Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It was reported at the 1995 Second National Retrovirus Conference that AIDS has now surpassed unintentional injury as the leading cause of death for male Americans between the ages of 25 to 44, and for women, AIDS is fourth behind unintentional injury. A study of multidrug resistant tuberculosis that showed improved survival rates as long as appropriate therapy began within four weeks of diagnosis was also presented. The current recommendation is to consider the PPD skin test positive in persons with HIV if the bump that appears is over five millimeters in diameter. A new ganciclovir implant study demonstrated the implant's effectiveness in preventing CMV disease progression with low rates of complications, suggesting implants should probably replace intravenous ganciclovir as maintenance therapy. Another study demonstrated the effectiveness of cidofovir as a treatment for CMV infection, indicating that cidofovir was appropriate as a salvage therapy for those failing ganciclovir and foscarnet. In vitro studies involving Taxol and Kaposi's sarcoma (KS) show partial responses (55 percent), and some disease stabilization (40 percent). Four of five patients with pulmonary KS responded with clearance of tumor lesions. The first randomized trial involving Loviride with zidovudine has shown a sustained increase in CD4 cells with headache, nausea, and diarrhea as the most common side effects. Preliminary assessments reveal a reduction in viral load using the combination as opposed to monotherapy. Additional Loviride combination trials are being planned in Europe.
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PMID:Second National Retrovirus conference: a further report. 1136 59

Kaposi's sarcoma is currently the most common tumor in Zimbabwe. The purpose of our study is to compare the effectiveness of supportive care vs. 3 intervention approaches, namely oral Etoposide, a 3-drug combination, and radiotherapy using quality of life (QOL) as the primary measure of success. In addition, our study was to determine whether a disease-specific module has greater sensitivity to group differences than a generic QOL questionnaire and to determine the most pragmatic approach to treating epidemic Kaposi's sarcoma (EKS) in Zimbabwe. Histologically confirmed HIV-positive patients with Kaposi's sarcoma were randomized to receive supportive care only or supportive care plus either radiotherapy, oral Etoposide or a 3-drug combination consisting of actinomycin-D, vincristine and bleomycin. No patient received antiretroviral therapy. The primary outcome was QOL measured by the functional living index-cancer (FLI-C) and supplemented by the Kaposi's sarcoma module (KSM). From 1994-1999, 495 EKS patients were accrued, and 470 were evaluable. Of these, 433 are known to be dead, 26 are lost to follow-up and 11 are still alive. The group treated with oral Etoposide had a significantly better QOL than the radiotherapy group for the total FLI-C score (adjusted mean plus standard error at 3-months 89 +/- 3 vs. 76 +/- 3; p = 0.004) and for the hardship (11 +/- 0.4 vs. 9 +/- 0.4; p = 0.001); social (10 +/- 0.4 vs. 8 +/- 0.4; p = 0.001) and nausea (9 +/- 0.4 vs. 8 +/- 0.4; p = 0.002) subscales. In addition, on the physical and psychological subscales, the Etoposide group had a significantly better QOL than the other 3 treatment groups (p < 0.04). The 3-drug combination, supportive care and radiotherapy groups did not differ significantly from each other with respect to the total FLI-C score or its subscales. There were no group differences with respect to survival. Oral Etoposide therapy resulted in better total FLI-C QOL score than radiotherapy. As well, Etoposide resulted in better physical and psychological subscale scores than radiotherapy, 3-drugs and supportive care. Thus, funds permitting, oral Etoposide is a pragmatic approach to treating EKS in an environment where antiretroviral drugs are not universally available. The study underscores the value of undertaking studies in areas of disease prevalence and the necessity of selecting appropriate outcome measures.
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PMID:Treatment of AIDS-associated Kaposi's sarcoma in Zimbabwe: results of a randomized quality of life focused clinical trial. 1547 10

Anthracycline compounds including daunorubicin are the foundation of many modem chemotherapeutic regimens. However, the side-effects of these compounds can be severe, leading to alopecia, nausea, immune deficiency, and cardiotoxicity. For immunocompromised patients with aggressive Kaposi's sarcoma (KS), these complications often preclude the completion of appropriate chemotherapeutic regimens. This review focuses on the development and efficacy of liposomal daunorubicin (DaunoXome; DNX) carriers for the treatment of KS. Encouragingly, DNX demonstrated increased in vivo stability and specificity. As a result, KS patients benefit from higher cumulative chemotherapeutic doses without significant cardiotoxicity. Tumor response to DNX treatment surpasses that of non-encapsulated daunorubicin and is similar to that observed with conventional multi-drug therapies such as ABV (doxorubicin, bleomycin, vincristine). Moreover, some reports indicate the patient quality of life during therapy may improve with DNX treatment. Although the development of DNX represents a significant advance in KS therapy, recent data suggest that additional modification of the liposomal carrier to include pegylation or target specific antibodies may further increase daunorubicin efficacy in the future.
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PMID:Liposomal daunorubicin as treatment for Kaposi's sarcoma. 1801 28

HIV/AIDS is still an important health problem worldwide and the number of people living with HIV worldwide continued to grow in the last years. The first HIV/AIDS cases had been reported in 1985 from Turkey and with an increasing trend during the following years, the number of cases reached to 3898 with 528 new cases in 2009. The aim of this retrospective study was to share the 18 years experience with the patients who were followed-up in Erciyes University Hospital Infectious Diseases Clinics in Cappadocia region. The records of 55 (81%) HIV/AIDS patients out of 68 who were admitted to our clinic between 1992- 2009 have been attained and the demographic and clinical characteristics, administered therapy regimens and adverse effects of antiretroviral therapy of those cases have been evaluated. Forty-three (78%) of the patients were male and 12 (22%) were female of which 11 (92%) of their spouses had HIV/AIDS. The median age of the patients was 45 and 20 (36%) of them were over 54 years old. Fifty (91%) of patients lived in Cappadocia region, and 24 (44%) had lived in foreign countries. Fifty (91%) patients had risky heterosexual contact as a risk factor. Of these patients, 47 (85%) were in full-blown AIDS stage at admission. Twenty-seven (49%) of the patients diagnosed occasionally during routine anti-HIV testing, did not have any symptoms. Fever, weakness and weight loss were the most frequently detected symptoms in the rest of the patients. Ten (18%) patients had underlying diseases such as hypertension, chronic hepatitis B or C, coronary artery disease, diabetes mellitus and chronic renal disfunction. Opportunistic infections were determined in 25 (45.5%) patients and 20 (40%) of these infections were determined at admission. The most frequent opportunistic infection was oral candidiasis, followed by Pneumocystis (carinii) jiroveci pneumonia and tuberculosis. Malignancy was diagnosed in three patients; two had Kaposi's sarcoma and one had multiorgan adenocarcinoma. Antiretroviral therapy was started in 37 (67%) of the patients and lamivudin/zidovudin + lopinavir/ritonavir was the most commonly used combination. Antiretroviral therapy was changed in 13 (35%) patients most frequently due to the development of side effects of the drugs. Nausea, vomiting and hyperlipidemia were the most frequent side effects, while diarrhea, skin rashes, anemia, leucopenia and lipoatrophy have also been detected. One patient discontinued therapy by his own will. Sixteen (27.6%) of 58 patients, whose records could be achieved, died. The mortality rates detected in 1992-1999 and 2000-2009 periods were 78.6% (11/14) and 11.4% (5/44), respectively. The mean exitus time of the patients was six months after the diagnosis. The reasons of mortality were opportunistic infections in six patients, and adenocarcinoma in one patient. Autopsy had been performed in seven cases, however three patients' records could be attained. One had disseminated candidiasis and miliary tuberculosis, one had multiorgan carcinoma, and one had pneumonia, kidney and colon necrosis and condyloma acuminata. In conclusion, increasing awareness of physicians about HIV/AIDS epidemiology in Turkey provides early diagnosis and prevents the dissemination of illness in community.
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PMID:[Epidemiological and clinical characteristics of HIV/AIDS patients followed-up in Cappadocia region: 18 years experience]. 2134 Nov 67

Multisystemic Castleman disease (MCD) can be associated with HHV8 infection, which involves the mantle zone of follicles. This condition results in an increase number of HHV8-positive (HHV8+) plasmablasts that multiply and amalgamate to form plasmablastic B-cell lymphoma. All previously reported cases of HIV-positive patients with MCD were coinfected with HHV8. Twelve cases of HIV- MCD that are HHV8+ were encountered in the literature, three of them developed lymphoma, and none of those cases were reported to have Kaposi's sarcoma (KS). We report a unique case of HIV-negative elderly woman with preexisting KS that presented to the hospital with recurring nausea, vomiting, and fever, assessment revealed diffuse lymphadenopathy. Axillary lymph node biopsy showed HHV8+ MCD with foci of microlymphoma. Despite the treatment with high-dose steroids, she developed multisystem failure that lead to her death.
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PMID:Does Kaposi's sarcoma predict multicentric Castleman disease in the presence of generalized lymphadenopathy? 2147 88

Kaposi's sarcoma (KS) of the gastrointestinal tract is not an uncommon disease among individuals with acquired immunodeficiency syndrome (AIDS). The majority is asymptomatic, and for this reason, gastrointestinal KS (GI-KS) remains undiagnosed. With continued tumor growth, considerable variation in clinical presentation occurs including abdominal pain, nausea, vomiting, iron deficiency anemia (either chronic or frank gastrointestinal bleeding), and rarely mechanical obstruction alone or combined with bowel perforation. Endoscopy with biopsy allows for histological and immunohistochemical testing to confirm the diagnosis of GI-KS among those with clinical symptoms. In previous studies, dual treatment with highly active antiretroviral therapy and systemic chemotherapy have been associated with improved morbidity and mortality in individuals with visceral KS. Therefore, investigators have suggested performing screening endoscopies in select patients for early detection and treatment to improve outcome. In this review, we describe a 44 years old man with AIDS and cutaneous KS who presented for evaluation of postprandial abdominal pain, vomiting, and weight loss. On upper endoscopy, an extensive, infiltrative, circumferential, reddish mass involving the entire body and antrum of the stomach was seen. Histologic examination later revealed spindle cell proliferation, and confirmatory immunohistochemical testing revealed human herpes virus 8 latent nuclear antigen expression consistent with a diagnosis of gastric KS. Following this, we present a comprehensive review of literature on KS with emphasis on gastrointestinal tract involvement and management.
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PMID:Gastrointestinal Kaposi's sarcoma: Case report and review of the literature. 2626 37


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