Functional outcome of pathologic fracture secondary to malignant disease in a rehabilitation hospital

Article Abstract:

Bone is one of the tissues within the body to which some cancer cells can spread. It is well appreciated that the metastatic spread of cancer to bone can increase the likelihood of bone fractures, but the best method for managing patients with bone fractures secondary to malignant disease remains uncertain. A study was conducted of 58 patients who were admitted to a rehabilitation hospital for pathological fractures secondary to cancer. The most common form of cancer among these 58 patients was breast cancer (31 patients), which explains the plurality of women (44) among the patients in the study. Thirty-four patients were discharged home after treatment for their fractures; seven of the remaining patients were transferred and the rest died. The average stay in the rehabilitation hospital was 37 days for the patients who ultimately went home; this stay is only three days longer that the average for patients with similar fractures unrelated to cancer. Among the patients who went home, there was significant improvement. While none could walk at the time of admission, 23 could at the time of discharge. Twenty-seven patients showed significant improvement in performing the activities of daily living. Eleven of the original 58 patients suffered from hypercalcemia, a common complication among cancer patients. All 11 of these patients died, indicating that hypercalcemia is a grave prognostic factor. Similarly, pain appears to be an indicator of grave prognosis. Forty-two patients were given oral narcotics for the alleviation of pain. However, intravenous infusion of narcotics was required for the alleviation of pain in 13 patients. Eleven of these 13 patients succumbed to their malignancy. The results of this study indicate that while patients requiring parenteral narcotics and patients with hypercalcemia are at serious risk, the majority of patients with bone fractures secondary to cancer are likely to benefit from rehabilitation programs. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Cancer, Fractures (Injuries), Fractures

---

Paraneoplastic Cushing's syndrome as an adverse prognostic factor in patients who die early with small cell lung cancer

Article Abstract:

Cancerous growths cause direct effects on the tissues they invade. However, in some cases the presence of a cancer causes symptoms which result from hormonal disturbances, not from direct effects of the cancer. Cushing's syndrome is a set of symptoms which can result from the excessive secretion of steroid hormones by the cortex of the adrenal gland. In as many as 30 percent of all cases, small cell lung cancer may involve secretion of adrenocorticotropic hormone (ACTH) which results in increased amounts of this adrenal-stimulating hormone circulating in the blood. However, most of these patients do not develop the clinical symptoms of Cushing's syndrome. Increased levels of ACTH in small cell lung cancer patients have not proved particularly useful as a prognostic indicator. However, the subset of patients who actually develop Cushing's syndrome may indeed be more likely to suffer an earlier death. A retrospective study was conducted to determine the possible role of Cushing's syndrome in the early death of lung cancer patients. Case records were examined to identify cases in which the patient died within three months of the initiation of chemotherapy. A total of 90 patients were found; 11 had symptoms of Cushing's syndrome and 79 did not. Although by the very nature of the subject definition for this study, all 90 patients died early, it was found that 82 percent of the patients with Cushing's syndrome died within two weeks of starting chemotherapy. In contrast, only 25 percent of the patients who did not have symptoms of Cushing's syndrome died within this interval. One of the factors which may contribute to the early death of these patients is infection. In the present series of patients, the deaths of five of the 11 patients with Cushing's syndrome were attributed to fungal or protozoal infection, in contrast with only six of 77 patients without symptoms of Cushing's syndrome. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Cushing syndrome, Lung cancer, Small cell, Small cell lung cancer

---

Frequency of the hypercalcemia-leukocytosis syndrome in oral malignancies

Article Abstract:

Cancers may sometimes cause symptoms that are not the direct result of the tumor mass or the spread of metastatic disease. Such syndromes are termed paraneoplastic syndromes. Hypercalcemia, high amounts of calcium in the blood, is one of the more common paraneoplastic syndromes and is especially common in cases of breast and lung cancer. Leukocytosis, in which there is an increase in the numbers of white blood cells, is also common. Leukocytosis may also result from infection, and it is critical to rule out the possibility of infection before making a diagnosis of leukocytosis as a paraneoplastic syndrome. Leukocytosis and hypercalcemia may occur together or separately. The occurrence of leukocytosis and hypercalcemia together seems to be especially common in cancer of the mouth and oral cavity. To evaluate the frequency of these paraneoplastic syndromes, observations were tabulated on 225 patients with cancer of the oral cavity. Ten patients (4.4 percent) had hypercalcemia, and 11 (4.9 percent) patients had leukocytosis. Based on chance alone, at most one patient in this group might be expected to have both syndromes. However, five patients, or 2.2 percent, had both hypercalcemia and leukocytosis, which is a coincidence far greater that predicted by chance. These results suggest that there ia a relationship between the two conditions. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Mouth cancer, Leukocytosis

Similar abstracts:

• Abstracts: Pregnancy outcome of patients with uncorrected uterine anomalies managed in a high-risk obstetric setting. part 2
• Abstracts: Refractory hypoglycemia secondary to topical salicylate intoxication. part 2 Refractory potassium repletion due to cisplatin-induced magnesium depletion
• Abstracts: Screening for alcoholism by life-style risk assessment in a community hospital. Alcohol abuse in patients with dilated cardiomyopathy: laboratory vs clinical detection
• Abstracts: Management of abnormal genital bleeding in girls and women. Breast implantation - the quest for safety and quality
• Abstracts: Prophylactic sclerotherapy for esophageal varices in men with alcoholic liver disease: a randomized, single-blind, multicenter clinical trial

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.