Biomedical subjects

M C Solomon

Publications and source records attributed to M C Solomon.

4 recordsLinked to original sources

PubMed1998

Age specific prostate specific antigen reference ranges: population specific.

PURPOSE: We determined whether 60 to 79-year-old men with a negative digital rectal examination and a serum prostate specific antigen (PSA) within age specific PSA reference ranges could safely forgo prostate biopsy. MATERIALS AND METHODS: We reviewed the medical records of all 60 to 79-year-old men at the Brooklyn Veterans Administration Medical Center who had a PSA assay, digital rectal examination and subsequent prostate biopsy for an abnormal rectal examination and/or PSA greater than 4.0 ng./ml. from January 1991 through August 1995. We compared our results using the standard reference range of 0 to 4.0 ng./ml. with those obtained had we used any of 4 different age specific PSA reference ranges. RESULTS: We performed 1,280 prostate biopsies in 1,046 men with available PSA and digital rectal examination data. Using age specific PSA reference ranges 73 of 1,280 biopsies (5.7%) would have been avoided. Of those 73 avoided biopsies 15 (20.5%) had cancer that would have gone undetected and 9 of 15 (60%) undetected cancers had unfavorable histology. Results were not statistically significantly different among the 4 age specific PSA reference ranges. Regarding race, cancer detection rates were significantly higher for black compared with white men but there was no statistically significant difference for missed cancers or missed cancers with unfavorable histology. CONCLUSIONS: In contrast to previous reports of unfavorable histological characteristics in only 5% of missed cancers using age specific PSA reference ranges, 60% of missed cancers in our patients exhibited unfavorable histology. We conclude that age specific PSA reference ranges did not safely eliminate the need for prostate biopsy in our study population. In 60 to 79-year-old men with a negative digital rectal examination we continue to use PSA greater than 4.0 ng./ml. as an indication for prostate biopsy.

Age Factors↗

PubMed1998

Early prostate cancer detection and potential for surgical cure in men with poorly differentiated tumors.

OBJECTIVES: Long-term cure after radical prostatectomy has been reported for men with organ-confined poorly differentiated prostate cancer. However, organ-confined rates have been disappointingly low, ranging from 8% to 18% in earlier series, which have consisted primarily of patients not screened for prostate-specific antigen (PSA). Recently, it has been our impression that a greater number of patients with poorly differentiated tumors have had organ-confined disease than earlier reports would have led us to predict. METHODS: To test this hypothesis, we reviewed the results of surgical staging in men with poorly differentiated tumors (Gleason score 8 to 10) entered into our prospective data base between August 1992 and June 1996. RESULTS: Of 109 men undergoing operation during the study period, 64 underwent exploration for planned radical prostatectomy with no previous therapy and comprise the study cohort. In 92%, the initial presentation was an elevated PSA level (median 10.8 ng/mL). We observed an organ-confined rate of 30% and found preoperative PSA levels of 10 ng/mL or less to be a significant predictor of organ-confined disease (45% versus 17%, P = 0.016, chi-square test). On preliminary follow-up (median 31 months), 84% of men with organ-confined tumors are free of PSA relapse, similar to that seen in 233 men with organ-confined moderately differentiated tumors undergoing operation during the study period (P = 0.12, log-rank test). CONCLUSIONS: Early prostate cancer detection, as reflected by PSA levels of 10 ng/mL or less, is associated with a higher organ-confined rate in men with poorly differentiated tumors. On preliminary follow-up, PSA relapse rates were lower in men with pathologically confirmed, organ-confined, poorly differentiated disease.

Adult↗

PubMed1996

In vitro activities of quinolones, beta-lactams, tobramycin, and trimethoprim-sulfamethoxazole against nonfermentative gram-negative bacilli.

From 1991 to 1995, 8,975 nonfermentative gram-negative bacilli were isolated from patients at The Ohio State University Medical Center: 71% Pseudomonas aeruginosa, 14% Stenotrophomonas maltophilia, 7.6% Acinetobacter baumannii, and < 2% each of 25 other species. The MICs of trovafloxacin (CP-99,219), ciprofloxacin, ofloxacin, ampicillin-sulbactam, piperacillin, piperacillin-tazobactam, ceftazidime, cefoperazone, ceftriaxone, imipenem, tobramycin, and trimethoprim-sulfamethoxazole (TMP-SMZ) were determined for 308 isolates, representing 13 species, by a standardized broth microdilution method. The activities of all drugs were species dependent. The fluoroquinolones had inconsistent activity against most species, although several relatively uncommon nonfermenters were consistently susceptible or resistant. Trovafloxacin was considerably more active than ciprofloxacin and ofloxacin against S. maltophilia, A. baumannii, and several less common species. Among the beta-lactams, relative activities varied considerably; overall, imipenem had the broadest spectrum of activity but was inactive against S. maltophilia and Burkholderia cepacia isolates. Tobramycin and TMP-SMZ had stereotypic spectra of activity. Tobramycin was active against most species except S. maltophilia, Alcaligenes xylosoxidans subsp. xylosoxidans, Burkholderia spp., and Weeksella virosa. TMP-SMZ was active against most species except P. aeruginosa and Pseudomonas fluorescens-putida. A review of laboratory records indicated few changes in susceptibility patterns from 1991 to 1995; the only clear trend was toward increasing P. aeruginosa resistance to all classes of drugs.

Anti-Bacterial Agents↗

PubMedDate not supplied

Glandular odontogenic cyst. A rare entity with aggressive biological behaviour. A case report.

Glandular Odontogenic cyst is an apparently rare jaw cyst characterised by typical histopathological features, propensity to reach large size and high rate of local recurrence, if not adequately treated. Identification of this cyst as a separate entity is important because of the difference in biological behaviour. We report a case of Glandular Odontogenic cyst occurring in maxilla.

Adolescent↗