Biomedical subjects
J R Bastable
Publications and source records attributed to J R Bastable.
Haematuria after strenuous exercise.
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A comparison of the effect of diethylstilbestrol with low dose estramustine phosphate in the treatment of advanced prostatic cancer: final analysis of a phase III trial of the European Organization for Research on Treatment of Cancer.
In a randomized phase III trial performed by the Urological Group of the European Organization for Research on Treatment of Cancer low dose estramustine phosphate (280 mg. twice daily for 8 weeks and 140 mg. twice daily thereafter) was compared to diethylstilbestrol (1 mg. 3 times daily) in patients with stages T3 to T4, M0 or M1 prostatic cancer. Of 248 patients entered 227 were evaluable for analysis: 115 received estramustine phosphate and 112 received diethylstilbestrol. The best response of the local tumor as assessed by palpation was seen in patients receiving diethylstilbestrol. There was no significant difference between treatments for response rate of metastases, interval to local progression, distant progression, over-all survival and death of carcinoma of the prostate. Duration of survival was correlated with the assessment of local response as determined by palpation. The response of distant lesions also was correlated closely with survival. Diethylstilbestrol (1 mg. 3 times daily) was associated with a significantly worse degree of cardiovascular toxicity than estramustine phosphate. This finding was especially obvious in patients who had no history of cardiovascular disease. Gastrointestinal toxicity occurred in 25 patients treated with estramustine phosphate, including 6 in whom cessation of treatment was necessary. Further studies are required to determine the optimum dose of diethylstilbestrol and estramustine phosphate, and to establish the best form of hormonal treatment for prostatic carcinoma.
Adjuvant chemotherapy with doxorubicin (Adriamycin) and 5-fluorouracil in T3, NX, MO bladder cancer treated with radiotherapy.
Radical radiotherapy alone has been compared with radical radiotherapy followed by chemotherapy using doxorubicin (Adriamycin) and 5-fluorouracil in a randomised prospective study on 129 patients presenting with T3, NX, MO transitional cell carcinoma of the bladder. One hundred and ten patients were evaluable with a minimum follow-up of 2 years. The addition of this form of chemotherapy did not appear to influence the survival rate or the proportion of patients free from tumour. It cannot be recommended for routine use in the primary treatment of infiltrating bladder cancer.
Vincristine in advanced bladder cancer: a European organization for research on treatment of cancer (EORTC) phase II study.
Thirty-seven patients with measurable deposits or primary lesions arising from transitional cell carcinoma of the bladder were treated with 1 mg/m2/week of vincristine. One complete response lasting 7 months was seen among the 23 patients with metastatic disease. Two partial responses were seen among the 14 patients with persistent primary tumor. Vincristine is not recommended for further evaluation as a single agent in transitional cell carcinoma of the bladder.
Nosocomial infection following prostatectomy in a new urology department.
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Acute phase reactant proteins in the clinical management of carcinoma of the bladder.
The levels of a number of acute phase reactant proteins have been measured in 250 patients with carcinoma of the bladder in all stages. Three of them, acid glycoprotein, antichymotrypsin, and C-reactive protein, frequently gave abnormal results in advanced disease. The levels of these 3 proteins in patients who were clinically tumour-free were not distinguishable from those from an age-matched control group. The levels in patients with T1 and T2 bladder tumours were sometimes elevated. In advanced disease, figures were commonly above the normal range.
The rate of urine production and the isotope renogram.
The rate of urine production has been measured in a group of normal subjects undergoing renography. It has been helpful in assessing the results. Renograms look unusual at low flow rates and can be misinterpreted if the urine flow rate is not known.
Bacteriuria after out-patient cystoscopy.
The presence of bacteriuria 48-72 hours after cystoscopy has been correlated with the sex and previous history of the patient, and with the use of chlorhexidine 1/5,000 and water as alternative irrigant solutions. The infection rate was higher in women than in men. Chlorhexidine in the irrigant solution protected against postoperative bacteriuria in patients who did not have a history of previous urinary infection, but did not do so where there was such history.
Continuous irrigation of the bladder after prostatectomy: its effect on post-prostatectomy infection.
The incidence of post-prostatectomy bacteriuria was measured in patients having no continuous bladder irrigation postoperatively, in those irrigated for 24 hours with chlorhexidine 1/5,000, and in those irrigated with normal saline. The infection rate after saline irrigation was greater than after chlorhexidine, but the infection rates after chlorhexidine irrigation and drainage alone were similar. The infection rate was higher in older patients, in those treated with retropubic rather than transurethral prostatectomies, in those who had postoperative catheters for more than 4 days, and in those admitted in acute retention of urine. The increase in infection rate associated with acute retention was seen only in the group treated with drainage alone postoperatively. Chlorhexidine irrigation appears to reduce the infection rate in these cases.
Estimation of residual urine volume with 131-I-Hippuran.
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