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  • 1
    Electronic Resource
    Electronic Resource
    Modification of pain on injection of propofol—a comparison between lignocaine and procaine (1991)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 46 (1991), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Pain on injection of propofol was assessed in a controlled, randomised study of 273 patients. They received either lignocaine 10 mg, procaine 10 mg or isotonic saline 0.5 ml, 15 seconds before the injection of propofol into a vein on the back of the hand. The incidence of pain on injection in the'control group (51%) was comparable with other studies. Lignocaine and procaine both significantly reduced the pain (35% and 34% respectively, p 〈 0.05) but there was no statistical difference between these two groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1991.tb09323.x
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  • 2
    Electronic Resource
    Electronic Resource
    Reduced apoptosis and proliferation and increased Bcl-2 in residual breast cancer following preoperative chemotherapy (1998)
    Springer
    Breast cancer research and treatment 48 (1998), S. 107-116 
    Details
    ISSN: 1573-7217
    Keywords: apoptosis ; proliferation ; Bcl-2 chemoresistance ; breast cancer ; immunostaining
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Experimental laboratory data suggest that tumour growth is a balance between apoptosis and proliferation and that suppression of drug-induced apoptosis by oncogenes such as bcl-2 may be an important cause of intrinsic chemoresistance. The aims of this study were to assess the in vivo relationship of apoptosis to proliferation and Bcl-2 protein in human breast tumours both prior to chemotherapy and in the residual resistant cell population at the completion of treatment. We examined apoptotic index (AI), Ki67 and Bcl-2 protein expression in the tissue of 40 patients with operable breast cancer immediately before ECF preoperative chemotherapy, and in 20 of these patients with residual tumour, at the completion of treatment. There was a significant positive association between AI and Ki67 both before and after chemotherapy, and in their percentage change with treatment. In the residual specimens AI and Ki67 were significantly reduced compared with pre-treatment biopsies, while Bcl-2 expression showed a significant increase. No differences were seen in the pre-treatment levels of any of the variables measured between patients obtaining pathological complete response and those who did not, although numbers were small. These data suggest that apoptosis and proliferation are closely related in vivo. It is possible that the phenotype of reduced apoptosis and proliferation, and increased Bcl-2 may be associated with breast cancer cells resistant to cytotoxic chemotherapy, although this can only be proven by assessing larger numbers of patients in relation to pathological response.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005933815809
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  • 3
    Electronic Resource
    Electronic Resource
    The significance of the concordance rate for Type 1 (insulin-dependent) diabetes in identical twins (1988)
    Springer
    Diabetologia 31 (1988), S. 747-750 
    Details
    ISSN: 1432-0428
    Keywords: Concordance ; identical twins ; Type 1 (insulin-dependent) diabetes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We studied prospectively 49 non-diabetic identical twins of recently-diagnosed Type 1 (insulin-dependent) diabetic patients for up to 24 years (median 9 years). During this time 15 developed Type 1 diabetes. Actuarial analysis indicates that by 12 years 34% of the twins will have developed Type 1 diabetes and that thereafter only another 2% will do so. Inevitable bias in ascertainment of the twins makes it likely that the true figure is less. We conclude that factors which are not genetically determined must be important in the pathogenesis of the disease. The rates of developing Type 1 diabetes in the co-twins declines sharply in the years after diagnosis of the index twin, which suggests that the initiation of the process leading to Type 1 diabetes occurs within a finite, and not a prolonged, period.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00274777
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  • 4
    Electronic Resource
    Electronic Resource
    A study to investigate the prevalence, severity and correlates of fatigue among patients with cancer in comparison with a control group of volunteers without cancer (2000)
    Springer
    Annals of oncology 11 (2000), S. 561-567 
    Details
    ISSN: 1569-8041
    Keywords: fatigue ; neoplasms ; prevalence ; quality of lif ; signs and symptoms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Determining the prevalence of fatigue among cancerpatients is complicated by the high prevalence of fatigue symptoms in thegeneral population. The aim of this study was to determine the prevalence,severity and correlates of fatigue among both cancer patients and controlsubjects without cancer. Patients and methods:A total of 227 cancer patients and 98control subjects were recruited to the study. They completed a number ofquestionnaires about fatigue, quality of life and psychological symptoms. Themajority of subjects also underwent assessment of voluntary muscle functionand nutritional status. Severe fatigue in the patients was defined as a scoreon the Fatigue Severity Scale in excess of the 95th percentile of the controlgroup. Results:The prevalence of severe fatigue was 15% amongpatients with recently diagnosed breast cancer, 16% among patients withrecently diagnosed prostate cancer, 50% among patients with inoperablenon small cell lung cancer and 78% among patients receiving specialistinpatient palliative care. In the patients a combination of dyspnoea,psychological distress, pain, and a measure of overall disease burdenaccounted for 56% of the variance in fatigue scores. Conclusions:Severe fatigue is a common problem among cancerpatients, particularly those with advanced disease. Fatigue is significantlyassociated with the severity of psychological symptoms (anxiety anddepression) and with the severity of pain and dyspnoea.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008331230608
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  • 5
    Electronic Resource
    Electronic Resource
    GM-CSF with biochemotherapy (cisplatin, DTIC, tamoxifen, IL-2 and interferon-alpha): A phase I trial in melanoma (2000)
    Springer
    Annals of oncology 11 (2000), S. 1183-1189 
    Details
    ISSN: 1569-8041
    Keywords: biochemotherapy ; cytokines ; GM-CSF ; melanoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Ineffective tumour antigen processing is recognisedas an important cause of failure of immunotherapy in melanoma. GM-CSF mayaugment the cytotoxic lymphocyte response by activating antigen-presentingcells. This study evaluates a schedule combining GM-CSF with biochemotherapy. Patients and methods:Nineteen patients with advanced malignantmelanoma received cisplatin (25 mg/m2 days 1–3), dacarbazine(220 mg/m2 days 1–3), interleukin-2 (9 MIU/m2/24h)and interferon-α2b (5 MIU/m2) both days 6–10 and days17–21, and tamoxifen 40 mg/day continuously. Subcutaneous GM-CSF wasgiven in escalating doses to three cohorts: 1) 450 µg/m2 days4–5 and 15–16; 2) as 1) plus 225 µg/m2 days6–10 and 17–21; 3) 450 µg/m2 days 4–10 and15–21. Each cycle was 28 days. Results:Constitutional side effects were the majornon-haematological toxicity and lymphopaenia the main haematological toxicity.Six patients responded (32%, 95% confidence interval:13%–57%), two patients had complete remission. There wasan apparent trend for increasing responses with increasing GM-CSF dose; zeroof six responses in cohort 1, two of seven in cohort 2 and three of six incohort 3 (P = 0.016). Median overall survival was 6.2 months.Increasing GM-CSF doses significantly increased serum concentrations ofneopterin and TNF-α. Conclusions:The combination of GM-CSF with biochemotherapy isfeasible and there appears to be a dose-response relationship with GM-CSF interms of host immunological response, and possibly clinical efficacy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008348005349
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  • 6
    Electronic Resource
    Electronic Resource
    Chemotherapy for symptom control in recurrent squamous cell carcinoma of the head and neck (1997)
    Springer
    Annals of oncology 8 (1997), S. 445-449 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; head and neck cancer ; symptom control
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The role of chemotherapy in patients with recurrent squamouscell carcinomas of the head and neck (SCCHN) is unclear. The aim of this studywas to assess the ability of combination chemotherapy to control symptoms inthis setting. Patients and methods: Using a prospectively accrued database all patientsreferred for chemotherapy with symptomatic relapse following surgery wereidentified. Objective response was recorded using standard criteria andmaximum symptom response was assessed retrospectively from case notes usinga published scoring scale. Results: A total of 57 (median age 56, range 37–85) patients werestudied who had received mainly cisplatin/5-fluorouracil combinations.Thirty-seven had previously received radiotherapy. Fifty-two patients hadevaluable disease; 18 (35%) had objective responses (14 PRs and 4 CRs).There were a total of 103 symptoms recorded with eight different individualsymptoms. Forty-four (43%) symptoms improved on treatment, 52(50%) were unchanged and 7 (7%) worsened. The number of pateintswith improvement in the most frequently recorded symptoms were as follows:pain 11/28 (39%), swelling 12/23 (52%) and dysphagia 6/18(33%). Sixty-seven percent of patients with objective response also hadan improvement in their symptoms but a significant proportion (33%) ofnon-responders had a symptomatic response. Lack of objective response was notcorrelated with worsening symptoms. Grade 3/4 toxicity was uncommon(6%–17%) and there were no toxic deaths. A majority ofpatients (82%) experienced either no change or an improvement inperformance status. Conclusion: These results demonstrate that chemotherapy improves many ofthe symptoms associated with recurrent SCCHN, without deterioration inperformance status. Symptomatic improvement is more likely if there isevidence of significant tumour shrinkage, but even non-responding patients canbenefit.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008203613364
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