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Biomedical subjects

J Page

Publications and source records attributed to J Page.

At least 73 records · Page 4Linked to original sources
PubMed1990

A randomised trial of cisplatin and vindesine versus supportive care only in advanced non-small cell lung cancer.

The value of chemotherapy in advanced non-small cell lung cancer (NSCLC) remains contentious. Because of this two separate but very similar trials were set up in Australia and Southampton (UK). Two hundred and one patients with stage IIIb or IV NSCLC were randomly assigned to cisplatin 120 mg m-2 on days 1 and 29 and vindesine 3 mg m-2 weekly x 6 or to no chemotherapy. Both groups were eligible to receive radiotherapy or other palliative treatment as required. Of 188 evaluable patients, 97 received chemotherapy and 91 were in the control arm. Response was assessed between days 42 and 49. Responders continued chemotherapy at the same doses though cisplatin being given 6 weekly x 4 and the vindesine 2 weekly x 12. The overall response rate to chemotherapy was 28%; there were no significant differences according to major prognostic criteria. Although the overall survival of the chemotherapy group (median 27 weeks) was longer than that of the no chemotherapy group (median 17 weeks) this was not statistically significant (log rank P = 0.33). For patients without dissemination (IIIb), median survival was 45 weeks in the chemotherapy arm and 26 weeks in the non-chemotherapy (log rank P = 0.075). Toxicity was universal and frequently severe: of 17 patients discontinuing chemotherapy after one cycle, 13 did so because of unacceptable toxicity. This chemotherapy cannot be recommended as routine treatment. Further phase III studies of chemotherapy in advanced NSCLC should continue to use a no chemotherapy control and should also attempt to measure quality of life, an issue not addressed effectively in this or other recent trials.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

In vivo pH of induced soft-tissue abscesses in diabetic and nondiabetic mice.

Infections in the diabetic host have been shown to persist longer than those in the nondiabetic host. To investigate whether intra-abscess milieu might be a contributing factor to this persistence, the in vivo intra-abscess pH was measured in induced soft-tissue abscesses in diabetic and nondiabetic mice. Two models (female genetically obese insulin-resistant and male streptozocin-induced diabetic mice) were used with appropriate controls. The bacteria injected to produce the soft-tissue abscesses were Bacteroides fragilis and Enterococcus (B + E), Staphylococcus epidermidis and Enterococcus (S + E), and S. aureus (SA). Intra-abscess pH measured on day 3 was consistently and significantly lower in all diabetic mice compared with their controls. In the diabetic mice, the pH of an abscess induced with B + E, S + E, and SA was 6.28 (n = 17), 6.79 (n = 10), and 6.52 (n = 10), respectively; the pH in the controls was 7.21 (n = 20), 7.30 (n = 10), and 7.17 (n = 10), respectively. Differences in all groups between diabetic and nondiabetic mice were significant. The blood glucose values of the diabetic mice averaged 722 mg/dl, and in the nondiabetic mice were 210 mg/dl. No animals were ketotic. There were no significant differences in total colony counts between any groups. In conclusion, there is a significantly lower pH in the abscess of the diabetic host compared with the nondiabetic host that is not related to the numbers or types of causative bacteria.

Abscess↗
PubMed1989

Recurrent transitional cell carcinoma of the renal pelvis presenting as diabetes insipidus.

We present the case of a 61-year old man with intracranial recurrence of transitional cell carcinoma of the renal pelvis presenting as diabetes insipidus. Metastatic infiltration of the pituitary stalk was demonstrated by magnetic resonance imaging when cerebral computerized tomography scanning was unhelpful. Successful treatment followed, comprising radiotherapy and intranasal desmopressin.

Carcinoma, Transitional Cell↗
PubMed1988

Chemotherapy for non-small cell lung cancer: a randomized trial of cisplatin/vindesine v no chemotherapy.

Separate but almost identical randomized trials testing the role of chemotherapy in non-small cell lung cancer (NSCLC) were started in Southampton, United Kingdom (UK) and in several centers in Australia. Between 1983 and 1987, 201 patients were assigned to either a chemotherapy arm: cisplatin 120 mg/m2 every 4 weeks and vindesine 3 mg/m2 weekly, or a no chemotherapy arm. Of 188 evaluable patients, 157 were randomized in Australia and 31 in Southampton. Objective responses after two cycles of cisplatin/vindesine were seen in 26 patients (28%). Median survival was 23 weeks for the treatment arm and 16 weeks in the no treatment arm (P = NS). Analysis of those patients with limited disease showed a median survival of 43 weeks for the chemotherapy arm and 26 weeks for the non-treatment arm (this difference approaches statistical significance). Toxicity was severe in the treatment arm, and all patients experienced subjective toxicity; 17 (18%) had WHO (World Health Organization) grade 3-4 myelotoxicity, 73% had grade 3-4 nausea and vomiting. There is a modest trend towards improved overall survival in patients with limited disease treated with chemotherapy. Because chemotherapy is palliative, future studies should have an appropriate control arm and should measure quality of life.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Phase II study of megestrol acetate for metastatic carcinoma of the prostate.

Forty-three males with recurrent and metastatic cancer of the prostate were treated with megestrol acetate (160 mg/day orally) after having failed first-line hormonal treatment (orchiectomy or diethylstilboestrol). Thirty-seven patients were evaluated objectively for response, 28 of whom received the drug for more than 6 weeks. One patient had a partial response (National Prostatic Cancer Project criteria) and seven had stable disease. Toxicity was usually mild, although five patients developed a transient rise in liver enzymes and one patient had a grand mal fit. Three patients showed evidence of tumour "flare". Megestrol acetate has only limited efficacy in patients previously treated for prostatic cancer by hormonal manipulation.

Aged↗
PubMed1986

The effects of oral agent or insulin treatments on the plasma lipoproteins and the plasma lipoprotein lipase activator in diabetic patients.

The structure and the metabolism of plasma lipoproteins are altered in diabetes mellitus. Insulin or oral agent treatments affect the lipoprotein metabolism in addition to improving hyperglycemia. However, it is not clear whether the alterations seen in lipoproteins during treatment are related to the degree of diabetic control or to the mode of diabetic treatment. The effects of insulin or oral agent treatments on the plasma lipoproteins and lipoprotein lipase activator were compared in a strictly defined non-obese, non-insulin dependent diabetic patient. Both treatment groups had similar plasma triglyceride, total cholesterol, low and high density lipoprotein cholesterol, and lipoprotein lipase activator levels. Lipoprotein lipase activator contents of the very low density lipoproteins correlated positively with their triglyceride (r = 0.803 in insulin, r = 0.828 in oral agent treated patients) and protein (r = 0.713 in insulin, r = 0.862 in oral agent treated patients) contents. The findings of this study indicated that plasma lipid levels, very low density lipoprotein compositions, and lipoprotein lipase activator contents were not significantly different in non-obese, non-insulin dependent diabetic patients treated with either oral hypoglycemic agents or insulin.

Administration, Oral↗
PubMed1985

Issues of transference in methadone maintenance treatment.

Methadone maintenance treatment involves a great deal of governmental regulations and controls which have to be enforced by the clinician, thus having important transferential implications for therapy. This issue is explored on the basis of a case example, and recommendations are made to detach rule enforcement from therapy.

Adult↗