Effects of vasodilators and peritoneal dialysis solution on the microcirculation of the rat cecum.
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Animals↗
Biomedical subjects
J Rubin
Publications and source records attributed to J Rubin.
Delta-9-tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy. A comparison with prochlorperazine and a placebo.
The antiemetic activity and side-effects of delta-9-tetrahydrocannabinol (THC) were evaluated in 116 patients (median age 61 years) receiving combined 5-fluorouracil and semustine (methyl CCNU) therapy for gastrointestinal carcinoma. In a double-blind study, patients were randomized to receive THC, 15 mg orally three times a day, prochlorperazine, 10 mg orally three times a day, or placebo. The THC had superior antiemetic activity in comparison to placebo, but it showed no advantage over prochlorperazine. Central nervous system side-effects, however, were significantly more frequent and more severe with THC. With the dosage and schedule we used, and in our patient population of largely elderly adults, THC therapy resulted in an overall more unpleasant treatment experience than that noted with prochlorperazine or placebo. Although THC may have a role in preventing nausea and vomiting associated with cancer chemotherapy, this role must be more clearly defined before THC can be recommended for general use.
Adult↗
Treatment of advanced breast cancer with cyclophosphamide, 5-fluorouracil, and prednisone with and without methanol-extracted residue of BCG.
The value of immunotherapy as an adjuvant to chemotherapy for advanced breast cancer is an unsettled question. To clarify this issue, 71 women with measurable or evaluable metastatic breast cancer were randomized to receive cyclophosphamide, 5-fluorouracil, and prednisone (CFP) with or without methanol-extracted residue of Bacillus Calmette-Guerin (MER). The total regression rates were 52% (CFP) and 39% (CFP + MER), including complete regression rates of 13% (CFP) and 65% (CFP + MER). The median duration of regressions for CFP-treated patients was 257-261 days and for CFP + MER-treated patients was 385 days. The median time to progression was 248-261 days in the CFP group and 159 days in the CFP-MER group. Projected median survival for both treatment groups is 20 months. Immunotherapy (MER) as used in this study does not appear to augment regression rates or vurvival for patients with advanced breast cancer receiving CFP.
Antineoplastic Agents↗
Peritoneal clearances with three types of commerically available peritoneal dialysis solutions. Effects of pH adjustment and intraperitoneal nitroprusside.
Peritoneal clearances were measured in multiple patients with different types of peritoneal dialysis solution to assess the effects of pH, choice of buffer anion (acetate versus lactate), and the effects of nitroprusside (a vasodilator) in combination with different buffer anions and varying pH. The studies show no differences in peritoneal clearances at very low solution pH (less than 6 as is commonly available) as compared to a pH nearer to 7 or above. There were no diffences between solutions with acetate as compared to those with acetate. Nitroprusside significantly increased clearances in all solutions to a similar extent.
Acetates↗
Equilibration of peritoneal dialysis solutions during long-dwell exchanges.
There is an increasing interest in CAPD for the treatment of chronic uremia. This technique uses long-dwell peritoneal exchanges lasting 4 hr or more. We have determined equilibration curves for multiple solutes during long exchanges with commercially available 1.5% and 4.25% dextrose dialysis solutions. For small solutes, rates of change of D/P ratios fall off dramatically after 3 hr of dwell time. For larger solutes, D/P ratios change more linearly. Some concentration gradients for net removal by diffusion persist well beyond 4 hr for all but the most highly diffusible solutes. Previously reported net sieving of sodium and chloride during hypertonic exchanges is still evident after many hours.
Adult↗
Variable premedication for upper gastrointestinal endoscopy.
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Diazepam↗
Clinical studies with a nonvasoactive peritoneal dialysis solution.
Topical application of dialysis solution to the rat microcirculation causes a transient vasoconstriction for 2 to 3 min. We assessed the clinical importance of this vasoconstriction by developing a dialysis solution without vasoactive properties, as assessed in the microcirculatory laboratory. The solution was of similar composition to human extracellular fluid. We tested its effects on Cur, Ccr, Cin, and dialysate protein concentration. We found that compared to commercial solutions, the lower osmolality of the NVS resulted in loss of ultrafiltration and decreases in clearance of urea and creatinine. The clearance of inulin was unchanged, and dialysate protein increased, suggesting a major increase in diffusive transport of large solutes. Increased diffusive transport of large solutes with NVS suggests that initial vasoconstriction seen in the rat could be present and clinically important during peritoneal dialysis in humans.
Adolescent↗
Comparison of the effects of lactate and acetate on clinical peritoneal clearances.
Peritoneal clearances of urea, creatinine, inulin and dialyzate protein concentration were compared in ten patients using dialysis solutions containing either lactate or acetate. No significant differences were found between solutions containing lactate or acetate.
Acetates↗
Repeated adjuvant chemotherapy with phenylalanine mustard or 5-fluorouracil, cyclophosphamide, and prednisone with or without radiation, after mastectomy for breast cancer.
172 patients who had had mastectomy for breast cancer were treated by repeated adjuvant chemotherapy, either with phenylalanine mustard (P.A.M.) or a combination of cyclophosphamide, 5-fluorouracil, and prednisone (C.F.P.) with and without radiotherapy. Tumours recurred significantly more frequently and mortality tended to be higher in P.A.M.-treated patients than in patients on other treatment. The interval between surgery and disease recurrence was significantly shorter for P.A.M.-treated premenopausal but not postmenopausal patients than for patients of equivalent menstrual status treated with C.F.P. with or without radiation. The associations in premenopausal patients between the mode of treatment and both survival and the disease-free interval were significant before and after adjustment for variations between the treatment groups in the number of involved lymph nodes and the size of the primary tumour.
Adult↗
Randomized phase II clinical trial of adriamycin, methotrexate, and actinomycin-D in advanced measurable pancreatic carcinoma: a Gastrointestinal Tumor Study Group Report.
Sixty-six patients with advanced pancreatic carcinoma were randomized to receive single agent chemotherapy with either adriamycin, methotrexate, or actinomycin-D using conventional dose, route and schedule of administration. All patients had measurable lesions which were used to objective assessment of response. For adriamycin, 2 of 25 patients (8%) evidenced a partial response (2 of 15 (13%) previously untreated patients). One of 25 patients treated with methotrexate and one of 28 received actinomycin-D responded. The duration of responses ranged from 43-64 days for those patients with no chemotherapy prior to study entry. The median survival of patients who received adriamycin as initial treatment was 12 weeks compared to 8 weeks for methotrexate and 6 weeks for actinomycin-D therapy.
Adult↗
The effect of glycopyrrolate (Robinul) on the lower oesophageal sphincter.
Regurgitation and inhalation of acid gastric content, with resultant chemical pneumonitis, remains a common cause of death during anaesthesia. The effects of intravenous glycopyrrolate 0.3 mg on the lower oesophageal sphincter tone was studied in normal human subjects. Glycopyrrolate decreased lower oesophageal sphincter pressure by 0.88 kPa (p less than 0.005). This finding is of clinical importance in the pre-operative preparation of patients presenting for emergency surgery. A drug which decreases lower oesophageal sphincter tone would presumably increase the hazard of gastro-oesophageal reflux and pulmonary aspiration of acid gastric content.
Adolescent↗
The action of commonly used antiemetics on the lower oesophageal sphincter.
The effects of five antiemetic drugs on the lower oesophageal sphincter (LOS) were studied in five groups, each comprising eight healthy volunteers. Cyclizine, prochlorperazine and metoclopramide have a desirable functional effect on LOS, while promethazine and droperidol were associated with evidence of increased gastro-oesophageal reflux.
Adult↗
Early clinical study of an intermittent schedule for maytansine (NSC-153858): brief communication.
Maytansine, an ansa macrolide, was evaluated in an early clinical trial in 40 adult patients with various solid tumors. Severe nausea and vomiting, sometimes associated with watery diarrhea and abdominal cramps, and liver function abnormalities, mainly elevation of serum glutamic--oxaloacetic transaminase levels, together constituted what we considered dose-limiting toxicity. Mild hematologic toxicity (mainly thrombocytopenia), neurotoxicity, and possibly cardiac toxicity were also noted. No antitumor effect was seen. An iv dose of 0.750 mg/m2 on days 1, 3, and 5 (total dose, 2.25 mg/m2) repeated every 4 weeks is recommended for Phase II trials.
Adult↗
The effect of atropine on the lower esophageal sphincter in late pregnancy.
Intraluminal gastroesophageal pressure and pH studies have been performed on 8 nonpregnant women, 10 pregnant women with heartburn, and 10 pregnant women without heartburn. Each patient was tested under resting conditions and after intravenous injection of 0.6 mg atropine. In both groups of pregnant patients the intragastric pressure was found to be higher than that of the nonpregnant subjects. The stomach to lower esophageal sphincter pressure (LESP) gradient under resting conditions was least in the pregnant patients with heartburn. After the administration of atropine, a fall in the LESP occurred in all 3 groups of patients which was most profound in the nonpregnant subjects and in the pregnant patients without heartburn. These changes and the pH recordings of the lower esophagus indicate the adverse effect that atropine has on the competency of the LESP both in pregnancy and in the nonpregnant state. Atropine should therefore be used with caution as a premedicant and preferably combined with metoclopramide (Maxolon).
Adolescent↗
Location of amino acid residues in human deoxy hemoglobin.
A table has been compiled of the spatial disposition of the amino acid residues in the human deoxy hemoglobin tetramer. The table also indicates regions of possible contact between residues in each subunit and possible contacts between subunits.
Amino Acids↗
Peritoneal dialysis for psoriasis. An uncontrolled study.
Remissions of long-standing psoriasis have been reported in patients starting either chronic hemodialysis or peritoneal dialysis for renal failure. To see if dialysis influences the course of psoriasis in the absence of renal failure, we selected three patients with severe, refractory, long-standing psoriasis to undergo weekly peritoneal dialysis treatments. Two began to improve after the first dialysis, with nearly complete resolution after four and nine treatments, respectively. The third patient showed no objective changes after four dialyses. These findings add to increasing anecdotal reports of psoriasis improving with dialysis and extend the observations to patients without renal disease.
Adult↗