Journal of the Royal Society of Medicine

Our medical research library holds 18 studies published in Journal of the Royal Society of Medicine (1978–2011). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 2 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it. For 6 studies PubMed has no abstract for, we give the abstract printed in the article or, where there is none, a summary we wrote from it, each labeled as such.

About the journal

• Publisher: London :
• Published: 1978 to the present, England
• Language: English
• ISSN: 0141-0768 (print), 1758-1095 (electronic)
• Continues: Proceedings of the Royal Society of Medicine
• Its record in the NLM Catalog

2010s

• A systematic review of lung-sparing extirpative surgery for pleural mesothelioma. E. Teh, F. Fiorentino, C. Tan, et al. 2011;104(2):69-80. Systematic review PubMed · Publisher · Free full text

  Abstract

  Objectives: There is a resurgence of interest in lung-sparing extirpative surgery for malignant pleural mesothelioma with recent reports of better survival and fewer adverse consequences than with extrapleural pneumonectomy. However, these operations are not well-characterized and to offer evidence-based clinical recommendations and to plan future trials a summary of what is already known is required.

  Design: A formal literature search was performed and all recovered titles were sequentially sifted by title, abstract and full-text reading according to prespecified criteria. Papers were selected if they contained data relevant to the area of enquiry. Quantitative synthesis and textual analysis, appropriate to the material, were performed.

  Setting: Follow-up studies of patients undergoing surgery for malignant pleural mesothelioma in specialist thoracic or cardiothoracic units.

  Participants: Among the operated patients described in these papers, a total of 1270 patients had undergone lung-sparing surgery for mesothelioma.

  Results: There were no randomized trials or other forms of controlled studies. From 464 titles, 26 papers contained sufficient data on 1270 patients to be included in the systematic review. Operative descriptions for all series were extracted and tabulated and variation was found in the nature of surgery within and between series, and the degree of detail with which it was described. There was more operative detail in recent papers. All available numerical data were extracted, tabulated and summarized using quantitative methods. The average survival at 1, 2, 3, 4 and 5 years was 51%, 26%, 16%, 11% and 9%, respectively. There were no data on patients' performance status, symptomatic change, or other patient reported outcomes.

  Conclusions: In the absence of any form of control data, no conclusions can be drawn concerning survival differences or symptomatic benefits attributable to surgery. As mesothelioma surgery is restricted to a selected minority of patients who often have multiple therapies, future research will require controlled studies with explicit definitions of the clinical and surgical intent.

2000s

• Simultaneous presentation of myasthenia gravis and mesothelioma. D.J. Thomson, A. Soni, M. Ward, et al. 2006;99(5):259-60. Case report PubMed · Publisher · Free full text

• Mesothelioma: time to take stock. C. Tan, T. Treasure. 2005;98(10):455-8. Review PubMed · Publisher · Free full text

  Summary

  In this review, two cardiothoracic surgeons from Guy's and St Thomas's, London, challenged the common view that little can be done for mesothelioma and described management strategies and the evidence for them. They reported that registered UK mesothelioma deaths rose from 153 in 1968 to 1862 in 2002, with a predicted peak of 1950 to 2450 deaths per year between 2011 and 2015. Most or nearly all UK deaths were attributed to asbestos exposure, and the rise followed the rise in asbestos imports. They outlined asbestos types and uses, UK regulation including the 1992 import ban, and continuing asbestos use in some developing countries. On chemotherapy, they cited a 23% response rate for cisplatin alone. They also cited a phase III trial in 456 patients in which cisplatin plus pemetrexed gave a 41.3% response rate and a longer median time to progression than cisplatin alone (5.7 versus 3.9 months). Radiotherapy was reported to prevent tumour growth at drain and biopsy sites and to relieve chest wall pain. The authors argued that the benefits of radical surgery had not been proven in randomized trials and that comparisons with historical controls were invalid. They concluded that trimodality therapy should be evaluated only within randomized trials. They did not favour screening, and recommended prompt diagnosis, palliation, treatment within trials, symptom control and referral for legal and compensation advice.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

1990s

• Asbestos exposure and asbestosis. J.A. Black. 1996;89(4):240. Comment · Letter PubMed · Publisher · Free full text

• Asbestos exposure and asbestosis: clarifying terminology and avoiding confusion. P.K. Woodard, H.P. McAdams, C.E. Putman. 1995;88(12):669-71. Review PubMed · Publisher · Free full text

• Correlation between serum oncogene protein expression and the development of neoplastic disease in a worker exposed to carcinogens. P.W. Brandt-Rauf, H.L. Niman, S.J. Smith. 1990;83(9):594-5. Case report PubMed · Publisher · Free full text

  Summary

  The authors reported a case suggesting that cancer-gene (oncogene) proteins in the blood might signal neoplastic disease before it becomes clinically apparent. A previously described cohort of 24 workers with known exposure to carcinogenic materials was referred to Columbia-Presbyterian Medical Center in New York. Their serum was screened for proteins encoded by nine different oncogenes. One 57-year-old white man had a long history of workplace exposure to asbestos, pesticides and polychlorinated biphenyls and had smoked 20 cigarettes a day for many years. His serum showed a marked elevation of proteins encoded by the H-ras oncogene, including the p21 protein, although he had no evidence of neoplastic disease at that time. About 18 months later he developed rectal bleeding due to a tubulo-villous adenoma of the colon. Six weeks after the adenoma was removed, his serum oncogene proteins had returned to a normal pattern. The authors presumed that the adenoma was the source of the serum ras protein. They stated that this remained presumptive because insufficient tissue was available to confirm increased oncogene protein in the adenoma itself. They noted that asbestos had been implicated in colorectal cancer. They hypothesized that prolonged asbestos exposure might have increased expression of the ras proto-oncogene, through chromosome damage or by carrying DNA into cells. They concluded that oncogene proteins have potential as markers for early detection, and said prospective studies were under way.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

• Presentation of malignant pleural mesothelioma with cerebral metastases. W.M. McNaughton, M.E. Broughton, G.C. Toner, et al. 1990;83(7):466-7. Case report PubMed · Publisher · Free full text

  Summary

  The authors reported a case of malignant pleural mesothelioma that first showed itself through symptoms of brain involvement, a presentation they said had not apparently been described. A 63-year-old Caucasian man, a non-smoker who had worked as an industrial plumber with known heavy asbestos exposure for 24 years, had 7 months of right shoulder pain and 2 weeks of weakness in the right hand. Chest X-ray showed a large right pleural opacity with rib erosion. At thoracotomy the mass was removed together with the 3rd, 4th and 5th ribs and a sliver of the right upper lobe. He then had one cycle of cyclophosphamide, doxorubicin and dacarbazine. His hand weakness kept getting worse, and computed tomography showed metastases in both sides of the brain. High-dose dexamethasone and 30 Gy whole-brain radiotherapy almost completely resolved his neurological symptoms. After 2 months he developed new weakness and difficulty speaking, and he died 3 weeks later. At necropsy no tumour had recurred in the chest. Five deposits of 1 to 2 cm were found in the brain, and their appearance under the microscope matched the original tumour. The authors cited necropsy series reporting 4 cases of brain metastases in 132 mesothelioma autopsies, and 9 in 207 Australian surveillance cases. They concluded that spread of mesothelioma to the brain is more common than generally recognized.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

1980s

• Dysphagia due to mesothelioma infiltrating the oesophagus: palliative treatment. C.A. Lockwood, H.W. Jones, C.K. Foote, et al. 1989;82(3):168. Case report PubMed · Publisher · Free full text

• Malignant mesothelioma. R. Rudd. 1989;82(3):126-9. Review PubMed · Publisher · Free full text

• Malignant mesothelioma. E. Heyderman, P.D. Ridley. 1989;82(9):571-3. Comment · Letter PubMed · Publisher · Free full text

• Palliation of malignant pleural mucous-secreting mesothelioma: a possible role for phenol irrigation. A. Marath, A. Manche, E.J. Weaver. 1989;82(11):685-7. Case report PubMed · Publisher · Free full text

• Fibrosing pleuritis with extrathoracic extension. B.I. Hoffbrand, M.R. Hetzel, P. Goldstraw. 1985;78(11):953-4. Case report PubMed · Publisher · Free full text

• Royal Naval dockyards asbestosis research project: nine-year follow-up study of men exposed to asbestos in Devonport Dockyard. C.E. Rossiter, J.R. Heath, P.G. Harries. 1980;73(5):337-44. PubMed · Publisher · Free full text

  Abstract

  Progression of asbestos-related disease was assessed in a group of 253 dockyard workers examined in 1966 and 1975. Despite the almost complete protection from exposure to asbestos since 1966, radiographic parenchymal abnormalities increased and occurred more frequently during the next 9 years in those men who had been more heavily exposed to asbestos. Lung function values were lower in those most heavily exposed and were declining at a faster rate than in those with less dust exposure. The most sensitive lung function index was the transfer factor.Those men with persistent crackles in 1966 exhibited a restrictive pattern of lung function, whereas an obstructive pattern was seen in men with wheezes in 1966. The men with irregular small opacities of category 1/1 or more or with diffuse pleural change in 1966 and who survived to 1975 had worse lung functions than any other groups.Progression of disease was greater for smokers than non-smokers, with those who gave up smoking between 1966 and 1975 suffering the greatest changes. This latter group showed most increase in small opacities and included almost all new cases of diffuse pleural changes. They also showed the greatest declines in forced expiratory volume and forced vital capacity.

1970s

• Awkward medicolegal problems in asbestos workers. A.J. Robertson. 1978;71(12):864. Editorial PubMed · Publisher · Free full text

• Awkward medicolegal problems in asbestos-induced disease. Problems in law. C. Clothier. 1978;71(12):922-5. PubMed · Publisher · Free full text

  Summary

  This paper, by a London barrister (QC), discussed the legal problems in claims for compensation for asbestos-induced disease, mainly asbestosis and mesothelioma. It did not report new data. The author explained that civil liability rested on fault. A claimant had to prove that the defendant owed a duty of care, that the duty was breached, and that the damage resulted from the breach. He described how the duty depended on what was known at the time. Awareness of the danger of asbestos had grown gradually, and the duty had widened to include people outside the workplace, such as wives who handled contaminated work clothes. He considered causation, judged on the balance of probabilities, the most troublesome element. Small exposures linked to mesothelioma, asbestos bodies in the lungs of ordinary people, mesothelioma without a known cause in the general population, and the combined effect of smoking in lung cancer all made causation hard to decide. He noted that courts had not treated smoking as contributory negligence and tended to favour claimants. He also discussed claimants who had worked for several employers, exposure before and after the 'date of knowledge' ('guilty' and 'innocent' dust), and employers that no longer existed. For these cases he pointed to the Third Parties (Rights Against Insurers) Act 1930. He then discussed time limits for bringing claims, which amending Acts had eased. He concluded that the examining physician was best placed to prompt claimants to seek redress.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

• Awkward mediolegal problems in asbestos-induced disease. Problem radiographs. R.W. Galloway. 1978;71(12):916-9. Case report PubMed · Publisher · Free full text

• Problems in the pathology of disease caused by asbestos. F. Whitwell. 1978;71(12):919-22. PubMed · Publisher · Free full text

  Summary

  The author, a Liverpool pathologist, discussed the problems of deciding whether disease had been caused by asbestos, at necropsy, for a pneumoconiosis panel, or from old reports and sections. Of 300 suspected mesotheliomas submitted to the Manchester Pneumoconiosis Medical Panel in 1970-1977, the necropsy pathologist's diagnosis was correct in about three-quarters; the commonest error was lung cancer, followed by asbestosis. About 90% of mesotheliomas were thought to have been caused by asbestos. Lung fibre counts in 100 consecutive mesothelioma specimens were compared with 300 control lungs: 75% of controls but 1% of asbestos-induced mesothelioma cases had under 20 000 fibres/g, and 7% of controls but 83% of mesothelioma cases had over 100 000 fibres/g. Seven patients with the lowest counts and no history of exposure were considered spontaneous mesotheliomas. The author concluded that the findings suggested a dose-relationship and did not support the idea that any slight, casual or brief exposure may cause mesothelioma. Among 600 adult necropsies in 1976, pleural plaques were found in 17% of males and 1.6% of females; in the control series, plaques occurred in 55% of patients with over 20 000 fibres/g and 5.5% of those with fewer. Asbestosis was distinguishable from similar fibroses only by asbestos bodies; electron microscopy might be needed where these were absent.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

• Risk factors in asbestos exposure. P.C. Elmes. 1978;71(12):914-6. PubMed · Free full text

  Summary

  This symposium paper, read to the Royal Society of Medicine's Section of Occupational Medicine on 27 October 1977, discussed the medicolegal aspects of asbestosis, lung cancer and mesothelioma by level of asbestos exposure. Under high exposure, as in factories before the 1933 regulations, asbestosis sometimes caused death after 10 to 15 years. In heavy smokers with asbestosis the lung cancer risk was stated as between 70 and 100%, so that all their lung cancers could be considered occupational. Under controlled (moderate) exposure, averaging 5-15 fibres/cc until about 1960 and later falling to the 2 fibres/cc standard, disabling asbestosis was described as rare before retiring age. Lung cancer risk in this group was given as about four-fold raised in non-smokers (80% attributable) and ten- to twenty-fold raised in heavy smokers (90-95%). Mesothelioma risk ranged from very high in insulation workers to very low with exclusively chrysotile exposure. The author regarded all cases with a history of occupational exposure as 100% attributable, and smoking as unimportant. For low continuous or occasional high exposure, the last 10 years were regarded as irrelevant for lung cancer and mesothelioma, but past short exposures were always relevant for mesothelioma. The author concluded that mesothelioma presented the main medicolegal problem in individual cases. He called identifying sources of exposure an urgent matter, both for individual claims and to prevent future cases.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

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