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Biomedical subjects

G R Kerr

Publications and source records attributed to G R Kerr.

At least 73 records · Page 4Linked to original sources

The results of a randomised trial of mixed-schedule (neutron/photon) irradiation in the treatment of supratentorial Grade III and Grade IV astrocytoma.

A randomised trial is reported of mixed-schedule (neutron/photon) irradiation compared with photon therapy for patients with Grade III or Grade IV astrocytoma. Thirty-one patients were allocated to be treated by the neutron/photon regime and 30 patients by photons. The median survival was 4 months in the mixed-schedule group and 8 months in the photon group. The survival rates were not significantly different. All patients who died had evidence of residual brain tumour. None had signs of radiation-related morbidity.

Adolescent↗

A phase I study of mixed (neutron and photon) irradiation using two fractions per day in the treatment of high-grade astrocytomas.

A Phase I study of the treatment of 50 patients with high-grade astrocytomas by mixed schedule (neutron and photon) irradiation given in 12 fractions over 4 weeks is reported. The neutron and photon fractions were separated each day by 2-3 h. A total neutron dose of 6.36 Gy (8% gamma) and 20.40 Gy of photons was prescribed. Treatment was well tolerated and there was no clinical evidence of radiation-related morbidity in the brain. The median survival was 6.9 months, similar to that expected after photon irradiation alone. A multivariate analysis of prognostic variables in presented.

Brain Neoplasms↗

Value of routine follow up of women treated for early carcinoma of the breast.

The value of routine follow up of women treated for early breast cancer by mastectomy with or without postoperative radiotherapy was assessed retrospectively. Over eight years 546 patients made 6863 clinic visits, during which 192 first relapses were detected. Ninety three relapses were detected at scheduled (routine) visits and 99 at unscheduled (interval) visits. First relapses within the treated area or in the contralateral breast were detected significantly more commonly at routine visits than were first metastatic relapses (66/89 (74%) compared with 27/103 (26%)). Patients whose local relapse was detected at a routine visit had a significantly better survival than those whose local relapse was detected at an interval visit. A relapse that was potentially curable (local or in the contralateral breast) was detected at 66 (1%) of 6764 routine visits, but only 26 (39%) of these patients remained free of disease. It is concluded that the intensity of follow up of such patients could be reduced without any adverse effect on prognosis but with appreciable financial and other benefits.

Breast Neoplasms↗

A report of a randomized trial of d(15)+Be neutrons compared with megavoltage X ray therapy of bladder cancer.

The results of a randomized trial of d(15)+Be neutrons compared with 4 or 6 MV photons for the treatment of transitional cell carcinoma of the bladder. Between December 1978 and December 1981, 113 patients were accrued, 53 allocated to be treated by neutrons and 60 by photons. Complete local tumor regression was observed in 64% of patients treated by neutrons and 62% treated by photons. Recurrent cancer was subsequently confirmed in 31% of patients, similar in both treatment groups. There was no significant difference in the control rates by T stage between the two treatment groups. Late morbidity was significantly worse in patients treated by neutrons. Following neutron therapy, 78% of patients had serious late morbidity in at least one tissue compared with 38% in the group treated by photons. Survival was significantly better in the photon treated group 45.3% (+/- 11%) at 5 years compared with 12% (+/- 6%) after neutron therapy.

Aged↗

Results of a randomised study to evaluate influence of dose on morbidity in radiotherapy for bladder cancer.

Ninety-four patients with invasive transitional-cell carcinoma of the bladder were randomised to receive three different doses of megavoltage X-rays. Doses of 50.0 Gy, 52.5 Gy and 57.5 Gy were given in 20 daily fractions. Patients were stratified into two groups by tumour size: less than 5.0 cm and 5.0-7.0 cm in diameter. The large tumours were more advanced (higher T stage) and included a larger number of patients with less well differentiated tumours. Comparisons of morbidity are made in each dose group defined by tumour size. Early and late morbidity was carefully assessed during follow-up and was found to be unacceptably high in the group who received 57.5 Gy in 20 daily fractions.

Actuarial Analysis↗

Brain metastases from carcinoma of breast: a review of 90 cases.

The case records of 90 patients developing brain metastases from carcinoma of the breast have been reviewed. Brain metastases developed more commonly in those patients who had Stage III disease at first diagnosis of breast cancer and in those who were pre- or perimenopausal at that time. Patients given whole-brain irradiation for brain metastases lived longer, from the date of central nervous system involvement, than those not given radiotherapy.

Brain Neoplasms↗

Fast neutrons in the treatment of head and neck cancers: the results of a multi-centre randomly controlled trial.

The results are presented of a multi-centre randomly controlled trial of fast neutron irradiation and mega-voltage X-rays in the treatment of patients with locally advanced squamous cell carcinoma of the head and neck region. No significant difference was observed in local tumour control rates. Salvage surgery was performed in a similar number of patients in the two groups. Late morbidity was also similar in the two treatment groups. Patients in a subgroup with cancer of the larynx treated by photons had a significantly better survival than those in the neutron treated group.

Aged↗

Subsequent malignancies in patients irradiated for testicular tumours.

897 patients received radiotherapy in Scotland for tumours of the testis between 1950-1969. 299 patients who died within two years of treatment, and a further 51 patients with inadequate follow-up data, were excluded from a survey of the incidence of second tumours. 547 patients with a mean follow-up of 15.4 years were included in the study. Fifty-one second and six third malignancies were found. The observed incidence is significantly higher than expected (ratio 1.87; p less than 0.001), both in the irradiated sites (ratio 1.94; p less than 0.05) and in unirradiated sites (ratio 1.99; p less than 0.01). These patients have a higher incidence of second testicular tumours (ratio 23.1; p less than 0.001). Analysis of the incidence of new malignancies in successive quinquennia after irradiation shows a significantly higher incidence in two periods. Within five years the greater incidence (p less than 0.05) is due mainly to the occurrence of second testicular tumours. In the period 15-19 years after irradiation the higher incidence (p less than 0.01) is accounted for by tumours arising in the urinary and gastro-intestinal tracts. The increased risk of developing a second cancer is low and there was no observed increase in radiation-related leukaemia.

Adolescent↗

Supermarket sales of high-sugar products in predominantly Black, Hispanic, and white census tracts of Houston, Texas.

Sales of 488 sweet foods and beverages by supermarkets located in predominantly Black, Hispanic, and white census tracts of Houston, TX, were examined in relation to sales of a number of commodity foods. Mean sweet energy/commodity food sales ratios in Black and Hispanic census tract supermarkets were 122 and 108%, respectively, of those in white census tracts. Ethnic differences in sweet energy/commodity sales ratios were almost always statistically significant (p less than 0.05), but variation within ethnic groups of supermarkets remained large, indicating that nonethnic factors also influenced the food purchase patterns. Supermarket sales records offer a relatively inexpensive source of data for comparative or longitudinal studies of community purchase of food products postulated to play a role in the development of nutrition-associated health problems. The major problems in interpreting the data result from a need to use ratios, and lack of a valid measure of the population consuming the foods purchased.

Black or African American↗

Results of radical radiotherapy of squamous cell carcinoma of the oesophagus.

A retrospective study was undertaken of 444 patients who were referred with squamous cell carcinoma of the oesophagus during the period January 1956 to December 1974 and who were treated by radical radiotherapy. The overall crude survival rate at 5 years was 9.0% which is similar to the results of most series reported from other centres and compares favourably with the results of radical surgery. The crude 5 year survival rate was 5.7% for males and 11.6% for females, a significant difference (P less than 0.05). Survival is analysed in terms of sex, site, size and histological grade. Patients (males and females) with the best 5-year survival rates had tumours no more than 5.0 cm in length (11.9%) or confined to the cervical oesophagus (18.9%). Histological grade appeared to have no influence on prognosis. The principal morbidity associated with radical radiotherapy is fibrous stricture formation. This occurred in 43.7% of the patients but was usually effectively managed by bouginage.

Adult↗

Relationship between dietary and biochemical measures of nutritional status in HANES I data.

Data from the first National Health and Nutrition Examination Survey were examined for individual 24-h dietary intakes of protein, vitamin A, thiamin, riboflavin, and iron, and for laboratory indices of the same nutrients in blood and urine. Mean intake values were close to or above reference standards for all nutrients except iron. Substandard laboratory values were recorded for: serum albumin and vitamin A--less than 3% of subjects; urinary thiamin/creatinine excretion--3 and 8% of white and Black subjects, respectively; Hb, hematocrit, and percentage transferrin saturation--5 to 15% of whites and 18 to 27% of Black subjects; serum iron--less than 6% of subjects. Individual dietary recall data were of limited value in predicting the laboratory indices; regression analyses indicated that sociodemographic variables may be of greater predictive value.

Adolescent↗

Ethnic patterns of salt purchase in Houston, Texas.

Dietary sodium may play a contributory role in the development of hypertension, but difficulties in defining the "usual" sodium intake of individuals prevent any stronger statement on the nature of the diet-disease relationship. The prevelance of hypertension is greater in black than in white populations of the United States, and there is speculation that dietary sodium intake may also be greater in black individuals. A significant proportion of dietary sodium is derived from table salt added to food during its preparation and consumption. In an attempt to identify whether purchase of table salt was sufficiently increased in black communities to support the hypothesis of an etiologic role in hypertension, the scales of table salt in supermarkets located in predominantly black, Hispanic and white census tracts of Houston, Texas, were compared. The mean ratio between sales of salt and a series of 20 staple food commodities in predominantly black and Hispanic census tract supermarkets were 148% and 202%, respectively, of that in predominantly white census tracts. The elevated ratios were not due to reduced sales of the food commodities. The authors conclude that sales of table salt, in relation to the series of food commodities, are 50-100% higher in Houston's black and Hispanic census tract supermarkets than in those of white census tracts. Whether the increased sales of table salt have causal relationship to the prevalence of hypertension in these communities can only be determined by further studies.

Black or African American↗

The results of treatment of carcinoma of the uterine cervix using a linear vaginal source and 4 MV X rays.

Between 1960 and 1976, 1645 women with carcinoma of the uterine cervix were treated in the Radiotherapy Department, Edinburgh. In the earlier years the majority of patients were treated using a partially afterloaded radium line source system, combined with 4 MV external irradiation. The radium was later replaced by caesium which, from 1972, was used in a fully afterloaded line source intracavitary applicator. In recent years a computer program has been used to calculate the dose distribution, resulting in improved pelvic dosimetry and a decline in the frequency and severity of radiation reactions. Actuarial survival rates are reported by stage for a 20-year period. The 5-year survival rate for patients with Stage I disease treated by the Edinburgh method was 74.7% (71.5% for the whole group). For patients with Stage II disease, the rates were 57.1% and 51.3% and for those with Stage III disease, the rates were 40.1% and 28.0%.

Actuarial Analysis↗

Height distributions of U.S. children: associations with race, poverty status and parental size.

The stature of children, relative to that of a reference population, is often used as a measure of the nutritional status of a population. But while undernourished children are often small in stature, all small-statured children cannot be assumed to be undernourished as a wide range of hereditary, socioeconomic and health factors also influence growth processes. The distribution of heights of 3850 "healthy" U.S. children 1-11 years of age who participated in the first National Health and Nutrition Examination Survey, a probability sample of the U.S. population, have been examined in relation to age- and sex-specific reference medians, and in relation to race, family income, and height of their parents. The distribution of heights of black children was shifted to the right (i.e., taller) of that of white children (Index of Dissimilarity = 7.9%). The distribution of heights of children of above poverty level income families was shifted to the right of that of children of below poverty level income families (Index of Dissimilarity = 8.4%). In both races, and with family incomes both above and below the poverty income level, the distribution of heights of children of tall parents was shifted to the right of that of children of short parents (Index of Dissimilarity = 20.25%). We concluded that parental stature, economic conditions and race must be considered in interpreting the growth of children in all societies, and before concluding that nutritional factors are the major determinants of short stature.

Black People↗

Effects of a low protein diet during pregnancy of the rhesus monkey. III. Growth of infants.

The growth of eight infants born to pregnant rhesus monkeys fed a control diet of modified cows' milk was compared to the growth of five infants born to mothers fed a diet containing only 25% as much protein but made isocaloric with supplemental lactose. The average body weight of infants whose mothers were fed the low protein diet was significantly less at birth and on day 180 after birth than for the infants whose mothers were fed the control diet. The mean head circumference was significantly less for the prenatally malnourished infants than for the control infants at birth; at day 180 after birth there was no significant difference. Although the average body length of infants from mothers fed the low protein diet was consistently less than that of infants from mothers fed the control diet, the differences were not significant.

Aging↗