Evaluation of mitoxantrone cardiac toxicity by nuclear angiography and endomyocardial biopsy: an update.

Sixty-six patients who underwent endomyocardial biopsy for detection of mitoxantrone (Novantrone; dihydroxyanthracenedione) cardiac toxicity were evaluated. All but one had breast cancer, 29 had received prior doxorubicin and 29 of the 37 patients who had not had prior doxorubicin received it or another anthracycline subsequently. Endomyocardial biopsy was carried out initially after four courses of chemotherapy with increasing intervals thereafter.

Mitoxantrone, cyclophosphamide, and 5-fluorouracil in the treatment of hormonally unresponsive metastatic breast cancer.

Fifty-five patients with newly diagnosed, estrogen receptor negative, metastatic breast cancer were entered in a trial of mitoxantrone, 10 mg/m2 intravenous (IV), cyclophosphamide, 500 mg/m2 IV, and 5-fluorouracil, 1000 mg/m2 IV, which were given on day 1 of a 21-day treatment interval. This trial was designed to test the efficacy of substituting mitoxantrone for doxorubicin as part of a combination that has proved to be effective in inducing remission. The trial was also intended to evaluate the response of resistant disease and of stable metastatic disease to a combination of doxorubicin and vinblastine sulfate.

Improving survival in patients with prostate cancer regionally spread at the time of diagnosis.

In the United States, cancer of the prostate ranks first among malignant neoplasms in elderly men. During the 20-year period 1960-1979, 5178 men with prostate cancer were registered at the Cancer Data Service of the University of Kansas. This study concerns 985 of these men in whom the cancer was regionally spread at the time of diagnosis.

A Vibrio cholerae infection in a transient teamster.

An illness indistinguishable clinically from classical cholera but caused by a non-cholera vibrio occurred in an over-the-road truck driver. The infecting organism was not finally identified as Vibrio cholera, Smith serotype 113 toxin positive, until 4 weeks after his hospital discharge. Hospital laboratories in most parts of the United States are unlikely to identify Vibrio cholerae in stool cultures unless specifically requested to do so.

Simultaneous Streptococcus and picornavirus infection. Muscle involvement in acute rhabdomyolysis.

Streptococci seldom invade muscle in healthy people with intact integument. However, infection with another agent simultaneously may change this general observation. In a two-week period we encountered dual infections with group A, beta-hemolytic streptococci and a picornavirus in each of two hospitalized patients.

Cancer stage-to-age relationship: implications for cancer screening in the elderly.

In a study specifically addressing the age-stage relationship, the authors examined the distribution of 30,991 cancers by disease-stage versus patient-age at the time of diagnosis. For cancer of the bladder, breast, cervix, ovary and uterus (endometrium), a highly significant positive relationship was found between advancing stage and advancing age (P less than 0.001).

Pre-test and post-test in a medicine clerkship.

Offered the opportunity to take the previous quarter's post-test as a pre-test at the beginning of their 3-month medicine clerkship with the understanding it would have no effect on their final grades, 132 of 148 students (89%) took this opportunity. Post-test means for each quarter's group were significantly greater than pre-test means (P=0.0001).

Survival in the elderly with acute leukemia.

The natural history of acute leukemia in the elderly is not well understood. There is disagreement about the value of treatment other than by supportive measures. In this study, the survival predictive power of 9 variables was analyzed in 103 patients aged 70 or older for whom a bone-marrow cytologic diagnosis of acute leukemia had been made at a referral hospital during the 30-year period, 1947--1976.

Offspring of patients treated for cancer in childhood.

Genetic effects of cancer in childhood were examined among offspring of patients enrolled in the tumor registries of the Sidney Farber Cancer Institute and the Kansas University Medical Center. For 146 patients, 84 women and 62 men, 293 pregnancies were reported after cessation of treatment of diverse neoplasms. The outcomes of 286 completed pregnancies were as follows: 242 live births (1 set of twins), 1 stillbirth, 25 spontaneous abortions, and 19 therapeutic abortions.

A possible association of pernicious anemia with neoplasia.

7 out of 39 patients with pernicious anemia developed 9 different neoplasms during a period of 3--20 years after the diagnosis of pernicious anemia. These primary neoplasms originated from the lymph nodes, larynx, colon, stomach, kidney, meninges, maxillary sinus and eighth nerve. Treatment with vitamin B12 did not influence the development of tumor.

Subarachnoid spinal analgesia. A comparative survey of current practice in Scotland and Sweden.

A postal inquiry into the current use of subarachnoid spinal analgesia obtained replies from approximately 70% of consultants in both Scotland and Sweden. Although medico-legal anxiety was still an important feature of Scottish practice, the publication of large series with a low incidence of complications had also exerted some influence, and 40% of consultants employed the technique. In contrast, 70% of Swedish replies indicated current use of spinal analgesia and the individual frequency of administration was considerably higher.

Measuring clinical competence of medical students.

Evidence of clinical competence for medical students entering the clinical clerkships at the University of Kansas College of Health Sciences is established by passing two different examinations: a 100 item multiple choice examination and a videotaped history and physical examination by each student of a simulated patient, being rated by that patient and two examiners. In 1976 the class of 196 medical students took an average 1.85 written examinations per student.

Performance of male and female medical students in a medicine clerkship.

Little has been published about objective evaluation and comparison of performance of female and male medical students in clinical clerkships. Data were collected on objective grading and examination results of a three-month medicine clerkship involving 269 medical students, 222 men and 47 women, during 1975 and 1976. There were no significant differences in final course grades between the two sexes.