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Biomedical subjects

S Wardell

Publications and source records attributed to S Wardell.

6 recordsLinked to original sources
PubMed2004

Gefitinib, a novel, orally administered agent for the treatment of cancer.

Traditional cytotoxic anticancer therapies do not differentiate between tumour and host cells, and research efforts have been focused on finding new agents that target tumour tissue. Gefitinib ('Iressa', ZD1839) is an orally active epidermal growth factor receptor tyrosine kinase inhibitor that blocks signal pathways implicated in solid tumour growth and metastasis. In phase II trials, gefitinib 250 mg/day demonstrated efficacy in the control of advanced non-small-cell lung cancer (NSCLC) in patients who had undergone prior chemotherapy. Response rates were 18.4 and 11.8%, and disease control rates were 54.4 and 42.2%, at 250 mg/day in two multicentre trials - IDEAL 1 and 2. Gefitinib also caused rapid relief from the symptoms of NSCLC in approximately 40% of patients, while displaying a generally good tolerability profile that most commonly included mild, reversible gastrointestinal and skin adverse events. Gefitinib 250 mg/day has been approved for use in advanced, previously treated NSCLC in several countries including the USA, Japan and Australia. As a monotherapy and combination therapy, it is being investigated for the treatment of several common tumour types in addition to NSCLC. The pharmacokinetics of gefitinib have shown it to be suitable for once daily dosing, with a terminal half-life of approximately 48 h in patients with cancer. Steady-state exposure is achieved after 10 days dosing, and exposure is dose proportional up to 250 mg/day. Gefitinib is cleared principally by the biliary route and in part by metabolism. This review summarizes relevant data from studies of gefitinib that inform its clinical administration.

Administration, Oral↗
PubMed1994

Safety of 1-stage bilateral total knee arthroplasty.

Bilateral total knee replacements during a single operation with intramedullary femoral guide rods have been associated with the possible development of a fat embolism syndrome. To assess the safety of this procedure, in which the femoral canal was decompressed by the use of an overdrilled entrance hole and fluted guide rod, 17 unilateral and 18 bilateral consecutive total knee patients were evaluated. There were no differences between the groups on the basis of changes in chest radiographs, percentage of estimated pulmonary shunting, mental status changes, or fat and bone marrow elements drawn from a central venous catheter in the right atrium. Although no patient had free fat in the blood, bone marrow elements were found in 3 bilateral and 2 unilateral cases. No patient had clinical manifestations of a fat emboli syndrome. With appropriate femoral canal decompression, bilateral 1-stage total knee replacement appears to be a safe procedure.

Adult↗
PubMed1993

Fatigue fractures of the sacrum in children: two case reports and a review of the literature.

We present the clinical and radiological features of two children with fatigue fractures of the sacrum. Both patients were active, had no underlying bone disease and presented with insidious onset of low back pain. Plain radiography was non-contributory to the diagnosis. In both patients a focal area of increased activity was present in the lateral aspect of the sacrum on bone scintigraphy, which corresponded to linear medullary sclerosis in the sacral ala demonstrated by computed tomography. Magnetic resonance imaging in one patient revealed a linear signal void in the sacral ala on T1- and T2-weighted images. This was surrounded by diffuse low marrow signal on T1-weighted images, and increased marrow signal on T2-weighted images. Fatigue fractures of the sacrum should be considered in the differential diagnosis of low back pain in children. An awareness of their appearance on magnetic resonance imaging is important as this modality is increasingly utilised, particularly in children.

Adolescent↗
PubMed1990

Ileal duplication cyst causing massive bleeding in a child.

Intestinal duplication is a rare congenital anomaly; nonetheless, it comprises more than half of all alimentary duplication disorders. Our case report describes the hemorrhagic sequelae of this entity with surgical and pathologic findings. A review of anatomical classification, embryology, and natural history of duplication cyst follows; differentiating characteristics of duplication cyst versus Meckel's diverticulum are outlined. Intestinal duplication cyst should be considered in the differential diagnosis of GI bleeding, especially in children.

Child↗