Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027947 (neutropenia)
 17,527 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty adults (mean age, 52 years) were enrolled in a randomized, comparative trial of oral ciprofloxacin (750 mg twice daily) and other antimicrobial therapies. Etiologic agents included Enterobacteriaceae (18 isolates), Pseudomonas aeruginosa (16 isolates), and Staphylococcus aureus (four isolates). Seven of 14 (50 percent) ciprofloxacin-treated infections are cured at up to 13 months follow-up and three infections appear improved. Treatment failure or relapse has occurred in four patients. Sixteen patients received other antimicrobial therapy and 11 patients (65 percent) remain without infection and have healed wounds, with follow-up from one to 13 months. One patient has had a relapse, while improvement is apparent in four patients. Complications that occurred in this group included drug-related neutropenia (two patients), diarrhea (two patients), drug allergy (one patient), and catheter-related staphylococcal cellulitis (one patient). Oral ciprofloxacin therapy for chronic osteomyelitis caused by susceptible organisms appears to be as effective as other antimicrobial therapies.
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PMID:Randomized trial of ciprofloxacin compared with other antimicrobial therapy in the treatment of osteomyelitis. 355 46

The toxicity of high dose cytosine arabinoside (Ara-C) in 23 leukemic children aged 1.5 years to 16 years 11 months was evaluated. The group included 11 children with acute lymphoblastic leukemia (ALL), nine with acute nonlymphoblastic leukemia (ANLL), two with chronic myelocytic leukemia (CML) in blastic crisis, and one with Burkitt's lymphoma. Toxicity consisted of bone marrow suppression in all patients, with a mean nadir time of 11 days for platelets and granulocytes. All patients experienced nausea and vomiting; 12 of 23 had drug induced fever; seven of 23 conjunctivitis; five of 23 mucositis; four of 23 diarrhea, and one of 23 elevated transaminase with hyperbilirubinemia. Adverse reactions were mild and reversible in all patients. No serious neurologic toxicity was seen. The toxicity observed in four patients with prior cranial irradiation was not any different from nonirradiated patients. The only life-threatening effect was neutropenia, the consequences of which were generally well controlled with antibiotic therapy. While this agent was effective in induction of remission in AML patients resistant to standard doses of Ara-C, it had no significant effect in a very small number of patients with relapsed ALL and CML in blast crisis. Side effects of high dose Ara-C though relatively substantial are manageable enough to warrant wider scale efficacy trials of this agent in childhood leukemias and solid tumors.
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PMID:Toxicity of high dose Ara-C in children and adolescents. 359 53

Cefuzonam (L-105, CZON), a new parenteral cephalosporin, was evaluated for its efficacy and safety in 22 children with bacterial infections (Table 1). The results obtained are summarized below. MICs of CZON to 26 strains of isolated organisms are shown in Table 2. MICs to all 14 strains of Haemophilus influenzae and 6 strains of Streptococcus pneumoniae were less than 0.05 microgram/ml. The MIC to 2 strains of Staphylococcus aureus was 0.39 microgram/ml and that to another was 0.78 microgram/ml. Two strains of Escherichia coli showed MICs of less than 0.05 and 0.10 microgram/ml, respectively. The MIC to 1 strain of Enterococcus faecalis was 6.25 micrograms/ml. The CZON was administered in 3 or 4 divided doses at a daily dosage ranging from 58.5 to 85.7 mg/kg by 30-minute drip infusion or intravenous injection to 22 patients (9 cases of pneumonia, 9 cases of tonsillitis, 2 cases of bronchitis, 1 case each of suppurative parotitis and acute pyelonephritis) and the following clinical results were obtained; excellent: 12 cases; good: 7 cases; fair: 3 cases. The overall efficacy rate was 86% (Table 4). Diarrhea was observed in four patients, and was resolved with or without discontinuation of the medication within a week. Anemia was noted in 2 cases. Leucopenia and neutropenia was observed in 1 case. There were a moderate rises in S-GOT and S-GPT activities in 1 patient (Table 4), and they necessitated the cessation of the CZON therapy. The S-GOT and S-GPT activities became normal after the drug treatment was stopped.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical evaluation of cefuzonam in children]. 359 88

Ceftriaxone has a very long serum half-life and enhanced in vitro activity against common pediatric pathogens. Therefore we evaluated the efficacy and safety of once daily ceftriaxone therapy in 57 children with serious infections including: meningitis (26 patients); ventriculitis (3); pyelonephritis (7); osteomyelitis (6); abscess (4); septic arthritis (3); sepsis (2); and miscellaneous infections (6). The most common isolates were Haemophilus influenzae (23), Escherichia coli (9) and Staphylococcus aureus (8). Ceftriaxone was given intravenously or intramuscularly in a dose of 50 mg/kg for non-central nervous system (CNS) infections. Patients with CNS infections received an initial dose of 100 mg/kg followed by 80 mg/kg 12 hours later and once daily thereafter. In a limited number of patients no major differences in serum ceftriaxone concentrations were found after intravenous or intramuscular injection. Of 57 patients with pathogens isolated 55 were completely cured; in one patient with Klebsiella pneumoniae ventriculitis, intraventricular gentamicin was briefly added to the regimen. Another patient with an anaerobic liver abscess recovered after metronidazole was administered. In three patients a delayed response to ceftriaxone was noted. One patient with previous recurrent infections had a second episode of H. influenzae meningitis 22 days after cessation of therapy. Clinical side effects were noted in 10 of 71 patients (including 14 treated patients who had negative cultures). Seven patients had diarrhea, one each had fever or rash and one had fever, rash and arthralgia. Laboratory side effects in 16 of 71 patients included eosinophilia (7), thrombocytosis (7), elevated liver enzymes (4) and leukopenia and neutropenia (2).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Once daily ceftriaxone for central nervous system infections and other serious pediatric infections. 372 39

The clinical and hematologic variables of 10 ponies with experimentally induced equine ehrlichial colitis (EEC; syn: Potomac horse fever) were studied for a 30-day period (6 ponies) or until death (4 ponies). The earliest clinical sign indicative of EEC was fever (rectal temperature exceeding 39 C). All ponies became depressed (CNS) at various times during the disease, and 90% of the ponies developed diarrhea between 9 and 15 days after infection was induced. The most significant hematologic change was an increase in plasma protein concentration after the onset of fever (P less than 0.05). The PCV in all ponies became increased above base line during the diarrheic phase of EEC. Forty percent of the ponies developed anemia (PCV less than or equal to 23%) during the study. White blood cell counts were highly variable, with 80% of the ponies developing leukopenia (WBC less than 5,000/microliters) during the illness and 60% of the ponies developing leukocytosis (WBC greater than 14,000/microliters) after leukopenia was observed. Differential WBC changes varied widely and included neutropenia with a left shift, lymphopenia, and eosinopenia. Serial thrombocyte counts, which were done for only 1 pony, identified the development of marked thrombocytopenia. Some hematologic changes in ponies with EEC were similar to those reported in canine monocytic and equine granulocytic ehrlichioses. These data are discussed in the context of the pathogenesis and differential diagnosis of EEC.
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PMID:Clinical and hematologic variables in ponies with experimentally induced equine ehrlichial colitis (Potomac horse fever). 382 43

Thirty-four patients with osteomyelitis were treated for a mean of 32.5 days with 2 to 4 g per day of imipenem/cilastatin. Twenty-six infections involving the lower extremities were associated with accidents and prosthesis implantation, and 19 of 34 patients had more than one organism isolated. Gram-positive and gram-negative organisms were equally represented, but follow-up bone culture samples showed only 11 percent of gram-positive organisms persisted versus 23 percent of gram-negative organisms. Seventy-four percent of patients were cured or improved, and failures were related to resistant organisms and the inability to perform adequate surgical debridement. Adverse drug side effects included nausea, diarrhea, liver enzyme elevations, and neutropenia, but discontinuation of treatment was required in only three patients. Imipenem/cilastatin holds promise as monotherapy in complicated polymicrobial osteomyelitis.
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PMID:Imipenem/cilastatin in the treatment of osteomyelitis. 385 7

The occurrence of hematologic and neurologic complications probably caused by an overdose of 5-FC has prompted us to study 5-FC pharmacokinetics in 10 patients under a 5-FC and amphotericin B. On the basis of our findings we have determined the optimal dosage that achieves desired concentrations. In 5 cases this dosages was found to differ from that suggested by the manufacturer. 5-FC concentrations were however higher than predicted levels as a result of the association with amphotericin B. A subsequent modification of dosage was needed in 10 patients. 5 undesirable side effects were recorded: thrombopenia (1 case), neutropenia (1 case), diarrhea (2 cases), and isolated rise in transaminases. In 4 patients with high 5-FC concentrations, chromatograms showed a peak possibly formed by 5-FU, suggesting that 5-FC may be converted into 5-FU.
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PMID:[Monitoring of treatment involving 5-fluorocytosine]. 391 Nov 61

Sixty-seven patients with complicated urinary tract infections were randomized in double-blind fashion to ceftazidime or moxalactam (MOX). A total of 54 patients were evaluable, 27 in each group. Patients received 500 mg of antibiotic intravenously every 12 h, except for those with Pseudomonas aeruginosa randomized to MOX who received 2 g intravenously every 12 h. Toxic effects with ceftazidime were experienced by the following number of patients: pain with infusion, one; posttherapy diarrhea, one; liver function test elevations, two; and neutropenia, one. Toxic effects with MOX were experienced by the following number of patients: liver function test elevations, two; and prolonged prothrombin time, one. All resolved. At 1 week posttherapy, bacteriologic results were 74% cured, 11% relapsed, 15% reinfection with ceftazidime and 52% cured, 33% relapsed, and 19% reinfection with MOX. Ceftazidime was effective for infections caused by MOX-resistant P. aeruginosa. P. aeruginosa resistant to MOX and other beta-lactams was isolated from one patient after MOX therapy. Enterococcal reinfection was common in both groups.
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PMID:Randomized, double-blind comparison of ceftazidime and moxalactam in complicated urinary tract infections. 391 59

A review of 58 patients with malignancies (age range, 14-73 years), who required surgical consultation for acute abdominal pain in the setting of neutropenia (granulocyte count less than 1000/mm3) after chemotherapy was conducted. Ninety percent had fevers greater than 37.8 degrees C, 30% had diarrhea or melena, and 25% had diminished bowel sounds. Five of the 29 patients (17%) with localized pain had surgical intervention; 3 of 29 patients (10%) with generalized pain underwent operations (2 for x-ray findings). All eight of these surgically treated patients survived to leave the hospital. Eighteen of the 29 patients with generalized pain were believed to have a similar syndrome of diarrhea (occasionally heme positive) and diffuse abdominal tenderness (some with peritoneal signs and distension), which was termed "neutropenic enteropathy." Eleven of these 18 patients had their symptoms resolve with antibiotic therapy, aggressive fluid replacement, and a return of their granulocyte count to normal. The other seven died of pneumonia (two), unknown causes (one), and diffuse enterocolitis throughout the intestinal tract (four documented at autopsy). The overall 30-day mortality rate in this series was 34%. Several factors correlated significantly with mortality: hypotension at the onset of pain (80% mortality), bacteremia (63% mortality), and fungemia (100% mortality). Absolute leukocyte count and absolute platelet count did not correlate with mortality. This study reaffirms that patients with neutropenic enteropathy are best treated conservatively. Patients with surgically correctable disease were identified by specific focal findings on examination or x-ray.
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PMID:Abdominal pain in neutropenic cancer patients. 394 98

Seventeen patients with persistent or recurrent epithelial cancer of the ovary were treated sequentially with methotrexate 125 mg/m2 or 250 mg/m2 iv followed in 1 hr with 5-fluorouracil 600 mg/m2 iv and in 24 hr with leucovorin rescue factor 10 mg/m2 q 6 hr for 6 doses every 14 days. Sixteen patients had Stage III or IV disease; one patient had Stage IIB disease. There were no complete or partial responders; nine patients had stabilization of disease for at least 1 month and three for greater than 4 months. There was minimal toxicity in the 89 courses given, with 8.9% neutropenia (less than 3000/mm3) and 2.2% thrombocytopenia (less than 100,000/mm3). Two patients developed severe diarrhea; there were no cases of mucositis.
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PMID:Treatment of persistent or recurrent ovarian carcinoma with sequential methotrexate and 5-fluorouracil. 395 21


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