Subject(s)
Ambulatory Care Information Systems/organization & administration , Medical Records Systems, Computerized/organization & administration , Longitudinal Studies , Outpatient Clinics, Hospital/organization & administration , Planning Techniques , Primary Health Care/economics , Primary Health Care/organization & administration , Primary Health Care/trends , Systems Analysis , United StatesABSTRACT
PURPOSE: Previous reports of chemotherapy in patients with adrenal cancer have described responses to cisplatin (CDDP). Because of these reports of good results, a phase II trial that used CDDP with and without mitotane (o,p'DDD) was initiated. PATIENTS AND METHODS: Patients with metastatic or residual adrenocortical carcinoma with objectively measurable disease or biochemical abnormalities were divided into good-risk and poor-risk categories. The latter received CDDP 100 mg/m2 intravenously, and the former received 75 mg/m2. o,p'DDD was administered at a 1,000-mg dose orally four times a day along with cortisone acetate and Florinef (fludrocortisone acetate; Bristol-Myers Squibb Co, Princeton, NJ). RESULTS: Of a total of 42 patients entered onto the study, 37 were eligible. Twenty-nine patients received good-risk and eight received poor-risk doses of CDDP. Functioning tumors were present in 45% of patients. Objective responses were noted in 30% (11 of 37) patients (95% confidence interval, 16% to 50%). Response duration was 7.9 months, and the median time to response was 76 days. The median survival of the 37 eligible patients was 11.8 months, and a significant survival advantage was found for patients who underwent prior surgical removal of their primary tumor or bulky disease, who had a performance status of 0 or 1, or who had synchronous metastatic disease. Toxicity of the CDDP and o,p'DDD combination was moderate to severe, and the most common side effects were gastrointestinal, renal, and neurologic. CONCLUSION: The regimen of CDDP and o,p'DDD has activity in patients with adrenocortical carcinoma; however, the toxicity of this treatment was moderate to severe.
Subject(s)
Adrenal Cortex Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma/drug therapy , Adolescent , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carcinoma/secondary , Cisplatin/administration & dosage , Female , Humans , Male , Middle Aged , Mitotane/administration & dosageABSTRACT
Detailed questionnaires were distributed to the 1,841 women who entered the 1979 New York City Marathon; the questions pertained to obstetric, gynecologic, and athletic histories, as well as height and weight. The incidence of oligomenorrhea/amenorrhea among the 394 respondents was 24% during training and 19% prior to training. The incidence of infertility among respondents was 10%. Of those women who had had regular menses prior to training, 93% continued to have regular menses during training. Amenorrheic women were significantly lighter (P less than 0.005) than regularly menstruating women and had significantly lower weight/height ratios (P less than. 0.0005). The best predictor of a women's menstrual pattern during training was her pretraining menstrual pattern. Thinness was associated with amenorrhea, regardless of training.
Subject(s)
Menstruation Disturbances/etiology , Physical Education and Training , Running , Adolescent , Adult , Amenorrhea/etiology , Body Weight , Female , Humans , Infertility, Female/etiology , Middle Aged , Surveys and QuestionnairesABSTRACT
This report describes the preliminary results of a feasibility study of detection of endometrial carcinoma in an asymptomatic population of women aged 45 and above. The initial sample of 1,280 women was evaluated by several cytologic smear techniques and by two endometrial sampling methods assigned by computer. The clinical approaches and the techniques used are detailed. During this initial period of study, eight histologically proved endometrial cancers were diagnosed, two of which were deeply invasive. With one exception, the eight patients were either obese or had a history of treatment with conjugated estrogens. A relatively small number of women with endometrial hyperplasia of various types were also identified. The accuracy of the detection methods and their long-term impact on morbidity and mortality cannot be assessed as yet. Incidentally, a small number of cancers and precancerous states of organs other than the endometrium have also been diagnosed.
Subject(s)
Uterine Neoplasms/diagnosis , Aged , Biopsy , Endometrium/pathology , Female , Humans , Hyperplasia , Informed Consent , Middle Aged , Precancerous Conditions/diagnosis , Surveys and Questionnaires , Vaginal SmearsABSTRACT
This report describes the preliminary results of a feasibility study of detection of endometrial carcinoma in an asymptomatic population of women aged 45 and above. The initial sample of 1280 women was evaluated by several cytologic smear techniques and by 2 endometrial sampling methods assigned by computer. The clinical approaches and the techniques used are detailed. During this initial period of study 8 histologically proved endometrial cancers were diagnosed, 2 of which were deeply invasive. With 1 exception, the 8 patients were either obese or had a past history of treatment with conjugated estrogens. A relatively small number of women with endometrial hyperplasia of various types were also identified. The accuracy of the detection methods and their long-term impact on morbidity and mortality cannot be assessed as yet. Incidentally, a small number of cancers and precancerous states of organs other than the endometrium have also been diagnosed.
Subject(s)
Uterine Neoplasms/diagnosis , Actinomycosis/diagnosis , Aged , Breast Neoplasms/diagnosis , Carcinoma in Situ/diagnosis , Carcinoma, Squamous Cell/diagnosis , Cervix Uteri/pathology , Endometrial Hyperplasia/diagnosis , Endometrium/pathology , Female , Histological Techniques , Humans , Informed Consent , Mass Screening , Menopause , Middle Aged , Obesity/complications , Ovarian Neoplasms/diagnosis , Precancerous Conditions/diagnosis , Surveys and Questionnaires , Vagina/pathology , Vaginal SmearsABSTRACT
Two cases of irradiation-associated carcinoma of the colon are reported and the literature reviewed. The clinical courses and operative difficulties in treating these patients are emphasized. The necessity for life-long follow-up examinations with proctoscopic and barium-enema evaluations in high-risk patients is stressed. Irradiation-associated carcinoma of the colon occurs almost exclusively in women, but should be investigated in patients of either sex who live for long periods after pelvic irradiation.
