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Biomedical subjects

D M Hoffman

Publications and source records attributed to D M Hoffman.

47 records · Page 3Linked to original sources
PubMed1980

The handling of antineoplastic drugs in a major cancer center.

It has long been known that many commonly used antineoplastic agents are carcinogenic. Yet most health care professionals take few precautions, if any, when handling these drugs. Recent findings suggest a possible hazard to personnel as evidenced by increased mutagenicity of urine of nurses exposed to anticancer drugs during preparation and administration of doses. Although more study is needed to determine the significance of these data, it would seem prudent to take measures to prevent any unnecessary exposure to these drugs by those preparing and administering them. The policies and procedures at the Memorial Sloan-Kettering Cancer Center require that chemotherapeutic drugs be prepared in a vertical laminar flow containment hood by personnel wearing sterile disposable gloves. Chemotherapeutic agents are specially labeled to ensure segregated disposal of waste, which is subsequently incinerated.

Antineoplastic Agents↗
PubMed1979

Stability of refrigerated and frozen solutions of doxorubicin hydrochloride.

The stability of refrigerated and frozen solutions of doxorubicin hydrochloride was studied. Vials of doxorubicin hydrochloride with lactose (Adriamycin) were reconstituted with Sterile Water for Injection, USP, to provide a drug concentration of 2 mg/ml. Samples were refrigerated (4 C) for up to one year and frozen (-20C) for 30 days then assayed by high-performance liquid chromatography. One sample was assayed then refrozen each test period. Refrigerated and frozen samples showed no substantial loss of potency after six months and one month of storage, respectively. Filtration through a 0.22-micron filter did not affect potency. Degradation products were not detected, except for an unidentified small peak detected in the sample refrigerated for one year. Doxorubicin hydrochloride, when reconstituted with sterile water for injection, may be refrigerated for six months or frozen for one month without loss of potency.

Doxorubicin↗
PubMed1976

Pharmaceutical services in a pediatric oncology day hospital.

The role of the pharmacist in a treatment center in which pediatric cancer patients receive intensive chemotherapy with a minimum of inhospital admission time is discussed. Functions of the pharmacist include: preparation and dispensing of oral and parenteral medications; monitoring of physicians' orders; maintaining patient profiles; maintaining investigational drug records; providing drug information; and conducting inservice educational programs.

Child↗
PubMedDate not supplied

Using daily ratings to confirm premenstrual syndrome/late luteal phase dysphoric disorder. Part I. Effects of demand characteristics and expectations.

Daily symptom ratings were evaluated in 31 women who met DSM III-R criteria for a diagnosis of Late Luteal Phase Dysphoric Disorder (LLPDD), and 34 women who reported no premenstrual symptomatology. Women in both groups were randomly assigned to be aware or unaware of the menstrual cycle focus of the study. Results revealed a consistent pattern of cyclic effects, with higher ratings in the mid-luteal, premenstrual and menstrual phases for many symptoms. Ratings of women reporting severe symptoms were not affected by knowing the purpose of the study and were higher than ratings in the asymptomatic group for many symptoms relevant to the LLPDD diagnosis. Awareness of the study focus did increase cyclicity in the ratings of asymptomatic women aware of the study focus compared with those who were unaware, but these differences were small and most were not significant. The implications of these findings for research and clinical diagnosis of PMS/LLPDD are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

Using daily ratings to confirm premenstrual syndrome/late luteal phase dysphoric disorder. Part II. What makes a "real" difference?

Five degree of change criteria used in previous research to confirm premenstrual syndrome/late luteal phase dysphoric disorder (PMS/LLPDD) based on daily ratings were examined to determine how well each differentiated between women claiming to experience severe symptoms and women with normal menstrual experience. Frequency and nature of stressful events and subjective perceptions of impairment were also examined. Ratings were evaluated in 31 women who met DSM III-R criteria for a provisional diagnosis of LLPDD, and 34 women who reported no premenstrual symptomatology. Ratings for a sample of women taking oral contraceptives and a sample of men were also included for comparison purposes. Results indicated no differences between the groups in the frequency of stressful events. However, the PMS/LLPDD group rated their problems as more disturbing and evidenced a cyclical pattern in the occurrence of negative interpersonal interactions at work that was suggestive of some impaired functioning. None of the five change criteria differentiated the PMS/LLPDD group from the normally cycling No PMS group, and only one differentiated this group from the oral contraceptive No PMS group. This was true whether a liberal or conservative standard of confirmation was applied. The implications of these findings for using daily ratings to confirm PMS/LLPDD are discussed.

Circadian Rhythm↗
PubMedDate not supplied

Treatment of metastatic renal cell carcinoma with high-dose bolus interleukin-2 in a non-intensive care unit: an analysis of 124 consecutively treated patients.

PURPOSE: In prior studies of high-dose interleukin-2 (IL-2) therapy in the treatment of metastatic renal cell carcinoma, the majority of patients were asymptomatic (65% of patients had Eastern Cooperative Oncology Group [ECOG] scores of 0 [no cancer-related symptoms]). These studies demonstrated that an ECOG score of 0 predicted an objective antitumor response to IL-2 (P = 0.03). The current study determined the response frequency to high-dose IL-2 therapy in a primarily symptomatic patient population (ECOG = 1 [presence of cancer-related symptoms] for 57.3% of patients). The IL-2 therapy was administered in a non-intensive care unit (non-ICU). PATIENTS AND METHODS: In this single-institution study of high-dose IL-2 therapy, 124 patients were consecutively enrolled and treated with the drug. Antitumor responses and safety were assessed by radiographic methods and the occurrence of grade 3 and 4 adverse events, respectively. RESULTS: The frequency of objective responses was 14.5% (18 of 124 patients). Seven patients (5.6%) and 11 patients (8.9%) experienced complete responses (CRs) and partial responses (PRs), respectively. Two of 7 patients (28.6%) with CR and 7 of 11 patients (63.6%) with PR had ECOG scores of 1. The median response duration is 18 months for all responders (CR plus PR). The median survival duration is 15 months for all patients. It was not possible to estimate the median survival duration for all responders because the majority of responding patients were alive at close of study. All patients with CR and 5 patients with PR were alive at close of study. The frequency of grade 3 and 4 adverse events was comparable to or less than published data and IL-2 was safely administered in a non-intensive care unit. CONCLUSION: The frequency of objective antitumor responses in patients with ECOG scores of 1 suggests that high-dose IL-2 therapy may have comparable effectiveness in symptomatic and asymptomatic patients. High-dose IL-2 can be administered in a non-ICU setting with acceptable toxicity and the chance of clinical benefit.

Adult↗
PubMedDate not supplied

Transesophageal echocardiography for the evaluation of mitral valve prostheses in the weanling sheep.

The sheep model has been widely accepted for evaluating the in vivo performance of artificial valves. Introduction of transthoracic echocardiography revolutionized the evaluation of human cardiac valves, but in many cases, resolution of transthoracic studies in sheep is inadequate. The authors used transesophageal echocardiography to follow the performance of chronically implanted mitral prostheses. The technique has proven feasible and safe, requiring sedation only and being done in the spontaneously breathing animal without endotracheal intubation in the left lateral position. The HP 77020A, equipped with a standard HP 5 mHz transesophageal transducer probe, is used. The authors have had to modify the probe to allow for automatic cooling. Standard insertion techniques are used and the probe is positioned in the stomach, close to the gastroesophageal junction. They were able to assess leaflet motion, vegetations, and calcification and use color flow doppler to evaluate stenosis and regurgitation. The technique is convenient and permits a complete assessment of valve function in 10 minutes. Reproducibility has been confirmed. Validation of quantitative data will require further study.

Animals↗