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Biomedical subjects

D M Bottomley

Publications and source records attributed to D M Bottomley.

9 recordsLinked to original sources
PubMed1999

Short-term morbidity and acceptability of 125iodine implantation for localized carcinoma of the prostate.

OBJECTIVE: To report the short-term morbidity and acceptability of the first 50 patients treated with the percutaneous implantation of radioactive iodine seeds for localized carcinoma of the prostate at the Cookridge Hospital. PATIENTS AND METHODS: Fifty patients were treated with transrectal ultrasonography-guided percutaneous implants with radioactive (125I) iodine seeds for localized carcinoma of the prostate. The mean hospital stay was 36 h and most patients were able to return to work or normal activity within one week of implantation. RESULTS: All patients developed urethritis which was most marked within the first 3 months of treatment; 8% of patients developed acute retention which resolved after temporary catheterization. At 3 months, 36% of patients still had moderate frequency and 18% moderate dysuria, but by 12 months these had resolved and only 5% of patients still complained of moderate nocturia. There were no cases of incontinence. The incidence of proctitis was very low, with only 2% still complaining of moderate symptoms at one year. Of those potent before implantation, 72% retained potency at one year. CONCLUSIONS: Although it is too early to comment either on late morbidity or on outcome, the results of this study show a side-effect profile similar to that reported by other centres using the same technique.

Aged↗
PubMed1998

Prostate brachytherapy.

In recent years there has been an increase in the number of centres, especially in the USA, using prostate brachytherapy as a means of treating localised prostate cancer. Several centres now have medium term follow up data of large numbers of patients treated with this technique suggesting that outcome in terms of tumour control may be comparable to patients treated surgically. This review summarises results from different brachytherapy series and outlines some of the possible advantages of this technique compared with current conventional treatments for localised prostate cancer.

Journal Article↗
PubMed1996

Epidermoid anal cancer in HIV infected patients.

Anal cancer associated with human immunodeficiency virus (HIV) infection is an unusual clinical situation in which the appropriate management remains unclear. Experience of treatment and follow-up is presented of six patients with histologically confirmed invasive epidermoid anal cancer on a background of HIV infection. Durable complete responses with acceptable toxicity occurred in two patients with moderate immunosuppression and Stage I-II tumours treated with a combination of concomitant chemotherapy (5-fluorouracil and mitomycin-C) and pelvic radiotherapy (45 Gy in 25 fractions). One patient treated with radiotherapy alone (60 Gy in 30 fractions in two phases) had a complete response. Two patients, one with Stage III tumour and the other with pre-existing acquired immunodeficiency syndrome, died within 6 months of treatment. Moderate to severe perianal skin reactions commonly occurred. Although the world experience of managing anal cancer in HIV infected individuals is small, this and other reports support the use of chemoradiotherapy in selected patients. The appropriate treatment of patients with more advanced tumours and/or advanced HIV infection is uncertain.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1994

The infra-red coagulator in the treatment of AIDS-related Kaposi's sarcoma and a comparison with radiotherapy.

Experience with 1 s pulses of the infra-red coagulator is reported for the treatment of 10 cutaneous AIDS-related Kaposi's sarcoma lesions in seven patients. The infra-red coagulator may be a useful addition in the palliative cosmetic treatment of Kaposi's sarcoma, producing an acceptable result in small (less than 2 cm in diameter) Kaposi's sarcoma lesions of the arms and trunk, but not in those situated on the legs.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Subcutaneous midazolam infusion in palliative care.

This article describes the use of a subcutaneous infusion of midazolam to control restlessness and agitation in 23 patients during the final stages of advanced cancer. Midazolam effectively controlled symptoms in 22 of the patients at an initial dose of 0.4-0.8 mg/hr rising to a mean maximum dose of 2.9 mg/hr. Midazolam mixed in the same syringe as diamorphine was well tolerated at injection sites. The wide dose range emphasizes the need for careful titration of dose for individual patients. At high doses, the volume of injection required presented some practical difficulties, but otherwise there were no major problems with this technique. Midazolam by subcutaneous infusion is a well-tolerated, safe and effective treatment for terminal restlessness and agitation, and deserves more extensive evaluation.

Adult↗