Gene/Protein Disease Symptom Drug Enzyme Compound
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 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Aminoglutethimide (AG) was administered as palliative therapy in 112 patients with metastatic breast cancer. In 36 patients, the dose level was 1000 mg/day; 76 patients received a dose level of 500 mg/day. Patients with brain or liver metastasis were excluded, as were patients with tumors determined to be negative for estrogen receptors. Objective regression was observed in 35 (31%) patients, with the duration of response ranging from 4 to 36 + months (mean, 12 months; median, 10 months). Response was observed in 11 of 31 (35%) patients with soft tissue metastasis; 16/59 (27%) patients with osseous metastasis; and 8 of 22 (36%) having visceral metastasis. In 93 patients with positive estrogen receptor (ER), 33 responded (35%), whereas in 19 patients with unknown ER status, two responded (11%). Response to previous treatment with tamoxifen (TAM) had occurred in 31 patients; of these, response to AG was noted in 11 (35%). Of 24 patients failing to respond to prior treatment with tamoxifen, four (17%) responded to subsequent therapy with AG. Thirteen patients had previously received combination chemotherapy, and response to AG was noted in two (15%). The side effects observed in this study included skin rash in ten patients, fever in eight, somnolence in three, weakness and dizziness in one, headache in one, insomnia in one, dyspnea in one, and ataxia in one. Treatment had to be discontinued in eight patients, due to the severity of the side effects. As expected, patients receiving AG at the lower dose level of 500 mg/day experienced fewer and less severe side effects than those treated with the higher dose. The response rate in the 1000 mg/day group was 10/36 (28%) and in the 500 mg/day group, it was 25/76 (33%). The lower dosage was better tolerated without apparent compromise in therapeutic efficacy.
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PMID:Aminoglutethimide in patients with metastatic breast cancer. 246 35

Sacral anesthesia is a safe and effective procedure which we have used in 28 resections for benign prostatic hypertrophy, and in 42 resections of bladder tumors, 7 of them in women. The average age was 69 years. Average time for prostatic resection was 49 minutes and for bladder tumors, 23. Recovery from anesthesia averaged 78 minutes in both groups. In 44.3% of the patients there was no need for other medication during operation. Hemodynamic changes were minor and were controlled by fluid replacement in a third of the patients. Complications included convulsions (2 patients), severe headache (2), arrhythmias (5) and skin rash (1). There were no late sequelae. 0.5% marcaine was the most effective drug. The success rate was 77.1% in both groups; failures were due to technical difficulties.
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PMID:[Transurethral procedures with sacral anesthesia]. 247 19

The clinical efficacy and safety of ibopamine and diuretic therapy were compared in a multicenter, multinational, parallel, positive-controlled, randomized, double-blind, 12-week study, involving 103 patients with mild CHF (NYHA Class II). Body weight, NYHA functional class, symptom assessment scores, laboratory blood tests, and exercise testing were evaluated at baseline at interim visits and at the end of 12 weeks. Clinical events were monitored throughout the study. There was no difference in any of the considered parameters between the two patient groups at baseline and at the end of the 12-week evaluation. A trend of improvement in clinical conditions that did not reach statistical significance was noted in each group throughout the study, as a probably "trial effect." Five patients on ibopamine had severe clinical events leading to drug discontinuation (CHF worsening, ventricular tachycardia, elevation of liver transaminases, headache, gastrointestinal disorders) and five on diuretic therapy experienced serious side effects (skin rash, palpitation, atrial fibrillation, elevation of liver transaminases, manic episode). One patient died while on diuretic therapy. Only headache and skin rash were considered to be related to the therapy (ibopamine and diuretic therapy, respectively). Our trial suggests that ibopamine can be safely and effectively used as an alternative for diuretics for up to 3 months in patients with mild CHF.
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PMID:Ibopamine versus hydrochlorothiazide/amiloride in patients with mild congestive heart failure. SK & F Ibopamine Working Group. 248 50

Inpatient and community-based care can be complementary in relation to the management of HIV disease. Medical records from 200 inpatients of Chikankata Hospital near Lusaka, Zambia and 200 home based patients were examined and compared for the common symptoms of presentation of HIV disease, associated opportunistic infections, and treatment protocols. Drug costs of both groups were also compared. The most common respiratory symptoms in the 2 groups are cough, chest pains, weight loss, and hemoptysis. Treatment employed for these symptoms were cortimoxazole, penicillin V, erthromycin, and tetracycline. Acetyl saliclic acid and paracetamol were used for pain relief in both groups. Gastointestinal system symptoms for both groups were diarrhea, weight loss, abdominal pain, and vomiting. Cotrimoxazole and metronidazole were used in treating diarrhea. Additional treatment protocol for the 2 patient samples included oral rehydration therapy for dehydration, antacid or bismuth subsalicylate for diarrhea and enteritis, and mycostatin for oral candidiasis. Central nervous system symptomatology included headache, dementia, neckace, and lethargy. Chloramphenicol was employed in treating bacterial meningitis. Diazepam and chlorpromazine were effective for restless patients. Genito-urinary system symptomatology for the 2 groups included dysuria, genital ulcers, hematuria, viral warts, and buboes. Antibodies were used for sexually transmitted diseases and infections. Skin symptomatology included rash and dermatitis, herpes zoster, abscess, kaposi's sarcoma, ulcers, furunculosis, and discharging anal sinus. In treating these symptoms, hospital based care and home based care were similar. Overall, it was found that hospital treatment protocols were detailed, expensive, and time consuming. Furthermore, hospital treatment for HIV positive patients is more expensive than HIV negative patients; hospital costs for 50 HIV negative patients totaled US$415.94 compared to US$1204.98 HIV positive/PTB negative patients and US$1705.62 for HIV positive/PTB positive patients. Drug cost/patient admission is increased by 469% if HIV positive. (author's modified).
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PMID:Clinical care as part of integrated AIDS management in a Zambian rural community. 248 94

An epidemic of group A meningococcal disease began in Auckland in May 1985. There were 122 paediatric cases of meningococcal disease in the next 25 months including 98 cases due to group A. The commonest clinical symptoms were vomiting, headache and photophobia, while frequent signs included fever, seizures, petechial rash and meningism or a bulging fontanelle. Complications were uncommon and included sterile arthritis and prolonged fever. The majority had disease confirmed by positive blood or cerebrospinal fluid culture. Significantly fewer positive cultures were seen in those treated with antibiotics prior to admission. The overall mortality was 7%. If the acute illness was survived, the only detected long term sequela was sensorineural hearing loss seen in 6%. A vaccine programme has been undertaken to control this epidemic.
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PMID:The clinical features of paediatric meningococcal disease Auckland, 1985-87. 249 88

The safety and tolerability of lisinopril (1.25-160 mg daily) were assessed in 3,270 patients (2,688 hypertensives and 582 patients with congestive heart failure (CHF] and 280 healthy subjects. The duration of therapy ranged from a single dose to 43 months; 438 patients received lisinopril for at least 12 months (mean 20 months). In the hypertensive population, the most frequent adverse events reported were headache, dizziness, cough, nausea, diarrhoea and fatigue, although not all of these events were thought to be related to lisinopril; 6.1% discontinued lisinopril due to adverse clinical events, most commonly cough and nausea. Twelve hypertensive patients died (0.45%), but most of these were not receiving lisinopril at the time of death and none was considered to be drug-related. In CHF patients, the most frequently reported adverse events were dizziness, dyspnoea, diarrhoea, hypotension and fatigue. Again, not all of these reports were considered to be drug-related. Therapy was withdrawn in 9.6% of patients--hypotension, dizziness, diarrhoea and rash being the most frequent reasons. Fifty-three CHF patients died (9.1%) and in three cases death was considered to be related to lisinopril therapy. Hypotension, orthostatic effects or dizziness following the initial dose of lisinopril occurred infrequently (in 1.3% of the hypertensive group, including those receiving hydrochlorothiazide, and in 4.8% of CHF patients). Changes in laboratory parameters were generally minor and seldom resulted in discontinuation of therapy. Long-term treatment of hypertension and CHF with lisinopril for at least 3 years confirms that the drug is well tolerated. Overall, the side-effect profile is very similar to that of other ACE inhibitors with regard to class-specific effects. However, taste disturbance was rarely observed.
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PMID:Clinical experience with lisinopril. Observations on safety and tolerability. 255 Jun 41

A clinical trial was conducted to determine the tolerance and toxicity of recombinant tumor necrosis factor (rTNF) and recombinant interferon gamma (rIFN-gamma) when administered concurrently by continuous intravenous infusion to 11 patients with the AIDS-related complex (ARC). In addition, HIV culture, p24 antigen levels, and CD4 positive lymphocytes were monitored to obtain preliminary evidence of antiviral and immunologic effects. Two 5-day treatment cycles were separated by a 9-day washout period. Two patients were entered at each dosage level and each patient received the two 5-day treatment cycles at two sequential dose levels ranging from 1 to 25 micrograms/m2. Two patients did not complete their second treatment cycle--one due to the development of a rash, the second due to central venous catheter discomfort. The occurrence of phlebitis with peripheral vein administration of these agents necessitated administration via central venous catheter. With the exception of a single patient who developed severe headache at the 25 micrograms/m2 dose, severe clinical toxicities were not observed. Fever, chills, headache, and myalgias were the most significant clinical toxicities observed and all were dose dependent. The percentage fall in total granulocytes was dose dependent and ranged from 17% at the 1 microgram/mm2 dose to 48% at both the 15 and 25 micrograms/mm2 dose levels. The mean nadir granulocyte count was 1694/mm3. No significant renal or hepatic toxicity was observed. Of 22 treatment cycles the CD4 cell number was increased in 11, unchanged in 7, and decreased in 4. The mean CD4 cell number did not change significantly (176 +/- 143/mm3 pretherapy versus 279 +/- 305/mm3 posttherapy).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A phase I/II study of recombinant tumor necrosis factor and recombinant interferon gamma in patients with AIDS-related complex. 256 51

In 38 children with juvenile chronic arthritis the authors tested Sulphasalazine in an open clinical trial. The drug was administered for 26 weeks, 20-30 mg/kg/day. The action of the drug was followed up with regard to clinical (number of criteria of juvenile chronic arthritis, functional state, period of morning stiffness, number of affected joints painfulness of joints) and laboratory (red cell sedimentation rate, circulating immunocomplexes) indicators. A favourable effect (improvement of at least five of the above indicators) was recorded in 42.1% of the children. Undesirable effects were found in 11 children (30%) incl. six where they were the cause of discontinuation of treatment. All undesirable effects were reversible. The majority of them (exanthema, headache, leukopenia, microscopic haematuria) developed during the first 3-4 weeks of treatment.
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PMID:[Sulfasalazine in the treatment of chronic juvenile arthritis]. 257 32

Since the introduction of fenofibrate to European clinical practice in 1975, some 6.5 million patient-years of experience in the treatment of hyperlipidemia have been accumulated. A review of results of clinical trials shows fenofibrate to have a broad spectrum of lipid-lowering activity, reducing the total cholesterol level by 20-25% in type IIa patients and triglycerides by 40-60% in type IIb and IV patients. High levels of low-density lipoprotein cholesterol are reduced and, where low at baseline, high-density lipoprotein levels are increased. An associated activity is a 10-28% reduction in serum uric acid levels. Adverse reactions in the mostly open clinical trials ranged from 2-15%; mild gastrointestinal problems dominated, and occurred with much the same frequency in the placebo-treated groups of controlled trials. There are also reports of fatigue, headache, loss of libido, dizziness, and insomnia. Some excess of skin rash emerged as the only statistically significant unwanted clinical effect in one placebo-controlled trial. Biochemically, there are occasional fluctuations in serum transaminase values, while gamma-glucuronyl transferase and alkaline phosphatase are often decreased, all without apparent clinical significance. Lithogenicity of the bile is often increased above pretreatment levels, but there is no evidence from trials or postmarketing surveillance that the use of fenofibrate is associated with an increase of gallstone formation.
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PMID:Review of European clinical experience with fenofibrate. 265 20

The rickettsioses have several unifying features. Arthropod vectors are the common means of transmission. Fever, headache, myalgias, and the characteristic eruption (except in Q fever and ehrlichioses) are the hallmarks of the clinical presentation. The diseases share a common pathogenesis, namely, vasculitis, and treatment uniformly consists of tetracycline or chloramphenicol. Distinguishing aspects of these processes include the multitude of different reservoirs, the progression of the rash, and the nonspecific antigen test (Weil-Felix) results.
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PMID:Rickettsial diseases. 266 89


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