Biomedical subjects

S Manson

Publications and source records attributed to S Manson.

5 recordsLinked to original sources

PubMed1992

Peripheral blood stem cell transplantation: impact on procedure load and workload in an apheresis unit.

Peripheral blood stem cells (PBSC) reinfusion appears to hasten hematologic reconstitution following myeloablative therapy. While procurement of PBSC adds apheresis procedures, rapid engraftment could decrease the demand for platelet transfusions. To determine the impact of PBSC collection on workload in our apheresis unit, we studied 3 consecutive groups of patients with metastatic breast cancer given comparable high-dose chemotherapy and autologous bone marrow transplant, with or without PBSC or granulocyte-colony stimulating factor (G-CSF). Forty-one transplants were performed with bone marrow cells only: 31 patients (Group A) did not receive G-CSF, while the following 10 patients (group B) received daily G-CSF until neutrophil engraftment. Bone marrow cells and PBSC were used for the most recent 11 transplants (group C), followed by daily G-CSF until engraftment. PBSC were mobilized with cyclophosphamide (4 g/m2) and etoposide (1 g/m2), followed by G-CSF, 8 micrograms/kg/day. PBSC collection was carried out on a Fenwal CS3000+ cell collector, using modified procedure 1, to obtain a minimum of 5 x 10(8) mononuclear cells/kg. The times to neutrophil count over 500/microL, platelet count over 20,000/microL, and discharge from the hospital after transplant were significantly shorter for patients in group C (medians of 8, 8, and 21 days, respectively) compared to group A (medians of 14, 14, and 29 days; P = 0.001) or group B (medians of 11, 24, and 32 days; P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

Psychiatric epidemiology of an Indian village. A 19-year replication study.

This 1988 study reports the point and lifetime prevalence of psychiatric disorders, using DSM-III-R criteria, of a sample (approximately 25%) of adult members of an Indian village previously studied in 1969. The basic instrument was the Schedule for Affective Disorders and Schizophrenia, augmented by available medical information and administered by experienced psychiatrists. Subjects were interviewed and results were weighed for the age- and sex-distributed population. The results indicated a high point prevalence of alcohol dependence (32.8%), with a lifetime prevalence of 72.8%, among males. The lifetime prevalence of affective disorders among women was also high (36.8%), but less so among men (19.3%). When compared with the DSM-III-R diagnoses of the 1969 study, the point prevalence rates of alcohol dependence and abuse disorders fell from 39% to 21%. Also, fewer subjects were judged to be psychiatrically impaired. Even though the prevalence of psychiatric disorders was lower in the current study, the rates for alcohol disorders and affective disorders were still far higher than those reported in Epidemiologic Catchment Area studies. Alcohol dependence (especially among young men) and affective disorder (among women) were major problems.

Adult↗

PubMed1991

Involved field radiation, fractionated total body irradiation, high dose cyclophosphamide, and autologous bone marrow transplantation in the treatment of malignant lymphomas.

We report the results of intensive therapy and autologous bone marrow transplantation (BMT) in 23 patients with malignant lymphoma (eight Hodgkin's disease and 15 non-Hodgkin's lymphoma) who failed primary therapy. All patients had evidence of disease prior to transplant therapy: 10 had never achieved a complete remission and 13 were in relapse. The preparative regimen included involved field radiation followed by fractionated total body irradiation and high dose cyclophosphamide. A complete remission was achieved in 15 patients, 11 of whom continue in unmaintained complete remission from 27 to 72 months after BMT (median follow-up of 52 months). Of the remaining patients, five did not achieve a complete remission and three died of early toxicity. The event-free survival of the entire group is 47%. Disease status at the time of BMT was significantly correlated with patient outcome. The event-free survival of 13 patients in whom there was no objective evidence of tumor growth on conventional dose therapy was 77% compared with only 10% in patients with tumors progressing on conventional dose therapy (p less than 0.002). All six patients transplanted in untreated relapse continue in unmaintained remission, suggesting that debulking chemotherapy may not be necessary before BMT. Alternative approaches are needed in patients whose tumors progress on conventional dose therapy.

Adolescent↗

PubMed1991

Collaborative research under the unification model.

The research role of the clinical nurse specialist is often the most difficult to implement. At the masters level, efforts are generally directed at utilization and evaluation of research more than design and implementation. Collaboration between several investigators, however, is an efficient and effective method of pooling the resources of a variety of researchers, allowing the actualization of all aspects of the research process. A collaborative effort to look at the clinical problem of fatigue was undertaken by a group of masters-prepared oncology nurses. Strategies for effective collaboration are outlined. Issues related to gaining group commitment and to delineating roles at the onset, voluntary participation, and timely communication are discussed. A realistic timetable and regular informal meetings helped to sustain the momentum of the study. All members were able to contribute a part of the completed project and to experience the professional and personal satisfaction of "owning" a research project from start to finish.

Humans↗

PubMedDate not supplied

Correlates of fatigue in people with breast or lung cancer.

Fatigue is regarded as a universal and unavoidable side effect of cancer therapy, yet its epidemiology and prevalence in populations of people with cancer have not been well-documented. Using the conceptual framework of Piper, et al., this study examined and described the perception and manifestations of fatigue and its physiological, biochemical, and behavioral correlates. A convenience sample (N = 77) of people with lung (n = 33) or breast cancer (n = 44) completed several instruments: a brief questionnaire, the Rhoten Fatigue Scale, a visual analogue scale (VAS), the Rhoten Fatigue Checklist, and the shortened version of the Profile of Mood States (POMS). Data on other factors thought to influence fatigue were collected via medical record audit. Seventy-five of 76 people (99%) completing the VAS experienced some level of fatigue. Significant correlates of fatigue included level of pain and POMS scores. Preliminary findings suggest that fatigue is a common problem with a complex etiology and that nurses must consider potential contributing factors when assessing fatigue and its impact on the individual.

Adult↗