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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a high-dose schedule for disseminated neuroblastoma, eight courses of chemotherapy were administered every 10 days, regardless of myelosuppression, to eradicate tumour cells rapidly and reduce emergence of drug-resistant clones. Relatively non-myelotoxic vincristine and cisplatin were alternated with high-dose cisplatin-etoposide and cyclophosphamide-etoposide. Of 12 evaluable patients, there were 1 complete (CR), 3 very good partial (VGPR), 5 partial (PR) and 3 mixed responses (MR) 100 days after starting treatment. 6 out of 9 achieved a bone marrow CR at 40 days. 9 of 11 primary tumours were completely resected, after which 4 patients had CR, 3 VGPR (bone scan alone being abnormal), 4 PR and 1 mixed response (MR). Myelotoxicity was the major adverse effect. The only death was due to fungal infection. Clinically important renal dysfunction occurred in 3 patients. 4 had convulsions and 4 temporary hypertension. This schedule produced a rapid response and its toxicity, though serious, was manageable. Further evaluation is warranted.
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PMID:High-dose rapid schedule chemotherapy for disseminated neuroblastoma. 138 81

Eight patients with systemic mycoses and with prior treatment failures were treated with itraconazole (600 mg/day) for a mean duration of 5.5 months. All six patients without AIDS experienced improvement or stabilization of their fungal infections while receiving high-dose itraconazole, although two patients later experienced treatment failures, one by relapse and one by progression, on lower doses. Treatment failures also occurred in the two patients with AIDS and cryptococcal meningitis. The failures were associated with low serum itraconazole concentrations (less than 2.5 micrograms/ml) in both patients. All other patients had mean trough levels in serum above 5 micrograms/ml. One patient who was improving on 600 mg/day developed a progressive infection after reduction of the dose to 400 mg/day. Side effects included reversible adrenal insufficiency in one patient; severe hypokalemia, mild diastolic hypertension, and rhabdomyolysis in one patient; mild hypokalemia and hypertension in four other patients; and breast tenderness in one patient. The mean decrease in serum potassium during treatment was statistically significant (P = 0.05). Selected patients with severe systemic mycoses may benefit from prolonged high-dose itraconazole treatment. However, 600 mg/day may be approaching the upper limits of acceptable dosing for long-term treatment.
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PMID:High-dose itraconazole in the treatment of severe mycoses. 164 87

Sixteen patients with coccidioidomycosis were treated with itraconazole for one year. Sixteen suffered from pulmonary coccidioidomycosis, two of them had associated mediastinal lesions, and one suffered from skin coccidioidomycosis. The daily dose used was 400 mg during the one-year period. Patients were clinically evaluated every month and tested for mycosis every three months. All patients except for one showed negative cultures on the third month after treatment began. Effectiveness achieved was excellent in eight patients (50 percent); a very good response was found in seven patients (44 percent); no response was seen in one patient (6 percent). There were four (25 percent) relapses and one dropout. Side effects seen were high blood pressure (19 percent) and lower limb edema (6 percent), which was temporary and at no time required discontinuing the drug therapy. We believe that itraconazole is an effective drug to treat coccidioidomycosis with a wide safety margin. It is well tolerated, and the incidence of relapses was low.
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PMID:Itraconazole in the treatment of coccidioidomycosis. 165 79

A 61-year-old man who had end-stage renal disease secondary to diabetes mellitus and hypertension developed peritonitis due to infection with Rhizopus as a complication of receiving continuous ambulatory peritoneal dialysis (CAPD). At the onset of infection, the patient was neither acidemic nor hyperglycemic; in addition, deferoxamine had not been administered and Elastoplast dressings had not been applied. The infection occurred after the technique for disinfection of the catheter used for CAPD had been changed. The catheter was removed, and therapy with amphotericin B was initiated. Although the patient died of apparently unrelated causes, an autopsy revealed active fungal infection with multiple abscesses and superficial invasion of the ileal wall.
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PMID:Peritonitis due to Rhizopus in a patient undergoing continuous ambulatory peritoneal dialysis. 201 28

A case of cerebral aspergillosis is reported, the presenting symptom was numbness of right face, which worsened after one year. CT-scan showed two enhanced low-density patches in the anterior and basal parts of right temporal lobe. During operation, an abscess in the deep part of right temporal lobe was revealed. The patient gradually felt amaurosis and oculomotor palsy of right eye. About six months later, she died from intracranial hypertension. Biopsy, as well as autopsy findings suggested fungal infection, and was identified as Aspergillus nidulans, which has probably never been reported in the literature.
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PMID:A case of cerebral aspergillosis caused by Aspergillus nidulans. Clinical, pathologic and mycologic identifications. 211 68

We report our experience in the management of children after orthotopic liver transplantation (OLT). From 03/84 to 04/87 50 patients (pts) were transplanted. Mean age was 4 3/12 years (8/12 to 13 2/12) and mean body weight 14.7 kg (5.8 to 40). Hospital mortality was 14%. Problems related to the surgery included: Abdominal complications: bleeding (8 pts), infection (18 pts), ascites and fistula (1 pt), need for secondary abdominal surgery (10 patients). Respiratory problems: lobar atelectasis (11 pts), right diaphragmatic paralysis (2 pts) and right pleural effusion (11 pts). Problems related to immunosuppression included: Bacterial infection (29 pts) fungal infection (5 pts), one patient died of disseminated cytomegalovirus infection. Side effect of cyclosporin A (CsA) were systemic blood hypertension (S.B.H.) (47 pts), sinusal bradycardia (37 pts), associated to SBH (24 pts), hypertensive encephalopathy (2 pts). Generalized seizures (2 pts in the absence of SBH). Renal side effects of CsA were hypercreatininemia, decreased sodium bicarbonate and hyperkaliemia. The nephrotoxicity of CsA was favoured by the use of other nephrotoxic drugs such as aminoglycosides, amphotericin B. Edematous pancreatitis was observed in 3 patients and related to the use of large doses of steroids. Problems related to the functioning of the graft included: Primary non-function of the graft (4 pts), hepatic artery thrombosis (8 pts) and severe acute rejection unresponsive to therapy (1 pt); these situations needed to be recognised early in order to organize a second OLT. Other causes of hepatic dysfunction were: portal vein thrombosis (1 pt), biliary tract obstruction (2 pts), angiocholitis (3 pts), right hepatic lobe necrosis (2 pts). Acute hepatic insufficiency in 7 children.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Intensive care for children after orthotopic liver transplantation. 265 16

Hemiplegic forms of human African trypanosomiasis are unusual. From 1963 to 1987, 14 cases have been reported in the literature. One may be mistakenly led to look for a space-occupying lesion when clinical features include hemiplegia, vascular shift from median line during arteriography, focal EEG anomalies and intracranial hypertension. The discussion on diagnosis also covers subacute or chronic meningo encephalitis (tuberculosis syphilis or fungal infection). CT scanner findings suggest the association of a massive demyelination of centrum semiovale, with cerebral oedema.
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PMID:[Hemiplegic forms of human African trypanosomiasis]. 305 54

Ellipticine and some derivatives are highly cytotoxic substances which kill L1210 cells at concentrations ranging form 10(-8) to 10(-6)M. Some compounds in this series bind with high affinity to DNA (affinity constant between 10(7) M-1 and 10(5) M-1) by intercalation between base pairs. The antitumoral properties of these derivatives are thought to be related to their DNA-binding ability. Both 9-hydroxylation of ellipticine and quaternarization of 2-pyridinic nitrogen tend to increase DNA binding and antitumor activity. 2-Methyl-9-hydroxyellipticine (NSC 264-137) was selected for a phase I and later for a phase II trial in human cancer. This drug does not affect blood cell counts in animals or in man. It is not mutagenic in the Ames' test nor teratogenic in mice, but is endowed with anti-inflammatory properties and induces a marked decrease of motoricity in mice. Transient bradycardia and decrease of blood pressure are the most noticeable cardiovascular effects in dogs. This compound administered at 80-100 mg/m2/week in 1-h intravenous (IV) infusion induces objective remissions in about 25% of patients suffering from advanced breast cancer refractory to all other treatment. These remissions, which occurred after 3-4 weeks, lasted for 1-18 months. This drug seems particularly to improve the condition of patients suffering from oesteolytic breast cancer metastasis. Activity against anaplastic thyroid carcinoma and ovarian carcinoma has also been observed in some cases. Toxic side effects are nausea and vomiting (one-third of the patients), hypertension (less than 10% of the patients), muscular cramp (one-third of the patients), fatigue which can be very pronounced (in most patients after 3 months of treatment), mouth dryness, and mycosis of the tongue and esophagus (less than 20% of the patients).
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PMID:Antitumor activity, pharmacology, and toxicity of ellipticines, ellipticinium, and 9-hydroxy derivatives: preliminary clinical trials of 2-methyl-9-hydroxy ellipticinium (NSC 264-137). 700 58

We investigated skin diseases associated with mucocutaneous Candida infection by analyzing the clinical records of 44695 in-patients of the department of dermatology of Kiel. For more than eighty skin diseases the relative risk (RR) was calculated by age-and sex-adjusting methods. 1996 patients demonstrated a mucocutaneous candidosis, 14.8% of them being hospitalized because of extensive Candida infection. In patients with dermatomyositis, bullous pemphigus, tinea inguinalis, and condylomata acuminata a Candida infection was observed more than threefold than expected. Furthermore, patients with urticaria, folliculitis, and bullous pemphigoid demonstrated candidosis more than twice as often as control patients. In addition, patients with erysipelas, acne, psoriasis, and atopic dermatitis showed a candidosis significantly more often (RR between 1.3 and 1.6). Some internistic maladies were investigated, too. In patients presenting with diabetes mellitus, heart-insufficiency, hypertension, chronic tonsillitis, and urinary tract infection a mucocutaneous Candida infection was significantly increased.
Mycoses 1995
PMID:[Mucocutaneous candidiasis in patients with skin diseases]. 763 Mar 73

A review and analysis of 5,001 neonatal venoarterial (VA) extracorporeal membrane oxygenation (ECMO) cases showed that bacterial and fungal infection occurred in 147 (2.9%) and 26 (0.6%) patients, respectively, with an overall incidence of 3.5%. Bivariate analysis was used to compare infected infants with controls, bacterial versus fungal groups, and bacterial subgroups with respect to patient demographics, primary diagnosis, mechanical complications, patient complications, duration of the ECMO course, and hospital mortality. Logistic regression models were constructed using variables that were statistically significant from the bivariate comparisons. Variables that remained significant after multivariate analysis included primary diagnosis of pneumonia/sepsis, mechanical complications of oxygenator failure, rupture of raceway or tubing, clots, and patient complications of hypertension and hyperbilirubinemia. The infection group had significantly longer mean total hours on bypass and higher hospital mortality. Infants with fungal infection had a significantly higher hospital mortality rate compared with those with bacterial infection. We conclude that infection during ECMO, especially fungal infection, carries an increased risk of hospital mortality and that mechanical complications are associated with an increased risk of infection, Key Words: Extracorporeal membrane oxygenation-Nosocomial-Bacterial infection-Fungal infection-Extracorporeal membrane oxygenation outcome.
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PMID:Bacterial and fungal infection in neonates undergoing venoarterial extracorporeal membrane oxygenation: an analysis of the registry data of the extracorporeal life support organization. 869 90


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