PubMed Health⌕ Search

Biomedical subjects

J R Vale

Publications and source records attributed to J R Vale.

At least 19 recordsLinked to original sources
PubMed1991

[Prognosis of inoperable non-small cell bronchial cancer].

The article describes a retrospective study of the prognosis for 450 patients with inoperable non-small cell lung cancer discharged during the period 1970 to 1979. 81% of the patients were males. The predominant cell type was squamous cell carcinoma. One out of seven patients was inoperable because of poor cardiorespiratory function, six out of ten because of mediastinal metastases. Median survival was six months and was related both to staging of the tumor and to cell type. The prognosis was worst for patients with adenocarcinoma. Only 8% of the 450 patients were alive after two years. Specific and palliative therapy had a minor effect on median survival. Controlled clinical trials can probably settle whether an extension of the criteria for surgical treatment can improve the prognosis of this large group of patients.

Adult↗
PubMed1989

Questionnaire reliability and validity for aluminum potroom workers.

As a part of a study on the respiratory symptoms of aluminum potroom workers, the reliability of a self-administered questionnaire and an interview questionnaire was studied with the use of 261 and 49 employees, respectively. The validity of the self-administered questionnaire (134 persons examined) and the interview questionnaire (90 persons examined) was assessed in a comparison of the statements with the case histories. The reliability of the self-administered questionnaire was fairly high, the kappa coefficient ranging from 0.58 to 0.83, while the reliability of the interview questionnaire varied from -0.03 to 0.45. The same pattern was present with regard to validity, as the self-administered questionnaire showed the highest mean sensitivity, specificity, and agreement in a comparison with the case histories. The self-administered questionnaire seemed to discriminate well between symptomatic and asymptomatic individuals, whereas supplemental information about symptoms, as obtained by a standardized interview questionnaire, appeared to be less valid.

Adult↗
PubMed1986

High-dose intravenous methylprednisolone pulse therapy as initial treatment in cryptogenic fibrosing alveolitis. A pilot study.

Ten patients with fibrosing alveolitis were treated in a simple random design initially with either a high dose of methylprednisolone (5 patients) or a conventional dose of prednisolone (5 patients) followed by a maintenance dose of 30 mg prednisolone daily. The patients were followed for 6 weeks. No significant (p greater than 0.05) differences were observed between patients with high and low initial dose of glucocorticosteroids, as regards forced vital capacity, transfer factor for carbon monoxide or symptom scores after 3 and 6 weeks of treatment. After 6 weeks the dyspnoea score and the 67Ga uptake decreased, on average, by 74 and 85%, respectively, while forced vital capacity and transfer factor increased by 15 and 29%.

Adult↗
PubMed1986

Changes in plasma and red cell volumes during exposure to high altitude.

Training at moderate altitude has been used by athletes to improve the performance at sea level. Not all athletes benefit from altitude training, and there also has been some doubt as to whether red cell volume increases in all subjects. Ten members of the Norwegian Everest Expedition 1985 took part in the present study. Plasma volume was determined by isotope dilution, using 125I-albumin. By simultaneous measurement of hematocrit the total blood volume and red cell volume were calculated. Measurements were done in Oslo (sea level) before departure, and in Base Camp (5300 m) four weeks later. The mean altitude during these four weeks was 4100 m. Red cell volume increased in all participants, and excessively in two of them. Since plasma volume decreased in four subjects, the change in total blood volume was less consistent. In one climber dehydration led to a decrease in total blood volume. While a significant correlation was found between maximal oxygen uptake and red cell volume at sea level, the hematologic response to altitude seemed independent on physical fitness. In one climber the erythropoietic response was so excessive (more than 50% increase in red cell volume), that he had to be hemodiluted.

Adult↗
PubMed1986

Bronchial challenge: interpretation of readings.

Bronchial reactivity as tested in vivo reflects to some extent the responsiveness of smooth muscle in the lower airways. The in vivo reactivity is often presented in terms of PC20 (provocation concentration leading to a 20% fall of FEV1), an index that is supposed to provide condensed information of the general dose/response relationship by a continuous variable. However, expressing the fall in relative terms is not strictly logical, as the random experimental error of FEV1 shows a homoschedastic distribution. Furthermore, PC20 becomes mathematically unstable in cases with a slight response and can be determined with reasonable precision only when the observed fall is close to 20% or more. When a small number of highly differing dose levels are used in clinical challenge testing, the results should rather be presented as the maximum, absolute change of FEV1 obtained at a specified dosage.

Asthma↗
PubMed1979

Survival in lung cancer after surgery.

In 1053 patients hospitalized for primary lung cancer the overall crude survival rate (5 years) was 15.5%. Prognostically favourable indices were: absence of clinical symptoms (27% survival) and a peripheral site of tumour in the lung (28% survival). Duration of symptoms, when present, had no consistent influence on prognosis. Resection could be done in 419 cases. In this group the 5 years survival rate was strongly related to the extent of surgery and the completeness of resection. Cases with a radical lobectomy had a survival rate of 52% against 9% only in patients with a pneumonectomy that might not have been radical. Of 33 cases of resected small cell anaplastic cancer, 10 survived more than 5 years. This unexpectedly high survival rate persisted after revision of the histological typing and may justify an active surgical attitude even in this group of patients. Although hardly decisive in this context, confusion between the comprehensive term small cell carcinoma and its subtype, oat cell cancer, should be avoided.

Adult↗
PubMed1979

Lung cancer. Symptoms, signs and diagnostic criteria.

A consecutive hospital series of 1 053 patients treated for lung cancer during the period 1962 through 1971 has been studied. Clinical symptoms were present more often in men than in women and in 42% symptoms had been noted more than 6 months prior to the diagnosis. Peripheral tumours gave less symptoms than central ones. Although in 22% of the patients the tumour was discovered on a chest film in the absence of relevant symptoms, 12% only had been detected by regular mass X-ray screening. More than 40% of the peripherally located tumours were clinically silent. Squamous cell and anaplastic small cell cancers were predominantly centrally located (80 and 90%, respectively) against 65% and 74% for adenocarcinomas and undifferentiated large cell tumours.

Adult↗
PubMed1979

Lung cancer. Treatment and early results.

Of 1053 patients with primary cancer of the lung, 549 (52%) underwent thoracotomy and 40% a presumably radical resection. Lobectomies were performed in 227 patients (41% of those operated), pneumonectomy in 160 (29%). Early mortality (death within 30 days) was 5.5% with the highest figure (11%) after pneumonectomy, 5% after explorative thoracotomy and 3% after lobectomy. Cardiorespiratory failure and myocardial infarction occurred in 19 (3.5%) of the operated cases and were responsible for 14 early deaths. Bronchopleural fistula developed in 11 patients. Of 874 morphologically classified tumours, squamous cell composed 45%, undifferentiated large cell 17%, small cell anaplastic 14%, adenocarcinoma 19%, carcinoid 2% and others 3%. Of 21 tumours typed as small cell anasplastic prior to therapy, six were differently classified at the later (postoperative/postmortal) stage.

Bronchial Fistula↗
PubMed1977

Effect in bronchial asthma of a new beta-adrenergic blocking drug atenolol (ICI 66, 082).

The bronchial effect of intravenous atenolol (ICI 66.082) has been studied in a double-blind cross over trial in 10 patients with pronounced, labile bronchial asthama. A single i.v. dose of atenolol 3 mg. sufficient to cause a fall in heart rate and systolic blood pressure at rest, induced only a slight and clincially almost negligible impairment of ventilatory function. An ordinary therapeutic dose of salbutamol by inhalation far outweighed the bronchial effect of atenolol. The drug appears promising with regard to its cardio-selective properties.

Adult↗