Showing papers by "Wishaw General Hospital published in 2002"
TL;DR: The results indicate that the majority of patients with inoperable non-small cell lung cancer have evidence of a systemic inflammatory response and an increase in the magnitude of the systemicinflammatory response resulted in greater weight loss, poorer performance status, more fatigue and poorer survival.
Abstract: The relationship between the magnitude of systemic inflammatory response and the nutritional/functional parameters in patients with inoperable non-small cell lung cancer were studied The extent of weight loss, albumin, C-reactive protein, performance status and quality of life was measured in 106 patients with inoperable non-small cell lung cancer (stages III and IV) Survival analysis was performed using the Cox proportional hazard model The majority of patients were male and almost 80% had elevated circulating C-reactive protein concentrations (>10 mg x l(-1)) On multivariate analysis, age (P=0012), tumour type (0002), weight loss (P=0056), C-reactive protein (P=0047), Karnofsky performance status (P=0002) and fatigue (P=0046) were independent predictors of survival The patients were grouped according to the magnitude of the C-reactive protein concentrations ( 100 mg x l(-1)) An increase in the magnitude of the systemic inflammatory response was associated with increased weight loss (P=0004), reduced albumin concentrations (P=0001), reduced performance status (P=0060), increased fatigue (P=0011) and reduced survival (HR 1936 95%CI 1414-2650, P<0001) These results indicate that the majority of patients with inoperable non-small cell lung cancer have evidence of a systemic inflammatory response Furthermore, an increase in the magnitude of the systemic inflammatory response resulted in greater weight loss, poorer performance status, more fatigue and poorer survival
300 citations
TL;DR: This case was similar in that the patient showed very rapid disease activity developing extensive metastatic lesions and treatment ultimately proved unsuccessful, and it has been proposed that it may be useful as a tumour marker in these patients.
Abstract: This case report describes a 42-year-old Caucasian woman who presented with persistent hyperamylasaemia and no evidence of pancreatic pathology. Further investigations resulted in a diagnosis of light-chain multiple myeloma. Amylase production by epithelial tumours has been well documented but the association with multiple myeloma has only been described in a small number of cases. The link does not appear to be immunoglobulin class-specific but the association with Bence Jones myeloma is unusual. The common features in this group of patients have been extensive extramedullary spread with a high tumour mass and a poor prognosis. This case was similar in that the patient showed very rapid disease activity developing extensive metastatic lesions and treatment ultimately proved unsuccessful. The amylase concentrations have been shown to decrease in response to treatment and increase at times of relapse and it has been proposed that it may be useful as a tumour marker in these patients. This case study adds to the pool of patents with this unusual association.
24 citations
TL;DR: Resistant mutants were more readily isolated by growth on culture plates that contained ciprofloxacin, and the resulting MIC of the resistant mutant was also more frequently increased.
10 citations
TL;DR: The personal view offered by Thomson et al.1 is both welcome and timely, and further evidence may have been cited which would reinforce the view that there are important shortfalls in the usefulness of troponin tests in the management of ACS.
Abstract: The personal view offered by Thomson et al.1 is both welcome and timely. The wholesale adoption of troponin measurements in risk stratification strategies for management of acute coronary syndrome (ACS) may rely as much on evangelism and fashion as reasoned critical appraisal, and the authors are right to sound a note of caution. Indeed. further evidence may have been cited which would reinforce the view that there are important shortfalls in the usefulness of troponin tests in the management of ACS. Firstly. although some trials of glycoprotein lIb/IlIa inhibitors have suggested that the benefits from drug therapy are concentrated in patients with raised troponln, in the only published trial in which patients were recruited prospectively by use of cardiac troponin measurements. treatment showed no benefit compared with placebo.r' Secondly. the clinical endpoint in many studies is a composite one of death and/or acute myocardial infarction (AMI) within 30 days of intervention. The concept of a primary endpoint of AMI when a substantial number of ACS patients have non-Q-wave AMI at presentation and enrolment in the study is a hard one to grasp. Definitions of AMI as an endpoint can be based on tortuous and arbitrary calculations of changes in serum creatine kinase and creatine kinase MB measurements. sometimes only 48 h after the subject has been enrolled in the trial and given treatment or placebo. I Misreporting of myocardial infarction endpoints in a clinical trial has recently been described.\" In 23% of cases there was disagreement between investigators and clinical events committees. Thirdly. a meta-analysis (in which seven of the 14 co-authors had links with the pharmaceutical companies that market the drugs of intervention) of relevant trials was recently published.\" Six trials. enrolling 31402 patients were included. Troponin results were available in 11059 cases (35%). Baseline troponin T was elevated in 4964 (45'Yr.) of these cases. a high proportion. suggesting either a non-random selection of cases with unstable angina or the inclusion of a substantial number of cases of AMIon enrolment. as opposed to as a clinical endpoint. In the troponin-positive group there was a reduction in the composite endpoint from 12·()% (placebo) to HH% (treatment). which was of marginal statistical significance and should be considered alongside the different definitions (and possibly clinical importance) of AMI