Clinical insights into cisplatin-induced arrhythmia in a patient with locally advanced non-small cell lung cancer: a case report.

OBJECTIVE: Cardiotoxicity is a common adverse effect of many antineoplastic agents, including anthracyclines and paclitaxel. However, it has not been defined as a causal side effect of cisplatin. Here we report on a patient with locally advanced non-small cell lung cancer who developed a cardiotoxic event induced by cisplatin that manifested primarily as arrhythmia. MATERIALS AND METHODS: Intensive cardiac monitoring through electrocardiogram was performed to estimate the severity degree and clinical condition of arrhythmia. RESULTS: The frequency and severity of the arrhythmia had a strong temporal relationship with the administration of cisplatin, that made it likely that cisplatin was responsible for the cardiotoxicity observed. CONCLUSIONS: In the present case report, we discuss the potential factors that may provide pivotal contributions to the patient's susceptibility to cardiotoxicity and review the published studies regarding the cardiotoxic influence of cisplatin. We also outline the critical points that oncologists should be aware of when dealing with such high-risk patients.

Effects of cigarette smoking and smoking cessation on plasma constituents and enzyme activities related to oxidative stress.

In order to study effects of cigarette smoking and smoking cessation on plasma constituents and enzyme activities related to oxidative stress, 1255 smokers and 524 healthy non-smokers were investigated in terms of plasma levels of lipoperoxides (LPO), nitric oxide (NO), vitamin C (VC), vitamin E (VE) and beta-carotene (beta-CAR). Additionally, erythrocytes were examined to determine the level of LPO, the activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px). The results showed that, when compared with the average values of the non-smoker group, the average plasma values of LPO, NO and the average erythrocyte value of LPO in the smoker group were significantly increased (P < 0. 001), while the average plasma values of VC, VE, beta-CAR, and the average erythrocyte activities of SOD, CAT, GSH-Px were significantly decreased (P < 0.001). A linear regression and correlation analysis for 65 male smokers who were all 40 years old showed that with longer smoking duration and greater daily smoking quantity, the plasma values of LPO, NO and the erythrocyte value of LPO were elevated, while the plasma values of VC, VE, beta-CAR and erythrocyte values of SOD, CAT, GSH-Px were decreased. In a group of 73 smokers who stopped smoking completely for six months, the average plasma values of LPO, NO and the average erythrocyte value of LPO decreased, although they were still significantly higher than those in the matched non-smoker group (P < 0.05). Additionally, the average plasma values of VC, VE, beta-CAR and the average erythrocyte values of SOD, CAT, GSH-Px increased, although they were still significantly lower than those in the matched non-smoker group (P < 0.05). However, after smoking cessation for one year the above average values were not significantly different from those in the matched non-smoker group (P > 0.05). This finding indicates that the markedly increased oxidative stress in smokers might gradually return to normal but only after a long period of smoking cessation. In conclusion, in the bodies of smokers a series of free radical chain reactions were gravely aggravated, the dynamic balance between oxidation and antioxidation was seriously disrupted, and oxidative stress was clearly exacerbated, which is closely related to many disorders or diseases in smokers. The present study underscored the need, urgency and importance of complete smoking cessation.