RESUMEN
We report a case of steroid-induced acute tumor lysis syndrome and review the literature. A 60-year-old woman was started on steroid therapy for dyspnea due to bilateral pleural effusion and a large mass involving the anterior mediastinum. The final diagnosis was precursor T-lymphoblastic lymphoma-leukemia. Following steroid therapy, the patient developed acute renal failure and laboratory evidence of metabolic changes induced by massive cytolysis. She received vigorous hydration, diuretic and allopurinol therapy, and haemodialysis. Her diuresis, renal function and laboratory data returned to normal within 2 weeks. A review of the medical literature on T-cell lymphoma revealed only one similar case of steroid-induced acute tumor lysis syndrome, a life-threatening metabolic emergency. This risk should be kept into account in the management of patients with lymphoproliferative disorders.
Asunto(s)
Dexametasona/efectos adversos , Linfoma de Células T/tratamiento farmacológico , Síndrome de Lisis Tumoral/etiología , Enfermedad Aguda , Femenino , Humanos , Persona de Mediana EdadRESUMEN
Association of all-trans retinoic acid (ATRA) and amifostine (AMF) might be an alternative in treatment of myelodisplatic syndromes. In this study we undertook a preliminary in vitro research on the effects of a combination of ATRA and AMF on normal hemopoietic progenitors. Mononuclear, non-adherent cells from peripheral blood of normal volunteers, were incubated with AMF, at a the concentration of 500 microM and then cultured for CFU-GM and BFU-E growth adding to culture dishes before gelling ATRA at the concentration 10(-6) and 10(-12)M. Controls were cultures not pre-incubated with AMF, cultures incubated with AMF without addition of ATRA and cultures without addition of any drug. ATRA addition did not have significant effects on hemopoietic progenitors growth. Association of ATRA and AMF do not appear to synergize to stimulate in vitro growth of hemopoietic progenitors.
Asunto(s)
Amifostina/farmacología , Antineoplásicos/farmacología , Antioxidantes/farmacología , Células Madre Hematopoyéticas/efectos de los fármacos , Leucocitos Mononucleares/efectos de los fármacos , Tretinoina/farmacología , División Celular/efectos de los fármacos , Células Cultivadas , Sinergismo Farmacológico , Células Precursoras Eritroides/citología , Células Precursoras Eritroides/efectos de los fármacos , Células Madre Hematopoyéticas/citología , Humanos , Leucocitos Mononucleares/citologíaRESUMEN
A reduced-order model based on proper orthogonal decomposition (POD) is proposed for the bidomain equations of cardiac electrophysiology. Its accuracy is assessed through electrocardiograms in various configurations, including myocardium infarctions and long-time simulations. We show in particular that a restitution curve can efficiently be approximated by this approach. The reduced-order model is then used in an inverse problem solved by an evolutionary algorithm. Some attempts are presented to identify ionic parameters and infarction locations from synthetic electrocardiograms.