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Biomedical subjects

M P Davis

Publications and source records attributed to M P Davis.

At least 37 records · Page 2Linked to original sources
PubMed1996

Dose-intensive chemotherapy with etoposide-cyclophosphamide for advanced breast cancer. North American Marrow Transplant Group.

Bone marrow and extensive bone involvement have limited the use of chemotherapy with stem cell support for treatment of women with metastatic breast cancer. The toxicity and efficacy of dose-intensive chemotherapy were studied using etoposide and cyclophosphamide without a stem cell support regimen for women with advanced breast cancer. The regimen was well tolerated, with treatment-related mortality similar to dose-intensive therapy with stem cell support. The overall 58% response rate is comparable to the response rate with dose-intensive chemotherapy regimens using stem cell support. The extent of disease, responsiveness to standard therapy, and dose of etoposide affected the response rate. Hematopoietic recovery was fairly prompt and was generally unaffected by the use of hematopoietic growth factors or the presence of breast cancer cells in the marrow. The use of stem cells or recombinant human interleukin-3 (rhIL-3) in combination with recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) resulted in some benefit in neutrophil recovery. It was concluded that in many women with advanced breast cancer, a dose-intensive regimen of etoposide and cyclophosphamide results in response or stabilization of disease. Hematopoietic recovery, particularly platelet recovery, may be accelerated by a combination of rhIL-3 and rhGM-CSF.

Adult↗
PubMed1995

An unique model for the analysis of neuronal nitric oxide signaling: the leech CNS.

An hypothesis for the presence of nitric oxide synthase (NOS) and the involvement of nitric oxide (NO) in neuronal signaling in the leach (Hirudo medicinalis) CNS is based on (i) the presence of fixative resistant NADPH-diaphorase (NADPH-d) in a specific neuronal population in the segmental ganglion; (ii) direct measurements with NO-sensitive electrodes giving an estimated NO concentration of 400-600 nM; (iii) biochemical assay for NOS using L-arginine/L-citrulline conversion in the CNS which gave a comparable value to that of the rat cerebellum and (iv) specific pharmacological effects of the NO precursor L-arginine and a NOS inhibitor (NG-Nitro-L-arginine) in modulation of chemical connections between NADPH-d-positive and NADPH-d-negative neurones. The very high value of estimated NO concentration and NOS activity and the relatively small number of putative NOS-containing (NADPH-d-positive) cells, including identified sensory (N, P, T cells), motor (AE) and interneurones (151) with known monosynaptic connections, make these neurones an ideal preparation on which to study the possible effects of NO on synaptic interactions.

Animals↗
PubMed1992

Phase II evaluation of piroxantrone in renal cell carcinoma. A Southwest Oncology Group Study.

The Southwest Oncology Group (SWOG) studied the response rate and toxicity of piroxantrone (150 mg/m2 q 21 days) in patients with advanced metastatic renal cell carcinoma. Among 32 eligible patients, there were no partial nor complete responses. There were two mixed responses. Significant white cell toxicity, anemia, nausea, and vomiting were observed. Mild or moderate degrees of fever, malaise, and stomatitis occurred. No significant cardiac toxicity was noted. Piroxantrone does not have significant activity as a single agent in advanced renal cell carcinoma.

Adult↗
PubMed1992

Partial purification and properties of an inducible uridine 5'-diphosphate-glucose-salicylic Acid glucosyltransferase from oat roots.

A salicylic acid (SA)-inducible uridine 5'-diphosphate (UDP)-glucose:SA 3-O-glucosyltransferase was extracted from oat (Avena sativa L. cv Dal) roots. Reverse phase high-performance liquid chromatography or anion exchange chromatography was used to separate SA from the product, beta-O-d-glucosylsalicylic acid. The soluble enzyme was purified 176-fold with 5% recovery using a combination of pH fractionation, anion exchange, gel filtration, and chromatofocusing chromatography. The partially purified protein had a native molecular weight of about 50,000, an apparent isoelectric point at pH 5.0, and maximum activity at pH 5.5. The enzyme had a K(m) of 0.28 mm for UDP-glucose and was highly specific for this sugar donor. More than 20 hydroxybenzoic and hydroxycinnamic acid derivatives were assayed as potential glucose acceptors. UDP-glucose:SA 3-O-glucosyltransferase activity was highly specific toward SA (K(m) = 0.16 mm). The enzyme was inhibited by UDP and uridine 5'-triphosphate but not by up to 7.5 mm uridine 5'-monophosphate.

Journal Article↗
PubMed1992

Assessment of aerobic power in chronic pain patients before and after a multi-disciplinary treatment program.

Physical exercise is widely used in the treatment of chronic pain patients, and direct measurement of physical capabilities is needed to objectively document change. In this study, 46 residential chronic pain patients undergoing treatment at a multidisciplinary rehabilitation center were administered a cycle ergometer graded exercise test, using a Medical Graphics CAD/NET exercise system, to measure aerobic fitness and other physiological parameters before and after the four-week treatment program. Patients evinced highly statistically significant changes in all major indices of cardiopulmonary functioning, including MAXVO2 and METS, and a measure of lower body power (WATTS). Possible mechanisms underlying such dramatic changes in this short time period include improved physical fitness, learning or desensitization to symptoms associated with exertion, and improved effort. Documenting treatment-related changes is important, and metabolic exercise testing provides an objective method for assessing changes in functional capacities. Such changes may have important practical implications for these individuals. The importance of assessing and improving aerobic fitness in chronic pain populations is discussed.

Adult↗
PubMed1990

The use of VP16 and cisplatin in the treatment of Merkel cell carcinoma.

A 70-year-old male with regionally recurrent Merkel cell cancer obtained a complete remission with three cycles of VP16 and cisplatin. His response was consolidated with local radiation therapy. Two additional patients have been reported to have responded to the same combination. Chemotherapy consisting of either cyclophosphamide, vincristine, and doxorubicin or VP16 and cisplatin should be considered in locally recurrent Merkel cell cancer.

Aged↗
PubMed1985

T-cell chronic lymphocytic leukaemia: anomalous cell markers, variable morphology, and marked responsiveness to pentostatin (2'-deoxycoformycin).

4 men with an unusual variant of T-cell chronic lymphocytic leukaemia are reported. The clinical features differed from the virus-associated T-cell disease reported from Japan, the Caribbean, and the southeastern United States. Cytology was pleiomorphic: cells with cerebriform nuclei resembling Sézary cells and lymphocytes with cytoplasmic granules resembling T-suppressor cells occurred in the same patients. Immunofluorescence studies with monoclonal antibodies suggested that the leukaemia cells expressed determinants of both helper- (OKT4+) and suppressor-(OKT8+) related antigens. The cells were TdT-negative. In all patients the disease was very refractory to conventional cytotoxic agents, but there was prompt and extensive response to the adenosine deaminase inhibitor pentostatin (2'-deoxycoformycin). This agent merits further study in the treatment of T-cell chronic lymphocytic leukaemia.

Adult↗
PubMed1985

Clinical characteristics and prognosis of 50 patients with a myeloproliferative syndrome and deletion of part of the long arm of chromosome 5.

Of 50 consecutive patients (30 female and 20 male; median age, 70 years) with a myeloproliferative disorder and a 5q- chromosome, 12 (24%) had refractory anemia, 16 (32%) had refractory anemia with excess blasts, 13 (26%) had acute nonlymphocytic leukemia, six (12%) had the 5q- syndrome, and three (6%) had an unclassifiable myeloproliferative disease. Twenty-five patients had only a 5q- anomaly (group 1), and 25 had a 5q- plus additional chromosome abnormalities (group 2). Four types of 5q- anomalies were recognized: a del(5)(q13q33) occurred in 39 patients, a del(5)(q31q35) in nine, a del(5)(q22q33) in one, and a del(5)(q13q35) in one. The survival distribution for patients in group 1 was significantly better (P = .012) than for those in group 2. Cox-model analyses indicated that having a 5q- chromosome and other abnormalities is significantly (P less than .01) associated with poor survival even after adjustment for the effects of other important factors such as type of disease, age, and sex. The two groups had similar distributions of most variables, including age, sex, and disease types. However, patients in group 1 had a significantly higher platelet count and mean corpuscular volume than those in group 2. Only two patients in group 1 had had prior chemotherapy, but nine in group 2 had had either prior chemotherapy or radiation or both, and one patient in group 2 had had heavy exposure to pesticides.

Adult↗
PubMed1984

Hematologic manifestations associated with deletions of the long arm of chromosome 20.

We investigated 20 patients with hematologic disorders who had a clone of cells with a deletion of most of a chromosome #20 long arm (20q-) in the bone marrow. Three patients had polycythemia vera (PV), 6 had acute nonlymphocytic leukemia (ANLL), 8 had preleukemia (PL), and 3 had other myeloproliferative disorders. In our laboratory, a 20q- chromosome is found in 6% of patients with PV, 3% of patients with ANLL, and 1% of patients with PL. Among the 6 patients with ANLL and a 20q- abnormality, 3 had erythroleukemia. There were no apparent clinical differences among our patients with 20q- chromosomes compared with other patients with similar disorders who did not have a 20q- chromosome. The breakpoint of the 20q- anomaly, in each instance, was in band 20q11, but it occurred near the centromere at 20q1101 in 16 patients and at the distal part of this band at 20q1109 in 4 patients. Three of the 4 patients with a breakpoint at 20q1109 had PL.

Aged↗
PubMed1984

Carcinosarcoma of the lung: Mayo Clinic experience and response to chemotherapy.

The clinical presentation, clinical course, and results of various treatment modalities of 17 patients with carcinosarcoma of the lung were reviewed. This group of patients was 0.2% of all Mayo Clinic patients with lung cancer who had been treated between 1971 and 1982. Most patients were men in the sixth decade of life who had a history of smoking. Ten of 17 neoplasms were located in the upper lobes. Noninvasive diagnostic tests had a low yield in detecting carcinosarcomas. Pulmonary resection with curative intent was performed in 15 of 17 patients; however, only 4 patients were alive at 6, 8, 28, and 39 months, respectively, postoperatively. The median survival was 1 year. Doxorubicin-based chemotherapeutic programs produced an objective response in two of four patients.

Adult↗
PubMed1983

Plasma and lipoprotein cholesterol and triglyceride concentrations in the Pima Indians: distributions differing from those of Caucasians.

Plasma and lipoprotein cholesterol and triglyceride concentrations were measured in Pima Indians, a genetically homogeneous population with a high prevalence of obesity and diabetes and a low frequency of coronary heart disease. The data for nondiabetic Pima Indians were compared with those of U.S. Caucasians measured during the Lipid Research Clinics Prevalence Study. Plasma total and low-density lipoprotein (LDL) cholesterol levels in Pima men older than 30 years of age and in women over 25 were lower than those of U.S. Caucasians, and in men the total and LDL cholesterol levels did not increase with age. In Pima male subjects of all ages high-density lipoprotein (HDL) cholesterol levels were lower than that in Caucasian male subjects, and in Pima female subjects HDL cholesterol levels averaged 11 mg/dl lower than those in female Caucasian subjects. On the other hand, plasma triglyceride levels in Pima male subjects up to 35 years of age and in female subjects up to 55 years old were higher than those of Caucasians. Comparison of plasma cholesterol and triglyceride levels in Pima male and female subjects showed the same relationships as those in Caucasians (i.e., higher in male subjects until the older age groups), but Pima male and female subjects had similar HDL cholesterol levels. There was a strong negative correlation between obesity and HDL cholesterol levels in Pimas. Obesity appeared to account for the lower HDL cholesterol levels in Pima male subjects compared with that in Caucasian male subjects, but obesity could not explain the lack of differences between the sexes in HDL levels in the Pimas. Triglyceride levels correlated positively with obesity in the Pimas, but the relationship was not as strong as that reported for Caucasians. The results indicate that there are differences in lipoprotein distributions between Pimas and U.S. Caucasians; the relationship between lipoprotein levels and the incidence of coronary disease in the Pimas must be determined.

Adolescent↗
PubMedDate not supplied

The business of palliative medicine: management metrics for an acute-care inpatient unit.

For any palliative medicine inpatient unit to be economically viable, certain management metrics need to be followed. Palliative medicine can provide both a compassionate and economical service within the current acute inpatient hospital environment. In this article, we will review the administrative and financial factors we have identified that influence the business of acute palliative medicine.

Commerce↗
PubMedDate not supplied

Mirtazepine: heir apparent to amitriptyline?

"What's new in therapeutics?" will examine and evaluate drugs that may have a place in hospice, palliative, and long-term care. Mirtazepine will be examined and evaluated. Mirtazepine is a potential alternative anti-depressant with multiple additional benefits. It is an atypical anti-depressant, which has both noradrenergic and specific serotonergic receptor antagonism (NaSSa), and a unique pharmacological profile. Mirtazepine appears to be a "designer drug" for palliative medicine with a number of benefits, but cost may be a drawback.

Amitriptyline↗
PubMedDate not supplied

Methadone-induced myoclonus in advanced cancer.

Methadone is recommended as being free of some of the neuropsychological side effects noticed with morphine, which are attributed to active metabolites. A patient that received methadone for cancer-associated pain developed myoclonus as a side effect. This has rarely been reported before in the literature. The pathophysiology and management of myoclonus are discussed.

Analgesics, Opioid↗