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Biomedical subjects

F Ries

Publications and source records attributed to F Ries.

At least 73 records · Page 4Linked to original sources
PubMed1991

Barbiturates in severe head injuries?

Possible mechanisms for the therapeutic effects of barbituric acid derivatives in severe head injuries have been discussed for half a century. In the following, a survey of the literature, and a discussion of three controlled clinical studies available until now is presented. A proven effect in terms of a beneficial long-term outcome for all injured patients has not been established. On the other hand there might be a subgroup of patients with an intact CO2 reactivity of the brain vessels who may profit from barbiturates administered after head trauma.

Barbiturates↗
PubMed1991

Treatment of advanced and refractory breast cancer with doxorubicin, vincristine and continuous infusion of verapamil. A phase I-II clinical trial.

Cancer cell resistance to several cytotoxic drugs, including doxorubicin and vincristine can be reduced in vitro by verapamil; this drug works at least in part by inhibitive competition for the multiple-drug resistance efflux-pump P-glycoprotein-170. To evaluate the clinical potential of this experimental concept we combined verapamil in continuous infusion with adriamycin and vincristine in the treatment of patients with advanced and anthracycline-refractory breast cancer. Sixteen patients were included and 55 treatment courses were given at different dose levels of chemotherapy; verapamil was given by continuous infusion of 0.003 mg kg-1 min-1 for 48 h. Overall, cardiac toxicity was low but a potentiation of neurotoxicity and hematotoxicity was observed. The objective response rate was 21% (3 partial responses in 16 patients) and the median survival was 6 months; these results are comparable to those of other second line treatment studies, using drugs not supposed to be cross-resistant.

Adult↗
PubMed1991

Prion diseases in man.

Human spongiform encephalopathies (HSE) are uncommon neurodegenerative diseases of unknown etiology. Whilst numerous observations provide arguments for an infectious disorder mediated by an unconventional agent of the so-called prion-type, the recent discovery of predisposing allelic variants suggests that HSE might be considered as genetically linked diseases.

Animals↗
PubMed1991

[Cavernous angiomas in the differential diagnosis of cerebrovascular malformations].

Cavernous angiomas, although rare, represent a clinical and a neuroradiological challenge in the differential diagnosis of cerebrovascular malformations. We report about three cases with a total of seven cavernous angiomas. Clinical features include intracerebral hemorrhage, epileptic seizures and focal neurological signs. Diagnosis is based on typical findings in MRI in combination with an angiography presenting a normal vascular situation or an avascular mass lesion, whereas CT-scan shows nonspecific features. Surgical removal is generally recommended, but could not be done in our cases. A histological verification of a clinically typical diagnosis is not mandatory. Indication for proton beam irradiation still has to be discussed. A definite therapeutical approach will have to consider the natural history in a larger number of cases.

Adult↗
PubMed1991

Correlation of regional cerebral blood flow and blood flow velocity in normal volunteers and patients with cerebro-vascular disease.

Transcranial Doppler sonography and measurement of regional cerebral blood flow using the Xenon133-inhalation technique have been used simultaneously in 10 normal volunteers and 13 patients with acute-onset cerebrovascular disorders during normocapnia and during hyperventilatory hypocapnia. Hypocapnia led to a reduction of both blood flow and blood velocity in the territory of the middle cerebral artery. However, correlation was poor in most cases with respect: 1) to hemispheric blood flow and flow velocity over the middle cerebral artery (BFV), 2) cerebral blood flow (CBF) over the middle cerebral artery (MCA) and BFV and 3) percentage changes of CBF over the MCA and BFV during hypocapnia. In normals correlation usually was better than in patients with cerebrovascular disorders. It was concluded that measurement of BFV over the MCA using transcranial Doppler sonography does not reflect either cerebral tissue perfusion or changes of tissue perfusion induced by alteration of CO2-content in the arterial blood.

Adult↗
PubMed1991

Air microbubbles as a contrast medium in transcranial Doppler sonography. A pilot study.

An insufficient signal-to-noise ratio is a significant limiting factor in assessing intracranial hemodynamic parameters by transcranial Doppler sonography. To establish the feasibility and validity of signal enhancement in transcranial Doppler sonography, stabilized air microbubbles bound to galactose microparticles as a carrier (SHU 454) were used in an animal model. The disadvantage of a short-lasting effect is caused by instability of the contrast medium and a consequent reduced capacity to pass through the lung. Eight pigs received SHU 454 intraarterially in various concentrations and forms of application during transcranial monitoring of the middle cerebral artery with a 2 MHz pulsed ultrasound device. The effect was reproducible, dependent on the dose and application modalities. The best results were obtained with low concentrations (100 mg of microparticles/ml of suspension) and low injection speeds (0.5-1.0 ml/sec) into the common carotid artery by injection pump, reaching a homogeneous average enhancement of 6 to 12 dB over at least 5 minutes. Histological examination of the brain showed no evidence of air embolization. Further development requires a stable solution with similar properties and an ability to pass through the lung, therefore being suitable for intravenous application in humans.

Air↗
PubMed1990

Cisplatin combined with carboplatin: a new way of intensification of platinum dose in the treatment of advanced ovarian cancer. Belgian Study Group for Ovarian Carcinoma.

We performed a phase I-II trial of escalating doses of cisplatin (CDDP: 50-100 mg/m2 per course) plus carboplatin (CBDCA: 300-400 mg/m2 per course) as a potential way in which to maximize platinum doses without causing excessive toxic effects in patients with advanced ovarian cancer. Thirty-three patients with nonoptimally debulked disease of FIGO (International Federation of Gynecology and Obstetrics) stages IIc-IV [median age: 60 yr; median WHO (World Health Organization) performance status: 2; no prior chemotherapy] received a median of six courses of therapy. CBDCA was infused on day 1 and CDDP on day 2 with an aggressive 48-hour hydration regimen. Myelosuppression was dose-limiting: at the highest dose levels, WHO grade 4 neutropenia and thrombocytopenia led to dose reduction and/or treatment delay in 45% of the patients. Nonhematologic toxic effects included acute nausea and vomiting (97% of the patients), mild alopecia (45%), ototoxic effects (39%), neurotoxic effects (21%), and renal toxic effects (serum creatinine greater than 1.5 mg/dL: 12.5%). The pathologic complete response rate was 22%. We conclude that CBDCA and CDDP can be given safely in combination at reasonably high doses (CBDCA at 300 mg/m2 per course and CDDP at 100 mg/m2 per course) over a 6-month period, provided a close hematologic follow-up is conducted. Randomized clinical trials are needed to define whether this regimen is any better than standard combination chemotherapy.

Adult↗
PubMed1990

A comparison of ondansetron with metoclopramide in the prophylaxis of chemotherapy-induced nausea and vomiting: a randomized, double-blind study. International Emesis Study Group.

The efficacy of ondansetron was compared with metoclopramide in the prophylaxis of nausea and vomiting induced by cyclophosphamide greater than or equal to 500 mg/m2 in combination with doxorubicin greater than or equal to 40 mg/m2 or epirubicin greater than or equal to 40 mg/m2. complete anti-emetic protection in the 24 h following chemotherapy was achieved in 26 of 40 (65%) patients treated with ondansetron compared with 17 of 42 (41%) patients treated with metoclopramide. Severe nausea was present in 3% of patients in the ondansetron group and 31% in the metoclopramide group. A worst day analysis of control of emesis and nausea on days 2 and 3 following chemotherapy also demonstrated ondansetron to be more effective than metoclopramide. Both treatments were well tolerated. Ondansetron is more effective as an anti-emetic than metoclopramide in this type of cytostatic therapy.

Adult↗
PubMed1990

Camembert, Listeria and the immunocompromised patient.

Listeriosis is a rare but well known infectious complication in pregnant women and immunocompromised patients. Epidemiological studies have shown an association between listeriosis and alimentary contamination by listeria of a variety of foodstuff including soft, ripened cheeses. We describe two case-reports of listeria meningitis with high evidence of food-related illness due to the consumption of contaminated camembert. These observations urged our State Department of Health to formulate a communication about alimentary listeriosis at the intent of all health care professionals, including recommendations for patients at risk.

Aged↗
PubMed1988

Role of intensive care unit in a medical oncology department.

Over a 4-year period, 912 patients were admitted to the ICU of the medical oncology service at the Institut Jules Bordet: 574 (63%) were admitted for medical emergencies and 338 (37%) for intensive treatment and/or monitoring. In the first group, the main causes of admission were hypercalcemia, thromboembolic disease, cardiac arhythmias, encephalopathies and pneumopathies. Overall mortality during the ICU stay was 23% (133/574). In the second group, patients were admitted primarily in order to receive, under optimal surveillance, anticancer treatment, either because they were at high risk of complications or because the approach was mainly investigational; several investigations, in the fields of supportive care and anticancer treatment, were successfully conducted within the ICU environment.

Arrhythmias, Cardiac↗
PubMed1987

[Intracranial and intraspinal hemorrhages in treatment with coumarin derivatives. Catamnesis of 63 cases between 1978 and 1986].

From 1978-1986, 63 patients (48-79 years) under coumarin derivatives had to be hospitalized neurosurgically because of intracranial or intraspinal bleedings. This corresponds to a twelvefold increased risk compared to the untreated people. The male/female ratio was 1.5. At the time of the bleeding there was no true indication for anticoagulation in at least 60% of the patients. 80% with coma on admission died. Only for 2/7 with an intraspinal hemorrhage the outcome was better than paraplegic. Women proved to have a better chance of survival. There is a need for more concise indications for chronic anticoagulation.

Acenocoumarol↗