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Biomedical subjects

J Spinelli

Publications and source records attributed to J Spinelli.

At least 37 records · Page 2Linked to original sources

Chlorhexidine rinse in prevention of dental caries in patients following radiation therapy.

Patients who receive cancer radiotherapy, which compromises salivary gland function, may develop xerostomia. These patients are at increased risk to develop rampant dental caries. Streptococcus mutans and species of lactobacillus have been associated with dental caries. Quantitative counts of these organisms demonstrated high caries risk in 85% of patients studied. The use of chlorhexidine rinse to reduce the counts of S. mutans and lactobacillus was studied. A modest reduction in S. mutans was seen, but little effect was demonstrated on lactobacillus counts. Caries activity was shown to be related to lactobacillus count.

Adolescent↗

Biopsychosocial aspects of long-term survival on end-stage renal failure therapy.

At ten-years follow-up of 64 haemodialysis patients, 43 had died and 21 were alive, twelve with cadaver renal transplants and nine on haemodialysis. Examination of the influence of psychological, demographic, physical and biochemical factors revealed the Beck Depression Inventory and age as the two most important predictors of survival. The behaviour of the patient was directly responsible for five (11.6%) of the deaths, by suicide in three cases and dietary non-compliance in two cases. Hypothetical mechanisms linking depression with reduced survival have been reviewed. As the impact of depression on survival was maximal in the first few years of dialysis, monitoring for depression should be incorporated into routine care from the start of dialysis together with evaluative interventions that might enhance survival.

Adolescent↗

The role of an immunoperoxidase technique in the diagnosis of oral herpes simplex virus infection in patients with leukemia.

Laboratory techniques are often used to confirm a clinical diagnosis of oral herpes simplex virus (HSV) infection in patients with leukemia. In the present study, an immunoperoxidase technique (IPT) was used to examine smears taken from the oral mucosa of 44 patients with leukemia at Vancouver General Hospital. It was found that the IPT was as sensitive and specific as viral culture in confirming the presence of HSV. The IPT was found to be more predictive of symptomatic oral HSV disease than viral culture because it did not give positive results if there was only viral shedding in the absence of clinical disease. As the IPT is rapid and inexpensive as well as being specific, sensitive, and predictive, it has a definite role in the laboratory confirmation of oral HSV lesions in leukemics.

Acute Disease↗

Neoadjuvant (preoperative) chemotherapy for breast cancer.

Despite recent developments in the treatment of breast cancer, metastatic breast cancer remains an incurable disease. Postoperative adjuvant treatment may improve the survival of a subgroup of node positive, Stage II breast cancer patients, but the proportion of failures is still high. Preoperative adjuvant chemotherapy, an example of a new approach in scheduling of available agents, is based on sound theoretical and experimental principles. In this report, the authors summarize the background data on the rationale for preoperative adjuvant chemotherapy and present preliminary results of this study in which preoperative treatment starting with one course of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) was given to newly diagnosed patients with breast cancer. Analysis of the first 43 patients given such treatment has shown that the side effects were comparable to those seen in patients treated with conventional postoperative chemotherapy, and that the delay time between diagnosis and starting chemotherapy has been substantially reduced compared to the historic group of patients. Additional aspects of this study include the introduction of fine-needle aspiration as the only diagnostic method for obtaining the tissue diagnosis of breast cancer, as well as a more intensive interaction between the surgeons from private practice and the oncology institute.

Adult↗

Ovarian carcinoma: a multivariate analysis of prognostic factors.

Five hundred and fifty six women with invasive epithelial ovarian carcinoma were assessed for postoperative treatment between 1966 and 1976. The records of this group were reviewed retrospectively. Sixteen characteristics of the patient and tumor were analyzed for prognostic significance by univariate and multivariate techniques. Tumor grade, the presence of residual disease, and patient performance status are identified as stage-specific independent prognostic factors. These independent factors define patient subsets with good, intermediate, and poor prognosis within each stage. The results show that more effective treatment strategies are required for patients in poor prognosis subsets. Estimates of tumor grade, extent of residual disease, and performance status should be included in reports of treatment outcome.

Adult↗

Recent trends in incidence rates of pleural mesothelioma in British Columbia.

A total of 64 cases of pleural mesothelioma were reported in British Columbia between 1973 and 1980, 54 in males and 10 in females. There was a significant (p less than 0.05) increase in the incidence among males. The overall incidence rates were 4.9 and 0.9 per million person-years for males and females respectively. The age distribution of the cases was roughly exponential up to age 70 years. Almost all of the cases were clustered in Cowichan Valley, Capital and Greater Vancouver counties, where there was a high level of shipbuilding activity 30 to 40 years ago. The increased incidence in males may be related to this activity, which involved exposure to asbestos.

Adult↗

Cancer and aplastic anemia in British Columbia farmers.

For evaluation of occupational mortality in agriculture, age-standardized proportional mortality ratios (PMR) were calculated for 28,032 male farmers with the use of British Columbia (B.C.) death registrations collected from 1950 to 1978. Farmers had significantly elevated risks of death from cancer of the lip (PMR = 191, P = .05), stomach (PMR = 119, P less than .0001), and prostate gland (PMR = 113, P less than .001). In addition, leukemia was higher than expected (PMR = 122, P less than .01), as was aplastic anemia (PMR = 174, P less than .01). The elevated risks were fairly consistent over the 29-year period for stomach, prostate gland, and lip cancer, as well as for leukemia. The PMR for aplastic anemia was highest for the years 1950-59 and declined over the next 19 years. Farmers also showed significant mortality deficits for several important cancer sites, including esophagus (PMR = 59, P less than .0001), colon (PMR = 84, P less than .001), larynx (PMR = 62, P less than .01), and lung (PMR = 66, P less than .0001) for the period 1950-78. More detailed studies in B.C. will be necessary to confirm and extend these cancer-agriculture associations.

Adult↗

Characteristics of yeasts isolated from Pacific crab meat.

A total of 202 cultures of yeasts were isolated and characterized from king crab and Dungeness crab meat. A yeastlike organism, resembling Aureobasidium pullulans, and 15 different species distributed among the genera Rhodotorula, Cryptococcus, Torulopsis, Candida, and Trichosporon were represented. Nine of the species grew at 5 C or lower. Although two of the species grew at 37 C, none of the isolates had the characteristics of pathogenic species. Members of the Cryptococcus and Candida failed to grow at 37 C. Furthermore, species of the former genus were not pathogenic to mice. The pigmentation of the Rhodotorula cultures decreased in intensity as the incubation temperature was decreased. Biochemical activities of the different species were studied by use of triglycerides, lecithin, and proteins (casein, gelatin, and crab-meat protein) as substrates. Eight of the species could attack triglycerides; eight, lecithin; five, gelatin; one, casein; and one, crab protein. An organism, tentatively identified as Trichosporon sp., was very active in attacking each of the substrates tested and grew well at 0.5 C.

Candida↗