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Biomedical subjects

L Edwards

Publications and source records attributed to L Edwards.

At least 19 recordsLinked to original sources
PubMed1992

Therapeutic response to somatostatin analogue, BIM 23014, in metastatic prostatic cancer.

Metastatic prostate cancer is well known to respond to hormonal manipulations, but once progression occurs new treatment modalities are required. Specific and systemic antitumour therapy is preferable to local treatments such as radiotherapy in such patients. The finding that somatostatin analogue, BIM 23014, inhibits prostatic tumour growth in animal models is of great interest. We treated 25 poor risk patients with progressive metastatic prostate cancer. Sixteen had also failed to respond to 'total androgen blockade'. Two patients have achieved a partial remission, one of which is maintained at over 30 months, and three had stable disease for over 6 months. Side effects have consisted of mild diarrhoea and abdominal cramp in the first few days of treatment in a minority of the patients. These results are encouraging and further randomized studies are in progress.

Aged↗
PubMed1992

Selective memory for sensory and affective information in chronic pain and depression.

Mood congruity effects in induced mood states and affective disorders are well established. Recent evidence suggests that a similar process occurs in chronic pain patients, although the extent to which the memory bias is a consequence of the affective or sensory state of the subject in this group is unknown. In this study selective memory for sensory and affective pain-related information was investigated in depressed and non-depressed chronic pain patients and depressed psychiatric patients. A recall test comprising sensory, affective and neutral adjectives matched for frequency was followed by a recognition task, where the words of the recall test were randomized with an equal number of new adjectives matched for word type and frequency. Comparison of the three patient groups with normal controls revealed specific recall biases directly related to pain and depression in both chronic pain groups and the controls. Contrary to expectations, the depressed psychiatric patients failed to show a recall bias for affective adjectives: the possibility of cognitive avoidance as an explanation for this is discussed. Signal detection analysis of the recognition results suggested that selective memory in chronic pain and depression may to some extent be accounted for by differences in 'true memory', the contribution of response bias remaining less clear.

Adult↗
PubMed1992

Acceleration of alveolar type II cell differentiation in fetal rhesus monkey lung by administration of EGF.

To examine the effect of epidermal growth factor (EGF) on lung parenchymal maturation in fetal rhesus monkey, recombinant human EGF was administered intraperitoneally (IP) at 66 mg/kg body wt over a 7-day period into the fetal peritoneal cavity alone or IP and into the amniotic fluid (AF) simultaneously. The saline carrier was injected IP and AF into control (CO) fetuses. The body weights of the IP + AF group were significantly larger than CO. Overall lung growth, measured as wet lung weight or fixed volume of the right cranial lobe, was unchanged. Fixed lung volume per gram body weight was significantly lower for both IP + AF and IP compared with CO. Morphogenesis of lung parenchyma, measured as percent parenchymal airspace or airspace size, was unchanged. Alveolar type II cell ultrastructure was significantly altered by EGF treatment; volume fraction of cytoplasmic glycogen was 50% less and lamellar bodies threefold greater for IP + AF and IP groups compared with CO. Total phospholipid content of AF was not altered, but relative percentages of different phospholipids were changed by EGF treatments; phosphatidylinositol was significantly reduced, and phosphatidylglycerol was significantly elevated. The lecithin-to-sphingomyelin ratio was unchanged. Surfactant apoprotein A concentration in AF was significantly elevated and was detected by immunoperoxidase in more cuboidal alveolar cells in EGF-treated animals when compared with CO. We conclude that exogenous EGF administered in the last trimester of pregnancy accelerates structural and functional cytodifferentiation of the alveolar type II cell in fetal primates. These maturational changes occur in the absence of significant alterations in overall lung growth or morphogenesis of the gas exchange area.

Amniotic Fluid↗
PubMed1992

Treatment of cutaneous squamous cell carcinomas by intralesional interferon alfa-2b therapy.

BACKGROUND AND DESIGN: Intralesional recombinant interferon alfa-2b has been shown to be effective in the treatment of actinic keratoses and basal cell carcinomas. This open-label study was designed to evaluate the effectiveness and cosmetic result of this therapy on actinically induced, primary cutaneous squamous cell carcinomas. Thirty-six squamous cell carcinomas (28 invasive lesions and 8 in situ lesions) ranging in size from 0.5 to 2.0 cm in the longest dimension were treated with interferon alfa-2b 1.5 million units injected intralesionally three times per week for 3 weeks. Eighteen weeks following therapy, the treatment sites were excised and examined for histologic evidence of remaining tumor. RESULTS: Thirty-three (97.1%) of 34 evaluable lesions revealed an absence of squamous cell carcinoma histologically after therapy, although three biopsy specimens (8.8%) obtained after treatment showed actinic keratoses, for an overall complete response rate of 88.2%. The lesion not eliminated after treatment was an invasive squamous cell carcinoma. The investigators and patients independently judged 93.9% of cases to have a very good or excellent cosmetic result. Adverse reactions were limited to those influenzalike symptoms well recognized to occur with interferon therapy and these were well tolerated. Only one patient discontinued therapy due to side effects. CONCLUSIONS: This trial demonstrates that intralesional interferon is effective in the treatment of small sun-induced squamous cell carcinomas with well-tolerated side effects and a highly acceptable cosmetic result.

Adult↗
PubMed1992

Reiter's syndrome of the vulva. The psoriasis spectrum.

BACKGROUND: Reiter's syndrome is a disease characterized by crusted, scaling, acral and genital plaques; urethritis or cervicitis; and arthritis, which occur in genetically susceptible patients in response to any of many infections. This disease rarely occurs in women, and specific characterizations of vulvar and cervical lesions are rare. OBSERVATIONS: We describe a 39-year-old woman with a history of mucocutaneous candidiasis that was refractory to oral ketoconazole therapy. She presented with well-demarcated, erythematous, crusted plaques over the vulva, hands, and feet, as well as with cervical lesions and a history of conjunctivitis and iritis. Following the biopsy of characteristic skin lesions, recognition of systemic signs, and cultures that were negative for yeast, her condition was diagnosed as Reiter's syndrome. CONCLUSIONS: Reiter's syndrome of the vulva, vagina, and cervix may not be recognized because of its uncommon occurrence in women and the physician's consequent unfamiliarity with its clinical appearance in the genital area. This disease and pustular psoriasis share many common features and exist on a spectrum. A high index of suspicion and correlation of the many facets of the disease will better enable the clinician to make this diagnosis.

Adult↗
PubMed1992

Desquamative vulvitis.

The typical appearance of inflammatory and bullous diseases may be changed when they occur on the vulva. The moist, warm, occluded environment produces a tendency for the thin skin of the vulva to erode and scar, resulting in a common final appearance often characterized by loss of the labia minora and agglutination of the clitoral hood. The most common diseases that may produce desquamative vulvitis include lichen sclerosus, lichen planus, immunobullous diseases, contact dermatitis, erythema multiforme, lupus erythematosus, and squamous cell carcinoma in situ. The differentiating characteristics and treatment of these diseases are discussed in this article.

Adult↗
PubMed1992

Vulvar cicatricial pemphigoid as a lichen sclerosus imitator. A case report.

Because vulvar lichen sclerosus is very common, a clinician confronted with hypopigmentation and agglutination of the labia minora is tempted to make a diagnosis of the disease without the benefit of a skin biopsy or a careful examination of other epithelial surfaces. Unfortunately, that clinical picture is also consistent with the end stage of several other diseases, including cicatricial pemphigoid (benign mucous membrane pemphigoid), as demonstrated by a case of cicatricial pemphigoid affecting the vulva.

Administration, Oral↗
PubMed1990

The effect of intralesional interferon gamma on basal cell carcinomas.

This open label study evaluated the effect of nine intralesional injections of two different doses of interferon gamma on basal cell carcinomas in 29 patients. One group of 15 patients received interferon gamma, 0.01 mg (20,000 IU), intralesionally three times a week for 3 weeks. Fourteen patients received interferon gamma, 0.05 mg (100,000 IU), intralesionally in the same dosage schedule. Excisional biopsy specimens 12 weeks after therapy showed no evidence of tumor remaining in 7 of 14 patients (50%) treated with the higher dose of interferon gamma, whereas only 1 of 15 patients (7%) treated with low-dose interferon gamma was cured according to histologic criteria (p = 0.025). Seventy-six percent of patients reported at least one adverse reaction, but most were considered mild by the patient and the investigator.

Adult↗
PubMed1990

Intralesional interferon therapy for basal cell carcinoma.

In a clinical trial of 172 patients at four medical centers, interferon alfa-2b (1.5 x 10(6) IU) or a placebo was injected directly into biopsy-proved noduloulcerative or superficial basal cell carcinomas three times weekly for 3 weeks, for a cumulative dose of 13.5 million IU. Efficacy of treatment was determined at 16 to 20 weeks by examination of biopsy specimens that demonstrated cure of lesions in 86% of interferon-treated patients and in only 29% of placebo-treated patients. During the treatment course and follow-up, an initial inflammatory response was observed at the treatment sites, followed by diminished erythema, improvement in overall appearance, and a decrease in size of lesions. Side effects of treatment, mainly flu-like symptoms, were usually mild and transient and occurred more commonly in the interferon-treated group. Only three patients, all in the interferon-treated group, discontinued therapy because of side effects. One year after initiation of therapy, 81% of interferon recipients and 20% of those given the placebo remained tumor free. Noduloulcerative and superficial lesions were equally responsive to treatment with interferon. For some patients with noduloulcerative or superficial basal cell carcinomas, intralesional interferon alfa-2b may be an alternative, effective treatment.

Basal Cell Carcinoma↗
PubMed1990

Midnight removal: an improved approach to removal of catheters.

There is no recognised policy regarding the timing of urethral catheter removal, although early morning removal is commonly practised. Removing the catheter at midnight allows patients to return to a normal voiding pattern more rapidly and to leave hospital earlier.

Female↗
PubMed1990

What on earth are we drinking?

During the past few years there has been a considerable increase in the number and variety of still and carbonated bottled drinking waters, which have an enormous variation in calcium content ranging from 0 to over 500 mg/l. Patients with upper urinary tract stones are often advised to maintain a high fluid intake in order to achieve an increased urinary output. If they find tap water unpalatable and drink bottled water instead, they could significantly increase their daily calcium intake by as much as 1.5 g. The majority of bottled waters presently available in this country, together with tap water samples from throughout the British Isles, have been analysed and the results suggest that there are some waters which stone formers should avoid.

Calcium↗
PubMed1990

The effect of topical interferon alpha 2b on actinic keratoses.

As a result of the known effects of intralesional interferon alfa 2b (Intron A) on actinic keratoses, we have now examined the effects of topical interferon alfa 2b gel on actinic keratoses. Twenty-four subjects each treated three actinic keratoses with either interferon gel 30 million IU/gm or a placebo preparation applied topically 4 times a day for 4 weeks. Although more lesions treated with the active interferon showed clinical improvement, this difference was not statistically significant.

Administration, Topical↗
PubMed1990

First family planning visit in school-based clinics.

The timing of the first family planning visit for 144 female adolescents using school-based clinics in four St. Paul, Minn., high schools was studied. Mean delay time for the sample was 11.4 months and the median was 7.8 months. Almost 50% of the sample arrived within two months of either a planned onset of sexual intercourse (virgin group) or a recent start of sexual activity (short delay group). Early onset of sexual activity (v age 15) was more prevalent among long delayers (47.9%) than among short delayers (21.1%). Longer delayers were more likely to come from the lowest socioeconomic groups. Short delayers and longer delayers were equally likely to have been motivated to attend the clinic because they feared they were pregnant. Reasons for choosing this clinic over others reflected the importance of confidentiality, comprehensiveness of services, and the specific adolescent orientation of care.

Adolescent↗
PubMed1990

The effect of topical tretinoin on dysplastic nevi. A preliminary trial.

Twenty-one patients were enrolled in a randomized, double-blind study that examined the effects of topical 0.05% tretinoin (all-trans-retinoic acid; vitamin A acid; Retin-A) solution on dysplastic nevi. Following histologic confirmation of the diagnosis of dysplastic nevus in three representative lesions, patients applied either tretinoin or a placebo containing 50% alcohol to selected dysplastic nevi once a day under tape occlusion, or twice a day unoccluded, for 4 months. Immediate posttreatment comparative photographs showed marked fading or elimination of some dysplastic nevi clinically, and histologic examination of excisional biopsy specimens showed disappearance or reversion to benign nevi in many of the treated lesions. There were no clinical or histologic changes in those dysplastic nevi treated with placebo. This study shows a definite biological effect of topical tretinoin on some dysplastic nevi.

Administration, Cutaneous↗