Phase I trial of ilmofosine as a 24 hour infusion weekly

Ilmofosine, an ether lipid derivative of lysophosphatidylcholine has antineoplastic activityin vitro andin vivo. Maximum efficacy in preclinical models is associated with prolonged exposure to the drug. In a Phase I trial of a weekly 2 hour infusion schedule of ilmofosine, a syndrome of lethargy, diminished performance status, and mild hepatotoxicity was dose-limiting at 550 mg/m². To avoid the higher drug concentrations associated with a brief infusion, a Phase I study of a weekly 24 hour infusional schedule was undertaken in an attempt to maximize dose-intensity. Doses were escalated from 550 to 800 mg/m². Toxicities included nausea, anorexia, fatigue, and minor elevations of liver function tests. The dose limiting toxicity at 800 mg/ m² was a syndrome of severe abdominal pain. No neutropenia or thrombocytopenia was observed except in one patient who was found to have a myelodysplastic syndrome, thought not to be related to drug therapy. The more prolonged infusion schedule of ilmofosine did not result in a substantial increase in the tolerable dose.     

Supersensitivity to the negative chronotopic action of carbachol and methacholine in the rat

Pretreatment of rats for 6 days with the ganglion blocking agent, chlorisondamine, produces a 2-3 fold increase in the sensitivity of the heart to the negative chronotropic action of carbachol and methacholine.     

Understanding coeliac disease: symptoms and long-term risks

Coeliac disease is a chronic, potentially life-threatening condition affecting as many as one in 300 men and women in the (UK). The Coeliac Society currently has more than 36,000 members. Essentially, coeliac disease is a complication of the gastrointestinal tract. Coeliac patients must avoid gluten in food products in order to avoid debilitating symptoms which include diarrhoea and iron deficiency. This article looks at the patients who are likely to be 'at-risk' of having coeliac disease and how they should be treated via adherence to a permanent gluten-free diet. The article focuses on osteoporosis, a common long-term condition associated with coeliac disease, and the risks coeliac patients face. The aim of this article is to provide background information on coeliac disease and its treatment, related conditions, and supporting patient and professional organizations.     

Can the elderly afford eye care? Can we afford eye care for the elderly?

Perhaps no group of Americans has a greater stake in the issues raised by the rapid growth in health care spending than the elderly. The elderly consume a share of the nation's health care that is disproportionate to their numbers. In 1984, per capita health care spending for the elderly was four times that for the rest of the population. Ophthalmic expenses form a significant portion of their health care spending. Increasing numbers of elderly and per capita spending have placed enormous pressure on Medicare. In recent years, changing patterns of ophthalmic care have influenced the size and direction of Medicare expenditures; for example, new technologies in cataract surgery have shifted services from inpatient to outpatient settings. Such shifting of costs and other program changes must be analyzed to determine the impact on future Medicare expenditures and beneficiaries.