Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serum melatonin and its main metabolic product 6-sulfatoxymelatonin were determined in 17 patients with breast cancer (BC) with either a fresh primary tumor (nine) or a secondary tumor (eight) as well as in four patients with untreated benign breast disease (controls). Circadian rhythms were detected in all groups with acrophases around 2 AM for melatonin and around 3 AM for 6-sulfatoxymelatonin. The nocturnal melatonin and 6-sulfatoxymelatonin concentrations were significantly depressed in the group of patients with primary breast cancer compared with controls (P less than 0.01, P less than 0.025). The circadian amplitudes of melatonin and 6-sulfatoxymelatonin were also depressed by 81% (P less than 0.01) and 63% (P less than 0.01). In contrast, patients with secondary BC had nocturnal melatonin and 6-sulfatoxymelatonin concentrations and amplitudes similar to controls. These results demonstrate that the depression of circulating melatonin in patients with primary BC is not due to an enhanced degradation to 6-sulfatoxymelatonin in the liver but must be due to a reduced activity of the pineal gland.
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PMID:Depression of serum melatonin in patients with primary breast cancer is not due to an increased peripheral metabolism. 200 58

Severe hypercalcemia is a medical emergency requiring urgent treatment. It most commonly is caused by malignant tumors, as in the case study, but can also be caused by advanced hyperparathyroidism or high serum levels of vitamin D. The patient described in the case study shows clinical evidence of volume contraction due to hypercalcemia-related anorexia and vomiting. His elevated serum concentrations of urea nitrogen and creatinine reflect intravascular volume depletion and hypercalcemia-induced reduction of renal perfusion. He is also likely to have irreversible renal damage as a result of nephrocalcinosis. His central nervous system depression is most likely a result of hypercalcemia, but other central nervous system disorders such as cerebral metastases should be considered. Appropriate treatment would include intravenous fluids to correct volume depletion, dilute extracellular fluid calcium, and promote renal calcium excretion. Before waiting for the effects of volume expansion, the first dose of an inhibitor of bone resorption should be given. The agent of choice now (this may change when second-generation bisphosphonates become available) is plicamycin. Etidronate is a reasonable second choice. Because both drugs require at least 48 hours before their hypocalcemic action is manifest, calcitonin could be used to accelerate the rate of decline of the serum calcium. As the patient becomes more alert, weight-bearing and ambulation should be encouraged. With this combination of therapeutic modalities, this patient's serum calcium level should be corrected within 3 to 5 days. Intermittent injections of mithramycin or etidronate could be given on an outpatient basis approximately once a week in order to maintain the serum calcium within the normal range. One of the most important aspects of treatment in hypercalcemic patients is eradication of the underlying disease, which usually calls for specific antitumor therapy, including chemotherapy, radiation therapy, or surgery. Most of the agents currently available for the correction of hypercalcemia have cumulative toxicities or are only transiently effective and, therefore, their use should be considered a temporizing measure until specific treatment directed at the primary disease takes effect.
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PMID:Management of severe hypercalcemia. 200 13

Preliminary data are presented of a clinically feasible pilot study to select a significant subgroup of patients among those with muscle-invading bladder tumors for local cure and bladder preservation, while also to offer all patients the possibility of preventing the development of distant metastases. Transurethral debulking surgical resection was combined with neoadjuvant methotrexate, cisplatin and vinblastine chemotherapy plus 2 additional courses of cisplatin and 4,000 cGy. If tumor was found on cystoscopic re-evaluation by biopsy and for cytology after cisplatin and partial irradiation (4,000 cGy.) immediate cystectomy was advised. If tumor was not found consolidation by a radiotherapy boost to a total of 6,480 cGy. plus 1 additional course of cisplatin was given. Of 53 consecutive patients the planned treatment was completed in 42 (79%). With a median followup of 26 months (range 15 to 42 months), 72% of all entered patients were alive, 70% have not required cystectomy and 74% have not had distant metastases. Among the 42 patients who completed the planned protocol chemotherapy dose reductions were required in 39% for stomatitis, bone marrow depression and/or renal dysfunction. There were 2 serious complications but no treatment-related sepsis, deaths or significant renal dysfunction. Eight patients underwent immediate radical cystectomy because of positive biopsy and/or cytology results after 4,000 cGy., while 34 completed full chemotherapy and radiotherapy without any significant bladder or bowel injury. Of 42 patients 22 (52%) have maintained the bladder without any recurrence, and of those selected for full chemotherapy and radiotherapy this number increased to 65%. To date 12 patients have persistent or recurrent bladder tumors: 5 (15%) had invasive tumors treated by cystectomy and 7 (21%) had carcinoma in situ treated by intravesical therapy. The true success of this or other selective bladder-preserving treatments will require 3 to 5 years of followup to be confident that such treatment has sterilized the bladder of cancer. This feasibility study has been clinically practical, modestly well tolerated and encouraging for the significant proportion of patients with a sustained complete response and for the 70% over-all survival rate at 2 years. To evaluate critically the efficacy of methotrexate, cisplatin and vinblastine chemotherapy in the prevention of occult distant micrometastases and in increasing the rate of successful bladder preservation, in May 1988 we began a randomized phase 3 trial with and without neoadjuvant methotrexate, cisplatin and vinblastine chemotherapy.
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PMID:Preliminary results in invasive bladder cancer with transurethral resection, neoadjuvant chemotherapy and combined pelvic irradiation plus cisplatin chemotherapy. 212 7

Fluosol, a perfluorcarbon emulsion, has the ability to carry oxygen in solution. In conjunction with oxygen breathing and radiation, Fluosol has been shown in animal models to enhance local tumor control. In September 1985, a Phase I/II Study was instituted to evaluate the effect of this adjuvant therapy with radiation in non small cell carcinoma of the luing. Fifty patients were enrolled in the study which was closed for accrual in November 1987. Five patients were withdrawn prior to the institution of radiation: one patient diagnosed with bone metastasis and four patients withdrawn due to mild to moderate reactions to Fluosol. Of the 49 patients administered Fluosol, 34 mild to moderate adverse reactions were noted in 22 patients to either the test dose/infusion (16 reactions including withdrawn patients) or post infusion (18). Flushing, dyspnea and hypertension (test dose/infusion) and chills and/or fever (postinfusion) were the typical symptoms. Transient elevation of blood chemistries (SGOT, SGPT, alkaline phosphatase, BUN) were noted in some patients. Six patients had transient depression of WBC counts (toxicity scores of 1 or 2) and two patients had transient depression of platelets (toxicity score of 1). None of these altered treatment. Forty-five patients received Fluosol of which 34 completed the planned therapy. Six patients were diangosed with metastatic disease during therapy and three patients died of their disease during treatment. One patient was withdrawn due to ineligibility and one patient withdrawn due to moderate reactions to Fluosol during the 3rd and 4th infusions. The total dose of Fluosol was escalated from 42 mL/Kg to 49 mL/Kg in 5, 6, or 7 weekly infusions. Patients breathed 100% oxygen for a minimum of one-half hr prior to and during radiation treatment. Radiation therapy was administered at a daily fraction of 165 to 200 cGy per fraction to a total dose of 5940 to 6800 cGy. Seventeen of 34 patients (50%) achieved a complete response to treatment and 11 patients (32%) had a partial response. Thirteen patients remain alive (range of 12 to 20 months) including 10 of 17 complete responders, 2 of 11 partial responders, and 1 treated with chemotherapy postradiation. The median absolute survival time of the patients completing therapy was 15.5 months and the 12 and 18 month absolute survival rates were 81% and 74%, respectively. The 45 patients starting protocol therapy had a median absolute survival of 9.2 months with a 12-month and 18-month survival of 45% and 35%, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Fluosol and oxygen breathing as an adjuvant to radiation therapy in the treatment of locally advanced non-small cell carcinoma of the lung: results of a phase I/II study. 216 21

An endometrial adenocarcinoma with metastases to the lung, liver, spleen, mesentery and serosal peritoneal surfaces was found in an 11-year-old Arabian mare. Clinical signs included generalized weight loss, depression, anorexia, ventral edema and abdominal distension. Ascites was due to thrombosis of the caudal vena cava. The diagnosis of endometrial adenocarcinoma was based on the histological appearance of uterine glandular epithelium and the presence of similar tissue in the metastatic tumors.
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PMID:Endometrial adenocarcinoma in a mare. 240 26

Hemibody irradiation (HBI) of 8 Gy has been shown to produce pain relief in widespread metastatic disease. The major problems occurred with high dose (over 6 Gy) to the upper hemibody. Because 8 Gy lower HBI was well tolerated, we decided to study the efficacy and tolerance of even higher radiation doses given to the lower hemibody. Nineteen patients with widespread metastatic cancers in the lower hemibody were treated from 1982 to 1984 with 16 Gy (8 Gy one week apart) to the lower hemibody (from top of iliac crest to knee joint) after premedication with an antiemetic. All the patients tolerated this high dose, lower HBI well, except for two patients who had slight nausea and vomiting, and one patient who had moist reaction in the perineum. There was no significant bone marrow depression. All patients had improvement in performance status and had prompt pain relief, ten (53%) with complete pain relief and nine (47%) with partial pain relief. The median duration of pain relief was 5 months. Ten of the 15 patients who died were pain-free at the time of death. The four patients still living are free of pain. The median survival was 7 months, and five patients survived 1 year. High dose (8 Gy X 2 spaced one week apart), lower HBI produces prolonged, prompt and effective palliation of pain with minimal morbidity and is well tolerated. It probably does not prolong survival. Because it requires only two treatments spaced one week apart, it is a very convenient and cost effective regimen for the sick and elderly patient.
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PMID:Once-a-week lower hemibody irradiation (HBI) for metastatic cancers. 242 77

The lack of an available exteriorized permanent epidural catheter led to the application of the Broviac catheter technology to the development of an epidural catheter. The resulting three-piece silicone-rubber catheter system allows specific spinal-level location of the catheter tip from a lumbar entry site, and exteriorization for ease of self-administration. Fifty-five cancer patients with metastatic disease and intractable pain received 58 catheters. No catheter infections were found during 3891 catheter-days of use, and only 18 minor side effects were noted, with no respiratory depression observed. Hospitalizations for pain control was decreased by 90% after catheter placement. Therefore, the authors recommend early placement of this silicone-rubber epidural catheter to control pain unrelieved by oral analgesics.
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PMID:A new permanent exteriorized epidural catheter for narcotic self-administration to control cancer pain. 243 5

Initial clinical trials using strontium-89 (Sr-89) chloride for the treatment of painful skeletal metastases have observed minimal or no hematological depression secondary to the radiostrontium. A patient with marked bone marrow depression temporally related to the administration of the Sr-89 is reported, and the need for close hematological monitoring is emphasized. Bone marrow tumor replacement may predispose patients to marrow depression from radiostrontium, and such patients should be treated with caution.
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PMID:Hematologic depression following therapy with strontium-89 chloride. 243 77

Despite the prevalent scepticism regarding its value, chemotherapy for metastatic renal cell cancer was used in 45 patients, of whom 44 were nephrectomized, aged between 34 and 75 yr with a mean age of 57.3 yr. In 32 patients chemotherapy was used as palliative treatment because of the presence of their often multiple metastases or in 13 patients following surgical removal of metastases and/or histologically high-grade malignancy, as adjuvant treatment. Our treatment schedule consisted on day 1 of vinblastine 5 mg/m2 to a maximum of 10 mg provided intravenously in 1 or 2 to 3 week intervals X 6 and CCNU 130 mg/m2 orally each 6th week. This treatment schedule was supported by an intensive antiemetic regimen. Gastrointestinal side effects were well tolerated while 30% hematological depression necessitated extension of treatment intervals. The mean number of cycles was 2.5-3.7, respectively, with a maximum of 6. Palliative treatment resulted in 19% complete plus partial remission, 62% stabilization, and 19% progression, while adjuvant therapy proved to be superior with 10 of 13 patients in remission at 3-21 months, and 1 of 3 patients with metastatic recurrence in further remission for 20 months; two of three patients died. Palliative chemotherapy with CCNU-vinblastine acted successfully by blocking cancer progression, while adjuvant treatment together with surgical extirpation of metastases may have prolonged tumor-free remission.
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PMID:Palliative and adjuvant chemotherapy of metastatic renal cancer. 245 28

Two hundred and two patients with bone pain from metastatic cancer were treated with 40 microCi/kg of Sr-89. Patients were followed with pain diaries, records of medication taken, sleep patterns, serial bone scans and a Karnofsky Index. One hundred and thirty-seven patients with adequate followup survived at least 3 months, including 100 with prostate and 28 with breast carcinoma. Eighty of the 100 patients with prostate cancer responded, and 25 of the 28 breast cancer patients improved. Ten patients with prostate cancer and five with breast cancer became pain free. Little hematologic depression was noted. Sr-89 kinetic studies showed that strontium taken up in osteoblastic areas remained for 100 days. The tumor-to-marrow absorbed dose ratio was 10:1.
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PMID:Strontium-89: treatment results and kinetics in patients with painful metastatic prostate and breast cancer in bone. 246 31


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