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41.
A case of ticarcillin-induced hemorrhagic cystitis is presented, and the literature on drug-induced hemorrhagic cystitis is reviewed. A 12-year-old white boy with cystic fibrosis was hospitalized for an exacerbation of his pulmonary disease. Laboratory tests on admission showed an elevated white blood cell (WBC) count, 10-20 WBCs per high-power field (HPF) in urine, and normal BUN and serum creatinine. The patient was given ticarcillin i.v. (as the disodium salt) (final dosage of 320 mg/kg/day) in divided doses every six hours and netilmicin i.v. (as the sulfate salt) (final dosage of 4 mg/kg every eight hours). On day 7 the patient complained of painful urination, and urinalysis showed a 10-20 WBCs/HPF and 2-5 red blood cells (RBCs)/HPF. Two days later, the patient had gross hematuria, and urinalysis revealed 10-20 WBCs/HPF and 10-20 RBCs/HPF. Ticarcillin and netilmicin were discontinued and the patient's symptoms abated within 48 hours. Repeat urinalysis on day 11 showed no RBCs and 10-20 WBCs/HPF, with no casts or protein. Three months later, the patient was again hospitalized for an exacerbation of his cystic fibrosis. He was placed on tobramycin sulfate i.v. and ticarcillin i.v. (340 mg/kg/day). After the fourth dose of ticarcillin, the patient again complained of urinary pain and frequency and also reported gross hematuria. Urinalysis showed bacteria, 2-5 WBCs/HPF, and 5-10 RBCs/HPF; however, urine cultures were negative. Ticarcillin was discontinued and cefoxitin sodium i.v. was started. The patient's symptoms resolved within 36 hours, and a urinalysis on the fourth hospital day was normal.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
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N Hijiya A Gajjar Z Zhang J T Sandlund R C Ribeiro J E Rubnitz S Jeha W Liu C Cheng S C Raimondi F G Behm G K Rivera M V Relling C-H Pui 《Leukemia》2004,18(10):1581-1586
We evaluated the clinical response to low-dose etoposide in relapsed acute lymphoblastic leukemia (ALL). Of the 45 patients with ALL in first bone marrow relapse enrolled on the ALL R15 protocol, 44 had received epipodophyllotoxins during frontline therapy. In the first week of remission induction therapy, patients received etoposide (50 mg/m(2) per day) administered orally as a single agent once or twice daily. On Day 8, patients started to receive dexamethasone, vincristine, and L-asparaginase. Etoposide was administered until Day 22. Two courses of consolidation therapy were followed by continuation therapy or hematopoietic stem cell transplantation. After 7 days of single-agent etoposide treatment, peripheral blast cell counts (P=0.013) and percentages of bone marrow blasts (P=0.016) were significantly reduced. In all, 38 (84.4%) attained second remission. Only time to relapse was significantly associated with outcome (P=0.025): the 5-year event-free survival estimates (+/-se) were 52.0+/-9.6% for those with late relapse and 20.0+/-8.0% for those with early relapse. We conclude that low-dose etoposide administered orally has a cytoreductive effect in relapsed ALL. 相似文献
44.
Recruitment and screening policies and procedures used to establish a paid donor oocyte registry 总被引:3,自引:2,他引:1
We have reviewed the demographic characteristics of, and report
abnormalities noted in, the de-novo growth and development of a paid oocyte
donation programme. The personal profiles of all prospective oocyte donors
were reviewed. Acceptance or rejection of candidates was based upon
screening the results of medical, genetic and psychological testing. A
total of 603 candidates initially responded to our advertisement. From this
pool, 313 individuals were considered suitable and contacted by telephone.
Following further conversation, 176 women were scheduled an entry
interview. On completion of the formal screening process, 17.6% (n = 31) of
those actually interviewed were denied entry. Thus, from the initial
interested parties, only 23% of women wishing to participate in oocyte
donation were considered suitable candidates. Given the high attrition
rate, we concluded that the need for rigorous and thorough medical,
psychological and genetic testing is mandatory for the establishment of a
donor registry. Furthermore, professional counselling of prospective donors
with respect to the results of tests and the implications of test results
with respect to their future medical and reproductive health, are important
parts of providing comprehensive care.
相似文献
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WE Gillies FRACO FRACS FRCS Anne MV Brooks MD PhD FRACO FRACS FRACP 《Clinical & experimental ophthalmology》1992,20(3):239-242
A method of combined cataract extraction with posterior chamber intraocular lens and trabeculectomy using separate incisions was tested in 44 operations on 38 patients. The mean preoperative intraocular pressure (IOP) of 28.1 ± 11.7 (range 12 to 56) mmHg on maximum medication was lowered to 13.9 ± 3.4 (9 to 23) mmHg at one year, with half the eyes still requiring topical medication. The IOP was 40 mmHg or more preoperatively in eight eyes and 20 mmHg or more in only two patients at one year. There were no rises in IOP above 20 mmHg in the early postoperative period (days 1 and 2). Visual acuity was 6/9 or better in 27 and 6/12 in three eyes. There was an expulsive haemorrhage in one case, rupture of the posterior capsule in two eyes and a choroidal detachment in one eye, but no flat anterior chambers. The two-incision method allowed placement of an intraocular lens with good postoperative pressure control. 相似文献
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Body mass index does not influence pharmacokinetics or outcome of treatment in children with acute lymphoblastic leukemia 下载免费PDF全文
Hijiya N Panetta JC Zhou Y Kyzer EP Howard SC Jeha S Razzouk BI Ribeiro RC Rubnitz JE Hudson MM Sandlund JT Pui CH Relling MV 《Blood》2006,108(13):3997-4002
There is conflicting information about the influence of body mass index (BMI) on the pharmacokinetics, toxicity, and outcome of chemotherapy. We compared pharmacokinetics, outcome, and toxicity data across 4 BMI groups (underweight, BMI < or = 10th percentile; normal; at risk of overweight, BMI > or = 85th and < 95th percentile; overweight, BMI > or = 95th percentile) in 621 children with acute lymphoblastic leukemia (ALL) treated on 4 consecutive St Jude Total Therapy studies. Chemotherapy doses were not adjusted to ideal BMI. Estimates of overall survival (86.1% +/- 3.4%, 86.0% +/- 1.7%, 85.9% +/- 4.3%, and 78.2% +/- 5.5%, respectively; P = .533), event-free survival (76.2% +/- 4.2%, 78.7% +/- 2.1%, 73.4% +/- 5.5%, and 72.7% +/- 5.9%, respectively; P = .722), and cumulative incidence of relapse (16.0% +/- 3.7%, 14.4% +/- 1.8%, 20.6% +/- 5.1%, and 16.7% +/- 5.1%, respectively; P = .862) did not differ across the 4 groups. In addition, the intracellular levels of thioguanine nucleotides and methotrexate polyglutamates did not differ between the 4 BMI groups (P = .73 and P = .74, respectively). The 4 groups also did not differ in the overall incidence of grade 3 or 4 toxicity during the induction or postinduction periods. Further, the systemic clearance of methotrexate, teniposide, etoposide, and cytarabine did not differ with BMI (P > .3). We conclude that BMI does not affect the outcome or toxicity of chemotherapy in this patient population with ALL. 相似文献
50.
MV Pravin Charles Joshy M Easow Noyal M Joseph M Ravishankar Shailesh Kumar Umadevi Sivaraman 《The Australasian medical journal》2013,6(9):430-434