Search PubMed⌕ Search

Biomedical subjects

J Otten

Publications and source records attributed to J Otten.

At least 55 records · Page 3Linked to original sources
PubMed1995

Bilateral Wilms' tumor: in situ cooling of the kidney facilitates curative excision of tumors, with preservation of renal function.

Bilateral synchronous multifocal Wilms' tumor is a rare malignancy for which no optimum treatment has been established thus far. The need to preserve renal parenchyma whenever possible is obvious. The authors describe a patient who underwent removal of six subcapsular tumors from a kidney that had been protected from ischemia by in situ cooling with UW-Belzer solution and by surface cooling. This technique was safe, easy to perform, and allowed all the time required to resect the tumors under adequate visual control and to wait for analysis of the frozen sections. It might be a useful alternative to the more complicated "bench" technique.

Adenosine↗
PubMed1995

Control of nausea and vomiting by Navoban (tropisetron) in 131 children receiving cytotoxic chemotherapy.

One hundred and thirty-one children with a median age of 5 years were administered Navoban (tropisetron), a selective antagonist of the serotonin receptor (5-HT3), dosed once daily at 0.2 mg/kg (with a maximum of 5 mg daily) in a study aimed at evaluating the prevention of nausea and vomiting induced by anti-cancer chemotherapy. The most common malignancy (in 49% of patients) was acute lymphocytic leukaemia. Patients received Navoban during one or more courses of emetogenic chemotherapy for a total of 455 courses administered intravenously or intravenously and intrathecally (IV + IT). Most patients (89%) had already received cytotoxic chemotherapy before enrollment for the trial. On Day 1, Navoban was administered slowly and intravenously as a single dose before the start of chemotherapy, or by mouth as a single daily dose on subsequent days (median treatment duration = 5 days). On the first 5 days of each course of chemotherapy, response to Navoban per 24-hour period was graded as: complete (absence of both nausea and vomiting), partial (1-4 vomits and/or less than 5 hours of nausea), or failure (more than 4 vomits and/or at least 5 hours of nausea). Ninety-six per cent of the intravenous chemotherapy group and 97% of the IV + IT chemotherapy group had a complete (70% and 55% respectively) or partial (26% and 42% respectively) response during the first 24-hour period of the first course in which Navoban was used. The second and subsequent courses yielded similar percentages. Delayed emesis was observed mainly during those courses employing the most emetogenic chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Dental caries, gingival health, and oral hygiene of long term survivors of paediatric malignant diseases.

Fifty two children who had had cancer and been treated with chemotherapy, and who were long term event free, were examined for caries prevalence, gingival health, and oral hygiene and compared with a control group. A higher dental caries prevalence for the 14-17 year age group was noted. The restorative index was significantly lower in the age group 10-13. There were no significant differences in gingival index, plaque index, or toothbrushing frequency. It is concluded that these patients should be considered as at high risk for caries after cancer treatment. Professional dental follow up should be integrated in the medical follow up.

Adolescent↗
PubMed1995

Retroperitoneal teratoma as first sign of Klinefelter's syndrome.

A 5 month old boy with a retroperitoneal teratoma was found to have a 47 XXY karyotype indicating Klinefelter's syndrome. This observation suggests that patients with the syndrome may be at risk of germinal tumours in sites other than those usually reported (mediastinum, brain, and testes).

Humans↗
PubMed1994

Bone metabolism and mineralisation after cytotoxic chemotherapy including ifosfamide.

Lumbar spine bone mineral density and bone mineral metabolism were studied in 13 children three months or more after completion of cytotoxic chemotherapy that included ifosfamide given for different malignancies. Blood and urine were analysed for calcium, phosphorus, and magnesium and blood for alkaline phosphatase activity, parathyroid hormone, and 1,25(OH)2 vitamin D3. Bone mineral density (BMD) was measured at the lumbar spine (L1-L4) using a commercial dual x ray absorptiometer. Serum concentrations of calcium, phosphorus, and magnesium and alkaline phosphatase activity, as well as plasma 1,25(OH)2 vitamin D3 concentrations were normal in all children. Slightly raised parathyroid hormone concentrations were seen in two children. An increased urinary excretion of calcium was found in five children. Mean (SD) BMD of the children was -0.88 (1.44). Three children had osteopenia, as defined by a BMD lower than -2 SD for age and sex related standards. No significant relation was found between the BMD and the biochemical parameters. In conclusion, a normal BMD was found in most patients who had received ifosfamide, even in those with persisting hypercalciuria.

Adolescent↗
PubMed1994

Prevention of emesis by tropisetron (Navoban) in children receiving cytotoxic therapy for solid malignancies.

Emesis is one of the most frequent and distressing adverse effects of cytotoxic chemotherapy. Conventional antiemetic regimens are unsatisfactory due to their poor efficacy and their adverse events, particularly in children. Tropisetron (Navoban; Sandoz Pharma Ltd, Basel, Switzerland) belongs to a new class of 5-hydroxytryptamine receptor antagonists with antiemetic effectiveness in patients receiving anticancer agents. We evaluated tropisetron (0.2 mg/kg/d) in 24 chemotherapy-treated children who had experienced severe emesis during previous chemotherapy courses in spite of concomitant administration of either alizapride or metoclopramide. Complete control of emesis was achieved in 70% of the courses (37% of those including cisplatin). No severe adverse effect was reported. Headache was observed in two courses and constipation was observed during two other courses. Tropisetron proved clearly superior to conventional antiemetics and safe in use.

Adolescent↗
PubMed1993

Curability of relapsed childhood B-cell non-Hodgkin's lymphoma after intensive first line therapy: a report from the Société Française d'Oncologie Pédiatrique.

The very high cure rate in advanced B-cell non-Hodgkin's lymphoma in children using intensive multiagent therapy has been previously reported by the French Sociéte Française d'Oncologie Pédiatrique lymphoma Malin B type (LMB) group. To address the issue of salvageability in an unselected group of patients who had all received the same front-line therapy, the outcome of relapses following the LMB 84 (216 patients) protocol have been reviewed. Fourteen percent of patients achieving complete remission (CR) relapsed, ie, 27 of 195. Relapse sites comprised the central nervous system (CNS) alone (6 cases), lung or mediastinum (2 cases), abdomen (8 cases), head and neck (2 cases), or multifocal (9 cases). There were three early deaths due to disease. Twenty-four patients received rescue chemotherapy regimens and 15 were treated with high-dose chemotherapy and bone marrow rescue (1 allogeneic). Of these, 9 were in second CR, 4 in second partial remission, and 2 treated during progressive disease. One died in CR from treatment-related toxicity. Ten relapsed postbone marrow transplant and 4 are alive disease free and probably cured. Two of the long-term survivors had some delay during initial chemotherapy due to toxicity and two were isolated CNS relapses. Twelve of 27 patients did not proceed to megatherapy (12 of 12 died).

Bone Marrow↗
PubMed1993

Primitive malignant nonepithelial hepatic tumors in children.

Primary intrahepatic malignant nonepithelial tumors are very rare in children and account for 2% of all malignant mesenchymatous tumors under the age of 15 years. Clinical presentation, radiologic features, and histologic types are not unequivocal. The predominant role of surgery takes place either initially in small localized tumors or later, after initial reductive chemotherapy. In all cases, complete resection is the necessary but not sufficient condition for cure. Additional radiotherapy seems ineffective. High-dose chemotherapy and/or liver transplantation can be proposed for resistant cases. The disease-free survival rate is 37% at 2 years for the whole series.

Adolescent↗
PubMed1993

Prepubertal melanoma in a medium-sized congenital naevus.

A case of malignant melanoma in a medium-sized congenital naevus in a prepubertal girl is presented. Risk factors for developing melanoma during childhood include giant congenital naevi, dysplastic naevus syndrome and xeroderma pigmentosum. The lifetime risk of melanoma associated with giant congenital naevi has been estimated to be 4%-20%; the risk associated with small and medium-sized congenital naevi however remains controversial. In the latter lesions, malignant transformation is considered an almost exclusively postpubertal phenomenon, in contrast to giant congenital naevi where it often occurs prior to puberty. In our patient, malignant transformation in a medium-sized congenital naevus occurred before puberty. We suggest that the true incidence of malignant transformation within these lesions and the time at which it occurs, should be documented by prospective studies and that not only the giant congenital naevi but also the smaller congenital naevi should be considered for prophylactic excision in early childhood.

Cell Transformation, Neoplastic↗
PubMed1993

Prevention of emesis by ICS 205-930 in children receiving cytotoxic chemotherapy.

Nausea and vomiting are among the most frequent and severe acute side-effects of cytotoxic therapy and are not optimally controlled by conventional antiemetics. This situation warrants the evaluation of new classes of antiemetic agents such as the 5-HT3 receptor antagonists. 19 children with a median age of 9 years (range 2-16 years), treated with cytotoxic drug combinations that had previously caused nausea and vomiting refractory to conventional antiemetics, were given the selective 5-HT3 receptor antagonist ICS 205-930. The drug was given intravenously (i.v.) at 0.2 mg/kg (maximum 5 mg) during the chemotherapy infusion period and was continued orally for up to 5 days in chemotherapy courses containing cisplatin. The number of emetic episodes was recorded and the response was scored according to following scale: grade 1 = no nausea, no emetic episode; grade 2 = up to four episodes of vomiting and less than 5 h of nausea; grade 3 = five or more than five emetic episodes and/or nausea for at least 5 h. The 19 patients received a total of 169 various courses of chemotherapy combined with ICS 205-930. A score of 3 was observed during one course only, a score of 2 in 37 out of the 169 courses, including the four courses with cisplatin. The drug was very well tolerated. Side-effects possibly related to ICS 205-930 were mild to moderate headache in 4 patients during seven courses overall and obstipation in 3 patients during 11 courses. The results strongly suggest that ICS 205-930 is a highly effective and safe antiemetic agent in non-naive pediatric patients receiving non-cisplatin cytotoxic chemotherapy and who had failed conventional antiemetic treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

Totally implantable central venous access devices in pediatric oncology--our experience in 46 patients.

Between 1986 and 1990, 50 venous access devices have been implanted in 45 children with various types of cancer and in one patient with Langerhans cell histiocytosis. Twenty-five devices were of the so-called "pediatric" type (Port-A-Cath: 24, Vascuport: 1) and 25 were "adult" ports (Port-A-Cath: 8, Vascuport: 6, Infuse-A-Port: 6, Theraport: 5). The catheters (in silicone elastomer or polyurethane) were inserted percutaneously or surgically. Cumulative total venous access was 15024 patient-days (mean: 290 days per patient, range 2-900 days). Occlusion of the system, the most frequent complication, was encountered in 5 patients (11%). Rarer complications were catheter-related infection (2 pts), pneumothorax (1 pt), skin necrosis (1 pt), catheter leakage (1 pt) and port-catheter disconnection (1 pt). No serious complication ever occurred in 35 patients (76%). Seven of the 11 complications, including all 3 port occlusions, were encountered with "pediatric" systems. All the adult access devices tested were safe and allowed long-standing access to the central venous system in this series of pediatric cancer patients. With proper placement technique and adequate nursing care, they represent a definite improvement in child cancer therapy.

Adolescent↗
PubMed1993

Renal function abnormalities after ifosfamide treatment in children.

Renal function was evaluated in 12 children (aged 2.5-17.5 years) who received ifosfamide as part of their chemotherapy for different malignancies. A blood and urine analysis evaluating renal glomerular and tubular function and an isotopic determination of glomerular filtration were carried out four months or later after treatment had been stopped. Three patients had several biochemical abnormalities suggesting a significant degree of proximal renal dysfunction (increased urinary excretion of calcium, glucose, beta 2-microglobulin, amino acids (three patients) and decreased tubular reabsorption of phosphate (one patient)). The tubular dysfunction in these patients was associated with a diminished glomerular filtration. These patients could be characterized by their younger age at treatment and a higher dose of ifosfamide received if calculated per kg body weight.

Adolescent↗
PubMed1993

The walk-through patient-focus assessment: preliminary results in augmenting patient satisfaction data.

This article describes a new tool, the Walk-through Patient-focus Assessment Tool (WTPFAT), which is intended to supplement traditional methods of collecting patient satisfaction data. The WTPFAT is an instrument that has been developed for use by health care workers, managers, and professionals to examine their environment from a patient-focus point of view.

Health Facility Environment↗
PubMed1993

[Visceral leishmaniasis: a possible diagnosis in Belgium].

A 22-months old girl contracted visceral leishmaniasis during a vacation in Portugal, 12 months prior the manifestation of disease. She presented with fever, hepatosplenomegaly and pancytopenia. A serological test proved the diagnosis. Therapy with a pentavalent antimony drug brought about immediate improvement. Visceral leishmaniasis has to be suspected in individuals with fever, hepatosplenomegaly and pancytopenia who have resided in endemic areas (Mediterranean countries, India, East Africa, South America) during the previous years. If untreated, visceral leishmaniasis runs a fatal course. Therefore, early diagnosis by morphological and serological means and specific therapy with pentavalent antimony drugs are mandatory.

Antimony↗
PubMed1992

Hospital outbreak of multidrug-resistant Mycobacterium tuberculosis infections. Factors in transmission to staff and HIV-infected patients.

OBJECTIVE: To describe transmission of multidrug-resistant (MDR) Mycobacterium tuberculosis infection among patients and health care workers (HCWs) in a ward and clinic for human immunodeficiency virus (HIV)-infected patients in a hospital, four studies were conducted. METHODS: Case patients and control patients were persons who had been treated in the HIV ward or clinic, whose clinical course was consistent with tuberculosis and who had at least one positive culture for M tuberculosis between January 1, 1988, and January 31, 1990, resistant to at least isoniazid and rifampin (case patients), or whose isolates were susceptible to all drugs tested (control patients). In the first study, case patients and control patients were compared to identify risk factors for MDR tuberculosis. In the second study, inpatient and outpatient days of MDR tuberculosis case patients were compared to determine whether acid-fast bacillus (AFB) smear-positivity or aerosolized pentamidine use was associated with higher numbers of subsequent MDR tuberculosis cases among exposed patients. In the third study, restriction fragment length polymorphism analysis was performed on available MDR and sensitive M tuberculosis isolates. In the fourth study, skin test conversion rates among HCWs in the HIV ward and clinic were compared with those of HCWs in another ward, and the strength of the associations between skin test conversions among HCWs on the HIV ward and the number of person-days that AFB smear-positive case patients and control patients were on this ward was estimated. RESULTS: Case patients were more likely than control patients to have been exposed on the HIV ward or clinic to an AFB smear-positive case patient (P less than .001). Inpatient and outpatient days of MDR tuberculosis case patients were associated with more subsequent cases of MDR tuberculosis if exposing case patients were smear-positive or if they received aerosolized pentamidine (P less than or equal to .01). Of 13 MDR isolates, all had one of two restriction fragment length polymorphism patterns; 10 sensitive isolates had restriction fragment length polymorphism patterns that were different from each other. The HCW skin test conversion rate was higher on the HIV ward and clinic than on the comparison ward (P less than .01). The risk of occupational acquisition of infection increased in direct proportion to the number of person-days that AFB smear-positive case patients were on the HIV ward (r = .75; P = .005), but did not increase in proportion to the number of person-days that AFB smear-positive control patients were there (r = -.36; P = NS). After isolation measures for AFB smear-positive tuberculosis patients were improved, MDR tuberculosis cases decreased to seven of 214 tuberculosis patients. CONCLUSIONS: Nosocomial transmission of MDR M tuberculosis infection to patients and HCWs occurred on the HIV ward and clinic. Infectiousness of MDR tuberculosis case patients was associated with AFB sputum-smear positivity. Case patients with MDR tuberculosis created a greater risk of skin test conversion for HCWs on the HIV ward than drug-susceptible control patients.

Adult↗
PubMed1992

Thyroid function during L-asparaginase therapy in children with acute lymphoblastic leukemia: difference between induction and late intensification.

Parameters of thyroid function were measured in nine children during induction therapy for acute lymphoblastic leukemia (ALL). Seven patients were reevaluated during the late intensification phase. Vincristine, anthracycline drugs (daunorubicin and adriamycin), corticosteroids, and L-asparaginase were used in the two phases of therapy. During induction, L-asparaginase (5,000 U/m2) was given daily on days 1-21. During late intensification, the drug was given on days 1, 4, 8, and 11 (10,000 U/m2). During induction, total T4 significantly decreased from 10.1 +/- 2.3 to 4.0 +/- 1.0 micrograms/dl, FT4 decreased from 1.4 +/- 0.3 to 0.7 +/- 0.2 ng/dl, total T3 decreased from 134 +/- 32 to 57 +/- 21 ng/dl, and thyroxine binding globulin (TBG) decreased from 2.1 +/- 0.6 to 0.8 +/- 0.3 mg/dl. During late intensification therapy, significant decreases in T3 (from 180 +/- 26 to 93 +/- 40 ng/dl) and TBG (from 1.9 +/- 0.5 to 1.1 +/- 0.5 mg/dl) were observed, but there were no significant changes in T4 and FT4. We conclude that during induction, the impairment of thyroid function is attributable to L-asparaginase, whereas during late intensification, low T3 and low TBG is due to glucocorticoid administration.

Adolescent↗
PubMed1992

[Medulloblastoma: analysis of 14 cases treated at the J. Bordet Institute and literature review].

Between 1966 and 1986, 14 patients with histologically verified cerebellar medulloblastomas were seen at J. Bordet Institute after total (4 cases) or partial (10 cases) tumor removal. Twelve received postoperative irradiation after some courses of chemotherapy (Vincristine, Procarbazine, Methotrexate) for 5. In 10 cases the X ray treatment was given to the whole cerebrospinal axis with approximately 50 Gy delivered to the primary tumor site, 25-35 Gy to the remaining brain and spinal cord. As in other series of the literature the long term prognosis is not too good, with approximately 50% of the patients surviving more than 5 years. Failure at the primary site happened in 4 cases. As a consequence of the small number of patients treated, no conclusion can be drawn from risk factor analysis. Yet it appears that younger patients fared better than older ones. A detailed description of the side effects of the treatment is therefore given for the five children treated at prepubertal age: some growth impairment seems to be the rule, a consequence of GH deficiency--if not compensated--and of the direct effect of ionizing radiation on the vertebral bodies. While discussing the progress of neurosurgery and radiotherapy for the treatment of medulloblastoma, the authors emphasize the need of more efficient adjuvant chemotherapy regimens and the interest of multicenter trial for evaluating them.

Adolescent↗