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Biomedical subjects

M L Lesser

Publications and source records attributed to M L Lesser.

83 records · Page 5Linked to original sources
PubMed1981

Asymptomatic bacteriospermia in fertile and infertile men.

Bacterial flora of the seminal fluid were examined in 430 asymptomatic men. Fertile men had significantly fewer positive cultures than any other group selected from the infertile population. Significantly more bacterial isolates were obtained from patients with a history of genital tract infection than from infertile men without a history of genital tract infection. Asymptomatic bacteriospermia was significantly more common among patients with a history of gonorrhea infection than in any other studied groups. Ureaplasma was isolated with the highest frequency from patients with nonspecific urethritis and/or with gonorrhea. It is proposed that follow-up seminal fluid cultures should be used to determine the end-point in treating male genital tract infections.

Bacterial Infections↗
PubMed1981

Breast self-examination and medical examination related to breast cancer stage.

The frequency and type of breast examinations reported by 1,216 primary breast cancer patients was studied in relation to local stage of disease. No significant relationship was found between the reported frequency of breast self-examination (BSE) and stage of disease; however, annual medical examination was significantly associated with small tumor size (P less than .04) and absence of axillary lymph node metastases (P less than .001). Regardless of the frequency of any method of examination, the majority (80 per cent) of tumors were first detected by the patients. Among those who detected their lesion, a greater frequency of medical examination was associated with an earlier pathological stage of disease (P less than .001). Patients who were examined more frequently by a physician appeared to be more sensitive to clinically significant breast abnormalities. These findings underscore the importance of examiner skill in the successful use of palpation to detect breast cancer. Instruction in BSE by a health professional during periodic examinations may provide the optimal opportunity for improved proficiency in self-examination.

Adult↗
PubMed1981

The effect of single dose N-methyl-N-nitrosourea on bladder carcinogenesis by N-[4-(5-nitro-2-furyl)-2-thiazolyl] formamide in rats.

The effect of a single intravesical dose of N-Methyl-N-Nitrosourea (MNU) on bladder carcinogenesis in Fischer rats by a suprathreshold dose of N-[4-(5-nitro-2-furyl)-2-thiazolyl] formamide (FANFT) was studied. Animals were sacrificed periodically during the course of the study and the experiment was terminated 50 weeks. Carcinomas were first noted in the MNU + FANFT group at 35 weeks versus 37 weeks for the group receiving FANFT alone. At 50 weeks, carcinomas were seen in 40 of 49 animals in the MNU + FANFT group and in 40 of 48 animals in the FANFT group. Of the animals developing bladder carcinomas 50 per cent receiving MNU + FANFT and 32 per cent receiving FANFT had high grade tumors. Six per cent of the animals receiving MNU alone developed bladder carcinomas whereas none was seen in a control group. In this system, the addition of an inducing dose of MNU did not alter the induction rate or results of carcinogenesis by FANFT. There was a tendency for higher grade tumors in those animals receiving the inducing dose of MNU.

Animals↗
PubMed1980

Serum zinc, copper, and the Cu/Zn ratio in patients with benign and malignant breast lesions.

Serum zinc, copper, and the Cu/Zn ratio were evaluated in 80 patients with breast lesions prior to surgery. There were 37 patients with benign and 43 with malignant breast lesions. There was no evidence of weight loss, impaired appetite, or change in eating pattern in any of the patients. There was a statistically significant difference for the mean SCL and Cu/Zn ratio between controls, age 66-94, and patients with malignant breast lesions. This difference was also observed between the ages of 20-45 and 66-94 among controls, suggesting that this is age related rather than disease related. The range of distribution for SZL and SCL were similar for all groups studied. Neither SZL, SCL, or the Cu/Zn ratio were of value in discriminating between controls and patients with benign or malignant breast lesions. We were unable to demonstrate the value of these parameters as markers of disease activity in patient with benign or malignant breast lesions.

Adenocarcinoma↗
PubMed1980

Epidemiology of breast carcinoma II: factors related to the predominance of left-sided disease.

A study of the laterality of 980 patients with unilateral breast carcinoma revealed a left/right ratio of 1.26. Detailed analysis disclosed a significant association between left predominance and the following clinicopathologic features: menarch after age 13, age at diagnosis, parity especially among those between ages 40 and 54, and all histologic types except medullary tumors. When asynchronous bilateral carcinoma was documented, the disease first occurred more often in the left breast. Patients with simultaneous bilateral disease usually had a larger tumor on the left. Because differences in breast size were considered a contributing factor, relative breast volumes were computed from the mammograms of 174 healthy women; 55% were found to have a larger left breast. These data and other observations cited in the literature suggest that the asymmetry of breast carcinoma reflects differences in the sensitivity of the mammary glands to hormonal stimulation, resulting in unequal volumes of tissue at risk to develop carcinoma.

Adolescent↗
PubMed1980

Statistical methods for measuring and comparing treatment efficacies: applications to nude mice experimentation.

A method is proposed for measuring and comparing the growth over time of a sample of tumors subjected to a number of different therapies. The procedure, which is illustrated by means of an example, does not require explicit parametric modelling of the growth curve itself and is particularly useful when the comparison of treatment efficacies is of chief interest. In addition, an ad hoc approach to the estimation of required sample sizes is delineated.

Animals↗
PubMedDate not supplied

Surgical treatment of oral cavity carcinoma.

Ninety-four squamous cell carcinomas of the oral cavity, treated on the author's service between 1969 and 1981, were evaluated. The series included squamous cell carcinomas of various intraoral sites excluding the lips and hard palate. Survival of 60 mo was 70% for stage I, 65% for stage II, 45% for stage III, and 27% for stage IV carcinoma. Twenty-four of 34 patients with "early" cancer (stages I and II) were treated by operation alone. Too few patients with "early" cancer were treated by combined irradiation and surgery to draw conclusions regarding relative efficacy of combination therapy. Sixty patients had "advanced" cancer (stages III and IV). Five-year survival was 37% for patients treated by operation alone, 18% after salvage surgery after failed irradiation, and 60% for patients treated by operation combined with planned perioperative irradiation. Combination therapy appeared to improve control of locoregional disease as well as survival in patients with "advanced" cancer.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

The effect of unbalanced randomization on the progressively censored Savage test.

Equal allocation of patients to treatment in a randomized clinical trial may have disadvantages ethically if the new treatment is believed to be at least as beneficial as the standard treatment. Others have considered, in a non-sequential setting, unbalanced randomized designs which allocate fewer patients to the potentially inferior standard treatment. This paper examines unbalanced randomized designs in a sequential comparison of two exponential survival distributions using the progressively censored Savage test. The results reveal no substantial sacrifice in asymptotic power or early stopping properties.

Clinical Trials as Topic↗
PubMedDate not supplied

Statistical and methodological issues in the evaluation of case management studies.

For the past 3 years, the nursing case management team at North Shore University Hospital in Manhasset, NY, has been involved in a project to implement more than 50 clinical pathways, which provide a written "time line" for clinical events that should occur during a patient's hospital stay. A major objective of this project was to evaluate the efficacy of these pathways with respect to a number of important outcomes, such as length of stay, hospital costs, quality of patient care, and nursing and patient satisfaction. This article discusses several statistics-related issues in the design and evaluation of such case management studies. In particular, the role of a research approach in implementing and evaluating hospital programs, the choice of a comparison (control) group, the exclusion of selected patients from analysis, and the problems of equating pathways with diagnosis-related groups are addressed.

Case Management↗
PubMedDate not supplied

Effect of doxycycline on pre-menstrual syndrome: a double-blind randomized clinical trial.

Thirty patients with well-defined symptoms of pre-menstrual syndrome were randomly treated with the antibiotic doxycycline or placebo. The antibiotic-treated group showed a highly significant reduction of symptoms. Subsequent antibiotic treatment of the original placebo group similarly diminished the symptoms in this group. A 6-month follow-up demonstrated that the improvement in symptom scores was permanent and independent from the presence of the antibiotic. Luteal phase endometrial biopsies showed a high incidence of out-of-phase endometrium. An unexpectedly high percentage of endometrial biopsy cultures yielded positive findings for mycoplasma, Chlamydia trachomatis and anaerobic bacteria. There were no characteristic hormonal changes in this study group. An infectious aetiology, possibly a sub-clinical endometrial or ovarian infection, behind certain cases of pre-menstrual syndrome is postulated.

Adult↗