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Biomedical subjects

J Rubin

Publications and source records attributed to J Rubin.

At least 199 records · Page 11Linked to original sources
PubMed1987

Diabetes, dialysate losses, and serum lipids during continuous ambulatory peritoneal dialysis.

We evaluated changes in dialysate losses of protein and absorption of glucose, serum chemistries including protein electrophoresis, and serum lipids among patients who had undergone continuous ambulatory peritoneal dialysis (CAPD) for at least 1 year. The patients' race, sex, and the presence of diabetes mellitus did not influence the results. Over a 2-year period, daily protein losses and glucose absorption from dialysate were constant, serum protein electrophoresis did not show changes consistent with the nephrotic syndrome, serum cholesterol increased after 1 year of therapy but stabilized thereafter, and concentrations of high density lipoproteins did not decrease.

Absorption↗
PubMed1987

Fungal peritonitis during continuous ambulatory peritoneal dialysis: a report of 17 cases.

Seventeen cases of fungal peritonitis and one case of Nocardia asteroides peritonitis were observed in 141 patients during the first 5 years of our continuous ambulatory peritoneal dialysis program (CAPD). Fungal peritonitis accounted for 7% of the episodes of peritonitis observed in this interval. There were eight deaths associated with fungal peritonitis. In only three instances could factors predisposing to fungal peritonitis be identified. We were unable to predict who would develop fungal peritonitis by analysis of nutritional, demographic, or technical factors associated with the dialysis procedure. The diagnosis of fungal peritonitis was easily established using routine blood agar culture techniques. Successful management of these patients included prompt removal of the Tenckhoff catheter and intravenous (IV) administration of amphotericin.

Amphotericin B↗
PubMed1987

Lack of value for cisplatin added to mitomycin-doxorubicin combination chemotherapy for carcinoma of unknown primary site. A randomized trial.

Fifty-five patients with metastatic carcinomas of unknown primary site (50 adenocarcinomas) were randomized, after stratification, to treatment with either mitomycin and doxorubicin (MA) or mitomycin, doxorubicin, and cisplatin (MAP). There was a moderate but nonsignificant improvement in regression frequency (14 vs. 27%) and a slight but also nonsignificant worsening of survival (median 5.5 months vs. median 4.6 months) by the addition of cisplatin at 60 mg/m2 to the MA regimen.

Adult↗
PubMed1987

A randomized clinical trial of combination chemotherapy in advanced colorectal cancer.

One hundred and sixty-five patients with advanced colorectal cancer were entered into a prospectively randomized trial of combination chemotherapy comparing three 5-fluorouracil plus methyl CCNU (FM)-based regimens: FM plus ICRF-159 (FMI), FM plus triazinate (FMT), and FM plus vincristine (FMV). Patients were stratified according to performance status, anatomic site of primary indicator lesion, and prior chemotherapy. Those with abnormal kidney or liver function were randomized between FMI and FMV because triazinate depends on both hepatic and renal mechanisms for elimination. There were no significant differences between the treatment regimens in objective response rate (11%-17%), interval to progression (median, 10-14 weeks), or survival (median, 5-6 months). The primary side effect observed was hematologic toxicity, which tended to increase in severity with repeated courses of therapy. Although ICRF-159 and triazinate have been shown to have limited single-agent phase II activity against colorectal cancer in previous trials, neither agent combined with 5-fluorouracil plus methyl CCNU has an improved treatment effect compared with FMV. We do not recommend the further use of these regimens in the treatment of advanced colorectal cancer.

Adult↗
PubMed1987

CAPD patients as renal transplant patients.

Most authors state that the continuous ambulatory peritoneal dialysis (CAPD) patient is not at increased risk when transplanted. These patients are always exposed to the risk of peritonitis, which may increase if patients are peritoneally dialyzed while immunosuppressed. The postoperative course of patients transplanted from our CAPD program from 1979 through August 1985 was evaluated. The transplant survival of patients dialyzed by CAPD, home hemodialysis, and at a free-standing dialysis facility were compared. Pretransplant dialysis modality did not influence long-term transplant success. Three of seven patients who required dialysis postoperatively developed peritonitis. The dialysis catheter was removed in two patients and one was treated by lavaging the peritoneal cavity with antibiotics. There was one instance of dialysate leaking through a drain in the transplant bed. This patient was converted to hemodialysis for subsequent dialysis. The dialysis catheters were removed at the time of discharge from hospital. Literature review confirmed this experience. Peritoneal dialysis post-transplant exposes the patient to a 10-33% risk of peritonitis and a 10% risk of a wound complication. Peritoneal dialysis patients are subject to risks unique to peritoneal dialysis. These complications do not translate into excessive morbidity or graft loss.

Adolescent↗
PubMed1987

Treatment of metastatic islet cell carcinoma with a somatostatin analogue (SMS 201-995).

We used an octapeptide analogue of somatostatin, SMS 201-995, in dosages ranging from 150 to 450 micrograms/d administered subcutaneously in three daily doses for 1 to 16 months, to treat 22 patients with advanced malignant islet cell carcinomas. Of the 22 patients, there were 9 with gastrinomas; 3 with glucagonomas; 4 with insulinomas; 1 with ectopic production of parathyroid hormone; and 3 with mixed syndromes. The only biochemical marker in 1 patient was pancreatic polypeptide, and 1 patient had no demonstrable peptide production from the tumor. In 14 patients, dramatic decreases in the levels of circulating peptides (insulin, vasoactive intestinal polypeptide, gastrin, and glucagon) have been accompanied by major alleviations of symptoms. Steatorrhea appears to be the most significant toxicity. This analogue of somatostatin may be appropriate for use as early therapy in patients who have symptoms from syndromes related to islet cell carcinomas but in whom there is no immediate threat from tumor progression.

Adenoma, Islet Cell↗
PubMed1987

Phase I study of two schedules of teroxirone.

Two schedules of teroxirone, a triazine triepoxide, were evaluated in a phase I study. Twenty-six patients were treated on 1 day every 5 weeks at doses of 36-2250 mg/m2. At doses greater than or equal to 1500 mg/m2, severe thrombophlebitis was seen without cytotoxic effect, and this schedule was closed. Twenty-seven patients were treated on 5 days every 5 weeks at daily doses of 16-450 mg/m2. Mild thrombophlebitis and moderate leukopenia were encountered. For phase II studies, a dose of 375 mg/m2 X 5 every 5 weeks is recommended. Pharmacologic studies showed rapid plasma elimination, which suggests the agent's possible usefulness for regional infusion.

Antineoplastic Agents↗
PubMed1987

Systems of membranes involved in peritoneal dialysis.

To evaluate whether the viscera contribute to the system of membranes used in peritoneal dialysis, dialysis rate studies were performed comparing control rats (n = 9, mean peritoneal area 509 +/- 38 cm2) with eviscerated rats (n = 12, mean peritoneal area 200 +/- 123 cm2). The mass transfer coefficient (MTC) and absorption from the peritoneal cavity were calculated for urea, creatinine, and inulin, which had been added to commercially available 1.5% hydrous dextrose dialysate. Rates of peritoneal blood flow to the peritoneal membranes remaining after evisceration were similar for both groups. Urea, creatinine, glucose, and inulin were used as markers to compare control and eviscerated animals. The MTC results were (in milliliters per minute, mean +/- SEM): urea 3.0 +/- 0.3, 4.1 +/- 0.5 (P less than 0.01); creatinine 1.4 +/- 0.2, 2.0 +/- 0.2 (P less than 0.05); glucose 1.2 +/- 0.3, 1.7 +/- 0.2 (P less than 0.09); inulin 0.3 +/- 0.02, 0.6 +/- 0.1 (P less than 0.01); and MTC inulin/MTC urea 0.16 +/- 0.01, 0.14 +/- 0.01. Absorption of urea, creatinine, glucose, and inulin from the peritoneal cavity was only 10% to 23% greater among control animals. Whether the results were caused by nonparticipation of the intestinal viscera or other mechanisms, such as improved contact between dialysate and membrane, awaits further study.

Animals↗
PubMed1986

Treatment of the malignant carcinoid syndrome. Evaluation of a long-acting somatostatin analogue.

We studied the effects of a long-acting analogue of somatostatin (SMS 201-995, Sandoz) in 25 patients with histologically proved metastatic carcinoid tumors and the carcinoid syndrome. This drug was self-administered by subcutaneous injection at a dose of 150 micrograms three times daily. Flushing and diarrhea associated with the syndrome were promptly relieved in 22 patients. All 25 patients had an elevated 24-hour urinary excretion of 5-hydroxyindoleacetic acid (5-HIAA) (mean, 265 mg per 24 hours; range, 14 to 1079), which served as an objective indicator of disease activity. Eighteen of the 25 patients (72 percent) had a decrease of 50 percent or more in their urinary 5-HIAA levels, as compared with the pretreatment values. The median duration of this biochemical response was more than 12 months (range, 1 to greater than 18). Since no serious toxicity was observed, we conclude that SMS 201-995 may be appropriate for use as early therapy in patients with symptoms due to the carcinoid syndrome who have not responded to simpler measures.

Adult↗
PubMed1986

The ligand binding subunit of the insulin-like growth factor 1 receptor has properties of a peripheral membrane protein.

125I-insulin-like growth factor 1 was cross-linked to its receptor in human placenta microsomal membranes. The microsomes were treated with urea, with dithiothreitol or with both reagents prior to centrifugation at 100,000 X g. We found that greater than 80% of the label was membrane-associated following separate treatment with urea or dithiothreitol, but greater than 80% of the radioactivity remained in the supernatant after simultaneous exposure to both reagents. In identical experiments employing 125I-epidermal growth factor, no condition led to the release of greater than 10% of label from the membrane. We conclude that the ligand binding subunit of the insulin-like growth factor 1 receptor, like peripheral membrane proteins, lacks a membrane anchoring domain.

Dithiothreitol↗
PubMed1986

Protein losses and tobramycin absorption in peritonitis treated by hourly peritoneal dialysis.

The effects of peritonitis on dialysate protein losses of IgG, IgA, IgM, transferrin, and complement were investigated. Thirteen patients who developed peritonitis while undergoing peritoneal dialysis were compared with seven noninfected dialysis patients. Dialysate protein losses increased during peritonitis, but IgG, IgA, IgM, transferrin, and complement losses did not. The ratio of the amount of these proteins to the total amount of protein, measured by trichloroacetic acid precipitation, was unaltered by peritonitis, suggesting that albumin is the predominant protein lost during peritonitis. The infected patients absorbed 55% of the administered dose of tobramycin, at 17 mL/min, and the noninfected 44%, at 13 mL/min.

Adolescent↗
PubMed1986

Clinical trial of cisplatin and intensive course 5-fluorouracil for the treatment of advanced colorectal cancer.

A clinical trial of 5-day Cisplatin combined with loading course 5-fluorouracil (5-FU) was conducted in 37 patients with advanced colorectal carcinoma. Objective tumor responses were seen in 10 of 34 patients (29%) who had not received prior chemotherapy. The estimated median survival for previously untreated patients is 26 weeks measured from the onset of therapy. Toxicity consisted primarily of leukopenia, vomiting, and reversible renal insufficiency. This combination of cisplatin and intensive course 5-FU has demonstrated Phase II activity in patients with advanced colorectal cancer. A controlled trial is now in progress to prospectively compare this regimen with full dose single agent 5-FU.

Adult↗