Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dissemination of tumor to the leptomeninges and cerebrospinal fluid represents a common pattern of metastasis for many cancers; however, few chemotherapeutic agents are available for intrathecal (i.t.) use and treatment results are often poor. We studied the neurotoxicity and pharmacokinetics of i.t. 4-hydroperoxycyclophosphamide (4-HC) in the rabbit and the activity of i.t. 4-HC in a VX2 rabbit model of leptomeningeal carcinomatosis to evaluate the potential use of 4-HC in the treatment of leptomeningeal tumors. Toxicity studies examined 4-HC doses ranging from 0.5 to 6.0 mumol administered by intraventricular injection weekly for 4 to 8 weeks. Clinical or histological neurotoxicity was not observed in rabbits treated with < 1.0 mumol 4-HC for 4 weeks. Clinical toxicity, characterized by lethargy, weight loss, seizures, or death, was apparent at doses > 2.0 mumol. Vasculitis of superficial arteries was observed in rabbits treated with > 1.0 mumol 4-HC. In cerebrospinal fluid pharmacokinetic studies, the mean drug half-life after intraventricular or intralumbar administration was 24.3 and 18.2 min. Regional inequities in drug exposure were apparent as area under the clearance curve values for cerebrospinal fluid distant from the injection site were lower than those of proximate sites (P < 0.001). Weekly intraventricular treatment of VX2 leptomeningeal tumor-bearing rabbits with 0.5 or 1.0 mumol of 4-HC resulted in an increased life span of 22.5 and 35%, respectively. These results indicate that i.t. 4-HC, at doses lower than those producing neurotoxicity in the rabbit, is effective treatment for VX2 leptomeningeal carcinomatosis.
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PMID:Intrathecal 4-hydroperoxycyclophosphamide: neurotoxicity, cerebrospinal fluid pharmacokinetics, and antitumor activity in a rabbit model of VX2 leptomeningeal carcinomatosis. 142 60

A novel carrier solution, icodextrin 20 (7.5%) has allowed exploration of prolonged intraperitoneal (IP) infusion of the cytotoxic drug, 5-fluorouracil. Eighteen patients with intraperitoneal carcinomatosis were entered into a feasibility and pharmacokinetic study of prolonged regional (IP) chemotherapy.. Specialist nurses trained the patients to self-administer their own treatment via a permanent i.p. catheter. A twin bag delivery system was used to perform one exchange daily. It proved possible to deliver continuous (5 days per week) i.p. 5-fluorouracil at doses of 200 mg/m2 and 300 mg/m2 for up to 12 weeks. The toxicities seen were infective peritonitis, nausea and vomiting, lethargy and anorexia. This was a nurse-led study and the home-based therapy holds promise for patients with malignant peritoneal disease.
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PMID:Intraperitoneal chemotherapy: a prolonged infusion of 5-fluorouracil using a novel carrier solution. 871 77

We report the case of a 63-year-old male who developed rapidly progressive bilateral deafness. Two months later he became stuporous, and was transferred to our hospital. The patient's MRI demonstrated bilateral hypertrophic VII-VIII cranial nerve roots that were well enhanced. Gradually, the patient's condition worsened, and he died on the 12th day after admission. Autopsy revealed meningeal carcinomatosis with poorly differentiated gastric adenocarcinoma. White firm masses of the bilateral seventh and eighth bilateral cranial nerve roots were found at autopsy, which were found to be metastases of the gastric cancer cells as well. Metastatic tumors can be take into consideration as a differential diagnosis for bilateral-enhanced eighth cranial nerve root masses.
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PMID:[A case of meningeal carcinomatosis presenting with bilateral hearing loss]. 1809 90

Erlotinib (Tarceva) is a selective small-molecule inhibitor of HER1/EGFR tyrosine kinases that is especially effective for treating non-small cell lung cancer (NSCLC) harboring a constitutively active EGFR mutation. Erlotinib treatment frequently induces adverse effects such as skin rashes and diarrhea, but severe toxicity is rare. Whereas interstitial pneumonia induced by erlotinib is sometimes observed, toxicity in the central nerve system (CNS) is rarely reported. Here, we report a 75-year-old female NSCLC patient who developed subacute encephalopathy during erlotinib treatment. She showed increased irritability, loss of consciousness, convulsions, confusion, lethargy, and urinary incontinence. A brain MRI and an analysis of her CSF and blood serum detected no other causes of encephalopathy such as brain metastasis, leptomeningeal carcinomatosis, metabolic disturbances, liver damage, or infectious disease. Her subacute encephalopathy was considered to have been induced by erlotinib because her symptoms improved rapidly and spontaneously after the cessation of erlotinib treatment.
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PMID:Subacute transient encephalopathy induced by erlotinib. 2232 99

A 4-year-old female neutered domestic shorthair cat was presented for evaluation of gradual onset of lethargy and anorexia. Physical examination revealed moderate abdominal distension. Investigations performed included complete blood count, serum biochemistry, urinalysis, pyelocentesis, abdominal fluid analysis, abdominal ultrasonography and exploratory celiotomy. Nephrectomy was performed on the hydronephrotic kidney and a sample of the omentum was also taken, as it was grossly abnormal. No other abnormalities were found in the remainder of the abdominal organs. Findings were consistent with unilateral hydronephrosis and squamous cell carcinoma of the renal pelvis with abdominal carcinomatosis. The patient was given supportive treatment while the results of the biopsies from the renal tissue and the omentum were pending. The patient deteriorated a short time after surgical intervention and was euthanased. This is the first report of a squamous cell carcinoma arising from the renal pelvis in a cat. A comparison with the disease presentation in humans is also discussed.
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PMID:Unilateral squamous cell carcinoma of the renal pelvis with hydronephrosis in a cat. 2381 13

A 7-yr-old, intact, female swift fox (Vulpes velox) presented to the Veterinary Health Center at Kansas State University with a history of chronic weight loss, lethargy, inappetence, and myiasis. On physical examination, a firm mass was palpated in the mid- to cranial abdomen. The fox was euthanatized as a result of the grave prognosis. Gross necropsy and histologic findings included a small intestinal adenocarcinoma with diffuse transperitoneal spread throughout the abdominal cavity (carcinomatosis). To the authors' knowledge, this is the first report of intestinal adenocarcinoma with carcinomatosis in a swift fox.
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PMID:SMALL INTESTINAL ADENOCARCINOMA WITH CARCINOMATOSIS IN A SWIFT FOX (VULPES VELOX). 2635 68

A 5-year-old female entire German Shepherd presented for otitis and lethargy. An incidental abdominal mass was identified on examination. Ultrasound examination (US) identified a heterogeneous left ovarian mass. Computed tomography (CT) was performed for surgical planning and staging. The reproductive tract was removed en bloc and submitted for histopathology. Multiple small (1-5 mm) nodules identified at coeliotomy on the surface of the liver, spleen and peritoneum were biopsied. The lesions were not visible on CT nor US on review. This is the first case report of the CT findings of ovarian papillary adenocarcinoma with carcinomatosis.
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PMID:IMAGING DIAGNOSIS-COMPUTED TOMOGRAPHY FINDINGS IN A CASE OF METASTATIC OVARIAN ADENOCARCINOMA IN A DOG. 2773 52