Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cisplatin plus 5-FU appears to have significant additive activity in various tumors, such as head and neck carcinoma and esophageal cancer. A partial explanation for this may be drug synergism, which has been noted in the L1210 leukemia model. Based on these data, a prospective trial of weekly bolus 5-FU (15 mg/kg) and cisplatin (60 mg/m2) given every 3 weeks was initiated at Indiana University. Forty-one patients, of whom 38 are fully evaluable for response, were treated with these two drugs. Ten partial and one complete response (complete + partial response rate = 29%) were observed in the 38 evaluable patients. Thirteen additional patients had stable disease for greater than or equal to 3 months. The median durations of remission and survival time were 6 and 10.3 months, respectively. Myelosuppression was unusually severe, with granulocyte counts less than 1000/mm3 in 65% of patients, including four patients with granulocyte count nadirs less than 100/mm3. Three patients developed granulocytopenic fever, with two drug-related deaths (sepsis, hyperosmolar coma). Nearly all patients had nausea and vomiting, but this was not a treatment-limiting toxic effect in any patient. Although this combination suggests a higher response rate than usually seen with bolus iv 5-FU in colon cancer, a trial comparing 5-FU alone or with cisplatin to determine whether true synergy exists is currently underway.
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PMID:Cisplatin plus 5-FU for the treatment of adenocarcinoma of the colon. 407 11

Ceftizoxime (CZX), a parenteral cephalosporin derivative belonging to the so-called third generation cephalosporin is reported to have a broad antibacterial activity, particularly against Gram-negative aerobic bacilli and some anaerobes, such as Bacteroides fragilis and a good stability to beta-lactamases. Clinical study was performed on a total of 20 cases, 9 females (1 case had urinary tract infection 3 times) and 11 males, aged from 27 to 82 years. All patients had the underlying diseases. They were bronchial asthma in 3 cases, influenza in 1, chronic pulmonary emphysema in 1, pulmonary fibrosis in 1, chronic bronchitis with strongyloidiasis in 1, lung cancer in 3, esophagus cancer in 2, stomach cancer in 1, hepatoma with urolithiasis in 1, liver cirrhosis with diabetes mellitus in 1, alcoholism with strongyloidiasis in 1, cholelithiasis in 1 and congestive heart failure in 1, respectively. Clinical diagnoses for infections were 2-acute bronchitis, 2-exacerbation of chronic bronchitis, 2-broncho-pneumonia, 2-pneumonia including one suspected case, 1-obstructive pneumonia, 2-secondary pulmonary infection, 1-pulmonary infection, 3-urinary tract infection (UTI), 1-UTI with sepsis, 1-sepsis, 1-sepsis with purulent meningitis, 1-biliary tract infection and 1-infected bronchoesophageal fistula. CZX was given by intravenous drip infusion, at a dose of 1 to 2 g, twice daily for 3 to 15 days. Because of severity in infections and underlying diseases, some cases were treated either steroid, gamma-globulin preparations or other antibiotics in combination with CZX. Twelve out of 15 cases assessed clinically responded satisfactorily to the treatment and efficacy rate was 80.0%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effectiveness of ceftizoxime on various infections in patients with underlying diseases]. 609 Jul 23

Eighteen patients with established malignant esophagorespiratory fistulas due to primary esophageal cancer were managed by substernal gastric bypass and isolation of the cancerous esophageal segment. Seven fistulas were esophagotracheal and 11 were esophagobronchial. Ten patients died in the hospital between two days and six weeks after operation. Eight patients left the hospital, surviving an average of 3 1/2 months, but 2 patients lived 5 and 7 months, respectively. Unrelenting respiratory infection and clinical inanition caused 7 hospital deaths in patients reestablished on oral alimentation with their fistulas disconnected. Anastomotic leaks occurred in 5 patients; three of these leaks closed. In the other 2 patients, cervicomediastinal sepsis and bilateral pneumonia with respiratory failure caused death. One patient died of anoxic cardiac arrest 48 hours postoperatively. Fifteen of the 18 patients resumed oral alimentation, but the overall results of palliative surgical therapy achieved in this series were not observably worthwhile for the majority.
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PMID:Pessimism concerning palliative bypass procedures for established malignant esophagorespiratory fistulas: a report of 18 patients. 619 80

Conventional treatment of esophageal cancer with surgery or radiation alone has afforded few long-term survivors. In order to improve outcome and determine the efficacy of a combined modality approach, this prospective study was performed. Between May 1993 and August 1994, 27 patients with loco-regional squamous cell carcinoma of the esophagus were treated with 2 courses of combined fluorouracil(1000mg per square meter of body-surface area daily for 5 days) and cisplatin(60mg per square meter on the first day)(D1 and D29) plus 48Gy of radiation therapy(RT) over 4 weeks. A transhiatal esophagectomy was planned 3-4 weeks after chemoradiotherapy. Twenty-seven patients completed a full course of therapy. Clinical response was evaluable in 26 patients: 22 patients showed improvement and relief from dysphagia, 2 patients stable disease, and 2 patients progression. One patient died of sepsis 1 week after completion of chemoradiotherapy and was excluded from the analysis. Ten patients underwent operation after chemoradiation. Of them, 5 showed complete histologic response. One of the complete responders died of recurred disease 8.5months after operation, the other 2 patients died of sudden death, and sepsis from wound deheiscence 7 days after operation, respectively. Nine patients refused operation because of excellent relief of their dysphagia and 6 patients were denied because of disease progression(2), fear of operations(2), old age and family member's disapprovement(1), and underlying liver cirrhosis(1). The last one patient was awaiting for operation. Of 13 patients who refused or denied operation, 6 patients finished further chemotherapy and radiatherapy(external radiation 1200 cGy+intracavitary radiation 900 cGy, 2 cycles of 5FU+cisplatin). This intensive preoperative chemoradiotherapy is feasible, and allows for a high rate of resectability and a high rate of complete pathologic response in a locoregional esophageal cancer. Toxicity is considerable but manageable. This study warrants further investigation.
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PMID:Preoperative chemoradiotherapy for locoregional esophageal cancer: preliminary report. 757 91

We described three septicemia cases in which blood cultures yielded gram-positive cocci identified as Leuconostoc spp. and Pediococcus spp. Patients were three male adults aged 63 to 71 years with severe underlying diseases, pancreatic cancer, esophageal cancer and diabetes mellitus with chronic renal failure. They had fever and chills at the onsets of septicemia with acute obstructive suppurative cholangitis, acute pneumonia, and infection complicated with invasion sites of esophageal cancer contagious to bronchus and subcutaneous tissue. Blood cultures yielded catalase and oxidase negative highly vancomycin-resistant (MIC: 1024 micrograms/ml <) gram-positive cocci showing alpha or gamma hemolysis on blood agar plates. Two cases were polymicrobial infections. In one case with esophageal cancer, clinical symptoms persisted after the start of antimicrobial chemotherapy and the patient died 10 days later associated with complications of esophageal cancer. Leuconostoc lactis, Leuconostoc mesenteroides subsp. dextranicum, and Pediococcus acidilactici wee identified by physiological reactions. These strains were also highly resistant to teicoplanin and fosfomycin, and tolerant to all rested beta-lactams such as benzylpenicillin. This is the first report in Japan to our knowledge on the identification of Leuconostoc spp. and Pediococcus spp. isolated from human infectious diseases.
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PMID:[Microbiological and clinical studies of vancomycin resistant Leuconostoc spp. and Pediococcus spp. isolated from septicemia patients]. 796 99

Alternating chemoradiotherapy has recently been reported to produce encouraging results in patients with advanced head and neck cancer. We have treated 17 patients with squamous cell carcinoma of the upper esophagus by alternating chemoradiotherapy and by following the patients for 2 to 5 years, or until their death. Chemotherapy (cisplatin and 5-fluorouracil) was delivered during weeks 1, 4, and 7, and radiotherapy (180 to 200 cGy twice each day to 2,000 cGy) during weeks 2, 5, and 8 (total 6,000 cGy). Three patients (18%) died of toxicity (nadir sepsis). All 14 patients who survived the treatment achieved a complete response as shown by endoscopy and biopsy specimens, with restoration of swallowing, and none experienced a local relapse. Three patients died of distant metastases (actuarial incidence 32% at 3 years). The 5-year survival rate was only 16%, however, because 8 other patients with no evidence of the cancer died of a variety of other causes: radiation pneumonitis (1), chronic neutropenia (1), esophageal actinomycosis (1), pneumonia (2), stroke (1), myocardial infarction (1), and small-cell lung cancer (1). Conceivably, some further improvement in the results might occur from cytokines, stem cells, and brachytherapy (by decreasing deaths due to toxicity), but with so many causes of comorbidity it seems unlikely, for the foreseeable future, that the 5-year survival rate could be much improved by better treatment of esophageal cancer.
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PMID:Patterns of failure in carcinoma of the upper esophagus after alternating chemoradiotherapy. 797 65

We have performed combined chemotherapy with 5-FU, a biochemical modulator, and low dose CDDP for advanced or recurrent cancer of the digestive system. The therapy was effective in 37% of all cases and in 45.5% and 41.6% of esophageal and gastric cancer cases, respectively. In addition, few patients developed adverse side effects including renal disorders, one of the major side effects of CDDP. Therefore, we considered home anti-cancer chemotherapy feasible. For 27 outpatients with advanced cancer of the digestive system including 15 cases of esophageal cancer, 4 cases of gastric cancer, 3 cases of colon cancer, 4 cases of pancreatic cancer and 1 case of gall bladder cancer, 4 to 6 week home adjuvant chemotherapy was performed. The regimen comprised 1 week of oral administration of 300 mg/body/day of UFT-E granules and 5 days of continuous intravenous infusion of 25 mg/body/day of CDDP using an infusor pump. During the follow-up, 3 cases of catheter obstruction, 3 cases of catheter sepsis and 1 case of pneumothorax appeared. These complications all resulted from the catheter, and safe home anti-cancer chemotherapy could be continued because 5-FU and CDDP did not cause severe side effects.
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PMID:[Combined chemotherapy with 5-FU and low dose CDDP for advanced or recurrent cancer of the digestive system and home anti-cancer chemotherapy]. 884 89

Cisplatin (P) and 5-fluorouracil (5FU) have demonstrated activity for the treatment of squamous cell carcinoma of the esophagus. Previous studies have shown that leucovorin (L) may potentiate the antitumoral activity of 5FU, so we tested the combination P-5FU-L in 31 patients with inoperable squamous cell esophageal carcinoma. Chemotherapy consisted of P 20 mg/m2 in 4 h, followed by L 200 mg/m2 in 2 h and 5FU 600 mg/m2 in 18 h. This schedule was repeated for 5 days every 4 weeks. The treatment plan included three courses of chemotherapy followed by radiotherapy. The overall response rate was 58% (95% CI = 39-76%), with one complete remission (3%), and 61% of patients reported an improvement in dysphagia. Gastrointestinal toxicity was the main side effect: grade 3-4 mucositis appeared in 19% of patients, grade 3-4 nausea/vomiting in 13%, and grade 3-4 diarrhea in 6.5%. There was one toxic death caused by neutropenia and sepsis. Nineteen patients received local radiotherapy after chemotherapy, which increased the overall response rate to 63% (5% complete responses). Dysphagia improved in 75% of them. The median survival for all patients was 11 months. This study shows that sequential therapy with P-5FU-L and radiotherapy achieves a high response rate as well as adequate symptomatic relief in patients with inoperable esophageal cancer. The results justify further evaluation of P-5FU-L in patients with earlier-stage disease.
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PMID:Phase II study of cisplatin, 5-fluorouracil, and leucovorin in inoperable squamous cell carcinoma of the esophagus. ONCOPAZ Cooperative Group, Spain. 893 75

The incidence of bacteria caused postoperative infections was performed at the timing when bacteria or fungi is not yet detected. This period is important for management of postoperative infections. MRSA, E. faecalis, P. aeruginosa and fungi were detected with high frequency irrespective of the surgical area. After the operation of esophageal cancer, the most frequent infection was postoperative pneumonia, and the isolated bacteria was P. aeruginosa frequently. In the cases of gastric cancer, hepato-biliary-pancreas cancer and colorectal cancer, intraabdominal sepsis was the highest incidence, and the isolated bacteria was E. faecalis. In terms of intravenous catheter infection, fungus was common. Thus, it may suggest that we can identify the bacteria caused, and the management for postoperative infections was performed appropriately by using the antibiotics which have the sensitive against the expected pathogen.
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PMID:[Severe surgical infection with no information in terms of bacteria]. 903 83

In surgery, deep-seated fungal infection is not rare. In our institute, fungal infection was analyzed during postoperative periods. As pathogen, fungus was the second frequent pathogen after the operations for esophageal cancer and gastric cancer, and the third pathogen after hepatobiliopancreatic cancer and colon cancer. Furthermore, fungus was found more frequently pathogen from distant infection than that from local foci. Especially in CV catheter sepsis, fungus was main pathogen (60 %). In order to inhibit CV catheter sepsis, nutrition support team (NST) has been induced in our institute for prevention of external pathway of fungus. After NST, the frequency of CV catheter sepsis decreased from 12 % to 3.6 %, and the isolated frequency of fungus in catheter sepsis patients also decreased from 84 % to 16 %, respectively. It demonstrates that the activity of NST successfully prevents the external pathway of fungus in CV catheter indwelling patients. However, internal pathway (fungal translocation) still remains, and that issue has to be overcome. Molecular biological technique was applied for diagnosis of fungemia. PCR-RFLPs was performed by using specific primer of 18s rRNA in V4 region. Clinical samples were applied for PCR-RFLPs, and antifungal therapy was performed according as the results of PCR-RFLPs. It indicated that molecular biological technique was useful for diagnosis of fungemia.
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PMID:[Deep-seated fungal infection in surgery]. 979 64


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