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Biomedical subjects

W Walop

Publications and source records attributed to W Walop.

12 recordsLinked to original sources
PubMed1991

Haemolytic anaemia after childhood Escherichia coli O 157 .H7 infection: are females at increased risk?

We conducted a 4-year retrospective cohort study to better define the risk of haemolytic anaemia and haemolytic uraemic syndrome (HUS) in children following sporadic gastrointestinal infection with the O 157.H7 serotype of Escherichia coli. Of the 72 children infected with this organism, 9 (12.5%) developed haemolytic anaemia, 6 of whom had HUS. No child in a cohort of 72 age-matched controls with Campylobacter jejuni gastroenteritis developed haemolytic anaemia (P = 0.003). Females had a significantly greater risk of developing haemolytic anaemia after E. coli O 157. H7 infection than did males (8/29 females v. 1/43 males; P = 0.003). In a logistic regression model, female gender emerged as the only statistically significant risk factor for haemolytic anaemia (odds ratio 3.85; 95% confidence interval 1.24-12). These results are consistent with recent reports of a moderate increase in the risk of HUS for females.

Adolescent↗
PubMed1991

'New data from old': epidemiology and record-linkage.

Record linkage in the context of epidemiology refers to the putting together of information (records) on the same person which may have been recorded on different occasions and became part of different data collections. The objective of this article is to provide an overview of the use of record linkage in epidemiology, particularly as it pertains to nutrition and food studies. A short description of epidemiological methodology is provided in order to clarify what epidemiologists expect to achieve by record linkage. A general description of the mechanics of record linkage explains how the methodology relates to the quality of the resulting data sets. The potential impact of the approach of record linkage on epidemiological research is discussed, particularly as it relates to nutritional and other food related studies. Ethical considerations related to record linkage are discussed, and in conclusion the future of record linkage is considered.

Animals↗
PubMed1990

The use of biomarkers in the prediction of survival in patients with pulmonary carcinoma.

Data on ten variables and 16 biomarkers were obtained on 119 patients with newly diagnosed pulmonary cancer. The prognostic value of 16 biomarkers (alpha-1-antitrypsin [AAT], adrenocorticotropic hormone [ACTH], alpha-fetoprotein [AFP], carcinoembryonic antigen [CEA], human chorionic gonadotropin [HCG], immune complexes, immunoglobulins, N-terminal peptide of proopiomelanocortin [NTERM], and tumor-associated antibody [TAA]) was tested by adding these to the model of age, gender, stage, morphology, Feinstein's classification of symptoms, Karnofsky scale, leukocyte count, recent weight loss, and liver enzymes. Using Cox's regression method and a forward stepwise procedure, seven biomarkers (ACTH, AAT, AFP, calcitonin, HCG, TAA, and prolactin) entered the model. Elevated levels of cortisol and TAA were associated with longer survival. The selection of biomarkers by stepwise regression needs to be interpreted with caution, especially since the Z scores were found to be dependent on the particular variables included in the model. Furthermore, when dichotomized on maximum of the normal laboratory values, HCG and AFP were infrequently (2%) elevated. The lack of correlation among the biomarkers supports the hypothesis of random derepression of the genome of cancer cells. Further studies in improved modeling and the formulation of a biomarker index could enhance our understanding of the biology of cancer.

Adenocarcinoma↗
PubMed1990

Iridium 192 implantation of T1 and T2 carcinomas of the mobile tongue.

Between 1970 and 1986, 166 patients with T1 or T2 epidermoid carcinomas of the mobile tongue were treated by iridium 192 implantation (70 T1N0, 83 T2N0, 13 T1-2 N1-3). Five-year actuarial survival was 52% for T1N0, 44% for T2aN0, and 8% for or T1-2 N1-3. Cause specific survivals were 90%, 71%, and 46%, respectively. Local control was 87% for both T1N0 and T2N0, and 69% for T1-2 N1-3. Seven of 23 failures were salvaged by surgery, increasing local control to 96% for T1 and 90% for T2. Thirty-six patients developed a minor or moderate necrosis (16% T1, 28% T2). Half of these involved bone but only five required surgical intervention. Both local control (LC) and necrosis (nec) increased with increasing dose but improvement beyond 65 Gy is minimal (less than or equal to 60 Gy: LC = 78% nec = 13%; 65 Gy: LC = 90% nec = 29%; greater than or equal to 70 Gy: LC = 94% nec = 23%). For N0 patients, neck management consisted of surveillance (n = 78), elective neck dissection followed with external irradiation for pathologically positive nodes (n = 72), or irradiation (n = 3). Clinically positive nodes (13 patients) were managed by either neck dissection followed by external irradiation if pathologically positive (n = 10) or irradiation alone (n = 3). Regional control was 79% for N0 patients, improving to 88% after surgical salvage, and was 9/13 for N1-3 patients. We recommend that T1 and T2 carcinomas of the mobile tongue be treated by iridium 192 implantation to deliver 65 Gy. Mandibular necrosis should be reduced by using an intra-oral lead-lined dental mold.

Adult↗
PubMed1990

Prognostic factors of local outcome for T1, T2 carcinomas of oral tongue treated by iridium 192 implantation.

The results of Iridium 192 implantation for 121 node negative T1 or T2 squamous carcinomas of mobile tongue were reviewed to look for predictors of local control and necrosis. Age, sex, total dose, dose rate, linear activity, and intersource spacing were examined. Minimum follow-up was 2 years but no patient with local recurrence or necrosis was excluded. There were 57 T1N0 tumors, 45 T2aN0 (2.1-3.0 cm), and 19 T2bN0 (3.1-4.0 cm). Local failures occurred in 14% of T1, 11% of T2a, and 26% of T2b. Univariate analysis showed that local control increased with increasing dose (55-60 Gy: 73%; 65-75 Gy: 92%, p = 0.005), whereas multivariate analysis revealed both sex and total dose to be significant. Radiation necrosis occurred in 17% of T1, 29% of T2a, and 47% of T2b (p = 0.034). Half were limited to soft tissue and the majority healed with conservative management. Univariate analysis showed that necrosis increased with increasing dose (55-60 Gy: 16%; 65-75 Gy: 33%, p = 0.037), as well as increasing dose rate, linear activity, and intersource spacing. With multivariate analysis only stage, dose rate, and spacing remained predictive of necrosis. Total dose was not adjusted for dose rate or tumor volume. This analysis suggests that within the therapeutic range of low dose rate brachytherapy, correction of total dose according to dose rate is unnecessary. We recommend 65 Gy. Lower dose rate (0.4-0.5 Gy/hr) and closer intersource spacing (12-14 mm) should be aimed for to minimize necrosis.

Adult↗
PubMed1989

An appraisal of pelvic ultrasound: a survey of gynecologists.

The clinical role and perceived usefulness of gynecologic ultrasonography (US) were determined by a survey of the 74 active members of the Eastern Ontario Obstetrical and Gynecological Society using a mailed questionnaire. There were 58 gynecologist respondents, 30 of whom had completed the specialty training before 1977 (Group I) when diagnostic US became generally available locally, and 28 whose training ended in or after 1977 (Group II). In general both groups found pelvic US to be useful and were cognizant of some of its potential benefits. Group II respondents tended to rely more upon both obstetrical and gynecological US than those in Group I, whereas Group I respondents were less familiar with some of the pitfalls or limitations of US in gynecologic practice. This suggests that the development of clinical decision-making skills by obstetric-gynecologic residents is influenced by the availability of US during their training. It may be of benefit to address the subject of relevant pitfalls in US by continuing medical education.

Attitude of Health Personnel↗
PubMed1987

The role of the NH2-terminal portion of pro-opiomelanocortin as a biomarker for human lung cancer.

In an epidemiological study, we evaluated the human amino-terminal portion (IR-hNT) of pro-opiomelanocortin (POMC) as a biomarker for lung cancer by measuring it by radioimmunoassay in the plasma of 180 patients with various histological types of pulmonary carcinoma. Seventy-seven patients with other cancers or benign lung disorders were our controls. An elevated IR-hNT level was measured in 12 percent of the lung neoplasm cases (22% in small-cell carcinoma) and in only 6 percent of the controls. The mean level in the lung cancer group was also higher than in the controls (p = 0.004), while it was higher in patients with small-cell carcinoma than in those with squamous-cell and adenocarcinoma (p = 0.013 and 0.002, respectively). Otherwise, we demonstrated a correlation between IR-hNT levels and altered liver function only in patients with a lung malignancy (p varying between 0.015 and less than 0.001). Finally, survival analysis failed to show that IR-hNT has a prognostic value when measured at the onset of lung cancer. These results allow us to conclude that IR-hNT, although not very sensitive in screening for carcinoma of the lung, may indicate the presence of liver metastases in this disease.

Adrenocorticotropic Hormone↗