0. DOCID:11745 SCORE: 0.00538912490268467
DOCNO: 3890524
OWNER: NLM
STATUS: MEDLINE
DESCRIPTOR: Gastroenterology
QUALIFIER: diagnosis
QUALIFIER: diagnosis
AUTHOR: J M Richter JM
AUTHOR: M J Barry MJ
PUBTYPE: Journal Article
JOURNALTITLE: The American journal of gastroenterology.
COUNTRY: UNITED STATES
TITLE: Decision analysis for the practicing gastroenterologist. 2. Insights into the efficacy of diagnostic strategies using decision analysis.
PUBDATE: 19850601
Decision analysis is a valuable tool for studying diagnostic strategies in gastroenterology. Multiple comprehensive patient management strategies can be compared in hypothetical populations of patients with varying characteristics reflecting real clinical situations which could not be readily empirically studied. Measures of clinical outcome can be compared and cost effectiveness ratios calculated. Analyses of the diagnostic approaches to suspected obstructive jaundice and pancreatic cancer presenting as abdominal pain are discussed as examples. A useful decision analysis combines the best data available in a clinically relevant fashion. Although decision analysis cannot replace empiric research, it helps clarify reasons for the uncertainty so common in clinical practice and provides insight into the diagnostic process that might otherwise be elusive.


1. DOCID:3917 SCORE: 0.00521807297784424
DOCNO: 974434
OWNER: NLM
STATUS: MEDLINE
QUALIFIER: mortality
QUALIFIER: mortality
QUALIFIER: adverse effects
AUTHOR: B Armstrong B
AUTHOR: A J Lea AJ
AUTHOR: A M Adelstein AM
AUTHOR: J W Donovan JW
AUTHOR: G C White GC
AUTHOR: S Ruttle S
PUBTYPE: Journal Article
JOURNALTITLE: British journal of preventive & social medicine.
COUNTRY: ENGLAND
TITLE: Cancer mortality and saccharin consumption in diabetics.
PUBDATE: 19760901
The mortality experience of 5971 members of the British Diabetic Association (BDA) was followed-up for between five and eight years to mid-1973. Overall, 1207 deaths occurred compared with 778 expected from the mortality of the population of England and Wales in 1972. This excess of deaths was due almost entirely to diabetes mellitus and ischaemic heart disease. Deaths from cancer (128) were significantly fewer than expected (168), mainly because of a deficit in the number of deaths from cancers related to smoking (cancers of the buccal cavity and pharynx, oesophagus, respiratory system, and bladder). There was also a lower than expected mortality from chronic bronchitis and emphysema. Data on saccharin consumption by BDA members showed that more than half of them used saccharin tablets daily, with an overall daily intake of three to six tablets, depending on age and sex. Information on a small sample of survivors from the mortality study suggested that about 23% of them would have taken saccharin daily for 10 years or more and 10% for 25 years or more by the end of the follow-up. It was concluded that these relatively high levels of saccharin intake had not increased the risk of cancer in general among BDA members.


2. DOCID:3389 SCORE: 0.00516274768365789
DOCNO: 903144
OWNER: NLM
STATUS: MEDLINE
QUALIFIER: adverse effects
QUALIFIER: adverse effects
QUALIFIER: adverse effects
QUALIFIER: pathology
AUTHOR: W B Ober WB
PUBTYPE: Journal Article
JOURNALTITLE: Human pathology.
COUNTRY: UNITED STATES
TITLE: Effects of oral and intrauterine administration of contraceptives on the uterus.
PUBDATE: 19770901
Combined regimen contraceptive steroids produce precocious endometrial secretion, followed by involution leading to a suppressed endometrium with small tubular glands and failure of spiral arterioles to develop; decidua-like stromal changes are dose related as is dilatation of venules. Thrombosis of the latter, perhaps estrogen mediated, leads to local tissue infarction and is the proximate cause of "breakthrough bleeding". Sequential regimen contraceptive steroids lead to retarded endometrial secretion, failure of spiral arterioles to develop, and a weak decidua-like stromal transformation. Contraceptive steroids occasionally produce polypoid lesions of the endocervix with atypical microglandular hyperplasia. There are conflicting reports about the effects of contraceptive steroids on the squamous epithelium of the exocervix, but they neither protect against cancer nor cause it in the usually accepted sense. Uterine leiomyomas may exhibit increased cellularity and bizarre, hyperchromatic nuclei or mutinucleation in women receiving contraceptive steroids. Both polyethylene and metal-containing intrauterine devices may initiate inflammatory responses in the endometrium varying from mild to severe, related to the time the device has been in contact with the mucosa. Salpingitis and ectopic pregnancy are increased in frequency in device users.


3. DOCID:7172 SCORE: 0.00506831951621653
DOCNO: 573065
OWNER: NLM
STATUS: MEDLINE
QUALIFIER: complications
QUALIFIER: complications
AUTHOR: H D Kim HD
AUTHOR: D R Boggs DR
PUBTYPE: Case Reports
PUBTYPE: Journal Article
JOURNALTITLE: The American journal of medicine.
COUNTRY: UNITED STATES
TITLE: A syndrome resembling idiopathic thrombocytopenic purpura in 10 patients with diverse forms of cancer.
PUBDATE: 19790901
Ten patients with diverse forms of carcinoma (six patients) and of cancer in the lymphoid system (four patients) presented with or subsequently had a syndrome resembling idiopathic thrombocytopenic purpura (ITP). These patients were older than patients who had ITP alone. ITP was coincident with a diagnosis of cancer (three patients), preceded a diagnosis of cancer (three patients) or followed a diagnosis of cancer (four patients). No patients responded to steroid therapy permanently. Therefore, the course of our patients was fairly typical of ITP in the adult. Since we found nine patients with cancer in a survey of 52 consecutive patients with ITP in the adult population admitted to one hospital, this diagnosis may be missed with some frequency; the development of thrombocytopenia being attributed to other causes.


4. DOCID:23389 SCORE: 0.00487046438781409
DOCNO: 7725562
OWNER: NLM
STATUS: MEDLINE
QUALIFIER: therapeutic use
QUALIFIER: diagnosis
QUALIFIER: drug therapy
QUALIFIER: drug therapy
QUALIFIER: drug therapy
QUALIFIER: diagnosis
QUALIFIER: drug therapy
QUALIFIER: drug therapy
AUTHOR: T Middelboe T
AUTHOR: L F Ovesen LF
AUTHOR: E L Mortensen EL
AUTHOR: P Bech P
AFFILIATION: Psykiatrisk afdeling E, Bispebjerg Hospital, København.
PUBTYPE: Journal Article
JOURNALTITLE: Ugeskrift for laeger.
COUNTRY: DENMARK
TITLE: [Symptoms of depression in cancer patients undergoing chemotherapy]
PUBDATE: 19950301
Symptoms of depression and anxiety were measured in a prospective follow-up study of 36 cancer patients before and during chemotherapy by means of the Hamilton rating scales and the Melancholia Scale. These scales proved useful in the examined population. Moderate or severe depression was seen in almost half of the patients before chemotherapy, but this figure decreased during follow-up. The symptomatology resembled that of primary depression, and the brief rating scales for depression seemed suitable for screening purpose. Problems in identifying morbid states of anxiety and depression are discussed.


5. DOCID:23358 SCORE: 0.00487044704688879
DOCNO: 7604470
OWNER: NLM
STATUS: MEDLINE
DESCRIPTOR: Adenocarcinoma, Mucinous
DESCRIPTOR: Bladder Neoplasms
DESCRIPTOR: Urinary Diversion
AUTHOR: B Djavan B
AUTHOR: S E Litwiller SE
AUTHOR: S Milchgrub S
AUTHOR: C G Roehrborn CG
AFFILIATION: Department of Surgery, University of Texas Southwestern Medical Center, Dallas 75235-9110, USA.
PUBTYPE: Case Reports
PUBTYPE: Journal Article
JOURNALTITLE: Urology.
COUNTRY: UNITED STATES
TITLE: Mucinous adenocarcinoma in defunctionalized bladders.
PUBDATE: 19950701
Primary adenocarcinoma of the bladder accounts for less than 2% of all bladder cancers. There is no report of such a case in a defunctionalized bladder. All reported cases of carcinoma in defunctionalized bladders were either squamous cell, signet ring cell, or transitional cell carcinoma, detected within an average of 5 years after urinary diversion, and all have been associated with chronic inflammation of the bladder. We report on 2 cases of adenocarcinoma that developed in defunctionalized bladders 30 and 8 years after ileal loop diversion for prune belly syndrome and neurogenic bladder, respectively.


6. DOCID:5592 SCORE: 0.0047263057302844
DOCNO: 384987
OWNER: NLM
STATUS: MEDLINE
QUALIFIER: psychology
AUTHOR: A Meares A
PUBTYPE: Case Reports
PUBTYPE: Journal Article
JOURNALTITLE: Australian family physician.
COUNTRY: AUSTRALIA
TITLE: The psychological treatment of cancer: the patient's confusion of the time for living with the time for dying.
PUBDATE: 19790701
It has been shown that it is possible to influence cancer growth by a form of intensive meditation, although it is not yet established whether it can be influenced to the point of cure. In working with these patients it has been observed that the course of the illness has often been influenced by the patient's confusion of the biologically appropriate time for living and the time for dying. Without recourse to any formal psychotherapy, the family physician aware of this reaction may be able to enhance the immune defences and increase the quality of life of such patients.


7. DOCID:3218 SCORE: 0.00469672948652417
DOCNO: 871189
OWNER: NLM
STATUS: MEDLINE
QUALIFIER: pathology
QUALIFIER: pathology
AUTHOR: A Nakase A
AUTHOR: T Koizumi T
AUTHOR: N Fujita N
AUTHOR: H Ono H
AUTHOR: Y Matsumoto Y
PUBTYPE: Journal Article
JOURNALTITLE: American journal of surgery.
COUNTRY: UNITED STATES
TITLE: Studies of the growth and infiltration of experimental tumor of the pancreas in rabbits.
PUBDATE: 19770501
An experimentally transplanted pancreatic cancer was induced by means of an intraductal injection of Vx2 carcinoma supernatant into the pancreatic duct of rabbits. The presence of ductal obstruction appeared to assist the nidation and growth of injected cancer cells in the pancreas. Tumors induced in the head of the pancreas grew by extension to the body and tail where they also produced interspersed, nodular tumor masses. Tumors induced in the body and tail region, on the other hand, grew by direct expansion towards the head, but this did not produce the interspersed nodular tumors in the head portion. These observations indicate that cancer of the head of the pancreas associated with the stenosis or obstruction of the pancreatic duct resulted in ductal dissemination and extensive lymphatic infiltration in the body and tail, a wider cancer invasion than recognizable at the gross cancer border. This extension was noncontinuous and interspersed, so that radical curative surgery for such cancer of the head of the pancreas would indicate total pancreatectomy.


8. DOCID:3911 SCORE: 0.00459939622579399
DOCNO: 599330
OWNER: NLM
STATUS: MEDLINE
QUALIFIER: genetics
QUALIFIER: genetics
AUTHOR: J D Dubosson JD
PUBTYPE: Journal Article
JOURNALTITLE: Journal de génétique humaine.
COUNTRY: SWITZERLAND
TITLE: [Hereditary adenocarcinomatosis in 4 generations of a Valais family]
PUBDATE: 19771201
An account is given of a family from the Canton of Valais, suffering from hereditary adenocarcinomatosis. The pedigree extends over four generations; the first three comprise 47 individuals (28 males, 19 females), of whom 21 (16 males and 5 females), i.e. 44.6%, are affected with malignant tumours. Of the 32 people in the fourth generation, only one individual is affected to date (a girl aged 21, IV/14). There were 27 tumours in all: 16 adenocarcinomas of the colon, two gastric adenocarcinomas, one duodenal adenocarcinoma, one rectal adenocarcinoma, one papillary carcinoma of the ovary, one osseous sarcoma, one cutaneous fibrosarcoma, a multiform glioblastoma of the basal nuclei of the brain, a basocellular epithelioma, also a cerebral metastasis from an adenocarcinoma, the origin of which has not been established, and a tumour invading the biliary tract. Three members of the family suffered from multiple tumours. In three of the patients, the colonic adenocarcinoma was accompanied by one or two polyps. The average age at the onset for all the tumours was 45 years. It was definitely lower in the third than the second generation (anticipation). The transmission was autosomal dominant, with predilection for the male sex (57.1% male and 26.3% female patients). The penetrance was about 80%. The author finally discusses the diagnostic criteria for hereditary adenocarcinoma and reviews the different familial forms of cancer.


9. DOCID:11535 SCORE: 0.00455381641509937
DOCNO: 6241848
OWNER: NLM
STATUS: MEDLINE
QUALIFIER: therapeutic use
QUALIFIER: drug therapy
QUALIFIER: analogs & derivatives
AUTHOR: A Guarnieri A
AUTHOR: E Tucci E
AUTHOR: C D'Aniello C
AUTHOR: A Carli A
AUTHOR: L Mariani L
AUTHOR: A De Stefano A
AUTHOR: P Nardi P
PUBTYPE: Journal Article
JOURNALTITLE: Chemioterapia : international journal of the Mediterranean Society of Chemotherapy.
COUNTRY: ITALY
TITLE: Oral route administration of medroxyprogesterone acetate (MAP) at high doses in the treatment of advanced breast cancer: clinical results.
PUBDATE: 19841001
Twenty-six patients with metastatic breast cancer were treated with high dose medroxyprogesterone acetate (MAP) p.o. according to currently available pharmacokinetic data (2000 mg/day b.i.d. for 30 days, 1000 mg/day for the following 60 days). Objective response (WHO criteria) was obtained in seven patients (CR + PR = 27%), with good results on visceral and soft tissue localizations; performance status improvement and/or pain relief was obtained in twenty-three (88%). Oral high dose MPA seems to be an effective and well tolerated palliative treatment in advanced breast cancer.


10. DOCID:11972 SCORE: 0.00450436760660057
DOCNO: 6694544
OWNER: NLM
STATUS: MEDLINE
DESCRIPTOR: Brachytherapy
DESCRIPTOR: Rectal Neoplasms
DESCRIPTOR: Uterine Neoplasms
QUALIFIER: administration & dosage
QUALIFIER: radiotherapy
QUALIFIER: radiotherapy
AUTHOR: N S Androsov NS
AUTHOR: I P Melenchuk IP
AUTHOR: V L Shpikalov VL
PUBTYPE: Journal Article
JOURNALTITLE: Meditsinskaia radiologiia.
COUNTRY: USSR
TITLE: [Interstitial gamma therapy of recurrences and metastases of cancer of the uterus and rectum to the vagina]
PUBDATE: 19840101
The authors devised a technique of interstitial radiation therapy for locally disseminated vaginal recurrences and metastases that occur after the use of various therapeutic methods for uterine and rectal cancer. Indications and counterindications to interstitial radiation therapy with 60Co as an independent method or the main therapeutic component in combined or multimodality treatment, were determined. Methods of the topometric and dosimetric planning of treatment, methods of needle administration and fixation by the system of manual afterloading were developed. Interstitial radiation therapy was given to 22 patients with a complete tumor regression in 17 of them. Interstitial radiation therapy is recommended as a method of choice for the therapy of vaginal recurrences and metastases.


11. DOCID:3152 SCORE: 0.0044378409483745
DOCNO: 846278
OWNER: NLM
STATUS: MEDLINE
QUALIFIER: surgery
QUALIFIER: mortality
QUALIFIER: surgery
AUTHOR: U Schulz U
AUTHOR: H U Drüner HU
AUTHOR: H J Lang HJ
PUBTYPE: Journal Article
JOURNALTITLE: Langenbecks Archiv für Chirurgie.
COUNTRY: GERMANY, WEST
TITLE: [Analysis of postoperative deaths in colon and rectal cancer (author's transl)]
PUBDATE: 19770201
Analysis of the clinical and autopsy reports of 200 deaths following surgery for colorectal cancer from 1956 to 1974, at the Dept. of Surgery, University of Heidelberg, revealed that pneumonia (24.5%) was the most common cause of death followed by peritonitis (22%), pulmonary embolism (15.5%), advanced tumor disease (14%), cardiac failure (9.5%), ileus (5.5%), and others (9%). The explanation for the postoperative mortality rate of 12% (cancer of colon) and 13.2% (cancer of rectum) lies in the fact that 82.5% of those who died postoperatively were beyond the age of 60, and 40.5% beyond 70 years at the time of surgery. Moreover, in 50.5% advanced tumors with regional and/or distant metastases were found. In 55.5% severe preoperative complications (ileus: 38%, peritonitis: 11%, abscess formation or hemorrhage: 6.5%) required an emergency operation. Only 38.5% of the procedures were considered for cure. Besides the need for early recognition of the cancer, intensification of pre- and postoper treatment appears to be the predominant task in the effort to decrease postoperative mortality.


12. DOCID:5885 SCORE: 0.00435011294132161
DOCNO: 7377241
OWNER: NLM
STATUS: MEDLINE
DESCRIPTOR: Palpation
DESCRIPTOR: Patients
DESCRIPTOR: Physicians
QUALIFIER: diagnosis
AUTHOR: J M Maharry JM
PUBTYPE: Journal Article
JOURNALTITLE: American journal of obstetrics and gynecology.
COUNTRY: UNITED STATES
TITLE: Carcinoma of the breast in a community hospital: who makes the diagnosis?
PUBDATE: 19800501
A review of 300 cases of breast cancer in a community hospital was undertaken to document who made the initial discovery of the breast lesion. In this series, the woman discovered her own cancer in 75% of the cases. Obstetrician-gynecologists, who made up only 8% of the medical staff, discovered almost one third of the primary lesions that were first noticed by physicians. Obstetrician-gynecologists were the first physicians consulted by 20% of the women who discovered their own breast lesions. Preoperative xeromammography was performed on 58% of the patients with breast cancer, and there was a false negative report in 21% of these patients.


13. DOCID:3610 SCORE: 0.00433846202143544
DOCNO: 1070507
OWNER: NLM
STATUS: MEDLINE
QUALIFIER: classification
AUTHOR: R Fries R
AUTHOR: H Grabner H
AUTHOR: J Leijhanec J
AUTHOR: F Wepner F
AUTHOR: B Kränzl B
AUTHOR: G Krekeler G
AUTHOR: O Kriens O
AUTHOR: H Mehnert H
AUTHOR: H Platz H
AUTHOR: F Scharf F
AUTHOR: K Schroll K
AUTHOR: P Schulz P
AUTHOR: E Waldhart E
AUTHOR: G Zisser G
PUBTYPE: Journal Article
JOURNALTITLE: Journal of maxillofacial surgery.
COUNTRY: GERMANY, WEST
TITLE: TNM-classification of carcinomas of the oral cavity-efficacy of clinically available data (TN).
PUBDATE: 19761201
Using adequate number of cases, the influence of the spread of primary tumour and the degree of regional metastasis on prognosis were investigated. Assuming a practicable classification as a prerequisite for clinico-therapeutic cancer research, experience has shown that the assessment of the spread of primary tumour alone does not suffice for the establishment of comparable homogenous data. The investigation on the importance of the degree of regional metastasis has shown, above all, that the percentage of N3-metastasis within the T-groups contributes essentially to the fact that these show a marked difference in their prognosis. It would therefore appear necessary also to examine the importance of other clinically accessible data in the assessment of prognosis. Only then could we be in a position to judge whether, and to what extent a clinically practicable classification and integration into special groups is possible on the basis of clinically available data. The inclusion of more clinics in the joint investigation is encouraged.


14. DOCID:10298 SCORE: 0.0043144898285483
DOCNO: 11644130
OWNER: KIE
STATUS: MEDLINE
DESCRIPTOR: Adolescent
DESCRIPTOR: Judicial Role
DESCRIPTOR: Jurisprudence
DESCRIPTOR: Minors
DESCRIPTOR: Parents
DESCRIPTOR: Public Policy
DESCRIPTOR: Religion
DESCRIPTOR: Treatment Refusal
AUTHOR: Carol Levine C
PUBTYPE: Journal Article
JOURNALTITLE: The Hastings Center report.
COUNTRY: United States
TITLE: When parents choose prayer over medicine, should courts step in?
PUBDATE: 19840201
A brief report is presented on the controversy over parental rights to refusal medical treatment for their children based on religious beliefs. Courts have ordered blood transfusions for children of Jehovah's Witnesses and cancer chemotherapy for a fundamentalist minister's daughter, and Indiana officials are concerned about high rates of maternal and perinatal mortality among Faith Assembly members. The 29 December 1983 issue of the New England Journal of Medicine includes articles by Rita Swan and Nathan A. Talbot, and an editorial by Arnold Relman, discussing the position of Christian Science and the question of government intervention to override parental decisions.