Toxic epidermal necrolysis resembling erythema multiforme.
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Biomedical subjects
Publications and source records attributed to M L Samuels.
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In this descriptive study the authors compare self-reported sexual behaviors of a group of hospitalized psychiatric clients with a group of noninstitutionalized adults. An interview method was used to obtain information about interest in sex, frequency of intercourse, and sexual satisfaction. Control group members and clients reported about the same interest in sex, frequency of intercourse, and satisfaction in their younger years. In their current lives, however, clients reported slightly less sexual feeling and a much lower frequency of intercourse. Nearly half of the clients were not having intercourse, with the majority of those attributing the reason as hospitalization. Concerns about normalizing the institutional environment for sexual expression for chronically mentally ill persons are discussed.
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Thirty-nine patients with metastatic prostate cancer refractory to hormonal manipulation were treated with vinblastine by continuous infusion. The dose was 1.5 mg/m2 daily for 5 days. A 21% response rate was obtained. Eight patients, two with visceral metastasis, one with nodal disease, and five with osseous metastasis achieved objective response. The median duration of response was 28 weeks. Myelosuppression was the major side effect: the median leukocyte count nadir was 2.8 X 10(3)/ml and the median platelet count nadir was 184 X 10(3)/ml.
Twenty-seven unselected patients with limited disease non-oat-cell bronchogenic carcinoma were treated with a chemotherapy- radiotherapy protocol which consisted of bleomycin, vincristine, and methotrexate followed by split-course radiation. There were 15 objective responders with a median survival time in excess of 70+ weeks in contrast to a median survival time of 26 weeks for nonresponders (P less than 0.01). Objective benefit was limited to the epidermoid carcinoma group since none of the adenocarcinoma group achieved a greater than 50% reduction in maximum tumor diameter. The median survival time for the entire groups was 42 weeks in contrast to a recent split-course radiotherapy historical control group whose median survival time was 38 weeks. Toxic effects were predominantly gastrointestinal.
This study had the limited aim of ascertaining the efficacy of bleomycin in controlling m etastatic renal carcinoma. Fifteen patients received bleomycin intramuscularly and five patients received the drug via continuous infusion. Only two patients had responses, both mixed. We concluded that the therapeutic value of bleomycin in the treatment of advanced renal carcinoma is negligible.
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Twenty-three patients with stage III germinal neoplasia of the testis were treated with a variation of our original vinblastine-bleomycin program. This modification consisted of 0.4 mg/kg of vinblastine given in two fractions on Days 1 and 2 followed by continuous intravenous administration of 30 units of bleomycin in 1000 cc of 5% glucose and distilled water over a 24-hour period for 5 successive days beginning on Day 2. Therapy was repeated every 28-35 days as toxicity permitted. There were 17 responses, nine of which were complete (39%). Eight of the complete responses were in patients with massive disease in whom a low complete response rate was expected. Toxic effects consisted of severe leukopenia in 90% thrombopenia in 50%, and unexplained transient hyperbilirubinemia in about 30% of the patients. Bleomycin pneumonitis occurred in one patient and resulted in death. Hypertension was a new and unexpected side reaction experienced by four patients. Further trials are indicated since the complete response rate in patients with advanced massive disease appears to be improved.
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