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Biomedical subjects

H Nava

Publications and source records attributed to H Nava.

26 records · Page 2Linked to original sources

Primary chemotherapy for localized non-Hodgkin's lymphomas with diffuse histologic characteristics. Preliminary report of a prospective study.

Thirty-three patients with diffuse non-Hodgkin's lymphoma (stages I and II) received intermediate doses of oral methotrexate followed by leucovorin calcium every four weeks, on days 1 and 8, followed on day 15 by intravenous cyclophosphamide and vincristine sulfate. Prednisone was given for four weeks on alternate courses of treatment. A total of six such four-week courses was planned. Involved-field radiation (3000 or 3600 rad [30 or 36 Gy]) was given between three courses of chemotherapy to 18 patients who presented with tumors exceeding 7 cm in greatest diameter and who had responded to the initial chemotherapy. On completion of treatment, 27 patients (82%) were in complete remission; all the failures were in patients with large intra-abdominal masses. The presence of high lactate dehydrogenase levels, large tumor size, and age over 60 years had a suggestive negative correlation with the achievement of complete remission. The median follow-up was 26 months (range, ten to 59 months). At 48 months, the actuarial disease-free survival, remission duration, and overall survival were 53%, 72%, and 68% respectively. No deaths from toxic effects and no septic episodes were observed during treatment. The complete remission rate achieved with this program is comparable with those of other intensive programs of treatment reported previously.

Adult↗

Pedunculated primary hepatocellular carcinoma.

A case report and two additional cases of pedunculated, primary hepatocellular carcinoma (PHCC) are added to those previously reviewed, and are compared with the more typical presentations of PHCC. Distinct differences include lesser associations with hepatitis B and alpha fetal protein among the pedunculated lesions. More importantly, this unique form of PHCC carries a much higher resectability rate that hopefully can be translated into longer survival in this subgroup.

Aged↗

Staging laparotomy and splenectomy in early Hodgkin's disease. No therapeutic benefit.

In a prospective randomized study of treatment for early-stage Hodgkin's disease presenting above the diaphragm, 76 patients had staging by laparotomy (Group I) and 28 had staging by closed techniques (Group II). Treatment consisted of involved-field radiotherapy alone (44 patients), involved-field radiotherapy followed by chemotherapy (38 patients), total nodal radiotherapy alone (15 patients), or total nodal radiotherapy followed by chemotherapy (seven patients). On presentation, both groups had similar clinical features and similar treatment distribution. With similar follow-up (87 months), no significant differences in remission or survival were observed between Groups I and II: remission 59 versus 68 percent; survival 74 versus 92 percent; p value 0.27 and 0.09, respectively. Multiple areas of relapse were more frequently observed in Group I (11 of 32 had relapse) as compared with Group II (none of nine had relapse, p less than 0.082). In Group I, relapse in the abdomen was observed as an isolated event or as part of disseminated relapse in 12 percent of patients compared with 3 percent (one patient) in Group II with abdominal relapse alone. Seven patients in Group I and two patients in Group II died with Hodgkin's disease. Six other patients in Group I died with complete remission of non-Hodgkin's lymphoma (one patient), leukoencephalopathy (one patient), sepsis during chemotherapy (two patients), myocardial infarction (one patient), and cerebrovascular accident (one patient). Three other patients in this group had other secondary malignancies successfully controlled (histiocytic lymphoma, squamous cell carcinoma of the cervix, and malignant schwannoma). No second primary lesions or death with complete remission were observed in Group II. Staging laparotomy with splenectomy in early-stage Hodgkin's disease did not improve the duration of remission or survival or decrease the number of abdominal relapses compared with closed staging.

Actuarial Analysis↗

Biliary cystadenocarcinoma: report of a case presenting with osseous metastasis and a review of the literature.

Biliary cystadenocarcinoma is a rare malignancy, and osseous metastasis resulting from this tumor have been recorded in only one of the 19 documented cases in the literature. The case report of this 59-year-old male is unusual in that the patient's initial clinical manifestations of the disease were that of osseous metastases, while the primary tumor eluded discovery for greater than 1 year. Although this is the first documented case in which radiation and chemotherapy were used to control the disease, the use of these agents may have contributed to the delay in establishing the primary site of the tumor. The clinical and pathologic features of this and the previously reported cases are reviewed with an emphasis on the newer diagnostic modalities being used in more recent cases to establish the diagnosis for this tumor.

Bone Neoplasms↗

An analysis of percutaneous transhepatic cholangiograms.

Percutaneous transhepatic cholangiograms (PTCs) of 74 cancer cases with obstruction of the biliary tree were reviewed and evaluated as to the location, degree of obstruction, and location of the obstructing elements ie, intraluminal polypoid intrusions and diffuse infiltration. Special attention was given to the diagnostic value of the sign of an extrinsic compressing mass, a disputed entity. Every one of the above parameters, including extrinsic mass compression effect, proved to be worthwhile in arriving at a reasonable diagnosis. A system for coding obstructions to give maximum information in minimum space for large series of cases and to improve diagnostic accuracy of PTC in the single case is presented.

Biliary Tract Neoplasms↗

Elemental diet as an adjuvant for patients with locally advanced gastrointestinal cancer receiving radiation therapy: a prospectively randomized study.

Thirty patients with locally advanced, nonresectable, nonmetastatic cancer in the peripancreatic region, stomach and colorectum-anus, to be treated with radiation therapy with or without adjuvant chemotherapy, were randomized to receive standard diet and either usual between-meal feedings or 300 calories tid of a high nitrogen elemental diet. Although weight loss associated with radiation therapy was not significantly reduced in those receiving the nutritional supplement, delayed hypersensitivity skin test responses tended to improve in patients receiving the elemental dietary supplement and to deteriorate in controls. Planned radiation therapy was completed in all nutritionally supported patients. One control patient expired shortly after treatment was halted abruptly, and three other control patients required rescue by total parenteral nutrition.

Energy Intake↗