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Biomedical subjects

P Friedmann

Publications and source records attributed to P Friedmann.

At least 73 records · Page 4Linked to original sources
PubMed1985

Survival following moderate-dose preoperative radiation therapy for carcinoma of the rectum.

We performed a retrospective study of patients with carcinoma of the rectum or rectosigmoid undergoing surgical resection. Forty-two patients received adjuvant preoperative radiation therapy (4000-4500 rad). One hundred twenty patients underwent surgical resection alone. Survival of radiation patients was significantly improved over that of Surgery Only patients, even after adjusting for nontreatment factors using Cox regression. Crude 5-year survival was 63% for radiation patients (74% adjusted) compared to 46% for surgery-only patients (48% adjusted) (P less than 0.025). Radiation patients also had longer disease-free survival than surgery-only patients (P less than 0.05) and fewer recurrences (14% versus 37%; P less than 0.025). Fewer radiation patients had lymph nodes involved with tumor than surgery-only patients (20% versus 35%; P = 0.07). Although 71% of radiation patients experienced radiation reactions, these were primarily mild and transitory. We believe that preoperative radiation is an effective and safe adjunct to surgery in the treatment of rectal cancer and that its use can lead to improved survival rates.

Aged↗
PubMed1984

Stabilization of large multilamellar liposomes by human serum in vitro.

The leakage of 5,6-carboxyfluorescein from large multilamellar liposomes prepared from dipalmitoylphosphatidylcholine (without or with cholesterol) was investigated in vitro in the presence of human serum. Below the phospholipid phase transition temperature, the rate of dye release is retarted 3-8-fold in the presence of up to 25% human serum in the incubation medium, as compared to the release in isotonic phosphate-buffered saline. This effect is significantly augmented by incorporation of 50 mol% cholesterol into the lipid bilayer. At and above the phase transition temperature, the initial rapid dye leakage in the presence of serum is followed by a slow long-term release. Incubation of the liposomes with serum is assumed to result in the association of serum proteins with the outermost lipid bilayer which in turn will lead to their stabilization, while the inner lamellae are not immediately accessible to the serum proteins. The permeability of the outer protein-rich lipid bilayer appears to be restricted, as concluded from the decreased dye release in the presence of serum. Massive leakage from multilamellar liposomes appears to be primarily due to bilayer defects occurring in the lipid transition region rather than being caused by protein-lipid interactions. The results of our in vitro experiments are discussed in terms of the potential usefulness of multilamellar liposomes as drug carriers in vivo for local and topical applications.

Blood↗
PubMed1982

Apathetic thyrotoxicosis presenting as an abdominal emergency: a diagnostic pitfall.

Thyrotoxicosis may present with a hyperkinetic clinical picture typically associated with Graves' or Plummer's disease, or in an apathetic form characterized by lethargy, weakness, and withdrawal. Both the hyperkinetic and apathetic forms of thyrotoxicosis may be associated with or masked by predominantly extrathyroidal manifestations, occasionally referable primarily to the abdomen. We present two cases of apathetic thyrotoxicosis that suggested the need for urgent surgical intervention, and review the literature on apathetic thyrotoxicosis as an abdominal emergency, as well as laboratory studies and possible etiology.

Abdomen, Acute↗
PubMed1981

Sequential femoropopliteal and femorotibial bypasses. A ten-year follow-up study.

Since 1970, we have performed 33 sequential femoropopliteal bypass grafts (of 482 femoropopliteal bypasses [7%]) and 22 sequential femorotibial bypass grafts (of 153 femorotibial bypasses [14%]). Patients ranged in age from 51 to 90 years. Twenty-two (66%) of the sequential femoropopliteal bypass grafts, and all of the sequential femorotibial bypass grafts, were for limb salvage. By life table analysis, interval patency rates for both types of sequential procedures at 60 months, 72 months, and even longer are good (greater than 80% for both sequential femoropopliteal and sequential femorotibial bypasses). These two sequential bypasses are effective alternatives when the saphenous vein is inadequate. We assume that these results are due to excellent inflow (using a prosthetic graft proximally) and the use of a segment of autogenous saphenous vein over the knee joint.

Actuarial Analysis↗
PubMed1981

Synergistic effect of acute renal failure and respiratory failure in the surgical intensive care unit.

A retrospective evaluation of the effect of renal and respiratory failure on mortality in our surgical intensive care unit was undertaken. The coexistence of combined renal and respiratory failure had a synergistic adverse effect on survival. Combined pulmonary and kidney failure appeared to develop simultaneously. A subset of patients with severe prerenal azotemia but without uremia had the highest mortality. These results are not consistent with the simple combination of single systems failure but rather suggest that renal and respiratory failure are makers of a generalized underlying defect.

Acute Kidney Injury↗
PubMed1980

[Determinants of the decision to retire. A contribution to the discussion on the "flexible retirement age limit" (author's transl)].

Our research intended to analyse the effects of the "Flexible Altersgrenze" (introduced in 1973) on the position of older workers. The study was designed as a casestudy in three firms of different branches of industry. We found out that all older workers planned to make use of the "Flexible Altersgrenze" in as far as their income and insurance claims permitted it. Under this scheme the retirement age would still be higher than most of the workers would prefer. The following stipulations infludenced the decision to retire: -- the state of physical health -- the strain of working-conditions in their present job and throughout their working-life -- a pessimistic view of their job prospects at that age -- unfavourable experiences with the effects of technical and organisational change in working-conditions -- the necessity of changing the job in later life because of the incapability to bear its strain.

Decision Making↗
PubMed1978

Adjuvant radiation therapy in colorectal carcinoma.

A series of sixty-five patients with adenocarcinoma of the rectum and rectosigmoid is reviewed. Thirty-two patients had surgery alone, fourteen patients underwent postoperative radiation therapy, and nineteen patients underwent preoperative radiation therapy. A moderate dose program of 4,000 to 4,500 r was used. The postoperative treatment group had a higher incidence of stage C lesions and a higher recurrence rate, but there were no statistically significant differences in survival. Postoperative radiation therapy in patients with stage C lesions did not prolong life and is of little benefit. The preoperative treatment group tolerated the radiation very well, and there were no major complications. Eight patients underwent anterior resections in irradiated fields. Two minor anastomotic leaks subsequently healed spontaneously. There were no pelvic recurrences in the preoperative treatment group, and the incidence of lymph node metastases was 26% as opposed to 41% in controls. We conclude that preoperative moderate dose radiation is not associated with increased risk of morbidity or mortality. It may be useful in reducing the incidence of lymph node metastases and pelvic recurrence. The effect on survival is not determined in this study.

Adenocarcinoma↗
PubMed1976

The sequential femoropopliteal bypass graft. A five year experience.

(1) A five year experience with sequential bypass grafts for femoropopliteal tibial reconstruction is presented. (2) Twenty-nine consecutive grafts were performed in twenty-eight patients in whom the saphenous vein was absent or inadequate for grafting purposes. (3) The series contains a high percentage of women (57 per cent), diabetics (39 per cent), and patients requiring surgery because of rest pain or tissue necrosis (83 per cent). (4) There was no operative mortality and no significant operative morbidity. (5) The overall graft patency rate is 71 per cent, which is comparable to that obtained with standard bypass technics. (6) There was no late failures in the ten grafts that survived one year or more. (7) This procedure appears to be a useful method for bypass grafting to the popliteal or tibial arteries below the knee when the saphenous vein is absent or inadequate.

Aged↗
PubMedDate not supplied

Ureteral lymphoma: MRI demonstration.

A case of ureteral lymphoma with no other areas of involvement was incidentally discovered on MRI examination. Bilateral ureteral soft tissue infiltration, asymmetrical hydronephrosis, and abnormal enhancement of lymphomatous tissue were noted. A follow-up MRI after chemotherapy demonstrated significant decrease in the size of the periureteral disease and improvement in the extent of hydronephrosis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Psychiatric histories of drug using mothers: treatment implications.

One hundred forty six crack/cocaine using mothers in New York City were interviewed in a cross sectional study about life histories and drug related behaviors. Forty one (28%) reported histories of previous psychiatric medication or hospitalization. These women were significantly more likely than the rest of the sample to currently be in drug treatment; to have sexual abuse histories; and to be currently involved with men who urged them to use crack during pregnancy. Within this group, two subgroups were distinguishable: one, who had been sexually abused and initiated drug use early, and the other whose psychiatric and drug use histories were not associated with sexual abuse. The implications of these findings for screening, treatment planning, and future research are discussed.

Adult↗