Clinical Studies with Vincristine

Forty patients with malignant neoplastic disease received vincristine in aneffort to define the toxicity, the tolerated dose, the effect of varying doseschedules, and the antitumor properties. The toxicity of vincristine is doserelated, and the tolerated dose for the weekly schedule is 0.05 mg. per Kg.for the majority of patients. The tolerated dose per unit time is independentof the schedule of administration. The toxic manifestations relate primarilyto the neuromuscular system and the gastrointestinal tract. At the tolerateddose or below, these manifestations are reversible and not accumulative.Hematologic toxicity is rare, and thrombocytosis occurs in some patients.Vincristine produces tumor regression in the majority of the patients withlymphoma where its activity compares favorably with that of the alkylatingagents and vinblastine. There is suggestive evidence that cross-resistance between vincristine and the alkylating agents and between vincristine and vinblastine does not occur.

Accepted on December 28, 1962     

Longitudinal neuropsychological evaluation of HIV-infected intravenous drug users

The present study aimed to describe the cognitive status of a group of HIV-positive asymptomatic intravenous drug users (IVDU) and changes which occurred over a 12-month follow-up period. Forty-two HIV positive IVDU were selected and matched for age, sex, educational level and pattern of drug abuse with 39 seronegative IVDU controls. Baseline and follow-up evaluation included neuropsychological tests exploring attention, language, memory, logic and visuomotor abilities, biological markers and clinical parameters. About one-third of both seropositive and seronegative subjects showed at baseline slight cognitive deficits, ‘which did not change during the follow-up period.     

The Management of Polycystic Kidney Disease with Special Reference to Dialysis and Transplantation

The records of 65 patients with adult type polycystic kidneydisease were examined in an attempt to identify the problemsand priorities in the management of these patients, with particularreference to ultimate haemodialysis or transplantation. Thethree main problems of patients presenting before the onsetof terminal renal failure were hypertension (72 per cent), pain(36 per cent) and urinary tract infection (32 per cent). Lesscommon complications included haematuria, splenomegaly, gastro-intestinaldisturbances and disorders of calcium metabolism. The polycystickidney patient who is considered for renal transplantation posesquestions of the desirability and timing of bilateral nephrectomy,vagotomy and splenectomy. Eight patients died without receivinga transplant, five of them from uraemia. Thirty-one patientsreceived 36 kidney transplants and 46 per cent of these werefunctioning one year after transplantation. Thirteen patientswho had received transplants died. Analysis of the causes ofdeath suggests that in nearly half, major contributing factorsmight have been anticipated and we therefore feel that regularsurveillance from the time of diagnosis is essential for patientswith polycystic kidney disease.