (35%). After retrospective evaluation it was concluded that dose modification, occurrence of leukopenia plus fever, need of blood transfusion, leukopenia, and thrombopenia during treatment all were without predictive value in the detection of bone marrow relapse. Increased concentrations of lactate dehydrogenase and alkaline phosphatase were, however, positively correlated to the finding of bone marrow relapse.

Adult↗
PubMed1986

Influence of surgical resection prior to chemotherapy on the long-term results in small cell lung cancer. A study of 150 operable patients.

The effect of surgical resection, prior to chemotherapy, on the long-term results obtained in treatment of operable patients with small cell lung cancer (SCC) was evaluated in a consecutive series of 874 patients treated with intensive combination chemotherapy with or without irradiation between 1973 and 1981. Evaluation of disease stage and operability was based on broncho-mediastinoscopy, chest X-ray, bone marrow examination, peritoneoscopy with liver biopsy and lung function tests. The same staging procedures were applied for restaging performed after 18 months of chemotherapy. The series comprised 440 patients with extensive disease and 437 with limited disease of whom 150 were regarded operable. Fifty-four operable patients received no thoracotomy because the treatment policy of SCC did not include surgery at the hospitals from which they were referred. These patients served as a reference with which data on operated patients were compared. Resections were performed in 52 patients while 44 were regarded to be irresectable at the thoracotomy. Thirty-six resections were regarded histologically complete while 16 patients proved to have microscopic (9 pts) or macroscopic (7 pts) residual tumor. The number and per cent of 30 months disease-free survivors in the various categories of the 874 patients were as follows: Completely resected, 12/36 patients (33%); Resected with residual tumor, 2/16 (12.5%); Operable but non-operated, 7/54 (13%); Irresectable, 3/44 (6.8%); Non-operable patients with limited disease, 15/284 (5.3%) and with extensive disease, 11/440 (2.5%). The similarity between rates of long-term survival observed in resected patients with residual tumor and operable, non-operated patients suggests that resection, per se, has no significant influence on long-term results in SCC. The relatively high rate of long-term survival in completely resected patients may therefore primarily be a result of early stage disease at the initiation of chemotherapy.

Carcinoma, Small Cell↗
PubMed1986

Primary resistance of renal adenocarcinoma to 1,2,4-triglycidylurazol (TGU, NSC 332488), a new triexpoxide cytostatic agent--a phase II study of the EORTC early clinical trials group.

Fourteen patients with metastatic renal adenocarcinoma without prior chemotherapy were treated with 1,2,4-triglycidylurazol (TGU, NSC-332488), a new triepoxide alkylating agent. TGU was chosen for this study among other triepoxides because of its high antitumour activity in animal models, its relatively good water solubility and the expected favourable therapeutic index. The starting dose was 800 mg/m2 i.v. (600 mg/m2 for patients with prior extensive radiotherapy) every 4 weeks. No objective tumour regression was seen in this favourable group of patients. Leuko- and thrombocytopenia were the most important side-effects. Severe cumulative and prolonged thrombocytopenia was seen. Other toxicities observed were nausea with or without vomiting in all patients and local phlebitis in some.

Adenocarcinoma↗
PubMed1986

Chemotherapy versus chemotherapy plus irradiation in limited small cell lung cancer. Results of a controlled trial with 5 years follow-up.

One hundred and forty-five patients with limited stage small cell lung cancer were included in a randomized trial to evaluate the effect of chemotherapy with or without chest irradiation. Seventy-six patients were allotted chemotherapy alone while 69 patients received the same chemotherapy plus radiotherapy, 40 Gy in split-course, administered in weeks 6 and 10 after the initiation of chemotherapy. The chemotherapy consisted of lomustine, cyclophosphamide, vincristine and methotrexate. Patients treated with chemotherapy alone survived for a median of 52 weeks compared to 44 weeks in patients receiving the combined regimen (P = 0.055). After exclusion of five early deaths and one patient refusing the irradiation plus 14 completely resected patients, the remaining 65 patients receiving chemotherapy alone and the 60 patients treated with chemotherapy plus radiotherapy were included in a new analysis. The difference in survival duration which could be ascribed to treatment with or without chest irradiation thereby diminished (P = 0.24). Eighteen months' disease-free survival was obtained in 9.2% of the 65 patients and in 9.8% of the 60 patients. The complete remission rates were 37% and 46%, respectively, (P = 0.33) and the median durations of complete remission were 40 weeks and 52 weeks (P = 0.67). Treatment failure of the primary tumour occurred in 85% of patients treated with chemotherapy alone in contrast to 61% of patients receiving the combined regimen (P = 0.005). Seventy-nine of these patients underwent autopsy at which no residual chest disease was observed in 17% and 37%, respectively (P = 0.045). The combined regimen was more toxic than chemotherapy alone resulting in significantly greater dose reductions and more pronounced thrombocytopenia. Lung and pericardial fibrosis was responsible for four deaths among the complete responders in the radiotherapy group. The combined regimen thus tended to be more efficacious with respect to tumour control at the expense, however, of increased toxicity which per se, eliminated a potential improvement of the overall therapeutical results.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Teniposide (VM-26), an overlooked highly active agent in small-cell lung cancer. Results of a phase II trial in untreated patients.

Teniposide, VM-26 (Vumon), was administered in a dose of 60 mg/m2 on days 1 to 5 every third week to 36 patients with histologically confirmed small-cell lung cancer. None had previously received chemotherapy or radiotherapy. The median age was 73 years (range, 52 to 79). Thirty-three patients were evaluable; 21 of these had local disease. Five patients had bone marrow metastases, four had liver involvement, and one CNS metastases. All patients had a performance status less than or equal to 2 before the start of treatment. Thirty patients obtained a response (90%), ten of whom had a complete remission (30%). The median duration of remission was 8+ months (range, 1.1 to 17+ months), whereas the median survival was 8.7 months (range, 1.9 to 20 months). Toxicity was primarily hematologic, with leukopenia the only dose-limiting effect. Besides alopecia, all other side effects were minimal including nausea and vomiting. We find these results provocative in regard to the response rate and the duration of response obtained as well as in reference to the dismal results that prior investigations in previously treated patients have shown. These data may indicate the need for reconsideration of the usual strategy for performing phase II trials.

Aged↗
PubMed1986

Mortality and morbidity in long-term surviving patients treated with chemotherapy with or without irradiation for small-cell lung cancer.

Mortality and morbidity was investigated in a consecutive series of 72 patients with small-cell lung cancer (SCLC) who were found to be disease-free at restaging after 18 months of treatment. These patients were all the long-term survivors among 874 patients included in one of six trials between 1973 and 1981. All studies used combination chemotherapy with or without irradiation. Follow-up of the patients varied between 4 and 11 years. The estimated 5-year survival rate subsequent to discontinuation of therapy was 0.24, corresponding to a death rate of 0.25 per year or ten times greater than the expected mortality for persons of the same age group. This high mortality was primarily related to recurrent SCLC, the estimated cumulative risk of relapse reaching 46% at the time of the latest recurrence 5 years from diagnosis. The risk of relapse was generally independent of the pretreatment disease stage although it was reduced in patients with resectable disease and was greater in those with pretreatment liver or bone marrow metastases. Equal risks of relapse were related to the use of regimens with and without radiotherapy. The cumulative risk of relapse in patients surviving 3 years from initiation of the treatment was less than 15% and accordingly, 3 years of follow-up seems sufficient for comparison of long-term results obtained in different trials. The second factor resulting in death or disease was second cancer, for which the cumulated risk increased to 32%, the latest occurring 5.4 years from the diagnosis of SCLC. Five of these cases were non-small-cell lung cancers and three were secondary leukemias. The estimated mortality related to non-neoplastic conditions was just significantly greater than expected. In spite of the increased mortality in this series, 38 of 54 2-year disease-free survivors and 20 of 22 5-year survivors resumed a lifestyle similar to that before diagnosis of SCLC.

Aged↗
PubMed1986

Long-term disease-free survival in small-cell carcinoma of the lung: a study of clinical determinants.

The influence of treatment and of pretreatment patient characteristics on the probability of long-term disease-free survival in small-cell lung cancer (SCLC) was investigated in a consecutive series of 874 patients. The patients were included in six controlled treatment trials from 1973 to 1981, using different combinations of chemotherapy with or without irradiation. All patients underwent pretreatment staging, including bronchoscopy, peritoneoscopy with liver biopsy, and bone marrow examination. The same procedures were repeated in patients without overt signs of disease 18 months from initiation of treatment, and patients without evidence of SCLC were regarded as long-term survivors. Seventy-two patients were disease-free at restaging, corresponding to 13% of 443 patients with limited-stage disease and 3% of 431 patients with extensive-stage disease. The possible relationship between different pretreatment variables and the probability of 18 months' disease-free survival was investigated by multiple regression analysis. Disease extent was the most important determinant of long-term survival. Being a woman was a positive factor and hypouricemia had negative influence on the long-term results, while features such as performance status and serum lactate dehydrogenase (LDH) did not have significant influence in the regression model. Differences between the efficacy of the applied treatment regimens were less in limited disease than they were in extensive disease, in which six-agent regimens of alternating chemotherapy was significantly better than treatment with three- or four-agent regimens. Accordingly, disease extent seems to be the most pivotal determinant of long-term survival in SCLC, but influence of the patient's sex and serum urate concentration should also be considered.

Adolescent↗
PubMed1986

Tumor markers in patients with lung cancer.

The most examined tumor markers in lung cancer patients are CEA, hormonal peptides, and some neurogenic enzymes in small cell carcinoma. Calcitonin, ACTH, ADH, CEA, neurophysin, oxytocin, beta-endorphin, neuron-specific enolase, and CK BB are elevated in serum specimens in 25-75% of cases of small cell carcinoma. The level of these markers is related to the stage of the disease in groups of patients; elevated pretreatment levels decrease with tumor regression. Marker levels are not valid in defining the tumor load and the presence of disease in the individual patient. It has not yet been documented that the markers can be used for clinical decisions on antineoplastic therapy. A recent development is the finding that measurement of CSF and plasma concentrations of ADH, calcitonin, CK BB, bombesin, and neuron-specific enolase may contribute in the diagnosis of CNS metastases including meningeal carcinomatosis.

ACTH Syndrome, Ectopic↗
PubMed1986

Isoelectric focusing of rabbit transcobalamin from serum and cerebrospinal fluid.

Isoelectric focusing in agarose gel separated rabbit transcobalamin into five to eight isopeptides with isoelectric point (pI) 5.4-6.8. Three different sets of patterns were observed in serum samples from 34 rabbits and in cerebrospinal fluid samples from 10 rabbits as a given pattern in serum corresponded to a given pattern in cerebrospinal fluid. Serum contained higher substance concentrations of acidic isopeptides than cerebrospinal fluid. No correlation was found between the isopeptide patterns and the unsaturated cobalamin-binding capacity. The unsaturated cobalamin-binding capacity of cerebrospinal fluid was high in relation to the protein concentration (0.5-1.3 nmol/l) compared to that of serum (6.6-22.8 nmol/l). The data suggest synthesis of transcobalamin into the cerebrospinal fluid.

Animals↗
PubMed1986

Cerebral effects of scalp cooling and extracerebral contribution to calculated blood flow values using the intravenous 133Xe technique.

With the intravenous 133Xe technique we measured cerebral blood flow (CBF) in eight healthy subjects during normal subcutaneous temperatures and during extracranial cooling. This gave rise to the possibility of evaluating the contribution of the extracerebral blood flow to the calculation of CBF values. With a two-compartmental analysis of the wash-out curves during cooling there was a significant reduction of the CBF indices f1, representing mainly fast blood flow in the grey matter and f2, representing blood flow in the slowly perfused white matter and extracerebral structures. The reduction of f1 was due to the 'slippage' phenomenon:calculation of f1 was affected by a reduction in f2 due to a considerably reduced extracerebral blood flow. The initial slope index (ISI) calculated from 30 to 90 s of the first part of the presumed mono-exponential 133Xe wash-out curve was not affected by slippage as the ISI remained unchanged in spite of reduced extracerebral blood flow. It is concluded that CBF was unaffected by extracranial cooling. Extracranial cooling can be used to reduce the extracerebral blood flow contribution to the calculated CBF values.

Adult↗
PubMed1986

Psychological evaluation and support in the pediatric intensive care unit.

This article has discussed the role of the psychological consultant in the PICU. New advances in critical care treatment have created the need for a greater awareness of psychological issues that affect the medical management of children, and the emotional impact on their families. Psychological consultation can assist in clarifying and addressing these issues by identifying and evaluating the stressors impinging on the patient, and implementing or directing appropriate interventions. This intervention may also entail assistance to the family and care providers in coping with intense and emotionally sensitive issues.

Child↗