Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gemcitabine is a novel nucleoside analogue with activity in solid tumours. This study assessed the objective response rate to gemcitabine given weekly intravenously at a dose of 1250 mg/m2 for 3 weeks followed by 1 week of rest (one cycle) in chemonaive patients with inoperable non-small cell lung cancer (NSCLC). 161 patients with NSCLC were recruited from 10 sites in nine countries. Most patients had stage IIIb (31.3%) or IV (64.6%) disease, and 93.8% had a performance status of 0 or 1 according to the WHO scale. Of 151 evaluable patients, there were 3 complete responses and 30 partial responses lasting at least 4 weeks for an objective response rate of 21.8% (95% CI 15.5-29.3%). All responses were validated by an extramural Oncology Review Board. The mean duration of response was 8.8 months. The mean survival for all patients (16.1% of patients still alive 26 months after last patient started treatment) was 11.5 months. Improvements were also observed in secondary efficacy parameters such as performance status, weight, analgesic requirement, pain, and other disease-related symptoms including cough, dyspnoea, haemoptysis, anorexia, somnolence and hoarseness. Haematological and non-haematological toxicity was mild given the biological activity of gemcitabine. This study confirms gemcitabine as one of the most active agents in NSCLC with the added benefit of a modest toxicity profile and ease of administration on an out-patient basis. Gemcitabine is a suitable candidate for combination chemotherapy in patients with NSCLC.
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PMID:Activity of gemcitabine in patients with non-small cell lung cancer: a multicentre, extended phase II study. 866 35

Abciximab, a platelet glycoprotein (GP) IIb/IIIa inhibitor, has been shown to improve clinical outcomes in patients undergoing percutaneous coronary intervention. However, there is a well-documented increase in bleeding risk associated with the use of this agent. Spontaneous pulmonary hemorrhage is a particularly rare and easily misdiagnosed complication that requires early diagnosis to ensure patient survival. A 61-year-old man presented to the emergency department with chest pain and inferolateral ST elevation on electrocardiogram. A paclitaxel drug-eluting stent was then placed in the left circumflex artery, without complications. Abciximab (a bolus of 0.25 mg/kg followed by an infusion of 10 mg/min for 12 h) was given. Approximately 20 min later, the patient developed dyspnea and hemoptysis. A chest radiograph revealed new bilateral diffuse interstitial infiltrates, and the patient was started on empirical antibiotics for pneumonia. Because of increasing dyspnea and somnolence, the patient was intubated and bronchoscopy was performed, revealing serial hemorrhagic returns from the left lower lobe, diagnostic of diffuse alveolar hemorrhage and judged to be secondary to abciximab, given the time course. All antiplatelet and antithrombotic agents were stopped. The patient stabilized over the next several days, with some recurrent hemoptysis, and was successfully extubated seven days later. Prognosis remains poor in GP IIb/IIIa inhibitor-induced pulmonary hemorrhage, and early diagnosis is critical so that antithrombotic and antiplatelet agents may be discontinued in a timely manner. A high degree of suspicion is required when treating a patient who presents with dyspnea and new radiological infiltrates after receiving a GP IIb/IIIa inhibitor.
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PMID:Abciximab-induced alveolar hemorrhage after percutaneous coronary intervention. 1827 91

Cryptococcus neoformans is present in our surroundings, and is particularly common in bird feces, such as pigeon droppings. Autopsy cases of cryptoccocal meningoencephalitis in young individuals are very rare. The aim of this study is to describe the autopsy findings of cryptococcal meningoencephalitis of the brain and spinal cord in a young man who presented no apparent immunosuppression. A 36-year-old Japanese man presented with hemoptysis and admitted to our hospital. Chest X-ray revealed a small cavity in the left lung. He soon developed somnolence, neck stiffness, positive abnormal neurological reactions, and increased muscular tonus. Cryptococcus neoformans was detected in the cerebrospinal fluid. Despite appropriate chemotherapy (amphotericin B), he died 18 days after the admission. Autopsy revealed clouding of the leptomeninges of the brain and spinal cord. The brain (1,830 g, normal 1,300-1,500 g) showed marked edema and bilateral tonsillar herniation. The lung revealed a cavity in the left lower lobe. Microscopically, the leptomeninges were diffusely infiltrated with numerous cryptococcus fungi and mononuclear cells. Cryptococcus fungi were also present in the parenchyma of the brain and spinal cord, in which mild gliosis and vascular proliferation were recognized. The lung cavity revealed a presence of Cryptococcus neoformans and gram-positive bacteria with granulomatous tissue reactions. The cryptococcal granulomas were also recognized in the liver and spleen. The cause of death was thought to be tonsillar herniation. The present study indicates that severe cryptococcosis involving leptomeninges and parenchyma of the brain and spinal cord may occur in an otherwise healthy individual.
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PMID:Cryptococcosis in the central nervous system in a 36-year-old Japanese man: an autopsy study. 2081 75