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T Devine

Publications and source records attributed to T Devine.

17 recordsLinked to original sources
PubMed2002

A randomised study of prophylactic G-CSF following MRC UKALL XI intensification regimen in childhood ALL and T-NHL.

BACKGROUND: Despite the current widespread use of prophylactic G-CSF in children with solid tumours and leukaemia, its effectiveness has not been clearly demonstrated. This randomised study evaluates the role of G-CSF given after a 5-day intensification block in children with acute lymphoblastic leukaemia (ALL). PROCEDURE: Forty-six children with ALL or T-Cell non-Hodgkins lymphoma (NHL) treated on MRC ALL 97, UKALL XI or UKCCSG 9504 NHL protocols were randomised to receive granulocyte colony-stimulating factor following either the first or the second block of intensive chemotherapy in a cross-over study to determine if the prophylactic administration of G-CSF could reduce the rate of readmission to hospital for management of febrile neutropenia. RESULTS: There was a statistically significant difference in the rate of hospital admission in the group receiving prophylaxis, with 34 of 46 being admitted, compared to 42 of 46 patients in the control arm (74 vs. 91%; P=0.0386). There were no differences found in duration of hospital admission, haematological toxicity, neutrophil recovery or duration of supportive care between the two groups. There was no demonstrable cost benefit derived from the prophylactic administration of G-CSF. CONCLUSIONS: This study shows that the prophylactic administration of G-CSF following intensification chemotherapy for childhood ALL and T-NHL produces a significant reduction in the rate of readmission to hospital for the management of febrile neutropenia.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2001

Response to influenza immunisation during treatment for cancer.

AIMS: To assess the annual risk of influenza infection in children with cancer and the immunogenicity of a trivalent split virus influenza vaccine in these children. METHODS: Eighty four children with cancer were tested for susceptibility to the circulating strains of influenza virus in autumn 1995 and 1996. Non-immunised children were reassessed the following spring for serological evidence of natural infection. Forty two patients received two doses of influenza vaccine. These children were receiving continuing chemotherapy for acute lymphoblastic leukaemia or were within six months of completing chemotherapy. RESULTS: Among the 84 children tested for influenza virus susceptibility only 8% of patients were fully protected (antibody titres >/= 40) against all three of the prevalent influenza virus strains; 33% were susceptible to all three viruses. Evidence of acquired natural infection was seen in 30% of unimmunised patients. Among immunised susceptible patients, 66% made some protective response to the vaccine and 55% showed protective antibody titres to all three viral strains following vaccination. Older age was associated with increased response to the H1N1 and H3N2 vaccine components, but total white cell count or neutrophil count at immunisation, type of cancer, or length of time on treatment for acute lymphoblastic leukaemia did not affect response. CONCLUSIONS: Most children with cancer studied were at risk of influenza infection. A significant response to immunisation was seen, supporting annual influenza vaccination for children being treated for cancer.

Acute Disease↗
PubMed2001

Transdermal fentanyl for pain relief in a paediatric palliative care population.

This multicentre, observational study examined the efficacy of the therapeutic transdermal fentanyl system (TTS-fentanyl) in children requiring opioids for pain in life-threatening disease. Forty-one children receiving oral morphine (median dose 60 mg/day) transferred to transdermal fentanyl (median dose 25 micrograms/h according with the manufacturer's dose conversion guidelines). Twenty-six children completed the 15-day treatment phase, seven died due to disease progression and eight were withdrawn because of adverse events, inadequate analgesia or a change to parenteral opioids. After 15 days, the median fentanyl dose was 75 micrograms/h (range 25-250). No serious adverse events were attributed to fentanyl. There was a trend toward improved side-effects and convenience with fentanyl. Twenty-three of 26 parents (three missing) and 25 of 26 investigators considered transdermal fentanyl to be better than previous treatment. For all records available (at 15 days or on withdrawal if earlier), 75% (27/36) reported that fentanyl treatment was 'good' or 'very good'. The findings suggest that transdermal fentanyl is both effective and acceptable for children and their families.

Administration, Cutaneous↗
PubMed2001

Presenting a case for involving children with a terminal illness in clinical trials.

Today's approaches to the treatment of childhood malignancies are the result of past clinical trials. In order to improve survival it is essential we continue to seek benefit from clinical trials. However, entry of terminally ill children into a phase I or phase II clinical trial, involving a novel, potentially therapeutic, agent is highly contentious. This article will argue in favour of a child's active and full participation in the decision to enter into a phase I or phase II clinical trial. A formal study of the role of children in clinical trials, especially phase I and phase II trials, is urgently required if standards of best practice are to be laid down and subsequently measured.

Child↗
PubMed1997

Abdominal aortic aneurysms. The old and the new.

Abdominal aortic aneurysms are more frequently diagnosed while they are asymptomatic, by ultrasound scanning or computerized tomography (CT). Large aneurysms should be treated. Open surgical repair is well proven but is a major procedure with some risk and a slow convalescence. New endoluminal techniques, inserting grafts through the femoral artery involve minimal trauma and risk, with rapid recovery, but long term success has yet to be confirmed. At present, we consider that endoluminal grafts should be reserved for patients at high risk, but with increasing experience they could be used in more than 50% of cases.

Angiography↗
PubMed1993

Surfactant therapy failure identifies infants at risk for pulmonary mortality.

OBJECTIVE: To characterize the clinical features of infants who do not respond to surfactant therapy. DESIGN: Patient series, chart review. SETTING: Academic referral neonatal intensive care unit. PATIENTS/SELECTION: Ninety-nine consecutive infants with respiratory distress syndrome who received surfactant therapy and 107 infants from the 2 years prior to initiation of surfactant therapy matched for birth weight, race, sex, gestational age, chronological age, and disease severity. MEASUREMENTS/RESULTS: Oxygen index was used to quantitate response to surfactant therapy. A 25% decrease in oxygen index 6 hours after the first surfactant dose was significantly different from that of the matched historical cohort (P = .04). Oxygen index decreased 25% or more in 49 infants, the response group, while oxygen index decreased less than 25% or increased following therapy in the remaining 50 infants, the nonresponse group. Pulmonary interstitial emphysema occurred more frequently in the nonresponse group. The only deaths from pulmonary causes at 10 days of age or younger occurred in the nonresponse group (n = 11). CONCLUSIONS: Pulmonary processes unresponsive to surfactant therapy contribute to morbidity and mortality in newborn respiratory distress syndrome. Classifying respiratory distress syndrome as "surfactant responsive" or "surfactant unresponsive" offers a scheme by which to investigate alternative explanations and interventions for newborn respiratory distress syndrome.

Female↗
PubMed1988

Leg ulcers.

Explore the source record for details and available documents.

Adult↗
PubMed1986

L7-S1 fixation-fusion for treatment of cauda equina compression in the dog.

The L7-S1 fixation-fusion technique for treatment of cauda equina compression was performed on 14 dogs, 13 of which were 6 years old or older, were severely lame, and had ventral bridging spondylitis at the L7-S1 vertebrae. One dog, 3 months old, had a congenital malformation of the L7 vertebra. The principles of the L7-S1 fusion technique were to expand the L7-S1 intervertebral foramina and spinal canal, remove pressure on the nerve roots, and provide stability to the L7-S1 vertebrae. This technique appeared to be applicable clinically for restoring normal function and activity to dogs with cauda equina compression.

Animals↗
PubMed1985

Trochlear recession for correction of luxating patella in the dog.

Trochlear recession is a surgical technique for stabilizing luxating patellas by recessing the trochlear sulcus 1 to 2 mm. The smooth hyaline cartilage of the articulating trochlear surface is preserved. This technique has provided excellent results in 41 stifles of 28 dogs, as determined by a 6-month to 6-year follow-up, with an average follow-up period of 3.2 years.

Animals↗
PubMed1984

Stereoselective binding of disopyramide to human plasma protein.

The binding of racemic disopyramide and its two enantiomers to protein were compared in two samples of human plasma, two samples of freshly drawn serum and in a solution of alpha 1-acid glycoprotein. The binding of S(+)-disopyramide was higher at all concentrations as compared to to R(-)-disopyramide, and the binding of the racemate was intermediate. Differences in binding were due to differences in the association constant.

Binding Sites↗
PubMed1984

Cranial tibial wedge osteotomy: a technique for eliminating cranial tibial thrust in cranial cruciate ligament repair.

Cranial tibial wedge osteotomy, surgical technique for cranial cruciate ligament rupture, was performed on 19 stifles in dogs. This procedure leveled the tibial plateau, thus causing weight-bearing forces to be compressive and eliminating cranial tibial thrust. Without cranial tibial thrust, which was antagonistic to the cranial cruciate ligament and its surgical reconstruction, cruciate ligament repairs were allowed to heal without constant loads. This technique was meant to be used as an adjunct to other cranial cruciate ligament repair techniques.

Animals↗
PubMed1983

Cranial tibial thrust: a primary force in the canine stifle.

A cranially directed force identified within the canine stifle joint was termed cranial tibial thrust. It was generated during weight bearing by tibial compression, of which the tarsal tendon of the biceps femoris is a major contributor, and by the slope of the tibial plateau, found to have a mean cranially directed inclination of 22.6 degrees. This force may be an important factor in cranial cruciate ligament rupture and in generation of cranial drawer sign.

Animals↗
PubMed1982

Wedge recession for treatment of recurrent luxation of the patella: a preliminary report.

Wedge recession is a method which utilizes the geometry of similar triangles to recess an articular wedge into the underlying bone. This concept has been applied to congenital luxating patellae in the dog. A trochlear wedge recession deepens the femoral trochlea and provides stability to the patella. Preliminary trials of the procedure in dogs produced excellent results.

Animals↗