Biomedical subjects

V Guinee

Publications and source records attributed to V Guinee.

7 recordsLinked to original sources

PubMed1992

Histoplasmosis in hairy cell leukemia: case report and review of the literature.

Progressive disseminated histoplasmosis (PDH) has been described in only six patients with hairy cell leukemia (HCL). Herein we describe an additional patient with HCL and disseminated histoplasmosis. Additionally, we note that three of seven cases of disseminated histoplasmosis and HCL have occurred in East Texas. PDH is to be suspected in febrile HCL patients in an endemic area who fail to respond to antibacterial therapy. We emphasize that serologic studies are useful in the diagnosis of PDH in HCL patients, and these patients respond well to therapy.

Acquired Immunodeficiency Syndrome↗

PubMed1989

Long-term survival and prognostic factors for 2170 breast cancer patients treated at two cancer centers (Milan and Houston).

Data on 2170 consecutive patients with breast cancer submitted to curative surgery with or without combined radiotherapy in the period 1968-1972 at the National Cancer Institute of Milan (Italy) and at the University of Texas M.D. Anderson Cancer Center of Houston (Texas, USA) were analyzed to evaluate the prognosis of breast cancer patients after loco-regional treatment only and to verify if different prognostic factors have the same relevance. Forty-four percent of patients were alive without evidence of disease at the end of the follow-up in both centers: 14% of patients treated in Milan died without evidence of breast cancer with an intercurrent disease, whereas the death rate for intercurrent disease was 27% in Houston. Thirty-seven percent of the patients in Milan and 26% of the patients in Houston died from breast cancer. A considerable percentage of patients (23.4% in Milano, 38.2% in Houston) had one or more of the required items not specified in the clinical chart. Since the lack of information was considered a possible source of bias, the series were divided into two groups: the first collecting patients with all information available, the second gathering patients with at least one of the required items missing. The latter group was defined "unknown". Multivariate analysis of survival, carried out by means of Cox's regression model, showed that mortality of these patients for all causes was significantly affected by the following criteria: status of regional nodes (P = 2 X 10(-13)), unknown (P = 10(-9)), maximum diameter of primary tumor (P = 7 X 10(-10)), age of the patients (P = 10(-4)), site of primary (P = 0.01), and Center (P = 0.04). A significant interaction was found between center and a) age of the patients, b) menopausal status and c) unknown. The relative P values were 6 X 10(-7) for age and center, 8 X 10(-3) for menopausal and center, 3 X 10(-2) for unknown and center. Multivariate analysis of breast cancer mortality was significantly affected by: status of regional nodes (P = 10(-18)), diameter of primary (P = 5 X 10(-14)), unknown (P = 2 X 10(-13)), center (P = 2 X 10(-6)), site of primary (P = 0.002), and age of the patients (P = 0.03). The same significant interaction as for mortality from all causes was found. It is concluded that comparability of results obtained in different institutions may be dependent on the standardization and availability of patients data.(ABSTRACT TRUNCATED AT 400 WORDS)

Age Factors↗

PubMed1987

Untreated prostatic carcinoma is not associated with frequent thrombohemorrhagic disorders.

We conducted an evaluation of the hemostatic integrity of patients with untreated cancer of the prostate. Of 60 patients analyzed retrospectively, only 1 had a mild case of disseminated intravascular coagulation, possibly associated with concomitant estrogen therapy, and in 1 patient mild deep vein thrombosis developed preoperatively, also possibly associated with multiple medications for concurrent disorders. Of 16 other patients prospectively evaluated on admission, only 1 had frankly abnormal levels of fibrinopeptide A unaccompanied by other coagulation abnormalities. Occasional individuals had minimal, negligible deviations of partial thromboplastin times, thrombin time, or antithrombin III values. In none of these patients did hemostatic complications develop during their hospital stay. These results demonstrate that although an occasional coagulation abnormality may occur in patients with cancer of the prostate (albeit with a lower incidence than in other neoplasms), this malignancy does not require increased precautions with respect to those given to the patient population at large.

Adult↗

PubMed1986

Pancreatic carcinoma and Trousseau's syndrome: experience at a large cancer center.

It is common belief that carcinoma of the pancreas has an inherent and unique ability to induce a hypercoagulable diathesis that leads to clinically significant thrombosis. We evaluated 130 consecutive patients with adenocarcinoma of the pancreas to document the incidence and the predisposing factors related to the postulated increased association of thromboembolic disorder (TED) and pancreatic carcinoma. Only nine such patients (6.9%) demonstrated TED complications of the classical Trousseau syndrome. In these instances, the location of the tumor and its mucin-producing potential were significant predisposing factors. In our series, TED was usually associated with tumors of the body and tail, which had a greater likelihood to be mucinogenic as compared with those localized to the head of the pancreas. Routine tests for hemostasis were not helpful in predicting the development of TED except, perhaps, for decreased platelet counts. Therefore, we believe that the relationship between cancer of the pancreas and TED should be de-emphasized since it is neither unique nor especially common to pancreatic carcinoma and since it may be frequently encountered in other varieties of visceral malignancies of the cancer patient population.

Adenocarcinoma↗

PubMedDate not supplied

Reliability of basic cancer patient data.

Pooling patient data from multi-institutional medical chart review occurs commonly in the study of cancer and other diseases. To determine the consistency of reporting among institutions, we presented a test set of 25 standardized medical charts to coders at 18 Comprehensive Cancer Centers and compared their resulting codes. This study measures the reproducibility of coding by different persons, but does not assess the accuracy of the underlying medical record. Among 34 data items, we found high disagreement rates in coding stage of disease (14 per cent) and date of diagnosis (8 per cent). Primary site, histologic type and other key items had good reproducibility (disagreement rates less than or equal to 5 per cent). A number of minor disagreements indicated that detailed distinctions could not be reliably coded from medical charts.

Forms and Records Control↗

PubMedDate not supplied

Absence of a relationship of size of primary colon carcinoma with metastasis and survival.

This retrospective study analysed the relationship of tumor size to regional and systemic metastasis and to survival according to stage of disease. Colon cancers (391 cases) that were treated surgically at M. D. Anderson Hospital from 1955 to 1975 were reviewed. Staging of disease was based on the Astler-Coller modification of Dukes' staging classification. The mean diameters (cm +/- s.e.m.) of Dukes' B1, B2, C2 and D tumors were 4.47 +/- 0.34 (n = 46), 6.61 +/- 0.29 (n = 147), 5.39 +/- 0.23 (n = 71) and 5.78 +/- 0.24 (n = 120), respectively. The mean diameter of Dukes' B2 tumors was significantly greater than C2 (P less than 0.001) and D (P less than 0.05) tumors. Within stage B and C, size of the primary tumor showed no relationship to five year adjusted survival. Our findings suggest that colon carcinoma metastasis and survival are independent of tumor size. Because tumor burden does not account for distant disease, specific tumor cell phenotypes and biological processes are probably more important in determining metastatic disease.

Colonic Neoplasms↗

PubMedDate not supplied

Perioperative blood transfusion in patients with colon carcinoma.

The effect of perioperative blood transfusion on 5- and 10-year survival following curative resection for intra-abdominal colon carcinoma was investigated retrospectively. Two hundred and seven patients with Dukes' stages A, B, and C carcinoma were divided into two groups: those who received perioperative blood transfusion and those who did not. The data indicated that survival was not altered by blood transfusion during primary surgical tumor resection. Location of tumor in intra-abdominal colon, size of tumor, units of blood received, and stage of disease also were considered in our analysis but did not change this conclusion.

Blood Transfusion↗