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Biomedical subjects

Q S Ringenberg

Publications and source records attributed to Q S Ringenberg.

36 records · Page 2Linked to original sources
PubMed1988

Phase II trial of 4'-deoxydoxorubicin (DxDx) in non-small cell lung cancer: a Cancer and Leukemia Group B Trial.

Eighty-seven patients with histologically or cytologically proven non-small-cell carcinoma of the lung were treated with 4'-deoxydoxorubicin (DxDx) 30 mg/m2 every 3 weeks. Three responses (4%), all partial, were observed. All responses occurred in patients with large-cell anaplastic lung cancer and none in squamous or adenocarcinoma histologies (P less than 0.01). The durations of partial response for these three responders were 70, 198+ and 209+ days. The side effects noted were predominantly neutropenia, anemia, and weight loss. In three patients, declines in cardiac ejection fraction of 7%, 12%, and 23% occurred after cumulative drug doses of 150 mg/m2, 150 mg/m2, and 233 mg/m2, respectively. 4'-Deoxydoxorubicin had little activity in non-small-cell lung cancer at the dose used in this study.

Carcinoma, Non-Small-Cell Lung↗
PubMed1988

Postmastectomy educational needs and social support.

Due to shorter hospitalization periods and changes in surgical procedures, breast cancer patients have less inpatient contact with rehabilitation resources. A questionnaire related to educational needs and social support was mailed statewide to 2,000 postmastectomy women who had received a Reach to Recovery visit. The findings are based on quantitative data reported by 933 women and from 27 women in follow-up interviews. Respondents ranked their educational needs in six categories from greatest to least importance as follows: (1) information about breast cancer, (2/3) personal hygiene/exercise and nutrition/weight control (both ranked of equal importance), (4) prosthesis/clothing information, (5) social support, and (6) sexual issues. Performance on the knowledge assessment correlated directly with the amount of educational experience and inversely with age. Respondents who lived in communities of less than 2,500 were less informed than those from other locations. Participation in formalized support groups was infrequent (11%). The major source of information was the media, with 88% indicating they would watch television programs about breast cancer. Thirty-three percent of the respondents indicated they owned a video cassette recorder (VCR); about 93% said VCRs were available for rent in their community. Work associates were identified as a group that encouraged information seeking; health care professionals were the most successful in motivating women to participate in support groups.

Adaptation, Psychological↗
PubMed1988

Breast cancer examination experience of medical students and residents.

A survey of fourth-year medical students and residents at three institutions revealed a low experience in examining patients with primary breast cancer. Although the experience was low, there was high confidence in their ability to examine the breast. Changes in learning experiences are necessary.

Breast Neoplasms↗
PubMed1988

Hematologic effects of heavy metal poisoning.

Heavy metal poisoning can cause a variety of hematologic disorders. Exposure to heavy metals is ubiquitous in the industrial environment and must be considered in the differential diagnosis of many types of anemia. The heavy metals most commonly associated with hematologic toxicity are arsenic and its derivative arsine, copper, gold, lead, and zinc. A few distinctive clinical features characterize the hematologic manifestations of many occult heavy metal poisonings. These features have a limited differential diagnosis. A knowledge of these clinical features can assist the astute clinician in making the correct diagnosis.

Anemia↗
PubMed1988

Management of cancer during pregnancy.

Although cancer during pregnancy is infrequent, its management is difficult for patients, their families, and their physicians. When termination of the pregnancy is unacceptable, decisions regarding the use of irradiation and chemotherapy are complicated by the well-known high risks of abortion and fetal malformation. This risk is concentrated in the first trimester and varies with the choice of chemotherapeutic agents or combinations of agents. There is only minimal evidence of increased risk of malformation or abortion in the second or third trimester. Recent progress in cancer therapy has made cure a reasonable goal, and for some malignant neoplasms, cure is still possible even when initial therapy is modified or delayed. When cure is a reasonable goal, curative therapy should not be compromised by modification or delay. When treatment for cure or significant palliation is not possible, however, the goal should shift to protection of the fetus from damage by the injudicious use of teratogenic cancer therapy. This report will review the available data that may assist in these difficult decisions.

Abnormalities, Drug-Induced↗
PubMed1988

The value of the physical examination in the diagnosis of anemia. Correlation of the physical findings and the hemoglobin concentration.

Certain clinical findings, such as pallor of the conjunctivae, nail beds, lips, oral mucosa, and palmar creases have traditionally been used by physicians in the diagnosis of anemia. We prospectively examined 50 patients to determine whether there was any correlation between these clinical findings and hemoglobin concentration. We noted a statistically significant correlation between hemoglobin concentration and the following: color tint of the lower eyelid conjunctiva, nail-bed rubor, nail-bed blanching, and palmar crease rubor. Results from our study support the contention that the presence and degree of anemia can be estimated clinically by careful physical examination.

Anemia↗
PubMed1987

Collecting cancer registry data with a Cancer Patient Questionnaire.

Tumor registries provide a valuable source of treatment, survival, and epidemiologic data but have been faulted for incomplete and insufficient collection of data. An eight page, 38-item Cancer Patient Questionnaire (CPQ) was developed to collect more extensive information for the tumor registry. The CPQ identified significantly more patients with a family history of cancer than had previously been detected by chart review by the tumor registrar. The CPQ agreed with data collected by the tumor registry in 96% of cases for place of birth, 84% of cases for occupational history, 91% of cases for tobacco use, and 88% of cases for number of pregnancies or live births. The Cancer Patient Questionnaire is complete and easy to use and may replace the chart review in the collection of these data.

Data Collection↗
PubMed1987

Efficacy of oral administration of etidronate disodium in maintaining normal serum calcium levels in previously hypercalcemic cancer patients.

As part of a multicenter trial of etidronate disodium for control of hypercalcemia in patients with malignancies, patients achieving normocalcemia within seven days after starting intravenous therapy with etidronate disodium plus saline were enrolled into a double-blind, placebo-controlled trial of oral etidronate disodium to maintain normocalcemia. By random assignment, patients received either oral etidronate disodium, 20 mg/kg/day, or placebo for up to three months. Efficacy was evaluated after 30 days of maintenance therapy: patients who were normocalcemic on day 30 were considered treatment successes. Of 81 patients who entered this phase of the study, 63 were evaluable for efficacy. Analysis of this group revealed that significantly (P less than 0.01) more patients in the etidronate disodium group (35%) than in the placebo group (6%) were normocalcemic at day 30. Life-table analysis of response indicated that patients treated with etidronate disodium maintained normocalcemia significantly (P less than 0.01) longer than did patients receiving placebo (median, 29 days versus 11 days). These results suggest that in patients whose calcium levels were normalized with IV etidronate disodium, oral etidronate disodium maintained normocalcemia significantly longer than no maintenance therapy in patients treated for hypercalcemia secondary to malignancy.

Administration, Oral↗
PubMed1986

Vascular toxicity associated with antineoplastic agents.

Vascular complications associated with antineoplastic agents are being reported with increasing frequency. Such vascular toxicity is clinically heterogeneous, ranging from asymptomatic arterial lesions to a fatal thrombotic microangiopathic syndrome. Mitomycin is most commonly implicated in the thrombotic microangiopathic syndrome, while bleomycin, either alone or in combination with a vinca alkaloid or cisplatin, appears to be an important cause of Raynaud's phenomenon. Acute arterial ischemic events, ie, myocardial infarction and cerebrovascular accidents, occur most frequently after cisplatin-based combination chemotherapy. Putative mechanisms for such toxicity include drug-induced endovascular damage, perturbation of the clotting system, platelet activation, an abnormality of thromboxane-prostacyclin homeostasis, autonomic dysfunction, vasculitis, and stimulation of fibroblasts. More than one mechanism may be operative in an individual patient. Better documentation of the incidence and types of vascular toxicity and studies to help elucidate the pathogenesis and management of such toxicity are needed.

Antineoplastic Agents↗
PubMed1986

Tumors of unknown origin in the bone marrow.

Tumors of unknown origin represent a common presentation of malignancy. However, tumors of unknown origin presenting as bone marrow metastases are infrequently reported. The records of 11,820 bone marrow biopsy procedures over a 15-year period at a university hospital and a veteran's hospital were reviewed, disclosing 25 cases of tumor of unknown primary site. Most of the patients were elderly and presented with bone pain or abdominal pain. Anemia, thrombocytopenia, and a leukoerythroblastic blood picture were common hematologic findings. Examination for detection of the primary site was usually unrewarding. The median survival of patients was very short (18 days) and therapy seldom altered survival.

Adenocarcinoma↗
PubMed1985

Tumors of unknown origin.

Tumors of unknown origin (TUOs) account for 3% of cancers and represent the eighth-most common cancer diagnosis. Although TUOs are commonly classified by their histological presentation, examination of the location of the metastases is equally important. When the histological type and location of metastases are both known, a finite number of common clinical syndromes emerge and one can predict the most common occult primaries.

Adenocarcinoma↗