PubMed Health⌕ Search

Biomedical subjects

B Haughey

Publications and source records attributed to B Haughey.

16 recordsLinked to original sources
PubMed1995

Squamous cell carcinoma of the pyriform sinus: a nonrandomized comparison of therapeutic modalities and long-term results.

From January 1964 through December 1991, 408 patients with squamous cell carcinomas involving the pyriform sinus were treated at Washington University Medical Center. Their ages ranged from 29 to 83 years (mean, 62.3; median 59) and the male to female ratio was 5:1. The mean duration of symptoms prior to diagnosis was 3.9 months (range 1 to 32 months) and 89% had a smoking or ethanol history. Sixty-seven percent had T3 or T4 lesions and 87% were stage III or IV at presentation. Sixty-nine percent had neck metastases. The treatment strategy varied with respect to radiation and reconstruction. Prior to 1978, preoperative radiation (3.5 to 5000 cGy) was used. Postoperative radiation was given thereafter (600+ Gy). Since 1982, flap reconstruction (usually pectoralis major myocutaneous) has been used to close the partial laryngopharyngectomy (PLP) defect. Almost all N0 necks were treated by radiation or surgery and all N1-N3 lesions were treated by combined therapy. Pyriform tumors were subdivided into three groups: 1. one-wall lesions (n = 48), 2. medial-wall lesions which involved the aryepiglottic fold or supraglottis (N = 267), and 3. two- or three-wall lesions which extended to the pyriform apex or post-cricoid region (N = 93). Ninety-five patients had single-modality therapy and 302 had combined treatment. Two hundred seven patients had conservation surgery (PLP) and 157 had total laryngopharyngectomy alone or in combination with radiation. Thirty-three patients were treated by radiation alone. Eleven patients were excluded from the study because of distant metastases (TxNxM1) at presentation. The cumulative survival (NED) at 5, 10, 15, and 20 years was 56%, 35%, 31%, and 20%, respectively. The cumulative locoregional control rate was 71%. At 5 years (NED), the cure rates for one-wall lesions (73%) were better than for medial-wall lesions (63%) or 2- and 3-wall lesions (49%). One-wall lesions were smaller, medial-wall lesions behaved similar to supraglottic tumors, and two- or three-wall tumors behaved as hypopharyngeal tumors. The cure rates were related to T stage with T1 + T2 > T3 + T4 (28%). Neck metastases reduced the cure rate by 26% and N1 > N2-N3 by an additional 12%. Other factors contributing to therapeutic failure were distant metastases (17.7%), second primary tumors (6.2%; oropharynx and lung were most common), and intercurrent disease fatalities (9.5%). The secondary therapeutic salvage rate was 44% for surgery and 32% for radiation therapy. The therapeutic complication rate was 19% with 3.6% leading to fatality.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1995

Squamous cell carcinomas of the aryepiglottic fold: therapeutic results and long-term follow-up.

Three hundred fifteen patients with squamous cell carcinomas involving the aryepiglottic (A-E) folds were treated between January 1964 and December 1991. The age ranged from 39 to 87 years (mean, 62.4 years; median, 61.3 years) and the male-to-female ratio was 5:1 (54 women and 261 men). Symptom duration prior to diagnosis was 4.8 months. Eighty percent of patients had T3 and T4 lesions and 56.3% had neck metastases at presentation. Six patients (1.8%) had distant metastases and were excluded from this study. Clinically the tumors presented as either exophytic infiltrating lesions which were confined to the A-E fold (n = 57) or mucosally spreading tumors which extended to the lateral supraglottis or pyriform sinus (n = 258). Prior to 1978 preoperative radiation (3000 to 5000 cGy) was used. Higher doses of postoperative radiation (5000 to 6000+ cGy) were used thereafter. After 1982 the use of myocutaneous flaps for closure of partial laryngopharyngectomy defects was routine. Almost all N0 neck disease was treated by radiation or surgery. Combined therapy was used in N1-N3 disease. One quarter of the patients had single-modality therapy (25.7%; 81 patients) with a cumulative 5-year disease-free survival of 53%. The remainder of the patients (n = 234) had combined therapy with a cumulative 5-year survival of 67.2%. The latter group had 163 conservation surgeries and 121 total laryngectomy resections. The 5-year disease-free survival for preoperative radiation with surgery (68%) and postoperative radiation with surgery (64%) was similar. Those treated by radiation alone had a 34% 5-year disease-free survival and those treated with surgery alone had a 61% 5-year disease-free survival. The cumulative locoregional control rate was 77%. The cumulative disease-free survival at 5, 10, 15, and 20 years is 66%, 57%, 55%, and 55%, respectively. Infiltrating tumors had a better disease-free survival (by more than 10%) than spreading tumors. The 5-year survival rates were separated well by clinical stages of tumors. In patients with T1 tumors the 5-year survival was 87%; in those with T2 tumors, 80%; in those with T3 tumors, 78%; and in those with T4 tumors, 41%. The survival rate was greater in those with N0 tumors than in those with N+ tumors by 25% and greater in those with N1 tumors than in those with N2 + N3 tumors by an additional 18%. The overall complication rate was 26% and in 7.7% these were fatal.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1994

Immediate mandibular reconstruction and placement of dental implants. At the time of ablative surgery.

The outcomes of surgical reconstruction for patients who have undergone extensive tumor resection of the mandible and associated soft tissue have been less than desirable for many reasons: lack of cancer cure, radiation problems, as well as inadequate functional reconstructive results. These patients traditionally have undergone multiple surgical procedures for restoration of the surgical deformity. With the advent of new donor sites and successful transfer of microvascular hard and soft tissue, one can restore the largest defects created during cancer excision. Combining these techniques with biocompatible dental implants and reconstructive bone plates, technology has advanced to the point of predictable outcomes. The restoration of appearance, mandibular function, and mastication is mandated by patients. Dental implants are now placed in vascularized bone reconstruction of the mandible immediately at the time of ablative surgery. This obviates the need for additional surgical reconstructive procedures, adjunctive hyperbaric oxygen therapy, and problems associated with the placement of dental implants in irradiated tissue.

Adult↗
PubMed1992

Diet in the epidemiology of postmenopausal breast cancer in the New York State Cohort.

A number of authors have presented evidence that high dietary fat increases the risk of breast cancer, and a number have presented evidence to the contrary. In this study, dietary histories were obtained in 1980 from 18,586 postmenopausal women in New York State. These women were followed through 1987 to ascertain their incidence of breast cancer and other cancers and deaths from all causes, as registered in the New York State Tumor Registry and Office of Vital Statistics. Survival analysis revealed that the incidence of breast cancer increased with age, was higher among the nulliparous, was higher for those with a late (> 26 years) age at first pregnancy, and increased with increasing socioeconomic status--all risk factors discovered before for breast cancer. No increase in risk was related to the ingested amount of calories, vitamins A, C, or E, dietary fiber, or fat. Although dietary fat has been found to be associated with higher risk of cancer at a number of other sites, e.g., the lung, colon, and rectum, and although some previous writers have suggested an association with risk of breast cancer, the findings in three cohort studies as well as in eight substantial case-control studies are negative and suggest that a relation is far from established.

Age Factors↗
PubMed1990

Diet in the epidemiology of gastric cancer.

We examined the nutritional epidemiology of gastric cancer in 293 cases and neighborhood-, age-, and sex-matched controls in communities throughout the counties of Niagara, Monroe, and Erie in western New York. The interview was highly detailed, requiring two and one-half hours to complete; it attempted to provide an estimate of total calories ingested as well as of macro- and micronutrients and behaviors that could affect alimentary exposures, such as the use of refrigeration. We found that risk was enhanced by sodium, fat, and retinol. Substantial reductions in risk were associated with ingestion of carotene, especially raw vegetables (including celery, cucumbers, carrots, green peppers, tomatoes, and onions), as well as with increased use of low-temperature food storage. Both refrigeration and carotene could inhibit oxidation products that could act as carcinogens in the stomach.

Adult↗
PubMed1990

Nutritional epidemiology of cancer of the esophagus.

This study of 178 cases of cancer of the esophagus from three counties in western New York, as compared with sex- and age-matched neighborhood controls in 1975-1986, replicated some earlier findings, particularly with regard to the increased risks associated with use of cigarettes and alcohol. The concentration of alcohol in an alcoholic beverage apparently did not affect risk: Beer carried a substantial risk, whereas less-dilute forms of alcohol carried no risk. These findings also suggest that the risk of cancer of the esophagus increases with ingestion of foods containing retinol but not carotene. Although increased risks were found to be associated with increases in total calories and fat ingested, as well as calcium, they appeared to be confounded with the risk associated with retinol, as distinct from carotene. Inasmuch as a difference in risk associated with retinol and carotene has been shown in a few previous inquiries dealing with esophageal cancer and cancer at other sites, a need for further investigations distinguishing risks associated with the two compounds is apparent.

Beer↗
PubMed1990

Development of a new in vivo model for head and neck cancer.

We have developed an improved model for studying in vivo nonsurgical treatment of head and neck cancer. In situ oral cavity implantation has been documented, but its natural history is not defined. In light of this, an improved model is described. Forty-two nude mice had tumor cells from one of two established laryngeal squamous cell carcinoma cell lines implanted into the floor of the mouth. The tumor mass was measured and followed. When the tumor burden was great enough to cause cachexia, the animals were killed and submitted for microscopic examination. Pulmonary metastases were noted in 44%, bone invasion in 80%, angioinvasion in 76%, and soft tissue invasion in 96% of the animals. Growth characteristics in the head and neck have not been documented in previous models. Our model not only exhibits the locally invasive activity typically associated with malignant neoplasms, but also closely parallels the results of clinical studies examining the percent of end stage patients and autopsies with pulmonary metastases. Therefore, this model should open the way for more meaningful in vivo studies of nonsurgical treatment modalities for both local and metastatic tumor foci in head and neck cancer.

Animals↗
PubMed1988

Dietary epidemiology of cancer of the colon in western New York.

The authors interviewed 428 pathologically confirmed cases of colon cancer and controls matched on age, sex, race, and neighborhood in the New York counties containing the cities of Buffalo, Niagara Falls, and Rochester. Risk of colon cancer in both males and females, studied separately, appeared to increase with the amount of total fats and total calories ingested. In addition, we found the risk to increase with increases in the Quetelet index of relative weight (weight (kg)/height (m)2). Dietary fiber was only equivocally associated with risk. Fats and Quetelet index were associated with increased risk in a regression analysis adjusting each factor for the other, as well as for fiber, age, and socioeconomic status. The same was true for calories and Quetelet index. Future efforts to clarify a possible protective role for fiber and to disentangle the effects of fats and calories need to be undertaken. The fact that calories ingested and obesity are each associated with increased risk suggests the importance of studying calorie expenditure.

Body Height↗
PubMed1985

An inquiry into the epidemiology of melanoma.

The authors conducted a study of 404 melanoma patients and 521 control patients of both sexes at Roswell Park Memorial Institute. As have previous investigators, they found that higher risk attaches to upper socioeconomic status, as measured by occupation and education, lightness of complexion and hair, and amount of blue in the admixture of eye color. The authors also found a higher risk among individuals who reacted to sun exposure by burning, blistering, or freckling rather than by tanning. A particular concern was to measure risk associated with exposure to the sun. As have two other investigators, they found that risk decreased with increasing exposure, suggesting either that individuals continually exposed to the sun have less risk because of tanning, or that susceptibles purposely avoid sun exposure, or both. The fact that melanoma occurs with greater frequency on sites exposed to the sun suggests that sun exposure plays a part. These studies showed a dose-response increase in risk (odds ratios of up to 4 for males and over 6 for females) with increases in number of traits possessed, such as light complexion, and burning or freckling in response to sun exposure. This is consistent with the authors' earlier finding of a strong familial aggregation of melanoma.

Adult↗
PubMed1983

Diet in the epidemiology of carcinoma of the prostate gland.

In vivo, in vitro, prospective, and retrospective epidemiologic inquiries have suggested that retinoids inhibit cancer, and fats have been hypothesized to enhance and ascorbic acid to reduce cancer risk. Comparison of 260 patients from Buffalo with cancer of the prostate gland was made with two different control series of similar size and age distribution. Regardless of the control group, risk of prostate cancer gained with increases in ingestion of retinoids, animal fats, and vitamin C. These anomalous findings may be due to peculiarities in methodology. From the possible specificity of effect of the nutrients studied, as shown in experimental animals and in vitro, a hypothesis could be made that a substance like vitamin A or C, which may inhibit certain cancers, also may enhance risk of other cancer types or have neither effect.

Adult↗
PubMed1980

Spouse-subject interviews and the reliability of diet studies.

Recently published data suggest relationships between ingestion of a number of food items and risk of cancer of the stomach, bowel and mouth. This engenders concern over the accuracy of such data. To study this, dietary interviews of 158 males in the Western New York Study of Cancer Epidemiology are compared to their spouses' estimates of the husband's dietary histories as taken in separate interviews. Respondents were asked to estimate the frequency with which the males consumed each of several foods. For analysis, the frequency estimates were assembled into categories similar to those used in recent epidemiologic analysis: 5-7 times per week, 1-4 times per week, 1-3 times per month and less than once per month. Generally, 60-80% of respondents pairs agree exactly on the frequency of consumption for individual food items. Over 90% of spouse and respondent food frequency estimates are within one frequency category of each other. Radical disagreements between spouses are rare; generally, in less than 2% of spouse pairs does one member estimate the maximum frequency category, and the other minimum frequency category. The authors suggest therefore that, although diet histories are not precisely replicable, they must be adequate to reveal gross differences between cases and controls.

Adult↗
PubMedDate not supplied

Understanding the effects of a myocardial infarction on sexual functioning: a basis for sexual counseling.

Sexual counseling is an integral component of the rehabilitative process for clients who have experienced a myocardial infarction (MI). This article describes myths and fears concerning the dangers of resuming sexual intercourse after a heart attack, positions for intercourse, and the effects of intercourse on arrhythmias, angina, and blood pressure. The purpose is to provide the results of empirical research to dispel myths and fears and to consider the causes of sexual dysfunction, the changes MI brings about in sexual activity for men and women, and the effects of age, exercise, and antihypertensive drugs on the resumption of sexual activity. Guidelines are provided for conducting a sexual/cardiac history as part of the counseling model with specific information for the post-MI client.

Clinical Protocols↗
PubMedDate not supplied

AIDS knowledge and attitudes of primary grade teachers and students.

This study was conducted to assess knowledge of and attitudes toward AIDS in primary grade teachers and students before the implementation of a mandated AIDS curriculum. Teachers and children completed questionnaires. Although both the teachers and the children were knowledgeable about some aspects of AIDS, both groups revealed misconceptions and misinformation. A high percentage of the children reported a fear of getting AIDS even though they constitute a very low-risk group. Deficiencies in knowledge and fear of AIDS underscore the importance of the provision of accurate information to both teachers and elementary school children. Implications for school nurses and other health care providers are discussed.

Acquired Immunodeficiency Syndrome↗