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Biomedical subjects

G Nitenberg

Publications and source records attributed to G Nitenberg.

At least 73 records · Page 4Linked to original sources
PubMed1988

Value of semiquantitative cultures of blood drawn through catheter hubs for estimating the risk of catheter tip colonization in cancer patients.

Colonization of central catheter tips has been associated with catheter-related infections. This colonization is defined as the presence of over 15 CFU in a semiquantitative catheter tip culture performed after catheter removal. Using a simple pour-plate technique, we determined the microbial concentrations in samples of blood collected via the hubs of 205 central catheters while they were in position in 179 cancer patients. All catheters were removed within three days of blood collection via the hub and cultured semiquantitatively. We then compared the results for the hub blood cultures and catheter tip cultures. Cultures from 18% of the hub samples and 29% of the tips were positive. When a cutoff limit of 1,000 CFU/ml was used for the blood cultures, the sensitivity was 20% and the specificity was 99% for estimating catheter tip colonization. These values did not seem to be related to the underlying disease, the site of catheter insertion, or the antibiotic treatment administered at catheter removal. We conclude that, if positive, cultures of blood sampled via the catheter hub can be useful in assessing the risk of catheter colonization in cancer patients.

Bacteria↗
PubMed1988

[Enteral nutrition in digestive cancer].

In view of the frequency and the importance of denutrition in digestive cancer patients, continuous enteral nutrition (EN) might be an useful adjuvant treatment should these patients be able to receive an efficient anti-tumoral course of treatment. EN is as effective as total parenteral nutrition in undernourished patients and probably decreases the extent and the frequency of post-operative complications. In contrast, when considered as a complement to radiation therapy or chemotherapy, EN does not enhance tolerance of treatment, response rate nor survival even though it improves the patient's nutritional status. These results must be considered with caution as most of the randomized trials conducted have only included small groups of patients. Further randomized trials are required in homogenous populations of digestive cancer patients in a state of undernutrition and who are eligible candidates for curative treatment. Basic research projects aiming at a specific form of nutritional support for cancer patients are badly needed.

Digestive System Neoplasms↗
PubMed1988

[Epidermoid cancers of the esophagus: combined chemotherapy, surgery and radiotherapy. Preliminary results in 50 cases].

Fifty operable epidermoid esophageal carcinomas were treated by combined chemotherapy, surgery and radiotherapy. The post-operative mortality was 5.4% and the severe post-operative morbidity was 29%. The vindesine-5FU-platinum association and the vindesine-endoxan-platinum association gave respectively 55% and 35% objective responses (OR) after two preoperative courses without increasing the operative mortality. The patients who showed an OR had a less important tumoral extension. Thus, an objective response to the pre-operative chemotherapy is in fact a new prognostic factor. Survival without recurrence seems to be increased when chemotherapy is efficient in the curative resection group. These findings incite to promote prospective randomized studies with this kind of combined therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

[Anastomotic fistula after gastrectomy. Diagnostic value of radiologic monitoring. Retrospective study of 123 gastrectomies].

In order to determine the usefulness of systematic radiological exploration after gastrectomy, 123 gastrectomies (39 total, 84 subtotal) performed over a 10-year period were reviewed. Control radiology had been carried out in 51% of the cases. Retrospectively, except for the lower percentage of total gastrectomies the two groups (with and without control radiology) were comparable. The overall incidence of fistula (9%) was similar to that found in the literature, bearing in mind that 90% of gastrectomies in this series were performed for cancer. The only two factors predictive of fistula were the presence of fever or of post-operative focal infection (P less than 0.001). It would appear that control radiology after gastrectomy is indicated only when post-operative fever is present. If this were done the number of useless examinations would be reduced and the cost-effectiveness ratio of radiology would be improved.

Female↗
PubMed1987

Early adjuvant intraportal chemotherapy after curative hepatectomy for colorectal liver metastases--a pilot study.

A preliminary study was conducted with early and continuous intraportal adjuvant chemotherapy (IPAC) after a curative hepatectomy for colorectal metastases. The IPAC consisted of 14 days of 5-FU infusion at the rate of 600 mg/m2/d. The ultimate aim of this study was to reduce the frequency of recurrences in the remaining liver after curative hepatectomy. Twelve patients were included. IPAC was initiated in nine of them, while three technical failures occurred. The 14-day course with continuous 5-FU was given five times. The treatment had to be ceased prematurely because one medical and three mechanical complications occurred during the infusion. Pains and vomiting were frequent, but were usually the result of mechanical complications. No important hepatotoxicity or haematological toxicity was observed. This study shows that a full course of chemotherapy could be administered in only 40% of the patients. Further pilot studies with the aim of improving feasibility should be undertaken. If the mechanical problems are improved and IPAC duration is reduced, then feasibility should be dramatically increased. Subsequently, only a prospective randomized study would confirm the efficiency of the method in minimizing liver recurrence.

Adenocarcinoma↗
PubMed1986

[Cardiotoxicity of 5-fluorouracil. Characteristics, mechanism, practical management].

5-fluorouracil is a drug that is widely used in cancerology. Its cardiotoxicity must be known, as it is not exceptional and potentially dangerous. Two cases are reported in which the coronary insufficiency was documented and recurred when 5-fluorouracil was reintroduced. The mechanism of cardiac toxicity seems to be coronary spasm, as shown by exercise tests and the normal results of coronary arteriography. It seems preferable to refrain from using 5-fluorouracil after a recent myocardial infarction or in patients with unstable angina. Reintroduction of the drug is usually followed by recurrence of cardiotoxicity, even under coronary vasodilators.

Coronary Disease↗
PubMed1985

[Cardiotoxicity of 5-fluorouracil. Apropos of a new case].

Five - Fluorouracil (5 FU) is widely used in oncology, especially in tumors of the gastrointestinal tract and in carcinoma of the breast. Its side effects (gastrointestinal, haematological, alopecia) are well known. However, its cardiac effects are not widely appreciated, despite an incidence similar to that observed with the anthracyclines (1.6% vs 2.2%) and a high mortality rate (12.5%). A new case of coronary insufficiency is reported illustrating the absence of a dose-effect relationship and the frequency of recurrence of symptoms when 5 FU is reintroduced even with coronary vasodilator therapy. The mechanism of cardiotoxicity in this case seems to be coronary spasm.

Coronary Disease↗
PubMed1983

[Modified duodenal diversion in the treatment of esophagitis from bile reflux complicating an upper-pole gastrectomy].

A surgical technique is described which has been adapted from the operation known as "total duodenal diversion", but which is suitable for the anatomical conditions resulting from an upper pole gastrectomy. The method was used successfully in two patients with severe esophagitis from bile reflux resistant to all medical treatment and resulting from upper pole gastrectomies.

Bile Reflux↗