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At least 307 records · Page 17Linked to original sources

A retrospective analysis comparing patients 70 years or older to patients younger than 70 years with non-small-cell lung cancer treated with surgery at Indiana university: 1989-1999.

Surgery remains the cornerstone of therapy for medically operable patients with early-stage non-small-cell lung cancer (NSCLC). However, there are few reports on the short-term morbidity and long-term survival following surgery in elderly patients with NSCLC. The surgical experience in 280 patients with NSCLC at Indiana University from 1989-1999 are reported with a comparison of patients who are >or= 70 years versus < 70 years of age. Preoperative characteristics, operative procedures, postoperative courses, and survival were compared between the age groups. Fifty percent of elderly patients had squamous cell carcinoma and 36.2% had adenocarcinoma, versus 41.3% and 44.4% in younger patients, respectively. In both groups, most patients had T1 or T2 tumors and N0 disease. The majority of patients in both age groups had a lobectomy. However, more patients younger than 70 years had chest wall resections and were more likely to undergo a pneumonectomy (19.5% vs. 6.9%). The median number of postoperative hospital days was shorter for younger patients (9 days vs. 11 days). Overall, more complications occurred in older patients, but no significant difference in cardiac or pulmonary complications was observed between the groups. There was no significant difference in survival between the age groups. This single-institution series demonstrates that surgical intervention for appropriately selected elderly patients with NSCLC results in similar complication rates and long-term survival when compared to their younger counterparts.

Journal Article↗

[Results of treatment for advanced non-seminomatous germ cell tumors of the testis based on Indiana University classification].

From 1980 to 1990, we treated 45 patients with non-seminomatous germ cell tumors of greater than or equal to stage II according to the Japanese general rule for clinical and pathological studies on testicular tumors. The patients were divided into 2 groups based on the Indiana University Classification: 26 good risk patients (score < or = 6) and 19 poor risk patients (score > or = 7). The clinical results, the % dose intensity of Cisplatin and half-lives of tumor makers were analyzed in the two groups. The per cent dose intensity of Cisplatin of the induction chemotherapy was 61 +/- 24% in 1980-1985 and 87 +/- 18% in 1986-1990. The NED rate improved from 66.7% (10/15) to 81.8% (9/11) in the good risk patients and from 33.3% (3/9) to 50.0% (5/10) in the poor risk patients between the above two periods. When the % dose intensity of Cisplatin exceeded 80%, the NED rate increased from 66.7% (10/15) to 90.0% (9/10) in good risk patients and from 33.3% (2/6) to 45.5% (5/11) in poor risk patients. The NED rate was only 25.0% (4/16) in the poor risk patients whose residual tumors were not resected. The half-lives of AFP and beta-HCG from the latter part of the first course to the second course were 6.8 +/- 1.9 days and 4.4 +/- 1.4 days, respectively, in the patients with a good prognosis, while they were 6.5 +/- 1.5 days and 4.4 +/- 2.9 days, respectively, in with a poor prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Long-term follow-up of the Indiana conservative resurfacing hip arthroplasty.

Sixty-four Indiana conservative (Depuy, Warsaw, IN) hip arthroplasties performed in 61 patients were reviewed for loosening, mechanisms of loosening, and revision rate. Mean follow-up time was 6.8 years. There were revisions in 26 hips (40.6%) with 4 hips awaiting revision, yielding a total of 30 hips (47%) defined as failures. Acetabular failure occurred in 20 hips, femoral failure in 18, and combined failure in 13. Failure of this prosthesis persists over time. There seems to be little or no place for this design in contemporary hip joint arthroplasty.

Adult↗

Outbreak of Salmonella indiana associated with egg mayonnaise sandwiches at an acute NHS hospital.

An outbreak of Salmonella indiana infection in December 2000 affected 17 staff, relatives and patients at an acute NHS Hospital in Swansea. Epidemiological investigation identified egg mayonnaise sandwiches as the vehicle of infection. It was not possible to definitively determine the source of the infection or how the prepared sandwiches became contaminated. The most likely explanation was a pasteurisation failure of a batch of the egg roll used to make these sandwiches. Sandwiches are the most frequently identified vehicle of infection in foodborne outbreaks of salmonella infection in hospitals in England and Wales. The process of sandwich preparation has inherent risks because it involves considerable handling of food, which is consumed without further cooking. Care is required in all stages of preparation including the sourcing of materials used to produce the sandwiches. NHS Trusts should review their Hazard Analysis Critical Control Point plans for sandwich production.

Case-Control Studies↗

Chronic oral etoposide: trials at Indiana University and with the Hoosier Oncology Group.

Etoposide has proven to be an active agent in the treatment of a variety of neoplasms, particularly germ cell cancers and small cell lung cancer. Yet despite its widespread use, the optimal dose and schedule for etoposide remain unknown. The fact that its efficacy appears to be schedule dependent, along with the recent availability of an oral formulation, formed the basis for several trials at Indiana University and through the Hoosier Oncology Group. These trials evaluated chronic daily administration of the drug in several malignancies. In testicular cancer, etoposide was shown to have a possible role in adjuvant therapy for refractory disease or as part of combination chemotherapy. In small cell lung cancer, etoposide demonstrated activity in both previously treated and untreated patients. The drug, however, had little impact on patients with advanced non-small cell lung cancer, advanced melanoma, or advanced soft tissue sarcoma. Since etoposide appears to be most effective in refractory small cell lung cancer and germ cell tumors, we believe the drug should be explored in tumors with a known history of chemosensitivity to conventionally administered etoposide.

Administration, Oral↗

The resting and house frequenting behavior of Mansonia annulifera, Ma. uniformis and Ma. indiana, the vectors of Malayan filariasis in Kerala State, India.

Mansonia annulifera, was recorded to be an endophilic species, preferring to rest indoors, while Ma. uniformis was exophilic, having a predilection for outdoor resting habitats, eg bushes and shrubs. Ma. indiana did not show a clear preference to either of these biotopes. In indoor resting collections, the unfed proportion of Ma. uniformis was significantly higher during post-dusk compared to day hours (p < 0.05), indicating that this exophilic species enters houses during dusk hours for feeding. The full fed proportion was higher during day hours compared to dusk/night hours. The semigravid proportion showed a significant reduction during post-dusk hours (p < 0.05). These findings suggest that after having a blood-meal this species rest indoors and leave the houses for outdoor resting sites during the dusk hours on the subsequent night.

Animals↗

Some remarks on a re-do urinary diversion by converting the ileal conduit to an Indiana pouch.

Although the ileal conduit is a wide accepted urinary diversion with a low rate of long way postoperative complications, some patients are not satisfied with the change of body image and the need to wear an external bag inherent to the Bricker's diversion. We report on a patient who underwent cystectomy and Bricker's diversion for bladder cancer which afterwards was converted to an Indiana pouch due to patient preference. The use of the proximal portion of the preexisting ileal conduit facilitated the pouch construction, minimizing the bowel requirement and the need for redoing the ureteral anastomoses. The conversion from ileal-conduit to a catheterizable pouch is technically feasible and involves a better perception of the body image, and a less cumbersome management of the diversion. Before any surgical reconstruction, a realistic discussion with the patient, explaining the potential physical and life-style changes, and problems encountered postoperatively, is the crucial issue.

Body Image↗

Scanning electron microscopy of the eggs of Mansonia uniformis, Ma. indiana and Ma. annulifera (Diptera: Culicidae).

Descriptions of the eggs of Mansonia uniformis, Ma. indiana and Ma. annulifera are provided with the aid of scanning electron micrographs. Eggs of these three species, although similar in shape and colour, are covered by outer chorionic reticulum and tubercles which provide reliable morphological character for their identification. Size, distribution and number of lobes on the large tubercles present in the region between the anterior tube and posterior region, are important distinguishing features. Measurements of egg sizes and other chorionic differences are also discussed.

Animals↗

Indiana pouch continent urinary reservoir in patients with previous pelvic irradiation.

Little information exists on the use of continent urinary reservoirs in patients with previous pelvic irradiation. We report the use of the Indiana pouch urinary reservoir in ten women with a history of pelvic irradiation for cervical cancer, of whom eight underwent a total pelvic exenteration for recurrent pelvic tumor and two had diversion for radiation-induced vesicovaginal fistula. All ten women achieved daytime continence, with a median time between catheterizations of 4.5 hours and a median pouch capacity of 500 mL. There was no evidence of leakage from the reservoir or significant ureteral reflux or obstruction on postoperative radiographic evaluation. No patient has required reoperation or had significant postoperative complications with the technique described.

Cecum↗

Ifosfamide in testicular cancer: the Indiana University experience.

The systemic treatment of patients with metastatic germ cell tumors has improved dramatically during the past 15 years. Nonetheless, a cohort of patients are candidates for salvage chemotherapy. Having ruled out the possibility of pseudoprogression (eg, false elevated serum markers, teratoma, bleomycin lung disease), salvage therapy is indicated. Numerous trials in Europe and at Indiana University have confirmed single-agent activity of ifosfamide in patients with refractory germ cell tumors. As a consequence, a trial evaluating VeIP (vinblastine, ifosfamide, cisplatin) and VIP (etoposide, ifosfamide, cisplatin) was undertaken in 57 patients previously not cured with cisplatin, vinblastine, and etoposide regimens. Twenty patients achieved disease-free status with chemotherapy alone (n = 12) or chemotherapy plus surgical resection of residual carcinoma or teratoma (n = 8). Fifteen of these 20 patients remained free of recurrent disease from 18 to 53 months, including seven patients in continuous remission for over 2 years. Ifosfamide combination chemotherapy has curative potential in this heavily pretreated population. Further work to determine the role of ifosfamide in initial therapy is under way.

Antineoplastic Combined Chemotherapy Protocols↗

Dietary fluoride supplements for Indiana's children: the role of the physician.

Fluoride supplements for Indiana children are necessary for caries reduction where communal and well water tests show deficient levels of fluoride. The role of the physician in providing optimum preventive dental care to young patients is discussed. Also, the proper dental protocol for fluoride supplements is provided.

Child↗

The Indiana conservative (surface-replacement) hip arthroplasty.

We reviewed the clinical results of the Indiana conservative hip arthroplasty in 116 hips with a two to seven-year follow-up. There were seventeen failures (14.6 per cent). The rate of non-traumatic loosening was 10 per cent and the failure rate for patients with inflammatory arthritis was 33 per cent. No infections, dislocations, subluxations, pulmonary emboli, or deaths were associated with the procedure. For forty-two hips with a successful result and a minimum follow-up of three years, the radiographs were analyzed. Factors that were found to have a high correlation with success of the arthroplasty were preservation of the acetabular subchondral bone, complete coverage of the acetabular component, and selection of the appropriate sizes of femoral and acetabular components. Radiolucency was not found to be a reliable diagnostic sign of, or prelude to, symptomatic loosening of the prosthetic implant.

Adult↗

Endoscopic screening for colorectal cancer: recent studies from Indiana University.

Fecal occult blood testing is inadequate as a sole screening measure for colorectal cancer. Endoscopic screening and adenoma removal is now proven to reduce colorectal cancer mortality. At the Indiana University Colorectal Cancer Screening Center, studies have clarified several issues regarding endoscopic screening for colorectal cancer. Screening colonoscopy in 621 asymptomatic adults aged 50 to 75 years demonstrated that 27% had colonic adenomas. Increasing age and male gender were both powerful predictors of an increased prevalence of colonic adenomas. A family history of a single first-degree relative who developed colorectal cancer at age 60 or older did not predict a higher prevalence of colonic adenomas. All cancers and all adenomas greater than or equal to 1 cm in size found in average-risk persons were found in persons aged 60 or older. Half of the people with adenomas had no neoplasia within reach of the flexible sigmoidoscope. Based on these findings, we have suggested that a single screening colonoscopy performed in average-risk person in their early sixties may be an effective method to reduce colorectal cancer mortality. In the screening colonoscopy study, distal colonic hyperplastic polyps were shown to not predict proximal colon adenomas. Therefore, colonoscopy is not warranted when only hyperplastic polyps are detected by flexible sigmoidoscopy in asymptomatic, average-risk people. Screening sigmoidoscopic exams using colonoscopes showed that 60 cm scopes have the optimal length for flexible sigmoidoscopy in unsedated patients. Finally, a screening colonoscopy study demonstrated that women with a personal history of breast cancer do not have an increased prevalence of colonic adenomas.

Aged↗

Bladder neck closure with an Indiana stoma outlet as a technique for continent vesicostomy.

A continent vesicostomy was performed upon two patients. The opened right colonic segment was used to augment the bladder and the ileocecal portion to create a continent abdominal stoma according to the technique used in the Indiana pouch. One patient had complete obstruction of the urethra 1 centimeter distal to bladder neck. The second patient was a paraplegic with an contractile bladder and complete outlet incontinence who was reluctant to perform transurethral self-catheterization. After postoperative follow-up evaluation of 36 and 22 months, respectively, both patients are completely continent day and night on self-catheterization every six hours with preserved function of the upper part of the tract.

Colon↗

Brain biopsy in Indiana AIDS patients.

The neuropathologic findings of brain biopsies in a series of Indiana AIDS patients were reviewed. All subjects displayed focal lesions on radiographic studies. The three most common diagnoses were toxoplasmosis, progressive multifocal leukoencephalopathy and primary central nervous symptoms (CNS) lymphoma. These findings were consistent with previous studies elsewhere. Biopsy appears to affect the course of treatment only if CNS lymphoma is discovered. Because the value of currently available therapy for this disease in AIDS patients is controversial, there is no clear consensus regarding the indications for biopsy in this population.

AIDS Dementia Complex↗

Neuropsychological function in patients with Gerstmann-Sträussler-Scheinker disease from the Indiana kindred (F198S).

Three patients with Gerstmann-Sträussler-Scheinker disease (GSS) caused by a serine-for-phenylalanine substitution at codon 198 of the prion protein gene (PRNP) were compared to 9 age- and education-matched non-mutation-carriers from the same large Indiana kindred (GSS-IK) on a comprehensive neuropsychological test battery. Clinically significant impairments in intelligence, secondary memory, attention and cognitive processing speed, executive ability, and manual motor skills were noted in 2 patients. The wide range and the severity of the cognitive deficits indicated generalized cerebral dysfunction consistent with global dementia. One patient, symptomatic for less than 1 year, had more selective deficits involving memory, motor skills, and verbal fluency, suggesting early subcortical involvement.

Adult↗