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Biomedical subjects

R M Chichmanian

Publications and source records attributed to R M Chichmanian.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Cardiac toxicity of fluoro-uracil. Typical and atypical aspects. Apropos of 8 cases].

The cardiac toxicity of 5 fluoro-uracil, an antimitotic agent widely used in various protocols, has been known for 16 years. Several cases have been reported in the literature, leading to the suggestion, without formal evidence, that the chief mechanism responsible for this cardiac toxicity is "classical" coronary spasm. However, certain clinical aspects already described may shed doubt on this theory. On the basis of 8 cases, the authors report different clinical pictures all caused by cardiac toxicity of 5FU. It is of interest to note that chest pain with the classically described electrocardiographic changes did not apply in the majority of cases. The commonest pattern was asymptomatic electrocardiographic abnormalities and/or arrhythmias without angina. Among the reported cases, one patient had pain with electrocardiographic abnormalities, recurrent after the withdrawal of 5FU and resistant to maximal medical treatment, despite the absence of any coronary disease or signs of spasm. One patient had a first myocardial infarction, later rechallenge with the drug resulting in failure. In another patient, with known coronary disease, 5FU probably cause cardiogenic shock. In total, some of our cases, as well as other features described in the literature, raise questions as to the pathophysiology of the cardiac toxicity of 5FU.

Adult↗
PubMed1991

In vitro and in vivo ciprofloxacin pharmacokinetics in human neutrophils.

Early in vitro investigations have shown that ciprofloxacin is concentrated within human neutrophils (polymorphonuclear leukocytes [PMNs]) at between 3 and 11 times the extracellular concentration. The elution of ciprofloxacin from cells is relatively rapid when the extracellular concentration is reduced. In order to estimate the in vivo intracellular penetration of ciprofloxacin and to determine its intracellular pharmacokinetics, PMNs were recovered from blood samples drawn from healthy volunteers at different times during a 24-h period after they were given a 750-mg oral dose. High-performance liquid chromatographic determination of ciprofloxacin in serum and cells showed that the intracellular/serum ratio was 3.7 at 1.5 h (maximum concentration of drug in serum), 5.7 at 12 h, and 20 at 24 h. The area under the curve ratio was 3.73. The mean elimination half-lives of ciprofloxacin were 3.7 and 6.2 h in serum and PMNs, respectively. These data show that in vivo findings are in agreement with in vitro findings. The large uptake of ciprofloxacin by PMNs combined with a prolonged intracellular half-life described under the conditions of human therapy should provide the basis for the use of ciprofloxacin in infections caused by susceptible intracellular bacteria.

Adult↗
PubMed1990

[Prolonged confusion syndrome in the course of cyclosporine treatment: a state of confusion?].

Cyclosporine is a potent immunosuppressant that is more and more widely used, particularly after organ transplantations. Many neurological side effects, including convulsions, that could be related to this drug, have been previously observed, most often with high blood concentrations. We report, for the first time, a case of prolonged confusion where a non convulsive status epilepticus may be discussed. It occurred in a 64-year-old woman, 17 days after a liver transplantation. The whole blood cyclosporine value was 230 micrograms/l (normal range: 100-200 micrograms/l) at the beginning of the status epilepticus. The cyclosporine imputability and the part of other factors that could have facilite are discussed.

Chronic Disease↗