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Biomedical subjects

R Rosell

Publications and source records attributed to R Rosell.

At least 127 records · Page 7Linked to original sources

Tick (Acari: Ixodidae) attachment cement and salivary gland cells contain similar immunoreactive polypeptides.

A specific antiserum (12C) raised to a 90-kDa immunogenic component of salivary glands of the tick Rhipicephalus appendiculatus recognized similar 90-kDa polypeptides from salivary glands of the American dog tick, Dermacentor variabilis, and the lone star tick, Amblyomma americanum, as well as 70-kDa polypeptides in the cement of D. variabilis, A. americanum, and R. sanguineus (brown dog tick). The reduction in size of the polypeptide for these ticks suggests that it is modified in some way during or after secretion. Immunostaining of salivary glands of unfed- and partially-fed female D. variabilis localized an immunoreactive protein in the d- and e-cells of the type III acini. The quantity of label in granules of glands from unfed ticks was visibly greater than in the granules of glands from partially fed ticks, suggesting that this component is secreted within the first 2 d of feeding. Collectively, these data support the conclusion that a 90-kDa polypeptide of saliva is conserved among ixodid tick genera and is a component of the attachment cement.

Animals↗

A phase II study of days 1 and 8 cisplatin and recombinant alpha-2B interferon in advanced non-small cell lung cancer.

Preclinical data from studies of human lung cancer xenografts suggest that the cytotoxic effects of cisplatin are enhanced by alpha-interferon. To verify the above observations, the authors initiated a Phase II trial in advanced non-small cell lung cancer (NSCLC). Cisplatin was given at 100 mg/m2 during a 28-day cycle in a divided day 1 and day 8 schedule. Starting on day 1, alpha-2B interferon was administered intramuscularly at a dose of 5 million units three times a week continuously for a minimum of 2 months. Between January 1989 and September 1989, 30 patients were evaluated for response and toxicity. According to the staging system proposed by Mountain, 20 patients had Stage IV disease, 7 had Stage IIIB disease, and 3 had Stage IIIA disease. Expression of neuron-specific enolase (NSE) and Leu-7 was immunohistochemically investigated to evaluate possible relationship to treatment response. The response rate was 13.3% (95% confidence interval [CI]: 1.2% to 25%). The four responders showed positivity for NSE, and two of them were positive for Leu-7. An average of three cycles was given. The mean dose intensity administered was 83% of the projected dose for cisplatin and 92% of the projected dose for alpha-2B interferon. A standard scale was used to assess interferon toxicity. Hematologic, renal, and systemic side effects were not significant. In advanced NSCLC the addition of alpha-2B interferon did not increase the cisplatin-induced response rate. Further studies should be performed to determine the real value of chemotherapy response in tumors showing positive immunoreactivity for neural markers such as NSE and Leu-7.

Adult↗

Determination of vitellogenin titer in the hemolymph of Dermacentor variabilis (Acarina: Ixodidae) using an indirect enzyme-linked immunosorbent assay.

Using polyclonal antibodies against Dermacentor variabilis (Say) egg vitellin, we developed an indirect, competitive enzyme-linked immunosorbent assay (ELISA). Vitellogenin in the hemolymph of females was quantitatively monitored through feeding (slow feeding and rapid engorgement feeding periods) and postfeeding (preoviposition and oviposition) until death. Vitellogenin concentrations in hemolymph ranged from 1 microgram/ml on the first day of feeding to a maximum of 430 micrograms/ml on the third day of oviposition. The temporal pattern of vitellogenin production in this tick shows a gradual increase in the hemolymph vitellogenin titer throughout the slow feeding period followed by a rapid and substantial rise during the rapid engorgement feeding period and a continuation of this rise in titer through the most productive egg laying part of oviposition. The vitellogenin titer rapidly falls toward the end of oviposition as the tick nears death. There was a 170-fold increase in vitellogenin concentration as measured from the onset of rapid engorgement to the maximum vitellogenin titer. The rapid engorgement feeding period signaled a sharp increase in vitellogenin production.

Animals↗

Sequential combination of methotrexate (MTX), 5-fluorouracil (FU), and high-dose folinic acid (FA) in advanced colorectal cancer: double biochemical modulation?

Thirty evaluable patients were treated with methotrexate (MTX) 200 mg/m2, i.v. infusion over 60 minutes, 24 hours prior to the administration of 5-fluorouracil 600 mg/m2, and folinic acid 200 mg/m2, i.v. infusion over 60 minutes, every 2 weeks. A partial or complete response was achieved in 12 patients (40%), and disease stable in 10 patients (33%). Median actuarial survival was 18 months. Side effects, which were within acceptable limits, included 11 cases of stomatitis (5 Grade 3), 3 cases of leukopenia (Grade 2) and 12 cases of mild nausea and vomiting. We conclude that the present combination is active in metastatic colorectal cancer with mild toxicity. These results are being confirmed and a randomized trial is being carried out to prove that this combination holds therapeutic advantage.

Adenocarcinoma↗

Randomized trial for the control of acute vomiting in cisplatin-treated patients: high-dose metoclopramide with dexamethasone and lorazepam as adjuncts versus high-dose alizapride plus dexamethasone and lorazepam. Study of the incidence of delayed emesis.

This study investigated the antiemetic activity of two different acute antiemesis regimens in patients receiving cisplatin-based chemotherapy. Seventy-four patients were treated with high-dose metoclopramide, dexamethasone and lorazepam (MDL) and 71 patients received high-dose alizapride, dexamethasone and lorazepam (ADL). Complete protection from vomiting was 50% in MDL-treated patients as compared with 30% in the ADL arm (p = 0.04). Incidence of delayed emesis was assessed in the first 82 patients accrued for the 120 h postcisplatin, being 69 and 60% in MDL and ADL, respectively.

Antiemetics↗

The antiemetic efficacy of thiethylperazine and methylprednisolone versus thiethylperazine and placebo in breast cancer patients treated with adjuvant chemotherapy (fluorouracil, doxorubicin and cyclophosphamide). A randomized, double-blind, cross-over trial.

Forty-six women with breast cancer treated with adjuvant FAC (fluorouracil, doxorubicin and cyclophosphamide) entered a multicenter, randomized, double-blind, cross-over trial in which thiethylperazine (T) (6.5 mg p.o every 8 h x 3 days) plus methylprednisolone (MP) (250 mg i.v. x 2 doses) was compared with thiethylperazine plus placebo. Forty-four patients were evaluable for efficacy. T + MP was significantly better in reducing vomiting (p less than 0.01) and nausea (p less than 0.02). The complete protection rate against vomiting was 36% for T + MP compared to 18% for T + placebo, and the percentage of nausea grades 0 + 1 (none or slight) was 59% and 27% respectively. The patient preference after cross-over was strikingly in favor of T + MP (70% versus 13%) (p less than 0.001). The most important side-effects of T + MP were facial flushing (22%) and euphoria (27%). Other side-effects, such as dryness of the mouth and sedation, were common after both treatments. In conclusion, the study suggested that T + MP is superior to T alone in protecting from nausea and vomiting induced by FAC.

Antiemetics↗

[The description of a new cellular type, Pinocchio cells, induced during the treatment of solid tumors with interleukin-2].

Three patients with renal adenocarcinoma and one with metastatic malignant melanoma were treated with continuous intravenous infusion of 18 x 10(6) IU/m2/day interleukin-2 during 5 days per week (2 weeks). Overall 60% of the calculated dose was administered owing to the development of severe toxicity. Among the hematological effects, eosinophilia was found in all patients, which was more marked 15-20 days after therapy was started. In addition, 15% of atypical lymphocytes were found in peripheral blood. These cells, denominated Pinocchio cells, show a cytoplasmatic prolongation with azurophilic granulation. Their cytochemical study disclosed a marked positivity for acid phosphatase and alpha-naphthyl acetate esterase, and a variable positivity for dipeptidyl-amino peptidase (DAP IV). The immunophenotype revealed that is a T lineage cell population, basically CD 3+, with small or absent positivity for the monoclonal CD 19 antibody. The presence of Pinocchio cells, which are effector cells mediating tumor destruction by an apoptosis mechanism, is related to the administered dose of interleukin-2.

Adenocarcinoma↗

A randomized study of two vindesine plus cisplatin-containing regimens with the addition of mitomycin C or ifosfamide in patients with advanced non-small cell lung cancer.

The current trial was carried out to assess the survival enhancement achieved, if any, by adding ifosfamide to vindesine and cisplatin (IVP) in contrast to mitomycin plus vindesine and cisplatin (MVP). Between June 1986 and September 1988, 110 patients were randomly allocated to receive either ifosfamide (3 g/m2 plus 3 g/m2 of mesna) or mitomycin 8 mg/m2, on days 1, 29, and 71 only. In both arms vindesine was given 3 mg/m2 weekly X 5 then every 2 weeks. In the MVP arm, 120 mg/m2 of cisplatin was administered on days 1 and 29 and then every 6 weeks, whereas in the IVP arm 100 mg/m2 of cisplatin was given on the same time schedule. One hundred three patients were evaluable for response and toxicity and 56% of patients had Mountain's Stage IV disease. The response rate was 26% (14/53 patients) in the MVP arm (95% confidence interval, 14%-39%) and 20% (ten of 50 patients) in the IVP arm (95% confidence interval, 10%-34%). Neither the response rate nor the median survival times were significantly different, although more nephrotoxicity was produced in the MVP arm, grade 1+ in 43% versus 26% in IVP arm (P = 0.04). Results obtained from this study fail to demonstrate that mitomycin or ifosfamide have a synergistic effect on the efficacy of the vindesine/cisplatin combination.

Adult↗

Cyclophosphamide and ifosfamide combination as neoadjuvant chemotherapy for locally advanced nonsmall-cell lung cancer: a meta-analytic review.

Twenty-three patients with marginally resectable and unresectable non-small-cell lung cancer (stages IIIA and IIIB) were treated by neoadjuvant chemotherapy. All patients received three cycles of preoperative chemotherapy with two alkylating agents, cyclophosphamide 2.5 g/m2 intravenously (i.v.) and ifosfamide 3.5 g/m2 i.v., mesna 12 g/m2 was given additionally to prevent drug hematuria. Six of 23 patients (26%) had partial response. Of the seven patients who underwent thoracotomy, two were completely resected, but with macroscopic residual disease. Mean time to progression for the whole group was 7 months. Fifteen patients had progression of disease, with local metastases only in six, and distant metastases in eight. After administering 52 chemotherapy cycles, cyclophosphamide-ifosfamide doses were cut down, as eight of 16 patients required hospitalization for fever during neutropenia nadirs. This two-alkylating (non-cisplatin) regimen, unlike cisplatin-based regimens, was ineffective, and further trials are not recommended.

Aged↗

[Carcinoma of unknown origin. Diagnostic study of 48 cases and its clinical yield].

Forty-eight patients fulfilling the criteria for carcinoma of unknown origin (CUO) between April 1983 and December 1987 were retrospectively analyzed. Mean age was 62 (33-83). Twenty-seven were males (56%) and 21 females (44%). The most common site of metastasis was the bone (35%), followed by the liver (19%) and lymph nodes (19%). 58% of cases were adenocarcinomas. Overall 274 studies for the detection of the primary tumor were carried out, the diagnosis being achieved in 10 cases (3.65%) which corresponded to lung neoplasms (5 cases), prostatic adenocarcinoma with negative markers (2 cases), bile duct neoplasms (2 cases) and pancreatic carcinoma (1 case). In our series, the most useful studies were computed tomography (CT) and fibrobronchoscopy. The necropsy, carried out in 11 patients, yielded 8 additional diagnoses: pulmonary neoplasm (one case), gastric adenocarcinoma (2 cases), malignant melanoma (2 cases), small intestine neoplasm (one case), parotid cancer (one case) and hepatocarcinoma (one case). Thirty-five patients were treated with chemotherapy and/or radiation; 12 objective responses (3 complete and 9 partial) were achieved, with a median duration of the response of 10 months (range 0.2-78 +). In view of the low diagnostic yield of the studies in patients with CUO we feel that the diagnostic study may be limited to CT scan with evaluation of the possible usefulness of bronchoscopy in individual patients. Regarding therapy, it is to be noted that there was a tendency for a longer survival in patients who responded.

Adult↗

Oral idarubicin in measurable gastric cancer.

Seventeen patients with advanced gastric adenocarcinoma, previously untreated with chemotherapy, have been included in a Phase II study with idarubicin (IDA), 15 mg/m2/day, orally, for three consecutive days every 3 weeks. All cases had measurable disease. Sixteen of 17 patients are evaluable for response. Complete or partial responses were not observed. Two patients had partial response less than 50%, one patient no change, and the remaining 13 patients disease progression. The median leukocytes and platelets nadir was 3600 and 186,000/mm3, respectively. Gastrointestinal toxicity was mild. The median total cumulative dose of IDA was 90 mg/m2 (range 45-180 mg/m2). Clinical cardiac toxicity was not observed. IDA, at the dose and by the route used, is not active in gastric cancer.

Adenocarcinoma↗

Antiemetic efficacy of escalating doses of alizapride against chemotherapy-induced emesis.

The antiemetic effect of a new benzamide, alizapride, was investigated with escalating doses through four levels starting at 5 mg/kg/cycle up to 20 mg/kg/cycle. 39 patients were accrued who received cancer chemotherapy which included the following drugs in various combinations: cyclophosphamide, adriamycin, fluorouracil, carboplatin and etoposide (VP-16). Complete control of emesis was achieved in a third of the 39 patients. There was no statistically significant difference among the dose levels with regard to the patient's assessment of the incidence and severity of nausea and vomiting. Alizapride was well tolerated at all dose levels tested with minimal toxicity. Mild sedation was reported in 60% of the patients. Neither extrapyramidal reactions nor hypotensive side effects were observed. Thus the therapeutic yield of alizapride could be further studied concerning the optimal dose and schedule as well as its use in combination with other antiemetic drugs.

Adult↗

Quality of life during chemotherapy in non-small cell lung cancer patients.

To evaluate the usefulness of chemotherapy in non-small cell lung cancer, objective response, length of remission and survival have been considered the main yardsticks. Subjective improvement and gain in Karnofsky performance status have attracted very little attention. Thirty-one patients with stages III and IV underwent combination chemotherapy with high-dose cisplatin, and were assessed with categorical scales and 100 mm visual analogue scales used by patients themselves to report on several symptoms of their illness. After chemotherapy 17 of 19 patients (89%) gained weight; 20 presented anorexia, 10 of those (50%) improved; 15 had pain, 7 of those (47%) were alleviated; cough was reported in 22, in 10 (45%) it was ameliorated; hemoptysis disappeared in 10 of 11 patients (91%); of the 9 patients who had dyspnea, 7 improved (78%); and astenia was attenuated in 8 of 16 patients (50%). Quality of life was reported improved in 75% of those patients who had considered themselves seriously affected prior to the treatment. When compared with Karnofsky performance status, no relationship was found (r = 0.31). It is concluded that, apart from the objective response achieved, a significant proportion of patients did benefit from treatment as demonstrated by a marked relief of symptoms.

Antineoplastic Agents↗