Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0006826 (cancer)
 1,092,456 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A woman with a moderately differentiated carcinoma that erupted through the skin and amputated her breast was treated with whirlpool, topical antimicrobials, radiation, and chemotherapy. The draining, necrotic, and septic wound was treated for 5 months with a whirlpool containing dilute povidone-iodine solution and intravenous chemotherapy. Wet bandages, necrotic tissue, and softened eschar were removed by whirlpool agitation or mechanically debrided. To start treatment the wound was dressed with Debrisan crystals and sterile gauze for 1 week. Afterwards, wet-to-dry dressings wetted with Dakin's solution were applied. Tissue ingrowth at the wound margin started after 2 weeks, with whirlpool treatments effecting a tissue-reddening hyperemia. Wound drainage ceased after 2 months, with granulation and revascularization resulting. Eleven months later the wound was closed, aseptic, and undergoing dry flaking. The patient was cancer free with a completely healed wound 2 years after treatment. In this case, nonspecific debridement using whirlpool and topical antimicrobials promoted healing of an open fungating wound from a breast carcinoma.
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PMID:Nonselective debridement and antimicrobial cleansing of a venting ductal breast carcinoma. 991 84

The transplantation of peripheral blood precursor cells (PBPC) is becoming of interest for autografting patients with a wide variety of haematological and other malignancies. For rapid quality control of PBPC apheresis products, flow cytometry is applied to quantify the number of CD34+ events. We studied the effect of different storage conditions on the number of CD34+ counts in EDTA-anticoagulated aliquots of PBPC grafts. Within 24 h, CD34+ signals decreased when samples were stored at room temperature (RT, 20 +/- 2 degrees C) compared to the results obtained directly after cytapheresis. The signal rate equalled or exceeded the baseline values after 24 h when aliquots were deposited at room temperature and subjected to agitation. Storage at 4 degrees C revealed no significant changes. These data indicate that quality control of PBPC samples by flow cytometry significantly depends on storages time, temperature and other conditions like the agitation of the specimen.
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PMID:Effect of storage conditions on the CD34+ counts in flow cytometric analysis after anticoagulation of samples with EDTA. 1016 57

This study investigated the role of phenobarbitone at the end of life by retrospective analysis of case notes. During a 3-year period, of the 748 patients who died in a 32-bed palliative care unit, 60 received phenobarbitone during the last week of life. Fifty-nine patients had advanced cancer, 16 of whom had cerebral involvement. Phenobarbitone was used to control agitation and seizures. It was administered via subcutaneous infusion at a dose of 600-2400 mg/day. The mean time from starting phenobarbitone to death was 34.1 hours. Phenobarbitone was well tolerated and effective, controlling physical and psychological agitation. No further seizures occurred. This study suggests that phenobarbitone has a useful role in the management of distressing symptoms in the last few days of life.
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PMID:The use of phenobarbitone in the management of agitation and seizures at the end of life. 1076 73

DACA, also known as XR5000, is an acridine derivative active against both topoisomerase I and II. In this phase I study, DACA was given as a 3-h intravenous infusion on 3 successive days, repeated every 3 weeks. A total of 41 patients were treated at 11 dose levels between 9 mg m(-2) d(-1) and the maximum tolerated dose of 800 mg m(-2) day(-1). The commonest, and dose-limiting, toxicity was pain in the infusion arm. One patient given DACA through a central venous catheter experienced chest pain with transient electrocardiogram changes, but no evidence of myocardial infarction. At the highest dose levels, several patients also experienced flushing, pain and paraesthesia around the mouth, eyes and nose and a feeling of agitation. Other side-effects, such as nausea and vomiting, myelosuppression, stomatitis and alopecia, were uncommon. There was one minor response but no objective responses. DACA pharmacokinetics were linear and did not differ between days 1 and 3. The pattern of toxicity seen with DACA is unusual and appears related to the mode of delivery. It is possible that higher doses of DACA could be administered using a different schedule of administration.
Br J Cancer 1999 Aug
PMID:Phase I and pharmacokinetic study of DACA (XR5000): a novel inhibitor of topoisomerase I and II. CRC Phase I/II Committee. 1046 97

Diisononyl phthalate (DINP) is one of several dialkyl phthalate esters that are widely used as plasticizers to impart softness and flexibility to normally rigid polyvinyl chloride (PVC) products. During the past 2 years, concern has been voiced by public interest groups and regulatory agencies in Europe, Canada, and the United States regarding the potential adverse health effects of DINP migrating from children's toys during mouthing activities. Concern has focused on potential chronic effects on the kidney and liver. In chronic high-dose studies with rodents, DINP causes a dose-related decrease in body weight, an increase in liver weight, and changes in liver cell histopathology (hypertrophy). To a lesser extent, the rodent kidney is also a target for prolonged high-level exposures of DINP. Prolonged high-level exposure of rodents to DINP leads to an increased incidence of liver tumors (adenomas and carcinomas). The chronic cancer and noncancer effects of DINP on rodent liver are consistent with its known action as a peroxisome proliferator. Peroxisome proliferation is a threshold-based effect that is reversible on cessation of exposure to proliferators such as DINP. Because rodents are uniquely responsive and humans and nonhuman primates are particularly nonresponsive to peroxisome proliferators, rodents are very poor animal models for use in human risk assessment of adverse effects mediated through peroxisome proliferation. Because DINP exerts its effects on rodent liver through a known threshold-based mechanism of little, if any, relevance to humans, a highly conservative risk assessment can be conducted using a NOAEL uncertainty factor approach. Chronic rodent no-observed-effect levels (NOELs) based on end points such as increased liver weight and changes in liver pathology that are early indicators of peroxisome proliferation but should not be considered adverse range from about 100 to 400 mg/kg/day. Application of a 100-fold uncertainty factor yields acceptable daily intakes (ADIs) ranging from 1 to 4 mg/kg/day. Estimates of DINP migration from soft PVC materials have been obtained from a variety of in vitro methods (simulated saliva and controlled agitation) as well as in vivo methods (controlled chewing) that more closely resemble child chewing and mouthing activities. Recent estimates by the Consumer Product Safety Commission (CPSC) suggest that maximum exposures occur in infants 3-12 months of age. The geometric mean (50th percentile) exposure is 5.7 microg/kg/day and the 95th percentile is 94.3 microg/kg/day. These exposure values are 17,500-70,000 and 1100-4200 times, respectively, lower than the chronic rodent NOAEL for DINP and 175-700 and 11-42 times lower than the corresponding ADI of 1-4 mg/kg/day. It is concluded, with a high degree of confidence, that the use of DINP in soft PVC toys and other children's products does not present a significant risk to children. The scientific evidence supports the continued use of DINP as a plasticizer in children's products.
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PMID:The potential health effects of phthalate esters in children's toys: a review and risk assessment. 1053 9

In 2 patients, a woman aged 38 years and a man aged 48 years, in the terminal phase of life due to metastasized+ malignancy, palliative care failed. They suffered seriously from pain, delirium, restlessness, nausea, and fear. Deep sedation was given to induce almost continuous sleep without the intention of causing death. After one and five quiet days respectively the patients died. Deep sedation is an option when palliative care fails to diminish serious suffering. Midazolam, given by continuous subcutaneous infusion is the drug of choice.
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PMID:[Sedation in the terminal phase of life]. 1063 3

This article describes the development of an instrument that measures symptom experience (symptom occurrence and symptom distress). The Adapted Symptom Distress Scale-2 (ASDS-2), adapted from the McCorkle and Young Distress Scale, is a 31-item, 5-point, self-report paper-and-pencil instrument that measures patients' perception of the occurrence and distress of 14 symptoms: nausea, vomiting, pain, eating, sleep, fatigue, bowel elimination, breathing, coughing, concentration, lacrimation, changes in body temperature, appearance, and restlessness. Use of the instrument yields a total score for symptom experience, scores for symptom occurrence, scores for symptom distress, and subscale scores for six symptom categories: gastrointestinal, fatigue/restlessness, concentration, pain/discomfort, respiratory, and appearance. Reliability and validity were determined with well adults (n = 97), medical-surgical patients (n = 82), and oncology patients (n = 175). Findings revealed a Cronbach's alpha of 0.91 for symptom experience, 0.90 for symptom occurrence, and 0.76 for symptom distress. Cronbach's alpha for the subscales ranged from 0.38 for appearance symptoms to 0.83 for gastrointestinal symptoms. Inclusion of symptoms reported by patients with cancer strengthened content validity. A contrasted groups approach was used to demonstrate construct validity.
Cancer Nurs 2000 Feb
PMID:An instrument to measure symptom experience. Symptom occurrence and symptom distress. 1067 7

A case of alcohol withdrawal occurred in a patient affected by cancer of the oral cavity is reported. The patient underwent resection of the floor of the oral cavity, partial glossectomy mandibulectomy and neck dissection; reconstruction was done using microsurgical forearm radial flap. The patient didn't refer his alcohol dependence before operation and withdrawal symptoms with agitation, tachycardia, tachypnea, tremors and vomiting appeared during his postoperative recovery in intensive care where the patient was unable to take any alcohol. A therapeutic plan to use in patients operated for oral cancer with alcohol withdrawal (92% association of oral cancer with alcohol dependence) is reported.
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PMID:[Postoperative treatment of alcohol withdrawal syndrome in a patient operated for oral cancer]. 1118 59

Clinical and laboratory observations support the view that angiogenesis is necessary for prostate cancer progression. The angiogenesis inhibitor TNP-470 has demonstrated in vivo antitumor activity in a series of clinical models. To evaluate a possible therapeutic clinical value, we conducted a Phase I dose escalation trial of alternate-day i.v. TNP-470 in 33 patients with metastatic and androgen-independent prostate cancer. The patients were evaluated during therapy for evidence of neurological toxic effects. An assay of endothelial and vascular proliferation "markers" and a sequential assay of serum prostate-specific antigen concentration were performed. The effects of TNP-470 could be evaluated in 32 of the 33 patients. The maximum tolerated dose was 70.88 mg/m(2) of body surface area. The dose-limiting toxic effect was a characteristic neuropsychiatric symptom complex (anesthesia, gait disturbance, and agitation) that resolved upon cessation of therapy. The times to clinical recovery of neurological side effects were 6, 8, and 14 weeks. No definite antitumor activity of TNP-470 was observed; however, transient stimulation of the serum prostate-specific antigen concentration occurred in some of the patients treated. Additional studies of TNP-470 should be conducted using an alternate-day i.v. injection of 47.25 mg/m(2) body surface area and should focus on understanding and overcoming the neurological toxic effects. In addition, valid intermediate end points that reflect the status of tumor-associated neovascularity are needed to facilitate effective development of treatment strategies.
Clin Cancer Res 2001 May
PMID:Phase I trial of the angiogenesis inhibitor TNP-470 for progressive androgen-independent prostate cancer. 1135 Aug 84

Although valid measurement of the severity of terminal delirium is of great importance in palliative care settings, existing instruments have considerable limitations. In order to quantify patients' communication capacity and agitated behaviour, two new operational observer-rating scales, the Communication Capacity Scale (Communication Scale) and Agitation Distress Scale (Agitation Scale), were validated. Thirty terminally ill cancer patients diagnosed with delirium were evaluated simultaneously by two palliative care physicians blinded to each other's coding using the Communication Scale and Agitation Scale. In addition, the Memorial Delirium Assessment Scale (MDAS), Delirium Rating Scale (DRS) and Sedation Scale were rated by one researcher. Both scales achieved high internal consistency and inter-rater reliability with Cronbach's alpha coefficients of 0.91 and 0.96, and Cohen's kappa values on each item of 0.72-1.00. The principal components analysis resulted in the emergence of only one component for each scale. The total score on the Communication Scale was highly associated with that of the MDAS (rho = 0.78), Sedation Scale (rho = 0.86), and cognitive items from the MDAS and DRS (rho = 0.83). The whole score on the Agitation Scale was significantly correlated with that of the DRS (rho = 0.61) and agitation items from the MDAS and DRS (rho = 0.61). In conclusion, the Communication Scale and Agitation Scale have acceptable reliability and validity to quantify patients' communication capacity and agitation symptoms of terminally ill cancer patients with delirium.
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PMID:Communication Capacity Scale and Agitation Distress Scale to measure the severity of delirium in terminally ill cancer patients: a validation study. 1140 91


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