First episodes of schizophrenia.
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Emotions↗
Biomedical subjects
C Vaughn
Publications and source records attributed to C Vaughn.
Adriamycin and cyclophosphamide versus hydroxyurea in advanced prostatic cancer. A randomized Southwest Oncology Group study.
Over a 24-month period, the Southwest Oncology Group (SWOG) conducted a randomized prospective chemotherapeutic trial in 158 patients with advanced prostatic cancer. Patients were initially randomized to receive either a combination of Adriamycin and cyclophosphamide (AC) or a single agent, hydroxyurea (H), and then crossed over to the other treatment on failure. Of the 137 evaluable patients, 43 (31%) had classically measurable metastatic disease in the lymph nodes, skin, chest, or liver. Focusing their efforts on this subset of patients with measurable disease, the authors of this report found the combination AC to have a superior response rate to the single agent, hydroxyurea. Objective response to AC was seen in 6 of 19 (32%) and in only one of 24 (4%) patients randomized to hydroxyurea (P = 0.06, Fisher's exact test). However, in the larger group of 137 evaluable patients, a survival advantage was not seen for those individuals treated with AC. Failure to demonstrate a survival advantage for an objectively superior drug combination would suggest the need for more active phase II agents in this disease.
Aged↗
Life events, relatives' expressed emotion and maintenance neuroleptics in schizophrenic relapse.
Data from two studies, one naturalistic and the other a controlled trial, were analysed to clarify the relationships between independent life events. Expressed Emotion of a key relative, maintenance neuroleptics and the relapse of schizophrenia. It was found that patients in the community who are unprotected by medication are vulnerable either to acute stress in the form of life events or to chronic stress in the form of living with a high Expressed Emotion relative. Patients on regular medication are protected against one or other stress, but are very likely to relapse if the two forms of stress occur together. A model of schizophrenic susceptibility to environmental stress is constructed to incorporate these observations.
Adult↗
Combination chemotherapy (CMFVP) versus L-phenylalanine mustard (L-PAM) for operable breast cancer with positive axillary nodes: a Southwest Oncology Group Study.
The Southwest Oncology Group in a prospective randomized study compared one year of adjuvant combination chemotherapy with continuous CMFVP to two years of intermittent L-PAM in women with operable breast cancer with histologically positive axillary lymph nodes. In fully evaluable patients with a 42-month median and 30-month minimum follow-up, treatment failures have occurred in 26% of 145 receiving CMFVP and 47% of 167 women given L-PAM (P = 0.002). Disease-free survival times were significantly longer with CMFVP than with L-PAM in the following subgroups: premenopausal women (P = 0.002), postmenopausal women (P = 0.002), women with 1-3 involved axillary nodes (P = 0.003), and women with four or more involved axillary nodes (P = 0.002). CMFVP was effective in pre- and postmenopausal women. There is a significant difference in survival in favor of CMFVP compared to L-PAM (P = 0.005). The life table estimates of survival at 42 months are 86% for women on the CMFVP treatment arm and 73% for women on the L-PAM treatment arm. There was no correlation between the interval from mastectomy to onset of chemotherapy (between one and six weeks) and recurrence rates. Acute toxicity with both treatment arms was moderate and reversible. These results show that continuous CMFVP is superior to intermittent L-PAM in decreasing recurrences and increasing survival in both pre- and postmenopausal women with operable breast cancer with histologically involved axillary nodes.
Breast Neoplasms↗
Adriamycin combinations in advanced breast cancer. A Southwest Oncology Group Study.
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Antineoplastic Agents↗
Phase II study of anguidine in gastrointestinal malignancies: a Southwest Oncology Group study.
The Southwest Oncology Group conducted a phase II study of anguidine in 134 patients with gastrointestinal malignancies. Anguidine was administered as a 4-hour infusion at doses of 3.0 and 4.5 mg/m2 daily x 5. Response rates for patients with colon carcinoma were 22% (four of 18 patients without previous chemotherapy) and 6% (four of 63 patients with previous chemotherapy). There were no responses in patients with pancreatic cancer (four patients) or gastric cancer (six). Toxic effects included thrombocytopenia (19.8%), leukopenia (18.8%), nausea and vomiting (49%), hypotension (37%), and confusion (12%). Antitumor activity of anguidine in patients with colon cancer may be similar to that of 5-FU, but nonhematologic toxicity is substantial.
Aged↗
The role of maintenance therapy and relatives' expressed emotion in relapse of schizophrenia: a two-year follow-up.
A two-year follow-up study was conducted, mainly from case notes, of patients who had originally taken part in a study of the influence of relatives expressed emotion on schizophrenic relapse. It was found that in the two years following discharge from hospital patients from high expressed emotion homes had a significantly greater relapse rate than those from low expressed emotion homes. The prophylactic effect of maintenance drugs was no longer evident for patients from high expressed emotion homes at the two-year follow-up. By contrast, a significant protective effect of maintenance therapy emerged for patients from low expressed emotion homes. The interpretation of these findings is discussed.
Attitude to Health↗
The interaction of life events and relatives' expressed emotion in schizophrenia and depressive neurosis.
A history of life events in the three months before onset of illness was taken in a group of schizophrenic and a group of depressed neurotic in-patients. The Expressed Emotion (EE) of the patients' key relatives was measured. There was no difference between the schizophrenic and depressed patients in the rate of events in the three month period before onset or in the proportion of undesirable events. However, the two groups exhibited significantly different patterns of interaction between life events and relatives' EE. Schizophrenic patients living with high EE relatives had a low rate of life events compared with those living with low EE relatives, whereas depressives living with high criticism relatives had a high rate of events compared with those living with low criticism relatives. The implications of these findings are discussed in relation to schizophrenic and depressive patients' differential vulnerability to environmental stress.
Adjustment Disorders↗
Bodily reactions to people and events in schizophrenics.
Schizophrenic patients were tested on psychophysiologic measures within their homes and in the laboratory. Sweat gland activity and heart rate changes when patients encounter novel situations such as life events, together with the home atmosphere generated by a critical or overinvolved relative, confirmed objectively the importance of previous social measures of these factors in determining relapse. Drug effects were also found to be modified by these social factors. Environmental and socially induced changes found in the home were undetectable in the laboratory situation.
Antipsychotic Agents↗
Cyclocytidine in breast cancer.
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Ancitabine↗
Phase II trial of piperazinedione in Hodgkin's disease, non-Hodgkin's lymphoma, and multiple myeloma: a Southwest Oncology Group study.
Piperazinedione given iv once every 3-4 weeks at a starting dose of 9-12 mg/m2 (4.5-12 mg/m2 for patients with myeloma) was evaluated in a Southwest Oncology Group phase II study for patients with far-advanced refractory lymphoma or multiple myeloma. Among 36 patients fully evaluable for tumor response (adequate trial), partial responses were observed in five (71%) of seven patients with Hodgkin's disease, in three (19%) of 16 patients with non-Hodgkin's lymphoma, and in none of 13 patients with multiple myeloma. Response was observed by the time of the second (five patients) or third (three patients) course. The median duration of response was 3.7 months (range, 1-17+ months). The dose-limiting toxic effects were hematologic, with 18 (50%) of 36 patients evaluable for toxicity experiencing severe leukopenia (wbc count less than 2000/mm3) and 22 (61%) experiencing severe thrombocytopenia (platelet count less than 50,000/mm3). Twenty patients had a decrease from their pretreatment hemoglobin level of greater than or equal to 2 g/100 ml. Hematologic toxic effects were often unpredictable and in several patients quite prolonged. This study indicates that piperazinedione had definite antitumor activity in patients with Hodgkin's disease and further trials in this disease using the drug at a reduced dose in combination with other effective drugs appear warranted.
Antibiotics, Antineoplastic↗
The measurement of expressed emotion in the families of psychiatric patients.
In a series of studies of the influence of family life on the course of an established schizophrenic illness, it has been shown that the level of emotion expressed by relatives shortly after a schizophrenic patient is admitted to hospital is strongly associated with symptomatic relapse during the nine months following discharge (Brown et al., 1962, 1972). This paper states the case for an abbreviated version of the primary research instrument used in these studies, the Camberwell Family Interview Schedule. In the 1972 study the single most important measure contributing to the overall expressed emotion index proved to be the number of critical remarks made about the patient by the relative when interviewed alone. An analysis of 15 tape-recorded interviews from this study showed that the majority of critical comments were produced within the first hour and there was virtually no relationship between total number of critical comments and length of interview (r = 0.08). This analysis supported the use of a shortened interview in which the areas most likely to produce any criticism were given priority in the sequence of questioning. This abbreviated version has been used successfully in a replication and extension of the 1972 study. A group of 37 schizophrenic patients is being compared with a group of 31 depressed neurotic patients. Patterns of emotional response of these patients' relatives are discussed.
Child↗
Psychohormonal treatment during the menopause.
Today the physician who treats women with emotional problems during menopause cannot function solely as a psychotherapist; he must deal with both their soma and psyche. The interaction between the endocrine and emotional states has long been known. When the equilibrium of an essentially normal state--menopause--is disturbed, a multifaceted approach is essential to restore homeostasis. Hormone replacement, psychotherapy and psychotropic drugs may all be necessary. Serial vaginal smears are useful in monitoring therapy.
Administration, Oral↗
Phase II trial of anguidine in patients with sarcomas unresponsive to prior chemotherapy: A Southwest Oncology Group Study.
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Adult↗
Minimal single-agent activity of maytansine in refractory breast cancer: a Southwest Oncology Group study.
Maytansine is an experimental antitumor agent that has shown minimal efficacy against breast cancer with minimal myelosuppression in phase I trials. Forty-one patients with advanced drug-resistant breast cancer were treated with a 5-day intermittent iv infusion of maytansine repeated every 21 days. All patients had been heavily pretreated with cyclophosphamide, methotrexate, 5-fluorouracil, or doxorubicin, and 12 had received vinblastine, mitomycin C, or investigational drugs. All patients had measurable disease and an expected survival of 6 weeks. The average performance status was 2.5. Twelve patients did not complete one full cycle of therapy, leaving 29 evaluable for response. One patient had a partial regression of pulmonary disease, seven had transient responses of less than 50% reduction in tumor or stable disease, and 21 had progressive disease. Toxic effects (vomiting, diarrhea, ileus, lethargy, and altered mentation) were considerable. Since maytansine is a relatively nonmyelotoxic metaphase inhibitor, we feel that even minimal efficacy in heavily pretreated patients justifies further evaluation of the agent in combination therapy.
Breast Neoplasms↗
Botulinum toxin: a new therapeutic use.
Botulinum Toxin is a powerful neurotoxin whose therapeutic uses for smooth muscle disorders have received little attention. Through innovative research, gastroenterologists at Johns Hopkins Hospital have developed a simple, less traumatic therapeutic use for this toxin in the treatment of achalasia. In this article, the authors describe the pathophysiology of this disease, its diagnosis and traditional treatment, and the newest potential therapy, Botulinum Toxin (BoTx) injection.
Aged↗