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Martin Tattersall

Publications and source records attributed to Martin Tattersall.

8 recordsLinked to original sources
PubMed2005

The Cancode interaction analysis system in the oncological setting: reliability and validity of video and audio tape coding.

Cancode is a computerized interaction analysis system developed for cancer consultations. This paper assesses its reliability and validity, and compares the use of audio versus video tape; by assessing 30 consultations between an actor and 10 oncologists. Weighted Kappa inter- and intra-rater scores ranged from 0.5 to 1.0 and 0.58-1.0, respectively, and use of video tape did not alter verbal coding. Factor analysis of verbal codes revealed two factors, 'verbal control' and 'verbal support'. Verbal and non-verbal doctor behavior differed by patient type ('verbal support' P = 0.007, 'verbal control' P = 0.004, 'Responsiveness' P = 0.000, and 'Immediacy' P = 0.000). Inter-doctor variation was noted for 'verbal support' (P = 0.000) and 'Relaxation' (P = 0.000). 'Responsiveness' was negatively correlated with 'verbal support' (-0.58) and 'verbal control' (-0.65). Cancode is reliable, valid and sensitive to doctors behavioral changes. For a more passive patient, the doctor may switch from a 'cure' to 'care' oriented consult, responding to psycho-social instead of informational needs.

Adult↗
PubMed2004

Systematic review of the efficacy of antiemetics in the treatment of nausea in patients with far-advanced cancer.

OBJECTIVES: To systematically review studies of antiemetics used in the treatment of nausea in patients with far-advanced cancer. DATA SOURCES: Randomized controlled trials (RCT) and uncontrolled studies identified by electronic and hand searching. REVIEW METHODS: Identified studies were appraised for quality and effect size. RESULTS: Of 21 studies included, 2 were systematic reviews, 7 were RCT and 12 were uncontrolled studies or case series. Differences in interventions and outcomes amongst the RCT precluded any quantitative data synthesis and all seven studies were prone to bias. Whereas uncontrolled studies indicated a high response rate to standard regimens (75-93% for both nausea and vomiting), RCT showed much lower response rates to these agents (23-36% for nausea, 18-52% for vomiting). The two methods of antiemetic choice (choice based either on the inferred mechanism or empirical) were equally effective. There is reasonably strong evidence for the use of metoclopramide in cancer-associated dyspepsia and steroids in malignant bowel obstruction. There was conflicting evidence about the efficacy of serotonin antagonists compared with standard treatments (e.g. metoclopramide, dopamine antagonists and dexamethasone). There was little or no evidence of the efficacy of some commonly used and seemingly effective drugs such as haloperidol, cyclizine, and methotrimeprazine. CONCLUSION: Evidence supporting the existing consensus-based guidelines for management of nausea and vomiting in advanced cancer is sparse. Current approaches to treatment based on the neuropharmacology of the emetic pathway may be inappropriate in this setting. Well-designed studies of the impact of "standard" management and novel agents on nausea and vomiting in palliative populations are needed.

Antiemetics↗
PubMed2004

Interactions of a herbal combination that inhibits growth of prostate cancer cells.

PURPOSE: PC SPES is an eight-component herbal product marketed for the treatment of prostate cancer. The manufacturer of PC SPES claims that the herbal combination is a synergistic blend, but the purported synergy has never been tested. We examined the interaction in cell culture of these eight individual herbal components by the use of an isobologram. METHODS: US patent no. 5,665,393 (1997) for PC SPES was acquired, and each of the eight herbal components described was acquired, properly identified, and extracted by 95% ethanol. The extracts were tested for cytotoxicity to PC 3 human prostate cancer cells in culture by the MTT (3-[4,5-dimethythiazol-2-yl]-2,5-diphenyltetrazolium bromide) assay. Seven combinations of herbal extracts were made, varying in the proportion of the most cytotoxic herbal extract, that of Panax notoginseng. The interactions of P. notoginseng with the other seven herbs were evaluated through the use of an isobologram. RESULTS: In all seven herbal combinations, P. notoginseng was found to be antagonistic with the other seven herbal components in the cytotoxicity assay ( P values: 0.09, 0.12, 0.12, 0.33, 0.45, 0.56, and 0.76). CONCLUSIONS: The interaction between the most cytotoxic herbal component of a widely used herbal product and the other seven components was antagonistic. Herbal combinations are no different from traditional combination pharmacotherapy. If herbal combinations are able to achieve antagonism, then theoretically they can achieve synergism if combined properly.

Cell Division↗
PubMed2003

Developments in drug delivery: implications for cancer care.

Changes in drug delivery as well as new drug development have impacted on cancer care in the past twenty years. Several modified release chemicals now have a role in cancer care, and new routes of drug delivery have been established as part of standard care. A range of strategies has been investigated to enhance anti-tumor selectivity of drugs including antibodies, liposomes and carrier molecules homing or activated in the environment of tumors. Fixed drug combinations are also used in cancer supportive care, and may find use in a range of settings.

Antineoplastic Agents↗