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At least 433 records · Page 24Linked to original sources
PubMed1990

Interventional antimicrobial strategy in febrile neutropenic patients. Results of a multicenter study in 1,260 patients with hematological malignancies. The Interventional Antimicrobial Strategy Study Group, Paul Ehrlich Society for Chemotherapy.

In a prospective, randomized multicenter trial of the Paul Ehrlich society different concepts for sequential empirical antimicrobial strategy for the treatment of patients with neutropenia less than 1.0/nl and fever greater than 38.5 degrees C and/or documented infection were studied. In phase I, patients with unexplained fever (FUO) were randomized for the combination of acylaminopenicillin plus aminoglycoside or third-generation cephalosporin plus aminoglycoside or double beta lactam therapy. Non-responders received additional vancomycin or all three substances of phase I in phase II. In phase III, all patients with persistent fever were then treated with amphotericin B plus 5-flucytosine and rifampin and randomized for the continuation of the double beta lactam regimen or additional imipenem/cilastatin. 667 (52.9%) of 1260 evaluable patients had FUO during the whole study period, of which 62.5% could be cured in phase I, 43.2% of non-responders in phase II and 55% of persistently febrile patients in phase III. The overall rate of complete response was 79.5%. 2.8% were non-responders, 11.7% were not evaluable for response and 40 patients (6%) died during the study, 24 (60%) of whom due to the underlying disease or the toxicity of antileukemic therapy. A significant difference between the treatment groups could not be detected in either of the three study phases.

Agranulocytosis↗
PubMed1996

Nerve conduction measures in mild diabetic neuropathy in the Early Diabetes Intervention Trial: the effects of age, sex, type of diabetes, disease duration, and anthropometric factors. Tolrestat Study Group for the Early Diabetes Intervention Trial.

We evaluated nerve conduction measures at baseline from 429 patients enrolled in a multicenter diabetic neuropathy study. We defined neuropathy by using recently proposed recommendations but included only patients who had measurable sural and peroneal responses and quantitative vibration thresholds. Patients with type II diabetes were older than type I patients (54.5 versus 39.1 years), were heavier (body mass index [BMI] of 30.9 versus 25.5 kg/m2, and in general had lower evoked amplitudes. The effects of diabetes type upon nerve conduction measures disappeared when age and BMI were included in regression models. The men had lower amplitudes and conduction velocities and longer latencies than the women. The effect of gender was greatly reduced when height was included in the regression models, but gender continued to be a significant predictor of median sensory amplitude, most conduction velocities, and most latencies in these models. The relationships between nerve conduction measures and age, sex, and anthropometric factors were similar for patients with type II, but not those with type I, diabetes to the relationships reported for normal subjects. This may be a result of greater homogeneity with respect to degree of neuropathy for type II patients than for type I patients. These findings are important in designing and interpreting clinical studies of diabetic neuropathy.

Adult↗
PubMed1999

Growth hormone, IGF-I and cancer. Less intervention to avoid cancer? More intervention to prevent cancer?

The GH/IGF-I axis has a clearly established role in somatic growth regulation and there is much evidence suggesting that it can play a contributing role in neoplastic tissue growth; a number of recent epidemiological reports indicate that it may also be an important determinant of cancer incidence. Whilst there have been previous reports of changes to the axis in patients with established cancers, these new studies are distinct in being prospective and the inferences that can be made from this are outlined in this review. The recent studies are considered within the context of other indirect epidemiological evidence, and together indicate that the GH/IGF-I axis may establish the level of predisposition to a number of common cancers and indeed that such risk may be programmed from early life. There is considerable evidence for a number of possible mechanisms, both direct and indirect, which could account for the associations between GH/IGF-I levels and cancer incidence; these mechanisms are briefly summarised. The implications of the new findings are then discussed in relation to the increasing clinical usage of chronic GH administration and the need for further studies to establish any consequent increase in cancer risk. Finally the opportunities for further work to optimise cancer risk assessment and risk reduction strategies are highlighted.

Adult↗