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Biomedical subjects

S Verma

Publications and source records attributed to S Verma.

At least 253 records · Page 14Linked to original sources

Phase I study of weekly intravenous administration of menogaril to adults with solid tumors.

Thirty-nine adults with solid tumors were treated on a Phase I study of menogaril administered i.v. once each week. Granulocytopenia was dose-limiting at a menogaril dose of 115 mg/m2/wk. Ten patients required delays in treatment of 1-4 weeks (median, 1 week) at some point during their treatment until they recovered from granulocytopenia. The average dose intensity possible on this schedule was at least 80% higher than that possible using a single-day or a five-times-daily schedule every 4 weeks. One patient developed infection while neutropenic, and only one patient developed thrombocytopenia. Dexamethasone appeared to reduce the degree of myelosuppression. Gastrointestinal toxicity was quite mild, and alopecia was uncommon. Arm vein phlebitis frequently followed menogaril administration, requiring the use of Hickman catheters (or equivalents). Two patients had myocardial infarcts while on treatment. It was unclear if the menogaril was in any way responsible. Reversible dyspnea and cough (with no evidence of congestive heart failure) were seen in some patients. Responses were seen in patients with gliomas, renal-cell carcinoma, and bladder carcinoma, and marked subjective improvement occurred in a single patient with prostate cancer. We plan to conduct a Phase II study in astrocytoma patients using a menogaril dose of 115 mg/m2/wk i.v.

Adult↗

Phase I study of the combination of disulfiram with cisplatin.

In light of preclinical evidence that disulfiram and related compounds decrease the toxicity and increase the therapeutic index of cisplatin, 12 patients were treated with a combination of cisplatin and oral disulfiram to determine the maximum tolerated dose of disulfiram that could be combined with cisplatin 100 mg/m2, and to determine the dose-limiting toxicity of disulfiram in this combination. Reversible confusion was the dose-limiting toxicity at a disulfiram dose of 3,000 mg/m2 administered 1 h before the end of a 2-h cisplatin infusion. A randomized study of cisplatin with or without disulfiram 2,000 mg/m2 p.o. is currently being conducted to determine the effect of disulfiram on cisplatin toxicity and pharmacology.

Antineoplastic Combined Chemotherapy Protocols↗

Cytosine arabinoside plus cisplatin and other drugs as chemotherapy for gliomas.

Twenty-five evaluable patients with gliomas were treated with a combination of cytosine arabinoside plus cisplatin administered intravenously (IV). Ten of the 25 patients (40%) responded, including three of 13 patients (23%) with prior cranial radiation, and seven of 12 patients (58%) without prior cranial radiation. In a second study, intramuscular (IM) and oral caffeine were added to IV cytosine arabinoside plus cisplatin. Caffeine-induced seizures prevented escalation of the dose of caffeine to a level that would have been anticipated to potentiate the cytotoxicity of the cytosine arabinoside plus cisplatin. Twelve of 25 treated patients (48%) responded. Most of the patients had not received prior cranial radiation. In a third study, IV cytosine arabinoside was administered in combination with intracarotid and IV cisplatin, plus BCNU and tenoposide (VM-26). This study is continuing to accrue patients. Myelosuppression has been pronounced, but has generally been rapidly reversible. It is too early to comment on efficacy of this combination. Our results to date permit us to conclude that the combination of cytosine arabinoside plus cisplatin is capable of inducing regression of gliomas in some patients. We feel that further studies are warranted.

Antineoplastic Combined Chemotherapy Protocols↗

Anatomic basis of Arnold's ear-cough reflex.

A clinical survey of 500 patients revealed 4.2% incidence of Arnold's ear-cough reflex. The reflex was bilateral in 2.8% of the patients. It was also elicitable from the anterior meatal wall in 2% of the patients, thus questioning the classically taught distribution of Arnold's nerve. Arnold's nerve also mediates the auriculo-palatal, auriculo-lacrimal, auriculo-cardiac and the ear-vomiting reflexes; but these are less apparent and not so commonly encountered.

Cough↗

CAMDEX. A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia.

A new interview schedule for the diagnosis and measurement of dementia in the elderly is described. The schedule named the Cambridge Mental Disorders of the Elderly Examination (CAMDEX), consists of three main sections: A structured clinical interview with the patient to obtain systematic information about the present state, past history and family history; a range of objective cognitive tests which constitute a mini-neuropsychological battery; a structured interview with a relative or other informant to obtain independent information about the respondent's present state, past history and family history. The CAMDEX is acceptable to patients, has a high inter-rater reliability and the cognitive section has been shown to have high sensitivity and specificity.

Aged↗

Patient benefits of l-dopa and a decarboxylase inhibitor in the treatment of Parkinson's disease in elderly patients.

Sixty patients suffering from Parkinson's disease, irrespective of previous treatment, were recruited and treated with benserazide/l-dopa or carbidopa/l-dopa, randomly allocated, in a double-blind comparative study. Duration of disease on entry was 1 year or less in 70% of patients and was graded as moderate in 55% of patients. Mean age of patients on entry was 76 years for males and 80 years for females. Assessments were made before treatment and after 1 week, 3 weeks, 6 weeks and, finally, at 12 weeks. The dosage of drug was titrated at each visit to give minimum risk with acceptable benefit. Both drugs effectively improved the disability scores of the parkinsonian symptoms and the Sheffield Unit's Activities of Daily Living scores, the latter showing the immediate benefit for the patient in terms of independence. More patients improved in the benserazide/l-dopa-treated group. Furthermore, apart from one activity the improvement in each individual symptom and activity was greater in the benserazide/l-dopa-treated group, but none of the differences reached a statistically significant level. Adverse events recorded during the study were few and in many cases transient. Two patients defaulted (1 on each treatment) and 7 patients died during the study from non-drug-related causes.

Activities of Daily Living↗

Vision screening of specialized populations.

This paper describes the vision screening tests for specialized populations as used by the Community Eye Care Services Program of the Pennsylvania College of Optometry. Referral criteria have been elaborated. This paper is designed to help those who are interested in organizing such a screening.

Adult↗