Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The mitomycins are antitumor antibiotics that are under investigation now for more than 30 years. Mitomycin C (MMC) is the best investigated subtype. It serves as a prototype for drugs with bioreductive alkylation, which is a unique feature of this class. MMC is mainly active under anaerobic circumstances. The pharmacokinetics are linear in a two-compartment model. The main toxicities of MMC are thrombocytopenia and leucocytopenia. Rare but severe side effects are a hemolytic uremic syndrome, pneumonitis and cardiac failure. MMC has a wide clinical antitumor spectrum with efficacy in various tumor types such as gastric cancer, pancreatic cancer, breast cancer, non-small cell lung cancer, cervical cancer, prostate cancer and bladder cancer. Still, the above mentioned side effects prevent a more widespread use. The most important features of the drug will be reviewed.
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PMID:Mitomycin C: mechanism of action, usefulness and limitations. 213 Oct 38

Eight patients with advanced cancer of the urinary tract were treated with recombinant interleukin-2(IL-2) at our department between December, 1985 and September, 1987. Patients were given 5 x 10(5)-4 x 10(6) units of IL-2 by intravenous drip infusion daily. One of five patients who received IL-2 for over 28 days showed 62% regression in size of hepatic metastasis of bladder cancer on computed tomography and another showed marked improvement of Performance Status. The upward tendency of natural killer and lymphokine-activated killer activity of peripheral blood was observed during treatment. Fever, mental disturbance, hypotension and eosinophilia and others were recognized during administration of IL-2, and cardiac failure and disturbance of renal function were also recognized as severe side effect.
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PMID:[Treatment of advanced cancer of the urinary tract with interleukin-2 (IL-2)]. 326 12

Cardiac metastases have been reported increasingly partly because of the longevity of cancer patients, but its antemortem diagnosis is frequently missed. This is due to the nonspecific clinical manifestations or relative lack of characteristic signs which are masked by the underlying disease. This is a report of a 42-year-old man diagnosed as having a metastatic cardiac tumor by echocardiography, six months after operation for squamous cell carcinoma of the gall bladder. Echocardiography revealed abnormal structures in the regions of the posterior and lateral walls of the left ventricle and interventricular septum, suggesting metastatic tumors. The cytological findings of a fine-needle aspiration biopsy specimen were squamous cell carcinoma. The patient died of cardiac failure eight months after the echocardiographic diagnosis. At autopsy, the abnormal structures in the heart were identified as cardiac metastatic tumors from gall bladder cancer. Reports of cardiac metastasis of gall bladder cancer is very rare (0-3%). The myocardial metastasis may have a more serious prognostic importance than the primary neoplasm itself; thus, its definite diagnosis is mandatory.
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PMID:[Metastatic tumor of the heart from gall bladder cancer detected by echocardiography: a case report]. 345 58

Authors used the Mainz pouch II technique for urinary diversion in 40 patients suffering from bladder cancer. They made minor modifications to the original surgical technique: a longer, 40 cm bowel is detubularized, the ureters are pulled through the mesosigma and embedded in a groove of the bowel's mucosa, the sigma pouch is fixed to the dorsal peritoneum, a straight suture is used. Single-row on the dorsal wall and two-rows on the ventral wall. Within a few days after the surgery suture insufficiency occurred in the abdominal wall in 5 cases, in the bowel in 2 cases. To treat suture disrupture of the bowel authors transformed the pouch, added a newly detubularized bowel segment to create a spheric rectum pouch and performed a definitive colostomy. During the follow-up period of six months to four years 8 of the 40 patients died from bladder cancer, 2 from cardiac failure, 1 from pulmonary embolism, and 6 have had a recurrence of the tumor. In the 23 tumor free patients we found no reflux, one has a slight stenosis of the ureter, febrile pyelonephritis did not occur, the pouch did not slip, the ureter had no kinking, and all patients are continent. Hyper-chloraemic acidosis has been prevented by regular administration of sodium bicarbonate or kalium citrate. Authors believe that Mainz pouch II is to be the most appropriate continent urinary diversion if an orthotopic substitution is not possible.
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PMID:Our experience with the Mainz pouch II: 40 patients; follow-up and complications. 855 96

From 1981 to 1994, intra-operative radiotherapy after subtotal cystectomy was performed on 22 patients with invasive bladder carcinoma on whom radical cystectomy could not be recommended because of old age or condition. All the patients received 25 to 30 Gy of radiotherapy focused on trigonum and internal urethral orifice after subtotal cystectomy with uretero-cutaneostomy. Of 22 patients, 15 patients died. Five patients died of bladder cancer, one died of gastric cancer, one died of rectal cancer and the others died of pneumonia, heart failure, sepsis and senility. The five-year survival rate was 41% and the cause-specific five-year survival rate was 75%. Local recurrence was seen only in one patients, who received second intra-operative radiotherapy and recovered well in complete remission. We believe that intra-operative radiotherapy after subtotal cystectomy is useful for patients with invasive bladder carcinoma on whom radical cystectomy could not be recommended because of old age or condition.
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PMID:[Clinical evaluation of intra-operative radiotherapy combined with subtotal cystectomy for invasive bladder carcinoma]. 861 87

A total of 42 Japanese centenarians (9 males & 33 females) autopsied in Tokyo Metropolitan Geriatric Hospital during 22 years (1975-1996) were clinico-pathologically examined to determine details of the main cause of death. The main cause of death of the 42 cases were sepsis (16 cases), pneumonia (14 cases), suffocation (4 cases), heart failure (4 cases), cerebrovascular disorder (2 cases) and malnutrition (2 cases). Most pneumonias were caused aspiration of foreign bodies, and the origins of sepsis were pyelonephritis (7 cases), biliary tract infection (3 cases), necrotic lesions of the intestine due to ileus, ischemia and pseudomembranous colitis (3 cases) and indwelling vein catheter (3 cases). Malignant neoplasms were observed in 16 cases (38%), and 5 of them had 2 or 3 lesions. Thus, the total number of lesions of malignant neoplasms were 22, as follows; colonic cancer (36%), urinary bladder cancer (14%), lung adenocarcinoma (9%), gastric cancer (9%), malignant lymphoma (9%) and others. However, none of these malignant neoplasms were directly related with the cause of death. All 42 centenarians died not of simple "senile decay", but due to diseases.
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PMID:[Pathologic evaluation of the main cause of death in Japanese centenarians]. 1036 29

Bladder-sparing radiotherapy with concurrent chemotherapy may be a reasonable alternative to cystectomy in patients with invasive bladder cancer. The purpose of this study was to determine the tolerance of combined treatment in elderly patients. In this retrospective study, the records of patients 70 or more years of age with stage T2-T4a, N0, M0 disease who were treated with bladder-sparing regimens between 1985 and 2000 were examined for toxicity. Of 149 consecutive patients treated for cancer of the bladder, 14 patients met eligibility criteria. The median age was 79 years. At a median follow-up of 17 months, the median survival was 19 months. All patients had at least mild toxicity, with 6 of 14 patients having grade III to IV toxicity. Grade III to IV toxicities included one patient with grade IV neutropenia, three with grade III gastrointestinal toxicities, one patient with grade III urinary frequency, one patient with grade IV ureteral obstruction who required stent placement, and one episode of hydration-induced grade III heart failure. Two of 14 patients stopped chemotherapy and 5 patients required dose reductions for toxicity. The observed rates of toxicity compare favorably with studies of bladder-sparing therapy in patients with median ages less than 70 years. Our study shows that bladder-sparing radiotherapy with concurrent chemotherapy is feasible in patients 70 or more years of age, and should be considered for such patients if they are inoperable or strongly wish to avoid cystectomy.
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PMID:Tolerance of radiotherapy and chemotherapy in elderly patients with bladder cancer. 1505 57

In this paper, we present GLARE, a domain-independent prototypical system for acquiring, representing and executing clinical guidelines. GLARE has been built within a 7-year project with Azienda Ospedaliera San Giovanni Battista in Turin (one of the largest hospitals in Italy) and has been successfully tested on clinical guidelines in different domains, including bladder cancer, reflux esophagitis, and heart failure. GLARE is characterized by the adoption of advanced Artificial Intelligence (AI) techniques, to support medical decision making and to manage temporal knowledge.
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PMID:The GLARE approach to clinical guidelines: main features. 1553 21

(1) In 2002/2003, the clinical evaluation of imatinib, a tyrosine kinase inhibitor, in the treatment of chronic myeloid leukaemia left many questions unanswered. This article examines data published since then; (2) The only new data on first-line efficacy are the 5-year results of an unblinded trial comparing imatinib versus the interferon plus cytarabine combination. The survival rate was 89% with imatinib, versus about 70% in previous clinical trials of interferon plus cytarabine. Fewer than 2% of patients relapsed after responding to imatinib; (3) As second-line treatment for patients in the chronic phase, we now have non-comparative follow-up data on 532 patients in whom interferon had failed. At 5 years the overall survival rate was 79%, versus about 50% with standard treatments; (4) As second-line treatment for patients in the accelerated phase, we now have non-comparative follow-up data on 235 patients. After 3 years 55% of the patients were still alive, while the usual survival time is 3 to 18 months; (5) As second-line treatment of the blast crisis, we now have non-comparative follow-up data on 260 patients. After 3 years 14% of the patients were still alive, while the usual survival time for patients at this stage is 2 to 4 months; (6) The only new study is a non-comparative follow-up study of 50 children and adolescents aged 2 to 19 years treated with imatinib. The estimated 2-year survival rate was 84%. The haematological and cytogenetic response rates were similar to those reported in adults; (7) The initial clinical evaluation of imatinib showed that its main adverse effects were nausea and vomiting, oedema, fluid retention, muscle cramps, and cutaneous disorders. It was estimated that heart failure occurred in 1 to 10 per 1000 patients. A study of 54 patients confirmed the high incidence of cutaneous disorders. Cases of prostate and bladder cancer have been reported in patients treated with imatinib in France. A study of 16 patients suggests that imatinib might alter bone metabolism; (8) In France, treatment with imatinib costs about 25% more than the interferon plus cytarabine combination; (9) In practice, imatinib seems to increase survival time when used as a first-line or second-line treatment for patients in different phases of chronic myeloid leukaemia. Adverse effects must continue to be closely monitored.
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PMID:Imatinib: a second look. Longer follow-up in chronic myeloid leukaemia: clear advantages. 1941 89

Although it is common to find metastases of transitional cell carcinoma of the bladder to the lymph nodes, lung, bone, and liver, cardiac metastases have only been rarely reported. We report a case of symptomatic metastasis of transitional cell cancer to the right ventricle. A 59-year-old man with a history of transitional cell bladder cancer status post cystectomy and chemotherapy, with neobladder placement, presented with hematuria, shortness of breath, murmur, and evidence of right-sided heart failure. On imaging workup, including transthoracic echocardiography and cardiac computed tomography, we found a large right ventricular mass. A review of the literature showed that there are only 9 cases of cardiac metastasis from transitional cell cancer reported; however, our case is unique because it is the only reported case of symptomatic improvement due to effective treatment with chemotherapy.
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PMID:A rare case of successfully treated cardiac metastasis from transitional cell bladder cancer. 2143 64


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