Measuring effectiveness of service aides in infant immunization surveillance program in North Central Texas.

The Immunization Division of Texas Public Health Region 5 sought to measure the per cent of referrals taking immunization action as a result of service aide contact. From data collected on newborn-nonresponders during a 12-month period, results show that aides may be credited with influencing 44 percent of the referrals reporting subsequent immunization.     

Radiation Therapy and cis-diammine-dichloroplatinum (II) in transplantable and primary murine bladder cancer

Preoperative radiation improves survival in advanced bladder cancer but the high failure rate, primarily due to distant metastases, suggests a need for adjuvant chemotherapy. The optimal drug might exhibit an additive effect with radiotherapy. Transitional cell carcinoma (TCC) induced in mice by FANFT closely resembles the human counterpart, and both primary and transplanted tumors were used to evaluate the possible additive effect of cis DDP and cyclophosphamide (CY), two drugs with activity in TCC, with radiation. One hundred C3H/He mice had 5 × 10⁴ TCC cells placed in their right hind limbs and randomized into a control (20) and 8 treatment groups (10); 3600 rad, 3600 rad + CY, 3600 rad + cis DDP, 1500 rad + cis DDP, 1500 rad + CY, CY, and cis DDP. Chemotherapy was initiated on day 7 and continued every week × 3. Radiation, in 250 rad or 600 rad fractions, was given biweekly to the tumor bearing limb using a CO₆₀ source. 3600 rad alone produced 60% cures with a significant reduction in average tumor diameter (p<0.001). 3600 rad + cis DDP achieved 78% cures; the best regimen. Therapy of palpable tumors yielded similar resultsave. tumor diameter (D-38) for controls 16.5, 3000 rad-10.6 (p<0.001), cis DDP-10.2, CY + 1600 rad- 8.1, cis DDP + 3000 rad-6.2. Cis DDP + 3000 rad was significantly better than cis DDP or 3000 rad alone. One hundred fifty mice ingesting FANFT for 11 months were randomized into 7 groups and subjected to the same regimens to evaluate the effect on primary tumors. The greatest reduction in tumor volume was in mice receiving 1500 rad + cis DDP (mean bladder weight, 29.68 vs. controls 53.57, p<0.005). These results consistently suggest cooperation between irradiation and cis DDP. Adjuvant cis DDP for invasive bladder cancer might be maximized by initiation with preoperative radiotherapy. Our initial clinical data with cis DDP + irradiation in advanced TCC is encouraging.     

Digital intravenous angiography in the diagnosis of renal artery occlusion

Digital intravenous angiography (DIVA) proved to be highly accurate and sensitive in the diagnosis of six cases of renal artery occlusion. The impact of this new modality on the diagnosis and management of such patients is considered.     

Pancreatic Cancer and Diabetes Mellitus

In a series of 6,500 patients with diabetes mellitus there were 37 cases of primary carcinoma of the pancreas which significantly exceeded the expected number for the patient years at risk in both males and females (p<0.01). There was no evidence that pancreatic cancer was more common in patients with long-standing diabetes. The increased incidence of pancreatic cancer in diabetic patients is probably the result of patients presenting with the symptoms of diabetes as long as four years before the cancer becomes manifest. An underlying pancreatic tumour should be suspected when an elderly diabetic proves difficult to control and loses weight despite adequate treatment.