Subject(s)
Vital Statistics , Anthropometry , Cause of Death , Germany , History, 19th Century , History, 20th Century , Humans , Life Expectancy , Morbidity , MortalitySubject(s)
Morbidity , Public Health/history , Cross-Sectional Studies , Germany , History, 18th Century , History, 19th Century , History, 20th Century , Humans , IncidenceABSTRACT
The realisation of a "medical record linkage" concept to achieve a lifelong medical surveillance requires the evaluation of the size and structure of the expected data. From this point of view the accessible health documentations of 120 persons of a small town covering the life period from birth to the age of 72 were evaluated retrospectively. The "epidemiological life report" resulting from this procedure enables the compilation of data on the reasons for utilising the health care system according to diagnostic-therapeutic and preventive aspects, and on the total number of medical expertises and paraclinical examinations. The number of data per person is considerable. In the course of a persons life he or she will come to the doctor for medical consultation about 600 times and will undergo 200 paraclinical examinations. A few aspects regarding the incidence of outpatient consultations are described in some detail.
Subject(s)
Health Status , Medical Record Linkage/methods , Population Surveillance/methods , Adult , Aged , Data Collection , Female , Germany , Humans , Male , Medical Records Systems, Computerized , Middle AgedSubject(s)
Morbidity , Mortality , Public Health/history , Cause of Death , Germany , History, 20th Century , HumansSubject(s)
Medical Records , Morbidity , Adult , Aged , Ambulatory Care , Germany, East/epidemiology , Humans , Insurance Claim Reporting , Middle Aged , Occupational Diseases/epidemiology , Time FactorsSubject(s)
Politics , Public Health/trends , Social Medicine/trends , Forecasting , Germany, East , Humans , Social Environment , Specialization/trendsABSTRACT
Early vocal cord carcinomas (TiS or T1) in a consecutive series of 177 patients treated by primary radiotherapy over a 10-year period 1970-79 at the Department of General Oncology, Radiumhemmet, Karolinska Sjukhuset, were analysed regarding treatment results. In 137 cases the tumours were invasive (T1N0M0) and in 40 cases carcinoma of in situ type (TiS). Patient were treated with cobalt 60 gamma irradiation in fractions of 2 Gy up to a total dose of 64 Gy delivered as split course (CRE=17.8). Minimum follow-up time was 5 years. Tumour recurred in 21 cases (12%). All but 4 patients were rescued by subsequent surgery, giving 98% total survival. Treatment failures after primary radiotherapy were analysed in detail. Failures could not be attributed to treatment irregularities. No difference in pretreatment tumour size was detected when cured patients were compared with patients who relapsed. Biological factors that cause a relative radioresistance are considered to be the main reason for radiotherapy failures in early glottic cancer.
Subject(s)
Carcinoma in Situ/radiotherapy , Carcinoma/radiotherapy , Glottis , Laryngeal Neoplasms/radiotherapy , Carcinoma/secondary , Cobalt Radioisotopes/therapeutic use , Female , Humans , Lung Neoplasms/secondary , Male , Middle Aged , Neoplasm Recurrence, Local/surgerySubject(s)
Medical Informatics Computing/trends , Medical Records , Public Health/trends , Germany, East , HumansSubject(s)
Health Status Indicators , Health Surveys , Humans , Models, Theoretical , Research Design , Terminology as TopicSubject(s)
Certification , Education, Medical, Graduate , Social Medicine/education , Specialty Boards , Germany, East , HumansABSTRACT
Report on a patient suffering from severe lung sarcoidosis and HTLV III-infection. Under combined treatment with cortisone and thymostimulin the patient recovered surprisingly well. The X-ray showed a frank improvement of the lung alterations, and in addition an extensive normalization of leucocytes and lymphocytes could be noticed. No side-effects could be observed under this treatment.
Subject(s)
Acquired Immunodeficiency Syndrome/drug therapy , Adjuvants, Immunologic/therapeutic use , Lung Diseases/complications , Sarcoidosis/complications , Thymus Extracts/therapeutic use , Triamcinolone Acetonide/therapeutic use , Acquired Immunodeficiency Syndrome/diagnosis , Drug Therapy, Combination , Humans , Lung Diseases/diagnosis , Lung Diseases/drug therapy , Male , Middle Aged , Recurrence , Sarcoidosis/diagnosis , Sarcoidosis/drug therapyABSTRACT
Thirty-six patients with squamous cell carcinoma of the head and neck were treated with sequential methotrexate-5-fluorouracil followed by leucovorin rescue. The frequency of objective tumor regression obtained was 64% (complete response + partial response) with 19% complete regression. In 20 not previously treated patients, the objective response rate was 70%. Approximately the same result was obtained for tumors of different anatomical sites of the head and neck. The degree of differentiation of the squamous cell carcinoma did not seem to be of prognostic importance for the initial tumor response. Toxicity was very mild and usually disappeared when the interval between the chemotherapy courses was prolonged from 1 to 2 weeks. Radiotherapy could be added sequentially to the treatment without measurable escalated toxicity.
Subject(s)
Carcinoma, Squamous Cell/drug therapy , Fluorouracil/administration & dosage , Head and Neck Neoplasms/drug therapy , Methotrexate/administration & dosage , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/radiotherapy , Drug Therapy, Combination , Follow-Up Studies , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/radiotherapy , Humans , Leucovorin/administration & dosageABSTRACT
Since experimental data strongly suggest a synergistic cytotoxic effect when methotrexate (MTX) and 5-fluorouracil (5-FU) are administered sequentially, we investigated antitumor effects and toxicity with sequential MTX/5-FU followed by leucovorin rescue in 52 patients with carcinoma of the head and neck. MTX (200 mg/m2) was given as an i.v. infusion over 1 hr. At 2 hr, 5-FU (600 mg/m2) was started as an i.v. infusion for 2 hr. At 24 hr, the leucovorin rescue was started. The chemotherapy course was repeated every week until toxicity (mainly gastrointestinal) occurred, after which the interval between courses was prolonged to 2 wk. Toxicity was mild and usually disappeared when the interval between the chemotherapy courses was prolonged to 2 wk. The regression rate was 15% for complete and 48% for partial regression (response rate, 63%). In 31 of the patients not previously treated, the objective response rate was 74%. About the same results were obtained for tumors of different anatomic sites of the head and neck. Radiotherapy could be added sequentially without measurable escalation of toxicity. We conclude that sequential MTX/5-FU treatment, which produces a very mild toxicity to normal tissue, is effective in inducing antitumor response in patients with carcinoma of the head and neck.
