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Biomedical subjects

L Rubinstein

Publications and source records attributed to L Rubinstein.

At least 37 records · Page 2Linked to original sources
PubMed1991

Intraperitoneal radioactive phosphate in early ovarian carcinoma: an analysis of complications.

Intraperitoneal radioactive chromic phosphate was administered to 69 patients with Stage I and II ovarian carcinoma who had undergone comprehensive surgical staging. Intestinal obstruction requiring surgical intervention occurred in four patients and was the most severe complication. Abdominal pain was the most common post-therapy complaint. Attention to time and technique of drug administration could minimize complications.

Adolescent↗
PubMed1990

Clinical toxicity associated with tiazofurin.

Tiazofurin, an investigational antimetabolite, is undergoing clinical evaluation in leukemia. We analyzed the data base of 198 patients entered in Phase I trials to characterize the incidence and severity of toxicities associated with tiazofurin according to dose and schedule. Severe myelosuppression occurred infrequently, and was not dose-dependent. A five day bolus schedule had a higher incidence of severe or life-threatening neutropenia than other schedules. Tiazofurin produced lymphopenia which was not dose-dependent in the range of 23-36% decrease from baseline, and the effect on lymphocyte count was generally greater than the decline in neutrophil count. Non-hematologic toxicity of a moderate or worse severity (greater than or equal to grade 2) included nausea and vomiting (18% of all courses), serum transaminase elevations (SGOT, 16%; SGPT, 9%), rash (9%), stomatitis (3%), conjunctivitis (3%), headache (10%), other signs of central nervous system toxicity (8%), and cardiac toxicity, primarily pleuropericarditis (4%). Dose-related cutaneous toxicity, headache, and nausea and vomiting were evident in the five day bolus schedule, and myalgia was more frequently reported at higher doses on the single dose schedule. The five day continuous infusion (CI) schedule had a higher incidence of neurotoxicity, cardiac toxicity, SGPT elevations and ocular toxicity than the daily for five days bolus schedule, but none of these differences attained statistical significance. Although the peak plasma concentrations of tiazofurin achieved with the five day bolus schedule were 3-fold higher than the steady-state plasma levels seen with an equal dose given by CI, the area under the concentration-time curve (AUC) was approximately 1.6-fold higher with CI. These observations suggest that both high peak plasma concentrations (above 400 microM) and prolonged exposure to plasma levels exceeding 50 microM may result in a higher incidence of serious non-hematologic toxicity.

Antineoplastic Agents↗
PubMed1990

Cancer recurrence after resection: T1 N0 non-small cell lung cancer. Lung Cancer Study Group.

The Lung Cancer Study Group entered 907 eligible patients with T1 N0 non-small cell lung cancer in one of three successive clinical trials. At the time of analysis, 201 of these patients were free from malignancy 60 months after operation. Thirty percent of patients who died were free from malignancy at death. Death rates were comparable for the total group (907 patients) and the patients free from malignancy at 60 months (201 patients) (0.086 versus 0.079, respectively); therefore death was not a suitable therapeutic end point. Cancer recurrences were more frequent in patients with non-squamous carcinoma than those with squamous carcinoma (0.088 versus 0.042); however, this difference was not observed after a 60-month malignancy-free interval (0.035 versus 0.022, respectively). Select comparisons between the total group of 907 patients and the 201 patients free from malignancy at 60 months are noteworthy: (1) the rate of occurrence of new, nonpulmonary malignancies was constant (0.016 versus 0.018, respectively); (2) the rate of pulmonary recurrences decreased (0.043 versus 0.013, respectively); and (3) the rate of occurrence of new lung cancer increased (0.009 versus 0.016, respectively). Therefore, although cancer recurrences decreased with survival, new lung cancer occurrences increased, and the probability of malignant disease appearing more than 60 months after operation for T1 N0 non-small cell lung cancer dictates continued patient surveillance.

Adenocarcinoma↗
PubMed1990

Attitudes and behaviors of dental hygienists concerning tobacco use.

This study surveyed a proportionate random sample of licensed dental hygienists in five states and the District of Columbia, to assess their antitobacco use behaviors and attitudes. The response rate was 79.4 percent. Descriptive data as well as chi-square, analysis of variance (ANOVA), and Duncan's multiple range test statistical results were reported. Only 6.9 percent of the hygienists sampled currently smoked. These hygienists appeared to exhibit significantly different aggregate attitudes and select clinical practice behaviors than their nonsmoking counterparts. Years of employment and geographic location showed no significant relationship to aggregate clinical practice behaviors or attitudes, although each was related to individual behaviors and attitudes. Overall, dental hygienists appeared committed to involvement in both individualized and community-based antitobacco-use efforts. Measures to coordinate hygienists' involvement at both of these levels need to be enhanced.

Analysis of Variance↗
PubMed1989

Display and analysis of patterns of differential activity of drugs against human tumor cell lines: development of mean graph and COMPARE algorithm.

The objective of this study was to develop and investigate an approach to optimally detect, rank, display, and analyze patterns of differential growth inhibition among cultured cell lines. Such patterns of cellular responsiveness are produced by substances tested in vitro against disease-oriented panels of human tumor cell lines in a new anticancer screening model under development by the National Cancer Institute. In the first phase of the study, we developed a key methodological tool, the mean graph, which allowed the transformation of the numerical cell line response data into graphic patterns. These patterns were particularly expressive of differential cell growth inhibition and were conveniently amenable to further analyses by an algorithm we devised and implemented in the COMPARE computer program.

Antineoplastic Agents↗
PubMed1989

Dental hygienists' anti-tobacco role: educational perspectives.

Dental hygienists need to assume a proactive health education role concerning tobacco use. To help measure, define, and broaden this role, a study was conducted to assess dental hygienists' current clinical practice behaviors, attitudes, and perceived curriculum adequacy concerning anti-tobacco efforts. The relationships among these variables and respondents' academic degree and year of graduation were analyzed. The study population consisted of a proportionate random sample of 500 dental hygienists in five states and the District of Columbia. A self-administered questionnaire yielded a response rate of 79.4 percent. Based on chi-square analyses of individual items, it was found that, when controlling for degree held, year of graduation was not significantly related to clinical practice behaviors or attitudes, but was significantly related to the majority of curriculum adequacy items. Academic degree, when controlled for year of graduation, was not significantly related to clinical practice behaviors, but was related to one attitude and two curriculum adequacy items. Analysis of variance and Duncan's multiple range test revealed the following significant relationships for aggregate data: year of graduation and degree held appeared to have no relationship to aggregate clinical practice behaviors or attitudes, M.S. degree respondents assigned higher curriculum adequacy ratings than did other subjects, and respondents who graduated prior to 1972 assigned their curricula more negative adequacy ratings than did all other graduates. The most recent graduates rated their curricula the most positively. The study's overall findings suggest that a fairly well-developed role for dental hygienists in anti-tobacco efforts exists. Given the current emphasis on health promotion, prevention, and holism in the provision of oral health care, it is commendable, but not surprising, that dental hygiene programs appear to have made positive modifications over time in tobacco-related content.

Attitude of Health Personnel↗
PubMed1988

Combined modality treatment for resected advanced non-small cell lung cancer: local control and local recurrence.

The purpose of this study was to compare the effect of post-operative thoracic radiation with or without systemic chemotherapy on survival and recurrence patterns in patients subjected to thoracotomy with curative intent, but subsequently found to have residual tumor in the resected margin or metastasis in the highest paratracheal lymph node. All patients were treated with postoperative mediastinal irradiation and randomized to receive or not receive combination chemotherapy (cytoxan, adriamycin, and platinum) for 6 months beginning concurrently with radiation. Of the 172 patients randomized, 164 were eligible for analysis. The mean time since randomization for the eligible patients is 4.2 years. Radiation therapy was administered to all patients by split course regimen [20 Gy in 5 fractions over 5 days]. Two such courses were given with a 3-week interval. The initial recurrence rates for both in-field recurrence and distant relapse were reduced in the combined postoperative radiation therapy and chemotherapy group, although only the latter difference achieved statistical significance (p = 0.01). Also, local recurrence overall (not restricted to initial recurrences) is examined as a function of histology, extent of residual disease after resection, and T and N status. The treatment effect achieves statistical significance only for patients with macroscopic residual (p = .023) or T3 tumor (p = .010). The combined therapy group of patients have a significantly longer recurrence-free survival [p = 0.006 by the two-sided Mantel-Haenszel logrank test] which fails, however, to translate to a significant difference in overall survival (p = 0.146). Median survival of the entire group is 14.5 months with 34% alive 2 years after resection. Most of the initial recurrences (82%) have been systemic, with brain being the most common site. Distant failure, therefore, remains an important problem even in the favorable prognosis subset of patients with advanced NSCLC, but combined modality approaches can produce improved recurrence-free survival.

Adenocarcinoma↗
PubMed1987

Oral health care for hospitalized patients: the nurse's role.

Oral health care is an essential component of daily hygiene for hospitalized patients, and nurses have an important role in helping patients maintain an acceptable level of oral health. This study tested the hypothesis that nursing students are graduating with an insufficient knowledge of oral health care for hospitalized patients. Four groups of senior nursing students comprised the study sample. Study data reveal gaps in the subjects' knowledge of and rationale for oral health care procedures for hospitalized patients. However, the subjects also indicated a high level of interest in improving their ability to offer appropriate oral care services. In addition to study findings, an oral health care instructional unit outline for nursing students is presented.

Clinical Competence↗
PubMed1980

Chromosome findings in 2,500 second trimester amniocenteses.

We have analyzed the chromosome abnormalities found in 2,500 amniocenteses for prenatal diagnosis; 1,887 (75%) were performed because the maternal age was 34 years or more. Chromosome abnormalities were detected in 1.80% of those referred for advanced maternal age, 1.2% between ages 34 and 39 years and 4.6% 40 years and over. Of these, four occurred in women who would have been 34 years at delivery (2.9%). Trisomy 21 accounted for 50% of the chromosome abnormalities; sex chromosome abnormalities, for 25%; the remaining 25% was divided equally between trisomy 18 and partial trisomies and mosaics. Unexpected translocations were found in 0.4%, of which two-thirds were balanced and identified in one parent. The accuracy was 99.6%.

Amniocentesis↗
PubMed1980

Follow-up of 2000 second-trimester amniocenteses.

The authors analyzed the outcome of 2000 consecutive second-trimester amniocenteses. Seventy-three percent were performed for maternal age of 34 years or more. The risk of spontaneous abortion before 28 weeks' gestation was 1.3% and for stillbirth or neonatal death, 1.4%. Total fetal loss was 2.7%, compared with 2.2% in a control population. Congenital malformations were found in 1.6% of the study group and in 1.9% of controls; no increase in skeletal problems was observed. Prematurity, defined as a birth weight of less than 2500 g, was noted in 3.6%, compared with 3.7% and 3.9% in 2 control populations. Respiratory difficulties persisting for more than 24 hours were observed in 0.8% of patients, compared with 0.7% of controls. Analyses of the outcome of amniocenteses performed at a single large center do not show an increase in perinatal complications or malformations.

Abortion, Spontaneous↗