ABSTRACT
A 49-year-old woman received an autologous transplant for breast cancer. Six weeks later she noticed visual disturbance of the left eye which correlated with a visual field abnormality. There was a milder degree of visual disturbance in the right eye. Treatment with high-dose steroids partially stabilized the problem, which was felt to be an ischemic optic neuropathy. She ultimately died of respiratory failure. Pathology of the optic nerves revealed demyelination. Visual disturbances following high-dose chemotherapy are uncommon; the pathology to date has not been elucidated. Steroid therapy may be useful.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Bone Marrow Transplantation , Breast Neoplasms/therapy , Demyelinating Diseases/chemically induced , Hematopoietic Stem Cell Transplantation , Ischemia/chemically induced , Optic Nerve/blood supply , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cisplatin/administration & dosage , Cisplatin/adverse effects , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Cyclophosphamide/adverse effects , Demyelinating Diseases/diagnosis , Diagnosis, Differential , Doxorubicin/administration & dosage , Doxorubicin/adverse effects , Fatal Outcome , Female , Fluorouracil/administration & dosage , Fluorouracil/adverse effects , Humans , Ischemia/diagnosis , Mastectomy, Modified Radical , Methotrexate/administration & dosage , Methotrexate/adverse effects , Middle Aged , Paraneoplastic Syndromes/diagnosis , Respiratory Insufficiency/etiology , Scotoma/chemically induced , Transplantation Conditioning , Visual FieldsABSTRACT
Hyperthermia has been combined with conventional radiation methods to achieve enhanced tumor destruction. We combined iodine 125 seeds with ferromagnetic thermoseeds in a single plaque to simultaneously deliver radiation and heat in a rabbit model of choroidal melanoma. Initially, six ferromagnetic thermoseeds were placed in parallel on a 14-mm episcleral plaque. The plaques were placed on normal rabbit eyes and on eyes containing transvitreally implanted choroidal melanoma. The heating response was assessed in both normal and tumor-containing eyes. Rigid copper-constantan and flexible Baily thermocouples were used to monitor temperature responses. The animals were subjected to an electromagnetic field of 100 kHz, with power of 1100 to 1500 W. The thermoseeds autoregulated at 48.2 degrees C. Scleral temperatures stabilized at 45.8 degrees C +/- 0.4 degrees C (SD), while temperatures at the base of the tumor stabilized at 43.6 degrees C +/- 0.1 degrees C. Ferromagnetic thermoseeds were then combined with iodine 125 seeds. Similar temperature responses were recorded, and autoradiographic findings confirmed a uniform radiation distribution. Varying the amount or type of ferromagnetic material in the thermoseeds allows the delivery of heat at virtually any temperature. Ferromagnetic hyperthermia may provide a more simplified approach over currently available methods of heat delivery.
Subject(s)
Brachytherapy , Choroid Neoplasms/therapy , Hyperthermia, Induced/methods , Melanoma/therapy , Animals , Brachytherapy/methods , Choroid Neoplasms/pathology , Combined Modality Therapy , Disease Models, Animal , Ferric Compounds , Hyperthermia, Induced/instrumentation , Iodine Radioisotopes/therapeutic use , Magnetics , Melanoma/pathology , RabbitsABSTRACT
An open, non-comparative, multi-centre study was carried out in general practice to assess the effectiveness, acceptability and tolerability of a 1% clotrimazole plus 1% hydrocortisone cream in the treatment of 112 infants with napkin dermatitis. The cream was applied twice daily to the affected area for 7 days and treatment was extended to 14 days for those who failed to respond adequately. Assessments made of the severity of symptoms showed that there was significant improvement in erythema, irritation and pustulation in all but a few patients and an overall impression of clinical response made at the last patient visit indicated that 92% of the patients were considered to have been cured or markedly improved. Acceptability and tolerability were good. In 2 cases, parents reported adverse reactions of discomfort during application of the cream and in 1 of these cases treatment was withdrawn after 4 days.
Subject(s)
Clotrimazole/administration & dosage , Diaper Rash/drug therapy , Hydrocortisone/administration & dosage , Imidazoles/administration & dosage , Clinical Trials as Topic , Drug Combinations , Female , Humans , Infant , Male , Time FactorsABSTRACT
A single-blind multicentre crossover study was carried out in general practice of 47 patients with symptoms due to hyperacidity. Patients were allocated at random to receive treatment either with Gastrils for the first 2 weeks followed by Aludrox tablets for the second 2 weeks, or with Aludrox tablets for the first 2 weeks followed by Gastrils for the second 2 weeks. Clinical evaluation took place initially, after the first 2 weeks treatment and after the second 2 weeks treatment. The efficacy and acceptability of both preparations were compared, likewise the flavours of different Gastrils packs. Analysis of the results showed that peppermint flavoured Gastrils were significantly preferred to Aludrox tablets, and a peppermint flavour to a banana flavour. Side-effects were significantly more prevalent with Aludrox tablets. Differences in antacid response were similar, but numerically, if not statistically significantly, Gastrils had a more beneficial effect.
Subject(s)
Aluminum Hydroxide/therapeutic use , Gastric Acid/metabolism , Magnesium/therapeutic use , Adolescent , Adult , Aged , Aluminum Hydroxide/adverse effects , Drug Evaluation , Female , Humans , Magnesium/adverse effects , Male , Middle AgedABSTRACT
Fifteen general practitioners conducted a randomized, double-blind comparative trial of two cerumenolytics, namely, Otocerol and Cerumol. A total of 106 patients were entered into the study (fifty-three in each group). Otocerol was shown to be marginally better than Cerumol in all parameters evaluated.