PubMed Health⌕ Search

Biomedical subjects

D H Abramson

Publications and source records attributed to D H Abramson.

At least 73 records · Page 4Linked to original sources
PubMed1993

Acute and long-term effects of radiation therapy to the eye in children.

The goal of radiation therapy in pediatric cancer is to destroy cancer cells and preserve functional surrounding normal cells. Although all radiation for pediatric cancers does not result in complications of the eye, acute and long-term radiation effects can occur after treatment. Acute radiation effects to the eye include erythema, epilation, conjunctivitis, dermatitis, keratitis, corneal ulceration, iritis, and retinal edema. Long-term radiation effects include tissue necrosis, decreased tear production, telangiectasia, scleral melting, cataract, corneal neovascularization, radiation retinopathy, retarded bone growth (of bones within the irradiated field), and radiation-induced cancers. Nursing interventions and implications will be presented in conjunction with medical management for each of these acute and long-term effects.

Acute Disease↗
PubMed1993

Nursing implications of visual fields in successfully treated retinoblastoma patients.

Very little data has been published on the long term peripheral vision of patients diagnosed and successfully treated for retinoblastoma. Nursing should address the patient's response to vision-conserving treatment and their adaptation to decreased peripheral vision. Computerized Humphrey's Central 30/Peripheral 30-60 visual fields were performed on ten patients (all with greater than ten year follow-up) who were successfully treated for retinoblastoma. All ten visual fields revealed an absolute and relative scotoma in the affected eye. Visual field loss was always worse than one would have predicted based upon the fundus examination of the tumor(s). Decisions for treatment must be based upon an interdisciplinary approach of nursing and medicine to evaluate patient survival and visual outcome. Nursing interventions include utilizing the visual field as a teaching aid, preparing the patient and the family for potential future visual loss and adaptation of lifestyle, and providing emotional support and realistic reassurance.

Child, Preschool↗
PubMed1992

Choroidal melanoma responses after brachytherapy treatment.

Serial ultrasonic measurements performed on 85 melanoma patients who were treated with radioactive plaques and followed for up to 141 months revealed that no 2 patients had identical patterns of change. Eighty-two of the patients were categorized into one of four patterns after treatment: Type D (decrease in height, 57 patients), Type S (same height, 12 patients), Type I (increase in height, 9 patients), and Type RG (tumour regrowth, 4 patients). The calculated mean total change in tumor height for Type D was 1.92 mm at 6 months, 2.58 mm at 12 months, 2.97 mm at 24 months and 3.61 mm at 48 months. For Type I, the mean total change in tumor height was 0.80 mm at 6 months, 0.95 mm at 12 months, 2.28 mm at 24 months, and 3.0 mm at 48 months.

Brachytherapy↗
PubMed1992

Bilateral retinoblastoma. Correlations between age at diagnosis and time course for new intraocular tumors.

A retrospective analysis of 355 eyes from 325 patients with bilateral retinoblastoma followed for at least five years was analyzed for the development of new ocular tumors. Eighty-eight eyes (24.8%) developed new tumors with more than 95% of these seen in patients diagnosed before the age of two years. Excluding one patient, no new tumors were seen in patients who were initially diagnosed after 33 months of age. The relative risk for developing new tumors was greater (45.1%) for patients diagnosed within the first six months of life than for patients diagnosed after the age of six months (14.2%). The highest percentage of patients (58%) to develop new tumors were those diagnosed before the age of three months. In patients initially treated before two years of age, new tumors were noted to develop up to 4.5 years later, whereas among eyes diagnosed after the age of two years, 100% of all new tumors were seen before 1.5 years of follow-up. Regardless of the age at diagnosis, however, the upper age limit for new tumor development ranged from 4.0-6.25 years, with a mean of 5.1 years. All new tumors were managed with either photocoagulation/cryotherapy or plaques.

Adolescent↗
PubMed1992

Retinoblastoma in the first year of life.

Children diagnosed with retinoblastoma in the first year of life present with differences in laterality, stage, signs, symptoms, and respond differently to treatments when compared to older children. Of those children diagnosed in the first year of life (between 1958 and 1983 inclusive), 280 were bilateral and 121 were unilateral, the most common stage of diagnosis (for unilateral and bilateral) was Group V, and children were affected equally by sex. Children examined in the first three months of life were more often seen because of a positive family history of retinoblastoma, rather than leukocoria. Children who were treated in the first year of life frequently develop second nonocular tumors because they harbor the germinal mutation and receive radiation.

Diagnosis, Differential↗
PubMed1992

Choroidal melanoma.

Choroidal melanoma is a rare and deadly cancer. Nursing care for these patients involves ophthalmic clinical expertise as well as psychosocial and emotional support. Although past research has been helpful in determining the prognosis of these patients, it is impossible to predict with certainty which patients have tumors or nevi that will grow, will compromise their vision, or will kill them. Providing emotional support, establishing a good rapport with the patients and their support persons, and encouraging patients to schedule and adhere to their mutually agreed on follow-up appointments are nursing interventions that may save or prolong a patient's life.

Adult↗
PubMed1992

Presenting signs and symptoms of choroidal melanoma: what do they mean?

Presenting signs and symptoms of 193 patients with choroidal melanomas (followed for up to 152 months) were recorded using retrospective chart review. Eighty patients (41%) had no symptoms (the melanoma was found during routine ophthalmologic examination in 65 patients and during treatment for other eye problem in 15 patients). We found 113 patients (59%) had symptoms (visual acuity or visual field defects, 77 patients; flashes or floaters, 30 patients; pain, 5 patients, and metastatic disease, 1 patient). The tumor size was related to the presence or absence of symptoms (chi-square, 10.6; P = .005). More tumors that presented with symptoms were medium sized (64%) than large (27%). Men had significantly more symptoms (chi-square, 4.1; P = .04). The right eye was more likely to be involved in patients with symptoms (chi-square, 7.3; P = .007). Kaplan-Meier survival analysis for age, sex, presence of tumor or retinal detachment in the macula, tumor location, presence of symptoms, laterality, and tumor size showed that only tumor size was related to a difference in incidence of metastasis (log-rank chi-square, 12.9; P = .002). With increased tumor height, the probability of developing metastasis was greater.

Adolescent↗
PubMed1991

Retinoblastoma. The long-term appearance of radiated intraocular tumors.

A retrospective analysis of 50 patients with retinoblastoma was undertaken to determine the appearance of intraocular retinoblastoma that had received external beam radiation a minimum of 10 years previously. Of the 91 tumors found in 59 eyes, 76 (84%) continued to be ophthalmoscopically visible after 10 years. The most common ophthalmoscopic appearance was a Type III regression pattern. The type of radiation regression pattern correlated with the pretreatment volume of the tumor. The largest tumors (mean, 10.0 disc diameter [dd]) became Type I regression patterns, whereas the smallest tumors (mean, 1.0 dd) completely disappeared. This represents the first long-term follow-up of the intraocular status of radiated retinoblastoma.

Child↗
PubMed1991

Retinoblastoma.

Retinoblastoma, although a rare childhood cancer, is the most common primary malignant intraocular tumor of infancy and early childhood. In 75% of the cases, retinoblastoma is unilateral, and in 25% of the cases, retinoblastoma is bilateral. Presenting signs and symptoms of retinoblastoma, genetics, diagnostic tests, and their implications are reviewed in this paper. Treatment options for retinoblastoma (enucleation, external beam radiation, radioactive plaque, cryotherapy, photocoagulation, and chemotherapy) and their nursing care are discussed. Finally, second tumors such as osteosarcomas are discussed.

Cryosurgery↗
PubMed1990

Changes in height of choroidal melanomas after plaque therapy.

Serial ultrasonic measurements of 82 uveal melanomas treated with brachytherapy plaques (cobalt-60 and iodine-125) and followed up for up to 141 months revealed that no two patients had identical patterns of change. The mean absolute change in tumour height after treatment was 1.8 mm at six months, 5.6 mm at 48 months for large tumours, and 0.9 and 1.9 mm for medium sized tumours. Eighty of the 82 patients fell into one of three patterns of response: 57 patients had a decrease in height after treatment (type D), 13 patients had the same height after treatment (type S), and 10 patients had a progressive increase in height (type I). Life table comparison showed no correlation between survival and location of tumour, sex of patient, size of tumour when treated, or laterality. There was a slight correlation between age and survival. Patients older than 60 died more frequently from metastatic melanoma than those under 60 (p = 0.06). Life table analysis showed a significant correlation between tumour regression type and survival. At 48 months the best cumulative probability of survival was in patients with type D (88% alive) compared with those of type I (34% alive, p = 0.0004).

Adult↗
PubMed1990

Ocular melanoma: total dose and dose rate effects with Co-60 plaque therapy.

From 1968 to 1987, 123 consecutive patients with nonmetastatic choroidal melanoma were treated with cobalt-60 plaques. One hundred sixteen patients were followed up for a mean of 3.8 years. Twenty patients had local failure, and 14 patients had distant failure. Complications included 32 cataracts, and seven enucleations were required. Local recurrence did not correlate with tumor height, tumor volume, dose, or dose rate. Increased volume (P = .004) and height (P = .01) correlated with increased rates of distant metastases. Dose adjusted for volume did not correlate with the rate of metastases.

Brachytherapy↗
PubMed1990

Retinoblastoma after 15 years.

Retinoblastoma, a cancer of early childhood, occurs once in 18,000 to 30,000 live births worldwide. Not only are bilateral cases diagnosed at an earlier age than unilateral cases, but bilateral cases are also associated with multifocal tumors. A ten-month-old girl was treated for bilateral retinoblastoma (the right eye was Group Ia; the left eye was Group IIIb) with 3500 rads of external beam radiation. The metastatic workup was negative. Because new tumors developed OS, a combination of photocoagulation and cryotherapy treatments were necessary. Fifteen years after treatment, the right eye had Type II regression and the left eye, Type III.

Adolescent↗
PubMed1989

Optic nerve involvement in retinoblastoma.

This retrospective review of 814 retinoblastoma patients discloses 240 cases of tumor extension into the optic nerve. Optic nerve involvement was classified according to the degree of invasion; grade I is superficial invasion of the optic nerve head only, grade II is involvement up to and including the lamina cribrosa, grade III is involvement beyond the lamina cribrosa, and grade IV is involvement up to and including the surgical margin. The incidence of optic nerve involvement was 29.5% (240/814). The mortality rate of patients with optic nerve involvement with grade I was 10%; grade II, 29%; grade III, 42%; and grade IV, 78%. Actuarial life-table analysis shows an increased mortality rate with increasing grade of optic nerve involvement. Multivariate statistical analysis shows that the grade of optic nerve involvement and the age at diagnosis of optic nerve involvement are the factors most significantly associated with survival.

Child, Preschool↗
PubMed1989

Neuron-specific enolase and retinoblastoma. Clinicopathologic correlations.

Neuron-specific enolase (a glycolytic, ubiquitous, intracellular enzyme) has recently been reported to be detectable in the aqueous humor of eyes containing retinoblastoma. Aqueous humor from 17 patients with histologically proven retinoblastoma was assayed for the presence of neuron-specific enolase (NSE). NSE was detectable in 17 out of 17 patients with levels between 619 and 60,000 ng/ml. A multitude of clinocopathological parameters were examined for statistically significant correlations with levels of aqueous humor NSE. This investigation demonstrated that only two parameters, the presence of tumor invasion into the anterior chamber, and inflammation significantly correlated with aqueous NSE levels. Histological parameters which did not correlate with aqueous NSE levels included tumor necrosis, calcification, Flexner-Wintersteiner rosettes, exophytic/endophytic tumor type, tumor extent relative to the equator, and optic nerve/choroidal invasion. Clinical parameters which showed no correlation included patient sex (M/F), enucleation age, presentation age, family history, laterality, prior treatment, and presence of metastatic disease. Neuron-specific enolase is present in the anterior chamber of eyes enucleated for retinoblastoma, but additional testing is necessary to determine the normal levels of neuron-specific enolase in children's eyes and the levels in eyes with lesions simulating retinoblastoma.

Anterior Chamber↗