Adriamycin alopecia prevented by cold air scalp cooling.

Preliminary studies are reported on the effectiveness of cold air scalp cooling to prevent alopecia in patients receiving Adriamycin. Cold air produced in a novel way using a vortex refrigeration tube was applied to the scalp for 15 min before and 30 min after the administration of Adriamycin and other cytotoxic agents. Sixteen of 26 patients had no hair loss, four had slight hair loss, and six required a wig. Two subgroups fared particularly well. Four of four patients treated with ABVD for Hodgkin's disease and nine of 13 treated with Adriamycin (40 mg/m2) and vincristine (2 mg) for breast cancer had no hair loss.

Acute respiratory distress in diabetic ketoacidosis: possible contribution of low colloid osmotic pressure.

The "shock lung" syndrome may occur in diabetic ketoacidosis in association with disseminated intravascular coagulation; occasionally it occurs alone after treatment of the ketoacidosis. Two patients developed pulmonary opacities with clinical features of acute respiratory distress such as are seen in the shock lung syndrome; in both, however, the findings suggested a different mechanism from that occurring in the syndrome. Hypoalbuminaemia was prominent, and it is postulated that a low plasma osmotic pressure caused by high volume crystalloid infusions may have precipitated the acute respiratory complications. Plasma osmotic pressure may be an important variable in patients given large volumes of crystalloid infusions; further studies are required to elucidate mechanisms of pulmonary oedema in such patients.

Prognostic factors in non-Hodgkin's lymphoma: the importance of symptomatic stage as an adjunct to the Kiel histopathological classification.

A prospective study of prognostic factors for patients with non-Hodgkin's lymphoma was carried out based on the Kiel histopathological classification. Other presentation features assessed for prognostic value included clinical features, haematological and biochemical findings, and immunochemical findings. The most powerful factors that emerged were the presence or absence of systemic symptoms and the histopathological grade of malignancy of the lymphoma (whether low or high grade). These 2 factors were largely independent. Clinical Stage I disease also carried a good prognosis, but beyond this, staging gave little further prognostic information. Nine of the group of 15 patients with Stage I high grade lymphoma have achieved prolonged disease-free survival after local therapy only. After allowing for histopathology and symptom assessment in patients with Stage II-IV disease, other factors, with the exception of C-reactive protein levels, were of minor importance.