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Biomedical subjects

P Engstrom

Publications and source records attributed to P Engstrom.

At least 55 records · Page 3Linked to original sources
PubMed1990

How valid are mammography self-reports?

We compared mammography reports in medical records to self-reports obtained during a 1989 telephone interview survey for a sample of 100 women members of a health maintenance organization (HMO) who indicated they had mammograms within the past year and 100 who said they had not had mammograms within the past year. Of the women reporting they had not had mammograms within the past year, none had mammogram reports in the HMO data center. Of the 100 women reporting they had mammograms within the past year, 94 had confirmatory radiology records.

Aged↗
PubMed1985

Oxygen tension in human tumors: in vivo mapping using CT-guided probes.

The role of oxygen in tumor response to therapy has been studied for several decades. We describe a technique that allows in vivo measurement of oxygen in tumors using computed tomography to guide probes. In the evaluation of 16 tumors, oxygen tensions were found to be substantially lower than surrounding tissue and varied nonrandomly. This technique has allowed construction of detailed tumor oxygen level maps.

Adult↗
PubMed1983

Cooperative groups and community hospitals. Measurement of impact in the community hospitals.

The Eastern Cooperative Oncology Group, composed of major cancer treatment centers, has an outreach program which involves community hospitals in ongoing cancer clinical trials. A prevalence survey was carried out in February 1981 among 104 community hospitals and 21 member institutions to determine the characteristics of patients being treated, their staffing, and reasons why patients were not on protocol studies. The survey sampled 25 (50) consecutive patients from community hospitals (member institutions). The purpose of the study was to assess the impact of a community cancer control program. The results of the study demonstrated that 16% of patients surveyed in the affiliated community hospitals were being treated on a research protocol. In addition, a further 35% had their treatment plan influenced by a protocol. Consequently protocols have impacted directly or indirectly on 51% of the patients. The corresponding figures in member institutions were 23% and 38% for a total of 61%. In studying protocol availability, it was found that 66% of all patients were ineligible for any protocol. Of patients eligible for a protocol but not registered on one, 52% were not registered because of physician preference for a specific treatment. The affiliates surveyed were shown to be on average half as large as member institutions in terms of number of beds and staff size. Also, staff/patient ratios are generally smaller in the community hospitals. The median age of patients was considerably lower than SEER incidence data. Also, elderly patients were slightly more prevalent in community hospitals than in member institutions. A clear relationship between disease stage and age in breast cancer patients was noted with the representation of early-stage disease much higher in young women.

Adult↗
PubMed1983

Carcinoids: the association of histologic growth pattern and survival.

There are five generally accepted carcinoid histologic growth patterns, i.e., insular, trabecular, glandular, undifferentiated, and mixed. To determine their possible prognostic significance, a panel of pathologists studied the growth patterns of 138 carcinoids collected from an Eastern Cooperative Oncology Group carcinoid advanced stage disease chemotherapy investigation. Survival times were measured from date of initial pathologic diagnosis of carcinoid disease to date of either death or last follow-up. Significant differences were observed in survival times between the five major growth patterns (P less than 0.001). Within the mixed growth pattern group, significant differences in survival time were also observed (P approximately 0.05). In decreasing order of median survival time in years, the growth patterns ranked as follows: mixed insular plus glandular, 4.4; insular, 2.9; trabecular, 2.5; mixed insular plus trabecular, 2.3; three pooled low incidence rate mixed growth patterns, 1.4; glandular, 0.9; and undifferentiated, 0.5. Histologic growth patterns are recommended as a stratification factor in future studies of this disease.

Aged↗
PubMed1982

Alpha-adrenergic stimulation of prostaglandin release from rabbit iris-ciliary body in vitro.

Because previous studies have suggested that ocular effects of adrenergic agonists are in part attributable to arachidonate metabolites, the effect of phenylephrine on synthesis and release of arachidonic acid (AA) and prostaglandins from isolated rabbit iris-ciliary body (ICB) slices was examined. ICB concentrated and incorporated exogenous 14C-AA into tissue phospholipid and neutral lipid stores. During the period of 14C-AA labeling of tissue lipids, a portion of AA was converted to prostaglandins (PGs), as determined by thin-layer chromatography in two solvent systems and by prevention of PG synthesis by indomethacin. PGs E2 and F2 alpha were the major PGs synthesized. PGD2, thromboxane B2, and 6-keto-PGF 1 alpha were also synthesized by ICB. Phenylephrine enhanced PGE2 and PGF2 alpha synthesis and release from superfused 14C-AA-labeled ICB. PGE2 was the major PG released upon stimulation by phenylephrine. Phenoxybenzamine, an alpha-adrenergic receptor antagonists, and indomethacin prevented phenylephrine-induced PG release. The phenylephrine-induced PG release thus represented newly synthesized PG and was a result of the alpha-adrenergic activity of phenylephrine. Phenoxybenzamine treatment did not inhibit enzymes involved in PG synthesis, inasmuch as bradykinin was capable of markedly stimulating PG release from IBC treated with phenoxybenzamine. Esterification of 14C-AA into a lipid tentatively identified as 1,2-diacylglycerol was also demonstrated. The presence of this glyceride suggests that ICB exhibits phosphatidylinositol turnover and that phospholipase C and diacylglycerol lipase activities might be involved in supplying AA for ocular PG synthesis upon alpha-adrenergic stimulation.

Adrenergic alpha-Agonists↗
PubMed1980

Survival and response to chemotherapy for advanced colorectal adenocarcinoma: an Eastern Cooperative Oncology Group report.

A series of 1,314 cases of advanced measurable colon or rectal cancer were evaluated for objective tumor response and survival. All patients received chemotherapy according to protocols conducted by the Eastern Cooperative Oncology Group during the period between 1974 and 1977. For those patients who had not received chemotherapy prior to study entry, no therapy program under evaluations was significantly more active than the oral or intravenous 5-fluorouracil treatment programs with respect to survival or objective tumor response. The survival and response rates therapy programs under study, including methyl-CCNU, appeared to be comparable. Initial performance status (P < 0.01), weight loss in the six months prior to study entry (P < 0.001), and prior chemotherapy status were shown to be most prognostic for survival, and thus merit inclusion as stratification factors in any comparative trial involving this population. These factors were shown to have a cumulatively greater influence upon survival than the treatment program. Treatment differences were most accentuated within the favorable subgroups of the leading prognostic factors. The location of the primary tumor had a significant effect upon the eventual sites of metastatic disease involvement at the time of study entry (P < 0.001). The consequences of this analysis suggest that investigators need to address characteristics of the population under study. It is also noted that patients with chemotherapy prior to study entry are best suited for survival studies, while patients with no chemotherapy prior to study entry are well suited for both objective tumor response and survival studies.

Antineoplastic Agents↗
PubMed1979

Chemotherapy of gastric and pancreatic carcinoma: a controlled evaluation of combinations of 5-fluorouracil with nitrosoureas and "lactones".

By random assignment a total of 176 eligible patients with advanced nonmeasurable pancreatic carcinoma were treated with 5-fluorouracil (5-FU) either alone or in combination with a nitrosourea (streptozotocin), in combination with a "lactone" (spironolactone), or in combination with both. By random assignment a total of 179 patients with advanced nonmeasurable gastric carcinoma were treated with 5-FU either alone or in combination with a nitrosourea (methyl CCNU), in combination with a lactone (testolactone), or in combination with both. The median survival period for all pancreatic carcinoma patients was 17 weeks, and for all gastric carcinoma patients 30 weeks. The addition of the nitrosoureas or the lactones or a combination of both produced no improvement in length of patient survival for either primary carcinoma when compared to treatment with 5-FU alone.

Adenocarcinoma↗
PubMed1976

Sequential and combination chemotherapy of advanced gastric cancer.

One hundred and forty-six previously untreated patients with advanced gastric cancer were assigned at random to therapy with the following regimens: 1) Methyl CCNU alone; 2) Methyl CCNU with cyclophosphamide induction; 3) 5-fluorouracil (5-FU) + methyl CCNU; and 4) 5-FU + methyl CCNU with cyclophosphamide induction. Cyclophosphamide induction produced an objective response rate of only 8%. In addition, it added to hematologic toxicity and detracted from the therapeutic activity of subsequent treatment. Methyl CCNU was relatively ineffective therapy with an overall objective response rate of 8%. The response rate to 5-FU + methyl CCNU without cyclophosphamide induction was 40% and this was significantly superior to all other regimens. The survival time of all patients treated with 5-FU + methyl CCNU was significantly superior to that of all patients treated with methyl CCNU alone.

Adenocarcinoma↗
PubMedDate not supplied

Hospital procedure volume and teaching status do not influence treatment and outcome measures of rectal cancer surgery in a large general population.

A clear benefit of increased hospital procedure volume or teaching hospital status on outcomes of rectal cancer surgery has yet to be shown. Few have examined treatment differences that may lead to varying outcomes. This study assessed the impact of hospital procedure volume and teaching status on both treatment and outcome measures of rectal cancer surgery in a large general population. Data were obtained for 1072 incident cases of rectal adenocarcinoma diagnosed in 1990 from Ontario, Canada, and treated with a major resection. Hospitals were classified by teaching status and procedure volume. Pathology reports were examined for 418 procedures. Abdominoperineal resections accounted for 31.0% of all procedures. There were no clinically significant differences in treatment measures, operative mortality, and long-term survival among the hospital groups according to both univariate and multivariate analyses. In conclusion, the absence of a hospital volume or teaching status effect on treatment and outcome measures suggests that for rectal cancer surgery in Ontario, centralization of procedures into high-volume or teaching centers is unlikely to improve surgical quality.

Adenocarcinoma↗