Biomedical subjects

James Anderson

Publications and source records attributed to James Anderson.

28 records · Page 2Linked to original sources

PubMed2005

Vascular complications of pancreatitis.

Vascular complications of pancreatitis are a major cause of morbidity and mortality. Arterial complications include haemorrhage from direct arterial erosion or pseudoaneurysm formation, and visceral ischaemia. Venous complications predominantly are related to splanchnic vein thrombosis. This review, with illustrative cases, describes the main manifestations of these complications and emphasizes the importance of early radiological diagnosis and intervention.

Adult↗

PubMed2004

Randomised phase 2 trial of SIR-Spheres plus fluorouracil/leucovorin chemotherapy versus fluorouracil/leucovorin chemotherapy alone in advanced colorectal cancer.

PURPOSE: Selective internal radiation therapy (SIRT) with SIR-Spheres(R) is a new technique for selectively targeting high doses of radiation to tumours within the liver. The primary objectives of this randomised trial were to compare the response rate, time to progressive disease (PD), and toxicity of a regimen of systemic fluorouracil/leucovorin chemotherapy versus the same chemotherapy plus a single administration of SIR-Spheres in patients with advanced colorectal liver metastases. The trial was designed to presage a larger trial that would have survival as the primary outcome. PATIENTS AND METHODS: Twenty-one patients with previously untreated advanced colorectal liver metastases, with or without extrahepatic metastases, were randomised into the study. RESULTS: Using RECIST criteria, the response rate for 11 patients receiving the combination treatment was significantly greater than for 10 patients receiving chemotherapy alone (First Integrated Response; 10 PR, 1 SD vs. 0 PR, 6 SD, 4 PD, P < 0.001 and Best Confirmed Response; 8 PR, 3 SD vs. 0 PR, 6 SD, 4 PD P < 0.001). The time to PD was greater for patients receiving the combination treatment (18.6 months vs. 3.6 months, P < 0.0005). Median survival was significantly longer for patients receiving the combination treatment (29.4 months vs. 12.8 months, P = 0.02). One patient in the combination arm died from chemotherapy induced neutropenic sepsis after the fourth chemotherapy cycle. There were more Grade 3 and 4 toxicity events in patients receiving the combination treatment. There was no difference in quality-of-life over a 3 month period between the two treatments when rated by patients (P = 0.96) or physicians (P = 0.98). CONCLUSIONS: This small phase 2 randomised trial demonstrated that the addition of a single administration of SIR-Spheres to a regimen of systemic fluorouracil/leucovorin chemotherapy significantly increased both treatment related response, time to PD, and survival with acceptable toxicity. The combination of SIR-Spheres plus systemic chemotherapy is now the subject of ongoing trials to further define patient benefit.

Aged↗

PubMed2004

Failure pattern and factors predictive of local failure in rhabdomyosarcoma: a report of group III patients on the third Intergroup Rhabdomyosarcoma Study.

PURPOSE: To analyze patterns of failure and factors predictive of local treatment failure in children enrolled on the third Intergroup Rhabdomyosarcoma Study who had either biopsy only or subtotal resection of their primary tumor, had no distant metastases, and received radiation therapy for local control. PATIENTS AND METHODS: Treatment failure was categorized as local, regional nodal, or distant metastatic. The 5-year cumulative risk of failure was estimated for each category and factors predictive of local failure risk were determined using the Cox model and binary recursive partitioning. RESULTS: The estimated 5-year cumulative incidence rates by failure category were: total local (with or without concurrent regional or distant failure), 19%; total regional nodal, 2%; total distant, 11%; and death from toxicity or unknown recurrence type, 4%. Lymph node involvement at diagnosis was the single factor most predictive of increased total local failure risk (5-year cumulative incidence 32%) compared with children with negative nodes or unknown node status (16%). No significant effect on local failure risk was observed by total radiotherapy dose over the prescribed range of 41.4 Gy to 50.4 Gy. For all patients (N = 405), the estimated 5-year failure-free survival and overall survival were, respectively, 70% and 78%. CONCLUSION: Local failure after radiotherapy for group III rhabdomyosarcoma patients is the predominant type of relapse. Involved lymph nodes at diagnosis predict a higher risk of local and distant treatment failure compared with patients whose lymph nodes are negative.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2004

Nuclear surveillance and degradation of hypomodified initiator tRNAMet in S. cerevisiae.

The tRNA m(1)A58 methyltransferase is composed of two subunits encoded by the essential genes TRM6 and TRM61 (formerly GCD10 and GCD14). The trm6-504 mutation results in a defective m(1)A methyltransferase (Mtase) and a temperature-sensitive growth phenotype that is attributable to the absence of m(1)A58 and consequential tRNA(i)(Met) instability. We used a genetic approach to identify the genes responsible for tRNA(i)(Met) degradation in trm6 cells. Three recessive extragenic mutations that suppress trm6-504 mutant phenotypes and restore hypomodified tRNA(i)(Met) to near normal levels were identified. The wild-type allele of one suppressor, DIS3/RRP44, encodes a 3'-5' exoribonuclease and a member of the multisubunit exosome complex. We provide evidence that a functional nuclear exosome is required for the degradation of tRNA(i)(Met) lacking m(1)A58. A second suppressor gene encodes Trf4p, a DNA polymerase (pol sigma) with poly(A) polymerase activity. Whereas deletion of TRF4 leads to stabilization of tRNA(i)(Met), overexpression of Trf4p destabilizes the hypomodified tRNA(i)(Met) in trm6 cells. The hypomodified, but not wild-type, pre-tRNA(i)(Met) accumulates as a polyadenylated species, whose abundance and length distribution both increase upon Trf4p overexpression. These data indicate that a tRNA surveillance pathway exists in yeast that requires Trf4p and the exosome for polyadenylation and degradation of hypomodified pre-tRNA(i)(Met).

Cell Nucleus↗

PubMed2004

Reform of statistical inference in psychology: the case of memory & cognition.

Geoffrey Loftus, Editor of Memory & Cognition from 1994 to 1997, strongly encouraged presentation of figures with error bars and avoidance of null hypothesis significance testing (NHST). The authors examined 696 Memory & Cognition articles published before, during, and after the Loftus editorship. Use of figures with bars increased to 47% under Loftus's editorship and then declined. Bars were rarely used for interpretation, and NHST remained almost universal. Analysis of 309 articles in other psychology journals confirmed that Loftus's influence was most evident in the articles he accepted for publication, but was otherwise limited. An e-mail survey of authors of papers accepted by Loftus revealed some support for his policy, but allegiance to traditional practices as well. Reform of psychologists' statistical practices would require more than editorial encouragement.

Bibliometrics↗

PubMed2003

Web-based decision support for clinical trial eligibility determination in an international clinical trials network.

Matching individuals to multisite cooperative clinical trials can be a complex and nonintuitive decision process that expends considerable time and may be prone to errors. We developed and tested a web-based decision support tool to aid investigators in matching patients to open clinical trials for children with rhabdomyosarcoma in the context of an international cooperative cancer clinical trials network. A decision tree for trial eligibility based on eight clinical variables representing major disease characteristics was translated into a web-based format. In a blinded fashion, we assessed the accuracy of the tool in assigning 100 randomly selected cases to the proper clinical trial. The web-based tool assigned patients to the proper clinical trial in all 100 randomly selected cases. The time needed to enter data and receive results using this tool is about 1 minute per patient entered. It is feasible to develop a web-based tool to help investigators in matching patients to clinical trials. When such decisions are complex and nonintuitive, such tools have the potential to improve the accuracy of clinical trial assignment and save time.

Child↗

PubMed2003

Development of the University of Wisconsin donation After Cardiac Death Evaluation Tool.

BACKGROUND: Donation after cardiac death is a method by which severely neurologically injured patients not fulfilling brain-death criteria can donate organs. OBJECTIVE: To develop an evaluation tool that can be used to predict if a patient is a suitable candidate for donation after cardiac death. METHODS: The University of Wisconsin Donation After Cardiac Death Evaluation Tool assigns numeric values to observable clinical parameters to yield an overall predictive score of suitability for donation after cardiac death. This evaluation tool is typically utilized in a critical care unit to evaluate patients with a severe neurological injury, who do not meet brain-death criteria, and for whom the physician and family have chosen to terminally withdraw life support. Each patient is disconnected from a ventilator and observed for up to 10 minutes. Observations are then scored to yield a prediction of suitability for donation after cardiac death. RESULTS: Using the University of Wisconsin Donation After Cardiac Death Evaluation Tool, we were able to predict suitability for donation after cardiac death 83.7% of the time, within a 60-minute period and 74.4% of the time within a 120-minute period. The actual results using the tool were higher when clinical observations were included in the donation after cardiac death evaluation--an overall accuracy of 88.4%.

Death↗

PubMed2003

Allele and antigen-specific treatment of rheumatoid arthritis: a double blind, placebo controlled phase 1 trial.

OBJECTIVE: Human cartilage glycoprotein 39 (HC gp-39) appears to be a relevant autoantigen in patients with rheumatoid arthritis (RA). Administration of major histocompatibility complex (MHC) Class II complexed antigens without requisite costimulatory signals can induce immunologic tolerance. We evaluated the safety, pharmacokinetics, and preliminary efficacy of AG4263 in patients with RA. AG4263 is a soluble complex of native HLA-DR4 (beta*0401) complexed to Org 36601, a 13-mer peptide derived from HC gp-39 (also referred to as CDP263). METHODS: Thirty-one HLA-DRB1*0401 positive patients with persistent RA disease activity despite concurrent methotrexate were randomized to 7 infusions of AG4263 (n = 24) or placebo (n = 7) over 6 weeks. The initial dose of 0.5 micro g/kg was escalated in subsequent cohorts to a maximum of 150 micro g/kg. Safety analyses included recording of adverse events and measurement of CD4/CD8 counts, reactivity to recall antigens, and development of antibodies to HLA-DR4. Efficacy was assessed using the Paulus 20 criteria. RESULTS: Treatment was well tolerated, with injection site reaction the most common adverse event. There was no loss of reactivity to recall antigens, change in cell counts, or antibodies to HLA-DR. The mean half-life of AG4263 was 12.5 h. Some evidence of clinical response was seen; responses were more common among patients receiving the highest doses of AG4263 and among those with baseline T cell reactivity to CDP263. CONCLUSION: AG4263 was safe, well tolerated, and without evidence of generalized immune suppression. Along with the observed trend toward clinical efficacy, the results suggest that this therapeutic approach warrants further investigation in patients with RA.

Aged↗

PubMed2002

Problem gambling in the partner of the emergency department patient as a risk factor for intimate partner violence.

It has been suggested that the increase in gambling activity nationally has resulted in an increase in intimate partner violence (IPV). There are apparently no studies that have assessed problem gambling as a risk factor for IPV. To determine if problem gambling in the partner is a risk factor for IPV, a cross-sectional study was conducted at a university-based Emergency Department (ED). All women aged 19 to 65 years who presented to the ED for treatment and were not decisionally incapacitated or acutely ill were eligible. Data were collected by a research assistant during 4 or 8-h blocks covering each day of the week over a 10-week period during the months of June through August 1999. There were 300 consecutive women approached, and 286 (95%) agreed to participate. Of the women who agreed to participate, 237 (83%) reported having an intimate partner in the last year, and 61 (25.7%) of these women were categorized as experiencing IPV. The odds ratio (OR) of experiencing IPV was the main outcome measure, estimated using standard logistic regression, given the presence of various personal and partner characteristics, including problem gambling in the partner. The results revealed that the relative odds were elevated for women whose partners were problem gamblers (adjusted OR: 10.5; 95% CI: 1.3-82) or problem drinkers (adjusted OR: 6.1; 95% CI: 2.5-14). The presence of both problem gambling and problem drinking in the partner was associated with an even higher OR (adjusted OR: 50; 95% CI: 9-280). Our study shows that problem gambling in the partner is associated with IPV. The causes of IPV are not fully known, but the association of problem gambling in the partner with IPV could lead to new intervention strategies and Emergency Medicine research in the future.

Adult↗

PubMed2002

Fabrication of an educational model for patients considering prostheses retained by osseointegrated implants.

Patients considering the use of implant-retained craniofacial prostheses are faced with a large body of new information. This article describes the fabrication of a 3-dimensional teaching aid that helps educate such patients about the role of osseointegration in prosthetic treatment. The model illustrates the stages of auricular prosthesis fabrication and can be used to demonstrate proper prosthesis hygiene.

Calcium Sulfate↗