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Biomedical subjects

S R Ebbs

Publications and source records attributed to S R Ebbs.

51 records · Page 3Linked to original sources
PubMed1988

Breast cyst type does not predict the natural history of cyst disease or breast cancer risk.

The sodium (Na) and potassium (K) concentrations were measured in the fluid of 169 breast cysts aspirated from 101 consecutive patients presenting to a single clinic. The Na/K ratio was used to define cysts as either apocrine (Na/K less than 3) or flattened (Na/K less than 3) in type. There was no consistency in the type of cyst for individual patients. Cyst type was not predictive of further cyst development, neither was a particular cyst type associated with the development of, or a history of, breast cancer.

Age Factors↗
PubMed1988

Does chemotherapy improve survival in advanced breast cancer? A statistical overview.

The relative efficacies of cytotoxic chemotherapy regimens in the treatment of advanced breast cancer are generally assessed by comparing response rates in randomised trials. Treatment attempts to prolong survival but trials rarely demonstrate a statistically significant survival advantage: it has been argued that chemotherapy does not prolong survival. The correlation between response rates and survival has been examined by reviewing 79 comparisons between arms with unequal response rates in 50 published trials of chemotherapy in advanced breast cancer. In 73% of comparisons the group with the higher response rate also demonstrated the longer median survival (P less than 0.001). Weighted linear regression showed a statistically significant relationship between relative response rates and survival (P less than 0.001). The number of patients in a comparison did not influence this relationship.

Antineoplastic Agents↗
PubMed1988

Simplifying infusion chemotherapy: preliminary communication.

A low-intervention policy for Hickman catheter maintenance has been evaluated and found to be safe and cost effective. A simple, lightweight, disposable device has been used for 24-hour ambulatory home infusion. Implementation of this policy as part of a prospective randomized trial of single-agent chemotherapy in advanced breast cancer has demonstrated that slow intravenous infusion reduces the acute toxicity of epirubicin when compared with bolus injection.

Breast Neoplasms↗
PubMed1988

A standardised approach to the insertion of Hickman catheters.

A standardised technique for the insertion of Hickman catheters under local anaesthetic is described. The external jugular vein is to be preferred, but if this proves too small the catheter may be introduced via the internal jugular vein using a Seldinger technique. A total of 44 Hickman catheters were inserted into 44 patients using this approach without major complication.

Anesthesia, Local↗
PubMed1987

Psoas abscess in Bristol: a 10-year review.

A consecutive series of 16 cases of psoas abscess managed over a 10-year period at the Bristol Royal Infirmary is presented. Tuberculosis accounted for 4 patients all normally resident in the United Kingdom. Intraabdominal inflammatory disorders accounted for 9 of the cases with Crohn's disease being the commonest of these with 5 cases. The remaining patients comprised 3 with primary staphylococcal abscesses, one appendicitis, one diverticulitis and 2 with colonic carcinoma. Diagnostic delay was common. Ultrasonography together with guided aspiration of pus was the most useful investigation giving the diagnosis in cases due to tuberculosis and staphylococci. The presence of gut associated organisms was indicative of gastrointestinal pathology. Four patients died and significant morbidity occurred in a further 5. We recommend effective dependent drainage together with resection of diseased gut in the cases of gastrointestinal origin.

Abscess↗
PubMed1986

Adenolymphoma of the parotid: aetiology, diagnosis and treatment.

In order to study the changing clinical pattern, diagnosis and surgical treatment of adenolymphoma, the records of all 57 patients with a confirmed histological diagnosis, made at Bristol Royal Infirmary between 1951 and 1984, were reviewed; in 3 patients (5 per cent) bilateral lesions had been found. No characteristics emerged in a review of the history and clinical examination which would have enabled a correct preoperative diagnosis to be made. During the period of study the incidence of adenolymphoma increased 24-fold. (Parotid pleomorphic salivary adenomas increased in incidence by only 42 per cent over the same period). Before 1965 all patients were men; between 1965 and 1975 the male to female ratio was 3:1; between 1975 and 1985, 1.6:1. Of the 48 patients who had a relevant history taken 45 were smokers (93.8 per cent). It is postulated that tobacco consumption is important in the development of adenolymphoma, and has produced the changes in incidence and sex ratio. Fine needle aspiration biopsy cytology (FNAB) afforded the only method of achieving a pre-operative diagnosis. This was successful in 64.7 per cent. Superficial parotidectomy induced a 43 per cent incidence of facial nerve neurapraxia. Controlled enucleation reduced this to 8 per cent. Enucleation is the procedure of choice for adenolymphoma but can only be employed with confidence if an exact pre-operative diagnosis is made.

Adenolymphoma↗
PubMedDate not supplied

Acquired tamoxifen resistance in human breast cancer and reduced intra-tumoral drug concentration.

Reduced intra-tumoral drug concentrations have been investigated as a mechanism of tamoxifen resistance in 51 patients with locally recurrent breast cancer. Serum tamoxifen was similar in patients with acquired and de-novo resistance, but intra-tumoral concentrations were significantly lower in patients with acquired resistance. Tumour oestrogen-receptor concentrations at relapse did not support the hypothesis that selective outgrowth of oestrogen-receptor-negative cells is a major mechanism for acquired tamoxifen resistance. Reduced intra-tumoral tamoxifen levels during prolonged therapy may be an important mechanism for acquired resistance in breast cancer.

Aged↗
PubMedDate not supplied

Patient and anatomical selectivity in postoperative radiotherapy for early breast cancer: a British perspective.

As radiotherapy following surgery for early breast cancer carries morbidity, financial cost, and potential mortality we have sought to select characteristics that will allow these risks to be minimised. The causes of increased mortality shown in the overview of mature trials of radiotherapy have been studied in a single large randomised trial. This has identified patients with large, poorly differentiated tumours to be most likely to benefit from the reduction in incidence of local recurrence achieved by radiotherapy while remaining at the lowest risk from suffering the increased mortality associated with the treatment. Much of the morbidity of radiotherapy is due to routine irradiation of lymphatic pathways. Three hundred and seven patients treated by breast-conserving surgery and breast radiotherapy have been evaluated. None received irradiation to their axilla or internal mammary lymphatics. Relapse in locoregional lymphatics (axilla or supraclavicular fossa) occurred in 15 patients. Only 4 had persisting symptoms from this relapse following further treatment.

Adult↗
PubMedDate not supplied

Testing "the soft option": trials of adjuvant endocrine therapy for the primary treatment of breast cancer.

Current concepts of the natural history of early breast cancer focus on a belief that for many women the tumor has disseminated prior to the time of diagnosis. For these women systemic treatment is essential to delay or prevent the return of the disease. Results of adjuvant chemotherapy trials indicate a benefit for premenopausal node-positive patients at the expense of toxicity. It is now being recognized that adjuvant endocrine therapy can obtain a similar advantage in a wider range of women with early breast cancer without the severity of side effects. This article seeks to review the role of adjuvant endocrine therapy: "the soft option."

Antineoplastic Combined Chemotherapy Protocols↗