摘要:

In a group of 23 children with acute leukemia, all but one of whom had entered complete remission, retrospec|tive analysis of hematological profiles demonstrated that administration of consolidation chemotherapy, with a combination of cytosine arabinoside (Ara-C) and 6-thioguanine (TG), was associated with a fall in the erythrocyte concentration in peripheral blood, the rate of which was at least as fast as would have occurred with total marrow ablation and consequent red cell aplasia. In the absence of profound myelosuppression or detectable hemorrhage, drug-induced erythrocytotoxicity was suspected, prompting in vitro studies of erythrocytes from children with acute leukemia and normal adults. At therapeutic concentration, Ara-C and TG, individually and in combination, produced significant stomatocytosis in samples from both groups.Since phenothiazines are stomatocytogenic and are administered as anti-emetics in conjunction with cancer chemotherapy, chlorpromazine was investigated in parallel studies that demonstrated stomatocytosis at therapeutic concentration, but no consistent interaction with the effects of Ara-C and TG in this regard.These observations suggest a possible pathogenetic mechanism for the development of anemia resulting from druginduced erythrocytotoxicity.

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Eighteen isolates ofNocardia asteroideswere tested for in vitro susceptibility to trimethoprim (TMP) and sulfamethoxazole (SMZ) alone and in various combinations using disc and paper strip diffusion tests. TMP-SMZ showed synergistic action for two-thirds of theNocardiaisolates tested. Five patients withNocardiapneumonia were treated with TMP-SMZ and all were cured. Four of the patients' isolates were tested and all showed synergistic patterns of inhibition with the spaced disc and paper strip methods. The agar diffusion disc and synergy tests of TMP-SMZ appear to correlate with clinical usefulness when theNocardiaare susceptible with large zones of inhibition around the combination TMP-SMZ disc.

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The prevalence of serum autontibodies was determined in 50 black adult patients with sickle cell anemia, and in 33 age-and sex-matched healthy black individuals. Twenty-seven of the patients (54%) had at least one type of autontibody, in contrast to only four (18.2%) of the control subjects (P<.01). Antismooth muscle, antiskeletal muscle and antinuclear antibodies were the most frequently seen autontibodies. There was no correlation between the presence of autoantibodies and history of hepatitis, number of blood transfusions or concurrent drug therapy. Sickle cell anemia is associated with the induction of autoimmune phenomena.

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Two hundred twenty-five patients with 358 febrile episodes were treated with tobramycin and ticarcillin (TT), tobramycin and mezlocillin (TM), or tobramycin, ticarcillin and cephalothin (TTC). There were no satistically significant differences in the response rates for patients who were proven to have infection (67% with TT, 69% with TTC and 53% with TM). Patients were more often cured of their infection if their neutrophil count rose during therapy. In this study, the addition of cephalothin to TT did not increase the frequency of azotemia (10% and 12%, respectively). Although mezlocillin has a broader spectrum of activity in vitro than ticarcillin, it was not more efficacious when combined with tobramycin than ticarcillin plus tobramycin for the treatment of infections in neutropenic patients.

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

During a six-month period in 1980, tuberculosis was detected in 70 patients at our municpal hospital. Clinical and epidemiologic features of the disease continue to reflect those noted decades ago. Management of these patients was complicated by difficulty in confirming the diagnosis and relapse in patients resisting chemotherapy, although organisms resistant to antituberculosis drugs were infrequent. The hospital cost of caring for tuberculous patients was high (mean: $1941.36). As tuberculosis today remains a disease of the poor, costs for its care still are borne by the public. At a time when reduction in Federal support for tuberculosis control is being considered, it is important to realize that the disease remains a serious medical problem and financial burden in the United States.

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

We followed sequentially the plasma potassium concentration in five, essentially anuric, hyperglycemic patients with no known abnormality of potassium metabolism and treated only with insulin. Acid-base balance, external potassium and fluid balance, and weights did not change during observation. The following changes in plasma potassium concentration (ΔK) were noted: In initial hyperkalemia (three patients) ΔK was −1.8±0.1 mmo l/l (P<0.005). In normokalemia (one patient) δK was −1.3 mmol/l. In hypokalemia (one patient) δK was +0.1 mmol/l. The correlation between the starting potassium concentration and the change in potassium concentration was −0.88 (p = 0.05).Conclusions: When only parenteral insulin is used for treatment and acid-base balances and body weights do not change during treatment in anuric hyperglycemia: a) The change in potassium concentration is dependent on the starting plasma potassium concentration, b) hyperkalemic patients will drop their plasma potassium concentration toward normal, and c) hypokalemic patients may not need potassium replacement.

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Carcinomatous meningitis was diagnosed in 13% of our patients with small cell lung cancer. Although half the patients with this complication responded to treatment, the medium survival from diagnosis was only six weeks. Asymmetric peripheral neuropathy and urinary retention are very specific signs of carcinomatous meningitis. Their recognition may prompt an earlier diagnosis and the institution of more effective treatment.

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Computerized axial tomography (CAT) was used to study 39 patients with known thyroid disease and 14 patients with primary hyperparathyroidism. In all, CAT was performed only when information that was required for diagnosis or therapy was not available from other less expensive techniques. The greatest value was found in the evaluation of cryptic symptoms or structures in the neck after surgery for thyroid cancer, the assessment of the extent of thyroid cancer, the localization of aberrant thyroid tissue, the etiology of unexplained recurrent laryngeal nerve paralysis and the identification and delineation of mediastinal goiter. In six of 14 patients undergoing neck exploration for primary hyperparathroidism CAT correctly localized the site of the enlarged parathyroid glands including one mediastinal parathyroid adenoma and one patient with two parathyroid adenomas.

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A 28-year-old male with nodular sclerosing Hodgkin's disease and massive mediastinal adenopathy was treated with combination chemotherapy and radiotherapy. Following 1, 300 rads and six cycles of chemotherapy the patient was felt, on the basis of chest x-ray and CT scan, to have extensive residual mediastinal and intrapericardial involvement with tumor. At thoracotomy he was found to have markedly enlarged mediastinal lymph nodes with the normal tissue being replaced by dense sclerotic material without tumor. In Hodgkin's disease, CT scanning has proved to be an extremely valuable tool in assisting in staging and treatment planning. This case emphasizes, however, that one must be cautious in the interpretation of persistent abnormalities following curative therapy. Carefully selected patient information obtained from exploratory thoracotomy continues to be helpful in defining disease status.

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Pulmonary mucormycosis is an unusual infection which appears to occur with increased frequency in diabetics. We report the development of pulmonary mucormycosis in an adult onset diabetic which resolved with medical therapy alone. Computerized tomography proved useful in assessing his response to therapy.

ISSN:0002-9629    

出版商:OVID    

年代:1984

数据来源: OVID