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Biomedical subjects

A Byrne

Publications and source records attributed to A Byrne.

At least 55 records · Page 3Linked to original sources
PubMed1994

Etoposide in the treatment of elderly/poor-prognosis patients with small-cell lung cancer.

Survival rates for cancer have improved in recent decades, specifically for younger patients. However for those over 65, who account for over half of all cancer patients, mortality rates remain poor. In those with small-cell lung cancer the achievement of cure is possible in only a minority (5-10%). For the elderly and those with extensive disease we have found that the use of oral etoposide offers similar survival rates to more intensive regimens, with minimal side effects and hospitalisation. Thus the expansion of the elderly population mandates for more specific chemotherapeutic approaches in this group.

Adult↗
PubMed1994

Comparable prognostic factors and survival in elderly patients with aggressive non-Hodgkin's lymphoma treated with standard-dose adriamycin-based regimens.

We retrospectively analysed the prognostic factors at diagnosis, clinical response, and survival of 192 patients with newly diagnosed aggressive NHL treated in a single institution between 1985 and 1991. Overall, 37.5% (72/192) of patients were 65 years or older (average age 71 years, range 65-85 years), and 62.5% (120/192) were under 65 years of age (average age 45, range 16-64 years). All patients were completely staged and had intermediate- or high-grade NHL. 127 patients were treated on similar regimens with the same chemotherapy dose intensity irrespective of age. Standard-dose m-BACOD (methotrexate, bleomycin, Adriamycin, cyclophosphamide, vincristine, prednisone) or CHOP were used to treat 60/72 (83%) elderly patients and 67/120 (56%) patients less than 65 years. The remaining younger patients were treated with more intensive regimens. There were no significant differences between the groups with regard to stage, histological grade, cell type, elevated LDH, number of extranodal sites, presence of B symptoms, or bulky disease. More elderly patients had a significantly (p < 0.02) poorer performance status (PS), with 42% (25/60) having a PS of 2 or more, compared to 22% (15/67) in those less than 65 years of age. Elderly patients had an inferior complete response rate, 65% versus 76%. However, overall response rates of 95% and 92% were similar. The disease-free survival at 3 years for complete responders in elderly patients was 74% compared to 82% in those under 65. The comparable 3-year overall survival was 59% and 62%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Pharmacokinetics and safety of weekly dapsone and dapsone plus pyrimethamine for prevention of pneumocystis pneumonia.

The safety and pharmacokinetics of weekly dapsone and weekly dapsone plus pyrimethamine were examined in adult patients with human immunodeficiency virus infection who were at risk for pneumocystis pneumonia because of a prior episode or a CD4+ T-cell count less than 250 cells per mm3. Groups of patients received 100, 200, and 300 mg of dapsone as a single weekly dose. The maximum tolerated dose of weekly dapsone was established as 200 mg per week in patients receiving at least 500 mg of zidovudine concomitantly. This dose of dapsone was then found to be well tolerated when combined with pyrimethamine at 25 mg. Further patients were randomized to dapsone at 200 mg or dapsone at 200 mg plus pyrimethamine at 25 mg once weekly. Twenty-six patients each were followed for a median of 33 weeks on dapsone alone and 45 weeks on the combination. Seven patients in each group withdrew because of toxicity. Five patients receiving dapsone developed documented pneumocystis pneumonia, while four and two patients receiving dapsone plus pyrimethamine developed documented and presumptive pneumocystis pneumonia, respectively. To evaluate the tolerability of a higher dose of pyrimethamine, 11 patients had their regimen changed to dapsone at 200 mg plus pyrimethamine at 75 mg, which was well tolerated by 10 of the patients for a median period of 11 weeks. The pharmacokinetics of dapsone and pyrimethamine were examined by using a population pharmacokinetic model. Decreases in the apparent volume of the peripheral compartment were observed when multiple-dose regimens of dapsone were compared with single-dose dapsone and when multiple-dose regimens of dapsone with pyrimethamine were compared with multiple-dose dapsone alone. When administered weekly, dapsone at 200 mg and dapsone at 200 mg with pyrimethamine at 25 mg are both well-tolerated regimens. This preliminary study suggests that the efficacy of these regimens in preventing pneumocystis pneumonia, however, may be less than that of trimethoprim-sulfamethoxazole.

AIDS-Related Opportunistic Infections↗
PubMed1994

Severe hypotension associated with combined lithium and chlorpromazine therapy: a case report and a review.

The case of a patient who developed a severe hypotensive reaction with a persistent hemianaesthesia following the addition of lithium carbonate to her treatment regimen is described. The patient had been receiving chlorpromazine therapy for the management of hypomania and the addition of lithium carbonate to the chlorpromazine produced a severe hypotensive episode which compromised her neurological functioning. Only three doses of lithium carbonate had actually been taken by the patient. This type of hypotensive response associated with the simultaneous use of chlorpromazine and lithium has not previously been noted in the literature.

Bipolar Disorder↗
PubMed1994

Benzodiazepines: the end of a dream.

It is suggested that the medical profession needs to reassess current use of benzodiazepines in light of new evidence of habituation and side effects. We should encourage patients with insomnia and anxiety to persevere with non drug treatments. Before prescribing, we must inform patients of the addictive potential of the drug.

Benzodiazepines↗
PubMed1994

Small cell lung cancer in the elderly.

Mortality rates for patients with lung cancer remain high, despite advances both in our understanding of lung cancer biology and in survival statistics for other types of cancer. Important strategies for improving the figures for lung cancer are identification of subgroups at highest risk for the disease and targeting high-intensity therapy to patients with the greatest chance for cure. In this context, special attention must be given to the elderly population, which accounts for approximately 60% of all cancer cases. Recognizing that close to 13% of the population of the United States can be considered elderly and that this figure is expected to more than double over the next 40 years, the elderly cohort clearly has a significant impact on cancer statistics in general. While approximately 26% of lung cancer patients are potentially curable, the 74% majority has only a remote chance of being cured of their disease. More active therapeutic modalities, with a meaningful effect on survival and quality of life but with more acceptable toxicity than intensive therapy designed for patients with a good chance of cure, are clearly needed for these patients. Several studies have demonstrated that use of oral active agents such as etoposide, alone or in combination with other agents, produce an overall response rate and median survival time similar to those of the more intensive schedules. Once further studies clarify the optimum schedule for use of oral etoposide, it is hoped that its use in combination with other therapeutic agents and/or with radiation therapy will improve the overall response and survival rates among patients at high risk or with poor prognostic factors, such as the elderly.

Age Distribution↗
PubMed1993

Transient neurogenic stuttering.

The occurrence of a transient neurogenic stutter in a male anorexic patient is described. The stutter developed following a prolonged period of starvation, and during refeeding the patient recovered from the stuttering behavior. The patient was not receiving any drugs known to cause stuttering, and it is postulated that the stutter developed as a result of the gross impairment of brain function secondary to chronic starvation. A review of the literature has failed to reveal any information on anorexia nervosa as a cause of neurogenic (acquired) stuttering.

Adult↗