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Biomedical subjects

D Hays

Publications and source records attributed to D Hays.

10 recordsLinked to original sources
PubMed1990

Soft tissue sarcoma of the perineal region in childhood. A report from the Intergroup Rhabdomyosarcoma Studies I and II, 1972 through 1984.

Thirty-six previously untreated patients younger than 21 years of age with sarcoma arising in the perineal region were entered on the Intergroup Rhabdomyosarcoma Studies (IRS) I and II from 1972 through 1984. The tumor histologic subtype was alveolar rhabdomyosarcoma (RMS) in 20 patients (56%), embryonal RMS in 11 patients (30%), and other types of sarcoma in 5 patients (14%). Fifteen children had grossly complete surgical excision (Clinical Groups I and II), and 15 had localized gross residual tumor (Group III) after initial operative management. Six patients had distant metastases (Group IV) at diagnosis. Twelve patients without distant metastases underwent regional lymph node biopsy; tumor involvement was found in six. Subsequent treatment consisted of chemotherapy with vincristine (VCR) and dactinomycin (AMD) for all patients; patients in Groups III and IV also received cyclophosphamide (CYC) with or without Adriamycin (ADR) (doxorubicin; Adria Laboratories, Columbus, OH). Radiation therapy (RT) was administered to patients in Clinical Groups II, III, and IV. Overall, 28 (78%) patients achieved a complete clinical response. The 3-year disease-free survival rate for these patients was 42%, compared with 52% for all other patients in the combined IRS I and IRS II series (P = 0.44). The overall 3-year survival rate was 59%, compared with 64% for all other patients in IRS I and IRS II (P = 0.48). Aggressive treatment is needed in children with perineal sarcoma to improve their prognosis.

Adolescent↗
PubMed1989

Results of intensive therapy in children with localized alveolar extremity rhabdomyosarcoma: a report from the Intergroup Rhabdomyosarcoma Study.

Preliminary analyses of treatment results and prognostic factors from the first Intergroup Rhabdomyosarcoma Study (IRS I) suggested that alveolar histology and extremity site were among factors associated with an adverse outcome in clinical group I patients whose tumors had been completely resected. A high incidence of alveolar histology among the extremity tumors compounded the problem. These findings prompted an amendment to IRS II shortly after the study opened. Therapy for patients with alveolar extremity tumors in groups I and II was changed to more intensive repetitive pulse vincristine, dactinomycin, and cyclophosphamide (VAC) for 2 years. The outcome of 44 patients who received intensive therapy on IRS II is compared with a control series of 30 patients who were treated on IRS I. The control patients received standard VAC therapy for 2 years or VA for 1 year. Half of group I control patients received local radiotherapy, whereas none was given to group I intensive therapy patients. In both studies group II patients received radiotherapy to the primary tumor site and to identified positive regional lymph nodes. Compared with the control group, patients given more intensive therapy had a longer disease-free survival (DFS) (69% v 43% at 3 years), but this was of marginal significance (P = .06). The overall survival difference (77% v 57% at 3 years) was not significant (P = .23). Despite the limited statistical evidence, there is some indication that intensive therapy improved the prognosis of children with localized alveolar rhabdomyosarcoma (RMS).

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Heterosexual women's perceptions of their marriages to bisexual or homosexual men.

Twenty-one heterosexual women who were or had been married to bisexual or homosexual men and had children by them responded to a 28-page questionnaire that explored their experiences as wives and mothers. All of the married women expected a lasting, monogamous marriage. Only three had partial knowledge of their husband's sexual orientation before marriage. All of them went through a painful grief reaction when they learned that their husbands had emotional or sexual, or both, attachments to other men. The suffering was aggravated by feeling deceived or stupid for not having guessed the truth. What made it difficult for them to seek support from family and friends was the fear of encountering social disapproval or ostracism. They were afraid for themselves, their husbands, and their children. At the time of the study 11 of the 21 women were still married and living with their husbands, but most of them felt unsure that the marriage would last. Ten were in transition, separated, or divorced. Only three of the still married wives had complete confidence in the future stability of their relationships. These marriages were characterized by good communications, husbands who considered themselves bisexual, and an open marriage contract whereby wives could have heterosexual affairs. Findings cannot be generalized from this small convenience sample, but will hopefully encourage further research. The writers are also soliciting more subjects to enlarge the sample.

Adult↗
PubMed1987

Fat-density oral contrast agent for abdominal CT.

To overcome the problem of inadequate mixing of gastrointestinal (GI) tract contents with conventional high-density oral contrast agents in abdominal computed tomography (CT), a flavored 12.5% corn oil emulsion (COE) was tested as an oral contrast agent in 62 patients. The results were compared with those obtained from 105 patients who received high-density oral contrast agents. A simple patient preparation regimen for the COE was developed, which appears to be reasonably well tolerated by the patients and yields diagnostic studies comparable to those obtained with conventional agents. Use of the COE resulted in consistent discrimination of the GI tract and depiction of the GI wall. Preliminary data suggest that it may be particularly useful for CT evaluation of the stomach, duodenum, and pancreas; in patients suspected of having solid tumors; and in thin people.

Barium Sulfate↗
PubMed1987

A comparison of fetal biometric ratios to neonatal morphometrics.

Ratios of fetal abdominal circumference to femur length (AC/FL) and thigh circumference to femur length (TC/FL) have been suggested as indices of fetal nutrition. Birthweight, skin-fold thickness, and ponderal index are accepted neonatal indices of nutrition. The purpose of this study was to compare fetal to neonatal indices of nutrition. In 52 patients in term labor, fetal abdominal circumference, thigh circumference, and femur length were measured ultrasonographically. Neonatal skin-fold thickness was calculated as the average of tricipital, subscapular, abdominal, and anterior thigh measurements determined with Harpenden skin-fold calipers. Linear correlation analysis demonstrated a significant relationship between AC/FL and ponderal index (r = 0.340, P = 0.028) and between TC/FL and ponderal index (r = 0.368, P = 0.007). Neither AC/FL nor TC/FL were significantly related to birthweight or skin-fold thickness. These data suggest that the diagnostic reliability of antenatal studies of fetal biometric ratios may be enhanced by using the ponderal index as a neonatal endpoint rather than birthweight or skin-fold thickness.

Abdomen↗
PubMed1987

Localized orbital rhabdomyosarcoma. An interim report of the Intergroup Rhabdomyosarcoma Study Committee.

Children with rhabdomyosarcoma (RMS) (1461 total cases) were included in two prospective, randomized protocols conducted by the Intergroup Rhabdomyosarcoma Study (IRS) Committee from November 1972 to June 1983. Treatment assignment was determined by extent of tumor at diagnosis (clinicopathologic group) and not by primary site. Accordingly, 127 patients with RMS confined to the region of the eyelid and orbit were treated by a variety of regimens characterized by initial partial tumor resection followed by concurrent multiagent chemotherapy and orbital radiation therapy. Recurrent tumor developed in ten patients. Seven relapsed initially in the orbit (of whom 4 were salvaged) and three in regional nodes. In addition to the six patients who died of tumor, three died of other causes for a 93% 3-year actuarial survival rate. In 89 children who had subtotal resection or biopsy only, the local control rate with radiotherapy and chemotherapy was 94%.

Adolescent↗
PubMed1985

Prognostic factors and outcome in bilateral Wilms' tumor.

Twenty-one patients with bilateral Wilms' tumor are reviewed and the details of diagnosis, therapy, and survival presented. All patients had an abdominal mass at the time of diagnosis. Associated findings included hypertension, aniridia, and genitourinary anomalies. Favorable histologic features were found in all simultaneously occurring tumors and in the initial tumor in nonsimultaneous tumors. Eleven of the 18 patients with simultaneously occurring tumors survived for at least 2 years, for an overall 2-year survival rate of 61%, which was similar to the 2-year survival rate of 60% found in a review of 61 other simultaneously occurring bilateral Wilms' tumors reported in the literature since 1971. Two "front-end" factors that affected prognosis were the patient's age and the stage of the most advanced tumor at the time of diagnosis. A significantly better survival was found in children whose tumor was diagnosed before the age of 2 years and in patients who had Stage I or II disease in the most advanced tumor, as compared with those who had Stage III or IV disease. The overall survival rate in this series and in the literature review is much poorer than that reported for bilateral Wilms' tumor in the National Wilm's Tumor Study; some possible reasons for this are given. The authors' current approach to diagnosis and therapy is reviewed.

Actuarial Analysis↗