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Biomedical subjects

S J Pocock

Publications and source records attributed to S J Pocock.

At least 127 records · Page 7Linked to original sources
PubMed1977

Variation in the incidence of diverticular disease within the city of Edinburgh.

An estimate of the incidence of diverticular disease of the colon was based on all the barium enema examinations in Edinburgh over four years (12 335 cases); using the census data for 1971, incidence rates for the city by age, sex, and electoral ward were calculated. The overall annual incidence rate was 1-55/1000, the rate rising sharply with increasing age. The incidence of diverticular disease varies from ward to ward (range 0-92-2-04/1000), adjacent wards have similar incidence rates and the six wards with the lowest rates are clustered together in the South East of the city. Ward incidence rates have a significant negative association with the percentage of owner occupiers living in that area.

Adolescent↗
PubMed1977

Prognosis of patients with acute myocardial infarction admitted to a coronary care unit. I: Survival in hospital.

On a basis of history, clinical examination, and the electrocardiogram it was possible to identify groups of patients with acute myocardial infarction with good and bad prognoses as regards hospital survival. Individual adverse factors were age, prevous history of ischaemic heart disease, anterior infarction, persistent sinus tachycardia, pulmonary crepitations, hypotension, and raised venous pressure. Multivariate analysis showed four factors remaining significant--age, tachycardia, hypotension, and pulmonary crepitations. As a result of treatment of cardiac arrest, hospital mortality, which would otherwise have been 20 percent, was 17 percent. Preceding unstable angina did not worsen the immediate prognosis.

Adult↗
PubMed1977

Prognosis of patients with acute myocardial infarction admitted to a coronary care unit. II. Survival after hospital discharge.

The factors adversely affecting long-term prognosis differed from those affecting outcome of acute infarction. Individual factors were previous history of infarction or hypertension, tachycardia, cardiac arrest, ventricular arrhythmia, atrial fibrillation, 3rd heart sound, raised venous pressure, and pulmonary crepitations. Multivariate analysis reduced these to 6--previous infarct or hypertension, sinus tachycardia, cardiac arrest, ventricular arrhythmia, and artial fibrillation. Of those who survived 5 years, approximately half had angina. Two-thirds of the under 60 survivors were at their normal work.

Coronary Care Units↗
PubMed1977

Chemotherapy of non-Hodgkin's lymphomas: Eastern Cooperative Oncology Group experience.

The addition of prednisone to the two-drug combination of cyclophosphamide and vincristine increases the number of complete remissions (CR). Patients who had CRs in at least two of the studies, EST 0168 and EST 3472, lived significantly longer than those who had partial remissions. In EST 0168, the survival time correlated strongly with the nodal pattern and cell type, confirming results of Rosenberg and co-workers. EST 1472 confirmed the activity of BCNU in lymphocytic lymphomas; when both agents are combined with prednisone, the induction potential of BCNU is equal to that of cyclophosphamide. In the histiocytic lymphomas, BCNU added to CVP increases the percentage of CRs but it does so at the expense of considerable toxicity. EST 0871 demonstrated that low-dose bleomycin and hexamethylmelamine are active agents in lymphoma and should be combined with other effective combinations in an attempt to improve the CR rate. Finally, our current studies demonstrate that the failure rate in the diffuse or unfavorable lymphomas is higher than that in the more favorable nodular forms.

Altretamine↗
PubMed1976

Combination chemotherapy for metastatic breast carcinoma. Prospective comparison of multiple drug therapy with L-phenylalanine mustard.

A prospective randomized clinical trial was undertaken in 184 patients with metastatic breast carcinoma to compare single drug chemotherapy with L-phenylalanine mustard (L-PAM) and intermittent combination chemotherapy with cyclophosphamide, methotrexate, and 5-fluourouracil (CMF). All patients had not been previously treated with cytotoxic drugs and all had objectively measurable visceral of soft tissue disease. Of the 93 patients who received CMF, 49 (53%) achieved a complete (14 patients) or partial (35 patients) regression of measurable tumor, for a median duration of 25 weeks. Eighteen of the 91 patients (20%) treated with L-PAM responded, for a median duration of 13 weeks. The toxicity was primarily hematologic, and greater in the CMF group, which also received more cycles of therapy because of the higher rate and duration of response. The overall survival of CMF-treated patients was superior to that of the single drug group. The differences were even greater when the patients were subclassified according to the presence of liver involvement or nonambulatory performance status. The superior antitumor effect of CMF over L-PAM suggests that it may be a more effective drug regimen to be used as an adjuvant to primary therapy.

Adult↗
PubMed1975

Clinical studies of 5-fluorouracil + premarin in the treatment of breast cancer.

Sixty patients with metastatic or primary inoperable breast cancer not suitable for hormone alteration therapy were blindly randomized between weekly 5-fluorouracil, intravenously, and daily physiologic doses of conjugated estrogens by mouth against weekly 5-fluorouracil, intravenously, and placebo. There was no difference in the survival or the effect on the tumor in the two groups. Numerous factors were analyzed as to their effect on the course of the disease. The number of organ sites of tumor involvement, age of the host, and previous treatment for the disseminated disease were not shown to influence the survival or the results of therapy of either group. However, the duration of the clinical cancer-free period from primary treatment to recurrence, the sites of organ involvement, and the performance status of the patients at the time of entry into the study significantly did influence the survival. There is no evidence in this study that physiologic doses of conjugated estrogens deleteriously influenced the course of the disease.

Adult↗
PubMed1975

Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial.

In controlled clinical trials there are usually several prognostic factors known or thought to influence the patient's ability to respond to treatment. Therefore, the method of sequential treatment assignment needs to be designed so that treatment balance is simultaneously achieved across all such patients factor. Traditional methods of restricted randomization such as "permuted blocks within strata" prove inadequate once the number of strata, or combinations of factor levels, approaches the sample size. A new general procedure for treatment assignment is described which concentrates on minimizing imbalance in the distributions of treatment numbers within the levels of each individual prognostic factor. The improved treatment balance obtained by this approach is explored using simulation for a simple model of a clinical trial. Further discussion centers on the selection, predictability and practicability of such a procedure.

Carmustine↗